COVID-19: spatio-temporal study in the large urban area of Madrid during five epidemic periods

COVID-19 vaccination, incidence, and mortality rates among individuals with mental disorders in South Korea: A nationwide retrospective study.

Background/Objectives: During the COVID-19 pandemic, neonatal care units had to change protocols, and little is known about its impact on parents' mental health. This study aimed to evaluate parental stress, depression, anxiety, and participation in neonatal care in a Brazilian neonatal intensive care unit (NICU) and observe changes over two different periods of the COVID-19 pandemic. Methods: Cross-sectional study comparing stress, depression, anxiety, and participation in neonatal care levels between two time periods: T1, high COVID-19 incidence (May 2020 to July 2020 and March 2021 to June 2021) and T2, low COVID-19 incidence (August 2020 to February 2021 and July 2021 to December 2021). High COVID-19 incidence was considered more than 40 confirmed COVID-19-related deaths/day. Validate tools used were the Parental Stressor Scale in NICU (PSS:NICU); the Edinburgh Postnatal Depression Scale (EPDS); the Edinburgh Postnatal Depression Scale-Anxiety subscale (EPDS-A); the State-Trait Anxiety Inventory (STAI); and the Index of Parental Participation (IPP). Stress level was pre-defined as the primary outcome. Results: 106 parents (98 mothers, 8 fathers) and 111 newborns were included. Overall, 51.9% of parents had a PSS:NICU score ≥ 3 (relevant stress level), 28.3% had an EPDS-A ≥ 6 (indicating anxiety), and 33.0% had an EPDS > 13 (indicating depression). At least one condition was present in 69 (65%) parents, while the three conditions were simultaneously observed in 17 (16%) parents. No significant differences were observed in the frequencies of stress, depression, or anxiety between the two periods. However, median stress occurrence level (SOL) was higher in T1 when compared to T2 (3.24 vs. 2.68; p = 0.02), mainly due to "Parental role alteration" (3.80 vs. 3.17; p = 0.046). The level of parental participation was not different between the two time periods (p = 0.23). Correlations between stress and both depression and anxiety scores were weak. Parental participation was not significantly correlated to other scores. Conclusions: Elevated levels of stress, depression, and anxiety were observed among NICU parents during both high and low COVID-19 incidence periods. High COVID-19 incidence seems to have particularly influenced stress levels related to parental role alteration. These findings highlight the importance of regularly assessing parental mental health in NICU settings.

Objectives This study explores the spatial disparities in COVID-19 incidence across neighborhoods in Uskudar, Istanbul, and examines the relationship between these disparities and neighborhood-level socioeconomic status. Methods This ecological study analyzed cumulative COVID-19 case data for 33 neighborhoods in Uskudar, collected up to 31 December 2020. Socioeconomic status was assessed using the Socioeconomic Development Index (SEDI) scores from Istanbul Metropolitan Municipality. Spatial analysis included Moran’s I statistics and Local Indicators of Spatial Association (LISA) cluster analysis. Bayesian Hierarchical Modeling with the Besag-York-Mollie (BYM) model was employed to decompose spatially structured and unstructured variations, adjusting for SEDI scores and their sub-components. Model validation involved convergence diagnostics and Monte Carlo error assessments. Results A total of 29,834 COVID-19 cases were identified, with an incidence rate of 56.1 per 1000 residents. Spatial analysis revealed significant clustering of high incidence rates in peripheral and inner city neighborhoods. Moran’s I statistic for COVID-19 incidence was 0.331 (p = 0.003), indicating positive spatial autocorrelation. SEDI scores were also spatially autocorrelated (Moran’s I = 0.293; p = 0.005) and negatively correlated with COVID-19 incidence (r = -0.570; p = 0.001). Bayesian hierarchical models confirmed the association between lower socioeconomic status and higher COVID-19 incidence, even after adjusting for spatial autocorrelation. Conclusions The study highlights significant spatial and socioeconomic disparities in COVID-19 incidence in Uskudar, Istanbul. Lower socioeconomic status is associated with higher COVID-19 incidence, underscoring the need for region-specific public health strategies that consider socioeconomic factors. These findings can guide future interventions to mitigate the impact of the pandemic on vulnerable populations. Key messages • Study reveals COVID-19 incidence in Uskudar is significantly influenced by socioeconomic status, highlighting need for targeted health interventions. • Positive spatial autocorrelation found in COVID-19 cases and socioeconomic index suggests clustering in specific Uskudar neighborhoods.

