1
|
Asamoah-Boaheng M, Grunau B, Karim ME, Kirkham TL, Demers PA, MacDonald C, Goldfarb DM. The Association of Post-COVID-19-Related Symptoms and Preceding Severe Acute Respiratory Syndrome Coronavirus 2 Infection Among Fully Vaccinated Paramedics in Canada. J Infect Dis 2024; 229:1019-1025. [PMID: 37930308 DOI: 10.1093/infdis/jiad475] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 10/18/2023] [Accepted: 10/21/2023] [Indexed: 11/07/2023] Open
Abstract
This study investigated the association between previous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and risk of symptoms associated with post-COVID conditions among fully vaccinated paramedics in Canada. We included vaccinated paramedics who provided blood sample and questionnaire data on the same date during the study period. We examined the presence of symptoms associated with post-COVID conditions and depression severity against prior SARS-CoV-2 infection categories. Compared to the "no previous SARS-CoV-2 infection" group, there was no detected association between known prior SARS-CoV-2 infection (odds ratio [OR], 1.42 [95% confidence interval {CI}, 0.96-2.09]), nor unknown prior SARS-CoV-2 infection (OR, 0.54 [95% CI, 0.29-1.00]), and the presence of symptoms associated with post-COVID conditions.
Collapse
Affiliation(s)
| | - Brian Grunau
- Department of Emergency Medicine, University of British Columbia, Vancouver
| | | | - Tracy L Kirkham
- Dalla Lana School of Public Health, University of Toronto, Ontario
| | - Paul A Demers
- Dalla Lana School of Public Health, University of Toronto, Ontario
| | - Chris MacDonald
- Dalla Lana School of Public Health, University of Toronto, Ontario
| | - David M Goldfarb
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| |
Collapse
|
2
|
Yassa M, Graber JM, Black K, Dos Santos Brandao De Resende A, Legard A, Caruth J. Comparison of COVID-19 Symptoms in Correctional Health Care Workers During the Initial and Omicron Surges. J Correct Health Care 2024. [PMID: 38574252 DOI: 10.1089/jchc.23.09.0072] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
There is a dearth of medical literature that characterizes the experience of correctional health care workers (HCWs) during the COVID-19 pandemic. We performed a retrospective chart review of the results of an ongoing universal SARS-CoV-2 testing program for New Jersey correctional system HCWs and describe their presenting symptoms, perceived exposure, and demographic characteristics during the initial (March 15, 2020, to August 31, 2020) and Omicron (March 1, 2022, to August 31, 2022) COVID-19 surges. Analysis included 123 eligible records. In both surges, nurses had a high proportion of infections and cough was the most commonly reported symptom. Fever was more than twice as commonly reported in the initial surge. During the Omicron surge, nasal symptoms predominated (39.5% [95% CI: 28.4-51.4]) compared with the initial surge (8.5% [95% CI: 2.4-20.4]). Perceived exposure source was predominantly work related during the initial surge and multiple other sources of exposure were identified during the Omicron surge. Ninety-six percent of HCWs received a COVID-19 booster shot by February 2022. The reinfection rate was less than 10% for our initial cohort. Presenting symptoms correlated with the circulating variant. Mass vaccination of staff, the lower virulence of the Omicron variant, and possibly prior infection likely contributed to the milder illness experienced during the Omicron surge.
Collapse
Affiliation(s)
- Maryam Yassa
- Department of Environmental and Occupational Medicine, Robert Wood Johnson Medical School, Piscataway, New Jersey, USA
- Environmental and Occupational Health and Justice, School of Public Health, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
| | - Judith M Graber
- Environmental and Occupational Health Sciences Institute, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
- Department of Biostatistics and Epidemiology, School of Public Health, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
| | - Kathleen Black
- Environmental and Occupational Health Sciences Institute, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
| | | | - Alicia Legard
- Environmental and Occupational Health Sciences Institute, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
| | - Julie Caruth
- Environmental and Occupational Health and Justice, School of Public Health, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
- Environmental and Occupational Health Sciences Institute, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
| |
Collapse
|
3
|
Rezaei Ghahroodi Z, Eftekhari Mahabadi S, Esberizi A, Sami R, Mansourian M. Association of the medication protocols and longitudinal change of COVID-19 symptoms: a hospital-based mixed-statistical methods study. J Biopharm Stat 2024:1-21. [PMID: 38515283 DOI: 10.1080/10543406.2024.2333527] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 03/17/2024] [Indexed: 03/23/2024]
Abstract
The objective of this study was to identify the relationship between hospitalization treatment strategies leading to change in symptoms during 12-week follow-up among hospitalized patients during the COVID-19 outbreak. In this article, data from a prospective cohort study on COVID-19 patients admitted to Khorshid Hospital, Isfahan, Iran, from February 2020 to February 2021, were analyzed and reported. Patient characteristics, including socio-demographics, comorbidities, signs and symptoms, and treatments during hospitalization, were investigated. Also, to investigate the treatment effects adjusted by other confounding factors that lead to symptom change during follow-up, the binary classification trees, generalized linear mixed model, machine learning, and joint generalized estimating equation methods were applied. This research scrutinized the effects of various medications on COVID-19 patients in a prospective hospital-based cohort study, and found that heparin, methylprednisolone, ceftriaxone, and hydroxychloroquine were the most frequently prescribed medications. The results indicate that of patients under 65 years of age, 76% had a cough at the time of admission, while of patients with Cr levels of 1.1 or more, 80% had not lost weight at the time of admission. The results of fitted models showed that, during the follow-up, women are more likely to have shortness of breath (OR = 1.25; P-value: 0.039), fatigue (OR = 1.31; P-value: 0.013) and cough (OR = 1.29; P-value: 0.019) compared to men. Additionally, patients with symptoms of chest pain, fatigue and decreased appetite during admission are at a higher risk of experiencing fatigue during follow-up. Each day increase in the duration of ceftriaxone multiplies the odds of shortness of breath by 1.15 (P-value: 0.012). With each passing week, the odds of losing weight increase by 1.41 (P-value: 0.038), while the odds of shortness of breath and cough decrease by 0.84 (P-value: 0.005) and 0.56 (P-value: 0.000), respectively. In addition, each day increase in the duration of meropenem or methylprednisolone decreased the odds of weight loss at follow-up by 0.88 (P-value: 0.026) and 0.91 (P-value: 0.023), respectively (among those who took these medications). Identified prognostic factors can help clinicians and policymakers adapt management strategies for patients in any pandemic like COVID-19, which ultimately leads to better hospital decision-making and improved patient quality of life outcomes.
Collapse
Affiliation(s)
- Zahra Rezaei Ghahroodi
- School of Mathematics, Statistics and Computer Science, University of Tehran, Tehran, Iran
| | | | - Alireza Esberizi
- School of Mathematics, Statistics and Computer Science, University of Tehran, Tehran, Iran
| | - Ramin Sami
- Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Marjan Mansourian
- Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
4
|
Di Fusco M, Sun X, Allen KE, Yehoshua A, Berk A, Alvarez MB, Porter TM, Ren J, Puzniak L, Lopez SMC, Cappelleri JC. Effectiveness of BNT162b2 BA.4/5 Bivalent COVID-19 Vaccine against Long COVID Symptoms: A US Nationwide Study. Vaccines (Basel) 2024; 12:183. [PMID: 38400166 PMCID: PMC10893330 DOI: 10.3390/vaccines12020183] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 02/09/2024] [Accepted: 02/10/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Long COVID has become a central public health concern. This study characterized the effectiveness of BNT162b2 BA.4/5 bivalent COVID-19 vaccine (bivalent) against long COVID symptoms. METHODS Symptomatic US adult outpatients testing positive for SARS-CoV-2 were recruited between 2 March and 18 May 2023. Symptoms were assessed longitudinally using a CDC-based symptom questionnaire at Week 4, Month 3, and Month 6 following infection. The odds ratio (OR) of long COVID between vaccination groups was assessed by using mixed-effects logistic models, adjusting for multiple covariates. RESULTS At Week 4, among 505 participants, 260 (51%) were vaccinated with bivalent and 245 (49%) were unvaccinated. Mean age was 46.3 years, 70.7% were female, 25.1% had ≥1 comorbidity, 43.0% prior infection, 23.0% reported Nirmatrelvir/Ritonavir use. At Month 6, the bivalent cohort had 41% lower risk of long COVID with ≥3 symptoms (OR: 0.59, 95% CI, 0.36-0.96, p = 0.034) and 37% lower risk of ≥2 symptoms (OR: 0.63, 95% CI, 0.41-0.96, p = 0.030). The bivalent cohort reported fewer and less durable symptoms throughout the six-month follow-up, driven by neurologic and general symptoms, especially fatigue. CONCLUSIONS Compared with unvaccinated participants, participants vaccinated with the bivalent were associated with approximately 40% lower risk of long COVID and less symptom burden over the six-month study duration.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Jinma Ren
- Pfizer Inc., New York, NY 10001, USA
| | | | | | | |
Collapse
|
5
|
Fischer-Grote L, Fössing V, Aigner M, Fehrmann E, Boeckle M. Effectiveness of Online and Remote Interventions for Mental Health in Children, Adolescents, and Young Adults After the Onset of the COVID-19 Pandemic: Systematic Review and Meta-Analysis. JMIR Ment Health 2024; 11:e46637. [PMID: 38315524 PMCID: PMC10877489 DOI: 10.2196/46637] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 09/21/2023] [Accepted: 10/21/2023] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND The prevalence of mental illness increased in children, adolescents, and young adults during the COVID-19 pandemic, while at the same time, access to treatment facilities has been restricted, resulting in a need for the quick implementation of remote or online interventions. OBJECTIVE This study aimed to give an overview of randomized controlled studies examining remote or online interventions for mental health in children, adolescents, and young adults and to explore the overall effectiveness of these interventions regarding different symptoms. METHODS A systematic literature search was conducted according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines using PubMed, PsycInfo, Psyndex, Embase, and Google Scholar. A meta-analysis was conducted using a random effects model to calculate overall effect sizes for interventions using standardized mean differences (SMDs) for postintervention scores. RESULTS We identified 17 articles with 8732 participants in the final sample, and 13 were included in the quantitative analysis. The studies examined different digital interventions for several outcomes, showing better outcomes than the control in some studies. Meta-analyses revealed significant medium overall effects for anxiety (SMD=0.44, 95% CI 0.20 to 0.67) and social functioning (SMD=0.42, 95% CI -0.68 to -0.17) and a large significant effect for depression (SMD=1.31, 95% CI 0.34 to 2.95). In contrast, no significant overall treatment effects for well-being, psychological distress, disordered eating, and COVID-19-related symptoms were found. CONCLUSIONS The qualitative and quantitative analyses of the included studies show promising results regarding the effectiveness of online interventions, especially for symptoms of anxiety and depression and for training of social functioning. However, the effectiveness needs to be further investigated for other groups of symptoms in the future. All in all, more research with high-quality studies is required.
Collapse
Affiliation(s)
- Linda Fischer-Grote
- Department of Psychology and Psychodynamics, Karl Landsteiner University of Health Sciences, Krems, Austria
- Department of Clinical Psychology and Psychotherapy, University Hospital Krems, Krems, Austria
| | - Vera Fössing
- Research Centre Transitional Psychiatry, Karl Landsteiner University of Health Sciences, Krems, Austria
| | - Martin Aigner
- Department of Psychology and Psychodynamics, Karl Landsteiner University of Health Sciences, Krems, Austria
- Department of Psychiatry for Adults, University Hospital Tulln, Tulln, Austria
| | - Elisabeth Fehrmann
- Department of Psychology and Psychodynamics, Karl Landsteiner University of Health Sciences, Krems, Austria
| | - Markus Boeckle
- Research Centre Transitional Psychiatry, Karl Landsteiner University of Health Sciences, Krems, Austria
| |
Collapse
|
6
|
Santin A, Spedicati B, Pecori A, Nardone GG, Concas MP, Piatti G, Menini A, Tirelli G, Boscolo-Rizzo P, Girotto G. The Bittersweet Symphony of COVID-19: Associations between TAS1Rs and TAS2R38 Genetic Variations and COVID-19 Symptoms. Life (Basel) 2024; 14:219. [PMID: 38398728 PMCID: PMC10890446 DOI: 10.3390/life14020219] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/23/2024] [Accepted: 01/31/2024] [Indexed: 02/25/2024] Open
Abstract
The innate immune system is crucial in fighting SARS-CoV-2 infection, which is responsible for coronavirus disease 2019 (COVID-19). Therefore, deepening our understanding of the underlying immune response mechanisms is fundamental for the development of novel therapeutic strategies. The role of extra-oral bitter (TAS2Rs) and sweet (TAS1Rs) taste receptors in immune response regulation has yet to be fully understood. However, a few studies have investigated the association between taste receptor genes and COVID-19 symptom severity, with controversial results. Therefore, this study aims to deepen the relationship between COVID-19 symptom presence/severity and TAS1R and TAS2R38 (TAS2Rs member) genetic variations in a cohort of 196 COVID-19 patients. Statistical analyses detected significant associations between rs307355 of the TAS1R3 gene and the following COVID-19-related symptoms: chest pain and shortness of breath. Specifically, homozygous C/C patients are exposed to an increased risk of manifesting severe forms of chest pain (OR 8.11, 95% CI 2.26-51.99) and shortness of breath (OR 4.83, 95% CI 1.71-17.32) in comparison with T/C carriers. Finally, no significant associations between the TAS2R38 haplotype and the presence/severity of COVID-19 symptoms were detected. This study, taking advantage of a clinically and genetically characterised cohort of COVID-19 patients, revealed TAS1R3 gene involvement in determining COVID-19 symptom severity independently of TAS2R38 activity, thus providing novel insights into the role of TAS1Rs in regulating the immune response to viral infections.
Collapse
Affiliation(s)
- Aurora Santin
- Department of Medicine, Surgery and Health Sciences, University of Trieste, 34149 Trieste, Italy; (A.S.); (B.S.); (G.G.N.); (G.T.); (P.B.-R.); (G.G.)
| | - Beatrice Spedicati
- Department of Medicine, Surgery and Health Sciences, University of Trieste, 34149 Trieste, Italy; (A.S.); (B.S.); (G.G.N.); (G.T.); (P.B.-R.); (G.G.)
- Institute for Maternal and Child Health, I.R.C.C.S. “Burlo Garofolo”, 34137 Trieste, Italy;
| | - Alessandro Pecori
- Institute for Maternal and Child Health, I.R.C.C.S. “Burlo Garofolo”, 34137 Trieste, Italy;
| | - Giuseppe Giovanni Nardone
- Department of Medicine, Surgery and Health Sciences, University of Trieste, 34149 Trieste, Italy; (A.S.); (B.S.); (G.G.N.); (G.T.); (P.B.-R.); (G.G.)
| | - Maria Pina Concas
- Institute for Maternal and Child Health, I.R.C.C.S. “Burlo Garofolo”, 34137 Trieste, Italy;
| | - Gioia Piatti
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy;
- Unit of Bronchopneumology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Anna Menini
- Neurobiology Group, SISSA, Scuola Internazionale Superiore di Studi Avanzati, 34136 Trieste, Italy;
| | - Giancarlo Tirelli
- Department of Medicine, Surgery and Health Sciences, University of Trieste, 34149 Trieste, Italy; (A.S.); (B.S.); (G.G.N.); (G.T.); (P.B.-R.); (G.G.)
| | - Paolo Boscolo-Rizzo
- Department of Medicine, Surgery and Health Sciences, University of Trieste, 34149 Trieste, Italy; (A.S.); (B.S.); (G.G.N.); (G.T.); (P.B.-R.); (G.G.)
| | - Giorgia Girotto
- Department of Medicine, Surgery and Health Sciences, University of Trieste, 34149 Trieste, Italy; (A.S.); (B.S.); (G.G.N.); (G.T.); (P.B.-R.); (G.G.)
- Institute for Maternal and Child Health, I.R.C.C.S. “Burlo Garofolo”, 34137 Trieste, Italy;
| |
Collapse
|
7
|
Prelog M, Jeske SD, Asam C, Fuchs A, Wieser A, Gall C, Wytopil M, Mueller-Schmucker SM, Beileke S, Goekkaya M, Kling E, Geldmacher C, Rubio-Acero R, Plank M, Christa C, Willmann A, Vu M, Einhauser S, Weps M, Lampl BMJ, Almanzar G, Kousha K, Schwägerl V, Liebl B, Weber B, Drescher J, Scheidt J, Gefeller O, Messmann H, Protzer U, Liese J, Hoelscher M, Wagner R, Überla K, Steininger P. Clinical and immunological benefits of full primary COVID-19 vaccination in individuals with SARS-CoV-2 breakthrough infections: A prospective cohort study in non-hospitalized adults. J Clin Virol 2024; 170:105622. [PMID: 38091664 DOI: 10.1016/j.jcv.2023.105622] [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: 07/19/2023] [Revised: 11/23/2023] [Accepted: 11/26/2023] [Indexed: 01/23/2024]
Abstract
BACKGROUND SARS-CoV-2 variants of concern (VOC) may result in breakthrough infections (BTIs) in vaccinated individuals. The aim of this study was to investigate the effects of full primary (two-dose) COVID-19 vaccination with wild-type-based SARS-CoV-2 vaccines on symptoms and immunogenicity of SARS-CoV-2 VOC BTIs. METHODS In a longitudinal multicenter controlled cohort study in Bavaria, Germany, COVID-19 vaccinated and unvaccinated non-hospitalized individuals were prospectively enrolled within 14 days of a PCR-confirmed SARS-CoV-2 infection. Individuals were visited weekly up to 4 times, performing a structured record of medical data and viral load assessment. SARS-CoV-2-specific antibody response was characterized by anti-spike-(S)- and anti-nucleocapsid-(N)-antibody concentrations, anti-S-IgG avidity and neutralization capacity. RESULTS A total of 300 individuals (212 BTIs, 88 non-BTIs) were included with VOC Alpha or Delta SARS-CoV-2 infections. Full primary COVID-19 vaccination provided a significant effectiveness against five symptoms (relative risk reduction): fever (33 %), cough (21 %), dysgeusia (22 %), dizziness (52 %) and nausea/vomiting (48 %). Full primary vaccinated individuals showed significantly higher 50 % inhibitory concentration (IC50) values against the infecting VOC compared to unvaccinated individuals at week 1 (269 vs. 56, respectively), and weeks 5-7 (1,917 vs. 932, respectively) with significantly higher relative anti-S-IgG avidity (78% vs. 27 % at week 4, respectively). CONCLUSIONS Full primary COVID-19 vaccination reduced symptom frequencies in non-hospitalized individuals with BTIs and elicited a more rapid and longer lasting neutralization capacity against the infecting VOC compared to unvaccinated individuals. These results support the recommendation to offer at least full primary vaccination to all adults to reduce disease severity caused by immune escape-variants.
