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Guo Z, Sun S, Xiao S, Chen G, Chen P, Yang Z, Tang X, Huang L, Wang Y. COVID-19 is associated with changes in brain function and structure: A multimodal meta-analysis of neuroimaging studies. Neurosci Biobehav Rev 2024; 164:105792. [PMID: 38969310 DOI: 10.1016/j.neubiorev.2024.105792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 04/23/2024] [Accepted: 06/27/2024] [Indexed: 07/07/2024]
Abstract
The actual role of coronavirus disease 2019 (COVID-19) in brain damage has been increasingly reported, necessitating a meta-analysis to collate and summarize the inconsistent findings from functional imaging and voxel-based morphometry (VBM) studies. A comprehensive voxel-wise meta-analysis of the whole brain was conducted to identify alterations in functional activity and gray matter volume (GMV) between COVID-19 patients and healthy controls (HCs) by using Seed-based d Mapping software. We included 15 functional imaging studies (484 patients with COVID-19, 534 HCs) and 9 VBM studies (449 patients with COVID-19, 388 HCs) in the analysis. Overall, patients with COVID-19 exhibited decreased functional activity in the right superior temporal gyrus (STG) (extending to the right middle and inferior temporal gyrus, insula, and temporal pole [TP]), left insula, right orbitofrontal cortex (OFC) (extending to the right olfactory cortex), and left cerebellum compared to HCs. For VBM, patients with COVID-19, relative to HCs, showed decreased GMV in the bilateral anterior cingulate cortex/medial prefrontal cortex (extending to the bilateral OFC), and left cerebellum, and increased GMV in the bilateral amygdala (extending to the bilateral hippocampus, STG, TP, MTG, and right striatum). Moreover, overlapping analysis revealed that patients with COVID-19 exhibited both decreased functional activity and increased GMV in the right TP (extending to the right STG). The multimodal meta-analysis suggests that brain changes of function and structure in the temporal lobe, OFC and cerebellum, and functional or structural alterations in the insula and the limbic system in COVID-19. These findings contribute to a better understanding of the pathophysiology of brain alterations in COVID-19. SIGNIFICANCE STATEMENT: This first large-scale multimodal meta-analysis collates existing neuroimaging studies and provides voxel-wise functional and structural whole-brain abnormalities in COVID-19. Findings of this meta-analysis provide valuable insights into the dynamic brain changes (from infection to recovery) and offer further explanations for the pathophysiological basis of brain alterations in COVID-19.
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Affiliation(s)
- Zixuan Guo
- Medical Imaging Center, The First Affiliated Hospital of Jinan University, Guangzhou, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Shilin Sun
- Medical Imaging Center, The First Affiliated Hospital of Jinan University, Guangzhou, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Shu Xiao
- Medical Imaging Center, The First Affiliated Hospital of Jinan University, Guangzhou, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Guanmao Chen
- Medical Imaging Center, The First Affiliated Hospital of Jinan University, Guangzhou, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Pan Chen
- Medical Imaging Center, The First Affiliated Hospital of Jinan University, Guangzhou, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Zibin Yang
- Medical Imaging Center, The First Affiliated Hospital of Jinan University, Guangzhou, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Xinyue Tang
- Medical Imaging Center, The First Affiliated Hospital of Jinan University, Guangzhou, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Li Huang
- Medical Imaging Center, The First Affiliated Hospital of Jinan University, Guangzhou, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Ying Wang
- Medical Imaging Center, The First Affiliated Hospital of Jinan University, Guangzhou, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China.
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Yoshino A, Murakami R, Hosoya K, Komachi T, Mori E, Nin T, Mahmut MK, Okubo K. A Nationwide survey of safety protocols and chemosensory assessments by Japanese clinicians pre- and post-COVID-19 pandemic. Auris Nasus Larynx 2024; 51:640-646. [PMID: 38626699 DOI: 10.1016/j.anl.2024.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 03/28/2024] [Accepted: 04/04/2024] [Indexed: 04/18/2024]
Abstract
OBJECTIVE There has been an increase of attention and awareness of smell and taste loss due to the impact of COVID-19. However, little is known about the influence of COVID-19 on the number of psychophysical tests performed, the timing of these tests, or the protection protocols employed to protect against virus transmission. This study aimed to explore the changes in examination approaches, types of tests employed, and safety measures adopted by clinicians before and after the COVID-19 pandemic. METHODS A survey was distributed to 404 institutes of the Oto-Rhino Laryngological Society of Japan, consisting of otolaryngologists working in university hospitals, general hospitals, and private clinics. The anonymous online survey contained questions related to safety measures and chemosensory assessments performed before and after the COVID-19 pandemic. Specifically, participants were queried on the number and types of examinations conducted, the type of examiners who performed them, the timing of tests in suspected and non-suspected COVID-19 cases, modifications made due to the pandemic, and the protective measures adopted during chemosensory examinations. RESULTS Of the 201 respondents, representing a 50 % response rate, 49 % were from general hospitals, 48 % from university hospitals, and 3 % from private clinics. The study found a slight decrease in the overall number of chemosensory tests conducted post-COVID-19. In terms of who performed the test, there were no differences pre- and post- COVID-19. Most examinations (52-68 %) for suspected COVID-19 cases were performed 1-2 months after the onset of symptoms. Modifications in testing rooms and personal protective equipment (PPE) were reported by the majority of institutions post-pandemic. While different examination rooms or PPE were not commonly used based on a patient's previous COVID-19 diagnosis, changes were observed in testing practices. Most examinations were conducted in rooms with windows or fans, and PPE usage was high; surgical masks, eye visors or face shields, and disposable gloves being commonly used. Virus transmission from patient to examiner was reported in only one case during T&T olfactometer examination. CONCLUSION We investigated the impact of the COVID-19 pandemic on the number of olfactory and gustatory tests performed, the type of examiner, the examination room, and the use of PPE and found no significant difference before and after the COVID-19 pandemic on these factors. Adherence to a protection protocol involving the proper use of PPE in controlled environments enabled the continuation of olfactory and gustatory tests during the pandemic.
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Affiliation(s)
- Ayaho Yoshino
- Department of Otolaryngology Head and Neck Surgery, Nippon Medical School Hospital, Tokyo, Japan.
| | - Ryosuke Murakami
- Department of Otolaryngology Head and Neck Surgery, Nippon Medical School Hospital, Tokyo, Japan
| | - Kei Hosoya
- Department of Otolaryngology, Nippon Medical School Musashi Kosugi Hospital, Kanagawa, Japan
| | - Taro Komachi
- Department of Otolaryngology, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Eri Mori
- Department of Otolaryngology Head and Neck Surgery, Jikei University School of Medicine, Tokyo, Japan
| | - Tomomi Nin
- Department of Otolaryngology Head and Neck Surgery, Hyogo Medical University, Hyogo, Japan
| | - Mehmet K Mahmut
- School of Psychological Sciences, Food, Flavour and Fragrance Lab, Macquarie University, Sydney, Australia
| | - Kimihiro Okubo
- Department of Otolaryngology Head and Neck Surgery, Nippon Medical School Hospital, Tokyo, Japan
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Lovey T, Hedrich N, Grobusch MP, Bernhard J, Schagenhauf P, Blanke U, Eperon G, Gautret P, de Frey A, Kuenzli E, Lindner A, Mockenhaupt F, Popescu C, Schnyder JL, de Jong HK, Dauda M, Nishiura H, Al-Tawfiq JA, Parker S, Larsen CS, Vayena E. Surveillance of global, travel-related illness using a novel app: a multivariable, cross-sectional study. BMJ Open 2024; 14:e083065. [PMID: 39067885 PMCID: PMC11287070 DOI: 10.1136/bmjopen-2023-083065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 06/28/2024] [Indexed: 07/30/2024] Open
Abstract
INTRODUCTION Current traveller health surveillance is 'top-down'. Mobile-based surveillance could capture infection symptoms in real time. We aimed to evaluate the spectrum of illness in travellers using a mobile app-based system. METHODS This study (ClinicalTrials.gov NCT04672577) used an application called Infection Tracking in Travellers (ITIT) that records travel-related illness symptoms with associated geolocation and weather data. The free ITIT app is available in 14 languages. Participants were recruited globally from April 2022 to July 2023. Participants >18 years of age travelled internationally and provided electronic consent. Incentives included the provision of travel health information imported from the WHO website. Symptoms were recorded with daily pop-up questionnaires and symptom severity was assessed using a Likert scale. Two post-travel questionnaires were administered. Logistic mixed models examined factors relating to symptom presence, and a random forest model examined symptom impact. RESULTS 609 participants were recruited until July 2023. Participants had an average age of 37 years (18-79), and an average travel duration of 26 days (2-281). Most participants were travelling for leisure/tourism (401; 66%), followed by 'visiting friends and relatives' (99; 16%) and business travel (80; 13%). All continents were visited by at least one traveller. Of 470 registered trips, symptoms were reported on 163 trips (35%). Gastrointestinal symptoms were reported on 87 trips (19%) and respiratory symptoms on 81 trips (17%). The most important factors in predicting the presence of symptoms were duration of travel, travelling in winter and high humidity. Diarrhoea, headache and nausea were symptoms with most impact on daily activities. Post-travel questionnaires showed that 12% of surveyed participants experienced symptoms with several episodes of self-treatment. Two diagnoses were recorded: Lyme disease and amoebic dysentery. CONCLUSION The digital tool ITIT successfully captures the spectrum of travel-related illness. This detailed epidemiology is crucial for outbreak detection and for the formulation of travel medicine guidelines. TRIAL REGISTRATION NUMBER NCT04672577.
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Affiliation(s)
- Thibault Lovey
- University of Zürich, Epidemiology, Biostatistics and Prevention Institute, Zürich, Switzerland
| | - Nadja Hedrich
- University of Zürich, Epidemiology, Biostatistics and Prevention Institute, Zürich, Switzerland
| | - Martin Peter Grobusch
- Center for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam UMC, Amsterdam, Netherlands
| | - Julian Bernhard
- Charité-Universitätsmedizin Berlin, Charité Center for Global Health, Institute of International Health, Berlin, Germany
| | - Patricia Schagenhauf
- University of Zürich, Epidemiology, Biostatistics and Prevention Institute, Zürich, Switzerland
- WHO Collaborating Centre for Travellers' Health, Department of Global and Public Health, MilMedBiol Competence Centre, Zürich, Switzerland
| | - The ITIT Global Network
- University of Zürich, Epidemiology, Biostatistics and Prevention Institute, Zürich, Switzerland
- Center for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam UMC, Amsterdam, Netherlands
- Charité-Universitätsmedizin Berlin, Charité Center for Global Health, Institute of International Health, Berlin, Germany
- WHO Collaborating Centre for Travellers' Health, Department of Global and Public Health, MilMedBiol Competence Centre, Zürich, Switzerland
| | - Ulf Blanke
- University of Zürich, Epidemiology, Biostatistics and Prevention Institute, Zürich, Switzerland
- Center for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam UMC, Amsterdam, Netherlands
- Charité-Universitätsmedizin Berlin, Charité Center for Global Health, Institute of International Health, Berlin, Germany
- WHO Collaborating Centre for Travellers' Health, Department of Global and Public Health, MilMedBiol Competence Centre, Zürich, Switzerland
| | - Gilles Eperon
- University of Zürich, Epidemiology, Biostatistics and Prevention Institute, Zürich, Switzerland
- Center for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam UMC, Amsterdam, Netherlands
- Charité-Universitätsmedizin Berlin, Charité Center for Global Health, Institute of International Health, Berlin, Germany
- WHO Collaborating Centre for Travellers' Health, Department of Global and Public Health, MilMedBiol Competence Centre, Zürich, Switzerland
| | - Philippe Gautret
- University of Zürich, Epidemiology, Biostatistics and Prevention Institute, Zürich, Switzerland
- Center for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam UMC, Amsterdam, Netherlands
- Charité-Universitätsmedizin Berlin, Charité Center for Global Health, Institute of International Health, Berlin, Germany
- WHO Collaborating Centre for Travellers' Health, Department of Global and Public Health, MilMedBiol Competence Centre, Zürich, Switzerland
| | - Albie de Frey
- University of Zürich, Epidemiology, Biostatistics and Prevention Institute, Zürich, Switzerland
- Center for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam UMC, Amsterdam, Netherlands
- Charité-Universitätsmedizin Berlin, Charité Center for Global Health, Institute of International Health, Berlin, Germany
- WHO Collaborating Centre for Travellers' Health, Department of Global and Public Health, MilMedBiol Competence Centre, Zürich, Switzerland
| | - Esther Kuenzli
- University of Zürich, Epidemiology, Biostatistics and Prevention Institute, Zürich, Switzerland
- Center for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam UMC, Amsterdam, Netherlands
- Charité-Universitätsmedizin Berlin, Charité Center for Global Health, Institute of International Health, Berlin, Germany
- WHO Collaborating Centre for Travellers' Health, Department of Global and Public Health, MilMedBiol Competence Centre, Zürich, Switzerland
| | - Andreas Lindner
- University of Zürich, Epidemiology, Biostatistics and Prevention Institute, Zürich, Switzerland
- Center for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam UMC, Amsterdam, Netherlands
- Charité-Universitätsmedizin Berlin, Charité Center for Global Health, Institute of International Health, Berlin, Germany
- WHO Collaborating Centre for Travellers' Health, Department of Global and Public Health, MilMedBiol Competence Centre, Zürich, Switzerland
| | - Frank Mockenhaupt
- University of Zürich, Epidemiology, Biostatistics and Prevention Institute, Zürich, Switzerland
- Center for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam UMC, Amsterdam, Netherlands
- Charité-Universitätsmedizin Berlin, Charité Center for Global Health, Institute of International Health, Berlin, Germany
- WHO Collaborating Centre for Travellers' Health, Department of Global and Public Health, MilMedBiol Competence Centre, Zürich, Switzerland
| | - Corneliu Popescu
- University of Zürich, Epidemiology, Biostatistics and Prevention Institute, Zürich, Switzerland
- Center for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam UMC, Amsterdam, Netherlands
- Charité-Universitätsmedizin Berlin, Charité Center for Global Health, Institute of International Health, Berlin, Germany
- WHO Collaborating Centre for Travellers' Health, Department of Global and Public Health, MilMedBiol Competence Centre, Zürich, Switzerland
| | - Jenny L Schnyder
- University of Zürich, Epidemiology, Biostatistics and Prevention Institute, Zürich, Switzerland
- Center for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam UMC, Amsterdam, Netherlands
- Charité-Universitätsmedizin Berlin, Charité Center for Global Health, Institute of International Health, Berlin, Germany
- WHO Collaborating Centre for Travellers' Health, Department of Global and Public Health, MilMedBiol Competence Centre, Zürich, Switzerland
| | - Hanna K de Jong
- University of Zürich, Epidemiology, Biostatistics and Prevention Institute, Zürich, Switzerland
- Center for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam UMC, Amsterdam, Netherlands
- Charité-Universitätsmedizin Berlin, Charité Center for Global Health, Institute of International Health, Berlin, Germany
- WHO Collaborating Centre for Travellers' Health, Department of Global and Public Health, MilMedBiol Competence Centre, Zürich, Switzerland
| | - Mohammed Dauda
- University of Zürich, Epidemiology, Biostatistics and Prevention Institute, Zürich, Switzerland
- Center for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam UMC, Amsterdam, Netherlands
- Charité-Universitätsmedizin Berlin, Charité Center for Global Health, Institute of International Health, Berlin, Germany
- WHO Collaborating Centre for Travellers' Health, Department of Global and Public Health, MilMedBiol Competence Centre, Zürich, Switzerland
| | - Hiroshi Nishiura
- University of Zürich, Epidemiology, Biostatistics and Prevention Institute, Zürich, Switzerland
- Center for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam UMC, Amsterdam, Netherlands
- Charité-Universitätsmedizin Berlin, Charité Center for Global Health, Institute of International Health, Berlin, Germany
- WHO Collaborating Centre for Travellers' Health, Department of Global and Public Health, MilMedBiol Competence Centre, Zürich, Switzerland
| | - Jaffar A Al-Tawfiq
- University of Zürich, Epidemiology, Biostatistics and Prevention Institute, Zürich, Switzerland
- Center for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam UMC, Amsterdam, Netherlands
- Charité-Universitätsmedizin Berlin, Charité Center for Global Health, Institute of International Health, Berlin, Germany
- WHO Collaborating Centre for Travellers' Health, Department of Global and Public Health, MilMedBiol Competence Centre, Zürich, Switzerland
| | - Salim Parker
- University of Zürich, Epidemiology, Biostatistics and Prevention Institute, Zürich, Switzerland
- Center for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam UMC, Amsterdam, Netherlands
- Charité-Universitätsmedizin Berlin, Charité Center for Global Health, Institute of International Health, Berlin, Germany
- WHO Collaborating Centre for Travellers' Health, Department of Global and Public Health, MilMedBiol Competence Centre, Zürich, Switzerland
| | - Carsten Schade Larsen
- University of Zürich, Epidemiology, Biostatistics and Prevention Institute, Zürich, Switzerland
- Center for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam UMC, Amsterdam, Netherlands
- Charité-Universitätsmedizin Berlin, Charité Center for Global Health, Institute of International Health, Berlin, Germany
- WHO Collaborating Centre for Travellers' Health, Department of Global and Public Health, MilMedBiol Competence Centre, Zürich, Switzerland
| | - Effy Vayena
- University of Zürich, Epidemiology, Biostatistics and Prevention Institute, Zürich, Switzerland
- Center for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam UMC, Amsterdam, Netherlands
- Charité-Universitätsmedizin Berlin, Charité Center for Global Health, Institute of International Health, Berlin, Germany
- WHO Collaborating Centre for Travellers' Health, Department of Global and Public Health, MilMedBiol Competence Centre, Zürich, Switzerland
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Verma AK, Lowery S, Lin LC, Duraisami E, Lloréns JEA, Qiu Q, Hefti M, Yu CR, Albers MW, Perlman S. Persistent Neurological Deficits in Mouse PASC Reveal Antiviral Drug Limitations. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.06.02.596989. [PMID: 38895239 PMCID: PMC11185538 DOI: 10.1101/2024.06.02.596989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
Post-Acute Sequelae of COVID-19 (PASC) encompasses persistent neurological symptoms, including olfactory and autonomic dysfunction. Here, we report chronic neurological dysfunction in mice infected with a virulent mouse-adapted SARS-CoV-2 that does not infect the brain. Long after recovery from nasal infection, we observed loss of tyrosine hydroxylase (TH) expression in olfactory bulb glomeruli and neurotransmitter levels in the substantia nigra (SN) persisted. Vulnerability of dopaminergic neurons in these brain areas was accompanied by increased levels of proinflammatory cytokines and neurobehavioral changes. RNAseq analysis unveiled persistent microglia activation, as found in human neurodegenerative diseases. Early treatment with antivirals (nirmatrelvir and molnupiravir) reduced virus titers and lung inflammation but failed to prevent neurological abnormalities, as observed in patients. Together these results show that chronic deficiencies in neuronal function in SARS-CoV-2-infected mice are not directly linked to ongoing olfactory epithelium dysfunction. Rather, they bear similarity with neurodegenerative disease, the vulnerability of which is exacerbated by chronic inflammation.
