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Toal CM, Fowler AJ, Pearse RM, Puthucheary Z, Prowle JR, Wan YI. Health Resource Utilisation and Disparities: an Ecological Study of Admission Patterns Across Ethnicity in England Between 2017 and 2020. J Racial Ethn Health Disparities 2023; 10:2872-2881. [PMID: 36471147 PMCID: PMC9734479 DOI: 10.1007/s40615-022-01464-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 11/16/2022] [Accepted: 11/17/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIM The COVID-19 pandemic highlighted adverse outcomes in Asian, Black, and ethnic minority groups. More research is required to explore underlying ethnic health inequalities. In this study, we aim to examine pre-COVID ethnic inequalities more generally through healthcare utilisation to contextualise underlying inequalities that were present before the pandemic. DESIGN This was an ecological study exploring all admissions to NHS hospitals in England from 2017 to 2020. METHODS The primary outcomes were admission rates within ethnic groups. Secondary outcomes included age-specific and age-standardised admission rates. Sub-analysis of admission rates across an index of multiple deprivation (IMD) deciles was also performed to contextualise the impact of socioeconomic differences amongst ethnic categories. Results were presented as a relative ratio (RR) with 95% confidence intervals. RESULTS Age-standardised admission rates were higher in Asian (RR 1.40 [1.38-1.41] in 2019) and Black (RR 1.37 [1.37-1.38]) and lower in Mixed groups (RR 0.91 [0.90-0.91]) relative to White. There was significant missingness or misassignment of ethnicity in NHS admissions: with 11.7% of admissions having an unknown/not-stated ethnicity assignment and 'other' ethnicity being significantly over-represented. Admission rates did not mirror the degree of deprivation across all ethnic categories. CONCLUSIONS This study shows Black and Asian ethnic groups have higher admission rates compared to White across all age groups and when standardised for age. There is evidence of incomplete and misidentification of ethnicity assignment in NHS admission records, which may introduce bias to work on these datasets. Differences in admission rates across individual ethnic categories cannot solely be explained by socioeconomic status. Further work is needed to identify ethnicity-specific factors of these inequalities to allow targeted interventions at the local level.
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Affiliation(s)
- C M Toal
- William Harvey Research Institute, Queen Mary University of London, London, EC1M 6BQ, UK.
- Acute Critical Care Research Unit, Royal London Hospital, Barts Health NHS Trust, London, E1 1FR, UK.
| | - A J Fowler
- William Harvey Research Institute, Queen Mary University of London, London, EC1M 6BQ, UK
- Acute Critical Care Research Unit, Royal London Hospital, Barts Health NHS Trust, London, E1 1FR, UK
| | - R M Pearse
- William Harvey Research Institute, Queen Mary University of London, London, EC1M 6BQ, UK
- Acute Critical Care Research Unit, Royal London Hospital, Barts Health NHS Trust, London, E1 1FR, UK
| | - Z Puthucheary
- William Harvey Research Institute, Queen Mary University of London, London, EC1M 6BQ, UK
- Acute Critical Care Research Unit, Royal London Hospital, Barts Health NHS Trust, London, E1 1FR, UK
| | - J R Prowle
- William Harvey Research Institute, Queen Mary University of London, London, EC1M 6BQ, UK
- Acute Critical Care Research Unit, Royal London Hospital, Barts Health NHS Trust, London, E1 1FR, UK
| | - Y I Wan
- William Harvey Research Institute, Queen Mary University of London, London, EC1M 6BQ, UK
- Acute Critical Care Research Unit, Royal London Hospital, Barts Health NHS Trust, London, E1 1FR, UK
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2
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Hraiech S, Pauly V, Orleans V, Auquier P, Azoulay E, Roch A, Boyer L, Papazian L. COVID-19 among undocumented migrants admitted to French intensive care units during the 2020-2021 period: a retrospective nationwide study. Ann Intensive Care 2023; 13:99. [PMID: 37803153 PMCID: PMC10558416 DOI: 10.1186/s13613-023-01197-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 09/26/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND Before the Coronavirus Disease 2019 (COVID-19) pandemic in France, undocumented migrants had a higher risk than general population for being admitted to the intensive care unit (ICU) because of acute respiratory failure or severe infection. Specific data concerning the impact of COVID-19 on undocumented migrants in France are lacking. We aimed to analyze the mortality and respiratory severity of COVID-19 in this specific population. We retrospectively included all undocumented adult migrants admitted in French ICUs from March 2020 through April 2021 using the French nationwide hospital information system (Programme de Médicalisation des Systèmes d'Information). We focused on admissions related to COVID-19. Undocumented migrants were compared to the general population, first in crude analysis, then after matching on age, severity and main comorbidities. The primary outcome was the ICU mortality from COVID-19. Secondary objectives were the incidence of acute respiratory distress syndrome (ARDS), the need for mechanical ventilation (MV), the duration of MV, ICU and hospital stay. RESULTS During the study period, the rate of ICU admission among patients hospitalized for COVID-19 was higher for undocumented migrants than for general population (463/1627 (28.5%) vs. 81 813/344 001 (23.8%); p < 0.001). Although ICU mortality was comparable after matching (14.3% for general population vs. 13.3% for undocumented migrants; p = 0.50), the incidence of ARDS was higher among undocumented migrants (odds ratio, confidence interval (OR (CI)) 1.25 (1.06-1.48); p = 0.01). Undocumented migrants needed more frequently invasive MV (OR (CI) 1.2 (1.01-1.42); p = 0.04 than general population. There were no differences between groups concerning duration of MV, ICU and hospital length of stay. CONCLUSION During the first waves of COVID-19 in France, undocumented migrants had a mortality similar to the general population but a higher risk for ICU admission and for developing an ARDS. These results highlight the need for reinforcing prevention and improving primary healthcare access for people in irregular situation.
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Affiliation(s)
- Sami Hraiech
- Service de Médecine Intensive - Réanimation, AP-HM, Hôpital Nord, Marseille, France.