Collapse
Affiliation(s)
- Martina Prelog
- Pediatric Rheumatology / Special Immunology, Department of Pediatrics, University Hospital Würzburg, Würzburg, Germany
| | - Samuel D Jeske
- Institute of Virology, Technical University of Munich, School of Medicine, Munich, Germany
| | - Claudia Asam
- Institute of Clinical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, Germany
| | - Andre Fuchs
- Internal Medicine III - Gastroenterology and Infectious Diseases, University Hospital of Augsburg, Augsburg, Germany
| | - Andreas Wieser
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität (LMU) Munich, Munich, Germany
| | - Christine Gall
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Monika Wytopil
- Institute of Clinical and Molecular Virology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Sandra M Mueller-Schmucker
- Institute of Clinical and Molecular Virology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Stephanie Beileke
- Institute of Clinical and Molecular Virology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Mehmet Goekkaya
- Environmental Medicine, Faculty of Medicine, University of Augsburg, Institute of Environmental Medicine Helmholtz Zentrum München, German Research Center for Environmental Health, Augsburg, Germany
| | - Elisabeth Kling
- Institute of Laboratory Medicine and Microbiology University Hospital Augsburg, Augsburg, Germany
| | - Christof Geldmacher
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität (LMU) Munich, Munich, Germany; German Centre for Infection Research (DZIF), Partner Site Munich, Munich, Germany
| | - Raquel Rubio-Acero
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität (LMU) Munich, Munich, Germany
| | - Michael Plank
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität (LMU) Munich, Munich, Germany
| | - Catharina Christa
- Institute of Virology, Technical University of Munich, School of Medicine, Munich, Germany
| | - Annika Willmann
- Institute of Virology, Technical University of Munich, School of Medicine, Munich, Germany
| | - Martin Vu
- Institute of Virology, Technical University of Munich, School of Medicine, Munich, Germany
| | - Sebastian Einhauser
- Institute of Medical Microbiology and Hygiene, Molecular Microbiology (Virology), University of Regensburg, Regensburg, Germany
| | - Manuela Weps
- Institute of Clinical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, Germany
| | - Benedikt M J Lampl
- Regensburg Department of Public Health, Division of Infection Control and Prevention, Regensburg, Germany; Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Giovanni Almanzar
- Pediatric Rheumatology / Special Immunology, Department of Pediatrics, University Hospital Würzburg, Würzburg, Germany
| | - Kimia Kousha
- Pediatric Rheumatology / Special Immunology, Department of Pediatrics, University Hospital Würzburg, Würzburg, Germany
| | - Valeria Schwägerl
- Pediatric Infectious Diseases, Department of Pediatrics, University Hospital Würzburg, Würzburg, Germany
| | - Bernhard Liebl
- Bavarian Health and Food Safety Authority (LGL), Oberschleißheim, Germany
| | - Beatrix Weber
- Institute for Information Systems, University of Applied Sciences Hof, Hof, Germany
| | | | - Jörg Scheidt
- Institute for Information Systems, University of Applied Sciences Hof, Hof, Germany
| | - Olaf Gefeller
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Helmut Messmann
- Internal Medicine III - Gastroenterology and Infectious Diseases, University Hospital of Augsburg, Augsburg, Germany
| | - Ulrike Protzer
- Institute of Virology, Technical University of Munich, School of Medicine, Munich, Germany; Institute of Virology, Helmholtz Munich, Munich, Germany, and German Center for Infection Research, Munich partner site
| | - Johannes Liese
- Pediatric Infectious Diseases, Department of Pediatrics, University Hospital Würzburg, Würzburg, Germany
| | - Michael Hoelscher
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität (LMU) Munich, Munich, Germany; German Centre for Infection Research (DZIF), Partner Site Munich, Munich, Germany
| | - Ralf Wagner
- Institute of Clinical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, Germany; Institute of Medical Microbiology and Hygiene, Molecular Microbiology (Virology), University of Regensburg, Regensburg, Germany
| | - Klaus Überla
- Institute of Clinical and Molecular Virology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Philipp Steininger
- Institute of Clinical and Molecular Virology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
| |
Collapse
|
8
|
Jiang K, Mujtaba MM, Bernard GR. Answering List-Type Questions in Health Domain with Pretrained Large Language Model: A Case for COVID-19 Symptoms. Stud Health Technol Inform 2024; 310:629-633. [PMID: 38269885 DOI: 10.3233/shti231041] [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] [Indexed: 01/26/2024]
Abstract
List-type questions, which can have a varying number of answers, are more common in the health domain where people seek for health-related information from a passage or passages. An example of this type of question answering task is to find COVID-19 symptoms from a Twitter post. However, due to the lack of annotated instances for supervised learning, automatic identification of COVID-19 symptoms from Twitter posts is challenging. We investigated detection of symptom mentions in Twitter posts using GPT-3, a pre-trained large language model, along with few-shot learning. Our results of 5-shot and 10-shot learning on a corpus of 655 annotated tweets demonstrate that few-shot learning with pre-trained large language model is a promising approach to answering list-type questions with a minimal amount of effort of annotation.
Collapse
Affiliation(s)
- Keyuan Jiang
- Purdue University Northwest, Hammond, Indiana, USA
| | | | | |
Collapse
|
9
|
Öner U, Cengiz Z. The effects of aromatherapy with thyme oil on disease symptoms, vital findings, and hemodynamic parameters in COVID-19 patients. Explore (NY) 2023:S1550-8307(23)00275-6. [PMID: 38129231 DOI: 10.1016/j.explore.2023.12.004] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/06/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE To determine the effect of aromatherapy with thyme oil on disease symptoms, vital signs, and hemodynamic parameters in COVID-19 patients. METHODS We conducted the randomized controlled trial with 140 (experimental group=70, control group=70) COVID-19 patients. Patients admitted to the COVID-19 service of the Batman Training and Research Hospital were included in the sample between 31.01 - 31.08 2022. Patients in the experimental group inhaled thyme oil 3 times a day during 5 days. At the end of day 5, symptoms and hemodynamic parameters were measured as posttest. Vital signs were measured 3 times a day during 5 days. The control group only received routine treatment. RESULTS Thyme oil was found to be effective in relieving symptoms of shortness of breath, dizziness, secretion, diarrhea, weakness, loss of appetite, cough, headache and muscle joint pain. Although there was improvement in the symptoms of nausea-vomiting, runny nose and loss of taste-smell, the effect was not statistically significant. Thyme oil significantly decreased body temperature, pulse rate and respiratory rate (p<0.05), increased SPO 2 (p<0.05), and did not affect systolic and diastolic blood pressure (p>0.05). It had a significant effect on the regulation of pH, decreased CO2 and increased O2 significantly (p<0.05). CONCLUSION Thyme oil aromatherapy was effective in reducing symptoms, regulating vital signs and hemodynamic parameters. Accordingly, thyme oil is recommended as non-pharmacological treatment method in COVID-19 patients.
Collapse
Affiliation(s)
- Uğur Öner
- Department of Fundamentals of Nursing, Batman University, Faculty of Health Sciences, Main Campus 72060, Batman, Turkey
| | - Zeliha Cengiz
- Department of Fundamentals of Nursing, Inonu University, Nursing Faculty, Malatya, Turkey.
| |
Collapse
|
10
|
Kavi A, Goudar SS, Somannavar MS, Moore JL, Derman RJ, Saleem S, Naqvi S, Billah SM, Haque R, Figueroa L, Mazariegos M, Lokangaka A, Tshefu A, Esamai F, Mwenechanya M, Chomba E, Patel A, Das P, Bauserman M, Petri WA, Krebs NF, Carlo WA, Bucher S, Hibberd PL, Koso-Thomas M, McClure EM, Goldenberg RL. COVID-19 symptoms and antibody positivity among unvaccinated pregnant women: An observational study in seven countries from the Global Network. BJOG 2023; 130 Suppl 3:140-148. [PMID: 37470094 PMCID: PMC10799161 DOI: 10.1111/1471-0528.17604] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 06/24/2023] [Indexed: 07/21/2023]
Abstract
OBJECTIVE To determine the relation of COVID-19 symptoms to COVID-19 antibody positivity among unvaccinated pregnant women in low- and middle-income countries (LMIC). DESIGN COVID-19 infection status measured by antibody positivity at delivery was compared with the symptoms of COVID-19 in the current pregnancy in a prospective, observational cohort study in seven LMICs. SETTING The study was conducted among women in the Global Network for Women's and Children's Health's Maternal and Newborn Health Registry (MNHR), a prospective, population-based study in Kenya, Zambia, the Democratic Republic of the Congo (DRC), Bangladesh, Pakistan, India (Belagavi and Nagpur sites) and Guatemala. POPULATION Pregnant women enrolled in the ongoing pregnancy registry at study sites. METHODS Data on COVID-19 symptoms during the current pregnancy were collected by trained staff between October 2020 and June 2022. COVID-19 antibody testing was performed on samples collected at delivery. The relation between COVID-19 antibody positivity and symptoms was assessed using generalised linear models with a binomial distribution adjusting for site and symptoms. MAIN OUTCOME MEASURES COVID-19 antibody status and symptoms of COVID-19 among pregnant women. RESULTS Among 19 218 non-vaccinated pregnant women who were evaluated, 14.1% of antibody-positive women had one or more symptoms compared with 13.4% in antibody-negative women. Overall, 85.3% of antibody-positive women reported no COVID-19 symptoms during the present pregnancy. Reported fever was significantly associated with antibody status (relative risk [RR] 1.10, 95% CI 1.03-11.18; P = 0.008). A multiple variable model adjusting for site and all eight symptoms during pregnancy showed similar results (RR 1.13, 95% CI 1.04-1.23; P = 0.012). None of the other symptoms was significantly related to antibody positivity. CONCLUSIONS In a population-based cohort in LMICs, unvaccinated pregnant women who were antibody-positive had slightly more symptoms during their pregnancy and a small but significantly greater increase in fever. However, for prevalence studies, evaluating COVID-19-related symptoms does not appear to be useful in differentiating pregnant women who have had a COVID-19 infection.
Collapse
Affiliation(s)
- Avinash Kavi
- KLE Academy of Higher Education and Research, Jawaharlal Nehru Medical College, Belagavi, India
| | - Shivaprasad S Goudar
- KLE Academy of Higher Education and Research, Jawaharlal Nehru Medical College, Belagavi, India
| | - Manjunath S Somannavar
- KLE Academy of Higher Education and Research, Jawaharlal Nehru Medical College, Belagavi, India
| | - Janet L Moore
- Research Triangle Institute (RTI) International, Research Triangle Park, North Carolina, USA
| | | | | | | | - Sk Masum Billah
- International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
- University of Sydney, Sydney, New South Wales, Australia
| | - Rashidul Haque
- International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | - Lester Figueroa
- Instituto de Nutrición de Centroamérica y Panamá (INCAP), Guatemala City, Guatemala
| | - Manolo Mazariegos
- Instituto de Nutrición de Centroamérica y Panamá (INCAP), Guatemala City, Guatemala
| | - Adrien Lokangaka
- Kinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo
| | - Antoinette Tshefu
- Kinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo
| | | | | | - Elwyn Chomba
- University of Zambia, University Teaching Hospital, Lusaka, Zambia
| | - Archana Patel
- Lata Medical Research Foundation, Nagpur, India
- Datta Meghe Institute of Medical, Sciences, Sawangi, India
| | | | - Melissa Bauserman
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Nancy F Krebs
- University of Colorado School of Medicine, Aurora, Colorado, USA
| | | | - Sherri Bucher
- Indiana School of Medicine, University of Indiana, Indianapolis, Indiana, USA
| | | | - Marion Koso-Thomas
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
| | - Elizabeth M McClure
- Research Triangle Institute (RTI) International, Research Triangle Park, North Carolina, USA
| | | |
Collapse
|
11
|
Di Fusco M, Sun X, Anatale-Tardiff L, Yehoshua A, Coetzer H, Alvarez MB, Allen KE, Porter TM, Puzniak L, Lopez SMC, Cappelleri JC. Impact of Bivalent BA.4/5 BNT162b2 COVID-19 Vaccine on Acute Symptoms, Quality of Life, Work Productivity and Activity Levels among Symptomatic US Adults Testing Positive for SARS-CoV-2 at a National Retail Pharmacy. Vaccines (Basel) 2023; 11:1669. [PMID: 38006001 PMCID: PMC10675533 DOI: 10.3390/vaccines11111669] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/23/2023] [Accepted: 10/28/2023] [Indexed: 11/26/2023] Open
Abstract
Evidence on the impact of COVID-19 vaccination on symptoms, Health-Related Quality of Life (HRQoL) and Work Productivity and Activity Impairment (WPAI) is scarce. We analyzed associations between bivalent BA.4/5 BNT162b2 (BNT162b2) and these patient-reported outcomes (PROs). Symptomatic US adults testing positive for SARS-CoV-2 were recruited between 2 March and 18 May 2023 (CT.gov NCT05160636). PROs were assessed using four questionnaires measuring symptoms, HRQoL and WPAI (a CDC-based symptom survey, PROMIS Fatigue, EQ-5D-5L, WPAI-GH), from pre-COVID to Week 4 following infection. Multivariable analysis using mixed models for repeated measures was conducted, adjusting for several covariates. The study included 643 participants: 316 vaccinated with BNT162b2 and 327 unvaccinated/not up-to-date. Mean (SD) age was 46.5 years (15.9), 71.2% were female, 44.2% reported prior infection, 25.7% had ≥1 comorbidity. The BNT162b2 cohort reported fewer acute symptoms through Week 4, especially systemic and respiratory symptoms. All PROs were adversely affected, especially at Week 1; however, at that time point, the BNT162b2 cohort reported better work performance, driven by less absenteeism, and fewer work hours lost. No significant differences were observed for HRQoL COVID-19 negatively impacted patient outcomes. Compared with unvaccinated/not up-to-date participants, those vaccinated with bivalent BA.4/5 BNT162b2 reported fewer and less persistent symptoms and improved work performance.
Collapse
Affiliation(s)
| | - Xiaowu Sun
- CVS Health, Woonsocket, RI 02895, USA (L.A.-T.); (H.C.)
| | | | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Di Fusco M, Cappelleri JC, Anatale-Tardiff L, Coetzer H, Yehoshua A, Alvarez MB, Allen KE, Porter TM, Puzniak L, Cha-Silva AS, Lopez SMC, Sun X. Impact of COVID-19 Infection on Health-Related Quality of Life, Work Productivity and Activity Impairment by Symptom-Based Long COVID Status and Age in the US. Healthcare (Basel) 2023; 11:2790. [PMID: 37893865 PMCID: PMC10606451 DOI: 10.3390/healthcare11202790] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/05/2023] [Accepted: 10/20/2023] [Indexed: 10/29/2023] Open
Abstract
COVID-19 infection adversely impacts patients' wellbeing and daily lives. This survey-based study examined differences in patient-reported COVID-19 symptoms, Health-Related Quality of Life (HRQoL) and Work Productivity and Activity Impairment (WPAI) among groups of patients defined based on age and symptom-based long COVID status. Symptomatic, COVID-19-positive US outpatients were recruited from 31 January-30 April 2022. Outcomes were collected via validated instruments at pre-COVID, Day 3, Week 1, Week 4, Month 3 and Month 6 following infection, with changes assessed from pre-COVID and between groups, adjusting for covariates. EQ-5D-5L HRQoL and WPAI scores declined in all groups, especially during the first week. Long COVID patients reported significantly higher symptoms burden and larger drops in HRQoL and WPAI scores than patients without long COVID. Their HRQoL and WPAI scores did not return to levels comparable to pre-COVID through Month 6, except for absenteeism. Patients without long COVID generally recovered between Week 4 and Month 3. Older (>50) and younger adults generally reported comparable symptoms burden and drops in HRQoL and WPAI scores. During the first week of infection, COVID-19-related health issues caused loss of 14 to 26 work hours across the groups. These data further knowledge regarding the differential impacts of COVID-19 on clinically relevant patient groups.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Xiaowu Sun
- CVS Health, Woonsocket, RI 02895, USA; (L.A.-T.); (X.S.)
| |
Collapse
|
13
|
Di Fusco M, Sun X, Moran MM, Coetzer H, Zamparo JM, Alvarez MB, Puzniak L, Tabak YP, Cappelleri JC. Impact of COVID-19 and effects of booster vaccination with BNT162b2 on six-month long COVID symptoms, quality of life, work productivity and activity impairment during Omicron. J Patient Rep Outcomes 2023; 7:77. [PMID: 37486567 PMCID: PMC10366033 DOI: 10.1186/s41687-023-00616-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 03/17/2023] [Accepted: 07/12/2023] [Indexed: 07/25/2023] Open
Abstract
BACKGROUND Longitudinal estimates of long COVID burden during Omicron remain limited. This study characterized long-term impacts of COVID-19 and booster vaccination on symptoms, Health-Related Quality of Life (HRQoL), and Work Productivity Activity Impairment (WPAI). METHODS Outpatients with ≥ 1 self-reported symptom and positive SARS-CoV-2 test at CVS Health United States test sites were recruited between 01/31 and 04/30/2022. Symptoms, EQ-5D and WPAI were collected via online surveys until 6 months following infection. Both observed and model-based estimates were analyzed. Effect sizes based on Cohen's d quantified the magnitude of outcome changes over time, within and between vaccination groups. Mixed models for repeated measures were conducted for multivariable analyses, adjusting for covariates. Logistic regression assessed odds ratio (OR) of long COVID between vaccination groups. RESULTS At long COVID start (Week 4), 328 participants included 87 (27%) Boosted with BNT162b2, 86 (26%) with a BNT162b2 primary series (Primed), and 155 (47%) Unvaccinated. Mean age was 42.0 years, 73.8% were female, 26.5% had ≥ 1 comorbidity, 36.9% prior infection, and 39.6% reported ≥ 3 symptoms (mean: 3.1 symptoms). At Month 6, among 260 participants, Boosted reported a mean of 1.1 symptoms versus 3.4 and 2.8 in Unvaccinated and Primed, respectively (p < 0.001). Boosted had reduced risks of ≥ 3 symptoms versus Unvaccinated (observed: OR 0.22, 95% CI 0.10-0.47, p < 0.001; model-based: OR 0.36, 95% CI 0.15-0.87, p = 0.019) and Primed (observed: OR 0.29, 95% CI 0.13-0.67, p = 0.003; model-based: OR 0.59, 95% CI 0.21-1.65, p = 0.459). Results were consistent using ≥ 2 symptoms. Regarding HRQoL, among those with long COVID, Boosted had higher EQ-5D Utility Index (UI) than Unvaccinated (observed: 0.922 vs. 0.731, p = 0.014; model-based: 0.910 vs. 0.758, p-value = 0.038) and Primed (0.922 vs. 0.648, p = 0.014; model-based: 0.910 vs. 0.708, p-value = 0.008). Observed and model-based estimates for EQ-VAS and UI among Boosted were comparable with pre-COVID since Month 3. Subjects vaccinated generally reported better WPAI scores. CONCLUSIONS Long COVID negatively impacted HRQoL and WPAI. The BNT162b2 booster could have a beneficial effect in reducing the risk and burden of long COVID. Boosted participants reported fewer and less durable symptoms, which contributed to improve HRQoL and maintain WPAI levels. Limitations included self-reported data and small sample size for WPAI.