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Affiliation(s)
- Abhishek Kumar Verma
- Department of Microbiology and Immunology, University of Iowa, Iowa City, IA 52242
| | - Shea Lowery
- Department of Microbiology and Immunology, University of Iowa, Iowa City, IA 52242
| | - Li-Chin Lin
- Iowa Neuroscience Institute, University of Iowa, IA, USA 52242
- Department of Neurology, University of Iowa, Iowa City, IA 52242
| | | | | | - Qiang Qiu
- Stowers Institute for Medical Research, Kansas City, MO 64110
| | - Marco Hefti
- Department of Pathology, University of Iowa, Iowa City, IA 52242
| | - C. Ron Yu
- Stowers Institute for Medical Research, Kansas City, MO 64110
| | - Mark W. Albers
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Stanley Perlman
- Department of Microbiology and Immunology, University of Iowa, Iowa City, IA 52242
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van der Knaap N, de Vreeze F, van Rosmalen F, Wintjens MSJN, van Santen S, Linden DEJ, Staals J, van Mook WNKA, Jansen JFA, van der Horst ICC, van Bussel BCT, Ariës MJH. The incidence of neurological complications in mechanically ventilated COVID-19 ICU patients: An observational single-center cohort study in three COVID-19 periods. Clin Neurol Neurosurg 2024; 241:108311. [PMID: 38704879 DOI: 10.1016/j.clineuro.2024.108311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 04/07/2024] [Accepted: 04/29/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND Neurological complications in COVID-19 patients admitted to an intensive care unit (ICU) have been previously reported. As the pandemic progressed, therapeutic strategies were tailored to new insights. This study describes the incidence, outcome, and types of reported neurological complications in invasively mechanically ventilated (IMV) COVID-19 patients in relation to three periods during the pandemic. METHODS IMV COVID-19 ICU patients from the Dutch Maastricht Intensive Care COVID (MaastrICCht) cohort were included in a single-center study (March 2020 - October 2021). Demographic, clinical, and follow-up data were collected. Electronic medical records were screened for neurological complications during hospitalization. Three distinct periods (P1, P2, P3) were defined, corresponding to periods with high hospitalization rates. ICU survivors with and without reported neurological complications were compared in an exploratory analysis. RESULTS IMV COVID-19 ICU patients (n=324; median age 64 [IQR 57-72] years; 238 males (73.5%)) were stratified into P1 (n=94), P2 (n=138), and P3 (n=92). ICU mortality did not significantly change over time (P1=38.3%; P2=41.3%; P3=37.0%; p=.787). The incidence of reported neurological complications during ICU admission gradually decreased over the periods (P1=29.8%; P2=24.6%; P3=18.5%; p=.028). Encephalopathy/delirium (48/324 (14.8%)) and ICU-acquired weakness (32/324 (9.9%)) were most frequently reported and associated with ICU treatment intensity. ICU survivors with neurological complications (n=53) were older (p=.025), predominantly male (p=.037), and had a longer duration of IMV (p<.001) and ICU stay (p<.001), compared to survivors without neurological complications (n=132). A multivariable analysis revealed that only age was independently associated with the occurrence of neurological complications (ORadj=1.0541; 95% CI=1.0171-1.0925; p=.004). Health-related quality-of-life at follow-up was not significantly different between survivors with and without neurological complications (n = 82, p=.054). CONCLUSIONS A high but decreasing incidence of neurological complications was reported during three consecutive COVID-19 periods in IMV COVID-19 patients. Neurological complications were related to the intensity of ICU support and treatment, and associated with prolonged ICU stay, but did not lead to significantly worse reported health-related quality-of-life at follow-up.
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Affiliation(s)
- Noa van der Knaap
- Department of Intensive Care Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands; Department of Radiology & Nuclear Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands; Research Institute of Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands
| | - Fleur de Vreeze
- Department of Intensive Care Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Frank van Rosmalen
- Department of Intensive Care Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands
| | - Marieke S J N Wintjens
- Department of Intensive Care Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands; Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Susanne van Santen
- Department of Intensive Care Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - David E J Linden
- Research Institute of Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands; Department of Neurology, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Julie Staals
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands; Department of Neurology, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Walther N K A van Mook
- Department of Intensive Care Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Jacobus F A Jansen
- Department of Radiology & Nuclear Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands; Research Institute of Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands; Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Iwan C C van der Horst
- Department of Intensive Care Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands
| | - Bas C T van Bussel
- Department of Intensive Care Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands; Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Marcel J H Ariës
- Department of Intensive Care Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands; Research Institute of Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands.
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Ho AZJ, Ishak NIB, Wong EHC. Effect of Olfactory Rehabilitation on the Recovery of Post-Coronavirus Disease Olfactory Dysfunction: A Randomized Controlled Trial. Cureus 2024; 16:e61855. [PMID: 38975544 PMCID: PMC11227608 DOI: 10.7759/cureus.61855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2024] [Indexed: 07/09/2024] Open
Abstract
Introduction Persistent olfactory dysfunction was seen in many patients upon coronavirus disease 2019 (COVID-19) infection recovery. However, research on its management was very limited, especially among the Southeast Asian population. Objectives We aim to investigate the role of olfactory rehabilitation and topical corticosteroids among post-COVID-19 olfactory dysfunction patients in Malaysia, and at the same time to determine factors leading to olfactory recovery post-COVID-19 infection. Methods Adult Malaysians with persistent olfactory dysfunction one month post-COVID-19 recovery were recruited. Thirty-one patients were randomly assigned into three groups with 10 patients being given olfactory training (Group 1), another 10 being given mometasone furoate nasal spray/olfactory training (Group 2), and 11 patients being assigned to the control group (Group 3). All groups were followed up for an average duration of six months. Olfactory function was evaluated by Top International Biotech Smell Identification Test (TIBSIT) scores and Olfactory Disorder Questionnaire (eODQ) prior to randomization, at three and six months after recruitment. Results The baseline characteristics of patients were similar in all groups. Generally, patients of all three groups showed a statistically significant improvement in the TIBSIT scores after six months. The TIBSIT scores for Group 2 were statistically significantly higher than the control at three months but not at six months. As for Group 1, no statistically significant differences in TIBSIT scores at both three and six months were noted when compared to control. Statistically significant improvements were seen in the eODQ scores in all three groups. Conclusion No superiority of intervention for post-COVID-19 olfactory dysfunction was seen compared to control.
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Affiliation(s)
- Alex Zxi Jian Ho
- Department of Otorhinolaryngology, International Islamic University Malaysia, Kuantan, MYS
| | - Nur Izzati B Ishak
- Department of Otorhinolaryngology, Head & Neck Surgery, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, MYS
| | - Eugene Hung Chih Wong
- Department of Otorhinolaryngology, Head & Neck Surgery, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, MYS
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Jansen EB, Ostadgavahi AT, Hewins B, Buchanan R, Thivierge BM, Sganzerla Martinez G, Goncin U, Francis ME, Swan CL, Scruten E, Bell J, Darbellay J, Facciuolo A, Falzarano D, Gerdts V, Fenton ME, Hedlin P, Kelvin DJ, Kelvin AA. PASC (Post Acute Sequelae of COVID-19) is associated with decreased neutralizing antibody titers in both biological sexes and increased ANG-2 and GM-CSF in females. Sci Rep 2024; 14:9854. [PMID: 38684819 PMCID: PMC11058778 DOI: 10.1038/s41598-024-60089-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 04/18/2024] [Indexed: 05/02/2024] Open
Abstract
Post-acute sequelae of COVID-19 (PASC) or the continuation of COVID-19 (Coronavirus disease 2019) symptoms past 12 weeks may affect as many as 30% of people recovering from a SARS-CoV-2 (severe acute respiratory coronavirus 2) infection. The mechanisms regulating the development of PASC are currently not known; however, hypotheses include virus reservoirs, pre-existing conditions, microblood clots, immune dysregulation, as well as poor antibody responses. Importantly, virus neutralizing antibodies are essential for COVID-19 recovery and protection from reinfection but there is currently limited information on these immune regulators and associated cytokines in PASC patients. Understanding the key drivers of general and specific symptoms associated with Long COVID and the presence of virus neutralizing antibodies in PASC will aid in the development of therapeutics, diagnostics, and vaccines which currently do not exist. We designed a cross-sectional study to investigate systemic antibody and cytokine responses during COVID-19 recovery and PASC. In total, 195 participants were recruited in one of four groups: (1) Those who never had COVID-19 (No COVID); (2) Those in acute COVID-19 recovery (Acute Recovery) (4-12 weeks post infection); (3) Those who recovered from COVID-19 (Recovered) (+ 12 weeks from infection); and (4) those who had PASC (PASC) (+ 12 weeks from infection). Participants completed a questionnaire on health history, sex, gender, demographics, experiences with COVID-19 acute and COVID-19 recovery/continuing symptoms. Serum samples collected were evaluated for antibody binding to viral proteins, virus neutralizing antibody titers, and serum cytokine levels using Ella SimplePlex Immunoassay™ panels. We found participants with PASC reported more pre-existing conditions (e.g. such as hypertension, asthma, and obesity), and PASC symptoms (e.g. fatigue, brain fog, headaches, and shortness of breath) following COVID-19 than COVID-19 Recovered individuals. Importantly, we found PASC individuals to have significantly decreased levels of neutralizing antibodies toward both SARS-CoV-2 and the Omicron BA.1 variant. Sex analysis indicated that female PASC study participants had sustained antibody levels as well as levels of the inflammatory cytokines GM-CSF and ANG-2 over time following COVID-19. Our study reports people experiencing PASC had lower levels of virus neutralizing antibodies; however, the results are limited by the collection time post-COVID-19 and post-vaccination. Moreover, we found females experiencing PASC had sustained levels of GM-CSF and ANG-2. With lower levels of virus neutralizing antibodies, this data suggests that PASC individuals not only have had a suboptimal antibody response during acute SARS-CoV-2 infection but may also have increased susceptibility to subsequent infections which may exacerbate or prolong current PASC illnesses. We also provide evidence suggesting GM-CSF and ANG-2 to play a role in the sex-bias of PASC. Taken together, our findings maybe important for understanding immune molecular drivers of PASC and PASC subgroups.
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Affiliation(s)
- Ethan B Jansen
- Vaccine and Infectious Disease Organization (VIDO), University of Saskatchewan, Saskatoon, SK, Canada
- Department of Biochemistry, Microbiology, and Immunology, University of Saskatchewan, Saskatoon, SK, Canada
| | | | - Benjamin Hewins
- Department of Microbiology and Immunology, Dalhousie University, Halifax, NS, Canada
| | - Rachelle Buchanan
- Vaccine and Infectious Disease Organization (VIDO), University of Saskatchewan, Saskatoon, SK, Canada
| | - Brittany M Thivierge
- Vaccine and Infectious Disease Organization (VIDO), University of Saskatchewan, Saskatoon, SK, Canada
| | | | - Una Goncin
- Department of Anesthesiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Magen E Francis
- Vaccine and Infectious Disease Organization (VIDO), University of Saskatchewan, Saskatoon, SK, Canada
- Department of Biochemistry, Microbiology, and Immunology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Cynthia L Swan
- Vaccine and Infectious Disease Organization (VIDO), University of Saskatchewan, Saskatoon, SK, Canada
| | - Erin Scruten
- Vaccine and Infectious Disease Organization (VIDO), University of Saskatchewan, Saskatoon, SK, Canada
| | - Jack Bell
- Vaccine and Infectious Disease Organization (VIDO), University of Saskatchewan, Saskatoon, SK, Canada
- Department of Biochemistry, Microbiology, and Immunology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Joseph Darbellay
- Vaccine and Infectious Disease Organization (VIDO), University of Saskatchewan, Saskatoon, SK, Canada
| | - Antonio Facciuolo
- Vaccine and Infectious Disease Organization (VIDO), University of Saskatchewan, Saskatoon, SK, Canada
- Department of Veterinary Microbiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Darryl Falzarano
- Vaccine and Infectious Disease Organization (VIDO), University of Saskatchewan, Saskatoon, SK, Canada
- Department of Veterinary Microbiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Volker Gerdts
- Vaccine and Infectious Disease Organization (VIDO), University of Saskatchewan, Saskatoon, SK, Canada
- Department of Veterinary Microbiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Mark E Fenton
- Division of Respirology, Critical Care, and Sleep Medicine, Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Peter Hedlin
- Department of Anesthesiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - David J Kelvin
- Department of Microbiology and Immunology, Dalhousie University, Halifax, NS, Canada
| | - Alyson A Kelvin
- Vaccine and Infectious Disease Organization (VIDO), University of Saskatchewan, Saskatoon, SK, Canada.
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Phetsouphanh C, Jacka B, Ballouz S, Jackson KJL, Wilson DB, Manandhar B, Klemm V, Tan HX, Wheatley A, Aggarwal A, Akerman A, Milogiannakis V, Starr M, Cunningham P, Turville SG, Kent SJ, Byrne A, Brew BJ, Darley DR, Dore GJ, Kelleher AD, Matthews GV. Improvement of immune dysregulation in individuals with long COVID at 24-months following SARS-CoV-2 infection. Nat Commun 2024; 15:3315. [PMID: 38632311 PMCID: PMC11024141 DOI: 10.1038/s41467-024-47720-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 04/11/2024] [Indexed: 04/19/2024] Open
Abstract
This study investigates the humoral and cellular immune responses and health-related quality of life measures in individuals with mild to moderate long COVID (LC) compared to age and gender matched recovered COVID-19 controls (MC) over 24 months. LC participants show elevated nucleocapsid IgG levels at 3 months, and higher neutralizing capacity up to 8 months post-infection. Increased spike-specific and nucleocapsid-specific CD4+ T cells, PD-1, and TIM-3 expression on CD4+ and CD8+ T cells were observed at 3 and 8 months, but these differences do not persist at 24 months. Some LC participants had detectable IFN-γ and IFN-β, that was attributed to reinfection and antigen re-exposure. Single-cell RNA sequencing at the 24 month timepoint shows similar immune cell proportions and reconstitution of naïve T and B cell subsets in LC and MC. No significant differences in exhaustion scores or antigen-specific T cell clones are observed. These findings suggest resolution of immune activation in LC and return to comparable immune responses between LC and MC over time. Improvement in self-reported health-related quality of life at 24 months was also evident in the majority of LC (62%). PTX3, CRP levels and platelet count are associated with improvements in health-related quality of life.
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Affiliation(s)
| | - Brendan Jacka
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Sara Ballouz
- Garvan Institute for Medical research, Sydney, NSW, Australia
- School of Computer Science and Engineering, Faculty of Engineering, University of New South Wales, Sydney, NSW, Australia
| | | | - Daniel B Wilson
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Bikash Manandhar
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Vera Klemm
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Hyon-Xhi Tan
- Department of Microbiology and Immunology, Peter Doherty Institute, University of Melbourne, Victoria, VIC, Australia
| | - Adam Wheatley
- Department of Microbiology and Immunology, Peter Doherty Institute, University of Melbourne, Victoria, VIC, Australia
| | - Anupriya Aggarwal
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Anouschka Akerman
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | | | - Mitchell Starr
- NSW State Reference Laboratory for HIV, St. Vincent's Centre for Applied Medical Research, Sydney, NSW, Australia
| | - Phillip Cunningham
- NSW State Reference Laboratory for HIV, St. Vincent's Centre for Applied Medical Research, Sydney, NSW, Australia
| | - Stuart G Turville
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Stephen J Kent
- Department of Microbiology and Immunology, Peter Doherty Institute, University of Melbourne, Victoria, VIC, Australia
| | - Anthony Byrne
- Heart Lung Clinic, St. Vincent's Hospital Sydney and Faculty of Medicine and Health (UNSW), Sydney, NSW, Australia
| | - Bruce J Brew
- Peter Duncan Neurosciences Unit- St Vincent's Centre for Applied Medical Research, Sydney, NSW, Australia
| | | | - Gregory J Dore
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
- St. Vincent's Hospital, Darlinghurst, NSW, Australia
| | - Anthony D Kelleher
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
- St. Vincent's Hospital, Darlinghurst, NSW, Australia.
| | - Gail V Matthews
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
- St. Vincent's Hospital, Darlinghurst, NSW, Australia.