Background. The defeat of the respiratory system is one of the leading problems of modern pediatrics, which was once again demonstrated by the pandemic of a new coronavirus infection. In addition to the immediate direct impact of SARS-CoV-2 on public health, the pandemic has affected the circulation of major respiratory pathogens. During the period of active circulation of the new coronavirus infection, the role of seasonal respiratory viruses and atypical pathogens in the nosological structure of diseases in children has significantly decreased. Objective. To study the causes of a significant increase in the incidence of microplasma pneumonia in the postcovid period with a decrease in the circulation of SARS-CoV-2. Materials and methods. The frequency of hospitalization of children with community-acquired pneumonia (CAP) in the hospital in different years of follow-up was studied: the pre-epidemic period, during the pandemic of a new coronavirus infection and at the stage of transition of SARS-CoV-2 to seasonal respiratory viruses. The etiology of pneumonia was confirmed by bacteriological studies of sputum, blood, PCR analysis for SARS-CoV-2, PCR and ELISA examination for Mycoplasma pneumoniae, Chlamydophila pneumoniae, PCR analysis "Respiratory screen". Results. Prior to the development of the pandemic of the new coronavirus infection in 2018 and 2019, 1,124 and 1,151 children were hospitalized with VP per year, while the proportion of mycoplasma pneumonia was 13.9% and 5.3%, respectively. The first increase in the incidence of COVID-19 in the Voronezh region occurred in the spring of 2020, while there was no increase in the number of pneumonia. In the 2020 epidemic season, other respiratory viruses and respiratory mycoplasmosis were practically not registered. The peak in the number of hospitalizations of children with lung damage associated with a new coronavirus infection occurred in 2021 (2,689 children with CAP). During this epidemic period, rhinovirus infection continued to circulate, as well as adaptation to the pandemic of other respiratory viruses (bocavirus, respiratory syncytial infections), and influenza and respiratory mycoplasmosis were practically not registered. In 2022, Omicron, the coronavirus strain, dominated the region, while the number of pneumonia decreased slightly (1,570 children). The decrease in SARS-CoV-2 activity in the Voronezh region began in February 2023, and the circulation of respiratory viruses returned to the pre-pandemic period. But since March, there has been an increase in the proportion of mycoplasma infection among hospitalized children, and for six months Mycoplasma pneumoniae has been playing a leading etiological role. It was difficult to explain such a significant increase in mycoplasma pneumonia in the region only by another periodic increase in the incidence of mycoplasmosis. Conclusions. The impact of the pandemic of the new coronavirus infection on the epidemic process of both respiratory viral infections and respiratory mycoplasmosis is obvious. The high incidence of COVID-19 and frequent lung damage in the new coronavirus infection have led to a significant increase in people in the population with a history of pneumonia.

Metabolic biomarkers measured from single blood test can identify apparently healthy people at high susceptibility for developing severe pneumonia, and may also be useful for preventive COVID-19 screening.

Background: The aim of this study is to systematically review and analyze the incidence and outcomes of COVID-19 in patients with pulmonary hypertension (PH). Methods: We searched PubMed, SCOPUS, Web of Science, and Embase for relevant publications up to March 27th, 2024. Articles were screened for studies on the incidence or outcomes of COVID-19 in PH patients. Screening, data extraction, and risk of bias assessment were performed independently in duplicate. When possible, relevant results were pooled using the random effects model. Results: Of the 5,981 articles, a total of 30 were included in the systematic review and 29 in the meta-analysis. The incidence rate of COVID-19 in PH patients was 25 (15-41) per 100,000 person- -day. The hospitalization rate was 47% (26.4-68.7), and the mean duration of hospitalization was 10.033 (9.644-10.422) ± 0.198 days. The rate of admission to the intensive care unit was 35.8% (23.9-49.9) and mechanical ventilation was required in 17.4% (11.6-25.3) of hospitalized patients. The in-hospital mortality rate was 23.1% (21.6-24.6). Further analysis of studies comparing COVID-19 patients with and without PH showed a higher mortality rate in COVID-19 patients with PH (OR = 1.722 CI 95% (1.393-2.128), P < 0.0001, I2 = 99%). Meta-regression showed no significant association between sex and the incidence of COVID-19 infection in PH patients. Conclusion: Pre-existing PH may not be associated with a higher incidence of COVID-19 but may be associated with worsening outcomes of COVID-19 infection.