Collapse
Affiliation(s)
- Manuela Di Fusco
- Health Economics and Outcomes Research, Pfizer Inc, New York, NY, USA.
| | | | | | | | | | - Mary B Alvarez
- Field Medical Outcomes and Analytics, Pfizer Inc, New York, NY, USA
| | | | | | | |
Collapse
|
14
|
Wang RC, Gottlieb M, Montoy JCC, Rodriguez RM, Yu H, Spatz ES, Chandler CW, Elmore JG, Hannikainen PA, Chang AM, Hill M, Huebinger RM, Idris AH, Koo K, Li SX, McDonald S, Nichol G, O’Laughlin KN, Plumb ID, Santangelo M, Saydah S, Stephens KA, Venkatesh AK, Weinstein RA. Association Between SARS-CoV-2 Variants and Frequency of Acute Symptoms: Analysis of a Multi-institutional Prospective Cohort Study-December 20, 2020-June 20, 2022. Open Forum Infect Dis 2023; 10:ofad275. [PMID: 37426947 PMCID: PMC10327880 DOI: 10.1093/ofid/ofad275] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 05/22/2023] [Indexed: 07/11/2023] Open
Abstract
Background While prior work examining severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern focused on hospitalization and death, less is known about differences in clinical presentation. We compared the prevalence of acute symptoms across pre-Delta, Delta, and Omicron. Methods We conducted an analysis of the Innovative Support for Patients with SARS-CoV-2 Infections Registry (INSPIRE), a cohort study enrolling symptomatic SARS-CoV-2-positive participants. We determined the association between the pre-Delta, Delta, and Omicron time periods and the prevalence of 21 coronavirus disease 2019 (COVID-19) acute symptoms. Results We enrolled 4113 participants from December 2020 to June 2022. Pre-Delta vs Delta vs Omicron participants had increasing sore throat (40.9%, 54.6%, 70.6%; P < .001), cough (50.9%, 63.3%, 66.7%; P < .001), and runny noses (48.9%, 71.3%, 72.9%; P < .001). We observed reductions during Omicron in chest pain (31.1%, 24.2%, 20.9%; P < .001), shortness of breath (42.7%, 29.5%, 27.5%; P < .001), loss of taste (47.1%, 61.8%, 19.2%; P < .001), and loss of smell (47.5%, 55.6%, 20.0%; P < .001). After adjustment, those infected during Omicron had significantly higher odds of sore throat vs pre-Delta (odds ratio [OR], 2.76; 95% CI, 2.26-3.35) and Delta (OR, 1.96; 95% CI, 1.69-2.28). Conclusions Participants infected during Omicron were more likely to report symptoms of common respiratory viruses, such as sore throat, and less likely to report loss of smell and taste. Trial registration NCT04610515.
Collapse
Affiliation(s)
- Ralph C Wang
- Department of Emergency Medicine, University of California San Francisco, San Francisco, California, USA
| | - Michael Gottlieb
- Department of Emergency Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Juan Carlos C Montoy
- Department of Emergency Medicine, University of California San Francisco, San Francisco, California, USA
| | - Robert M Rodriguez
- Department of Emergency Medicine, University of California San Francisco, San Francisco, California, USA
| | - Huihui Yu
- Center for Outcomes Research and Evaluation, Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Erica S Spatz
- Center for Outcomes Research and Evaluation, Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Christopher W Chandler
- Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Joann G Elmore
- Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
- Department of Health Policy and Management, Fielding School of Public Health, University of California Los Angeles, Los Angeles, California, USA
| | - Paavali A Hannikainen
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Anna Marie Chang
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Mandy Hill
- Department of Emergency Medicine, UTHealth Houston, Houston, Texas, USA
| | - Ryan M Huebinger
- Department of Emergency Medicine, UTHealth Houston, Houston, Texas, USA
| | - Ahamed H Idris
- Department of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Katherine Koo
- Department of Medicine, Division of Infectious Diseases, Rush University Medical Center, Chicago, Illinois, USA
| | - Shu-Xia Li
- Center for Outcomes Research and Evaluation, Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Samuel McDonald
- Department of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Graham Nichol
- Departments of Medicine and Emergency Medicine, University of Washington, Seattle, Washington, USA
| | - Kelli N O’Laughlin
- Departments of Emergency Medicine and Global Health, University of Washington, Seattle, Washington, USA
| | - Ian D Plumb
- Centers for Disease Control and Prevention, National Center for Immunizations and Respiratory Diseases, Atlanta, Georgia, USA
| | - Michelle Santangelo
- Division of Infectious Diseases, Department of Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Sharon Saydah
- Centers for Disease Control and Prevention, National Center for Immunizations and Respiratory Diseases, Atlanta, Georgia, USA
| | - Kari A Stephens
- Departments of Family Medicine and Biomedical Informatics & Medical Education, University of Washington, Seattle, Washington, USA
| | - Arjun K Venkatesh
- Center for Outcomes Research and Evaluation, Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Robert A Weinstein
- Department of Medicine, Division of Infectious Diseases, Rush University Medical Center, Chicago, Illinois, USA
| |
Collapse
|
15
|
Jiang K, Mujtaba MM, Bernard GR. Large Language Model as Unsupervised Health Information Retriever. Stud Health Technol Inform 2023; 302:833-834. [PMID: 37203511 DOI: 10.3233/shti230282] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Retrieving health information is a task of search for health-related information from a variety of sources. Gathering self-reported health information may help enrich the knowledge body of the disease and its symptoms. We investigated retrieving symptom mentions in COVID-19-related Twitter posts with a pretrained large language model (GPT-3) without providing any examples (zero-shot learning). We introduced a new performance measure of total match (TM) to include exact, partial and semantic matches. Our results show that the zero-shot approach is a powerful method without the need to annotate any data, and it can assist in generating instances for few-shot learning which may achieve better performance.
Collapse
Affiliation(s)
- Keyuan Jiang
- Purdue University Northwest, Hammond, Indiana, USA
| | | | | |
Collapse
|
16
|
Imeshtari V, Vezza F, Barletta VI, Bongiovanni A, Colaprico C, Shaholli D, Ricci E, Carluccio G, Moretti L, Manai MV, Chiappetta M, Paolini R, Marte M, Previte CM, Barone LC, Faticoni A, Cammalleri V, Pocino RN, Picchioni F, Kibi S, Deriu G, Serruto P, Dorelli B, Mazzalai E, Giffi M, Marotta D, Manzi M, Marasca V, Cocchiara RA, Ciccone F, Pasculli P, Massetti P, Antonelli G, Mastroianni CM, La Torre G. Synergistic Effect between SARS-CoV-2 Wave and COVID-19 Vaccination on the Occurrence of Mild Symptoms in Healthcare Workers. Vaccines (Basel) 2023; 11:vaccines11050882. [PMID: 37242986 DOI: 10.3390/vaccines11050882] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Since the beginning of the pandemic, five variants of epidemiological interest have been identified, each of them with its pattern of symptomology and disease severity. The aim of this study is to analyze the role of vaccination status in modulating the pattern of symptomatology associated with COVID-19 infection during four waves. METHODS Data from the surveillance activity of healthcare workers were used to carry out descriptive analysis, association analyses and multivariable analysis. A synergism analysis between vaccination status and symptomatology during the waves was performed. RESULTS Females were found at a higher risk of developing symptoms. Four SARS-CoV-2 waves were identified. Pharyngitis and rhinitis were more frequent during the fourth wave and among vaccinated subjects while cough, fever, flu syndrome, headache, anosmia, ageusia, arthralgia/arthritis and myalgia were more frequent during the first three waves and among unvaccinated subjects. A correlation was found between vaccination and the different waves in terms of developing pharyngitis and rhinitis. CONCLUSION Vaccination status and viruses' mutations had a synergic effect in the mitigation of the symptomatology caused by SARS-CoV-2 in healthcare workers.
Collapse
Affiliation(s)
- Valentin Imeshtari
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Francesca Vezza
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Vanessa India Barletta
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Andrea Bongiovanni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Corrado Colaprico
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - David Shaholli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Eleonora Ricci
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Giovanna Carluccio
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Luca Moretti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Maria Vittoria Manai
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Marta Chiappetta
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Riccardo Paolini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Mattia Marte
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Carlo Maria Previte
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Lavinia Camilla Barone
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Augusto Faticoni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Vittoria Cammalleri
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Roberta Noemi Pocino
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Filippo Picchioni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Shizuka Kibi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Gloria Deriu
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Pasquale Serruto
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Barbara Dorelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Elena Mazzalai
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Monica Giffi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Daniela Marotta
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Mattia Manzi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Valentina Marasca
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Rosario Andrea Cocchiara
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Federica Ciccone
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Patrizia Pasculli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Paola Massetti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Guido Antonelli
- Laboratory of Microbiology and Virology, Department of Molecular Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | | | - Giuseppe La Torre
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| |
Collapse
|
17
|
Shokri MA, Moghadam Fard T, Ramim T, Hejrati A, Hejrati L, Mokhtare M. What is the role of proton pump inhibitors consumption on the clinical presentation and severity of COVID-19 infection? Ann Pharm Fr 2023; 81:210-9. [PMID: 36049543 DOI: 10.1016/j.pharma.2022.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 08/21/2022] [Accepted: 08/23/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Proton pump inhibitors (PPI) are among the most prescribed drugs worldwide; therefore, assessing their effect on COVID-19 infection symptoms and severity is of great importance. This study was designed to evaluate the role of previous PPI consumption on the clinical presentation and severity of COVID-19. PATIENTS AND METHODS All adult COVID-19 patients were eligible in this observational cross-sectional study. The patients' demographic and clinical data, history of PPI consumption, and comorbid disease were recorded. Charlson comorbidity index (CCI) and quick COVID-19 severity index (qCSI) score were calculated for each patient. IBM SPSS version 25 was used for statistical analysis. RESULTS Totally 670 patients completed the study (PPI users=121). The average severity (qCSI) score of PPI user patients with comorbidity score of zero was significantly higher than non-users (P-value=0.001). Mortality rate was 6.6% and 3.8% in PPI-users and non-users respectively (P-value=0.117). PPI users were significantly more symptomatic compared to non-users (P-value=0.001). CONCLUSION We found that PPI users were meaningfully more symptomatic and had a higher severity (qCSI) score. Rational prescription of PPIs should be considered by physicians during and after the pandemic.
Collapse
|
18
|
Vawter NL, Godino JG, Lewis SV, Northrup AW, Samaniego JC, Poblete JY, Guereca JA, Sharp SP, Matthews E, Crespo NC, Lucatero PG, Vidaurrazaga MM, Ramers CB. COVID-19 monoclonal antibody treatment impact on symptoms and post-COVID conditions among high-risk patients at a Federally Qualified Health Center. BMC Infect Dis 2023; 23:105. [PMID: 36814187 DOI: 10.1186/s12879-023-08057-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 02/06/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Monoclonal antibody (mAb) treatment for COVID-19 is associated with improved clinical outcomes. However, there is limited information regarding the impact of treatment on symptoms and the prevalence of post-COVID Conditions (PCC). Understanding of the association between time to mAb infusion and the development of PCC is also limited. METHODS This longitudinal study was conducted among patients with COVID-19 who received mAb infusions at a Federally Qualified Health Center in San Diego, CA. A series of telephone interviews were conducted at baseline and follow-up (14 days and 28+ days). A comprehensive symptom inventory was completed and physical and mental health status were measured using PROMIS-29 and PHQ-2. Pearson's Chi-squared tests and independent two-sample t-tests were performed to test for association between time to mAb infusion and outcomes at follow-up. A Poisson regression model was used to analyze whether time to mAb infusion predicts risk of developing PCC. RESULTS Participants (N = 411) were 53% female, ranged in age from 16 to 92 years (mean 50), and a majority (56%) were Latino/Hispanic. Cross-sectional findings revealed a high symptom burden at baseline (70% of patients had cough, 50% had fever, and 44% had headache). The prevalence of many symptoms decreased substantially by the final follow-up survey (29% of patients had cough, 3% had fever, and 28% had headache). Longitudinal findings indicated that 10 symptoms decreased in prevalence from baseline to final follow-up, 2 remained the same, and 14 increased. The severity of symptoms and most patient-reported physical and mental health measure scores decreased over time. The prevalence of PCC was 69% when PCC was defined as ≥ 1 symptom at final follow-up. Time to mAb infusion was not significantly associated with any outcome at follow-up. Time to infusion was not associated with PCC status at final follow-up in the crude or adjusted Poisson regression models. CONCLUSIONS The prevalence of PCC was high among this patient population following COVID-19 mAb treatment. Time to mAb infusion did not predict the development of PCC. Further research in these areas is essential to answer urgent clinical questions about effective treatments of COVID-19.
Collapse
|
19
|
Udzik J, Kowalczyk A, Waszczyk A, Nowaczyk Z, Barczyszyn A, Działa K, Mularczyk M, Niekrasz M. Neurological Manifestations of Non-Severe COVID-19-A Multidirectional Approach. Brain Sci 2023; 13. [PMID: 36831898 DOI: 10.3390/brainsci13020355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/14/2023] [Accepted: 02/17/2023] [Indexed: 02/22/2023] Open
Abstract
COVID-19 remains a significant clinical issue worldwide, with frequent neurological manifestations. In this study, the authors combine data obtained from the patient's medical history, physical examinations, and additional test results in the pursuit of any clinically relevant connections. Fifty-eight adult patients hospitalized in the Department of Neurology and Infectiology over a five-months period were retrospectively enrolled in this study. On admission, all patients included in this study were classified as mild or moderate COVID-19 cases, according to the World Health Organization (WHO) guidelines. Laboratory tests, Electroencephalography (EEG), and Magnetic Resonance Imaging (MRI) were performed. There was no statistically significant difference in the Neutrophil-Lymphocyte Ratio (NLR), C-reactive protein (CRP), and Interleukin 6 (IL-6) in patients who reported to the hospital within a week from the symptoms' onset and in those who reported later. In total, 49.06% of patients with eligible EEG recordings presented abnormal brain activity, while 27.59% of the study population had COVID-19-associated MRI findings. EEG and MRI abnormality occurrence did not correlate with the incidence of mild neurological symptoms (headache, olfactory, and gustatory disorders) of the SARS-CoV-2 infection. In three patients in this study population, unprovoked generalized epileptic seizures occurred for the first time in their life. Non-severe SARS-CoV-2 infection causes functional and structural abnormalities within the central nervous system. Brain microhemorrhages are frequently present in non-severe COVID-19 patients. There is no significant association between mild neurological symptoms of COVID-19 and additional test abnormalities. The time from SARS-CoV-2 infection's onset to hospital admission does not seem to influence the prognostic value of CRP, IL-6, and NLR in non-severe COVID-19. Mild-to-moderate SARS-CoV-2 infection can be a trigger factor for epilepsy and epileptic seizures.
Collapse
|
20
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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
| |
Collapse
|
21
|
Skourtis A, Ekmektzoglou K, Xanthos T, Stouraitou S, Iacovidou N. Non-Typical Clinical Presentation of COVID-19 Patients in Association with Disease Severity and Length of Hospital Stay. J Pers Med 2023; 13. [PMID: 36675793 DOI: 10.3390/jpm13010132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/20/2022] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND This study aimed to investigate the incidence of non-typical symptoms in ambulatory patients with mild-to-moderate COVID-19 infection and their potential association with disease progression. MATERIALS AND METHODS Data on the symptomatology of COVID-19 patients presenting to the fast-track emergency department were collected between March 2020 and March 2021. Fever, cough, shortness of breath, and fatigue-weakness were defined as "typical" symptoms, whereas all other symptoms such as nasal congestion, rhinorrhea, gastrointestinal symptoms, etc., were defined as "non-typical". RESULTS A total of 570 COVID-19 patients with a mean age of 42.25 years were included, the majority of whom were male (61.3%; N = 349), and were divided according to their symptoms into two groups. The mean length of hospital stay was found to be 9.5 days. A higher proportion of patients without non-typical symptoms were admitted to the hospital (p = 0.001) and the ICU (p = 0.048) as well. No significant differences were observed between non-typical symptoms and outcome (p = 0.685). Patients who did not demonstrate at least one non-typical symptom had an extended length of stay (p = 0.041). No statistically significant differences in length of hospital stay were associated with individual symptoms. CONCLUSION With the possible exception of gastrointestinal symptoms, non-typical symptoms of COVID-19 at baseline appear to predispose to a milder disease.
Collapse
|
22
|
Alhotye M, Daynes E, Gerlis C, Singh SJ. Symptoms burden and rehabilitation preference after an episode of COVID-19: A patients survey. Chron Respir Dis 2023; 20:14799731231177316. [PMID: 37192536 DOI: 10.1177/14799731231177316] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND After COVID-19 infection, individuals can experience a variety of symptoms that might require further treatment. Early data showed the value of adapted pulmonary rehabilitation programmes and technology-based interventions. To develop appropriate services, it is important to understand the symptom burden and the preferred mode of rehabilitation delivery. METHODS Post-hospital discharge (H) and post-community-managed (C) individuals received a follow-up call. A survey was completed to assess the most burdensome symptoms for which the patients would require support and their preference for the mode of rehabilitation delivery. RESULTS Overall, 160 individuals who received a follow-up call completed the survey (51.2% male, mean [SD] age 54 [15] years) and 126 (78.8%) were post-hospital, while 34 (21.3%) had community-managed infections. A total of 101 (63.1%) reported that COVID-19-related symptoms were affecting their daily activities, and 106 (66.3%) reported their desire to be more active. The most common symptoms identified as needing support were fatigue and shortness of breath. Both groups expressed a preference for a face-to-face group programme (C: 54.8%; H: 46.8%), while (38.7%) of post-community-managed individuals and (40.3%) post-hospital patients preferred a supported digital rehabilitation programme. Few opted a non-digital home-based programme (C: 3.2%; H:12.9%, respectively). CONCLUSION The survey responses indicated a significant symptom burden that may benefit from an intervention such as rehabilitation. Preferences for rehabilitation indicated that a face-to-face intervention was preferred by the majority, with a large proportion preferring digital intervention.
Collapse
Affiliation(s)
- Munyra Alhotye
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Department of Respiratory Therapy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Enya Daynes
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Centre for Exercise and Rehabilitation Science (CERS), University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Charlotte Gerlis
- Centre for Exercise and Rehabilitation Science (CERS), University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Sally J Singh
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Centre for Exercise and Rehabilitation Science (CERS), University Hospitals of Leicester NHS Trust, Leicester, UK
| |
Collapse
|
23
|
Liu R, Zheng X, Wang Z, Zhou M, Weng J, Li YM, Chen X. COVID-19 symptoms and compliance: The mediating role of fundamental social motives. Front Psychol 2023; 14:1093875. [PMID: 37020914 PMCID: PMC10067610 DOI: 10.3389/fpsyg.2023.1093875] [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] [Received: 11/09/2022] [Accepted: 02/28/2023] [Indexed: 04/07/2023] Open
Abstract
Background Understanding the compliance of infected individuals and the psychological process underlying compliance during pandemics is important for preventing and controlling the spread of pathogens. Our study investigated whether fundamental social motives mediate the relationship between having infectious disease and compliance. Methods An online survey was conducted in March 2020, during the severe phase of the COVID-19 outbreak in China to collect data from 15,758 participants. The survey comprised self-report questionnaires with items pertaining to current symptoms (COVID-19 symptoms, other symptoms or no symptoms), the Fundamental Social Motive Inventory, and measures of compliance. Correlation analysis, linear regression analysis, and structural equation model were used for data analysis. Results The participants with COVID-19 symptoms had lower levels of compliance than those without symptoms, and their lower compliance was caused by a decrease in disease avoidance (indirect effect = -0.058, 95% CI = [-0.061, -0.056]) and familial motives (indirect effect = -0.113, 95% CI = [-0.116, -0.062]). Whereas exclusion concern (indirect effect = 0.014, 95% CI = [0.011, 0.017]) suppressed the effects of COVID-19 symptoms on compliance, the effect disappeared in the multiple mediation model, while those of disease avoidance and familial motives remained. Conclusion Our findings emphasize the critical role of disease avoidance and familial motives in promoting compliance with public health norms during pandemics and suggest that enhancing these motives may serve as an effective intervention strategy to mitigate noncompliance among potentially infected individuals.