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van der Knaap N, Ariës MJH, van der Horst ICC, Jansen JFA. On the merits and potential of advanced neuroimaging techniques in COVID-19: A scoping review. Neuroimage Clin 2024; 42:103589. [PMID: 38461701 PMCID: PMC10938171 DOI: 10.1016/j.nicl.2024.103589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 02/29/2024] [Accepted: 03/03/2024] [Indexed: 03/12/2024]
Abstract
Many Coronavirus Disease 2019 (COVID-19) patients are suffering from long-term neuropsychological sequelae. These patients may benefit from a better understanding of the underlying neuropathophysiological mechanisms and identification of potential biomarkers and treatment targets. Structural clinical neuroimaging techniques have limited ability to visualize subtle cerebral abnormalities and to investigate brain function. This scoping review assesses the merits and potential of advanced neuroimaging techniques in COVID-19 using literature including advanced neuroimaging or postmortem analyses in adult COVID-19 patients published from the start of the pandemic until December 2023. Findings were summarized according to distinct categories of reported cerebral abnormalities revealed by different imaging techniques. Although no unified COVID-19-specific pattern could be subtracted, a broad range of cerebral abnormalities were revealed by advanced neuroimaging (likely attributable to hypoxic, vascular, and inflammatory pathology), even in absence of structural clinical imaging findings. These abnormalities are validated by postmortem examinations. This scoping review emphasizes the added value of advanced neuroimaging compared to structural clinical imaging and highlights implications for brain functioning and long-term consequences in COVID-19.
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Affiliation(s)
- Noa van der Knaap
- Department of Intensive Care Medicine, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Radiology & Nuclear Medicine, Maastricht University Medical Center, Maastricht, the Netherlands; Research Institute of Mental Health & Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Marcel J H Ariës
- Department of Intensive Care Medicine, Maastricht University Medical Center, Maastricht, the Netherlands; Research Institute of Mental Health & Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Iwan C C van der Horst
- Department of Intensive Care Medicine, Maastricht University Medical Center, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands
| | - Jacobus F A Jansen
- Department of Radiology & Nuclear Medicine, Maastricht University Medical Center, Maastricht, the Netherlands; Research Institute of Mental Health & Neuroscience, Maastricht University, Maastricht, the Netherlands; Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands.
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10
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Lukasik H, Grote H, Bogaert S, Volkenstein S, Schlegtendal A, Eitner L, Beermann L, Maier C, Brinkmann F, van Ackeren K. Olfactory disorders in childhood: A comparative study of olfaction in children with adenoid hyperplasia versus a control group and the postoperative effects of adenoidectomy with respect to olfactory ability. Int J Pediatr Otorhinolaryngol 2023; 174:111735. [PMID: 37801831 DOI: 10.1016/j.ijporl.2023.111735] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 07/27/2023] [Accepted: 09/16/2023] [Indexed: 10/08/2023]
Abstract
PURPOSE Hyposmia in childhood is poorly characterized. The "U-Sniff Test", validated for children with anosmia, can be used to objectify olfactory impairment but has not been used to distinguish between hyposmia and normosmia. Therefore, we investigated children with enlarged adenoids with respect to hyposmia, its correlation with adenoid size, and the sensitivity of questionnaires to predict olfactory impairment. METHODS In a prospective comparison, olfaction was assessed by "U-Sniff Test" (score 0-12; <8 hyposmia) in 41 children (5-18 years) with adenoid hyperplasia and compared with 196 children without any respiratory affection (control) after exclusion of previous SARS-Cov2-infection from December 2020 to December 2021. ENT-related complaints were collected using a self-designed questionnaire. We were able to include 13 children in a follow-up examination to compare preoperative performance in the "U-Sniff Test" with postoperative outcome after adenoidectomy. STATISTICS chi-square-test (p < 0.05), odds-ratio, Spearman's rho, ROC-, cluster analysis. RESULTS Severe hyposmia was present in 36.6% of children with adenoid-hyperplasia compared to 3.1% of the control-group. Adenoid-children scored significantly more often between 8 and 10 points (58.5%) than the control (31.6%; p < 0.01). Adenoid size and olfactory performance correlate significantly (r: 0.83; CI -0.89 … -0.72). Hyposmia in the adenoid group is characterized predominately by loss of the odors banana, butter and rose. None of children with hyposmia or parents reported impaired olfactory performance. Postoperatively, olfactory function improved significantly in 85% of cases (p 0.01, SD ± 1.71, Δ3.54points). CONCLUSION Questionnaires are insufficient to detect hyposmia in this cohort. In contrast, the "U-Sniff Test" detects even reduced olfactory performance without reaching the cut-off value, which represents the majority of test results in the adenoid group. Therefore, we recommend the classification of moderate hyposmia (8-10 points) to be included for our study population.
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Affiliation(s)
- H Lukasik
- Department of Otorhinolaryngology, Head and Neck Surgery, Johannes Wesling Klinikum, Ruhr-University Bochum, Minden, Germany; Department of Otorhinolaryngology, Head and Neck Surgery, St. Elisabeth-Hospital, Ruhr-University Bochum, Bochum, Germany.
| | - H Grote
- Department of Pediatrics, St. Josef Hospital, Ruhr-University Bochum, Bochum, Germany
| | - S Bogaert
- Department of Otorhinolaryngology, Head and Neck Surgery, St. Elisabeth-Hospital, Ruhr-University Bochum, Bochum, Germany
| | - S Volkenstein
- Department of Otorhinolaryngology, Head and Neck Surgery, Johannes Wesling Klinikum, Ruhr-University Bochum, Minden, Germany
| | - A Schlegtendal
- Department of Pediatrics, St. Josef Hospital, Ruhr-University Bochum, Bochum, Germany
| | - L Eitner
- Department of Pediatrics, St. Josef Hospital, Ruhr-University Bochum, Bochum, Germany
| | - L Beermann
- Department of Pediatrics, St. Josef Hospital, Ruhr-University Bochum, Bochum, Germany
| | - C Maier
- Department of Pediatrics, St. Josef Hospital, Ruhr-University Bochum, Bochum, Germany
| | - F Brinkmann
- Department of Pediatrics, St. Josef Hospital, Ruhr-University Bochum, Bochum, Germany; Division of Pediatric Pulmonology and Allergology, University Children's Hospital, German Center for Lung Research (ARCN, DZL), Luebeck, Germany
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11
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Faviez C, Talmatkadi M, Foulquié P, Mebarki A, Schück S, Burgun A, Chen X. Assessment of the Early Detection of Anosmia and Ageusia Symptoms in COVID-19 on Twitter: Retrospective Study. JMIR INFODEMIOLOGY 2023; 3:e41863. [PMID: 37643302 PMCID: PMC10521907 DOI: 10.2196/41863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 06/29/2023] [Accepted: 08/01/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND During the unprecedented COVID-19 pandemic, social media has been extensively used to amplify the spread of information and to express personal health-related experiences regarding symptoms, including anosmia and ageusia, 2 symptoms that have been reported later than other symptoms. OBJECTIVE Our objective is to investigate to what extent Twitter users reported anosmia and ageusia symptoms in their tweets and if they connected them to COVID-19, to evaluate whether these symptoms could have been identified as COVID-19 symptoms earlier using Twitter rather than the official notice. METHODS We collected French tweets posted between January 1, 2020, and March 31, 2020, containing anosmia- or ageusia-related keywords. Symptoms were detected using fuzzy matching. The analysis consisted of 3 parts. First, we compared the coverage of anosmia and ageusia symptoms in Twitter and in traditional media to determine if the association between COVID-19 and anosmia or ageusia could have been identified earlier through Twitter. Second, we conducted a manual analysis of anosmia- and ageusia-related tweets to obtain quantitative and qualitative insights regarding their nature and to assess when the first associations between COVID-19 and these symptoms were established. We randomly annotated tweets from 2 periods: the early stage and the rapid spread stage of the epidemic. For each tweet, each symptom was annotated regarding 3 modalities: symptom (yes or no), associated with COVID-19 (yes, no, or unknown), and whether it was experienced by someone (yes, no, or unknown). Third, to evaluate if there was a global increase of tweets mentioning anosmia or ageusia in early 2020, corresponding to the beginning of the COVID-19 epidemic, we compared the tweets reporting experienced anosmia or ageusia between the first periods of 2019 and 2020. RESULTS In total, 832 (respectively 12,544) tweets containing anosmia (respectively ageusia) related keywords were extracted over the analysis period in 2020. The comparison to traditional media showed a strong correlation without any lag, which suggests an important reactivity of Twitter but no earlier detection on Twitter. The annotation of tweets from 2020 showed that tweets correlating anosmia or ageusia with COVID-19 could be found a few days before the official announcement. However, no association could be found during the first stage of the pandemic. Information about the temporality of symptoms and the psychological impact of these symptoms could be found in the tweets. The comparison between early 2020 and early 2019 showed no difference regarding the volumes of tweets. CONCLUSIONS Based on our analysis of French tweets, associations between COVID-19 and anosmia or ageusia by web users could have been found on Twitter just a few days before the official announcement but not during the early stage of the pandemic. Patients share qualitative information on Twitter regarding anosmia or ageusia symptoms that could be of interest for future analyses.
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Affiliation(s)
- Carole Faviez
- Centre de Recherche des Cordeliers, Université Paris Cité, Sorbonne Université, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR 1138, Paris, France
- Health Data- and Model- Driven Knowledge Acquisition (HeKA), Inria Paris, Paris, France
| | | | | | | | | | - Anita Burgun
- Centre de Recherche des Cordeliers, Université Paris Cité, Sorbonne Université, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR 1138, Paris, France
- Health Data- and Model- Driven Knowledge Acquisition (HeKA), Inria Paris, Paris, France
- Department of Medical Informatics, Hôpital Necker-Enfant Malades, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
| | - Xiaoyi Chen
- Centre de Recherche des Cordeliers, Université Paris Cité, Sorbonne Université, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR 1138, Paris, France
- Health Data- and Model- Driven Knowledge Acquisition (HeKA), Inria Paris, Paris, France
- Data Science Platform, Imagine Institute, Université Paris Cité, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR 1163, Paris, France
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12
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Tseng YJ, Olson KL, Bloch D, Mandl KD. Engaging a national-scale cohort of smart thermometer users in participatory surveillance. NPJ Digit Med 2023; 6:175. [PMID: 37730764 PMCID: PMC10511532 DOI: 10.1038/s41746-023-00917-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 09/04/2023] [Indexed: 09/22/2023] Open
Abstract
Participatory surveillance systems crowdsource individual reports to rapidly assess population health phenomena. The value of these systems increases when more people join and persistently contribute. We examine the level of and factors associated with engagement in participatory surveillance among a retrospective, national-scale cohort of individuals using smartphone-connected thermometers with a companion app that allows them to report demographic and symptom information. Between January 1, 2020 and October 29, 2022, 1,325,845 participants took 20,617,435 temperature readings, yielding 3,529,377 episodes of consecutive readings. There were 1,735,805 (49.2%) episodes with self-reported symptoms (including reports of no symptoms). Compared to before the pandemic, participants were more likely to report their symptoms during pandemic waves, especially after the winter wave began (September 13, 2020) (OR across pandemic periods range from 3.0 to 4.0). Further, symptoms were more likely to be reported during febrile episodes (OR = 2.6, 95% CI = 2.6-2.6), and for new participants, during their first episode (OR = 2.4, 95% CI = 2.4-2.5). Compared with participants aged 50-65 years old, participants over 65 years were less likely to report their symptoms (OR = 0.3, 95% CI = 0.3-0.3). Participants in a household with both adults and children (OR = 1.6 [1.6-1.7]) were more likely to report symptoms. We find that the use of smart thermometers with companion apps facilitates the collection of data on a large, national scale, and provides real time insight into transmissible disease phenomena. Nearly half of individuals using these devices are willing to report their symptoms after taking their temperature, although participation varies among individuals and over pandemic stages.
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Affiliation(s)
- Yi-Ju Tseng
- Computational Health Informatics Program, Boston Children's Hospital, Boston, MA, USA
- Department of Computer Science, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Karen L Olson
- Computational Health Informatics Program, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | | | - Kenneth D Mandl
- Computational Health Informatics Program, Boston Children's Hospital, Boston, MA, USA.
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA.
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13
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Cherobin GB, Guimarães RES, de Paula Gomes MC, Vasconcelos LOG, de Abreu LAN. Intranasal Insulin for the Treatment of Persistent Post-COVID-19 Olfactory Dysfunction. Otolaryngol Head Neck Surg 2023; 169:719-724. [PMID: 37078341 DOI: 10.1002/ohn.352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 03/06/2023] [Accepted: 03/31/2023] [Indexed: 04/21/2023]
Abstract
OBJECTIVE To investigate if intranasal insulin could be a treatment option for those suffering from recalcitrant olfactory dysfunction due to COVID-19. STUDY DESIGN Prospective interventional cohort with a single group. SETTING Sixteen volunteers with anosmia, severe hyposmia, or moderate hyposmia for more than 60 days as sequelae of severe acute respiratory syndrome coronavirus 2 infections were selected for the study. All volunteers reported that standard therapies, such as corticosteroids, have failed to improve their olfactory function. METHODS Olfactory function was assessed by the Chemosensory Clinical Research Center test of olfaction (COT) before and after the intervention. Changes in qualitative, quantitative, and global COT scores were investigated. The insulin therapy session consisted of placing into each olfactory cleft 2 pieces of gelatin sponge soaked with neutral protamine Hagedorn (NPH) insulin, 40 IU on each side. The procedure was repeated twice a week for 1 month. Glycaemic blood level was measured before and after each session. RESULTS The qualitative COT score rose 1.53 points, p = .0001, 95% confidence interval (CI) (-2.12 to -0.94). The quantitative COT score increased by 2.00 points, p = .0002, 95% CI (-3.59 to -1.41). Global COT score had an improvement of 2.01 points, p = .00003, 95% CI (-2.7 to -1.3). Glycaemic blood level dropped on average 10.4 mg/dL, p < .00003, 95% CI (8.1-12.8). CONCLUSION Our results suggest that the administration of NPH insulin into the olfactory cleft yields a rapid improvement in the sense of smell of patients suffering from persistent post-COVID-19 olfactory dysfunction. Moreover, the procedure seems to be safe and tolerable.
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Affiliation(s)
- Giancarlo B Cherobin
- Department of Ophthalmology and Otolaryngology, Medical School of Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Roberto E S Guimarães
- Department of Ophthalmology and Otolaryngology, Medical School of Federal University of Minas Gerais, Belo Horizonte, Brazil
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14
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Madanchi M, Brenner M, Navarini AA, Juratli HA. Ageusia as a symptom of monkeypox infection. J Dtsch Dermatol Ges 2023; 21:1035-1036. [PMID: 37282803 DOI: 10.1111/ddg.15118] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 04/04/2023] [Indexed: 06/08/2023]
Affiliation(s)
- Matiar Madanchi
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
| | - Maja Brenner
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
| | | | - Hazem A Juratli
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
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15
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Madanchi M, Brenner M, Navarini AA, Juratli HA. Ageusie als Symptom bei Affenpockeninfektion. J Dtsch Dermatol Ges 2023; 21:1035-1037. [PMID: 37700418 DOI: 10.1111/ddg.15118_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 04/04/2023] [Indexed: 09/14/2023]
Affiliation(s)
- Matiar Madanchi
- Dermatologische Abteilung, Universitätsspital Basel, Basel, Schweiz
| | - Maja Brenner
- Dermatologische Abteilung, Universitätsspital Basel, Basel, Schweiz
| | | | - Hazem A Juratli
- Dermatologische Abteilung, Universitätsspital Basel, Basel, Schweiz
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Kervevan J, Staropoli I, Slama D, Jeger-Madiot R, Donnadieu F, Planas D, Pietri MP, Loghmari-Bouchneb W, Alaba Tanah M, Robinot R, Boufassa F, White M, Salmon-Ceron D, Chakrabarti LA. Divergent adaptive immune responses define two types of long COVID. Front Immunol 2023; 14:1221961. [PMID: 37559726 PMCID: PMC10408302 DOI: 10.3389/fimmu.2023.1221961] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 07/03/2023] [Indexed: 08/11/2023] Open
Abstract
Background The role of adaptive immune responses in long COVID remains poorly understood, with contrasting hypotheses suggesting either an insufficient antiviral response or an excessive immune response associated with inflammatory damage. To address this issue, we set to characterize humoral and CD4+ T cell responses in long COVID patients prior to SARS-CoV-2 vaccination. Methods Long COVID patients who were seropositive (LC+, n=28) or seronegative (LC-, n=23) by spike ELISA assay were recruited based on (i) an initial SARS-CoV-2 infection documented by PCR or the conjunction of three major signs of COVID-19 and (ii) the persistence or resurgence of at least 3 symptoms for over 3 months. They were compared to COVID patients with resolved symptoms (RE, n=29) and uninfected control individuals (HD, n=29). Results The spectrum of persistent symptoms proved similar in both long COVID groups, with a trend for a higher number of symptoms in the seronegative group (median=6 vs 4.5; P=0.01). The use a highly sensitive S-flow assay enabled the detection of low levels of SARS-CoV-2 spike-specific IgG in 22.7% of ELISA-seronegative long COVID (LC-) patients. In contrast, spike-specific IgG levels were uniformly high in the LC+ and RE groups. Multiplexed antibody analyses to 30 different viral antigens showed that LC- patients had defective antibody responses to all SARS-CoV-2 proteins tested but had in most cases preserved responses to other viruses. A sensitive primary T cell line assay revealed low but detectable SARS-CoV-2-specific CD4 responses in 39.1% of LC- patients, while response frequencies were high in the LC+ and RE groups. Correlation analyses showed overall strong associations between humoral and cellular responses, with exceptions in the LC- group. Conclusions These findings provide evidence for two major types of antiviral immune responses in long COVID. Seropositive patients showed coordinated cellular and humoral responses at least as high as those of recovered patients. In contrast, ELISA-seronegative long COVID patients showed overall low antiviral responses, with detectable specific CD4+ T cells and/or antibodies in close to half of patients (52.2%). These divergent findings in patients sharing a comparable spectrum of persistent symptoms raise the possibility of multiple etiologies in long COVID.