Using spatial analysis techniques, this study investigates the associations between socioeconomic indicators measured at the census tract level and the incidence of Zika virus (ZIKV) infection in pregnant persons and microcephaly in newborns in Recife, Pernambuco, Brazil, from 2015 to 2021. In this ecological study, data on cases of ZIKV infections among pregnant persons registered in the Brazilian Information System for Notifiable Diseases (Sistema de Informação de Agravos de Notificaçao, SINAN-Zika) and cases of microcephaly among live births registered in the Public Health Event Registration System (Registro de Eventos em Saúde Pública, RESP-Microcefalia) and the Live Birth Information System (Sistema de Informações Sobre Nascidos Vivos, SINASC) were georeferenced based on residential address and aggregated within census tracts. Spatial autocorrelation was performed using the bivariate global and local Moran's I indices, which considered the incidence rates of maternal ZIKV infections and microcephaly during the epidemic (2015-2017) and post-epidemic (2018-2021) time periods in relation to each other as well as social, economic, sanitation, and urban infrastructure covariates derived from the 2010 census. From 2015 to 2021, the city of Recife registered 253 cases (n = 240 in 2015-2017 and n = 13 in 2018-2021) of ZIKV infection in pregnant persons and 147 cases (n = 137 in 2015-2017 and n = 10 in 2018-2021) of microcephaly in newborns. The global bivariate Moran's I index between the incidences of ZIKV infection in pregnant persons and microcephaly were 0.127 (p = 0.001) in 2015-2017 and 0.074 (p = 0.002) in 2018-2021, indicating a positive spatial correlation, as higher was the ZIKV infection in pregnant persons, higher was the incidence of microcephaly. Furthermore, incidences of maternal ZIKV infection and microcephaly were consistently associated with indicators of greater social vulnerability and economic deprivation at the census tract level. During the epidemic and post-epidemic periods in Recife, cases of ZIKV in pregnant persons and microcephaly were concentrated in census tracts with relatively higher socioeconomic vulnerability, reinforcing the need for research to inform the development of social protection and environmental policies to mitigate ZIKV-related risks.

Effect of COVID-19 on Urology Residency Training: A Nationwide Survey of Program Directors by the Society of Academic Urologists.

Socio-economic inequality in global incidence and mortality rates from coronavirus disease 2019: an ecological study

α1-Antitrypsin deficiency and the risk of COVID-19: an urgent call to action

In December 2019, a novel coronavirus was identified in Wuhan City, Hubei Province, China and later the disease was named coronavirus disease 2019 (COVID-19). On March 11, 2020, the World Health Organization (WHO) officially announced that COVID-19 had reached global pandemic status. This article summarized the understanding of the etiology, pathogenesis, epidemiology, clinical characteristics, diagnosis, treatment, rehabilitation, and prevention and control measures of COVID-19 based on the available data and anti-epidemic experience in China.

Equitable vaccination distribution is a priority for outcompeting the transmission of COVID-19. Here, the impact of demographic, socioeconomic, and environmental factors on county-level vaccination rates and COVID-19 incidence changes is assessed. In particular, using data from 3142 US counties with over 328 million individuals, correlations were computed between cumulative vaccination rate and change in COVID-19 incidence from 1 December 2020 to 6 June 2021, with 44 different demographic, environmental, and socioeconomic factors. This correlation analysis was also performed using multivariate linear regression to adjust for age as a potential confounding variable. These correlation analyses demonstrated that counties with high levels of uninsured individuals have significantly lower COVID-19 vaccination rates (Spearman correlation: −0.460, p-value: <0.001). In addition, severe housing problems and high housing costs were strongly correlated with increased COVID-19 incidence (Spearman correlations: 0.335, 0.314, p-values: <0.001, <0.001). This study shows that socioeconomic factors are strongly correlated to both COVID-19 vaccination rates and incidence rates, underscoring the need to improve COVID-19 vaccination campaigns in marginalized communities.

Like most countries worldwide, the coronavirus disease (COVID-19) has adversely affected Ireland. The aim of this study was to (i) investigate the spatio-temporal trend of COVID-19 incidence; (ii) describe mobility trends as measured by aggregated mobile phone records; and (iii) investigate the association between deprivation index, population density and COVID-19 cases while accounting for spatial and temporal correlation. Standardised incidence ratios of cases were calculated and mapped at a high spatial resolution (electoral division level) over time. Trends in the percentage change in mobility compared to a pre-COVID-19 period were plotted to investigate the impact of lockdown restrictions. We implemented a hierarchical Bayesian spatio-temporal model (Besag, York and Mollié (BYM)), commonly used for disease mapping, to investigate the association between covariates and the number of cases. There have been three distinct “waves” of COVID-19 cases in Ireland to date. Lockdown restrictions led to a substantial reduction in human movement, particularly during the 1st and 3rd wave. Despite adjustment for population density (incidence ratio (IR) = 1.985 (1.915–2.058)) and the average number of persons per room (IR = 10.411 (5.264–22.533)), we found an association between deprivation index and COVID-19 incidence (IR = 1.210 (CI: 1.077–1.357) for the most deprived quintile compared to the least deprived). There is a large range of spatial heterogeneity in COVID-19 cases in Ireland. The methods presented can be used to explore locally intensive surveillance with the possibility of localised lockdown measures to curb the transmission of infection, while keeping other, low-incidence areas open. Our results suggest that prioritising densely populated deprived areas (that are at increased risk of comorbidities) during vaccination rollout may capture people that are at risk of infection and, potentially, also those at increased risk of hospitalisation.