Collapse
Affiliation(s)
- Ruoting Liu
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences (CAS), Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xueying Zheng
- Department of Endocrinology, The First Affiliated Hospital of University of Science and Technology of China Anhui Provincial Hospital, Hefei, Anhui Province, China
- Department of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui Province, China
| | - Ziyu Wang
- Department of Linguistics and Cognitive Science, College of Arts and Sciences, University of Delaware, Newark, DE, United States
| | - Mingjie Zhou
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences (CAS), Beijing, China
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences (CAS), Beijing, China
| | - Jianping Weng
- Department of Endocrinology, The First Affiliated Hospital of University of Science and Technology of China Anhui Provincial Hospital, Hefei, Anhui Province, China
- Department of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui Province, China
| | - Yan-mei Li
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences (CAS), Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
- *Correspondence: Yan-mei Li,
| | - Xuefeng Chen
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
- Institute of Psychology, Chinese Academy of Sciences (CAS), Beijing, China
- Xuefeng Chen,
| |
Collapse
|
24
|
Kalak G, Jarjou’i A, Bohadana A, Wild P, Rokach A, Amiad N, Abdelrahman N, Arish N, Chen-Shuali C, Izbicki G. Prevalence and Persistence of Symptoms in Adult COVID-19 Survivors 3 and 18 Months after Discharge from Hospital or Corona Hotels. J Clin Med 2022; 11:jcm11247413. [PMID: 36556030 PMCID: PMC9784691 DOI: 10.3390/jcm11247413] [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] [Received: 10/27/2022] [Revised: 11/17/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
COVID-19 is characterized by persistent symptoms beyond acute illness. In this prospective cohort study of patients with COVID-19, we sought to characterize the prevalence and persistence of symptoms up to 18 months after diagnosis. We followed 166 patients and assessed their symptoms during acute illness, and at 3 and 18 months after disease onset. The mean number of symptoms per patient during acute disease was 2.3 (SD:1.2), dropping to 1.8 (SD:1.1) at 3 months after recovery and to 0.6 (SD:0.9) at 18 months after recovery. However, this decrease was not unidirectional. Between acute illness and 3 months, the frequency of symptoms decreased for cough (64.5%→24.7%), ageusia (21.7% to6%), anosmia (17.5%→5.4%), and generalized pain (10.8% to 5.4%) but increased for dyspnea (53%→57.2%) weakness (47%→54.8%), and brain fog (3%→8.4%). Between 3 and 18 months, the frequency of symptoms decreased for all symptoms but remained relatively high for dyspnea (15.8%), weakness (21.2%), and brain fog (7.3%). Symptoms may persist for at least 18 months after acute COVID-19 infection. During the medium- to long-term recovery period, the prevalence of some symptoms may decrease or remain stable, and the prevalence of others may increase before slowly decreasing thereafter. These data should be considered when planning post-acute care for these patients.
Collapse
Affiliation(s)
- George Kalak
- Department of Medicine, Pulmonary Institute, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
| | - Amir Jarjou’i
- Department of Medicine, Pulmonary Institute, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
| | - Abraham Bohadana
- Department of Medicine, Pulmonary Institute, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
| | - Pascal Wild
- PW Statistical Consulting, 54520 Laxou, France
| | - Ariel Rokach
- Department of Medicine, Pulmonary Institute, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
| | - Noa Amiad
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
| | - Nader Abdelrahman
- Department of Medicine, Pulmonary Institute, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
| | - Nissim Arish
- Department of Medicine, Pulmonary Institute, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
| | - Chen Chen-Shuali
- Department of Medicine, Pulmonary Institute, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
| | - Gabriel Izbicki
- Department of Medicine, Pulmonary Institute, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
- Correspondence: ; Tel.: +972-26555676; Fax: +972-26555686
| |
Collapse
|
25
|
Di Fusco M, Sun X, Moran MM, Coetzer H, Zamparo JM, Puzniak L, Alvarez MB, Tabak YP, Cappelleri JC. Impact of COVID-19 and effects of BNT162b2 on patient-reported outcomes: quality of life, symptoms, and work productivity among US adult outpatients. J Patient Rep Outcomes 2022; 6:123. [PMID: 36469198 PMCID: PMC9722994 DOI: 10.1186/s41687-022-00528-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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: 09/02/2022] [Accepted: 11/10/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Although there is extensive literature on the clinical benefits of COVID-19 vaccination, data on humanistic effects are limited. This study evaluated the impact of SARS-CoV-2 infection on symptoms, Health-Related Quality of Life (HRQoL) and Work Productivity and Impairment (WPAI) prior to and one month following infection between individuals vaccinated with BNT162b2 and those unvaccinated. METHODS Subjects with ≥ 1 self-reported symptom and positive RT-PCR for SARS-CoV-2 at CVS Health US test sites were recruited between 01/31/2022 and 04/30/2022. Socio-demographics, clinical characteristics and vaccination status were evaluated. Self-reported symptoms, HRQoL, and WPAI outcomes were assessed using questionnaires and validated instruments (EQ-5D-5L, WPAI-GH) across acute COVID time points from pre-COVID to Week 4, and between vaccination groups. Mixed models for repeated measures were conducted for multivariable analyses, adjusting for several covariates. Effect size (ES) of Cohen's d was calculated to quantify the magnitude of outcome changes within and between vaccination groups. RESULTS The study population included 430 subjects: 197 unvaccinated and 233 vaccinated with BNT162b2. Mean (SD) age was 42.4 years (14.3), 76.0% were female, 38.8% reported prior infection and 24.2% at least one comorbidity. Statistically significant differences in outcomes were observed compared with baseline and between groups. The EQ-Visual analogue scale scores and Utility Index dropped in both cohorts at Day 3 and increased by Week 4 but did not return to pre-COVID levels. The mean changes were statistically lower in the BNT162b2 cohort at Day 3 and Week 4. The BNT162b2 cohort reported lower prevalence and fewer symptoms at index date and Week 4. At Week 1, COVID-19 had a large impact on all WPAI-GH domains: the work productivity time loss among unvaccinated and vaccinated was 65.0% and 53.8%, and the mean activity impairment was 50.2% and 43.9%, respectively. Except for absenteeism at Week 4, the BNT162b2 cohort was associated with statistically significant less worsening in all WPAI-GH scores at both Week 1 and 4. CONCLUSIONS COVID-19 negatively impacted HRQoL and work productivity among mildly symptomatic outpatients. Compared with unvaccinated, those vaccinated with BNT162b2 were less impacted by COVID-19 infection and recovered faster.
Collapse
Affiliation(s)
- Manuela Di Fusco
- grid.410513.20000 0000 8800 7493Health Economics and Outcomes Research, Pfizer Inc., New York, NY USA
| | - Xiaowu Sun
- grid.427922.80000 0004 5998 0293CVS Health, Woonsocket, RI USA
| | - Mary M. Moran
- grid.410513.20000 0000 8800 7493MDSCA Vaccines, Pfizer Inc., Collegeville, PA USA
| | | | - Joann M. Zamparo
- grid.410513.20000 0000 8800 7493MDSCA Vaccines, Pfizer Inc., Collegeville, PA USA
| | - Laura Puzniak
- grid.410513.20000 0000 8800 7493MDSCA Vaccines, Pfizer Inc., Collegeville, PA USA
| | - Mary B. Alvarez
- grid.410513.20000 0000 8800 7493Field Medical Outcomes and Analytics, Pfizer Inc., New York, NY USA
| | - Ying P. Tabak
- grid.427922.80000 0004 5998 0293CVS Health, Woonsocket, RI USA
| | - Joseph C. Cappelleri
- grid.410513.20000 0000 8800 7493Statistical Research and Data Science Center, Pfizer Inc., Groton, CT USA
| |
Collapse
|
26
|
Sun Y, Wang P, Tang J. Impact of mental health, job insecurity, and COVID-19 symptoms on protective behavior changes among White, Black, and other minorities in the US. Front Psychol 2022; 13:1040413. [PMID: 36478929 PMCID: PMC9720273 DOI: 10.3389/fpsyg.2022.1040413] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 11/02/2022] [Indexed: 11/07/2023] Open
Abstract
INTRODUCTION Job insecurity such as loss of jobs or reduced wages has become a serious social problem in the US since COVID-19 started. Combined with psychological distress and experience of COVID-19 symptoms, the changes of people's protective behaviors vary across states in the US. METHODS This research investigated racial differences in the COVID-19 related factors among White, Black, and other minorities in the US, and examined how mental health mediated the impact of job insecurity on protective behaviors, and how the COVID-19 symptoms moderated the mediation effect of mental health. The 731 valid responses in a cross-sectional survey from May 23 to 27, 2020, in the US were analyzed with independent sample t-tests, Pearson's chi-square tests, and path analysis. RESULTS The findings showed that there were significant differences in job insecurity and Nonpharmaceutical Interventions (NPIs) practice among White, Black, and other minorities. Job insecurity was significantly negatively associated with NPIs practice and was significantly positively associated with mental health. Mental health significantly partially mediated the effect of job insecurity on NPIs practice, in that job insecurity is a better predictor of NPIs practice for individuals with worse mental health than that for individuals with better mental health. Experience of COVID-19 symptoms moderates the mediation effect of mental health on the relationship between job insecurity and NPIs practice, in that mental health is a better predictor of NPIs practice for individuals with a higher experience of COVID-19 symptoms than for individuals with a lower experience of COVID-19 symptoms. DISCUSSION The findings in this study shed lights on psychological and behavioral studies of people's behavior changes during a pandemic. The study indicates the importance of treating mental health to promote protective behaviors during a pandemic, as well as advocating for employees by identifying the needs for those whose jobs were negatively impacted the most.
Collapse
Affiliation(s)
- Yingying Sun
- School of Public Administration and Policy, Renmin University of China, Beijing, China
| | - Ping Wang
- College of Business, James Madison University, Harrisonburg, VA, United States
| | - Jun Tang
- School of Public Administration and Policy, Renmin University of China, Beijing, China
| |
Collapse
|
27
|
Ghosh AK, Landt O, Yeasmin M, Sharif M, Ratul RH, Molla MA, Nafisa T, Mosaddeque MB, Hosen N, Bulbul MRH, Mamunur R, Islam A, Shakil SS, Kaiser M, Amin MR, Lytton SD. Clinical Presentation of COVID-19 and Antibody Responses in Bangladeshi Patients Infected with the Delta or Omicron Variants of SARS-CoV-2. Vaccines (Basel) 2022; 10. [PMID: 36423054 DOI: 10.3390/vaccines10111959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/10/2022] [Accepted: 11/16/2022] [Indexed: 11/19/2022] Open
Abstract
The clinical presentation of COVID-19 and the specific antibody responses associated with SARS-CoV-2 variants have not been investigated during the emergence of Omicron variants in Bangladesh. The Delta and Omicron variants were identified by post-PCR melting curve analysis of the spike (S) protein receptor binding domain amplicons. Anti-S-protein immunoglobulin-G anti-nucleocapsid (N)-protein immunoglobulin-G and immunoglobulin-A levels were measured by ELISA. The Delta variant was found in 40 out of 40 (100%) SARS-CoV-2 RT-PCR positive COVID-19 patients between 13 September and 23 October 2021 and Omicron variants in 90 out of 90 (100%) RT-PCR positive COVID-19 patients between 9 January and 10 February 2022. The Delta variant associated with hospitalization (74%, 80%, and 40%) and oxygen support (60%, 57%, and 40%) in the no vaccine, dose-1, and dose-2 vaccinated cases, respectively, whereas the Omicron COVID-19 required neither hospitalization nor oxygen support (0%, p < 0.0001). Fever, cough, and breathlessness were found at a significantly higher frequency among the Delta than Omicron variants (p < 0.001). The viral RNA levels of the Delta variant were higher than that of the Omicron variants (Ct median 19.9 versus 23.85; p < 0.02). Anti-spike protein immunoglobulin-G and anti-N-protein immunoglobulin-G within 1 week post onset of Delta variant COVID-19 symptoms indicate prior SARS-CoV-2 infection. The Delta variant and Omicron BA.1 and BA.2 breakthrough infections in the Dhaka region, at 240 days post onset of COVID-19 symptoms, negatively correlated with the time interval between the second vaccine dose and serum sampling. The findings of lower anti-spike protein immunoglobulin-G reactivity after booster vaccination than after the second vaccine dose suggest that the booster vaccine is not necessarily beneficial in young Bangladeshi adults having a history of repeated SARS-CoV-2 infections.
Collapse
|
28
|
Elhambakhsh F, Sabri-Laghaie K, Noorossana R. A latent space model and Hotelling's T 2 control chart to monitor the networks of Covid-19 symptoms. J Appl Stat 2022; 50:2450-2472. [PMID: 37529564 PMCID: PMC10388834 DOI: 10.1080/02664763.2022.2145459] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 10/08/2022] [Indexed: 11/16/2022]
Abstract
In the COVID-19 coronavirus pandemic, potential patients that suffer from different symptoms can be diagnosed with COVID-19. At the early stages of the pandemic, patients were mainly diagnosed with fever and respiratory symptoms. Recently, patients with new symptoms, such as gastrointestinal or loss of senses, are also diagnosed with COVID-19. Monitoring these symptoms can help the healthcare system to be aware of new symptoms that can be related to the COVID-19 coronavirus. This article focuses on monitoring the behavior of COVID-19 symptoms over time. In this regard, a Latent space model (LSM) and a Generalized linear model (GLM) are introduced to model the networks of symptoms. We apply Hotelling's T2 control chart to the estimated parameters of the LSM and GLM, to identify significant changes and detect anomalies in the networks. The performance of the proposed methods is evaluated using simulation and calculating average run length (ARL). Then, dynamic networks are generated from a COVID-19 epidemic survey dataset.
Collapse
Affiliation(s)
- Fatemeh Elhambakhsh
- Industrial Engineering Department, Iran University of Science and Technology, Tehran, Iran
| | | | - Rassoul Noorossana
- Industrial Engineering Department, Iran University of Science and Technology, Tehran, Iran
| |
Collapse
|
29
|
Gupta A, Saidha PK, Satya S, Saini U, Kapoor S. Changing Trends in COVID-19 Symptomatology: A Survey-Based Analysis. Indian J Otolaryngol Head Neck Surg 2022; 74:3293-303. [PMID: 36447476 DOI: 10.1007/s12070-022-03112-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 06/17/2022] [Indexed: 01/09/2023] Open
Abstract
India currently ranks the highest in the world with over 3.86 lakhs new COVID-19 cases per day. With a spike in the number of cases in the second wave of COVID-19 in 2021 compared to the first wave of the outbreak in 2020, there have been varied clinical manifestations among masses. This study aimed to determine the changing trends in prevalence of COVID-19 symptoms during the pandemic. A cross-sectional study among 166 individuals was carried out using a self-designed survey-based questionnaire. Two groups were made on the basis of symptoms and compared: Group A- patients who tested COVID-19 positive in 2020 and Group B- patients who tested COVID-19 positive in 2021. 130 participants (78.31%) had tested positive for COVID-19, out of which 110 (84.62%) were symptomatic and 20 (15.38%) were asymptomatic. Fever was the most common presenting symptom (27.69%) followed by difficulty in breathing (24.62%). Group A individuals (n = 37), reported fever as the most common presenting symptom (45.95%), followed by body ache (13.51%); while those in Group B (n = 93) reported difficulty in breathing (33.33%) followed by fever (20.43%). The most common general symptoms were fever and difficulty in breathing while sore throat, cough and anosmia were the most common ENT symptoms. 57.83% had been vaccinated out of which 38.55% experienced symptoms post-vaccination. The prevalence of symptoms in the first and second wave of the pandemic can help in better understanding of the changing symptomatology of SARS-CoV-2 virus.
Collapse
|
30
|
Perrella A, Bisogno M, D’Argenzio A, Trama U, Coscioni E, Orlando V. Risk of SARS-CoV-2 Infection Breakthrough among the Non-Vaccinated and Vaccinated Population in Italy: A Real-World Evidence Study Based on Big Data. Healthcare (Basel) 2022; 10:healthcare10061085. [PMID: 35742137 PMCID: PMC9222607 DOI: 10.3390/healthcare10061085] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/07/2022] [Accepted: 06/08/2022] [Indexed: 02/05/2023] Open
Abstract
SARS-CoV-2 infection after vaccination can occur because COVID-19 vaccines do not offer 100% protection. The study aim was to assess duration of vaccination coverage, disease symptoms and type of hospitalization among non-vaccinated and vaccinated subjects to evaluate the vaccination trend over time. A retrospective cohort study was carried out among people testing COVID-19 positive in Campania Region using information from the Health Information System of Campania Region (Sinfonia). Vaccination status was assessed considering: no vaccination, partial vaccination and effective vaccination. Univariate and multivariate logistic regression models were constructed to evaluate the association between ICU admissions caused by COVID-19 and gender, age groups and vaccine type. Vaccine coverage duration trends were investigated using segmented linear regression and breakpoint estimations. Vaccination coverage was assessed by analyzing COVID-19 positive subjects in the 9 months after an effective dose vaccination. A significant risk of hospitalization in the ICU was caused by vaccination status: subjects non-vaccinated (OR: 7.14) and partially vaccinated (OR: 3.68) were 3 and 7 times more at risk of hospitalization, respectively, than subjects effectively vaccinated. Regarding subjects with an effective vaccination, the vaccine’s ability to protect against infection in the months following vaccination decreased. The risk of contracting COVID-19 after vaccination was higher 5 months (β = 1441, p < 0.001) and 7 months (β = 3110, p < 0.001) after administration of an effective dose. COVID-19 vaccines were demonstrated to protect from symptomatic infection by significantly reducing hospitalization risk, and their full protection against SARS-CoV-2 was demonstrated to decrease after 5 months regardless of age, gender or vaccine type.
Collapse
Affiliation(s)
- Alessandro Perrella
- Regional Task Force COVID-19, Campania Region, 80143 Naples, Italy; (A.D.); (U.T.); (E.C.)
- UOC Emerging Infectious Disease with High Contagiousness AORN Ospedali dei Colli P.O.C. Cotugno, 80131 Naples, Italy
- Correspondence: (A.P.); (V.O.)
| | - Massimo Bisogno
- Sinfonia Regional Health Information System of Campania Region, 80143 Naples, Italy;
| | - Angelo D’Argenzio
- Regional Task Force COVID-19, Campania Region, 80143 Naples, Italy; (A.D.); (U.T.); (E.C.)
- Directorate-General for Health Protection, Campania Region, 80143 Naples, Italy
| | - Ugo Trama
- Regional Task Force COVID-19, Campania Region, 80143 Naples, Italy; (A.D.); (U.T.); (E.C.)
- Directorate-General for Health Protection, Campania Region, 80143 Naples, Italy
| | - Enrico Coscioni
- Regional Task Force COVID-19, Campania Region, 80143 Naples, Italy; (A.D.); (U.T.); (E.C.)
