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Sileo FG, Bonvicini L, Mancuso P, Vicentini M, Aguzzoli L, Khalil A, Giorgi Rossi P. COVID-19 incidence in women of reproductive age: a population-based study in Reggio Emilia, northern Italy. BMC Pregnancy Childbirth 2023; 23:726. [PMID: 37833634 PMCID: PMC10576401 DOI: 10.1186/s12884-023-06044-z] [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: 03/06/2023] [Accepted: 10/03/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Despite being at higher risk of severe disease and pregnancy complications, evidence on susceptibility to SARS-CoV-2 infection in pregnancy is still limited. The aim of the study is to compare the likelihood of undergoing a SARS-CoV-2 test and testing positive for COVID-19 in pregnancy and puerperium with that of the general female population of reproductive age. METHODS This is a retrospective population-based cohort study including 117,606 women of reproductive age (March 2020-September 2021) with 6608 (5.6%) women having ≥ 1 pregnancy. Women were linked to the pregnancy registry to be classified as "non-pregnant", "pregnant", and "puerperium"; then, according to the national case-based integrated COVID-19 surveillance system, all women undergoing a SARS-CoV-2 test during the study period were identified. The Incidence Rate Ratio was calculated to compare the likelihood of being tested for SARS-CoV-2 in pregnant, puerperium and non-pregnant women among all women included. The likelihood of having a COVID-19 diagnosis was calculated using two comparators (not-pregnant women and the person-time before/after pregnancy) by means of Cox proportional hazards models, adjusting for age and with the cluster option to control standard error calculation in repeated pregnancies. Only first infection and swabs before the first one positive were included. RESULTS The probability of being tested for SARS-CoV-2 was 4.9 (95% CI: 4.8-5.1) and 3.6 times higher (95%CI: 3.4-3.9) in pregnancy (including spontaneous miscarriages) and in the puerperium, respectively. The Hazard Ratio (HR) of covid-19 diagnosis during pregnancy vs. non-pregnancy was 1.17 (95% CI 1.03-1.33) with similar results when comparing the risk during pregnancy with that of the same women outside pregnancy (puerperium excluded), with an HR of 1.13 (95% CI 0.96-1.33); the excess decreased when excluding the test performed at admission for delivery (HR 1.08 (95%CI 0.90-1.30). In the puerperium, the HR was 0.62 (95% CI 0.41-0.92) comparing women with ≥ 1childbirth with all other women and excluding the first two weeks of puerperium. CONCLUSIONS Women during pregnancy showed a small increase in the risk of infection, compatible with a higher likelihood of being tested. A lower probability of infection during the puerperium was observed during the entire pandemic period, suggesting likely protective behaviors which were effective in reducing their probability of infection.
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Affiliation(s)
- Filomena Giulia Sileo
- Department of Biomedical, Metabolic and Neural Sciences, International Doctorate School in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena, Via Campi 80, 41125, Modena, Italy
- Prenatal Medicine Unit, Obstetrics and Gynecology Unit, Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, Via del Pozzo 71, 41125, Modena, Italy
| | - Laura Bonvicini
- Epidemiology Unit, Azienda Unità Sanitaria Locale -IRCCS Di Reggio Emilia, Via Giovanni Amendola 2, 42123, Reggio Emilia, Italy
| | - Pamela Mancuso
- Epidemiology Unit, Azienda Unità Sanitaria Locale -IRCCS Di Reggio Emilia, Via Giovanni Amendola 2, 42123, Reggio Emilia, Italy
| | - Massimo Vicentini
- Epidemiology Unit, Azienda Unità Sanitaria Locale -IRCCS Di Reggio Emilia, Via Giovanni Amendola 2, 42123, Reggio Emilia, Italy
| | - Lorenzo Aguzzoli
- Unit of Obstetrics and Gynecology, Azienda Unità Sanitaria Locale-IRCCS, Viale Risorgimento, 80, 42123, Reggio Emilia, Italy
| | - Asma Khalil
- Fetal Medicine Unit, St George's Hospital, St George's University of London, Blackshaw Road, TootingLondon, SW17 0QT, UK
- Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, Blackshaw Road, Tooting, London, SW17 0QT, UK
| | - Paolo Giorgi Rossi
- Epidemiology Unit, Azienda Unità Sanitaria Locale -IRCCS Di Reggio Emilia, Via Giovanni Amendola 2, 42123, Reggio Emilia, Italy.