- Faculté de medecine, Centre d'Etudes et de Recherches sur les Services de Santé et qualite de vie EA 3279, Aix-Marseille Université, 13005, Marseille, France.
| | - Vanessa Pauly
- Faculté de medecine, Centre d'Etudes et de Recherches sur les Services de Santé et qualite de vie EA 3279, Aix-Marseille Université, 13005, Marseille, France
- Départment d'Informatique Médical, AP-HM, Marseille, France
| | - Véronica Orleans
- Faculté de medecine, Centre d'Etudes et de Recherches sur les Services de Santé et qualite de vie EA 3279, Aix-Marseille Université, 13005, Marseille, France
- Départment d'Informatique Médical, AP-HM, Marseille, France
| | - Pascal Auquier
- Faculté de medecine, Centre d'Etudes et de Recherches sur les Services de Santé et qualite de vie EA 3279, Aix-Marseille Université, 13005, Marseille, France
| | - Elie Azoulay
- Service de Médecine Intensive et Réanimation, Hôpital Saint-Louis, AP-HP, Paris, France
| | - Antoine Roch
- Service de Médecine Intensive - Réanimation, AP-HM, Hôpital Nord, Marseille, France
- Faculté de medecine, Centre d'Etudes et de Recherches sur les Services de Santé et qualite de vie EA 3279, Aix-Marseille Université, 13005, Marseille, France
| | - Laurent Boyer
- Faculté de medecine, Centre d'Etudes et de Recherches sur les Services de Santé et qualite de vie EA 3279, Aix-Marseille Université, 13005, Marseille, France
- Départment d'Informatique Médical, AP-HM, Marseille, France
| | - Laurent Papazian
- Faculté de medecine, Centre d'Etudes et de Recherches sur les Services de Santé et qualite de vie EA 3279, Aix-Marseille Université, 13005, Marseille, France
- Centre Hospitalier de Bastia, 20600, Bastia, Corsica, France
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Mazzalai E, Giannini D, Tosti ME, D’Angelo F, Declich S, Jaljaa A, Caminada S, Turatto F, De Marchi C, Gatta A, Angelozzi A, Marchetti G, Pizzarelli S, Marceca M. Risk of Covid-19 Severe Outcomes and Mortality in Migrants and Ethnic Minorities Compared to the General Population in the European WHO Region: a Systematic Review. J Int Migr Integr 2023; 24:1-31. [PMID: 36647529 PMCID: PMC9833641 DOI: 10.1007/s12134-023-01007-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2022] [Indexed: 01/13/2023]
Abstract
The Covid-19 pandemic has had a major impact on migrants and ethnic minorities (MEMs). Socio-economic factors and legal, administrative and language barriers are among the reasons for this increased susceptibility. The aim of the study is to investigate the impact of Covid-19 on MEMs compared to the general population in terms of serious outcomes. We conducted a systematic review collecting studies on the impact of Covid-19 on MEMs compared to the general population in the WHO European Region regarding hospitalisation, intensive care unit (ICU) admission and mortality, published between 01/01/2020 and 19/03/2021. Nine researchers were involved in selection, study quality assessment and data extraction. Of the 82 studies included, 15 of the 16 regarding hospitalisation for Covid-19 reported an increased risk for MEMs compared to the white and/or native population and 22 out of the 28 studies focusing on the ICU admission rates found an increased risk for MEMs. Among the 65 studies on mortality, 43 report a higher risk for MEMs. An increased risk of adverse outcomes was reported for MEMs. Social determinants of health are among the main factors involved in the genesis of health inequalities: a disadvantaged socio-economic status, a framework of structural racism and asymmetric access to healthcare are linked to increased susceptibility to the consequences of Covid-19. These findings underline the need for policymakers to consider the socio-economic barriers when designing prevention plans. Supplementary Information The online version contains supplementary material available at 10.1007/s12134-023-01007-x.
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Affiliation(s)
- Elena Mazzalai
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Dara Giannini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
- Italian Society of Migration Medicine (SIMM), Rome, Italy
| | - Maria Elena Tosti
- National Centre for Global Health, Istituto Superiore di Sanità, Rome, Italy
| | - Franca D’Angelo
- National Centre for Global Health, Istituto Superiore di Sanità, Rome, Italy
| | - Silvia Declich
- Italian Society of Migration Medicine (SIMM), Rome, Italy
- National Centre for Global Health, Istituto Superiore di Sanità, Rome, Italy
| | - Anissa Jaljaa
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Susanna Caminada
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
- Italian Society of Migration Medicine (SIMM), Rome, Italy
| | - Federica Turatto
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Chiara De Marchi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Angela Gatta
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Aurora Angelozzi
- Department for Organisational Development, Local Health Unit Roma 1, Rome, Italy
| | - Giulia Marchetti
- Italian Society of Migration Medicine (SIMM), Rome, Italy
- National Centre for Global Health, Istituto Superiore di Sanità, Rome, Italy
| | - Scilla Pizzarelli
- Knowledge Unit, Documentation and Library, Istituto Superiore di Sanità, Rome, Italy
| | - Maurizio Marceca
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
- Italian Society of Migration Medicine (SIMM), Rome, Italy
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Hentschel CB, Abramoff BA, Dillingham TR, Pezzin LE. Race, ethnicity, and utilization of outpatient rehabilitation for treatment of post COVID-19 condition. PM R 2022; 14:1315-1324. [PMID: 35789541 PMCID: PMC9350262 DOI: 10.1002/pmrj.12869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 05/26/2022] [Accepted: 06/20/2022] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Outpatient rehabilitation is recommended in the treatment of post coronavirus disease 2019 (COVID-19) condition. Although racial and ethnic disparities in the incidence and severity of COVID-19 have been well documented, little is known about the use of outpatient rehabilitation among patients with post COVID-19 condition. OBJECTIVE To examine factors associated with outpatient rehabilitation use following COVID-19 and to ascertain whether differential incidence of sequelae explain variation in post COVID-19 rehabilitation utilization by race and ethnicity. DESIGN Case-control study. SETTING Community. PARTICIPANTS U.S. adults with COVID-19 during 2020 in the TriNetX database. INTERVENTION N/A. MAIN OUTCOME MEASURES Receipt of outpatient rehabilitation services within 6 months of COVID-19 diagnosis and incidence of post COVID-19 condition symptoms (weakness, fatigue, pain, cognitive impairment, mobility difficulties, and dyspnea). RESULTS From 406,630 laboratory-confirmed COVID-19 cases, we identified 8724 individuals who received outpatient rehabilitation and matched 28,719 controls. Of rehabilitation users, 43.3% were 40 years old or younger, 54.8% were female, 58.2% were White, 17.9% were African American/Black, 2.1% were Asian, 13.0% were Hispanic, 39.2% had no comorbidities, and 40.3% had been hospitalized for COVID-19. Dyspnea (20.4%), fatigue (12.4%), and weakness (8.2%) were the most frequently identified symptoms. Although there were no racial differences in the incidence of the six post COVID-19 condition symptoms considered, African American/Black individuals were significantly less likely than their White counterparts to receive outpatient rehabilitation (odds ratio [OR] = 0.89; 95% confidence interval [CI]: 0.84-0.96; p = .003). Hispanic individuals had higher outpatient rehabilitation utilization (OR = 1.22; 95% CI: 1.11-1.33; p < .001) and a significantly higher incidence of post COVID-19 fatigue. CONCLUSIONS In this large nationally representative study, African American/Black race was associated with lower utilization of outpatient rehabilitation services despite a similar incidence of post COVID-19 condition symptoms. Further research is needed to better understand access barriers to rehabilitation services for post COVID-19 condition recovery care and address racial inequalities in receipt of care.