- Division of Cardiac Surgery, AOU San Giovanni di Dio e Ruggi d’Aragona, 84131 Salerno, Italy
| | - Valentina Orlando
- Directorate-General for Health Protection, Campania Region, 80143 Naples, Italy
- CIRFF, Center of Drug Utilization and Pharmacoeconomics, Department of Pharmacy, University of Naples Federico II, 80131 Naples, Italy
- Correspondence: (A.P.); (V.O.)
| |
Collapse
|
31
|
Jiang K, Zhu M, Bernard GR. Discovery of COVID-19 Symptomatic Experience Reported by Twitter Users. Stud Health Technol Inform 2022; 294:664-668. [PMID: 35612172 DOI: 10.3233/shti220552] [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] [Indexed: 06/15/2023]
Abstract
Since the beginning of the COVID-19 pandemic, patients shared their personal experiences of the viral infection on social media. Gathering their symptomatic experiences reported on Twitter may help better understand the infectious disease and supplement our knowledge of the disease gathered by healthcare workers. In this study, we identified personal experience tweets related to COVID-19 infection using a pre-trained and fine-tuned language model, and annotated the machine-identified tweets in order to extract the information of infection status, symptom concepts, and the days the symptomatic experience occurred. Our result shows that the top 10 most common symptoms mentioned in the collected Twitter data are in line with those published by WHO and CDC. The symptoms along with the day information appear to provide additional insight on how the infection progresses in infected individuals.
Collapse
Affiliation(s)
- Keyuan Jiang
- Purdue University Northwest, Hammond, Indiana, U.S.A
| | - Minghao Zhu
- College of Electronic & Information Engineering, Tongji University, Shanghai, China
| | | |
Collapse
|
32
|
Ho TT, Tran KD, Huang Y. FedSGDCOVID: Federated SGD COVID-19 Detection under Local Differential Privacy Using Chest X-ray Images and Symptom Information. Sensors (Basel) 2022; 22:s22103728. [PMID: 35632136 PMCID: PMC9147951 DOI: 10.3390/s22103728] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/09/2022] [Accepted: 05/10/2022] [Indexed: 12/15/2022]
Abstract
Coronavirus (COVID-19) has created an unprecedented global crisis because of its detrimental effect on the global economy and health. COVID-19 cases have been rapidly increasing, with no sign of stopping. As a result, test kits and accurate detection models are in short supply. Early identification of COVID-19 patients will help decrease the infection rate. Thus, developing an automatic algorithm that enables the early detection of COVID-19 is essential. Moreover, patient data are sensitive, and they must be protected to prevent malicious attackers from revealing information through model updates and reconstruction. In this study, we presented a higher privacy-preserving federated learning system for COVID-19 detection without sharing data among data owners. First, we constructed a federated learning system using chest X-ray images and symptom information. The purpose is to develop a decentralized model across multiple hospitals without sharing data. We found that adding the spatial pyramid pooling to a 2D convolutional neural network improves the accuracy of chest X-ray images. Second, we explored that the accuracy of federated learning for COVID-19 identification reduces significantly for non-independent and identically distributed (Non-IID) data. We then proposed a strategy to improve the model's accuracy on Non-IID data by increasing the total number of clients, parallelism (client-fraction), and computation per client. Finally, for our federated learning model, we applied a differential privacy stochastic gradient descent (DP-SGD) to improve the privacy of patient data. We also proposed a strategy to maintain the robustness of federated learning to ensure the security and accuracy of the model.
Collapse
|
33
|
Molteni E, Sudre CH, Canas LDS, Bhopal SS, Hughes RC, Chen L, Deng J, Murray B, Kerfoot E, Antonelli M, Graham M, Kläser K, May A, Hu C, Pujol JC, Wolf J, Hammers A, Spector TD, Ourselin S, Modat M, Steves CJ, Absoud M, Duncan EL. Illness Characteristics of COVID-19 in Children Infected with the SARS-CoV-2 Delta Variant. Children (Basel) 2022; 9:652. [PMID: 35626830 PMCID: PMC9140086 DOI: 10.3390/children9050652] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 04/29/2022] [Accepted: 04/30/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND The Delta (B.1.617.2) SARS-CoV-2 variant was the predominant UK circulating strain between May and November 2021. We investigated whether COVID-19 from Delta infection differed from infection with previous variants in children. METHODS Through the prospective COVID Symptom Study, 109,626 UK school-aged children were proxy-reported between 28 December 2020 and 8 July 2021. We selected all symptomatic children who tested positive for SARS-CoV-2 and were proxy-reported at least weekly, within two timeframes: 28 December 2020 to 6 May 2021 (Alpha (B.1.1.7), the main UK circulating variant) and 26 May to 8 July 2021 (Delta, the main UK circulating variant), with all children unvaccinated (as per national policy at the time). We assessed illness profiles (symptom prevalence, duration, and burden), hospital presentation, and presence of long (≥28 day) illness, and calculated odds ratios for symptoms presenting within the first 28 days of illness. RESULTS 694 (276 younger (5-11 years), 418 older (12-17 years)) symptomatic children tested positive for SARS-CoV-2 with Alpha infection and 706 (227 younger and 479 older) children with Delta infection. Median illness duration was short with either variant (overall cohort: 5 days (IQR 2-9.75) with Alpha, 5 days (IQR 2-9) with Delta). The seven most prevalent symptoms were common to both variants. Symptom burden over the first 28 days was slightly greater with Delta compared with Alpha infection (in younger children, 3 (IQR 2-5) symptoms with Alpha, 4 (IQR 2-7) with Delta; in older children, 5 (IQR 3-8) symptoms with Alpha, 6 (IQR 3-9) with Delta infection ). The odds of presenting several symptoms were higher with Delta than Alpha infection, including headache and fever. Few children presented to hospital, and long illness duration was uncommon, with either variant. CONCLUSIONS COVID-19 in UK school-aged children due to SARS-CoV-2 Delta strain B.1.617.2 resembles illness due to the Alpha variant B.1.1.7., with short duration and similar symptom burden.
Collapse
Affiliation(s)
- Erika Molteni
- School of Biomedical Engineering & Imaging Sciences, King’s College London, London WC2R 2LS, UK; (E.M.); (C.H.S.); (L.D.S.C.); (L.C.); (J.D.); (B.M.); (E.K.); (M.A.); (M.G.); (K.K.); (A.H.); (S.O.); (M.M.)
| | - Carole H. Sudre
- School of Biomedical Engineering & Imaging Sciences, King’s College London, London WC2R 2LS, UK; (E.M.); (C.H.S.); (L.D.S.C.); (L.C.); (J.D.); (B.M.); (E.K.); (M.A.); (M.G.); (K.K.); (A.H.); (S.O.); (M.M.)
- MRC Unit for Lifelong Health and Ageing, Department of Population Health Sciences, University College London, London WC1E 6BT, UK
- Centre for Medical Image Computing, Department of Computer Science, University College London, London WC1E 6BT, UK
| | - Liane Dos Santos Canas
- School of Biomedical Engineering & Imaging Sciences, King’s College London, London WC2R 2LS, UK; (E.M.); (C.H.S.); (L.D.S.C.); (L.C.); (J.D.); (B.M.); (E.K.); (M.A.); (M.G.); (K.K.); (A.H.); (S.O.); (M.M.)
| | - Sunil S. Bhopal
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE1 7RU, UK;
| | - Robert C. Hughes
- Department of Population Health, Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK;
| | - Liyuan Chen
- School of Biomedical Engineering & Imaging Sciences, King’s College London, London WC2R 2LS, UK; (E.M.); (C.H.S.); (L.D.S.C.); (L.C.); (J.D.); (B.M.); (E.K.); (M.A.); (M.G.); (K.K.); (A.H.); (S.O.); (M.M.)
| | - Jie Deng
- School of Biomedical Engineering & Imaging Sciences, King’s College London, London WC2R 2LS, UK; (E.M.); (C.H.S.); (L.D.S.C.); (L.C.); (J.D.); (B.M.); (E.K.); (M.A.); (M.G.); (K.K.); (A.H.); (S.O.); (M.M.)
| | - Benjamin Murray
- School of Biomedical Engineering & Imaging Sciences, King’s College London, London WC2R 2LS, UK; (E.M.); (C.H.S.); (L.D.S.C.); (L.C.); (J.D.); (B.M.); (E.K.); (M.A.); (M.G.); (K.K.); (A.H.); (S.O.); (M.M.)
| | - Eric Kerfoot
- School of Biomedical Engineering & Imaging Sciences, King’s College London, London WC2R 2LS, UK; (E.M.); (C.H.S.); (L.D.S.C.); (L.C.); (J.D.); (B.M.); (E.K.); (M.A.); (M.G.); (K.K.); (A.H.); (S.O.); (M.M.)
| | - Michela Antonelli
- School of Biomedical Engineering & Imaging Sciences, King’s College London, London WC2R 2LS, UK; (E.M.); (C.H.S.); (L.D.S.C.); (L.C.); (J.D.); (B.M.); (E.K.); (M.A.); (M.G.); (K.K.); (A.H.); (S.O.); (M.M.)
| | - Mark Graham
- School of Biomedical Engineering & Imaging Sciences, King’s College London, London WC2R 2LS, UK; (E.M.); (C.H.S.); (L.D.S.C.); (L.C.); (J.D.); (B.M.); (E.K.); (M.A.); (M.G.); (K.K.); (A.H.); (S.O.); (M.M.)
| | - Kerstin Kläser
- School of Biomedical Engineering & Imaging Sciences, King’s College London, London WC2R 2LS, UK; (E.M.); (C.H.S.); (L.D.S.C.); (L.C.); (J.D.); (B.M.); (E.K.); (M.A.); (M.G.); (K.K.); (A.H.); (S.O.); (M.M.)
| | - Anna May
- ZOE Limited London, London SE1 7RW, UK; (A.M.); (C.H.); (J.C.P.); (J.W.)
| | - Christina Hu
- ZOE Limited London, London SE1 7RW, UK; (A.M.); (C.H.); (J.C.P.); (J.W.)
| | | | - Jonathan Wolf
- ZOE Limited London, London SE1 7RW, UK; (A.M.); (C.H.); (J.C.P.); (J.W.)
| | - Alexander Hammers
- School of Biomedical Engineering & Imaging Sciences, King’s College London, London WC2R 2LS, UK; (E.M.); (C.H.S.); (L.D.S.C.); (L.C.); (J.D.); (B.M.); (E.K.); (M.A.); (M.G.); (K.K.); (A.H.); (S.O.); (M.M.)
- King’s College London & Guy’s and St Thomas’ PET Centre, London WC2R 2LS, UK
| | - Timothy D. Spector
- Department of Twin Research and Genetic Epidemiology, King’s College London, London WC2R 2LS, UK; (T.D.S.); (C.J.S.)
| | - Sebastien Ourselin
- School of Biomedical Engineering & Imaging Sciences, King’s College London, London WC2R 2LS, UK; (E.M.); (C.H.S.); (L.D.S.C.); (L.C.); (J.D.); (B.M.); (E.K.); (M.A.); (M.G.); (K.K.); (A.H.); (S.O.); (M.M.)
| | - Marc Modat
- School of Biomedical Engineering & Imaging Sciences, King’s College London, London WC2R 2LS, UK; (E.M.); (C.H.S.); (L.D.S.C.); (L.C.); (J.D.); (B.M.); (E.K.); (M.A.); (M.G.); (K.K.); (A.H.); (S.O.); (M.M.)
| | - Claire J. Steves
- Department of Twin Research and Genetic Epidemiology, King’s College London, London WC2R 2LS, UK; (T.D.S.); (C.J.S.)
- Department of Aging and Health, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 7EH, UK
| | - Michael Absoud
- Children’s Neurosciences, Evelina London Children’s Hospital, St Thomas’ Hospital, King’s Health Partners, Academic Health Science Centre, London SE1 7EH, UK
- Department of Women and Children’s Health, Faculty of Life Sciences and Medicine, School of Life Course Sciences, King’s College London, London WC2R 2LS, UK
| | - Emma L. Duncan
- Department of Twin Research and Genetic Epidemiology, King’s College London, London WC2R 2LS, UK; (T.D.S.); (C.J.S.)
- Department of Endocrinology, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 7EH, UK
| |
Collapse
|
34
|
Molteni E, Sudre CH, Canas LDS, Bhopal SS, Hughes RC, Chen L, Deng J, Murray B, Kerfoot E, Antonelli M, Graham M, Kläser K, May A, Hu C, Pujol JC, Wolf J, Hammers A, Spector TD, Ourselin S, Modat M, Steves CJ, Absoud M, Duncan EL. Illness Characteristics of COVID-19 in Children Infected with the SARS-CoV-2 Delta Variant. Children (Basel) 2022; 9:children9050652. [PMID: 35626830 DOI: 10.1101/2021.10.06.21264467] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 04/29/2022] [Accepted: 04/30/2022] [Indexed: 05/22/2023]
Abstract
BACKGROUND The Delta (B.1.617.2) SARS-CoV-2 variant was the predominant UK circulating strain between May and November 2021. We investigated whether COVID-19 from Delta infection differed from infection with previous variants in children. METHODS Through the prospective COVID Symptom Study, 109,626 UK school-aged children were proxy-reported between 28 December 2020 and 8 July 2021. We selected all symptomatic children who tested positive for SARS-CoV-2 and were proxy-reported at least weekly, within two timeframes: 28 December 2020 to 6 May 2021 (Alpha (B.1.1.7), the main UK circulating variant) and 26 May to 8 July 2021 (Delta, the main UK circulating variant), with all children unvaccinated (as per national policy at the time). We assessed illness profiles (symptom prevalence, duration, and burden), hospital presentation, and presence of long (≥28 day) illness, and calculated odds ratios for symptoms presenting within the first 28 days of illness. RESULTS 694 (276 younger (5-11 years), 418 older (12-17 years)) symptomatic children tested positive for SARS-CoV-2 with Alpha infection and 706 (227 younger and 479 older) children with Delta infection. Median illness duration was short with either variant (overall cohort: 5 days (IQR 2-9.75) with Alpha, 5 days (IQR 2-9) with Delta). The seven most prevalent symptoms were common to both variants. Symptom burden over the first 28 days was slightly greater with Delta compared with Alpha infection (in younger children, 3 (IQR 2-5) symptoms with Alpha, 4 (IQR 2-7) with Delta; in older children, 5 (IQR 3-8) symptoms with Alpha, 6 (IQR 3-9) with Delta infection ). The odds of presenting several symptoms were higher with Delta than Alpha infection, including headache and fever. Few children presented to hospital, and long illness duration was uncommon, with either variant. CONCLUSIONS COVID-19 in UK school-aged children due to SARS-CoV-2 Delta strain B.1.617.2 resembles illness due to the Alpha variant B.1.1.7., with short duration and similar symptom burden.
Collapse
Affiliation(s)
- Erika Molteni
- School of Biomedical Engineering & Imaging Sciences, King's College London, London WC2R 2LS, UK
| | - Carole H Sudre
- School of Biomedical Engineering & Imaging Sciences, King's College London, London WC2R 2LS, UK
- MRC Unit for Lifelong Health and Ageing, Department of Population Health Sciences, University College London, London WC1E 6BT, UK
- Centre for Medical Image Computing, Department of Computer Science, University College London, London WC1E 6BT, UK
| | - Liane Dos Santos Canas
- School of Biomedical Engineering & Imaging Sciences, King's College London, London WC2R 2LS, UK
| | - Sunil S Bhopal
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
| | - Robert C Hughes
- Department of Population Health, Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Liyuan Chen
- School of Biomedical Engineering & Imaging Sciences, King's College London, London WC2R 2LS, UK
| | - Jie Deng
- School of Biomedical Engineering & Imaging Sciences, King's College London, London WC2R 2LS, UK
| | - Benjamin Murray
- School of Biomedical Engineering & Imaging Sciences, King's College London, London WC2R 2LS, UK
| | - Eric Kerfoot
- School of Biomedical Engineering & Imaging Sciences, King's College London, London WC2R 2LS, UK
| | - Michela Antonelli
- School of Biomedical Engineering & Imaging Sciences, King's College London, London WC2R 2LS, UK
| | - Mark Graham
- School of Biomedical Engineering & Imaging Sciences, King's College London, London WC2R 2LS, UK
| | - Kerstin Kläser
- School of Biomedical Engineering & Imaging Sciences, King's College London, London WC2R 2LS, UK
| | - Anna May
- ZOE Limited London, London SE1 7RW, UK
| | | | | | | | - Alexander Hammers
- School of Biomedical Engineering & Imaging Sciences, King's College London, London WC2R 2LS, UK
- King's College London & Guy's and St Thomas' PET Centre, London WC2R 2LS, UK
| | - Timothy D Spector
- Department of Twin Research and Genetic Epidemiology, King's College London, London WC2R 2LS, UK
| | - Sebastien Ourselin
- School of Biomedical Engineering & Imaging Sciences, King's College London, London WC2R 2LS, UK
| | - Marc Modat
- School of Biomedical Engineering & Imaging Sciences, King's College London, London WC2R 2LS, UK
| | - Claire J Steves
- Department of Twin Research and Genetic Epidemiology, King's College London, London WC2R 2LS, UK
- Department of Aging and Health, Guy's and St Thomas' NHS Foundation Trust, London SE1 7EH, UK
| | - Michael Absoud
- Children's Neurosciences, Evelina London Children's Hospital, St Thomas' Hospital, King's Health Partners, Academic Health Science Centre, London SE1 7EH, UK
- Department of Women and Children's Health, Faculty of Life Sciences and Medicine, School of Life Course Sciences, King's College London, London WC2R 2LS, UK
| | - Emma L Duncan
- Department of Twin Research and Genetic Epidemiology, King's College London, London WC2R 2LS, UK
- Department of Endocrinology, Guy's and St Thomas' NHS Foundation Trust, London SE1 7EH, UK
| |
Collapse
|
35
|
Bouwensch C, Hahn V, Boulmé F. Analysis of 160 nonhospitalized COVID-19 patients with mild to moderate symptoms from an Austrian general medical practice: from typical disease pattern to unexpected clinical features. Wien Med Wochenschr 2022; 172:198-210. [PMID: 35239080 PMCID: PMC8892401 DOI: 10.1007/s10354-022-00919-0] [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: 06/24/2021] [Accepted: 01/25/2022] [Indexed: 10/27/2022]
Abstract
Patients from the general practice who had severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection between January 2020 and March 2021 participated in an online survey to report their symptoms. This observational study describes the broad range of mild to moderate symptoms experienced by 160 symptom-based coronavirus disease 2019 (COVID-19) nonhospitalized patients, including 89 laboratory-confirmed cases. Compared to confirmed cases, a higher number of presumed and suspected patients had sore throat, shortness of breath, tightness in the chest, fatigue, or severe neck tension. Unexpected COVID-19-associated clinical features, such as alteration of blood consistency, hormonal imbalance, increased muscle tone and/or aches of skeletal muscles, joint pain, or dermatological disorders were observed by the participants. In the early period of the pandemic, COVID-19 diagnosis of patients was based on medical symptoms rather than polymerase chain reaction (PCR) or serological testing. These real-world data are essential to understand the pathophysiology of this virus infection and to develop innovative therapeutic approaches.