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Zhang Y, Liu J, Yang F, He Y, Yan S, Bai Y, Zhang Z, Luan F. COVID-19-related secretory otitis media in the omicron era: a case series. Eur Arch Otorhinolaryngol 2023; 280:4697-4700. [PMID: 37341758 DOI: 10.1007/s00405-023-08075-w] [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: 03/28/2023] [Accepted: 06/14/2023] [Indexed: 06/22/2023]
Abstract
OBJECTIVES Increased numbers of patients with secretory otitis media appeared in outpatient clinics after the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) Omicron pandemic; however, the relationship between SARS-CoV-2 Omicron variant infection and secretory otitis media is uncertain. METHODS We performed tympanocentesis and used reverse transcription-polymerase chain reaction (RT-PCR) testing to examine middle ear effusion (MEE) and nasopharyngeal secretions from 30 patients with secretory otitis media associated with SARS-CoV-2 infection. RT-PCR was performed using the open reading frame 1ab and nucleocapsid protein gene kit from Shanghai Berger Medical Technology Co., Ltd., as the sole assay method, in accordance with the manufacturer's instructions. RESULTS MEEs from 5 of the 30 patients tested positive for SARS-CoV-2, including one patient with positive results for both the nasopharyngeal secretion and MEE. We report and discuss the medical records of six patients, including these five MEE-positive patients and a MEE-negative patient. CONCLUSION SARS-CoV-2 RNA can be detected in MEE caused by coronavirus disease 2019-related secretory otitis media even when a patient's nasopharyngeal secretion tests PCR-negative for SARS-CoV-2. The virus can remain in the MEE for a long time after SARS-CoV-2 infection.
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Affiliation(s)
- Yu Zhang
- Department of Otolaryngology, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, China
| | - Jingrui Liu
- Department of Otolaryngology, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, China
| | - Feifei Yang
- Department of Otolaryngology, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, China
| | - Yanan He
- Department of Otolaryngology, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, China
| | - Sinan Yan
- Department of Otolaryngology, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, China
| | - Yushuang Bai
- Department of Otolaryngology, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, China
| | - Zhanchi Zhang
- Department of Human Anatomy, Hebei Medical University, Shijiazhuang, 050017, China.
- Hebei Key Laboratory of Neurodegenerative Disease Mechanism, Hebei Medical University, Shijiazhuang, 050017, China.
| | - Feng Luan
- Department of Otolaryngology, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, China.