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Affiliation(s)
| | - Benjamin A. Abramoff
- Department of Physical Medicine and Rehabilitation, University of Pennsylvania – Perelman School of Medicine
| | - Timothy R. Dillingham
- Department of Physical Medicine and Rehabilitation, University of Pennsylvania – Perelman School of Medicine
| | - Liliana E. Pezzin
- Institute for Health and Equity and Collaborative for Healthcare Delivery Science, Medical College of Wisconsin
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5
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Degarege A, Naveed Z, Kabayundo J, Brett-Major D. Heterogeneity and Risk of Bias in Studies Examining Risk Factors for Severe Illness and Death in COVID-19: A Systematic Review and Meta-Analysis. Pathogens 2022; 11:563. [PMID: 35631084 PMCID: PMC9147100 DOI: 10.3390/pathogens11050563] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 05/02/2022] [Accepted: 05/05/2022] [Indexed: 02/07/2023] Open
Abstract
This systematic review and meta-analysis synthesized the evidence on the impacts of demographics and comorbidities on the clinical outcomes of COVID-19, as well as the sources of the heterogeneity and publication bias of the relevant studies. Two authors independently searched the literature from PubMed, Embase, Cochrane library, and CINAHL on 18 May 2021; removed duplicates; screened the titles, abstracts, and full texts by using criteria; and extracted data from the eligible articles. The variations among the studies were examined by using Cochrane, Q.; I2, and meta-regression. Out of 11,975 articles that were obtained from the databases and screened, 559 studies were abstracted, and then, where appropriate, were analyzed by meta-analysis (n = 542). COVID-19-related severe illness, admission to the ICU, and death were significantly correlated with comorbidities, male sex, and an age older than 60 or 65 years, although high heterogeneity was present in the pooled estimates. The study design, the study country, the sample size, and the year of publication contributed to this. There was publication bias among the studies that compared the odds of COVID-19-related deaths, severe illness, and admission to the ICU on the basis of the comorbidity status. While an older age and chronic diseases were shown to increase the risk of developing severe illness, admission to the ICU, and death among the COVID-19 patients in our analysis, a marked heterogeneity was present when linking the specific risks with the outcomes.
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Affiliation(s)
- Abraham Degarege
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA; (Z.N.); (J.K.); (D.B.-M.)
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6
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Alharbi AA, Alqumaizi KI, Bin Hussain I, Alsabaani A, Arkoubi A, Alkaabba A, AlHazmi A, Alharbi NS, Suhail HM, Alqumaizi AK. Characteristics of Hospitalized COVID-19 Patients in the Four Southern Regions Under the Proposed Southern Business Unit of Saudi Arabia. Int J Gen Med 2022; 15:3573-3582. [PMID: 35386862 PMCID: PMC8979417 DOI: 10.2147/ijgm.s357552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 03/23/2022] [Indexed: 01/28/2023] Open
Abstract
Background This is the first descriptive and comparative study conducted of COVID-19 inpatients from multi-centers in the four administrative southern regions and proposed Southern Business Unit (Jazan, Najran, Bisha, and Aseer) of the Kingdom of Saudi Arabia (KSA). Methods Participants were 809 randomly selected patients admitted to the eight sampled hospitals with confirmed COVID-19 between March 2020 and February 2021. We assessed and compared socio-demographics, clinical characteristics, and clinical outcomes of the four regions. Results Socio-demographic and clinical characteristics of the participants are a mean age of 60 ± 17.7 years, 70% Saudi male, the prevalence of diabetes (DM2) 58%, hypertension (HTN) 48%, obesity 43%, cardiac diseases 15%, and immunity or cancer diseases almost 1%. The prevalence of complications during admission were bacterial pneumonia 65%, acquired respiratory distress syndrome (ARDS) 32%, sepsis 20%, multi-organ failure 18%, acute kidney diseases 15%, and arrhythmia 4%. Clinical outcomes were: admitted to intensive care unit (ICU) 52%, mortality rate 25%, referred to other facilities 9%, and mean length of stay (LOS) was 11± 9.5 days. We observed statistically significant variation in many variables among the four regions. Najran and Aseer had a higher prevalence of risk factors for severity including age and comorbidities accompanied by higher rates of complications, ICU admissions, LOS, and mortality. Bisha and Jazan had lower prevalence of risk factors and LOS with lower rates of complications, ICU admissions, and mortality. Conclusion This study reveals that the geographic region in which the patient was cared for was related to the severity and outcome of COVID-19 infection. Policy makers should search for solutions to regional differences in underlying health conditions such as DM2, HTN, and obesity to plan for improvements in preventive care as well as resource distribution to ensure quality for all Saudi citizens. This study will serve as guidance to begin to form strategies for these improvements as envisioned in the future New Model of Care.
