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Angiola F, Franchetti G, Cestonaro C, Agnolucci J, Giordano R, Viel G. Dying at home during the SARS-CoV-2 endemic: The importance of defining the exact mechanism of death. Leg Med (Tokyo) 2024; 66:102361. [PMID: 38039658 DOI: 10.1016/j.legalmed.2023.102361] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 11/08/2023] [Accepted: 11/22/2023] [Indexed: 12/03/2023]
Abstract
INTRODUCTION Coronavirus Disease 2019 (COVID-19) has become endemic in Europe thanks to the presence of less deadly and more infectious variants and to the existence of a significant portion of unvaccinated people among the general population. SARS-Cov-2 related deaths are probably going to fade in the next years, but Covid-19 should still be considered a potential cause of death in the out-of-hospital setting in the next future. MATERIAL AND METHODS Three (3) cases of unexpected death at home are here presented. Each case has been investigated with the same methodological approach: death scene investigation (DSI), complete autopsy with histology, immunohistochemistry, RNA in situ hybridization for SARS-CoV-2 spike protein in lung tissue, toxicology and microbiology. RESULTS AND DISCUSSION All three cases had a COVID + post-mortem nasopharyngeal swab. Histology and immunohistochemistry revealed a SARS-CoV-2 lung involvement in only two of the cases (Cases 2 and 3), while a septic bacterial pneumonia was found in Case 1, where RNA-in situ hybridization for viral spike protein showed no reactivity in pneumocytes. The integration of all postmortem evidence allowed to attribute a different role of SARS-Cov-2 in the determinism of the death. CONCLUSION In the current post-pandemic context, SARS-CoV-2 remains a possible cause of death when investigating out-of-hospital unexpected deaths. Since a positive post-mortem swab does not automatically imply a COVID-19-related death, histology and immunohistochemistry are helpful for identifying SARS-CoV-2 lung involvement and, therefore, its potential active role in the determinism of death.
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Affiliation(s)
- Francesco Angiola
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Falloppio 50, 35121 Padova, Italy
| | - Giorgia Franchetti
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Falloppio 50, 35121 Padova, Italy
| | - Clara Cestonaro
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Falloppio 50, 35121 Padova, Italy
| | - Jacopo Agnolucci
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Falloppio 50, 35121 Padova, Italy
| | - Renzo Giordano
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Falloppio 50, 35121 Padova, Italy
| | - Guido Viel
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Falloppio 50, 35121 Padova, Italy.
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Mohamed DM, SalahEldin MA, Idris AB, Idris EB, Mohamed SG, Badawi MM. Pneumonia in Sudan: Systematic and Scoping Review of the Literature and Meta-Analysis. Cureus 2023; 15:e46473. [PMID: 37927707 PMCID: PMC10623489 DOI: 10.7759/cureus.46473] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2023] [Indexed: 11/07/2023] Open
Abstract
In addition to excessive burden of non-communicable diseases, natural and manmade disasters, and internal conflicts, Sudan is predominantly susceptible to communicable diseases, such as malaria, tuberculosis, and pneumonia, which bring about an extra burden of demand for high-quality healthcare. According to the WHO and the Sudan Health Observatory, pneumonia is one of the leading causes of death in Sudan. This study therefore aimed to illustrate pneumonia literature in Sudan, estimate infection prevalence regardless of the cause among Sudanese children and adults, and demonstrate its related risk factors. A systematic and scoping review of the literature was conducted and regulated in accordance to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). After abstract and full-text screening, only 15 articles met our inclusion criteria and passed the quality assessment procedure. Seven included studies determined prevalence of pneumonia; the overall pooled prevalence was around 30%. Furthermore, 12 research articles investigated risk factors related to pneumonia among Sudanese population. Further research with larger sample sizes targeting risk factors of pneumonia among Sudanese population is needed to be conducted.
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Affiliation(s)
- D M Mohamed
- Internal Medicine, Sultan Qaboos University Hospital, Muscat, OMN
| | - M A SalahEldin
- Medical Microbiology, University of Khartoum, Khartoum, SDN
| | - A B Idris
- General Surgery, Sudan Medical Specialization Board, Khartoum, SDN
| | - E B Idris
- Medical Microbiology, Rashid Medical Complex, Riyadh, SAU
| | - S G Mohamed
- Medical Microbiology, University of Khartoum, Khartoum, SDN
| | - Marwan M Badawi
- Medical Unit, Higher Academy for Strategic and Security Studies, Khartoum, SDN
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Yuan N, Lv ZH, Sun CR, Wen YY, Tao TY, Qian D, Tao FP, Yu JH. Post-acute COVID-19 symptom risk in hospitalized and non-hospitalized COVID-19 survivors: A systematic review and meta-analysis. Front Public Health 2023; 11:1112383. [PMID: 36875356 PMCID: PMC9978404 DOI: 10.3389/fpubh.2023.1112383] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 01/30/2023] [Indexed: 02/18/2023] Open
Abstract
Background Post-acute coronavirus disease 2019 (COVID-19) symptoms occurred in most of the COVID-19 survivors. However, few studies have examined the issue of whether hospitalization results in different post-acute COVID-19 symptom risks. This study aimed to compare potential COVID-19 long-term effects in hospitalized and non-hospitalized COVID-19 survivors. Methods This study is designed as a systematic review and meta-analysis of observational studies. A systematic search of six databases was performed for identifying articles published from inception until April 20th, 2022, which compared post-acute COVID-19 symptom risk in hospitalized and non-hospitalized COVID-19 survivors using a predesigned search strategy included terms for SARS-CoV-2 (eg, COVID, coronavirus, and 2019-nCoV), post-acute COVID-19 Syndrome (eg, post-COVID, post COVID conditions, chronic COVID symptom, long COVID, long COVID symptom, long-haul COVID, COVID sequelae, convalescence, and persistent COVID symptom), and hospitalization (hospitalized, in hospital, and home-isolated). The present meta-analysis was conducted according to The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement using R software 4.1.3 to create forest plots. Q statistics and the I 2 index were used to evaluate heterogeneity in this meta-analysis. Results Six observational studies conducted in Spain, Austria, Switzerland, Canada, and the USA involving 419 hospitalized and 742 non-hospitalized COVID-19 survivors were included. The number of COVID-19 survivors in included studies ranged from 63 to 431, and follow-up data were collected through visits in four studies and another two used an electronic questionnaire, visit and telephone, respectively. Significant increase in the risks of long dyspnea (OR = 3.18, 95% CI = 1.90-5.32), anxiety (OR = 3.09, 95% CI = 1.47-6.47), myalgia (OR = 2.33, 95% CI = 1.02-5.33), and hair loss (OR = 2.76, 95% CI = 1.07-7.12) risk were found in hospitalized COVID-19 survivors compared with outpatients. Conversely, persisting ageusia risk was significantly reduced in hospitalized COVID-19 survivors than in non-hospitalized patients. Conclusion The findings suggested that special attention and patient-centered rehabilitation service based on a needs survey should be provided for hospitalized COVID-19 survivors who experienced high post-acute COVID-19 symptoms risk.