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Affiliation(s)
- Jérôme Kervevan
- Virus and Immunity Unit, Institut Pasteur, Université de Paris Cité, CNRS UMR3569, Paris, France
| | - Isabelle Staropoli
- Virus and Immunity Unit, Institut Pasteur, Université de Paris Cité, CNRS UMR3569, Paris, France
| | - Dorsaf Slama
- Department of Infectious Diseases and Immunology, Hôtel Dieu Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris Cité, Paris, France
| | - Raphaël Jeger-Madiot
- Virus and Immunity Unit, Institut Pasteur, Université de Paris Cité, CNRS UMR3569, Paris, France
| | - Françoise Donnadieu
- Infectious Disease Analytics and Epidemiology G5 Unit, Institut Pasteur, Université de Paris Cité, Paris, France
| | - Delphine Planas
- Virus and Immunity Unit, Institut Pasteur, Université de Paris Cité, CNRS UMR3569, Paris, France
| | - Marie-Pierre Pietri
- Department of Infectious Diseases and Immunology, Hôtel Dieu Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris Cité, Paris, France
| | - Wiem Loghmari-Bouchneb
- Department of Infectious Diseases and Immunology, Hôtel Dieu Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris Cité, Paris, France
| | - Motolete Alaba Tanah
- Department of Infectious Diseases and Immunology, Hôtel Dieu Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris Cité, Paris, France
| | - Rémy Robinot
- Virus and Immunity Unit, Institut Pasteur, Université de Paris Cité, CNRS UMR3569, Paris, France
| | - Faroudy Boufassa
- INSERM U1018, Center for Research in Epidemiology and Population Health (CESP), Le Kremlin-Bicêtre, France
| | - Michael White
- Infectious Disease Analytics and Epidemiology G5 Unit, Institut Pasteur, Université de Paris Cité, Paris, France
| | - Dominique Salmon-Ceron
- Department of Infectious Diseases and Immunology, Hôtel Dieu Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris Cité, Paris, France
| | - Lisa A. Chakrabarti
- Virus and Immunity Unit, Institut Pasteur, Université de Paris Cité, CNRS UMR3569, Paris, France
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17
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Yoo S, Gulbransen-Diaz N, Parker C, Wang AP. Designing Digital COVID-19 Screening: Insights and Deliberations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3899. [PMID: 36900909 PMCID: PMC10001447 DOI: 10.3390/ijerph20053899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 02/10/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
Due to the global COVID-19 pandemic, public health control and screening measures have been introduced at healthcare facilities, including those housing our most vulnerable populations. These warning measures situated at hospital entrances are presently labour-intensive, requiring additional staff to conduct manual temperature checks and risk-assessment questionnaires of every individual entering the premises. To make this process more efficient, we present eGate, a digital COVID-19 health-screening smart Internet of Things system deployed at multiple entry points around a children's hospital. This paper reports on design insights based on the experiences of concierge screening staff stationed alongside the eGate system. Our work contributes towards social-technical deliberations on how to improve design and deploy of digital health-screening systems in hospitals. It specifically outlines a series of design recommendations for future health screening interventions, key considerations relevant to digital screening control systems and their implementation, and the plausible effects on the staff who work alongside them.
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Affiliation(s)
- Soojeong Yoo
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, London W1W 7TY, UK
| | - Natalia Gulbransen-Diaz
- School of Architecture, Planning and Design, The University of Sydney, Sydney, NSW 2006, Australia
| | - Callum Parker
- School of Architecture, Planning and Design, The University of Sydney, Sydney, NSW 2006, Australia
| | - Audrey P. Wang
- Biomedical Informatics and Digital Health, School of Medical Sciences, The University of Sydney, Sydney, NSW 2006, Australia
- DHI Laboratory, Research Education Network, Western Sydney Local Health District, Westmead Health Precinct, Westmead, NSW 2145, Australia
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18
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Humer E, Keil T, Stupp C, Schlee W, Wildner M, Heuschmann P, Winter M, Probst T, Pryss R. Associations of Country-Specific and Sociodemographic Factors With Self-Reported COVID-19-Related Symptoms: Multivariable Analysis of Data From the CoronaCheck Mobile Health Platform. JMIR Public Health Surveill 2023; 9:e40958. [PMID: 36515987 PMCID: PMC9901499 DOI: 10.2196/40958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 11/07/2022] [Accepted: 12/13/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The COVID-19 symptom-monitoring apps provide direct feedback to users about the suspected risk of infection with SARS-CoV-2 and advice on how to proceed to prevent the spread of the virus. We have developed the CoronaCheck mobile health (mHealth) platform, the first free app that provides easy access to valid information about the risk of infection with SARS-CoV-2 in English and German. Previous studies have suggested that the clinical characteristics of individuals infected with SARS-CoV-2 vary by age, gender, and viral variant; however, potential differences between countries have not been adequately studied. OBJECTIVE The aim of this study is to describe the characteristics of the users of the CoronaCheck mHealth platform and to determine country-specific and sociodemographic associations of COVID-19-related symptoms and previous contacts with individuals infected with COVID-19. METHODS Between April 8, 2020, and February 3, 2022, data on sociodemographic characteristics, symptoms, and reports of previous close contacts with individuals infected with COVID-19 were collected from CoronaCheck users in different countries. Multivariable logistic regression analyses were performed to examine whether self-reports of COVID-19-related symptoms and recent contact with a person infected with COVID-19 differed between countries (Germany, India, South Africa), gender identities, age groups, education, and calendar year. RESULTS Most app users (N=23,179) were from Germany (n=8116, 35.0%), India (n=6622, 28.6%), and South Africa (n=3705, 16.0%). Most data were collected in 2020 (n=19,723, 85.1%). In addition, 64% (n=14,842) of the users were male, 52.1% (n=12,077) were ≥30 years old, and 38.6% (n=8953) had an education level of more than 11 years of schooling. Headache, muscle pain, fever, loss of smell, loss of taste, and previous contacts with individuals infected with COVID-19 were reported more frequently by users in India (adjusted odds ratios [aORs] 1.3-8.3, 95% CI 1.2-9.2) and South Africa (aORs 1.1-2.6, 95% CI 1.0-3.0) than those in Germany. Cough, general weakness, sore throat, and shortness of breath were more frequently reported in India (aORs 1.3-2.6, 95% CI 1.2-2.9) compared to Germany. Gender-diverse users reported symptoms and contacts with confirmed COVID-19 cases more often compared to male users. CONCLUSIONS Patterns of self-reported COVID-19-related symptoms and awareness of a previous contact with individuals infected with COVID-19 seemed to differ between India, South Africa, and Germany, as well as by gender identity in these countries. Viral symptom-collecting apps, such as the CoronaCheck mHealth platform, may be promising tools for pandemics to support appropriate assessments. Future mHealth research on country-specific differences during a pandemic should aim to recruit representative samples.
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Affiliation(s)
- Elke Humer
- Department for Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, Krems, Austria
| | - Thomas Keil
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
- State Institute of Health, Bavarian Health and Food Safety Authority, Erlangen, Germany
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Carolin Stupp
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
- State Institute of Health, Bavarian Health and Food Safety Authority, Erlangen, Germany
| | - Winfried Schlee
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
- Eastern Switzerland University of Applied Sciences, St Gallen, Switzerland
| | - Manfred Wildner
- State Institute of Health, Bavarian Health and Food Safety Authority, Erlangen, Germany
- Pettenkofer School of Public Health, University of Munich, Munich, Germany
| | - Peter Heuschmann
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
- Clinical Trial Center Würzburg, University Hospital Würzburg, Würzburg, Germany
| | - Michael Winter
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Thomas Probst
- Department for Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, Krems, Austria
| | - Rüdiger Pryss
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
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19
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Brechbühl J, Ferreira F, Lopes AC, Corset E, Gilliand N, Broillet MC. Ocular Symptoms Associated with COVID-19 Are Correlated with the Expression Profile of Mouse SARS-CoV-2 Binding Sites. Viruses 2023; 15:354. [PMID: 36851565 PMCID: PMC9961464 DOI: 10.3390/v15020354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/19/2023] [Accepted: 01/24/2023] [Indexed: 01/28/2023] Open
Abstract
The COVID-19 pandemic has engendered significant scientific efforts in the understanding of its infectious agent SARS-CoV-2 and of its associated symptoms. A peculiar characteristic of this virus lies in its ability to challenge our senses, as its infection can lead to anosmia and ageusia. While ocular symptoms, such as conjunctivitis, optic neuritis or dry eyes, are also reported after viral infection, they have lower frequencies and severities, and their functional development is still elusive. Here, using combined technical approaches based on histological and gene profiling methods, we characterized the expression of SARS-CoV-2 binding sites (Ace2/Tmprss2) in the mouse eye. We found that ACE2 was ectopically expressed in subtissular ocular regions, such as in the optic nerve and in the Harderian/intraorbital lacrimal glands. Moreover, we observed an important variation of Ace2/Tmprss2 expression that is not only dependent on the age and sex of the animal, but also highly heterogenous between individuals. Our results thus give new insight into the expression of SARS-CoV-2 binding sites in the mouse eye and propose an interpretation of the human ocular-associated symptoms linked to SARS-CoV-2.
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Affiliation(s)
- Julien Brechbühl
- Department of Biomedical Sciences, Faculty of Biology and Medicine, University of Lausanne, Bugnon 27, CH-1011 Lausanne, Switzerland
| | | | | | | | | | - Marie-Christine Broillet
- Department of Biomedical Sciences, Faculty of Biology and Medicine, University of Lausanne, Bugnon 27, CH-1011 Lausanne, Switzerland
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20
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Dimou A. Areas of Uncertainty in SARS-CoV-2 Vaccination for Cancer Patients. Vaccines (Basel) 2022; 10:vaccines10122117. [PMID: 36560527 PMCID: PMC9784623 DOI: 10.3390/vaccines10122117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 11/13/2022] [Accepted: 12/01/2022] [Indexed: 12/14/2022] Open
Abstract
Early in the COVID-19 pandemic, it was recognized that infection with SARS-CoV-2 is associated with increased morbidity and mortality in patients with cancer; therefore, preventive vaccination in cancer survivors is expected to be particularly impactful. Heterogeneity in how a neoplastic disease diagnosis and treatment interferes with humoral and cellular immunity, however, poses a number of challenges in vaccination strategies. Herein, the available literature on the effectiveness of COVID-19 vaccines among patients with cancer is critically appraised under the lens of anti-neoplastic treatment optimization. The objective of this review is to highlight areas of uncertainty, where more research could inform future SARS-CoV-2 immunization programs and maximize benefits in the high-risk cancer survivor population, and also minimize cancer treatment deviations from standard practices.
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Affiliation(s)
- Anastasios Dimou
- Division of Medical Oncology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
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21
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Spatial modeling of vaccine deserts as barriers to controlling SARS-CoV-2. COMMUNICATIONS MEDICINE 2022; 2:141. [DOI: 10.1038/s43856-022-00183-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 09/07/2022] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
COVID-19 vaccine distribution is at risk of further propagating the inequities of COVID-19, which in the United States (US) has disproportionately impacted the elderly, people of color, and the medically vulnerable. We sought to measure if the disparities seen in the geographic distribution of other COVID-19 healthcare resources were also present during the initial rollout of the COVID-19 vaccine.
Methods
Using a comprehensive COVID-19 vaccine database (VaccineFinder), we built an empirically parameterized spatial model of access to essential resources that incorporated vaccine supply, time-willing-to-travel for vaccination, and previous vaccination across the US. We then identified vaccine deserts—US Census tracts with localized, geographic barriers to vaccine-associated herd immunity. We link our model results with Census data and two high-resolution surveys to understand the distribution and determinates of spatially accessibility to the COVID-19 vaccine.
Results
We find that in early 2021, vaccine deserts were home to over 30 million people, >10% of the US population. Vaccine deserts were concentrated in rural locations and communities with a higher percentage of medically vulnerable populations. We also find that in locations of similar urbanicity, early vaccination distribution disadvantaged neighborhoods with more people of color and older aged residents.
Conclusion
Given sufficient vaccine supply, data-driven vaccine distribution to vaccine deserts may improve immunization rates and help control COVID-19.
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22
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Fagherazzi G, Zhang L, Elbéji A, Higa E, Despotovic V, Ollert M, Aguayo GA, Nazarov PV, Fischer A. A voice-based biomarker for monitoring symptom resolution in adults with COVID-19: Findings from the prospective Predi-COVID cohort study. PLOS DIGITAL HEALTH 2022; 1:e0000112. [PMID: 36812535 PMCID: PMC9931359 DOI: 10.1371/journal.pdig.0000112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 08/26/2022] [Indexed: 11/06/2022]
Abstract
People with COVID-19 can experience impairing symptoms that require enhanced surveillance. Our objective was to train an artificial intelligence-based model to predict the presence of COVID-19 symptoms and derive a digital vocal biomarker for easily and quantitatively monitoring symptom resolution. We used data from 272 participants in the prospective Predi-COVID cohort study recruited between May 2020 and May 2021. A total of 6473 voice features were derived from recordings of participants reading a standardized pre-specified text. Models were trained separately for Android devices and iOS devices. A binary outcome (symptomatic versus asymptomatic) was considered, based on a list of 14 frequent COVID-19 related symptoms. A total of 1775 audio recordings were analyzed (6.5 recordings per participant on average), including 1049 corresponding to symptomatic cases and 726 to asymptomatic ones. The best performances were obtained from Support Vector Machine models for both audio formats. We observed an elevated predictive capacity for both Android (AUC = 0.92, balanced accuracy = 0.83) and iOS (AUC = 0.85, balanced accuracy = 0.77) as well as low Brier scores (0.11 and 0.16 respectively for Android and iOS when assessing calibration. The vocal biomarker derived from the predictive models accurately discriminated asymptomatic from symptomatic individuals with COVID-19 (t-test P-values<0.001). In this prospective cohort study, we have demonstrated that using a simple, reproducible task of reading a standardized pre-specified text of 25 seconds enabled us to derive a vocal biomarker for monitoring the resolution of COVID-19 related symptoms with high accuracy and calibration.
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Affiliation(s)
- Guy Fagherazzi
- Deep Digital Phenotyping Research Unit. Department of Precision Health, Luxembourg Institute of Health, 1 A-B rue Thomas Edison, L-1445 Strassen, Luxembourg
- * E-mail:
| | - Lu Zhang
- Bioinformatics Platform, Luxembourg Institute of Health, 1A-B, rue Thomas Edison, L-1445 Strassen, Luxembourg
| | - Abir Elbéji
- Deep Digital Phenotyping Research Unit. Department of Precision Health, Luxembourg Institute of Health, 1 A-B rue Thomas Edison, L-1445 Strassen, Luxembourg
| | - Eduardo Higa
- Deep Digital Phenotyping Research Unit. Department of Precision Health, Luxembourg Institute of Health, 1 A-B rue Thomas Edison, L-1445 Strassen, Luxembourg
| | - Vladimir Despotovic
- Department of Computer Science, Faculty of Science, Technology and Medicine, University of Luxembourg, Avenue de la Fonte 6, L-4364 Esch-sur-Alzette, Luxembourg
| | - Markus Ollert
- Department of Infection and Immunity, Luxembourg Institute of Health, 29, Rue Henri Koch, L-4354 Esch-sur-Alzette, Luxembourg
- Department of Dermatology and Allergy Center, Odense Research Center for Anaphylaxis, University of Southern Denmark, 5000 Odense, Denmark
| | - Gloria A. Aguayo
- Deep Digital Phenotyping Research Unit. Department of Precision Health, Luxembourg Institute of Health, 1 A-B rue Thomas Edison, L-1445 Strassen, Luxembourg
| | - Petr V. Nazarov
- Bioinformatics Platform, Luxembourg Institute of Health, 1A-B, rue Thomas Edison, L-1445 Strassen, Luxembourg
- Multiomics Data Science, Luxembourg Institute of Health, 1A-B, rue Thomas Edison, L-1445 Strassen, Luxembourg
| | - Aurélie Fischer
- Deep Digital Phenotyping Research Unit. Department of Precision Health, Luxembourg Institute of Health, 1 A-B rue Thomas Edison, L-1445 Strassen, Luxembourg
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23
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Neukam K, Lucero A, Gutiérrez-Valencia A, Amaya L, Echegoyen N, Martelli A, Videla C, Di Lello FA, Martínez AP. Point-of-care detection of SARS-CoV-2 antigen among symptomatic vs. asymptomatic persons: Testing for COVID-19 vs. infectivity. Front Public Health 2022; 10:995249. [PMID: 36324442 PMCID: PMC9619045 DOI: 10.3389/fpubh.2022.995249] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 09/12/2022] [Indexed: 01/26/2023] Open
Abstract
Background Management of the coronavirus disease 2019 (COVID-19) pandemic caused by a novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) requires rapid and simple methods to detect COVID-19 patients and identify potential infectors. This study aimed to evaluate the utility of a point-of-care (PoC) rapid antigen diagnostic test (Ag-RDT) in these settings. Patients and methods Individuals who consecutively presented for SARS-CoV-2 testing at a tertiary care center in Buenos Aires, Argentina, underwent PoC Ag-RDT testing and real-time RT-PCR (qRT-PCR) on the same day during June 2021. Results Of 584 included subjects, 108 (18.5%) were symptomatic for COVID-19 while the remaining presented for miscellaneous reasons unrelated to possible or confirmed contact with a SARS-CoV-2-infected individual. A positive Ag-RDT result was obtained in 26 (24.1%) symptomatic and 7 (1.5%) asymptomatic persons (p < 0.001), which was concordant with qRT-PCR in 105/108 [97.2%, Cohen's kappa coefficient (κ) = 0.927] symptomatic and 467/476 (98.1% κ = 0.563) asymptomatic participants, with a positive percentage agreement (PPA; 95% confidence interval) of 89.7% (71.5-97.3%) and 42.9% (18.8-70.4%), respectively. None of the 11 false-negative diagnoses showed a Ct-value ≤20. Considering only failures with a Ct-value below 31 as hypothetical infectivity threshold of 105 SARS-CoV-2 RNA copies/mL, concordance was observed in 98.1% (κ = 0.746) in the asymptomatic population, accounting for a PPA of 66.7% (30.9-91%). Conclusions PoC Ag-RDT accurately detected active SARS-CoV-2 infection and showed acceptable diagnostic performance in asymptomatic persons potentially spreading infectious virus. Ag-RDT may therefore be useful to slow down or stop transmission by enabling adequate decisions on isolation at a public health level.