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Affiliation(s)
- Abdullah A Alharbi
- Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan City, Saudi Arabia
| | - Khalid I Alqumaizi
- Family Medicine Department, Faculty of Medicine, AlMaarefa University, Riyadh, Saudi Arabia
| | - Ibrahim Bin Hussain
- Department of Pediatrics, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia.,Department of Pediatrics, College of Medicine, Al Faisal University, Riyadh, Saudi Arabia.,Southern Business Unit, Health Holding Company Project, Healthcare Transformation, Vision Realization Office, Ministry of Health, Riyadh, Saudi Arabia
| | - Abdullah Alsabaani
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Amr Arkoubi
- Department of Surgery, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Abdulaziz Alkaabba
- Department of Family Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Arwa AlHazmi
- Southern Business Unit, Health Holding Company Project, Healthcare Transformation, Vision Realization Office, Ministry of Health, Riyadh, Saudi Arabia
| | - Nasser S Alharbi
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Hussam M Suhail
- Faculty of Medicine, Jazan University, Jazan City, Saudi Arabia
| | - Abdullah K Alqumaizi
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
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Ramos-Rincon JM, Cobos-Palacios L, López-Sampalo A, Ricci M, Rubio-Rivas M, Martos-Pérez F, Lalueza-Blanco A, Moragón-Ledesma S, Fonseca-Aizpuru EM, García-García GM, Beato-Perez JL, Josa-Laorden C, Arnalich-Fernández F, Molinos-Castro S, Torres-Peña JD, Artero A, Vargas-Núñez JA, Mendez-Bailon M, Loureiro-Amigo J, Hernández-Garrido MS, Peris-García J, López-Reboiro ML, Barón-Franco B, Casas-Rojo JM, Gómez-Huelgas R. Ethnicity and Clinical Outcomes in Patients Hospitalized for COVID-19 in Spain: Results from the Multicenter SEMI-COVID-19 Registry. J Clin Med 2022; 11:1949. [PMID: 35407557 PMCID: PMC8999367 DOI: 10.3390/jcm11071949] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/26/2022] [Accepted: 03/28/2022] [Indexed: 02/05/2023] Open
Abstract
(1) Background: This work aims to analyze clinical outcomes according to ethnic groups in patients hospitalized for COVID-19 in Spain. (2) Methods: This nationwide, retrospective, multicenter, observational study analyzed hospitalized patients with confirmed COVID-19 in 150 Spanish hospitals (SEMI-COVID-19 Registry) from 1 March 2020 to 31 December 2021. Clinical outcomes were assessed according to ethnicity (Latin Americans, Sub-Saharan Africans, Asians, North Africans, Europeans). The outcomes were in-hospital mortality (IHM), intensive care unit (ICU) admission, and the use of invasive mechanical ventilation (IMV). Associations between ethnic groups and clinical outcomes adjusted for patient characteristics and baseline Charlson Comorbidity Index values and wave were evaluated using logistic regression. (3) Results: Of 23,953 patients (median age 69.5 years, 42.9% women), 7.0% were Latin American, 1.2% were North African, 0.5% were Asian, 0.5% were Sub-Saharan African, and 89.7% were European. Ethnic minority patients were significantly younger than European patients (median (IQR) age 49.1 (40.5−58.9) to 57.1 (44.1−67.1) vs. 71.5 (59.5−81.4) years, p < 0.001). The unadjusted IHM was higher in European (21.6%) versus North African (11.4%), Asian (10.9%), Latin American (7.1%), and Sub-Saharan African (3.2%) patients. After further adjustment, the IHM was lower in Sub-Saharan African (OR 0.28 (0.10−0.79), p = 0.017) versus European patients, while ICU admission rates were higher in Latin American and North African versus European patients (OR (95%CI) 1.37 (1.17−1.60), p < 0.001) and (OR (95%CI) 1.74 (1.26−2.41), p < 0.001). Moreover, Latin American patients were 39% more likely than European patients to use IMV (OR (95%CI) 1.43 (1.21−1.71), p < 0.001). (4) Conclusion: The adjusted IHM was similar in all groups except for Sub-Saharan Africans, who had lower IHM. Latin American patients were admitted to the ICU and required IMV more often.
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Affiliation(s)
| | - Lidia Cobos-Palacios
- Internal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), 29010 Malaga, Spain; (L.C.-P.); (A.L.-S.); (M.R.); (R.G.-H.)
- Medicine Department, University of Málaga, 29010 Malaga, Spain
| | - Almudena López-Sampalo
- Internal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), 29010 Malaga, Spain; (L.C.-P.); (A.L.-S.); (M.R.); (R.G.-H.)
- Medicine Department, University of Málaga, 29010 Malaga, Spain
| | - Michele Ricci
- Internal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), 29010 Malaga, Spain; (L.C.-P.); (A.L.-S.); (M.R.); (R.G.-H.)
- Medicine Department, University of Málaga, 29010 Malaga, Spain
| | - Manuel Rubio-Rivas
- Department of Internal Medicine, Bellvitge University Hospital, L’Hospitalet de Llobregat, 08907 Barcelona, Spain;
| | | | | | - Sergio Moragón-Ledesma
- Internal Medicine Department, Gregorio Marañón General University Hospital, 28007 Madrid, Spain;
| | | | | | - Jose-Luis Beato-Perez
- Internal Medicine Department, Albacete University Hospital Complex, 02006 Albacete, Spain;
| | | | | | - Sonia Molinos-Castro
- Internal Medicine Department, Santiago de Compostela Clinic Hospital, 15706 Santiago de Compostela, Spain;
| | - José-David Torres-Peña
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, 14004 Cordoba, Spain;
- Spain CIBER Fisiopatologia de la Obesidad y la Nutricion, Carlos III Health Institute, 28029 Madrid, Spain
| | - Arturo Artero
- Internal Medicine Department, Doctor Peset University Hospital, 46017 Valencia, Spain;
| | - Juan-Antonio Vargas-Núñez
- Internal Medicine Department, Puerta de Hierro University Hospital, Instituto de Investigación Sanitaria Puerta de Hierro—Segovia de Arana, 28222 Madrid, Spain;
| | | | - Jose Loureiro-Amigo
- Internal Medicine Department, Moisès Broggi Hospital, 08970 Sant Joan Despí, Spain;
| | | | - Jorge Peris-García
- Internal Medicine Department, de Sant Joan d’Alacant University Clínic Hospital, 03550 Alicante, Spain;
| | | | - Bosco Barón-Franco
- Internal Medicine Department, University Hospital Virgen del Rocío, 41013 Sevilla, Spain;
| | - Jose-Manuel Casas-Rojo
- Internal Medicine Department, Infanta Cristina University Hospital, Parla, 28981 Madrid, Spain;
| | - Ricardo Gómez-Huelgas
- Internal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), 29010 Malaga, Spain; (L.C.-P.); (A.L.-S.); (M.R.); (R.G.-H.)