Collapse
Affiliation(s)
- Carina Bouwensch
- General medical practice, Lange Gasse 72/8, 1080, Vienna, Austria.
| | - Viktoria Hahn
- General medical practice, Lange Gasse 72/8, 1080, Vienna, Austria
| | | |
Collapse
|
36
|
Kadirvelu B, Burcea G, Quint JK, Costelloe CE, Faisal AA. Variation in global COVID-19 symptoms by geography and by chronic disease: A global survey using the COVID-19 Symptom Mapper. EClinicalMedicine 2022; 45:101317. [PMID: 35265823 PMCID: PMC8898170 DOI: 10.1016/j.eclinm.2022.101317] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 01/25/2022] [Accepted: 02/07/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND COVID-19 is typically characterised by a triad of symptoms: cough, fever and loss of taste and smell, however, this varies globally. This study examines variations in COVID-19 symptom profiles based on underlying chronic disease and geographical location. METHODS Using a global online symptom survey of 78,299 responders in 190 countries between 09/04/2020 and 22/09/2020, we conducted an exploratory study to examine symptom profiles associated with a positive COVID-19 test result by country and underlying chronic disease (single, co- or multi-morbidities) using statistical and machine learning methods. FINDINGS From the results of 7980 COVID-19 tested positive responders, we find that symptom patterns differ by country. For example, India reported a lower proportion of headache (22.8% vs 47.8%, p<1e-13) and itchy eyes (7.3% vs. 16.5%, p=2e-8) than other countries. As with geographic location, we find people differed in their reported symptoms if they suffered from specific chronic diseases. For example, COVID-19 positive responders with asthma (25.3% vs. 13.7%, p=7e-6) were more likely to report shortness of breath compared to those with no underlying chronic disease. INTERPRETATION We have identified variation in COVID-19 symptom profiles depending on geographic location and underlying chronic disease. Failure to reflect this symptom variation in public health messaging may contribute to asymptomatic COVID-19 spread and put patients with chronic diseases at a greater risk of infection. Future work should focus on symptom profile variation in the emerging variants of the SARS-CoV-2 virus. This is crucial to speed up clinical diagnosis, predict prognostic outcomes and target treatment. FUNDING We acknowledge funding to AAF by a UKRI Turing AI Fellowship and to CEC by a personal NIHR Career Development Fellowship (grant number NIHR-2016-090-015). JKQ has received grants from The Health Foundation, MRC, GSK, Bayer, BI, Asthma UK-British Lung Foundation, IQVIA, Chiesi AZ, and Insmed. This work is supported by BREATHE - The Health Data Research Hub for Respiratory Health [MC_PC_19004]. BREATHE is funded through the UK Research and Innovation Industrial Strategy Challenge Fund and delivered through Health Data Research UK. Imperial College London is grateful for the support from the Northwest London NIHR Applied Research Collaboration. The views expressed in this publication are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.
Collapse
Affiliation(s)
| | - Gabriel Burcea
- Global Digital Health Unit, School of Public Health, Imperial College London, London, UK
| | - Jennifer K. Quint
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Ceire E. Costelloe
- Global Digital Health Unit, School of Public Health, Imperial College London, London, UK
| | - A. Aldo Faisal
- Brain & Behaviour Lab, Dept. Of Computing & Dept. Of Bioengineering, UKRI Centre for Doctoral Training in AI for Healthcare, and the Global Covid Observatory, Imperial College London, UK and MRC London Institute for Medical Sciences, London, UK
- Institute for Artificial & Human Intelligence, University of Bayreuth, Bayreuth, Germany
- Correspondence to: Aldo A. Faisal, Brain & Behaviour Lab, Dept. Of Computing & Dept. Of Bioengineering, UKRI Centre for Doctoral Training in AI for Healthcare, and the Global Covid Observatory, Imperial College London, UK.
| |
Collapse
|
37
|
Batista KS, Cintra VM, Lucena PAF, Manhães-de-Castro R, Toscano AE, Costa LP, Queiroz MEBS, de Andrade SM, Guzman-Quevedo O, Aquino JDS. The role of vitamin B12 in viral infections: a comprehensive review of its relationship with the muscle-gut-brain axis and implications for SARS-CoV-2 infection. Nutr Rev 2022; 80:561-578. [PMID: 34791425 PMCID: PMC8689946 DOI: 10.1093/nutrit/nuab092] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
This comprehensive review establishes the role of vitamin B12 as adjunct therapy for viral infections in the treatment and persistent symptoms of COVID-19, focusing on symptoms related to the muscle-gut-brain axis. Vitamin B12 can help balance immune responses to better fight viral infections. Furthermore, data from randomized clinical trials and meta-analysis indicate that vitamin B12 in the forms of methylcobalamin and cyanocobalamin may increase serum vitamin B12 levels, and resulted in decreased serum methylmalonic acid and homocysteine concentrations, and decreased pain intensity, memory loss, and impaired concentration. Among studies, there is much variation in vitamin B12 doses, chemical forms, supplementation time, and administration routes. Larger randomized clinical trials of vitamin B12 supplementation and analysis of markers such as total vitamin B12, holotranscobalamin, total homocysteine and methylmalonic acid, total folic acid, and, if possible, polymorphisms and methylation of genes need to be conducted with people with and without COVID-19 or who have had COVID-19 to facilitate the proper vitamin B12 form to be administered in individual treatment.
Collapse
Affiliation(s)
- Kamila S Batista
- K.S. Batista and J.d.S. Aquino are with the Experimental Nutrition Laboratory, Department of Nutrition and Post Graduate Program in Nutrition Sciences, Federal University of Paraíba, Paraíba, Brazil. V.M. Cintra and P.A.F Lucena are with the Department of Medicine, Faculty of Medical Sciences of Paraíba, and the Department of Nutrition, Integrated Colleges of Patos, Paraíba, Brazil. V.M. Cintra is with the the Multiprofessional Residence in Child Health of Secretariat of Health of the State of Paraíba, Brazil. P.A.F Lucena is with Coordination of Neurology Services, Hospital Metropolitano Dom José Maria Pires, Santa Rita, Paraíba and Emergency, Trauma Hospital Senador Humberto Lucena, João Pessoa, Paraíba, Brazil. R. Manhães-de-Castro is with the Studies in Nutrition and Phenotypic Plasticity Unit, Department of Nutrition, Federal University of Pernambuco, Recife, Pernambuco, Brazil. R. Manhães-de-Castro and A.E. Toscano are with the Post Graduate Program in Nutrition, Health Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil. A.E. Toscano is with the Department of Nursing, CAV, Federal University of Pernambuco, Pernambuco, Brazil. A.E. Toscano and O. Guzman-Quevedo are with the Post Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Recife, Pernambuco, Brazil. L.P. Costa, M.E.B.S. Queirozj, and S.M. de Andrade are with the Ageing and Neuroscience Laboratory, Health Sciences Center, Federal University of Paraíba, Paraíba, Brazil. O. Guzman-Quevedo is with the Higher Technological Institute of Tacámbaro, Tacámbaro, Michoacán, Mexico. O. Guzman-Quevedo is with the Center for Biomedical Research of Michoacán, Mexican Institute of Social Security, Morelia, Michoacán, Mexico
| | - Vanessa M Cintra
- K.S. Batista and J.d.S. Aquino are with the Experimental Nutrition Laboratory, Department of Nutrition and Post Graduate Program in Nutrition Sciences, Federal University of Paraíba, Paraíba, Brazil. V.M. Cintra and P.A.F Lucena are with the Department of Medicine, Faculty of Medical Sciences of Paraíba, and the Department of Nutrition, Integrated Colleges of Patos, Paraíba, Brazil. V.M. Cintra is with the the Multiprofessional Residence in Child Health of Secretariat of Health of the State of Paraíba, Brazil. P.A.F Lucena is with Coordination of Neurology Services, Hospital Metropolitano Dom José Maria Pires, Santa Rita, Paraíba and Emergency, Trauma Hospital Senador Humberto Lucena, João Pessoa, Paraíba, Brazil. R. Manhães-de-Castro is with the Studies in Nutrition and Phenotypic Plasticity Unit, Department of Nutrition, Federal University of Pernambuco, Recife, Pernambuco, Brazil. R. Manhães-de-Castro and A.E. Toscano are with the Post Graduate Program in Nutrition, Health Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil. A.E. Toscano is with the Department of Nursing, CAV, Federal University of Pernambuco, Pernambuco, Brazil. A.E. Toscano and O. Guzman-Quevedo are with the Post Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Recife, Pernambuco, Brazil. L.P. Costa, M.E.B.S. Queirozj, and S.M. de Andrade are with the Ageing and Neuroscience Laboratory, Health Sciences Center, Federal University of Paraíba, Paraíba, Brazil. O. Guzman-Quevedo is with the Higher Technological Institute of Tacámbaro, Tacámbaro, Michoacán, Mexico. O. Guzman-Quevedo is with the Center for Biomedical Research of Michoacán, Mexican Institute of Social Security, Morelia, Michoacán, Mexico
| | - Paulo A F Lucena
- K.S. Batista and J.d.S. Aquino are with the Experimental Nutrition Laboratory, Department of Nutrition and Post Graduate Program in Nutrition Sciences, Federal University of Paraíba, Paraíba, Brazil. V.M. Cintra and P.A.F Lucena are with the Department of Medicine, Faculty of Medical Sciences of Paraíba, and the Department of Nutrition, Integrated Colleges of Patos, Paraíba, Brazil. V.M. Cintra is with the the Multiprofessional Residence in Child Health of Secretariat of Health of the State of Paraíba, Brazil. P.A.F Lucena is with Coordination of Neurology Services, Hospital Metropolitano Dom José Maria Pires, Santa Rita, Paraíba and Emergency, Trauma Hospital Senador Humberto Lucena, João Pessoa, Paraíba, Brazil. R. Manhães-de-Castro is with the Studies in Nutrition and Phenotypic Plasticity Unit, Department of Nutrition, Federal University of Pernambuco, Recife, Pernambuco, Brazil. R. Manhães-de-Castro and A.E. Toscano are with the Post Graduate Program in Nutrition, Health Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil. A.E. Toscano is with the Department of Nursing, CAV, Federal University of Pernambuco, Pernambuco, Brazil. A.E. Toscano and O. Guzman-Quevedo are with the Post Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Recife, Pernambuco, Brazil. L.P. Costa, M.E.B.S. Queirozj, and S.M. de Andrade are with the Ageing and Neuroscience Laboratory, Health Sciences Center, Federal University of Paraíba, Paraíba, Brazil. O. Guzman-Quevedo is with the Higher Technological Institute of Tacámbaro, Tacámbaro, Michoacán, Mexico. O. Guzman-Quevedo is with the Center for Biomedical Research of Michoacán, Mexican Institute of Social Security, Morelia, Michoacán, Mexico
| | - Raul Manhães-de-Castro
- K.S. Batista and J.d.S. Aquino are with the Experimental Nutrition Laboratory, Department of Nutrition and Post Graduate Program in Nutrition Sciences, Federal University of Paraíba, Paraíba, Brazil. V.M. Cintra and P.A.F Lucena are with the Department of Medicine, Faculty of Medical Sciences of Paraíba, and the Department of Nutrition, Integrated Colleges of Patos, Paraíba, Brazil. V.M. Cintra is with the the Multiprofessional Residence in Child Health of Secretariat of Health of the State of Paraíba, Brazil. P.A.F Lucena is with Coordination of Neurology Services, Hospital Metropolitano Dom José Maria Pires, Santa Rita, Paraíba and Emergency, Trauma Hospital Senador Humberto Lucena, João Pessoa, Paraíba, Brazil. R. Manhães-de-Castro is with the Studies in Nutrition and Phenotypic Plasticity Unit, Department of Nutrition, Federal University of Pernambuco, Recife, Pernambuco, Brazil. R. Manhães-de-Castro and A.E. Toscano are with the Post Graduate Program in Nutrition, Health Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil. A.E. Toscano is with the Department of Nursing, CAV, Federal University of Pernambuco, Pernambuco, Brazil. A.E. Toscano and O. Guzman-Quevedo are with the Post Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Recife, Pernambuco, Brazil. L.P. Costa, M.E.B.S. Queirozj, and S.M. de Andrade are with the Ageing and Neuroscience Laboratory, Health Sciences Center, Federal University of Paraíba, Paraíba, Brazil. O. Guzman-Quevedo is with the Higher Technological Institute of Tacámbaro, Tacámbaro, Michoacán, Mexico. O. Guzman-Quevedo is with the Center for Biomedical Research of Michoacán, Mexican Institute of Social Security, Morelia, Michoacán, Mexico
| | - Ana E Toscano
- K.S. Batista and J.d.S. Aquino are with the Experimental Nutrition Laboratory, Department of Nutrition and Post Graduate Program in Nutrition Sciences, Federal University of Paraíba, Paraíba, Brazil. V.M. Cintra and P.A.F Lucena are with the Department of Medicine, Faculty of Medical Sciences of Paraíba, and the Department of Nutrition, Integrated Colleges of Patos, Paraíba, Brazil. V.M. Cintra is with the the Multiprofessional Residence in Child Health of Secretariat of Health of the State of Paraíba, Brazil. P.A.F Lucena is with Coordination of Neurology Services, Hospital Metropolitano Dom José Maria Pires, Santa Rita, Paraíba and Emergency, Trauma Hospital Senador Humberto Lucena, João Pessoa, Paraíba, Brazil. R. Manhães-de-Castro is with the Studies in Nutrition and Phenotypic Plasticity Unit, Department of Nutrition, Federal University of Pernambuco, Recife, Pernambuco, Brazil. R. Manhães-de-Castro and A.E. Toscano are with the Post Graduate Program in Nutrition, Health Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil. A.E. Toscano is with the Department of Nursing, CAV, Federal University of Pernambuco, Pernambuco, Brazil. A.E. Toscano and O. Guzman-Quevedo are with the Post Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Recife, Pernambuco, Brazil. L.P. Costa, M.E.B.S. Queirozj, and S.M. de Andrade are with the Ageing and Neuroscience Laboratory, Health Sciences Center, Federal University of Paraíba, Paraíba, Brazil. O. Guzman-Quevedo is with the Higher Technological Institute of Tacámbaro, Tacámbaro, Michoacán, Mexico. O. Guzman-Quevedo is with the Center for Biomedical Research of Michoacán, Mexican Institute of Social Security, Morelia, Michoacán, Mexico
| | - Larissa P Costa
- K.S. Batista and J.d.S. Aquino are with the Experimental Nutrition Laboratory, Department of Nutrition and Post Graduate Program in Nutrition Sciences, Federal University of Paraíba, Paraíba, Brazil. V.M. Cintra and P.A.F Lucena are with the Department of Medicine, Faculty of Medical Sciences of Paraíba, and the Department of Nutrition, Integrated Colleges of Patos, Paraíba, Brazil. V.M. Cintra is with the the Multiprofessional Residence in Child Health of Secretariat of Health of the State of Paraíba, Brazil. P.A.F Lucena is with Coordination of Neurology Services, Hospital Metropolitano Dom José Maria Pires, Santa Rita, Paraíba and Emergency, Trauma Hospital Senador Humberto Lucena, João Pessoa, Paraíba, Brazil. R. Manhães-de-Castro is with the Studies in Nutrition and Phenotypic Plasticity Unit, Department of Nutrition, Federal University of Pernambuco, Recife, Pernambuco, Brazil. R. Manhães-de-Castro and A.E. Toscano are with the Post Graduate Program in Nutrition, Health Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil. A.E. Toscano is with the Department of Nursing, CAV, Federal University of Pernambuco, Pernambuco, Brazil. A.E. Toscano and O. Guzman-Quevedo are with the Post Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Recife, Pernambuco, Brazil. L.P. Costa, M.E.B.S. Queirozj, and S.M. de Andrade are with the Ageing and Neuroscience Laboratory, Health Sciences Center, Federal University of Paraíba, Paraíba, Brazil. O. Guzman-Quevedo is with the Higher Technological Institute of Tacámbaro, Tacámbaro, Michoacán, Mexico. O. Guzman-Quevedo is with the Center for Biomedical Research of Michoacán, Mexican Institute of Social Security, Morelia, Michoacán, Mexico
| | - Maria E B S Queiroz
- K.S. Batista and J.d.S. Aquino are with the Experimental Nutrition Laboratory, Department of Nutrition and Post Graduate Program in Nutrition Sciences, Federal University of Paraíba, Paraíba, Brazil. V.M. Cintra and P.A.F Lucena are with the Department of Medicine, Faculty of Medical Sciences of Paraíba, and the Department of Nutrition, Integrated Colleges of Patos, Paraíba, Brazil. V.M. Cintra is with the the Multiprofessional Residence in Child Health of Secretariat of Health of the State of Paraíba, Brazil. P.A.F Lucena is with Coordination of Neurology Services, Hospital Metropolitano Dom José Maria Pires, Santa Rita, Paraíba and Emergency, Trauma Hospital Senador Humberto Lucena, João Pessoa, Paraíba, Brazil. R. Manhães-de-Castro is with the Studies in Nutrition and Phenotypic Plasticity Unit, Department of Nutrition, Federal University of Pernambuco, Recife, Pernambuco, Brazil. R. Manhães-de-Castro and A.E. Toscano are with the Post Graduate Program in Nutrition, Health Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil. A.E. Toscano is with the Department of Nursing, CAV, Federal University of Pernambuco, Pernambuco, Brazil. A.E. Toscano and O. Guzman-Quevedo are with the Post Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Recife, Pernambuco, Brazil. L.P. Costa, M.E.B.S. Queirozj, and S.M. de Andrade are with the Ageing and Neuroscience Laboratory, Health Sciences Center, Federal University of Paraíba, Paraíba, Brazil. O. Guzman-Quevedo is with the Higher Technological Institute of Tacámbaro, Tacámbaro, Michoacán, Mexico. O. Guzman-Quevedo is with the Center for Biomedical Research of Michoacán, Mexican Institute of Social Security, Morelia, Michoacán, Mexico
| | - Suellen M de Andrade
- K.S. Batista and J.d.S. Aquino are with the Experimental Nutrition Laboratory, Department of Nutrition and Post Graduate Program in Nutrition Sciences, Federal University of Paraíba, Paraíba, Brazil. V.M. Cintra and P.A.F Lucena are with the Department of Medicine, Faculty of Medical Sciences of Paraíba, and the Department of Nutrition, Integrated Colleges of Patos, Paraíba, Brazil. V.M. Cintra is with the the Multiprofessional Residence in Child Health of Secretariat of Health of the State of Paraíba, Brazil. P.A.F Lucena is with Coordination of Neurology Services, Hospital Metropolitano Dom José Maria Pires, Santa Rita, Paraíba and Emergency, Trauma Hospital Senador Humberto Lucena, João Pessoa, Paraíba, Brazil. R. Manhães-de-Castro is with the Studies in Nutrition and Phenotypic Plasticity Unit, Department of Nutrition, Federal University of Pernambuco, Recife, Pernambuco, Brazil. R. Manhães-de-Castro and A.E. Toscano are with the Post Graduate Program in Nutrition, Health Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil. A.E. Toscano is with the Department of Nursing, CAV, Federal University of Pernambuco, Pernambuco, Brazil. A.E. Toscano and O. Guzman-Quevedo are with the Post Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Recife, Pernambuco, Brazil. L.P. Costa, M.E.B.S. Queirozj, and S.M. de Andrade are with the Ageing and Neuroscience Laboratory, Health Sciences Center, Federal University of Paraíba, Paraíba, Brazil. O. Guzman-Quevedo is with the Higher Technological Institute of Tacámbaro, Tacámbaro, Michoacán, Mexico. O. Guzman-Quevedo is with the Center for Biomedical Research of Michoacán, Mexican Institute of Social Security, Morelia, Michoacán, Mexico
| | - Omar Guzman-Quevedo
- K.S. Batista and J.d.S. Aquino are with the Experimental Nutrition Laboratory, Department of Nutrition and Post Graduate Program in Nutrition Sciences, Federal University of Paraíba, Paraíba, Brazil. V.M. Cintra and P.A.F Lucena are with the Department of Medicine, Faculty of Medical Sciences of Paraíba, and the Department of Nutrition, Integrated Colleges of Patos, Paraíba, Brazil. V.M. Cintra is with the the Multiprofessional Residence in Child Health of Secretariat of Health of the State of Paraíba, Brazil. P.A.F Lucena is with Coordination of Neurology Services, Hospital Metropolitano Dom José Maria Pires, Santa Rita, Paraíba and Emergency, Trauma Hospital Senador Humberto Lucena, João Pessoa, Paraíba, Brazil. R. Manhães-de-Castro is with the Studies in Nutrition and Phenotypic Plasticity Unit, Department of Nutrition, Federal University of Pernambuco, Recife, Pernambuco, Brazil. R. Manhães-de-Castro and A.E. Toscano are with the Post Graduate Program in Nutrition, Health Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil. A.E. Toscano is with the Department of Nursing, CAV, Federal University of Pernambuco, Pernambuco, Brazil. A.E. Toscano and O. Guzman-Quevedo are with the Post Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Recife, Pernambuco, Brazil. L.P. Costa, M.E.B.S. Queirozj, and S.M. de Andrade are with the Ageing and Neuroscience Laboratory, Health Sciences Center, Federal University of Paraíba, Paraíba, Brazil. O. Guzman-Quevedo is with the Higher Technological Institute of Tacámbaro, Tacámbaro, Michoacán, Mexico. O. Guzman-Quevedo is with the Center for Biomedical Research of Michoacán, Mexican Institute of Social Security, Morelia, Michoacán, Mexico
| | - Jailane de S Aquino
- K.S. Batista and J.d.S. Aquino are with the Experimental Nutrition Laboratory, Department of Nutrition and Post Graduate Program in Nutrition Sciences, Federal University of Paraíba, Paraíba, Brazil. V.M. Cintra and P.A.F Lucena are with the Department of Medicine, Faculty of Medical Sciences of Paraíba, and the Department of Nutrition, Integrated Colleges of Patos, Paraíba, Brazil. V.M. Cintra is with the the Multiprofessional Residence in Child Health of Secretariat of Health of the State of Paraíba, Brazil. P.A.F Lucena is with Coordination of Neurology Services, Hospital Metropolitano Dom José Maria Pires, Santa Rita, Paraíba and Emergency, Trauma Hospital Senador Humberto Lucena, João Pessoa, Paraíba, Brazil. R. Manhães-de-Castro is with the Studies in Nutrition and Phenotypic Plasticity Unit, Department of Nutrition, Federal University of Pernambuco, Recife, Pernambuco, Brazil. R. Manhães-de-Castro and A.E. Toscano are with the Post Graduate Program in Nutrition, Health Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil. A.E. Toscano is with the Department of Nursing, CAV, Federal University of Pernambuco, Pernambuco, Brazil. A.E. Toscano and O. Guzman-Quevedo are with the Post Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Recife, Pernambuco, Brazil. L.P. Costa, M.E.B.S. Queirozj, and S.M. de Andrade are with the Ageing and Neuroscience Laboratory, Health Sciences Center, Federal University of Paraíba, Paraíba, Brazil. O. Guzman-Quevedo is with the Higher Technological Institute of Tacámbaro, Tacámbaro, Michoacán, Mexico. O. Guzman-Quevedo is with the Center for Biomedical Research of Michoacán, Mexican Institute of Social Security, Morelia, Michoacán, Mexico
| |
Collapse
|
38
|
Emily L, Gilad G, Haim ME, Galina G. Functional dependency and COVID-19 in elderly patients with mild to moderate disease. Experience of tertiary geriatric hospital. Exp Gerontol 2022; 157:111620. [PMID: 34742855 DOI: 10.1016/j.exger.2021.111620] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 10/31/2021] [Accepted: 11/02/2021] [Indexed: 01/10/2023]
Abstract
Clinical course of COVID-19 may be associated with functional dependency of geriatric patients. Data from the records of patients admitted to the COVID-19 Geriatric Unit were gathered during three months, including background, clinical aspects, time to resolution of infection and functional status. Functionally dependent patients had higher rates of diabetes (p = 0.03) and stroke (p = 0.004), as well as longer time to resolution of infection (p < 0.001), but less respiratory COVID-19 symptoms (p = 0.007), compared to independent patients. Time to resolution of infection was longer in women (p = 0.01) and positively associated with WBC level (p < 0.01) and age (p < 0.001). An adjusted analysis which controlled these variables confirmed the significant effect of functional status on the time to resolution of infection (p = 0.015). Functionally dependent geriatric patients with mild to moderate infection had less respiratory COVID-19 symptoms but showed longer time to resolution of infection compared to independent. Assessment of functional status in the elderly population may contribute to decision making for care of geriatric inpatients with COVID-19.