BackgroundCOVID-19 has been characterised by its global and rapid spread, with high infection, hospitalisation, and mortality rates worldwide. However, the course of the pandemic showed differences in chronology and intensity in different geographical areas and countries, probably due to a multitude of factors. Among these, socio-economic deprivation has been supposed to play a substantial role, although available evidence is not fully in agreement. Our study aimed to assess incidence and fatality rates of COVID-19 across the levels of socio-economic deprivation during the first epidemic wave (March–May 2020) in the Italian Province of Foggia, Apulia Region.MethodsBased on the data of the regional active surveillance platform, we performed a retrospective epidemiological study among all COVID-19 confirmed cases that occurred in the Apulian District of Foggia, Italy, from March 1st to May 5th, 2020. Geocoded addresses were linked to the individual Census Tract (CT) of residence. Effects of socio-economic condition were calculated by means of the Socio-Economic and Health-related Deprivation Index (SEHDI) on COVID-19 incidence and fatality.ResultsOf the 1054 confirmed COVID-19 cases, 537 (50.9%) were men, 682 (64.7%) were 0–64 years old, and 338 (32.1%) had pre-existing comorbidities. COVID-19 incidence was higher in the less deprived areas (p < 0.05), independently on age. The level of socio-economic deprivation did not show a significant impact on the vital status, while a higher fatality was observed in male cases (p < 0.001), cases > 65 years (p < 0.001), cases having a connection with a nursing home (p < 0.05) or having at least 1 comorbidity (p < 0.001). On the other hand, a significant protection for healthcare workers was apparent (p < 0.001).ConclusionsOur findings show that deprivation alone does not affect COVID-19 incidence and fatality burden, suggesting that the burden of disease is driven by a complexity of factors not yet fully understood. Better knowledge is needed to identify subgroups at higher risk and implement effective preventive strategies.

BACKGROUND: The high incidence of COVID-19 has been a major challenge to health systems in virtually every country in the world during the pandemic. Under these conditions, the elderly were especially vulnerable and were at risk for an unfavorable course of the disease. The elderly were not only at higher risk of contracting COVID-19 and had a worse outcome, but they could also experience reduced access to care for existing chronic noncommunicable diseases and be lost to follow-up. АIM: The aim of the study was to identify risk factors for the development of a severe course of COVID-19 in patients aged 60 years and older who applied for outpatient care during various periods of increased incidence of COVID-19: from March 2020 to February 2022. MATERIALS AND METHODS: The study was performed on the basis of the Center for Family Medicine of the North-Western State Medical University named after I.I. Mechnikov. A retrospective cohort study is based on an analysis of outpatient records of patients enrolled in the framework of compulsory health insurance, who applied for medical care at Center for Family Medicine and underwent COVID-19 during various periods of increased incidence, namely: from 19.03.2020 to 30.06.2020 (1st period), from 01.10.2021 to 30.11.2021 (2nd period) and from 18.01.2022 to 28.02.2022 (3rd period). Elderly patients were defined as study participants aged 60 years or older. RESULTS: The study included 343 patients: 137 men (39.9%) and 206 women (60.1%). The number of participants aged 60 and over was 85 (24.8%). It was found that in elderly patients such non-specific symptoms of acute respiratory viral infection as nasal congestion, rhinorrhea, sore throat, increased body temperature up to 38 ℃ (р 0.05) began to occur significantly more often. The severity of COVID-19 in elderly patients is influenced by the SARS-CoV-2 variant: the incidence of pneumonia and the number of hospitalizations were significantly less during the 3rd period of increase in the incidence (р 0.05), and the likelihood of developing a severe course of the disease was increased in 33.4 times and 23.8 times in waves 1 and 2, respectively, in comparison with wave 3. CONCLUSIONS: Over time, nasal congestion, rhinorrhea, sore throat, and an increase in body temperature up to 38 ℃ became significantly more common (p 0.05). Polymerase chain reaction testing for COVID-19 should be performed in all patients with symptoms of acute respiratory disease, regardless of severity. Pneumonia and hospitalization were significantly less common during the 3rd period of increased incidence (p 0.05), and the probability of developing a severe course of the disease was increased by 33.4 and 23.8 times in the 1st and 2nd waves, respectively, in compared to the 3rd wave. The data obtained should be taken into account when predicting severe outcomes in outpatients, developing tactics for monitoring and managing such patients.