- Medicine Department, University of Málaga, 29010 Malaga, Spain
- Spain CIBER Fisiopatologia de la Obesidad y la Nutricion, Carlos III Health Institute, 28029 Madrid, Spain
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Al Zahmi F, Habuza T, Awawdeh R, Elshekhali H, Lee M, Salamin N, Sajid R, Kiran D, Nihalani S, Smetanina D, Talako T, Neidl-Van Gorkom K, Zaki N, Loney T, Statsenko Y. Ethnicity-Specific Features of COVID-19 Among Arabs, Africans, South Asians, East Asians, and Caucasians in the United Arab Emirates. Front Cell Infect Microbiol 2022; 11:773141. [PMID: 35368452 PMCID: PMC8967254 DOI: 10.3389/fcimb.2021.773141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 11/22/2021] [Indexed: 01/08/2023] Open
Abstract
BackgroundDubai (United Arab Emirates; UAE) has a multi-national population which makes it exceptionally interesting study sample because of its unique demographic factors.ObjectiveTo stratify the risk factors for the multinational society of the UAE.MethodsA retrospective chart review of 560 patients sequentially admitted to inpatient care with laboratory confirmed COVID-19 was conducted. We studied patients’ demographics, clinical features, laboratory results, disease severity, and outcomes. The parameters were compared across different ethnic groups using tree-based estimators to rank the ethnicity-specific disease features. We trained ML classification algorithms to build a model of ethnic specificity of COVID-19 based on clinical presentation and laboratory findings on admission.ResultsOut of 560 patients, 43.6% were South Asians, 26.4% Middle Easterns, 16.8% East Asians, 10.7% Caucasians, and 2.5% are under others. UAE nationals represented half of the Middle Eastern patients, and 13% of the entire cohort. Hypertension was the most common comorbidity in COVID-19 patients. Subjective complaint of fever and cough were the chief presenting symptoms. Two-thirds of the patients had either a mild disease or were asymptomatic. Only 20% of the entire cohort needed oxygen therapy, and 12% needed ICU admission. Forty patients (~7%) needed invasive ventilation and fifteen patients died (2.7%). We observed differences in disease severity among different ethnic groups. Caucasian or East-Asian COVID-19 patients tended to have a more severe disease despite a lower risk profile. In contrast to this, Middle Eastern COVID-19 patients had a higher risk factor profile, but they did not differ markedly in disease severity from the other ethnic groups. There was no noticeable difference between the Middle Eastern subethnicities—Arabs and Africans—in disease severity (p = 0.81). However, there were disparities in the SOFA score, D-dimer (p = 0.015), fibrinogen (p = 0.007), and background diseases (hypertension, p = 0.003; diabetes and smoking, p = 0.045) between the subethnicities.ConclusionWe observed variations in disease severity among different ethnic groups. The high accuracy (average AUC = 0.9586) of the ethnicity classification model based on the laboratory and clinical findings suggests the presence of ethnic-specific disease features. Larger studies are needed to explore the role of ethnicity in COVID-19 disease features.
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Affiliation(s)
- Fatmah Al Zahmi
- Mediclinic Parkview Hospital, Dubai, United Arab Emirates
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
- *Correspondence: Fatmah Al Zahmi, ; Yauhen Statsenko, ;
| | - Tetiana Habuza
- College of Information Technology, United Arab Emirates University, Al Ain, United Arab Emirates
- Big Data Analytics Center, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Rasha Awawdeh
- Mediclinic Parkview Hospital, Dubai, United Arab Emirates
| | | | - Martin Lee
- Mediclinic Parkview Hospital, Dubai, United Arab Emirates
| | - Nassim Salamin
- Mediclinic Parkview Hospital, Dubai, United Arab Emirates
| | - Ruhina Sajid
- Mediclinic Parkview Hospital, Dubai, United Arab Emirates
| | - Dhanya Kiran
- Mediclinic Parkview Hospital, Dubai, United Arab Emirates
| | | | - Darya Smetanina
- College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Tatsiana Talako
- Belarusian Medical Academy of Postgraduate Education, Minsk, Belarus
- Minsk Scientific and Practical Center for Surgery, Transplantology and Hematology, Minsk, Belarus
| | - Klaus Neidl-Van Gorkom
- College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Nazar Zaki
- College of Information Technology, United Arab Emirates University, Al Ain, United Arab Emirates
- Big Data Analytics Center, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Tom Loney
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Yauhen Statsenko
- Big Data Analytics Center, United Arab Emirates University, Al Ain, United Arab Emirates
- College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- *Correspondence: Fatmah Al Zahmi, ; Yauhen Statsenko, ;
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9
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Abstract
Research indicates that severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection can impact every organ, and the effects can range from asymptomatic to severe disease. Since it was first discovered in December 2019, our understanding has grown about its impact on kidney disease. In general, children have less severe disease than adults, and this tendency appears to extend to special pediatric kidney populations (e.g., chronic kidney disease and immunosuppressed patients with solid organ transplants or nephrotic syndrome). However, in a fraction of infected children, SARS-CoV2 causes an array of kidney manifestations, ranging from acute kidney injury to thrombotic microangiopathy, with potential implications for increased risk of morbidity and mortality. Additional considerations surround the propensity for clotting extracorporeal circuits in children with SARS-CoV2 infection that are receiving kidney replacement therapy. This review provides an update on our current understanding of SARS-CoV2 for pediatric nephrologists and highlights knowledge gaps to be addressed by future research during this ongoing pandemic, particularly the social disparities magnified during this period.
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Affiliation(s)
- Erica C Bjornstad
- Department of Pediatrics, Nephrology, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Michael E Seifert
- Department of Pediatrics, Nephrology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Keia Sanderson
- Department of Medicine, Nephrology and Hypertension, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Daniel I Feig
- Department of Pediatrics, Nephrology, University of Alabama at Birmingham, Birmingham, AL, USA
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10
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Valls Carbó A, González Del Castillo J, Miró O, Lopez-Ayala P, Jimenez S, Jacob J, Bibiano C, Martín-Sánchez FJ. Increased severity in SARS-CoV-2 infection of minorities in Spain. Rev Esp Quimioter 2021; 34:664-667. [PMID: 34622269 PMCID: PMC8638765 DOI: 10.37201/req/099.2021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Introduction With the global spread of COVID-19, studies in the US and UK have shown that certain communities have been strongly impacted by COVID-19 in terms of incidence and mortality. The objective of the study was to determine social determinants of health among COVID-19 patients hospitalized in the two major cities of Spain. Material and methods A multicenter retrospective case series study was performed collecting administrative databases of all COVID-19 patients ≥18 years belonging to two centers in Madrid and two in Barcelona (Spain) collecting data from 1st March to 15th April 2020. Variables obtained age, gender, birthplace and residence ZIP code. From ZIP code we obtained per capita income of the area. Predictors of the outcomes were explored through generalized linear mixed-effects models, using center as random effect. Results There were 5,235 patients included in the analysis. After multivariable analysis adjusted by age, sex, per capita income, population density, hospital experience, center and hospital saturation, patients born in Latin American countries were found to have an increase in ICU admission rates (OR 1.56 [1.13-2.15], p<0.01) but no differences were found in the same model regarding mortality (OR 1.35 [0.95-1.92], p=0.09). Conclusions COVID-19 severity varies widely, not only depending on biological but also socio-economic factors. With the emerging evidence that this subset of population is at higher risk of poorer outcomes, targeted public health strategies and studies are needed.