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Affiliation(s)
- Karin Neukam
- Unit of Infectious Diseases, Microbiology and Preventive Medicine, Virgen del Rocío University Hospital, Seville, Spain,Instituto de Biomedicina de Sevilla, University of Seville, Consejo Superior de Investigaciones Científicas (CSIC), Seville, Spain,*Correspondence: Karin Neukam
| | - Alicia Lucero
- Virology Section, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno “CEMIC”, Buenos Aires, Argentina
| | - Alicia Gutiérrez-Valencia
- Unit of Infectious Diseases, Microbiology and Preventive Medicine, Virgen del Rocío University Hospital, Seville, Spain,Instituto de Biomedicina de Sevilla, University of Seville, Consejo Superior de Investigaciones Científicas (CSIC), Seville, Spain
| | - Lucas Amaya
- Virology Section, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno “CEMIC”, Buenos Aires, Argentina
| | - Natalia Echegoyen
- Virology Section, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno “CEMIC”, Buenos Aires, Argentina
| | - Antonella Martelli
- Virology Section, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno “CEMIC”, Buenos Aires, Argentina
| | - Cristina Videla
- Virology Section, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno “CEMIC”, Buenos Aires, Argentina
| | - Federico A. Di Lello
- Facultad de Farmacia y Bioquímica, Instituto de Investigaciones en Bacteriología y Virología Molecular (IBaViM), Universidad de Buenos Aires, Buenos Aires, Argentina,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina,Federico A. Di Lello
| | - Alfredo P. Martínez
- Virology Section, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno “CEMIC”, Buenos Aires, Argentina
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24
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Mustafin RN, Kazantseva AV, Kovas YV, Khusnutdinova EK. Role Of Retroelements In The Development Of COVID-19 Neurological Consequences. RUSSIAN OPEN MEDICAL JOURNAL 2022. [DOI: 10.15275/rusomj.2022.0313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Retroelements play a key role in brain functioning in humans and other animals, since they represent dynamic regulatory elements controlling the expression of specific neuron types. The activity of retroelements in the brain is impaired under the influence of SARS-CoV-2, penetrating the blood-brain barrier. We propose a new concept, according to which the neurological complications of COVID-19 and their long-term effects are caused by modified expression of retroelements in neurons due to viral effect. This effect is implemented in several ways: a direct effect of the virus on the promoter regions of retroelement-encoding genes, virus interaction with miRNAs causing silencing of transposons, and an effect of the viral RNA on the products of retroelement transcription. Aging-related physiological activation of retroelements in the elderly is responsible for more severe course of COVID-19. The associations of multiple sclerosis, Parkinson’s disease, Guillain-Barré syndrome, acute disseminated encephalomyelitis with coronavirus lesions also indicate the role of retroelements in such complications, because retroelements are involved in the mechanisms of the development of these diseases. According to meta-analyses, COVID-19-caused neurological complications ranged 36.4-73%. The neuropsychiatric consequences of COVID-19 are observed in patients over a long period after recovery, and their prevalence may exceed those during the acute phase of the disease. Even 12 months after recovery, unmotivated fatigue, headache, mental disorders, and neurocognitive impairment were observed in 82%, 60%, 26.2-45%, and 16.2-46.8% of patients, correspondingly. These manifestations are explained by the role of retroelements in the integration of SARS-CoV-2 into the human genome using their reverse transcriptase and endonuclease, which results in a long-term viral persistence. The research on the role of specific retroelements in these changes can become the basis for developing targeted therapy for neurological consequences of COVID-19 using miRNAs, since epigenetic changes in the functioning of the genome in neurons, affected by transposons, are reversible.
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Affiliation(s)
| | - Anastasiya V. Kazantseva
- Ufa Federal Research Center of the Russian Academy of Sciences; Bashkir State University, Ufa, Russia
| | - Yulia V. Kovas
- Bashkir State University, Ufa, Russia;University of London, London, Great Britain
| | - Elza K. Khusnutdinova
- Academy of Sciences of the Republic of Bashkortostan; Russian Academy of Education; Ufa Federal Research Center, Russian Academy of Sciences, Ufa, Russia
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25
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Avnat E, Shapira G, Gurwitz D, Shomron N. Elevated Expression of RGS2 May Underlie Reduced Olfaction in COVID-19 Patients. J Pers Med 2022; 12:jpm12091396. [PMID: 36143181 PMCID: PMC9504192 DOI: 10.3390/jpm12091396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/15/2022] [Accepted: 08/25/2022] [Indexed: 12/03/2022] Open
Abstract
Anosmia is common in COVID-19 patients, lasting for weeks or months following recovery. The biological mechanism underlying olfactory deficiency in COVID-19 does not involve direct damage to nasal olfactory neurons, which do not express the proteins required for SARS-CoV-2 infection. A recent study suggested that anosmia results from downregulation of olfactory receptors. We hypothesized that anosmia in COVID-19 may also reflect SARS-CoV-2 infection-driven elevated expression of regulator of G protein signaling 2 (RGS2), a key regulator of odorant receptors, thereby silencing their signaling. To test our hypothesis, we analyzed gene expression of nasopharyngeal swabs from SARS-CoV-2 positive patients and non-infected controls (two published RNA-sequencing datasets, 580 individuals). Our analysis found upregulated RGS2 expression in SARS-CoV-2 positive patients (FC = 14.5, Padj = 1.69 × 10−5 and FC = 2.4; Padj = 0.001, per dataset). Additionally, RGS2 expression was strongly correlated with PTGS2, IL1B, CXCL8, NAMPT and other inflammation markers with substantial upregulation in early infection. These observations suggest that upregulated expression of RGS2 may underlie anosmia in COVID-19 patients. As a regulator of numerous G-protein coupled receptors, RGS2 may drive further neurological symptoms of COVID-19. Studies are required for clarifying the cellular mechanisms by which SARS-CoV-2 infection drives the upregulation of RGS2 and other genes implicated in inflammation. Insights on these pathway(s) may assist in understanding anosmia and additional neurological symptoms reported in COVID-19 patients.
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Affiliation(s)
- Eden Avnat
- Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Guy Shapira
- Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
- Edmond J Safra Center for Bioinformatics, Tel Aviv University, Tel Aviv 69978, Israel
| | - David Gurwitz
- Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 69978, Israel
- Correspondence: (D.G.); (N.S.); Tel.: +972-3-640-7611 (D.G.); +972-3-640-6594 (N.S.)
| | - Noam Shomron
- Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
- Edmond J Safra Center for Bioinformatics, Tel Aviv University, Tel Aviv 69978, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 69978, Israel
- Correspondence: (D.G.); (N.S.); Tel.: +972-3-640-7611 (D.G.); +972-3-640-6594 (N.S.)
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Hao M, Wang D, Xia Q, Kan S, Chang L, Liu H, Yang Z, Liu W. Pathogenic Mechanism and Multi-omics Analysis of Oral Manifestations in COVID-19. Front Immunol 2022; 13:879792. [PMID: 35860279 PMCID: PMC9290522 DOI: 10.3389/fimmu.2022.879792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 06/10/2022] [Indexed: 11/16/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a respiratory infectious disease that seriously threatens human life. The clinical manifestations of severe COVID-19 include acute respiratory distress syndrome and multiple organ failure. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causal agent of COVID-19, spreads through contaminated droplets. SARS-CoV-2 particles have been detected in the saliva of COVID-19 patients, implying that the virus can infect and damage the oral cavity. The oral manifestations of COVID-19 include xerostomia and gustatory dysfunction. Numerous studies showed that the four structural proteins of SARS-CoV-2 are its potential pathogenic factors, especially the S protein, which binds to human ACE2 receptors facilitating the entry of the virus into the host cells. Usually, upon entry into the host cell, a pathogen triggers the host’s immune response. However, a mount of multi-omics and immunological analyses revealed that COVID-19 is caused by immune dysregulation. A decrease in the number and phenotypes of immune cells, IFN-1 production and excessive release of certain cytokines have also been reported. In conclusion, this review summarizes the oral manifestations of COVID-19 and multi-omics analysis of SARS-CoV-2 infection.
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Affiliation(s)
- Ming Hao
- Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Jilin University, Changchun, China
| | - Dongxu Wang
- Laboratory Animal Center, College of Animal Science, Jilin University, Changchun, China
| | - Qianyun Xia
- Laboratory Animal Center, College of Animal Science, Jilin University, Changchun, China
| | - Shaoning Kan
- Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Jilin University, Changchun, China
| | - Lu Chang
- Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Jilin University, Changchun, China
| | - Huimin Liu
- Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Jilin University, Changchun, China
| | - Zhijing Yang
- Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Jilin University, Changchun, China
| | - Weiwei Liu
- Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Jilin University, Changchun, China
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Hospital of Stomatology, Jilin University, Changchun, China
- *Correspondence: Weiwei Liu,
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Kuhn KG, Khadka K, Adesigbin K, Altidort B, Boyina K, Withers E, Maytubby P, Wendelboe A. Characterization of persons with reported SARS-CoV-2 infection in the Oklahoma City tri-county area: Evidence from the first 12 months of transmission. Am J Infect Control 2022; 50:729-734. [PMID: 35292299 PMCID: PMC8917874 DOI: 10.1016/j.ajic.2022.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 03/05/2022] [Accepted: 03/05/2022] [Indexed: 11/18/2022]
Abstract
Background To describe characteristics, hospitalization, and death for reported cases of SARS-CoV-2 infection in the Oklahoma City tri-county area. Methods We extracted notified cases of SARS-CoV-2 infection for our study area and used descriptive statistics and modeling to examine case characteristics and calculate the odds of hospitalization and death in relation to a range of explanatory variables. Results Between March 12th, 2020 and February 28th, 2021, 124,925 cases of SARS-CoV-2 infection were reported from the study region. Being male, White or Black/African American, aged 50 years or older, presenting with apnea, cough, and shortness of breath, and having diabetes was associated with increased odds of hospitalization. The odds of dying were significantly associated with being Black/African American, presenting with cough and fever, having kidney disease and diabetes and being aged 70 years or older. Conclusions The first cohort analysis of SARS-CoV-2 positive individuals in the Oklahoma City tri-county area confirms comorbidities and age as important predictors of COVID-19 hospitalization or death. As a novel aspect, we show that early symptoms of breathing difficulties in particular are associated with hospitalization and death. Initial case assessment and SARS-CoV-2 guidelines should continue to focus on age, comorbidities, and early symptoms.
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Affiliation(s)
- Katrin Gaardbo Kuhn
- Department of Biostatistics & Epidemiology, Hudson College of Public Health, Oklahoma University Health Sciences Center, Oklahoma City, OK.
| | - Kapil Khadka
- Oklahoma City-County Health Department, Oklahoma City, OK
| | | | | | - Kavya Boyina
- Department of Biostatistics & Epidemiology, Hudson College of Public Health, Oklahoma University Health Sciences Center, Oklahoma City, OK
| | - Eddie Withers
- Oklahoma City-County Health Department, Oklahoma City, OK
| | - Phil Maytubby
- Oklahoma City-County Health Department, Oklahoma City, OK
| | - Aaron Wendelboe
- Department of Biostatistics & Epidemiology, Hudson College of Public Health, Oklahoma University Health Sciences Center, Oklahoma City, OK
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Consolazio D, Murtas R, Tunesi S, Lamberti A, Senatore S, Faccini M, Russo AG. A Comparison Between Omicron and Earlier COVID-19 Variants' Disease Severity in the Milan Area, Italy. FRONTIERS IN EPIDEMIOLOGY 2022; 2:891162. [PMID: 38455311 PMCID: PMC10910966 DOI: 10.3389/fepid.2022.891162] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 05/16/2022] [Indexed: 03/09/2024]
Abstract
Background In the context of the fourth wave of the COVID-19 pandemic in Italy, which occurred in correspondence with the outbreak of the Omicron variant, it became fundamental to assess differences in the risk of severe disease between the Omicron variant and the earlier SARS-CoV-2 variants that were still in circulation despite Omicron becoming prevalent. Methods We collected data on 2,267 genotyped PCR-positive swab tests and assessed whether the presence of symptoms, risk of hospitalization, and recovery times were significantly different between Omicron and the earlier variants. Multivariable models adjusted for sex, age class, citizenship, comorbidities, and symptomatology allowed assessing the difference in outcomes between Omicron and the earlier variants according to vaccination status and timing of administration. Results Compared to the earlier variants in the same period, Omicron was less symptomatic, resulted in fewer hospital admissions for those who were unvaccinated and for those who were already immunized after the booster dose, and was associated with quicker recovery, yet not in subjects with three vaccination doses. Conclusion Despite being milder, Omicron's higher transmissibility and vaccine resistance should not lead to underrating its damage potential, especially with regard to hospital and health service saturation.
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Affiliation(s)
- David Consolazio
- Epidemiology Unit, Agency for Health Protection of the Metropolitan City of Milan, Milan, Italy
- Department of Sociology and Social Research, University of Milan-Bicocca, Milan, Italy
| | - Rossella Murtas
- Epidemiology Unit, Agency for Health Protection of the Metropolitan City of Milan, Milan, Italy
| | - Sara Tunesi
- Epidemiology Unit, Agency for Health Protection of the Metropolitan City of Milan, Milan, Italy
| | - Anna Lamberti
- Preventive Medicine - Infectious Diseases Unit, Agency for Health Protection of the Metropolitan City of Milan, Milan, Italy
| | - Sabrina Senatore
- Preventive Medicine - Infectious Diseases Unit, Agency for Health Protection of the Metropolitan City of Milan, Milan, Italy
| | - Marino Faccini
- Preventive Medicine - Infectious Diseases Unit, Agency for Health Protection of the Metropolitan City of Milan, Milan, Italy
| | - Antonio Giampiero Russo
- Epidemiology Unit, Agency for Health Protection of the Metropolitan City of Milan, Milan, Italy
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Smartphone apps in the COVID-19 pandemic. Nat Biotechnol 2022; 40:1013-1022. [PMID: 35726090 DOI: 10.1038/s41587-022-01350-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 05/04/2022] [Indexed: 01/08/2023]
Abstract
At the beginning of the COVID-19 pandemic, analog tools such as nasopharyngeal swabs for PCR tests were center stage and the major prevention tactics of masking and physical distancing were a throwback to the 1918 influenza pandemic. Overall, there has been scant regard for digital tools, particularly those based on smartphone apps, which is surprising given the ubiquity of smartphones across the globe. Smartphone apps, given accessibility in the time of physical distancing, were widely used for tracking, tracing and educating the public about COVID-19. Despite limitations, such as concerns around data privacy, data security, digital health illiteracy and structural inequities, there is ample evidence that apps are beneficial for understanding outbreak epidemiology, individual screening and contact tracing. While there were successes and failures in each category, outbreak epidemiology and individual screening were substantially enhanced by the reach of smartphone apps and accessory wearables. Continued use of apps within the digital infrastructure promises to provide an important tool for rigorous investigation of outcomes both in the ongoing outbreak and in future epidemics.
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Hu W, Chen N, Yan W, Pei P, Wei Y, Zhan X. Knowledge Mapping of Olfactory Dysfunction: A Bibliometric Study. Front Syst Neurosci 2022; 16:904982. [PMID: 35770245 PMCID: PMC9234575 DOI: 10.3389/fnsys.2022.904982] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 05/18/2022] [Indexed: 12/13/2022] Open
Abstract
Background Olfaction is one of the five basic senses of human beings. As such, olfactory dysfunction seriously affects patients' quality of life and can even endanger them. In recent years, olfactory dysfunction has attracted greater research interest, and numerous studies have been published on olfactory dysfunction. However, there are few studies on olfactory dysfunction through bibliometric analysis. This study aims to describe the current situation and identify the foci and potential new research directions of olfactory dysfunction using a bibliometric approach. Methods Articles related to olfactory dysfunction published from 2002 to 2021 were located in the Web of Science Core Collection of Clarivate Analytics (London, UK). Bibliometric analyses were conducted with the CiteSpace (Chaomei Chen, Drexel University, Philadelphia, PA, USA) and VOSviewer (Center for Science and Technology Studies, Leiden University, Leiden, Netherlands) software programs. Results The number of articles published each year showed an upward trend, especially in 2020, where a sharp increase had occurred due to the coronavirus disease 2019 (COVID-19) pandemic. The United States was the country with the most publications and the strongest international cooperation. In terms of institutions, the greatest number of publications from a single institution came from Dresden University of Technology. Thomas Hummel was the author who had contributed the most articles. An analysis of co-citation networks and burst keywords in the field revealed a shift from “gonadotropin-releasing hormone” and “apoptosis” earlier on to “olfactory training,” “COVID-19,” and “Parkinson's disease” more recently. “Outcome,” “COVID-19,” “infection,” and “pathogenesis” are topics of the research frontier and hotspots. Conclusion More attention has been paid to olfactory dysfunction as the understanding of it has improved in the past 20 years. This study provides researchers with an objective, systematic, and comprehensive analysis of the literature on olfactory dysfunction. The current frontier areas and hotspots in the field focus on the pathological mechanisms of olfactory dysfunction after infection with COVID-19 and its different prognoses. The pathophysiological mechanism of olfactory dysfunction in neurodegenerative diseases and COVID-19 will be a primary future research direction.