Collapse
|
39
|
Gemicioglu B, Uzun H, Borekci S, Karaali R, Kurugoglu S, Atukeren P, Sirolu S, Durmus S, Dirican A, Kuskucu MA, Tabak F. Focusing on Asthma and Chronic Obstructive Pulmonary Disease with COVID-19. J Infect Dev Ctries 2021; 15:1415-1425. [PMID: 34780364 DOI: 10.3855/jidc.14611] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 06/13/2021] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION We aimed to evaluate clinical and laboratory findings of hospitalized asthma and chronic obstructive pulmonary disease (COPD) patients with COVID-19 and demonstrate that they have different symptoms and/or laboratory results and outcomes than COVID-19 patients with comorbidity (CoV-com) and without comorbidity (CoV-alone). METHODOLOGY The data of the demographic, clinical, laboratory findings of hospitalized CoV-alone, asthma, COPD patients with COVID-19 (CoV-asthma, CoV-COPD, respectively), and CoV-com were analyzed. RESULTS Out of 1082 patients hospitalized for COVID-19, 585 (54.1%) had CoV-alone, 40 (3.7%) had CoV-asthma, 46 (4.3%) had CoV-COPD and 411 (38%) had CoV-com. Cough, shortness of breath, fever and weakness were the most common four symptoms seen in all COVID-19 patients. Shortness of breath, myalgia, headache symptoms were more common in CoV-asthma than the other groups (p < 0.001, p < 0.01, p < 0.05 respectively). Sputum was more common in CoV-COPD than other groups (p < 0.01). COPD group most frequently had increased values, different from the other groups with CRP>5ng/mL in 91.3%, D-dimer > 0.05mg/dL in 89.1%, troponin > 0.014micg/L in %63.9, INR>1.15 in 52.2%, CK-MB>25U/L in 48.5%, PT>14s in 40.9% of patients (p < 0.05, p < 0.001, p < 0.001, p < 0.001, p < 0.05, p < 0.001, respectively). NT-ProBNP was found to have the highest AUC value and the best differentiating parameter for CoV-asthma from CoV-alone. Typical CT findings were present in 44.4% of CoV-alone, 57.5% of CoV-asthma, 28.3% of CoV-COPD and 38.9% of CoV-com groups. CoV-COPD and CoV-com patients died more frequently than other groups (17.8%, 18.5%). CONCLUSIONS CoV-asthma and CoV-COPD patients might have different symptoms and laboratory parameters than other COVID-19 patients which can guide the physicians.
Collapse
Affiliation(s)
- Bilun Gemicioglu
- Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Pulmonary Diseases, Istanbul, Turkey.
| | - Hafize Uzun
- Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Medical Biochemistry, Istanbul, Turkey
| | - Sermin Borekci
- Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Pulmonary Diseases, Istanbul, Turkey
| | - Ridvan Karaali
- Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - Sebuh Kurugoglu
- Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Radiology, Istanbul, Turkey
| | - Pınar Atukeren
- Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Medical Biochemistry, Istanbul, Turkey
| | - Sabri Sirolu
- Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Radiology, Istanbul, Turkey
| | - Sinem Durmus
- Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Medical Biochemistry, Istanbul, Turkey
| | - Ahmet Dirican
- Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Biostatistic, Istanbul, Turkey
| | - Mert Ahmet Kuskucu
- Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Microbiology, Istanbul, Turkey
| | - Fehmi Tabak
- Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| |
Collapse
|
40
|
Kocadagli O, Baygul A, Gokmen N, Incir S, Aktan C. Clinical prognosis evaluation of COVID-19 patients: An interpretable hybrid machine learning approach. Curr Res Transl Med 2021; 70:103319. [PMID: 34768217 PMCID: PMC8577545 DOI: 10.1016/j.retram.2021.103319] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 10/12/2021] [Accepted: 10/26/2021] [Indexed: 12/23/2022]
Abstract
This retrospective cohort study deals with evaluating severity of COVID-19 cases on the first symptoms and blood-test results of infected patients admitted to Emergency Department of Koc University Hospital (Istanbul, Turkey). To figure out remarkable hematological characteristics and risk factors in the prognosis evaluation of COVID-19 cases, the hybrid machine learning (ML) approaches integrated with feature selection procedure based Genetic Algorithms and information complexity were used in addition to the multivariate statistical analysis. Specifically, COVID-19 dataset includes demographic features, symptoms, blood test results and disease histories of total 166 inpatients with different age and gender groups. Analysis results point out that the hybrid ML methods has brought out potential risk factors on the severity of COVID-19 cases and their impacts on the prognosis evaluation, accurately.
Collapse
Affiliation(s)
- Ozan Kocadagli
- Department of Statistics, Mimar Sinan University, Silahsör Cad. No. 71, 34380 Bomonti/Sisli, Istanbul, Turkey.
| | - Arzu Baygul
- Department of Biostatistics, Faculty of Medicine, Koc University, Turkey.
| | - Neslihan Gokmen
- Neslihan Gokmen, Department of Basic Sciences, Istanbul Technical University, Turkey.
| | - Said Incir
- Said Incir, Department of Biochemistry, Koc University Hospital, Turkey.
| | - Cagdas Aktan
- Department of Medical Biology, Beykent University, Turkey.
| |
Collapse
|
41
|
Najafloo R, Majidi J, Asghari A, Aleemardani M, Kamrava SK, Simorgh S, Seifalian A, Bagher Z, Seifalian AM. Mechanism of Anosmia Caused by Symptoms of COVID-19 and Emerging Treatments. ACS Chem Neurosci 2021; 12:3795-3805. [PMID: 34609841 PMCID: PMC8507153 DOI: 10.1021/acschemneuro.1c00477] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 09/20/2021] [Indexed: 01/08/2023] Open
Abstract
The occurrence of anosmia, the loss or change in sense of smell, is one of the most common symptoms of COVID-19 experienced by almost 53% of those affected. Several hypotheses explain the mechanism of anosmia in patients suffering from COVID-19. This study aims to review the related mechanisms and answer the questions regarding COVID-19-related anosmia as well as propose a new strategy for treatment of long-term anosmia as a result of COVID-19 infection. This paper covers all of the studies investigating olfactory disorders following COVID-19 infection and explains the possible reasons for the correlated anosmia, including olfactory cleft syndrome, local inflammation in the nasal epithelium, early apoptosis of olfactory cells, changes in olfactory cilia and odor transmission, damage to microglial cells, effect on olfactory bulbs, epithelial olfactory injury, and impairment of olfactory neurons and stem cells. The key questions that arise in this field have been discussed, such as why prevalent anosmia is varied among the age categories and among sexes and the correlation of anosmia with mild or severe COVID-19 infection. The angiotensin-converting enzyme 2 receptor is a significant player in the mechanism of anosmia in COVID-19 patients. Based on current studies, a novel approach to treat long-COVID-19 with ongoing anosmia has been proposed. The fields of smart drug delivery, tissue engineering, and cell therapy provide a hypothesized strategy that can minimize the side effects of current treatments and support efficient recovery of the olfactory system.
Collapse
Affiliation(s)
- Raziyeh Najafloo
- Department
of Tissue Engineering & Regenerative Medicine, Faculty of Advanced
Technologies in Medicine, Iran University
of Medical Sciences (IUMS), Tehran 1449614535, Iran
| | - Jila Majidi
- Department
of Tissue Engineering & Regenerative Medicine, Faculty of Advanced
Technologies in Medicine, Iran University
of Medical Sciences (IUMS), Tehran 1449614535, Iran
| | - Alimohamad Asghari
- Skull
Base Research Center, Hazrat Rasoul Akram Hospital, The Five Senses
Health Institute, Iran University of Medical
Sciences (IUMS), Tehran 1445613131, Iran
| | - Mina Aleemardani
- Biomaterials
and Tissue Engineering Group, Department of Materials Science and
Engineering, Kroto Research Institute, The
University of Sheffield, Sheffield S3 7HQ, United Kingdom
| | - Seyed Kamran Kamrava
- ENT
and Head and Neck Research Center and Department, Hazrat Rasoul Akram
Hospital, The Five Senses Health Institute, Iran University of Medical Sciences (IUMS), Tehran 1445613131, Iran
| | - Sara Simorgh
- Department
of Tissue Engineering & Regenerative Medicine, Faculty of Advanced
Technologies in Medicine, Iran University
of Medical Sciences (IUMS), Tehran 1449614535, Iran
| | - Amelia Seifalian
- University
College London Medical School (UCL), London WC1E 6BT, United
Kingdom
- Watford
General Hospital, Watford WD18 0HB, United Kingdom
| | - Zohreh Bagher
- Department
of Tissue Engineering & Regenerative Medicine, Faculty of Advanced
Technologies in Medicine, Iran University
of Medical Sciences (IUMS), Tehran 1449614535, Iran
- ENT
and Head and Neck Research Center and Department, Hazrat Rasoul Akram
Hospital, The Five Senses Health Institute, Iran University of Medical Sciences (IUMS), Tehran 1445613131, Iran
| | - Alexander M. Seifalian
- Nanotechnology
and Regenerative Medicine Commercialisation Centre (NanoRegMed Ltd.), London BioScience Innovation Centre, London NW1 0NH, United Kingdom
| |
Collapse
|
42
|
Amin MT, Hasan M, Bhuiya NMMA. Prevalence of Covid-19 Associated Symptoms, Their Onset and Duration, and Variations Among Different Groups of Patients in Bangladesh. Front Public Health 2021; 9:738352. [PMID: 34660518 PMCID: PMC8511678 DOI: 10.3389/fpubh.2021.738352] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 08/30/2021] [Indexed: 01/12/2023] Open
Abstract
Objective: This study aimed to assess the prevalence, onset, and duration of COVID-19 associated symptoms, hospitalization, and recovery time from the infection in Bangladesh. Methods: A retrospective study was designed adopting the snowball sampling technique (n = 439). The association of gender, age, and comorbidity on COVID-19 associated complications was determined using chi-square and binary logistic regression analysis (p < 0.05). Result: Fever, exhaustion, cough, loss of taste, sore throat, body ache, and hair-loss were prevalent among more than 50% of the participants and developed within fourth days in above 90% of the patients. Shortness of breath was significantly higher in males (χ2 = 5.671; OR 1.641). Significant comorbidity association on the shortness of breath (χ2 = 40.119; OR 2.564), vomiting (χ2 = 4.422; OR 1.018), and loss of speech (χ2 = 17.299; OR 3.430) was observed. Patients (>40 years) exerted higher association in shortness of breath (χ2 = 24.083; OR 2.901). Age and comorbidity were significantly associated with COVID-19 associated hospitalization (χ2 = 16.890 and χ2 = 23.638, respectively) and recovery time (χ2 = 12.870 and χ2 = 26.924, respectively). Conclusion: The study suggests that the hospitalization rate increased for older (>40 years) and comorbid patients. Comorbid patients demonstrated higher susceptibility to have shortness of breath, vomiting, loss of speech, and confusion, whereas male patients showed significant increase in the prevalence of sore throat, loss of smell, and vomiting compared to female patients.
Collapse
Affiliation(s)
| | - Mahmud Hasan
- Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, United States
| | | |
Collapse
|
43
|
Yamamoto N, Nishida N, Yamamoto R, Gojobori T, Shimotohno K, Mizokami M, Ariumi Y. Angiotensin-Converting Enzyme (ACE) 1 Gene Polymorphism and Phenotypic Expression of COVID-19 Symptoms. Genes (Basel) 2021; 12:1572. [PMID: 34680966 DOI: 10.3390/genes12101572] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/16/2021] [Accepted: 09/28/2021] [Indexed: 12/25/2022] Open
Abstract
The renin–angiotensin–aldosterone system (RAAS) appears to play an important role in SARS-CoV-2 infection. Polymorphisms within the genes that control this enzymatic system are candidates for elucidating the pathogenesis of COVID-19, since COVID-19 is not only a pulmonary disease but also affects many organs and systems throughout the body in multiple ways. Most striking is the fact that ACE2, one of the major components of the RAAS, is a prerequisite for SARS-COV-2 infection. Recently, we and other groups reported an association between a polymorphism of the ACE1 gene (a homolog of ACE2) and the phenotypic expression of COVID-19, particularly in its severity. The ethnic difference in ACE1 insertion (I)/deletion (D) polymorphism seems to explain the apparent difference in mortality between the West and East Asia. The purpose of this review was to further evaluate the evidence linking ACE1 polymorphisms to COVID-19. We searched the Medline database (2019–2021) for reference citations of relevant articles and selected studies on the clinical outcome of COVID-19 related to ACE1 I/D polymorphism. Although the numbers of patients are not large enough yet, most available evidence supports the notion that the DD genotype adversely influences COVID-19 symptoms. Surprisingly, small studies conducted in several countries yielded opposite results, suggesting that the ACE1 II genotype is a risk factor. This contradictory result may be the case in certain geographic areas, especially in subgroups of patients. It may also be due to interactions with other genes or to yet unexplained biochemical mechanisms. According to our hypothesis, such candidates are genes that are functionally involved in the pathophysiology of COVID-19, can act in concert with the ACE1 DD genotype, and that show differences in their frequency between the West and East Asia. For this, we conducted research focusing on Alu-related genes. The current study on the ACE1 genotype will provide potentially new clues to the pathogenesis, treatment, and diagnosis of SARS-CoV-2 infections.