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Affiliation(s)
| | | | | | | | | | | | | | - F J Martín-Sánchez
- Francisco Javier Martín Sanchez, Emergency Department. Hospital Clínico San Carlos. Calle Profesor Martín-Lagos s/n, 28040 Madrid, Spain.
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11
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Sellner J, Jenkins TM, von Oertzen TJ, Bassetti CL, Beghi E, Bereczki D, Bodini B, Cavallieri F, Di Liberto G, Helbok R, Macerollo A, Maia LF, Oreja‐Guevara C, Özturk S, Rakusa M, Pisani A, Priori A, Sauerbier A, Soffietti R, Taba P, Zedde M, Crean M, Burlica A, Twardzik A, Moro E. A plea for equitable global access to COVID-19 diagnostics, vaccination and therapy: The NeuroCOVID-19 Task Force of the European Academy of Neurology. Eur J Neurol 2021; 28:3849-3855. [PMID: 33460486 PMCID: PMC8014664 DOI: 10.1111/ene.14741] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 01/13/2021] [Indexed: 12/13/2022]
Abstract
Coronavirus disease 2019 (COVID-19), a multi-organ disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), continues to challenge health and care systems around the globe. The pandemic has disrupted acute neurology services and routine patient care and has impacted the clinical course in patients with chronic neurological disease. COVID-19 appears to have exposed inequalities of societies and healthcare systems and had a disproportionate impact on already vulnerable communities. The next challenge will be to set up initiatives to stop disparities in all aspects related to COVID-19. From the medical perspective, there is a need to consider inequalities in prevention, treatment and long-term consequences. Some of the issues of direct relevance to neurologists are summarised. With this appraisal, the European Academy of Neurology NeuroCOVID-19 Task Force intends to raise awareness of the potential impact of COVID-19 on inequalities in healthcare and calls for action to prevent disparity at individual, national and supranational levels.
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Affiliation(s)
- Johann Sellner
- Department of NeurologyLandesklinikum Mistelbach‐GänserndorfMistelbachAustria
- Department of NeurologyChristian Doppler Medical CenterParacelsus Medical UniversitySalzburgAustria
- Department of NeurologyKlinikum rechts der IsarTechnische Universität MünchenMünchenGermany
| | - Thomas M. Jenkins
- Sheffield Institute for Translational NeuroscienceUniversity of SheffieldSheffieldUK
- Sheffield Teaching Hospitals NHS Foundation TrustSheffieldUK
| | - Tim J. von Oertzen
- Faculty of MedicineJohannes‐Kepler UniversitätLinzAustria
- Department of Neurology 1Kepler UniversitätsklinikumLinzAustria
| | | | - Ettore Beghi
- Istituto di Ricerche Farmacologiche Mario NegriIRCCSMilanItaly
| | | | - Benedetta Bodini
- Department of NeurologySaint‐Antoine HospitalAPHPSorbonne UniversityParisFrance
| | - Francesco Cavallieri
- Neurology UnitNeuromotor and Rehabilitation DepartmentAzienda USL‐IRCCS di Reggio EmiliaReggio EmiliaItaly
- Clinical and Experimental Medicine PhD ProgramUniversity of Modena and Reggio EmiliaModenaItaly
| | - Giovanni Di Liberto
- Department of Clinical NeurosciencesCentre Hospitalier Universitaire Vaudois and University of LausanneLausanneSwitzerland
| | - Raimund Helbok
- Department of NeurologyMedical University of InnsbruckInnsbruckAustria
| | - Antonella Macerollo
- Walton Centre NHS Foundation TrustLiverpoolUK
- School of PsychologyFaculty of Health and Life SciencesUniversity of LiverpoolLiverpoolUK
| | - Luis F. Maia
- Department of NeurologyHospital Santo AntónioCentro Hospitalar Universitário do PortoPortoPortugal
- i3S ‐ Instituto de Investigação e Inovação em Saúde Universidade do PortoPortoPortugal
| | - Celia Oreja‐Guevara
- Department of NeurologyHospital Clinico San CarlosMadridSpain
- Departamento de MedicinaFacultad de MedicinaUniversidad Complutense de Madrid (UCMMadridSpain
- IdISSCMadridSpain
| | - Serefnur Özturk
- Department of NeurologyFaculty of MedicineSelcuk UniversityKonyaTurkey
| | - Martin Rakusa
- Department of NeurologyUniversity Medical Centre MariborMariborSlovenia
| | - Antonio Pisani
- Department of Brain and Behavioral SciencesUniversity of PaviaPaviaItaly
- IRCCS Mondino FoundationPaviaItaly
| | - Alberto Priori
- Division of NeurologyDepartment of Neurology‘Aldo Ravelli’ Research CenterUniversity of Milan and ASST Santi Paolo e CarloMilanItaly
| | - Anna Sauerbier
- Department of NeurologyUniversity Hospital CologneCologneGermany
- King's College HospitalNational Parkinson Foundation International Centre of ExcellenceLondonUK
| | - Riccardo Soffietti
- Division of Neuro‐OncologyDepartment of NeuroscienceUniversity of TurinTurinItaly
| | - Pille Taba
- Department of Neurology and NeurosurgeryInstitute of Clinical MedicineUniversity of TartuTartuEstonia
| | - Marialuisa Zedde
- Neurology UnitNeuromotor and Rehabilitation DepartmentAzienda USL‐IRCCS di Reggio EmiliaReggio EmiliaItaly
- Clinical and Experimental Medicine PhD ProgramUniversity of Modena and Reggio EmiliaModenaItaly
| | - Michael Crean
- European Academy of Neurology (EAN) Head OfficeViennaAustria
| | - Anja Burlica
- European Academy of Neurology (EAN) Head OfficeViennaAustria
| | - Alex Twardzik
- European Academy of Neurology (EAN) Head OfficeViennaAustria
| | - Elena Moro
- Division of NeurologyCHU of GrenobleGrenoble Institute of NeurosciencesGrenoble Alpes UniversityGrenobleFrance
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12
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Anyfantakis D, Mantadaki AE, Mastronikolis S, Spandidos DA, Symvoulakis EK. COVID-19 pandemic and reasons to prioritize the needs of the health care system to ensure its sustainability: A scoping review from January to October 2020 (Review). Exp Ther Med 2021; 22:1039. [PMID: 34373725 PMCID: PMC8343896 DOI: 10.3892/etm.2021.10471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 06/29/2021] [Indexed: 12/23/2022] Open
Abstract
The worldwide spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) led the World Health Organization to characterize the pandemic as a public health emergency of international concern. National health care systems in countries during the initial surge of the pandemic were unable to handle the sanitarian crisis that had emerged. Thus, the prevention and control of future global health emergencies must be a priority. The present scoping review aimed to retrieve articles that summarize the current experience on issues related to historical knowledge, and epidemiology, clinical features and overall burden of SARS-CoV-2 on health care services. In summary, a comprehensive overview of the information that has been learnt during this period is presented in the current review. Furthermore, taking into account the global experience, the need for planning cohesive and functional health services before similar pandemic events occur in the future is highlighted. The next public health issue should be prevented rather than treated. In spite of the vaccination benefits, a number of sporadic cases of SARS-CoV-2infections will persist. Information collected remains relevant for appraising how similar threats can be faced in the future. Overall, collaborative health care plans need to be rethought to increase preparedness.