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Affiliation(s)
- Niu Yuan
- Department of Nursing, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.,Department of Respiratory Medicine, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Zhang-Hong Lv
- Department of Nursing, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.,Department of Respiratory Medicine, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Chun-Rong Sun
- Department of Nursing, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.,Ear, Nose and Throat Department, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Yuan-Yuan Wen
- Department of Nursing, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.,Department of Surgical Oncology, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Ting-Yu Tao
- Department of Nursing, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.,Department of Respiratory Medicine, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Dan Qian
- Department of Nursing, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.,Department of Respiratory Medicine, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Fang-Ping Tao
- Department of Nursing, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.,Department of Respiratory Medicine, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Jia-Hui Yu
- Department of Nursing, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.,Department of Respiratory Medicine, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
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Saad RK, Abu Khudair S, El Rabbat M, Omar M, Al Nsour M, Khader Y, Rawaf S. Published Research on COVID-19 in the Eastern Mediterranean Region: Bibliometric Analysis (Preprint). Interact J Med Res 2022; 11:e38935. [PMID: 35852846 PMCID: PMC9384956 DOI: 10.2196/38935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/14/2022] [Accepted: 06/21/2022] [Indexed: 11/24/2022] Open
Abstract
Background The challenges presented by the COVID-19 pandemic have led to unprecedented global research activity. The Eastern Mediterranean Region (EMR) continues to contribute to COVID-19 research driven by the unique challenges of the region, including the protracted conflicts, already stressed health systems, and serious health and social inequalities. Objective This study aims to provide an overview of the publication activities and trends in COVID-19 research in the EMR from the onset of the disease to early 2022 using bibliometric methods. Methods A literature search using Scopus was conducted from December 1, 2019, to January 31, 2022, using keywords relevant to COVID-19 and the World Health Organization (WHO) EMR country list. Data were exported and analyzed using Microsoft Excel and the Citation Overview function on Scopus. The quality of journals was determined using SCImago Journal Rank and CiteScore. VOSviewer software was used to visualize the relationships between authors, countries, and key terms used in the retrieved documents. Results A total of 6880 documents were retrieved, of which 1805 (26.24%) were from the Kingdom of Saudi Arabia (KSA) and 1782 (25.90%) from Iran, followed by Pakistan, Egypt, and Jordan. Most published documents were affiliated with EMR universities, primarily the Tehran University of Medical Sciences in Iran and King Saud University in KSA (396/6880, 5.76%, and 370/6880, 5.4%, respectively), while only 407 (5.92%) of 6880 documents were associated with universities outside the EMR. For most of the identified publications (5020/6880, 72.97%), no funding source was reported, while King Saud University contributed the largest share (282/1860, 15.16%) of funded publications. Retrieved documents were cited 53,516 times, with an average of 7.78 (SD 34.30). Iran was the EMR country with the most links to other countries (77 links and total link strength of 1279). The 5 authors with the most publications were from KSA, Qatar, and Jordan. There were 290 high-frequency keywords that occurred ≥10 times and were linked in 7 different clusters. The cluster with the most linked keywords was related to epidemiology and mortality. Recent topics included vaccines, vaccination, machine learning, and online learning. Conclusions This is the first study to show trends in and project future developments of COVID-19 research activity in the EMR. Authors and institutions who led research on COVID-19 in the region were from Iran and KSA. There were multiple regional collaborative efforts; however, international collaboration was limited. Recently, interest has been shifting toward topics related to vaccination, machine learning, and online learning. Understanding the current state of research is instrumental to future research production, and our study will inform regional research initiatives on emerging concepts, as well as opportunities for collaboration and funding.
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Affiliation(s)
- Randa K Saad
- Global Health Development| Eastern Mediterranean Public Health Network, Amman, Jordan
| | - Sara Abu Khudair
- Global Health Development| Eastern Mediterranean Public Health Network, Amman, Jordan
| | - Maha El Rabbat
- Public Health Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mayeh Omar
- Nuffield Centre for International Health and Development, Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
| | - Mohannad Al Nsour
- Global Health Development| Eastern Mediterranean Public Health Network, Amman, Jordan
| | - Yousef Khader
- Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Salman Rawaf
- Department of Life Sciences, School of Public Health, Imperial College London, London, United Kingdom
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