Collapse
|
44
|
Totsika V, Emerson E, Hastings RP, Hatton C. The impact of the COVID-19 pandemic on the health of adults with intellectual impairment: evidence from two longitudinal UK surveys. J Intellect Disabil Res 2021; 65:890-897. [PMID: 34212443 PMCID: PMC8447167 DOI: 10.1111/jir.12866] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 05/22/2021] [Accepted: 06/20/2021] [Indexed: 05/22/2023]
Abstract
BACKGROUND People with an intellectual impairment experience high levels of social and health inequalities. We investigated the impact of COVID-19 on the physical and mental health of people with intellectual impairment, controlling for demographic risk, socio-economic circumstances and pre-pandemic health levels. METHOD Data were drawn from two UK birth cohorts that surveyed their participants on the impact of COVID-19 in May 2020: the Millennium Cohort Study (20-year-old participants) and the British Cohort Survey (50-year-old participants). Health outcomes (COVID-19 infection, COVID-19 symptoms, self-reported physical health, mental health, health service use and impact on health behaviours) were compared between people with and without intellectual impairment, adjusting for gender and ethnicity. Differences were further adjusted for self-reported health pre-pandemic and the impact of COVID-19 on socio-economic circumstances. RESULTS Controlling for gender and ethnicity, poor health was reported less often by younger adults [relative risks (RR): 0.44 95% confidence interval (CI) 0.23, 0.86] and more often by older adults (RR: 1.99 95% CI 1.45, 2.73) with intellectual impairment compared with peers. Older adults were also more likely to experience fever and loss of taste/smell. Adjusting for pre-pandemic health and socio-economic circumstances eliminated some differences in the older cohort, but not in the younger one. CONCLUSION In young adulthood, the impact of COVID-19 on health outcomes was not negative. The pattern was reversed in later adulthood, although differences were mostly eliminated after adjustment suggesting a socio-economic and age gradient of COVID-19 impacts on intellectual impairment.
Collapse
Affiliation(s)
- V. Totsika
- Division of PsychiatryUniversity College LondonLondonUK
- Centre for Educational Development Appraisal and ResearchUniversity of WarwickCoventryUK
- Centre for Developmental Psychiatry and PsychologyMonash UniversityMelbourneVictoriaAustralia
| | - E. Emerson
- Centre for Disability Research, Faculty of Health and MedicineLancaster UniversityLancasterUK
- Centre for Disability Research & Policy, Faculty of Health SciencesUniversity of SydneySydneyNew South WalesAustralia
- College of Nursing and Health SciencesFlinders UniversityAdelaideSouth AustraliaAustralia
| | - R. P. Hastings
- Centre for Educational Development Appraisal and ResearchUniversity of WarwickCoventryUK
- Centre for Developmental Psychiatry and PsychologyMonash UniversityMelbourneVictoriaAustralia
| | - C. Hatton
- Department of Social Care and Social WorkManchester Metropolitan UniversityManchesterUK
| |
Collapse
|
45
|
Mowbray F, Woodland L, Smith LE, Amlôt R, Rubin GJ. Is My Cough a Cold or Covid? A Qualitative Study of COVID-19 Symptom Recognition and Attitudes Toward Testing in the UK. Front Public Health 2021; 9:716421. [PMID: 34485238 PMCID: PMC8416344 DOI: 10.3389/fpubh.2021.716421] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 06/01/2021] [Accepted: 07/26/2021] [Indexed: 01/09/2023] Open
Abstract
Objective: Key to reducing the spread of COVID-19 in the UK is increased use of the NHS Test and Trace (NHSTT) system. This study explored one of the main issues that determine whether people engage with NHSTT, how people understand symptoms that may indicate the presence of COVID-19 and that should trigger a request for a test. Methods: In this qualitative study, a series of semi-structured telephone interviews were conducted with 40 people (21 members of the general population, 19 students). There was nearly an equal split between male and female participants in both samples. Data were collected between 30 November and 11 December 2020 and explored using thematic analysis. There was substantial similarity in responses for both populations so we combined our results and highlighted where differences were present. Results: Participants generally had good knowledge of the main symptoms of COVID-19 (high temperature, new, persistent cough, anosmia) but had low confidence in their ability to differentiate them from symptoms of other illnesses. Attribution of symptoms to COVID-19 was most likely where the symptoms were severe, many symptoms were present, symptoms had lasted for some time and when perceived risk of exposure to infection was high due to previous contact with others. Participants felt encouraged to engage in testing where symptoms were present and had persisted for several days, though, many had concerns about the safety of testing centres and the accuracy of test results. Students had mixed feelings about mass asymptomatic testing, seeing it as a way to access a more normal student experience, but also a potential waste of resources. Conclusions: This study offers novel insights into how people attribute symptoms to COVID-19 and barriers and facilitators to engaging with NHSTT. Participants had positive views of testing, but there is a need to improve not just recognition of each main symptom, but also understanding that even single, mild symptoms may necessitate a test rather than a “wait and see” approach, and to address concerns around test accuracy to increase testing uptake.
Collapse
Affiliation(s)
- Fiona Mowbray
- Weston Education Centre, King's College London, London, United Kingdom
| | - Lisa Woodland
- Weston Education Centre, King's College London, London, United Kingdom
| | - Louise E Smith
- Weston Education Centre, King's College London, London, United Kingdom
| | - Richard Amlôt
- Emergency Response Department, Public Health England, Salisbury, United Kingdom
| | - G James Rubin
- Weston Education Centre, King's College London, London, United Kingdom
| |
Collapse
|
46
|
Sultana MS, Khan AH, Hossain S, Hasan MT. Mental health difficulties in students with suspected COVID-19 symptoms and students without suspected COVID-19 symptoms: A cross-sectional comparative study during the COVID-19 pandemic. Child Youth Serv Rev 2021; 128:106137. [PMID: 34248237 PMCID: PMC8253598 DOI: 10.1016/j.childyouth.2021.106137] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 06/04/2021] [Accepted: 06/30/2021] [Indexed: 05/17/2023]
Abstract
INTRODUCTION Mental health problems are taking a heavy toll on students during the COVID-19 pandemic. The purpose of this study was to compare the level of anxiety symptoms, depressive symptoms, post-traumatic stress symptoms (PTSS), and fear of COVID-19 between students with suspected COVID-19 symptoms and students without any suspected symptoms during the pandemic in Bangladesh. METHODS This cross-sectional comparative study was conducted online among Bangladeshi students from May to July 2020. Anxiety symptoms, depressive symptoms, PTSS, and fear of COVID-19 were assessed by using the Generalized Anxiety Disorder scale, Patient Health Questionnaire, the Impact of Event Scale, and Fear of COVID-19 Scale, respectively. College and University students were the participants of the study. RESULTS Among 3777 students, 1259 had suspected COVID-19 symptoms and 2518 had no suspected COVID-19 symptoms. Students who experienced suspected COVID-19 symptoms had higher prevalence (moderate to severe) of depressive symptoms (61.15% vs. 47.62%), anxiety symptoms (44.96% vs. 36.97%), and PTSS (48.3% vs. 39.75%) compared to those who had no such symptoms. The study identified having suspected COVID-19 symptoms as a significant associated factor for anxiety symptoms (β1' = 1.39; 95% CI: 1.03-1.74), depressive symptoms (β1' = 1.88; 95% CI: 1.43-2.32), PTSS (β1' = 3.66; 95% CI: 2.66-4.65), and fear of COVID-19 (β1' = 0.48; 95% CI: 0.02 to 0.94). Students with suspected COVID-19 symptoms thought more that they would be better off dead, or of hurting themselves (P < 0.01) and felt more afraid as if something awful might happen (P < 0.01) than their counterparts. CONCLUSION Mental health difficulties are more prevalent among students with suspected COVID-19 symptoms than the students without having such symptoms. This finding suggests that public health practitioners should deploy a rapid diagnostic system and consider psychological intervention in addition to clinical management for those who have COVID-19 like symptoms during the pandemic.
Collapse
Affiliation(s)
- Mst Sadia Sultana
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | - Abid Hasan Khan
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | - Sahadat Hossain
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh
- Public Health Foundation, Bangladesh
| | - M Tasdik Hasan
- Public Health Foundation, Bangladesh
- Department of Primary Care and Mental Health, University of Liverpool, United Kingdom
| |
Collapse
|
47
|
Davis HE, Assaf GS, McCorkell L, Wei H, Low RJ, Re'em Y, Redfield S, Austin JP, Akrami A. Characterizing long COVID in an international cohort: 7 months of symptoms and their impact. EClinicalMedicine 2021; 38:101019. [PMID: 34308300 PMCID: PMC8280690 DOI: 10.1016/j.eclinm.2021.101019] [Citation(s) in RCA: 1087] [Impact Index Per Article: 362.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 06/18/2021] [Accepted: 06/21/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND A significant number of patients with COVID-19 experience prolonged symptoms, known as Long COVID. Few systematic studies have investigated this population, particularly in outpatient settings. Hence, relatively little is known about symptom makeup and severity, expected clinical course, impact on daily functioning, and return to baseline health. METHODS We conducted an online survey of people with suspected and confirmed COVID-19, distributed via COVID-19 support groups (e.g. Body Politic, Long COVID Support Group, Long Haul COVID Fighters) and social media (e.g. Twitter, Facebook). Data were collected from September 6, 2020 to November 25, 2020. We analyzed responses from 3762 participants with confirmed (diagnostic/antibody positive; 1020) or suspected (diagnostic/antibody negative or untested; 2742) COVID-19, from 56 countries, with illness lasting over 28 days and onset prior to June 2020. We estimated the prevalence of 203 symptoms in 10 organ systems and traced 66 symptoms over seven months. We measured the impact on life, work, and return to baseline health. FINDINGS For the majority of respondents (>91%), the time to recovery exceeded 35 weeks. During their illness, participants experienced an average of 55.9+/- 25.5 (mean+/-STD) symptoms, across an average of 9.1 organ systems. The most frequent symptoms after month 6 were fatigue, post-exertional malaise, and cognitive dysfunction. Symptoms varied in their prevalence over time, and we identified three symptom clusters, each with a characteristic temporal profile. 85.9% of participants (95% CI, 84.8% to 87.0%) experienced relapses, primarily triggered by exercise, physical or mental activity, and stress. 86.7% (85.6% to 92.5%) of unrecovered respondents were experiencing fatigue at the time of survey, compared to 44.7% (38.5% to 50.5%) of recovered respondents. 1700 respondents (45.2%) required a reduced work schedule compared to pre-illness, and an additional 839 (22.3%) were not working at the time of survey due to illness. Cognitive dysfunction or memory issues were common across all age groups (~88%). Except for loss of smell and taste, the prevalence and trajectory of all symptoms were similar between groups with confirmed and suspected COVID-19. INTERPRETATION Patients with Long COVID report prolonged, multisystem involvement and significant disability. By seven months, many patients have not yet recovered (mainly from systemic and neurological/cognitive symptoms), have not returned to previous levels of work, and continue to experience significant symptom burden. FUNDING All authors contributed to this work in a voluntary capacity. The cost of survey hosting (on Qualtrics) and publication fee was covered by AA's research grant (Wellcome Trust/Gatsby Charity via Sainsbury Wellcome center, UCL).
Collapse
Affiliation(s)
| | | | | | | | - Ryan J. Low
- Patient-Led Research Collaborative
- Sainsbury Wellcome Centre, University College London, London, United Kingdom
| | - Yochai Re'em
- Patient-Led Research Collaborative
- Department of Psychiatry, NewYork-Presbyterian Hospital / Weill Cornell Medicine, NYC, United States
| | | | - Jared P. Austin
- Patient-Led Research Collaborative
- Oregon Health and Science University, Portland, OR, United States
| | - Athena Akrami
- Patient-Led Research Collaborative
- Sainsbury Wellcome Centre, University College London, London, United Kingdom
| |
Collapse
|
48
|
Abstract
Integrated, data-driven criteria are necessary to evaluate delivery outcomes in pregnancies affected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the ongoing COVID-19 pandemic. This study analyzed maternal demographics, clinical characteristics, treatments, and delivery outcomes of 85 ethnically diverse, adult pregnant women who tested positive for SARS-CoV-2 at the time of delivery. Median maternal and gestational ages were 27 years (interquartile range [IQR]: 23-31) and 39 weeks (IQR: 37.3-40.0), respectively. Of the 85 SARS-CoV-2-positive participants, 67 (79%) had no COVID-19 symptoms at the time of routine COVID-19 admission testing, 14 (16%) reported mild COVID-19 symptoms, and 4 (5%) presented severe COVID-19 symptoms that required hospitalization. Patients in the severe COVID-19 group had significantly longer hospitalizations than those with nonsevere COVID-19 (7 [IQR: 4.5-9.5] vs 2 [IQR: 2-3] days; P<0.01). Neonatal outcomes included 100% live births with a median 1-minute Apgar score of 8 and 15% preterm births. No neonatal deaths or vertical transmissions were reported, and all neonatal intensive care unit admissions were related to prematurity. Overall, maternal symptom prevalence and peripartum complication rates were low, suggesting a generally good prognosis for pregnant women with SARS-CoV-2 infections at the time of delivery.
Collapse
Affiliation(s)
- Viviana Zlochiver
- Advocate Aurora Research Institute, Advocate Aurora Health, Milwaukee, WI
| | - Blair Tilkens
- Department of Internal Medicine, Aurora St. Luke's Medical Center, Advocate Aurora Health, Milwaukee, WI
| | | | - Fatima Aziz
- Maternal Fetal Medicine Division, Department of Obstetrics and Gynecology, Aurora Medical Center Grafton, Grafton, WI
| | - M Fuad Jan
- Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke's Medical Centers, Milwaukee, WI; University of Wisconsin School of Medicine and Public Health, Madison, WI
| |
Collapse
|
49
|
Savio A, Calza S, Guerrini G, Romano V, Marchina E. Rapid Point-Of-Care Serology and Clinical History Assessment Increase Protection Provided by RT-PCR Screening: A Pilot Study Involving Three Nursing Homes in Brescia, a Hotspot of Lombardy. Front Public Health 2021; 9:649524. [PMID: 34249831 PMCID: PMC8264443 DOI: 10.3389/fpubh.2021.649524] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 05/27/2021] [Indexed: 12/21/2022] Open
Abstract
Background: COVID-19 outbursts have been registered worldwide within care homes with asymptomatic transmission combined with shortage/inaccuracy of diagnostic tests undermining the efforts at containment of the disease. Nursing facilities in Lombardy (Italy) were left with no, or limited, access to testing for 8 weeks after the outbreak of COVID-19. Methods: This study includes 246 residents and 286 workers of three different nursing homes in Brescia-Lombardy. Clinical questionnaires and rapid serology tests were devised to integrate the data of the first available RT-PCR screening. Follow-up serology after 60-days was performed on 67 of 86 workers with positive serology or clinically suspicious. Findings: Thirty-seven residents and 18 workers had previous positive RT-PCR. Thorough screening disclosed two additional RT-PCR-positive workers. Serology screening revealed antibodies in 59 residents and 48 workers, including 32/37 residents and all workers previously positive at RT-PCR. Follow up serology disclosed antibodies in two additional workers with recent symptoms at the time of screening. The professionals in close contact with residents had more infections (47/226–20.79% vs. 1/60–1.66%; p = 0.00013 Fisher exact-test). A suspicious clinical score was present in 44/64 residents and in 41/50 workers who tested positive with either method with totally asymptomatic disease more frequent among residents 28.1 vs. 10.0% (p = 0.019 Fisher exact-test). Interpretation: Based on the available RT-PCR ± results at the time of symptoms/contacts, our integrated clinical and serological screening demonstrated sensitivity 89% and specificity 87%. This multimodal assessment proved extremely useful in understanding the viral spread in nursing homes, in defining its stage and in implementing protective measures. Rapid serology tests demonstrated efficient and particularly suited for older people less able to move/cooperate.
Collapse
Affiliation(s)
- Antonella Savio
- Histopathology Department, The Royal Marsden Hospital, London, United Kingdom
| | - Stefano Calza
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | | | | | - Eleonora Marchina
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| |
Collapse
|
50
|
Ghosn J, Piroth L, Epaulard O, Le Turnier P, Mentré F, Bachelet D, Laouénan C. Persistent COVID-19 symptoms are highly prevalent 6 months after hospitalization: results from a large prospective cohort. Clin Microbiol Infect 2021; 27:1041.e1-1041.e4. [PMID: 34125067 PMCID: PMC8107834 DOI: 10.1016/j.cmi.2021.03.012] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [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: 01/05/2021] [Revised: 03/01/2021] [Accepted: 03/06/2021] [Indexed: 12/13/2022]
Abstract
Objectives Persistent COVID-19 symptoms have been reported up to 3 months after hospital discharge. Little is known on the frequency and the nature of persistent symptoms beyond 3 months. Here we have assessed, in the longitudinal prospective French COVID-19 cohort, symptoms that persisted 6 months after admission for COVID-19. Methods Hospitalized patients with virologically confirmed COVID-19 were enrolled. Follow-up was planned with a physician's visit at month (M)3 and M6 after admission. Associations between persistence of symptoms at M6 and clinical characteristics at admission were assessed through bivariate and multivariate logistic regression. Results M6 data were available for 1137 participants. Median age was 61 years (IQR 51–71) and 288 (29%, 95% CI 26–32%) were admitted to intensive care unit (ICU) during the acute phase. Six hundred and fifty-five (68%, 95% CI 65–71%) and 639 (60%, 95% CI 57–63%) participants had at least one symptom at M3 and M6 visit, respectively, mostly fatigue, dyspnoea, joint pain and myalgia. At M6, 255 (24%, 95% CI 21–27%) of participants had three or more persistent symptoms. The presence of three or more symptoms at M6 was independently associated with female gender (adjusted odds ratio (aOR) 2.40, 95% CI 1.75–3.30), having three or more symptoms at admission (aOR 2.04, 95% CI 1.45–2.89) and ICU admission/transfer during acute phase (aOR 1.55, 95% CI 1.09–2.18), but not significantly with age or having two or more comorbidities. One hundred and twenty-five (29%, 95% CI 25–34%) of those who initially had a professional occupation were not back to work at M6. Discussion A fourth of individuals admitted to hospital for COVID-19 still had three or more persistent symptoms at M6. Longitudinal follow-up of individuals with severe COVID-19 is warranted to better understand the pathophysiology underlying this long-term persistence.
Collapse
Affiliation(s)
- Jade Ghosn
- Université de Paris, INSERM, IAME UMR 1137, Paris, France; Infectious and Tropical Diseases Department, AP-HP, Hôpital Bichat, Paris, France
| | - Lionel Piroth
- Infectious Diseases Department, University Hospital and INSERM CIC 1432, Dijon, France
| | - Olivier Epaulard
- Infectious Diseases Unit, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Paul Le Turnier
- Department of Infectious Diseases, Hotel-Dieu Hospital - INSERM CIC 1413, Nantes University Hospital, Nantes, France
| | - France Mentré
- Université de Paris, INSERM, IAME UMR 1137, Paris, France; INSERM, Centre d'Investigation clinique-Epidémiologie Clinique 1425, Hôpital Bichat, Paris, France; Departement of Epidemiology Biostatistics and Clinical Research, AP-HP, Hôpital Bichat, Paris, France
| | - Delphine Bachelet
- INSERM, Centre d'Investigation clinique-Epidémiologie Clinique 1425, Hôpital Bichat, Paris, France; Departement of Epidemiology Biostatistics and Clinical Research, AP-HP, Hôpital Bichat, Paris, France
| | - Cédric Laouénan
- Université de Paris, INSERM, IAME UMR 1137, Paris, France; INSERM, Centre d'Investigation clinique-Epidémiologie Clinique 1425, Hôpital Bichat, Paris, France; Departement of Epidemiology Biostatistics and Clinical Research, AP-HP, Hôpital Bichat, Paris, France.
| | | |
Collapse
|