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Affiliation(s)
| | - Aikaterini E. Mantadaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, 71500 Heraklion, Greece
| | - Stylianos Mastronikolis
- Clinic of Social and Family Medicine, Faculty of Medicine, University of Crete, 71500 Heraklion, Greece
| | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, School of Medicine, University of Crete, 71500 Heraklion, Greece
| | - Emmanouil K. Symvoulakis
- Clinic of Social and Family Medicine, Faculty of Medicine, University of Crete, 71500 Heraklion, Greece
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13
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Clemente-suárez VJ, Navarro-jiménez E, Moreno-luna L, Saavedra-serrano MC, Jimenez M, Simón JA, Tornero-aguilera JF. The Impact of the COVID-19 Pandemic on Social, Health, and Economy. Sustainability 2021; 13:6314. [DOI: 10.3390/su13116314] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
In late December 2019, a series of acute atypical respiratory disease occurred in Wuhan, China, which rapidly spread to other areas worldwide. It was soon discovered that a novel coronavirus was responsible, named the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2, 2019-nCoV). The impact of the COVID-19 pandemic on the population’s health is unprecedented in recent years and the impact on a social level even more so. The COVID-19 pandemic is the most large-scale pandemic on earth this century, and the impact in all life sectors is devasting and directly affected human activity in the first wave. The impact on the economy, social care systems, and human relationships is causing an unprecedented global crisis. SARS-CoV-2 has a strong direct acute impact on population health, not only at the physiological level but also at the psychological level for those who suffer it, those close to them, and the general population, who suffer from the social consequences of the pandemic. In this line, the economic recession increased, even more, the social imbalance and inequity, hitting the most vulnerable families, and creating a difficult context for public institutions to address. We are facing one of the greatest challenges of social intervention, which requires fast, effective, and well-coordinated responses from public institutions, the private sector, and non-governmental organizations to serve an increasingly hopeless population with increasingly urgent needs. Long-term legislation is necessary to reduce the vulnerability of the less fortunate, as well as to analyze the societal response to improve the social organization management of available resources. Therefore, in this scoping review, a consensus and critical review were performed using both primary sources, such as scientific articles, and secondary ones, such as bibliographic indexes, web pages, and databases. The main search engines were PubMed, SciELO, and Google Scholar. The method was a narrative literature review of the available literature. The aim was to assess the effects of the COVID-19 pandemic on population health, where the possible interventions at the health level are discussed, the impact in economic and social areas, and the government and health systems interventions in the pandemic, and finally, possible economic models for the recovery of the crisis are proposed.
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14
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Diendéré EA, Sondo KA, Ouédraogo AR, Dahourou DL, Cissé K, Sawadogo A, Maiga S, Kuiré M, Zida S, Kaboré PR, Minoungou CJW, Habou U, Badalo H, Zoungrana N, Ouédraogo AG, Belem AR, Zoungrana J, Poda A, Diallo I, Kaboré F, Sanou A, Kouanda S. Predictors of severe hypoxemia among COVID-19 patients in Burkina Faso (West Africa): Findings from hospital based cross-sectional study. Int J Infect Dis 2021; 108:289-295. [PMID: 33894354 PMCID: PMC8059284 DOI: 10.1016/j.ijid.2021.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/31/2021] [Accepted: 04/04/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction COVID-19 is one of the world’s major health crises. The objective of this study was to determine the predictive factors of severe hypoxemia in patients hospitalized in COVID-19 health facilities in Burkina Faso. Patients and method This study was a hospital-based cross-sectional study. The data collected relate to the period of the first wave of the epidemic (March 9 to June 30, 2020). All patients hospitalized for COVID-19 in the requisitioned health facilities of Ouagadougou were included in this study. Predictors of severe hypoxemia were identified using a multivariate logistic regression model. Results During the study period, 442 patients were included, representing 45.7% of the total number of positive patients in the entire country. The most common co-morbidities were diabetes (55; 12.4%) and arterial hypertension (97; 21.9%). Severe hypoxemia (SpO2 < 90%) was observed in 64 patients (14.5%). Age over 65 years (OR = 8.24; 95% CI: 2.83–24.01) and diabetes (OR = 2.43; 95% CI: 1.17–5.06) were the predictors for occurrence of severe hypoxemia in multivariate analysis. Conclusion The predictive factors of COVID-19 are similar in African and Caucasian populations. The surveillance of COVID-19 in risk groups should be strengthened to reduce their morbidity and mortality.