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Affiliation(s)
- Wen Hu
- Department of Otolaryngology, Smell and Taste Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Na Chen
- Department of Otolaryngology, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Weiheng Yan
- Department of Otorhinolaryngology Head and Neck Surgery, Children's Hospital, Capital Institute of Pediatrics, Beijing, China
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Pei Pei
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Beijing, China
| | - Yongxiang Wei
- Department of Otolaryngology, Smell and Taste Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Department of Otorhinolaryngology Head and Neck Surgery, Children's Hospital, Capital Institute of Pediatrics, Beijing, China
- *Correspondence: Yongxiang Wei
| | - Xiaojun Zhan
- Department of Otorhinolaryngology Head and Neck Surgery, Children's Hospital, Capital Institute of Pediatrics, Beijing, China
- Xiaojun Zhan
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Olfactory Dysfunction in COVID-19: Pathology and Long-Term Implications for Brain Health. Trends Mol Med 2022; 28:781-794. [PMID: 35810128 PMCID: PMC9212891 DOI: 10.1016/j.molmed.2022.06.005] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 06/09/2022] [Accepted: 06/13/2022] [Indexed: 11/24/2022]
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COVID-19 Induced Taste Dysfunction and Recovery: Association with Smell Dysfunction and Oral Health Behaviour. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58060715. [PMID: 35743978 PMCID: PMC9231283 DOI: 10.3390/medicina58060715] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/20/2022] [Accepted: 05/23/2022] [Indexed: 11/17/2022]
Abstract
Background and Objectives: Disruption to taste and smell are common symptoms of COVID-19 infection. The current literature overlooks taste symptoms and tends to focus on the sense of smell. Persisting cases (>28 days) of taste dysfunction are increasingly recognised as a major future healthcare challenge. This study focuses on the severity and recovery of COVID-19 induced taste loss and association with olfactory symptoms, lifestyle and oral health factors. Materials and Methods: This study was a cross-sectional survey comparing 182 rapid taste recovery participants (≤28 days) with 47 participants with prolonged taste recovery >28 days. Analyses of taste loss in association with smell loss, age, sex, illness severity, diet, BMI, vitamin-D supplementation, antidepressants, alcohol use, smoking, brushing frequency, flossing, missing teeth, appliances and number of dental restorations were conducted. Differences in the severity of the loss of sour, sweet, salt, bitter and umami tastes were explored. Results: Both the severity and the duration of taste and smell loss were closely correlated (p < 0.001). Salt taste was significantly less affected than all other taste qualities (p < 0.001). Persisting taste loss was associated with older age (mean ± 95% CI = 31.73 ± 1.23 years vs. 36.66 ± 3.59 years, p < 0.001) and reduced likelihood of using floss (odds ratio ± 95% CI = 2.22 (1.15−4.25), p = 0.047). Conclusions: Smell and taste loss in COVID-19 are closely related, although a minority of individuals can experience taste or smell dysfunction in the absence of the other. The taste of salt may be less severely affected than other taste qualities and future work exploring this finding objectively is indicated. The association of flossing with rapid taste recovery adds to the growing evidence of a link between good periodontal health and favourable COVID-19 outcomes.
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Lee B, Ashcroft T, Agyei-Manu E, Farfan de los Godos E, Leow A, Krishan P, Kulkarni D, Nundy M, Hartnup K, Shi T, McSwiggan E, Nair H, Theodoratou E, McQuillan R. Clinical features of COVID-19 for integration of COVID-19 into influenza surveillance: A systematic review. J Glob Health 2022; 12:05012. [PMID: 35567582 PMCID: PMC9107308 DOI: 10.7189/jogh.12.05012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background In November 2020, the World Health Organization (WHO) created interim guidance on how to integrate testing for SARS-CoV-2 into existing influenza surveillance systems. Influenza-like illness (ILI) and severe acute respiratory illness (SARI) case definitions have been used to specify the case definition of COVID-19 for surveillance purposes. This review aims to assess whether the common clinical features of COVID-19 have changed to the point that the criteria used to identify both COVID-19 and influenza in surveillance programs needs to be altered. Methods A systematic review of reviews following PRISMA-P guidelines was conducted using the "COVID-19 evidence review" database from August 19, 2020, to August 19, 2021. Reviews providing pooled estimates of the prevalence of clinical features of COVID-19 within the general population, diagnosed by polymerase chain reaction or rapid diagnostic test, were included. These were critically appraised and sensitivity analysis was undertaken to examine potential causes of bias. Results Fourteen reviews were identified, including three on adults only and three on children only. For all reviews, combined fever (median prevalence = 73.0%, IQR = 58.3-78.7) and cough (45.1%, IQR = 28.9-54.0) were the most common features. These were followed by loss of taste or smell (45.1%, IQR = 28.9-54.0), hypoxemia (33%, one review), fatigue (26.4%, IQR = 9.0-39.4) and expectoration (23.9%, IQR = 23.3-25.5). Fever and cough continued to be the most prevalent features for adults and children, with subsequent symptoms being similar for adults only. However, the pattern differed for children, with headache (34.3%, IQR = 18-50.7) and nasal congestion (20%, one review) being the third and fourth commonest symptoms. Conclusions The prevalent features found in this recent review were the same as the ones identified at the beginning of the pandemic. Therefore, the current approach of using the ILI and SARI criteria which incorporate fever and cough will identify COVID-19 cases in addition to influenza. Interestingly, children may present with different features, as headaches and nasal congestion were more common in this group. Future research could examine this further and investigate whether symptomology changes with new variants of COVID-19.
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Affiliation(s)
- Bohee Lee
- Centre for Population Health Sciences, Usher Institute, University of Edinburgh, Edinburgh, Scotland, UK
- Asthma UK Centre for Applied Research, University of Edinburgh, Edinburgh, Scotland UK
| | - Thulani Ashcroft
- Centre for Population Health Sciences, Usher Institute, University of Edinburgh, Edinburgh, Scotland, UK
| | - Eldad Agyei-Manu
- Centre for Population Health Sciences, Usher Institute, University of Edinburgh, Edinburgh, Scotland, UK
| | - Emma Farfan de los Godos
- Centre for Population Health Sciences, Usher Institute, University of Edinburgh, Edinburgh, Scotland, UK
- Asthma UK Centre for Applied Research, University of Edinburgh, Edinburgh, Scotland UK
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, Scotland, UK
- Cancer Research UK Edinburgh Centre, MRC Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, Scotland, UK
| | - Amanda Leow
- Centre for Population Health Sciences, Usher Institute, University of Edinburgh, Edinburgh, Scotland, UK
| | - Prerna Krishan
- Centre for Population Health Sciences, Usher Institute, University of Edinburgh, Edinburgh, Scotland, UK
| | - Durga Kulkarni
- Centre for Population Health Sciences, Usher Institute, University of Edinburgh, Edinburgh, Scotland, UK
| | - Madhurima Nundy
- Centre for Population Health Sciences, Usher Institute, University of Edinburgh, Edinburgh, Scotland, UK
| | - Karen Hartnup
- Centre for Population Health Sciences, Usher Institute, University of Edinburgh, Edinburgh, Scotland, UK
| | - Ting Shi
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, Scotland, UK
| | - Emilie McSwiggan
- Centre for Population Health Sciences, Usher Institute, University of Edinburgh, Edinburgh, Scotland, UK
| | - Harish Nair
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, Scotland, UK
| | - Evropi Theodoratou
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, Scotland, UK
- Cancer Research UK Edinburgh Centre, MRC Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, Scotland, UK
| | - Ruth McQuillan
- Centre for Population Health Sciences, Usher Institute, University of Edinburgh, Edinburgh, Scotland, UK
| | - the Usher Network for COVID-19 Evidence Reviews (UNCOVER) group
- Centre for Population Health Sciences, Usher Institute, University of Edinburgh, Edinburgh, Scotland, UK
- Asthma UK Centre for Applied Research, University of Edinburgh, Edinburgh, Scotland UK
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, Scotland, UK
- Cancer Research UK Edinburgh Centre, MRC Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, Scotland, UK
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Triyono EA, Seipalla F, Djaja N, Akbas AMI, Ar-Rahmah KA, Budiono PS, Pamungkas AP, Fernanda Y, Jam'Annuri A, Maheswari CA. Clinical characteristics of patients with COVID-19 admitted to the COVID-19 Emergency Field Hospital of Bangkalan, Indonesia. F1000Res 2022; 11:414. [PMID: 36249995 PMCID: PMC9490276 DOI: 10.12688/f1000research.110716.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/21/2022] [Indexed: 09/05/2024] Open
Abstract
Background: Following the surge of coronavirus disease 2019 (COVID-19) cases in the epicenter of East Java Province, this study aimed to determine the clinical characteristics of patients with COVID-19 at one of the emergency field hospitals in Indonesia. Methods: This was a single-centered, retrospective descriptive study of 763 patients admitted to the COVID-19 Emergency Field Hospital of Bangkalan from July 5 2021 to September 30 2021. The demographic data, clinical signs and symptoms, pre-existing comorbidities, therapy, and clinical outcomes of the patients were analyzed using SPSS. Results: The clinical characteristics of patients with COVID-19 at the emergency hospital were varied. A total of 763 patients were included. The most common age was between 40 and 49 years (31.1%), a slight majority were women (51.5%), and most had travelled abroad in the last 14 days (99.1%). Of the 763 patients, 70.9% had no comorbidities. Half of the patients were asymptomatic (49.4%), 46% were mild cases, 4.1% were moderate, and 0.5% severe. The most common symptoms were productive cough (15.7%) and headache (15.3%). Supportive and comorbidity therapy were given which showed excellent clinical outcomes. Conclusions: The majority of COVID-19 patients were asymptomatic, female, middle aged and had recently been overseas. Therapy without antibiotics or antivirals showed positive outcomes in COVID-19 patients.
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Affiliation(s)
- Erwin Astha Triyono
- COVID-19 Emergency Field Hospital of Bangkalan, Bangkalan, East Java Province, 69112, Indonesia
- Department of Internal Medicine, Faculty of Medicine-Dr. Soetomo Teaching Hospital Universitas Airlangga,, Surabaya, East Java Province, 60286, Indonesia
| | - Fenska Seipalla
- COVID-19 Emergency Field Hospital of Bangkalan, Bangkalan, East Java Province, 69112, Indonesia
| | - Nathania Djaja
- COVID-19 Emergency Field Hospital of Bangkalan, Bangkalan, East Java Province, 69112, Indonesia
| | | | | | | | - Aditya Putra Pamungkas
- COVID-19 Emergency Field Hospital of Bangkalan, Bangkalan, East Java Province, 69112, Indonesia
| | - Yussika Fernanda
- COVID-19 Emergency Field Hospital of Bangkalan, Bangkalan, East Java Province, 69112, Indonesia
| | - Alfin Jam'Annuri
- COVID-19 Emergency Field Hospital of Bangkalan, Bangkalan, East Java Province, 69112, Indonesia
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Triyono EA, Seipalla F, Djaja N, Akbas AMI, Ar-Rahmah KA, Budiono PS, Pamungkas AP, Fernanda Y, Jam'Annuri A, Maheswari CA. Clinical characteristics of patients with COVID-19 admitted to the COVID-19 Emergency Field Hospital of Bangkalan, Indonesia. F1000Res 2022; 11:414. [PMID: 36249995 PMCID: PMC9490276 DOI: 10.12688/f1000research.110716.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/22/2022] [Indexed: 01/08/2023] Open
Abstract
Background: Following the surge of coronavirus disease 2019 (COVID-19) cases in the epicenter of East Java Province, this study aimed to determine the clinical characteristics of patients with COVID-19 at one of the emergency field hospitals in Indonesia. Methods: This was a single-centered, retrospective descriptive study of 763 patients admitted to the COVID-19 Emergency Field Hospital of Bangkalan from July 5 2021 to September 30 2021. The demographic data, clinical signs and symptoms, pre-existing comorbidities, therapy, and clinical outcomes of the patients were analyzed using SPSS. Results: The clinical characteristics of patients with COVID-19 at the emergency hospital were varied. A total of 763 patients were included. The most common age was between 40 and 49 years (31.1%), a slight majority were women (51.5%), and most had travelled abroad in the last 14 days (99.1%). Of the 763 patients, 70.9% had no comorbidities. Half of the patients were asymptomatic (49.4%), 46% were mild cases, 4.1% were moderate, and 0.5% severe. The most common symptoms were productive cough (15.7%) and headache (15.3%). Supportive and comorbidity therapy were given which showed excellent clinical outcomes. Conclusions: This study presents the description of the clinical characteristics of COVID-19 patients during high surge cases of COVID-19 that are mostly dominated by Indonesian migrant workers in a field hospital. majority of COVID-19 patients were asymptomatic and therapy without antibiotics or antivirals showed positive outcomes in COVID-19 patients.
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Affiliation(s)
- Erwin Astha Triyono
- COVID-19 Emergency Field Hospital of Bangkalan, Bangkalan, East Java Province, 69112, Indonesia
- Department of Internal Medicine, Faculty of Medicine-Dr. Soetomo Teaching Hospital Universitas Airlangga,, Surabaya, East Java Province, 60286, Indonesia
| | - Fenska Seipalla
- COVID-19 Emergency Field Hospital of Bangkalan, Bangkalan, East Java Province, 69112, Indonesia
| | - Nathania Djaja
- COVID-19 Emergency Field Hospital of Bangkalan, Bangkalan, East Java Province, 69112, Indonesia
| | | | | | | | - Aditya Putra Pamungkas
- COVID-19 Emergency Field Hospital of Bangkalan, Bangkalan, East Java Province, 69112, Indonesia
| | - Yussika Fernanda
- COVID-19 Emergency Field Hospital of Bangkalan, Bangkalan, East Java Province, 69112, Indonesia
| | - Alfin Jam'Annuri
- COVID-19 Emergency Field Hospital of Bangkalan, Bangkalan, East Java Province, 69112, Indonesia
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36
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Relationship between Recovery from COVID-19-Induced Smell Loss and General and Oral Health Factors. Medicina (B Aires) 2022; 58:medicina58020283. [PMID: 35208609 PMCID: PMC8877343 DOI: 10.3390/medicina58020283] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 02/09/2022] [Indexed: 01/22/2023] Open
Abstract
Background and Objectives: Loss of smell is one of the strongest predictors of coronavirus disease 2019 (COVID-19) and can persist long after other symptoms have resolved. “Long” cases (>28 days) of smell dysfunction present future challenges to medical and dental professionals, as there is a lack of evidence on the causes and any exacerbating or relieving factors. This study aimed to explore the persistence of COVID-19-induced smell loss and association with physical, lifestyle and oral health factors. Materials and Methods: This study was a cross-sectional survey of 235 participants. Recovery of smell was explored, comparing rapid recovery (≤28 days) with prolonged recovery (>28 days). Associative factors included age, sex, illness severity, diet, BMI, vitamin D supplementation, antidepressants, alcohol use, smoking, brushing frequency, flossing, missing teeth, appliances and number of dental restorations. Results: Smell loss showed 87% resolution within 30 days. Prolonged smell loss was significantly associated with older age (mean ± 95%, CI = 31.53 ± 1.36 years for rapid recovery vs. mean ± 95%, CI = 36.0 ± 3 years for prolonged recovery, p = 0.003) and increased self-reported illness severity (mean ± 95%, CI = 4.39 ± 0.27 for rapid recovery vs. 5.01 ± 0.54 for prolonged recovery, p = 0.016). Fisher’s exact test revealed flossing was associated with rapid recovery, with flossers comprising 75% of the rapid-recovery group, compared to 56% in the prolonged-recovery group (odds ratio ± 95%, CI = 2.26 (1.23–4.15), p = 0.01). All other factors were not significantly associated (p > 0.05). Conclusions: Increased age and illness severity were associated with prolonged smell recovery. Use of floss was the only modifiable factor associated with rapid recovery of smell loss. As 87% of cases resolve within 30 days, future studies may benefit from targeted recruitment of individuals experiencing prolonged sense loss. This would increase statistical confidence when declaring no association with the other factors assessed, avoiding type II errors.
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37
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Sarubbo F, El Haji K, Vidal-Balle A, Bargay Lleonart J. Neurological consequences of COVID-19 and brain related pathogenic mechanisms: A new challenge for neuroscience. Brain Behav Immun Health 2022; 19:100399. [PMID: 34870247 PMCID: PMC8629776 DOI: 10.1016/j.bbih.2021.100399] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 11/26/2021] [Accepted: 11/26/2021] [Indexed: 12/15/2022] Open
Abstract
Due to the infection by the SARS-CoV-2 virus (COVID-19) there were also reported neurological symptoms, being the most frequent and best cited those that affect the cerebrovascular, sensorial, cognitive and motor functions, together with the neurological diffuse symptoms as for examples headache or dizziness. Besides, some of them behave high risk of mortality. Consequently, it is crucial to elucidate the mechanisms of action in brain of SARS-CoV-2 virus in order to create new therapeutic targets to fight against this new disease. Since now the mechanisms of arrival to the brain seems to be related with the following processes: blood brain barrier (BBB) disruption together with nervous or axonal transport of the virus by the trigeminal nerve, the vagus nerve, or the brain-gut-axis. Being two the mechanisms of brain affectation most cited: a direct affectation of the virus in the brain through neuroinvasion and an indirect mechanism of action due to the effects of the systemic infection. Both processes include the triggering of inflammation, hypoxia and the increased likelihood of secondary infections. This topic supposes a major novel challenge for neuroscience. Therefore, the aim of this review is to provide summarized information about the neurological symptomatology and the brain pathogenic mechanisms involved and reported in COVID-19.