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Šuljagić V, Đurić-Petković D, Lazić S, Mladenović J, Rakonjac B, Opačić D, Ljubenović N, Milojković B, Radojević K, Nenezić I, Rančić N. Epidemiological Predictors of Positive SARS-CoV-2 Polymerase Chain Reaction Test in Three Cohorts: Hospitalized Patients, Healthcare Workers, and Military Population, Serbia, 2020. Int J Environ Res Public Health 2023; 20:3601. [PMID: 36834297 PMCID: PMC9967496 DOI: 10.3390/ijerph20043601] [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] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/10/2023] [Accepted: 02/11/2023] [Indexed: 06/18/2023]
Abstract
(1) Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its resulting coronavirus disease 2019 (COVID-19) has caused a fast-moving pandemic. Diagnostic testing, aimed to identify patients infected with SARS-CoV-2, plays a key role in controlling the COVID-19 pandemic in different populations. (2) Methods: This retrospective cohort study aimed to investigate predictors associated with positive polymerase chain reaction (PCR) SARS-CoV-2 test results in hospitalized patients, healthcare workers (HCWs), and military personnel (MP) during 2020, before the widespread availability of COVID-19 vaccines. Persons with a positive test result were compared with persons with a negative test result in three cohorts during the study period. (3) Results: A total of 6912 respondents were tested, and 1334 (19.3%) of them had positive PCR SARS-CoV-2 test results. Contact with a known COVID-19 case within 14 days (p < 0.001; OR: 1.48; 95% CI: 1.25-1.76), fever (p < 0.001; OR: 3.66; 95% CI: 3.04-4.41), cough (p < 0.001; OR: 1.91; 95% CI: 1.59-2.30), headache (p = 0.028; OR: 1.24; 95% CI: 1.02-1.50), and myalgia/arthralgia (p < 0.001; OR: 1.99; 95% CI: 1.65-2.42) were independently associated with positive PCR SARS-CoV-2 test results in the cohort of MP. Furthermore, fever (p < 0.001; OR: 2.75; 95% CI: 1.83-4.13), cough (p < 0.001; OR: 2.04; 95% CI: 1.32-3.13), headache (p = 0.008; OR: 1.76; 95% CI: 1.15-2.68), and myalgia/arthralgia (p = 0.039; OR: 1.58; 95% CI: 1.02-2.45) were independently associated with positive PCR SARS-CoV-2 test results in the cohort of HCWs. Moreover, independent predictors of positive PCR SARS-CoV-2 test results in hospitalized patients were contact with a known COVID-19 case within 14 days (p < 0.001; OR: 2.56; 95% CI: 1.71-3.83), fever (p < 0.001; OR: 1.89; 95% CI: 1.38-2.59), pneumonia (p = 0.041; OR: 1.45; 95% CI: 1.01-2.09), and neurological diseases (p = 0.009; OR: 0.375; 95% CI: 0.18-0.78). (4) Conclusions: According to data gathered from cohorts of hospitalized patients, HCWs, and MP, before the widespread availability of COVID-19 vaccines in Serbia, we can conclude that predictors of positive PCR SARS-CoV-2 test results in MP and HCWs were similar. Accurate estimates of COVID-19 in different population groups are important for health authorities.
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Affiliation(s)
- Vesna Šuljagić
- Department of Healthcare-Related Infection Control, Military Medical Academy, 11000 Belgrade, Serbia
- Medical Faculty, Military Medical Academy, University of Defence, 11000 Belgrade, Serbia
| | | | - Srđan Lazić
- Medical Faculty, Military Medical Academy, University of Defence, 11000 Belgrade, Serbia
- Institute of Epidemiology, Military Medical Academy, 11000 Belgrade, Serbia
| | - Jovan Mladenović
- Institute of Epidemiology, Military Medical Academy, 11000 Belgrade, Serbia
| | - Bojan Rakonjac
- Institute of Microbiology, Military Medical Academy, 11000 Belgrade, Serbia