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Affiliation(s)
- Eric Arnaud Diendéré
- Internal Medicine Department, Bogodogo Teaching Hospital, Ouagadougou, Burkina Faso.
| | | | | | - Désiré Lucien Dahourou
- Department of Biomedical and Public Health, Research Institute of Health Sciences, Ouagadougou, Burkina Faso.
| | - Kadari Cissé
- Department of Biomedical and Public Health, Research Institute of Health Sciences, Ouagadougou, Burkina Faso.
| | - Abdoulaye Sawadogo
- Infectious Diseases Department, Ouahigouya Teaching Hospital, Ouahigouya, Burkina Faso.
| | - Soumaila Maiga
- Pneumology Department, Ouahigouya Teaching Hospital, Ouahigouya, Burkina Faso.
| | - Marcel Kuiré
- Internal Medicine Department, Pissy District Hospital, Ouagadougou, Burkina Faso.
| | - Seidou Zida
- Internal Medicine Department, Pissy District Hospital, Ouagadougou, Burkina Faso.
| | - Pierre R Kaboré
- Internal Medicine Department, Pissy District Hospital, Ouagadougou, Burkina Faso.
| | | | - Ulrich Habou
- Internal Medicine Department, Bogodogo Teaching Hospital, Ouagadougou, Burkina Faso.
| | - Habil Badalo
- Internal Medicine Department, Bogodogo Teaching Hospital, Ouagadougou, Burkina Faso.
| | - Noelie Zoungrana
- Directorate of Medical and Technical Services, Tengandogo Teaching Hospital, Ouagadougou, Burkina Faso.
| | - Arsène G Ouédraogo
- Infectious Diseases Department, Yalgado Ouédraogo Teaching Hospital, Ouagadougou, Burkina Faso.
| | - Arielle Rita Belem
- Infectious Diseases Department, Souro Sanon Teaching Hospital, Bobo-Dioulasso, Burkina Faso.
| | - Jacques Zoungrana
- Infectious Diseases Department, Souro Sanon Teaching Hospital, Bobo-Dioulasso, Burkina Faso.
| | - Armel Poda
- Infectious Diseases Department, Souro Sanon Teaching Hospital, Bobo-Dioulasso, Burkina Faso.
| | - Ismael Diallo
- Infectious Diseases Department, Yalgado Ouédraogo Teaching Hospital, Ouagadougou, Burkina Faso.
| | - Flavien Kaboré
- Anaesthesia and Resuscitation Department, Tengandogo Teaching Hospital, Ouagadougou, Burkina Faso.
| | - Adama Sanou
- Directorate of Medical and Technical Services, Tengandogo Teaching Hospital, Ouagadougou, Burkina Faso.
| | - Séni Kouanda
- Department of Biomedical and Public Health, Research Institute of Health Sciences, Ouagadougou, Burkina Faso.
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15
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Abstract
Vitamin D is a potent steroid hormone that induces widespread changes in gene expression and controls key biological pathways. Here we review pathophysiology of vitamin D with particular reference to COVID-19 and pancreatic cancer. Utility as a therapeutic agent is limited by hypercalcemic effects and attempts to circumvent this problem have used vitamin D superagonists, with increased efficacy and reduced calcemic effect. A further caveat is that vitamin D mediates multiple diverse effects. Some of these (anti-fibrosis) are likely beneficial in patients with COVID-19 and pancreatic cancer, whereas others (reduced immunity), may be beneficial through attenuation of the cytokine storm in patients with advanced COVID-19, but detrimental in pancreatic cancer. Vitamin D superagonists represent an untapped resource for development of effective therapeutic agents. However, to be successful this approach will require agonists with high cell-tissue specificity.
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Affiliation(s)
- David J. Easty
- Department of Medical Oncology, Our Lady of Lourdes Hospital, Drogheda, Ireland
| | - Christine J. Farr
- Department of Genetics, University of Cambridge, Cambridge, United Kingdom
| | - Bryan T. Hennessy
- Department of Molecular Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Oncology, Our Lady of Lourdes Hospital, Drogheda, Ireland
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16
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Castro-Sánchez E, Russell AM, Dolman L, Wells M. What place does nurse-led research have in the COVID-19 pandemic? Int Nurs Rev 2021; 68:214-218. [PMID: 33565619 PMCID: PMC8013712 DOI: 10.1111/inr.12660] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 12/09/2020] [Accepted: 12/21/2020] [Indexed: 12/19/2022]
Abstract
AIM Reflect upon the visibility of nursing-led research during the COVID-19 pandemic. BACKGROUND The emerging SARS-CoV-2 infection has galvanized collaborative and multidisciplinary efforts in clinical and research practice worldwide. The scarce evidence-base to manage patients with COVID-19 has included limited nurse-led research. INTRODUCTION Clinical research nurses have greatly contributed to the delivery of COVID-19 research, yet the number of COVID-19 nursing-led research papers appears to be limited, with even fewer nurse-led research projects funded. METHODS Authors' views and PubMed search on 'COVID-19 and nursing'. FINDINGS There is a dearth of nursing-led research. Most papers describe the nursing contribution to COVID-19 care, changes in nursing working arrangements and emotional burden. There are opportunities to explore the consequences to vulnerable population groups of public health measures implemented to stop the progress of the COVID-19 pandemic. DISCUSSION Workforce gaps, limited integration in research structures and clinical redeployment may have hampered nurse-led research. COVID-19 may exacerbate staffing deficits by disrupting the education pipeline, obstructing the transition from clinical to academic practice, particularly in areas where clinical academic roles are yet to emerge. CONCLUSION The absence of nurse-led research in COVID-19 can be explained by chronic, underlying factors and the features of the pandemic response. Emerging models of care, effective staffing and inequalities related to COVID-19 appear obvious research areas. Nursing leadership needs to strengthen its political voice and lobbying skills to secure nurse-led research funding. IMPLICATIONS FOR NURSING POLICY Embracing international nursing research, strengthening collaborations and lobbying policymakers for investment in nurse-sensitive research would enhance the response to COVID-19.
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Affiliation(s)
- E Castro-Sánchez
- School of Health Sciences, City, University of London, London, UK.,NIHR Senior Nurse Research Leader, Imperial College Healthcare NHS Trust, London, UK
| | - A M Russell
- Senior Lecturer, College of Medicine and Health, University of Exeter South Cloisters, St Luke's Campus, Exeter, UK
| | - L Dolman
- NIHR Senior Nurse Research Leader, Imperial College Healthcare NHS Trust, London, UK
| | - M Wells
- NIHR Senior Nurse Research Leader, Imperial College Healthcare NHS Trust, London, UK.,Surgery and Cancer, Imperial College London, London, UK
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