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Affiliation(s)
- Fiorella Sarubbo
- Research Unit, University Hospital Son Llàtzer, Health Research Institute of the Balearic Islands (IdISBa), Crta, Manacor Km 4, 07198, Palma, Spain
- University of the Balearic Islands (UIB), Biology Department, Mallorca, Spain
- University of the Balearic Islands (UIB), Medicine Faculty, Mallorca, Spain
| | - Khaoulah El Haji
- Research Unit, University Hospital Son Llàtzer, Health Research Institute of the Balearic Islands (IdISBa), Crta, Manacor Km 4, 07198, Palma, Spain
| | - Aina Vidal-Balle
- Research Unit, University Hospital Son Llàtzer, Health Research Institute of the Balearic Islands (IdISBa), Crta, Manacor Km 4, 07198, Palma, Spain
| | - Joan Bargay Lleonart
- Research Unit, University Hospital Son Llàtzer, Health Research Institute of the Balearic Islands (IdISBa), Crta, Manacor Km 4, 07198, Palma, Spain
- University of the Balearic Islands (UIB), Medicine Faculty, Mallorca, Spain
- Hematology Department, University Hospital Son Llàtzer, Crta, Manacor Km 4, 07198, Palma, Spain
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38
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Fumagalli V, Ravà M, Marotta D, Di Lucia P, Laura C, Sala E, Grillo M, Bono E, Giustini L, Perucchini C, Mainetti M, Sessa A, Garcia-Manteiga JM, Donnici L, Manganaro L, Delbue S, Broccoli V, De Francesco R, D’Adamo P, Kuka M, Guidotti LG, Iannacone M. Administration of aerosolized SARS-CoV-2 to K18-hACE2 mice uncouples respiratory infection from fatal neuroinvasion. Sci Immunol 2022; 7:eabl9929. [PMID: 34812647 PMCID: PMC9835999 DOI: 10.1126/sciimmunol.abl9929] [Citation(s) in RCA: 48] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
The development of a tractable small animal model faithfully reproducing human coronavirus disease 2019 pathogenesis would arguably meet a pressing need in biomedical research. Thus far, most investigators have used transgenic mice expressing the human ACE2 in epithelial cells (K18-hACE2 transgenic mice) that are intranasally instilled with a liquid severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) suspension under deep anesthesia. Unfortunately, this experimental approach results in disproportionate high central nervous system infection leading to fatal encephalitis, which is rarely observed in humans and severely limits this model’s usefulness. Here, we describe the use of an inhalation tower system that allows exposure of unanesthetized mice to aerosolized virus under controlled conditions. Aerosol exposure of K18-hACE2 transgenic mice to SARS-CoV-2 resulted in robust viral replication in the respiratory tract, anosmia, and airway obstruction but did not lead to fatal viral neuroinvasion. When compared with intranasal inoculation, aerosol infection resulted in a more pronounced lung pathology including increased immune infiltration, fibrin deposition, and a transcriptional signature comparable to that observed in SARS-CoV-2–infected patients. This model may prove useful for studies of viral transmission, disease pathogenesis (including long-term consequences of SARS-CoV-2 infection), and therapeutic interventions.
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Affiliation(s)
- Valeria Fumagalli
- Division of Immunology, Transplantation, and Infectious Diseases, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.,Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Micol Ravà
- Division of Immunology, Transplantation, and Infectious Diseases, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Davide Marotta
- Division of Immunology, Transplantation, and Infectious Diseases, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.,Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Pietro Di Lucia
- Division of Immunology, Transplantation, and Infectious Diseases, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Chiara Laura
- Division of Immunology, Transplantation, and Infectious Diseases, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.,Vita-Salute San Raffaele University, 20132 Milan, Italy.,Center for Omics Sciences, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Eleonora Sala
- Division of Immunology, Transplantation, and Infectious Diseases, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.,Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Marta Grillo
- Division of Immunology, Transplantation, and Infectious Diseases, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Elisa Bono
- Division of Immunology, Transplantation, and Infectious Diseases, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Leonardo Giustini
- Division of Immunology, Transplantation, and Infectious Diseases, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Chiara Perucchini
- Division of Immunology, Transplantation, and Infectious Diseases, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Marta Mainetti
- Division of Immunology, Transplantation, and Infectious Diseases, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Alessandro Sessa
- Division of Neuroscience, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | | | - Lorena Donnici
- INGM - Istituto Nazionale di Genetica Molecolare “Romeo ed Erica Invernizzi”, Milan, Italy
| | - Lara Manganaro
- INGM - Istituto Nazionale di Genetica Molecolare “Romeo ed Erica Invernizzi”, Milan, Italy
| | - Serena Delbue
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Italy
| | - Vania Broccoli
- Division of Neuroscience, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.,National Research Council of Italy, Institute of Neuroscience
| | - Raffaele De Francesco
- INGM - Istituto Nazionale di Genetica Molecolare “Romeo ed Erica Invernizzi”, Milan, Italy,Department of Pharmacological and Biomolecular Sciences (DiSFeB), University of Milan, Italy
| | - Patrizia D’Adamo
- Division of Neuroscience, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.,Center of Advanced Services for in-vivo testing – Animal behavior Facility, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Mirela Kuka
- Division of Immunology, Transplantation, and Infectious Diseases, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.,Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Luca G. Guidotti
- Division of Immunology, Transplantation, and Infectious Diseases, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.,Vita-Salute San Raffaele University, 20132 Milan, Italy.,Correspondence to: or
| | - Matteo Iannacone
- Division of Immunology, Transplantation, and Infectious Diseases, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.,Vita-Salute San Raffaele University, 20132 Milan, Italy.,Experimental Imaging Centre, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.,Correspondence to: or
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39
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Armocida B, Zamagni G, Magni E, Monasta L, Comar M, Zanotta N, Cason C, Argentini G, Urriza M, Cassone A, Vascotto F, Buzzetti R, Barbi E, Del Pin M, Pani P, Knowles A, Carletti C, Concina F, Milinco M, Ronfani L. Clinical, anamnestic, and sociodemographic predictors of positive SARS-CoV-2 testing in children: A cross sectional study in a tertiary hospital in Italy. PLoS One 2022; 17:e0262923. [PMID: 35077483 PMCID: PMC8789147 DOI: 10.1371/journal.pone.0262923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 01/07/2022] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES We aimed to identify clinical, anamnestic, and sociodemographic characteristics associated with a positive swab for SARS-CoV2, and to provide a predictive score to identify at risk population in children aged 2-14 years attending school and tested for clinical symptoms of COVID-19. DESIGN Cross sectional study. SETTING Outpatient clinic of the IRCCS Burlo Garofolo, a maternal and child health tertiary care hospital and research centre in Italy. DATA COLLECTION AND ANALYSIS Data were collected through a predefined form, filled out by parents, and gathered information on sociodemographic characteristics, and specific symptoms, which were analysed to determine their association with a positive SARS-CoV-2 swab. The regression coefficients of the variables included in the multivariate analysis were further used in the calculation of a predictive score of the positive or negative test. RESULTS Between September 20th and December 23rd 2020, from 1484 children included in the study, 127 (8.6%) tested positive. In the multivariate analysis, the variables retained by the model were the presence of contact with a cohabiting, non-cohabiting or unspecified symptomatic case (respectively OR 37.2, 95% CI 20.1-68.7; 5.1, 95% CI 2.7-9.6; 15.6, 95% CI 7.3-33.2); female sex (OR 1.49, 95% CI 1.0-2.3); age (6-10 years old: OR 3.2, 95% CI 1.7-6.1 p<0.001; >10 years old: OR 4.8, 95% CI 2.7-8.8 p<0.001); fever (OR 3.9, 95% CI 2.3-6.4); chills (OR 1.9, 95% CI 1.1-3.3); headache (OR 1.45, 95% CI 0.9-2.4); ageusia (OR 1.3, 95% CI 0.5-4.0); sore throat (OR 0.48, 95% CI 0.3-0.8); earache (OR 0.4, 95% CI 0.1-1.3); rhinorrhoea (OR 0.8, 95% CI 0.5-1.3); and diarrhoea (OR 0.52, 95% CI 0.2-1.1). The predictive score based on these variables generated 93% sensitivity and 99% negative predictive value. CONCLUSIONS The timely identification of SARS-CoV2 cases among children is useful to reduce the dissemination of the disease and its related burden. The predictive score may be adopted in a public health perspective to rapidly identify at risk children.
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Affiliation(s)
- Benedetta Armocida
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Giulia Zamagni
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Elena Magni
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Lorenzo Monasta
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Manola Comar
- Unit of Advanced Microbiology Diagnosis and Translational Research, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Trieste, Italy
- University of Trieste, Trieste, Italy
| | - Nunzia Zanotta
- Unit of Advanced Microbiology Diagnosis and Translational Research, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Carolina Cason
- Unit of Advanced Microbiology Diagnosis and Translational Research, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Giorgia Argentini
- Medical Direction, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Marianela Urriza
- Medical Direction, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Andrea Cassone
- Health Professions Direction, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Fulvia Vascotto
- Health Professions Direction, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Trieste, Italy
| | | | - Egidio Barbi
- University of Trieste, Trieste, Italy
- Department of Pediatrics, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Trieste, Italy
| | | | - Paola Pani
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Alessandra Knowles
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Claudia Carletti
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Federica Concina
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Mariarosa Milinco
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Luca Ronfani
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Trieste, Italy
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40
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Adorni F, Jesuthasan N, Perdixi E, Sojic A, Giacomelli A, Noale M, Trevisan C, Franchini M, Pieroni S, Cori L, Mastroianni CM, Bianchi F, Antonelli-Incalzi R, Maggi S, Galli M, Prinelli F. Epidemiology of SARS-CoV-2 Infection in Italy Using Real-World Data: Methodology and Cohort Description of the Second Phase of Web-Based EPICOVID19 Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1274. [PMID: 35162295 PMCID: PMC8835202 DOI: 10.3390/ijerph19031274] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 01/16/2022] [Accepted: 01/19/2022] [Indexed: 12/29/2022]
Abstract
Digital technologies have been extensively employed in response to the SARS-CoV-2 pandemic worldwide. This study describes the methodology of the two-phase internet-based EPICOVID19 survey, and the characteristics of the adult volunteer respondents who lived in Italy during the first (April-May 2020) and the second wave (January-February 2021) of the epidemic. Validated scales and ad hoc questionnaires were used to collect socio-demographic, medical and behavioural characteristics, as well as information on COVID-19. Among those who provided email addresses during phase I (105,355), 41,473 participated in phase II (mean age 50.7 years ± 13.5 SD, 60.6% females). After a median follow-up of ten months, 52.8% had undergone nasopharyngeal swab (NPS) testing and 13.2% had a positive result. More than 40% had undergone serological test (ST) and 11.9% were positive. Out of the 2073 participants with at least one positive ST, 72.8% had only negative results from NPS or never performed it. These results indicate that a large fraction of individuals remained undiagnosed, possibly contributing to the spread of the virus in the community. Participatory online surveys offer a unique opportunity to collect relevant data at individual level from large samples during confinement.
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Affiliation(s)
- Fulvio Adorni
- National Research Council, Institute of Biomedical Technologies, Via Fratelli Cervi 93, 20054 Segrate, Italy; (N.J.); (E.P.); (A.S.); (F.P.)
| | - Nithiya Jesuthasan
- National Research Council, Institute of Biomedical Technologies, Via Fratelli Cervi 93, 20054 Segrate, Italy; (N.J.); (E.P.); (A.S.); (F.P.)
| | - Elena Perdixi
- National Research Council, Institute of Biomedical Technologies, Via Fratelli Cervi 93, 20054 Segrate, Italy; (N.J.); (E.P.); (A.S.); (F.P.)
| | - Aleksandra Sojic
- National Research Council, Institute of Biomedical Technologies, Via Fratelli Cervi 93, 20054 Segrate, Italy; (N.J.); (E.P.); (A.S.); (F.P.)
| | - Andrea Giacomelli
- Infectious Diseases Unit, Department of Biomedical and Clinical Sciences L. Sacco, Università di Milano, ASST Fatebenefratelli Sacco, 20157 Milan, Italy; (A.G.); (M.G.)
| | - Marianna Noale
- National Research Council, Neuroscience Institute, Aging Branch, Via Vincenzo Maria Gallucci 16, 35128 Padova, Italy; (M.N.); (S.M.)
| | - Caterina Trevisan
- Geriatric Unit, Department of Medicine (DIMED), University of Padova, Via Giustiniani 2, 35128 Padova, Italy;
- Department of Medical Sciences, University of Ferrara, Via Aldo Moro 8, Cona, 44124 Ferrara, Italy
| | - Michela Franchini
- National Research Council, Institute of Clinical Physiology, Via G. Moruzzi 1, 56124 Pisa, Italy; (M.F.); (S.P.); (L.C.); (F.B.)
| | - Stefania Pieroni
- National Research Council, Institute of Clinical Physiology, Via G. Moruzzi 1, 56124 Pisa, Italy; (M.F.); (S.P.); (L.C.); (F.B.)
| | - Liliana Cori
- National Research Council, Institute of Clinical Physiology, Via G. Moruzzi 1, 56124 Pisa, Italy; (M.F.); (S.P.); (L.C.); (F.B.)
| | - Claudio Maria Mastroianni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy;
| | - Fabrizio Bianchi
- National Research Council, Institute of Clinical Physiology, Via G. Moruzzi 1, 56124 Pisa, Italy; (M.F.); (S.P.); (L.C.); (F.B.)
| | | | - Stefania Maggi
- National Research Council, Neuroscience Institute, Aging Branch, Via Vincenzo Maria Gallucci 16, 35128 Padova, Italy; (M.N.); (S.M.)
| | - Massimo Galli
- Infectious Diseases Unit, Department of Biomedical and Clinical Sciences L. Sacco, Università di Milano, ASST Fatebenefratelli Sacco, 20157 Milan, Italy; (A.G.); (M.G.)
| | - Federica Prinelli
- National Research Council, Institute of Biomedical Technologies, Via Fratelli Cervi 93, 20054 Segrate, Italy; (N.J.); (E.P.); (A.S.); (F.P.)
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41
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Astley CM, Tuli G, Mc Cord KA, Cohn EL, Rader B, Varrelman TJ, Chiu SL, Deng X, Stewart K, Farag TH, Barkume KM, LaRocca S, Morris KA, Kreuter F, Brownstein JS. Global monitoring of the impact of the COVID-19 pandemic through online surveys sampled from the Facebook user base. Proc Natl Acad Sci U S A 2021; 118:e2111455118. [PMID: 34903657 PMCID: PMC8713788 DOI: 10.1073/pnas.2111455118] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2021] [Indexed: 11/18/2022] Open
Abstract
Simultaneously tracking the global impact of COVID-19 is challenging because of regional variation in resources and reporting. Leveraging self-reported survey outcomes via an existing international social media network has the potential to provide standardized data streams to support monitoring and decision-making worldwide, in real time, and with limited local resources. The University of Maryland Global COVID-19 Trends and Impact Survey (UMD-CTIS), in partnership with Facebook, has invited daily cross-sectional samples from the social media platform's active users to participate in the survey since its launch on April 23, 2020. We analyzed UMD-CTIS survey data through December 20, 2020, from 31,142,582 responses representing 114 countries/territories weighted for nonresponse and adjusted to basic demographics. We show consistent respondent demographics over time for many countries/territories. Machine Learning models trained on national and pooled global data verified known symptom indicators. COVID-like illness (CLI) signals were correlated with government benchmark data. Importantly, the best benchmarked UMD-CTIS signal uses a single survey item whereby respondents report on CLI in their local community. In regions with strained health infrastructure but active social media users, we show it is possible to define COVID-19 impact trajectories using a remote platform independent of local government resources. This syndromic surveillance public health tool is the largest global health survey to date and, with brief participant engagement, can provide meaningful, timely insights into the global COVID-19 pandemic at a local scale.