| | - Dolores Opačić
- Institute of Epidemiology, Military Medical Academy, 11000 Belgrade, Serbia
| | - Nenad Ljubenović
- Institute of Epidemiology, Military Medical Academy, 11000 Belgrade, Serbia
| | - Biljana Milojković
- Institute of Epidemiology, Military Medical Academy, 11000 Belgrade, Serbia
| | - Katarina Radojević
- Torlak Institute of Virology, Vaccines, and Serums, 11000 Belgrade, Serbia
| | - Ivana Nenezić
- Department of Healthcare-Related Infection Control, Military Medical Academy, 11000 Belgrade, Serbia
| | - Nemanja Rančić
- Medical Faculty, Military Medical Academy, University of Defence, 11000 Belgrade, Serbia
- Centre for Clinical Pharmacology, Military Medical Academy, 11000 Belgrade, Serbia
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Ellis JE, Guest P, Lawson V, Loecherbach J, Lindner N, McCulloch A. Performance Evaluation of the Microfluidic Antigen LumiraDx SARS-CoV-2 and Flu A/B Test in Diagnosing COVID-19 and Influenza in Patients with Respiratory Symptoms. Infect Dis Ther 2022; 11:2099-2109. [PMID: 36152227 PMCID: PMC9510530 DOI: 10.1007/s40121-022-00696-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/07/2022] [Indexed: 11/28/2022] Open
Abstract
Introduction Coronavirus disease 2019 (COVID-19) and influenza share similar symptoms, which hampers diagnosis. Given that they require different containment and treatment strategies, fast and accurate distinction between the two infections is needed. This study evaluates the sensitivity and specificity of the microfluidic antigen LumiraDx SARS-CoV-2 and Flu A/B Test for simultaneous detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and influenza A/B from a single nasal swab. Methods Nasal samples were collected from patients as part of the ASPIRE (NCT04557046) and INSPIRE (NCT04288921) studies at point-of-care testing sites in the USA. ASPIRE study participants were included after developing COVID-19 symptoms in the last 14 days or following a positive SARS-CoV-2 test in the last 48 h. INSPIRE study participants were included after developing influenza symptoms in the last 4 days. Samples were extracted into proprietary buffer and analysed using the LumiraDx SARS-CoV-2 and Flu A/B Test. A reference sample was taken from each subject, placed into universal transport medium and tested using reference SARS-CoV-2 and influenza reverse transcription polymerase chain reaction (RT-PCR) tests. The test and reference samples were compared using the positive percent agreement (PPA) and negative percent agreement (NPA), together with their 95% confidence intervals (CIs). Results Analysis of the data from the ASPIRE (N = 124) and INSPIRE (N = 159) studies revealed high levels of agreement between the LumiraDx SARS-CoV-2 and Flu A/B Test and the reference tests in detecting SARS-CoV-2 (PPA = 95.5% [95% CI 84.9%, 98.7%]; NPA = 96.0% [95% CI 90.9%, 98.3%]), influenza A (PPA = 83.3% [95% CI 66.4%, 92.7%]; NPA = 97.7% [95% CI 93.4%, 99.2%]) and influenza B (PPA = 80.0% [95% CI 62.7%, 90.5%]; NPA = 95.3% [95% CI 90.2%, 97.9%]). Conclusions The LumiraDx SARS-CoV-2 and Flu A/B Test shows a high agreement with the reference RT-PCR tests while simultaneously detecting and differentiating between SARS-CoV-2 and influenza A/B. Trial Registration ClinicalTrials.gov identifiers NCT04557046 and NCT04288921. Supplementary Information The online version contains supplementary material available at 10.1007/s40121-022-00696-8.
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Affiliation(s)
- Jayne E Ellis
- LumiraDx Ltd, Stirling, UK. .,LumiraDx Ltd, 3 More London Riverside, London, SE1 2AQ, UK.