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Affiliation(s)
- Christina M Astley
- Division of Endocrinology, Boston Children's Hospital, Boston, MA 02115;
- Computational Epidemiology Lab, Boston Children's Hospital, Boston, MA 02115
- Harvard Medical School, Boston, MA 02115
- Broad Institute of Harvard and MIT, Cambridge, MA 02142
| | - Gaurav Tuli
- Computational Epidemiology Lab, Boston Children's Hospital, Boston, MA 02115
| | - Kimberly A Mc Cord
- Computational Epidemiology Lab, Boston Children's Hospital, Boston, MA 02115
| | - Emily L Cohn
- Computational Epidemiology Lab, Boston Children's Hospital, Boston, MA 02115
| | - Benjamin Rader
- Computational Epidemiology Lab, Boston Children's Hospital, Boston, MA 02115
- Department of Epidemiology, Boston University, Boston, MA 02118
| | - Tanner J Varrelman
- Computational Epidemiology Lab, Boston Children's Hospital, Boston, MA 02115
| | - Samantha L Chiu
- Joint Program in Survey Methodology, University of Maryland, College Park, MD 20742
| | - Xiaoyi Deng
- Joint Program in Survey Methodology, University of Maryland, College Park, MD 20742
| | - Kathleen Stewart
- Center for Geospatial Information Science, University of Maryland, College Park, MD 20742
| | | | | | | | | | - Frauke Kreuter
- Joint Program in Survey Methodology, University of Maryland, College Park, MD 20742
- Department of Statistics, Ludwig-Maximilians-Universität, Munich 80539, Germany
| | - John S Brownstein
- Computational Epidemiology Lab, Boston Children's Hospital, Boston, MA 02115
- Harvard Medical School, Boston, MA 02115
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42
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Zhang MM, Chen LN, Qian JM. Gastrointestinal manifestations and possible mechanisms of COVID-19 in different periods. J Dig Dis 2021; 22:683-694. [PMID: 34738727 PMCID: PMC8652439 DOI: 10.1111/1751-2980.13065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 10/30/2021] [Accepted: 11/02/2021] [Indexed: 12/11/2022]
Abstract
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, has become a pandemic worldwide. Although COVID-19 mainly affects the respiratory system, gastrointestinal (GI) manifestations have been frequently reported in such cases, even as initial symptoms. There have been several studies on different GI manifestations in patients with mild and severe disease or in remission. In this review article we summarized different GI manifestations of COVID-19 at various disease stages and the possible mechanisms based on published literatures, as well as the significance of GI manifestations in systemic inflammatory injury.
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Affiliation(s)
- Meng Meng Zhang
- Department of GastroenterologyPeking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Lu Ni Chen
- Department of Microbiology and Tumor and Cell BiologyKarolinska InstituteSolnaSweden
| | - Jia Ming Qian
- Department of GastroenterologyPeking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
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43
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Kerai S, Singh R, Dutta S, Mahajan A, Agarwal M. Comparison of Clinical Characteristics and Outcome of Critically Ill Patients Admitted to Tertiary Care Intensive Care Units in India during the Peak Months of First and Second Waves of COVID-19 Pandemic: A Retrospective Analysis. Indian J Crit Care Med 2021; 25:1349-1356. [PMID: 35027793 PMCID: PMC8693101 DOI: 10.5005/jp-journals-10071-24046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Coronavirus disease-2019 (COVID-19) continues to pose serious challenges to healthcare systems globally with the disease progressing over time in crest-trough pattern of waves. We compared the patient characteristics and outcomes of critically ill patients admitted during the first and second waves of COVID-19 pandemic. MATERIALS AND METHODS We did a retrospective analysis of medical records of critically ill patients admitted to intensive care unit (ICU) at the peak period of both waves. The data on demographics, symptoms, treatment received, and outcomes of patients were recorded. RESULTS Compared to first wave, significantly more females, younger age group, and those without underlying comorbidities required ICU admission during the second wave. The treatments received during both periods were similar except for preferential use of methylprednisolone over dexamethasone and proclivity of bilevel positive airway pressure (BiPAP) ventilation over high-flow nasal cannula (HFNC). There was no significant difference in the duration of ICU stay and mortality of patients. During the first wave, the factors associated with nonsurvival of patients were advanced age, comorbidities, severe disease, and a lesser number of days on HFNC. All these factors along with higher Sequential Organ Failure Assessment (SOFA) score were observed to be linked with patient nonsurvival during the second wave. CONCLUSION In India, the second wave of COVID-19 significantly influenced ICU demographics with a predominance of females and young adults requiring critical care. During both time periods, patients received similar treatment except for the propensity to use methylprednisolone and BiPAP as opposed to dexamethasone and HFNC in second wave. No significant difference in ICU mortality was noted. HOW TO CITE THIS ARTICLE Kerai S, Singh R, Dutta S, Mahajan A, Agarwal M. Comparison of Clinical Characteristics and Outcome of Critically Ill Patients Admitted to Tertiary Care Intensive Care Units in India during the Peak Months of First and Second Waves of COVID-19 Pandemic: A Retrospective Analysis. Indian J Crit Care Med 2021;25(12):1349-1356.
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Affiliation(s)
- Sukhyanti Kerai
- Department of Anaesthesiology and Critical Care, Maulana Azad Medical College, New Delhi, India
| | - Rahil Singh
- Department of Anaesthesiology and Critical Care, Maulana Azad Medical College, New Delhi, India
| | - Shanta Dutta
- Department of Anaesthesiology and Intensive Care, Maulana Azad Medical College, New Delhi, India
| | - Aayushi Mahajan
- Department of Anaesthesiology and Intensive Care, Maulana Azad Medical College, New Delhi, India
| | - Munisha Agarwal
- Department of Anaesthesiology and Intensive Care, Maulana Azad Medical College, New Delhi, India
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Khan M, Yoo SJ, Clijsters M, Backaert W, Vanstapel A, Speleman K, Lietaer C, Choi S, Hether TD, Marcelis L, Nam A, Pan L, Reeves JW, Van Bulck P, Zhou H, Bourgeois M, Debaveye Y, De Munter P, Gunst J, Jorissen M, Lagrou K, Lorent N, Neyrinck A, Peetermans M, Thal DR, Vandenbriele C, Wauters J, Mombaerts P, Van Gerven L. Visualizing in deceased COVID-19 patients how SARS-CoV-2 attacks the respiratory and olfactory mucosae but spares the olfactory bulb. Cell 2021; 184:5932-5949.e15. [PMID: 34798069 PMCID: PMC8564600 DOI: 10.1016/j.cell.2021.10.027] [Citation(s) in RCA: 224] [Impact Index Per Article: 74.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/01/2021] [Accepted: 10/25/2021] [Indexed: 12/28/2022]
Abstract
Anosmia, the loss of smell, is a common and often the sole symptom of COVID-19. The onset of the sequence of pathobiological events leading to olfactory dysfunction remains obscure. Here, we have developed a postmortem bedside surgical procedure to harvest endoscopically samples of respiratory and olfactory mucosae and whole olfactory bulbs. Our cohort of 85 cases included COVID-19 patients who died a few days after infection with SARS-CoV-2, enabling us to catch the virus while it was still replicating. We found that sustentacular cells are the major target cell type in the olfactory mucosa. We failed to find evidence for infection of olfactory sensory neurons, and the parenchyma of the olfactory bulb is spared as well. Thus, SARS-CoV-2 does not appear to be a neurotropic virus. We postulate that transient insufficient support from sustentacular cells triggers transient olfactory dysfunction in COVID-19. Olfactory sensory neurons would become affected without getting infected.
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Affiliation(s)
- Mona Khan
- Max Planck Research Unit for Neurogenetics, Frankfurt, Germany
| | - Seung-Jun Yoo
- Max Planck Research Unit for Neurogenetics, Frankfurt, Germany
| | - Marnick Clijsters
- Department of Neurosciences, Experimental Otorhinolaryngology, Rhinology Research, KU Leuven, Leuven, Belgium
| | - Wout Backaert
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Unit, KU Leuven, Leuven, Belgium
| | - Arno Vanstapel
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
| | - Kato Speleman
- Department of Otorhinolaryngology, Head and Neck Surgery, AZ Sint-Jan Brugge-Oostende AV, Bruges, Belgium
| | - Charlotte Lietaer
- Department of Otorhinolaryngology, Head and Neck Surgery, AZ Sint-Jan Brugge-Oostende AV, Bruges, Belgium
| | - Sumin Choi
- Max Planck Research Unit for Neurogenetics, Frankfurt, Germany
| | | | - Lukas Marcelis
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
| | - Andrew Nam
- NanoString Technologies Inc., Seattle, WA, USA
| | - Liuliu Pan
- NanoString Technologies Inc., Seattle, WA, USA
| | | | - Pauline Van Bulck
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Hai Zhou
- Max Planck Research Unit for Neurogenetics, Frankfurt, Germany
| | - Marc Bourgeois
- Department of Anesthesiology and Intensive Care Medicine, AZ Sint-Jan Brugge-Oostende AV, Bruges, Belgium
| | - Yves Debaveye
- Intensive Care Medicine, University Hospitals Leuven, Leuven, Belgium; Department of Cellular and Molecular Medicine, Laboratory of Intensive Care Medicine, KU Leuven, Leuven, Belgium
| | - Paul De Munter
- Department of General Internal Medicine, University Hospitals Leuven, Leuven, Belgium; Department of Microbiology, Immunology and Transplantation, Laboratory for Clinical Infectious and Inflammatory Disorders, KU Leuven, Leuven, Belgium
| | - Jan Gunst
- Intensive Care Medicine, University Hospitals Leuven, Leuven, Belgium; Department of Cellular and Molecular Medicine, Laboratory of Intensive Care Medicine, KU Leuven, Leuven, Belgium
| | - Mark Jorissen
- Department of Neurosciences, Experimental Otorhinolaryngology, Rhinology Research, KU Leuven, Leuven, Belgium; Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Katrien Lagrou
- Department of Laboratory Medicine and National Reference Centre for Respiratory Pathogens, University Hospitals Leuven, Leuven, Belgium; Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical Bacteriology and Mycology, KU Leuven, Leuven, Belgium
| | - Natalie Lorent
- Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium
| | - Arne Neyrinck
- Department of Anesthesia, University Hospitals Leuven, Leuven, Belgium; Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium
| | - Marijke Peetermans
- Department of General Internal Medicine, University Hospitals Leuven, Leuven, Belgium; Department of Microbiology, Immunology and Transplantation, Laboratory for Clinical Infectious and Inflammatory Disorders, KU Leuven, Leuven, Belgium
| | - Dietmar Rudolf Thal
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium; Department of Imaging and Pathology, Laboratory of Neuropathology and Leuven Brain Institute, KU Leuven, Leuven, Belgium
| | - Christophe Vandenbriele
- Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium; Department of Cardiovascular Diseases, University Hospitals Leuven, Leuven, Belgium
| | - Joost Wauters
- Department of General Internal Medicine, University Hospitals Leuven, Leuven, Belgium; Department of Microbiology, Immunology and Transplantation, Laboratory for Clinical Infectious and Inflammatory Disorders, KU Leuven, Leuven, Belgium
| | - Peter Mombaerts
- Max Planck Research Unit for Neurogenetics, Frankfurt, Germany.
| | - Laura Van Gerven
- Department of Neurosciences, Experimental Otorhinolaryngology, Rhinology Research, KU Leuven, Leuven, Belgium; Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Unit, KU Leuven, Leuven, Belgium.
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French N, Jones G, Heuer C, Hope V, Jefferies S, Muellner P, McNeill A, Haslett S, Priest P. Creating symptom-based criteria for diagnostic testing: a case study based on a multivariate analysis of data collected during the first wave of the COVID-19 pandemic in New Zealand. BMC Infect Dis 2021; 21:1119. [PMID: 34715802 PMCID: PMC8556148 DOI: 10.1186/s12879-021-06810-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 10/20/2021] [Indexed: 02/08/2023] Open
Abstract
Background Diagnostic testing using PCR is a fundamental component of COVID-19 pandemic control. Criteria for determining who should be tested by PCR vary between countries, and ultimately depend on resource constraints and public health objectives. Decisions are often based on sets of symptoms in individuals presenting to health services, as well as demographic variables, such as age, and travel history. The objective of this study was to determine the sensitivity and specificity of sets of symptoms used for triaging individuals for confirmatory testing, with the aim of optimising public health decision making under different scenarios. Methods Data from the first wave of COVID-19 in New Zealand were analysed; comprising 1153 PCR-confirmed and 4750 symptomatic PCR negative individuals. Data were analysed using Multiple Correspondence Analysis (MCA), automated search algorithms, Bayesian Latent Class Analysis, Decision Tree Analysis and Random Forest (RF) machine learning. Results Clinical criteria used to guide who should be tested by PCR were based on a set of mostly respiratory symptoms: a new or worsening cough, sore throat, shortness of breath, coryza, anosmia, with or without fever. This set has relatively high sensitivity (> 90%) but low specificity (< 10%), using PCR as a quasi-gold standard. In contrast, a group of mostly non-respiratory symptoms, including weakness, muscle pain, joint pain, headache, anosmia and ageusia, explained more variance in the MCA and were associated with higher specificity, at the cost of reduced sensitivity. Using RF models, the incorporation of 15 common symptoms, age, sex and prioritised ethnicity provided algorithms that were both sensitive and specific (> 85% for both) for predicting PCR outcomes. Conclusions If predominantly respiratory symptoms are used for test-triaging, a large proportion of the individuals being tested may not have COVID-19. This could overwhelm testing capacity and hinder attempts to trace and eliminate infection. Specificity can be increased using alternative rules based on sets of symptoms informed by multivariate analysis and automated search algorithms, albeit at the cost of sensitivity. Both sensitivity and specificity can be improved through machine learning algorithms, incorporating symptom and demographic data, and hence may provide an alternative approach to test-triaging that can be optimised according to prevailing conditions. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06810-4.
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Affiliation(s)
- Nigel French
- Infectious Disease Research Centre, Massey University, Palmerston North, New Zealand.
| | - Geoff Jones
- School of Fundamental Science, Massey University, PO Box 11222, Palmerston North, New Zealand
| | - Cord Heuer
- Infectious Disease Research Centre, Massey University, Palmerston North, New Zealand
| | - Virginia Hope
- Institute of Environmental Sciences and Research Ltd, Porirua, New Zealand
| | - Sarah Jefferies
- Institute of Environmental Sciences and Research Ltd, Porirua, New Zealand
| | - Petra Muellner
- Infectious Disease Research Centre, Massey University, Palmerston North, New Zealand.,Epi-Interactive Ltd, Wellington, New Zealand
| | - Andrea McNeill
- Institute of Environmental Sciences and Research Ltd, Porirua, New Zealand
| | - Stephen Haslett
- School of Fundamental Science, Massey University, PO Box 11222, Palmerston North, New Zealand
| | - Patricia Priest
- Department of Preventive & Social Medicine, University of Otago, Dunedin, New Zealand
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Greenleaf A, Mwima G, Lethoko M, Conkling M, Keefer G, Chang C, McLeod N, Maruyama H, Chen Q, Farley S, Low A. Participatory surveillance of COVID-19 in Lesotho via weekly calls: Protocol for cell phone data collection. JMIR Res Protoc 2021; 10:e31236. [PMID: 34351866 PMCID: PMC8478051 DOI: 10.2196/31236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/01/2021] [Accepted: 08/01/2021] [Indexed: 11/17/2022] Open
Abstract
Background The increase in cell phone ownership in low- and middle-income countries (LMIC) has created an opportunity for low-cost, rapid data collection by calling participants on their cell phones. Cell phones can be mobilized for a myriad of data collection purposes, including surveillance. In LMIC, cell phone–based surveillance has been used to track Ebola, measles, acute flaccid paralysis, and diarrheal disease, as well as noncommunicable diseases. Phone-based surveillance in LMIC is a particularly pertinent, burgeoning approach in the context of the COVID-19 pandemic. Participatory surveillance via cell phone could allow governments to assess burden of disease and complements existing surveillance systems. Objective We describe the protocol for the LeCellPHIA (Lesotho Cell Phone PHIA) project, a cell phone surveillance system that collects weekly population-based data on influenza-like illness (ILI) in Lesotho by calling a representative sample of a recent face-to-face survey. Methods We established a phone-based surveillance system to collect ILI symptoms from approximately 1700 participants who had participated in a recent face-to-face survey in Lesotho, the Population-based HIV Impact Assessment (PHIA) Survey. Of the 15,267 PHIA participants who were over 18 years old, 11,975 (78.44%) consented to future research and provided a valid phone number. We followed the PHIA sample design and included 342 primary sampling units from 10 districts. We randomly selected 5 households from each primary sampling unit that had an eligible participant and sampled 1 person per household. We oversampled the elderly, as they are more likely to be affected by COVID-19. A 3-day Zoom training was conducted in June 2020 to train LeCellPHIA interviewers. Results The surveillance system launched July 1, 2020, beginning with a 2-week enrollment period followed by weekly calls that will continue until September 30, 2022. Of the 11,975 phone numbers that were in the sample frame, 3020 were sampled, and 1778 were enrolled. Conclusions The surveillance system will track COVID-19 in a resource-limited setting. The novel approach of a weekly cell phone–based surveillance system can be used to track other health outcomes, and this protocol provides information about how to implement such a system. International Registered Report Identifier (IRRID) DERR1-10.2196/31236
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Affiliation(s)
- Abigail Greenleaf
- ICAP at Columbia University, Mailman School of Public Health, Columbia University, 60 Haven Ave, New York, US
| | - Gerald Mwima
- ICAP at Columbia University - Lesotho, Mailman School of Public Health, Columbia University, Maseru, LS
| | - Molibeli Lethoko
- ICAP at Columbia University - Lesotho, Mailman School of Public Health, Columbia University, Maseru, LS
| | - Martha Conkling
- Division of Global HIV/AIDS, Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, US
| | - George Keefer
- ICAP at Columbia University, Mailman School of Public Health, Columbia University, 60 Haven Ave, New York, US
| | - Christiana Chang
- ICAP at Columbia University, Mailman School of Public Health, Columbia University, 60 Haven Ave, New York, US
| | - Natasha McLeod
- ICAP at Columbia University, Mailman School of Public Health, Columbia University, 60 Haven Ave, New York, US
| | - Haruka Maruyama
- ICAP at Columbia University - Tanzania, Mailman School of Public Health, Columbia University, Dar es Salaam, TZ
| | - Qixuan Chen
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, US
| | - Shannon Farley
- ICAP at Columbia University, Mailman School of Public Health, Columbia University, 60 Haven Ave, New York, US
| | - Andrea Low
- ICAP at Columbia University, Mailman School of Public Health, Columbia University, 60 Haven Ave, New York, US
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