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Mueller SK, Traxdorf M, Mantsopoulos K, Gostian AO, Sievert M, Koch M, Huebner MJ, Iro H. Considerations for Continuing Semielective and Emergency Otolaryngological Procedures During the COVID-19 Pandemic. Ear Nose Throat J 2021; 100:19-25. [PMID: 32894699 PMCID: PMC7477481 DOI: 10.1177/0145561320952506] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 07/22/2020] [Revised: 08/02/2020] [Accepted: 08/04/2020] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION During the COVID-19 pandemic, worldwide over 600,000 human beings died due to the cause of the disease. In order to deescalate the transmission rate and to avoid crush loading the countries medical health systems social distancing, face masks, and lockdowns have been considered essential by the majority of governments. Whereas some countries have highly reduced or completely stopped otorhinolaryngological procedures, other countries have continued selected surgeries. The objective of this study was to analyze procedures and outcomes of continuing semielective and emergency surgeries during the COVID-19 pandemic. METHODS Retrospective analysis of n = 750 patients who received semi-elective or emergency surgery between March 26 and June 16, 2020, in the Otolaryngology Department of the Friedrich-Alexander-University of Erlangen-Nürnberg. All patients were screened for COVID symptoms and swabbed for SARS-CoV-2 prior to surgery. RESULTS Of the n = 750 patients, n = 699 patients received semielective surgery and n = 51 emergency surgery. For 27 patients, the swab result could not be awaited due to a life-threatening condition. In these cases, surgery was performed in full protective equipment. No patient was tested positive during or after the surgery (follow-up 45 to 127 days). No member of the medical personnel showed symptoms or was tested positive after contact with patients. Due to the continuation of surgeries, patients' lives were saved and improvement of long-term quality-of-life and outcomes is anticipated. CONCLUSIONS Continuing selected otorhinolaryngological surgeries is crucial for patients' health, survival, and long-time quality of life, yet, the protection of the medical personnel has to be granted.
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Affiliation(s)
- Sarina K. Mueller
- Department of Otorhinolaryngology, Head and Neck Surgery, University
Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg
(FAU), Erlangen, Germany
| | - Maximilian Traxdorf
- Department of Otorhinolaryngology, Head and Neck Surgery, University
Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg
(FAU), Erlangen, Germany
| | - Konstantinos Mantsopoulos
- Department of Otorhinolaryngology, Head and Neck Surgery, University
Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg
(FAU), Erlangen, Germany
| | - Antoniu-Oreste Gostian
- Department of Otorhinolaryngology, Head and Neck Surgery, University
Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg
(FAU), Erlangen, Germany
| | - Matti Sievert
- Department of Otorhinolaryngology, Head and Neck Surgery, University
Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg
(FAU), Erlangen, Germany
| | - Michael Koch
- Department of Otorhinolaryngology, Head and Neck Surgery, University
Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg
(FAU), Erlangen, Germany
| | - Matthias J. Huebner
- Intensive Care Medicine/Department of Pediatric Cardiology,
University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg
(FAU), Erlangen, Germany
| | - Heinrich Iro
- Department of Otorhinolaryngology, Head and Neck Surgery, University
Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg
(FAU), Erlangen, Germany
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Abstract
Long and sharp objects can be foreign body intentionally or accidentally ingested. Timing of endoscopy relies on foreign body shape and size, localization in gastrointestinal tract, patient’s clinical conditions, occurrence of symptoms, or onset of complications. We present a case of a 47-year-old male with no known comorbidity, who accidentally swallowed a portion of a naso-pharyngeal swab half-broken during the second diagnostic test for SARS-CoV-2. The intact swab had a total length of 15 cm and was made of wood. The patient was asymptomatic, laboratory tests were normal, and neck-chest-abdominal X-ray and CT scan were negative for major complications. Upper gastrointestinal endoscopy was promptly performed to prevent the long sharp swab from crossing the pylorus leading to serious complications and, therefore, risk surgical intervention. The patient was intubated and the procedure was carried out under general anesthesia. In the gastric body, broken naso-pharyngeal swab was detected among the food debris, and using a latex rubber hood, the 7.5 cm foreign body was removed with a retrieval alligator-tooth forceps. Our hospital is located in a high-risk area of COVID-19 outbreak where many naso-pharyngeal swabs are performed, and to our knowledge, this is the first report of swab ingestion during SARS-CoV-2 test.
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Affiliation(s)
- Luca De Luca
- Department of Internal Medicine, Gastroenterology and Digestive Endoscopy Unit, Ospedali Riuniti Marche Nord, Piazzale Cinelli, 1, 61121, Pesaro, PU, Italy.
| | - Stefania Maltoni
- Department of Internal Medicine, Gastroenterology and Digestive Endoscopy Unit, Ospedali Riuniti Marche Nord, Piazzale Cinelli, 1, 61121, Pesaro, PU, Italy
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