COVID-19 Incidence Rates Research Articles

Nationwide epidemiology and health resource use among children with COVID-19 in Japan

BackgroundThe COVID-19 pandemic posed substantial challenges to healthcare systems. Understanding the responses of pediatric health services is crucial for future pandemic planning and preparedness, yet such data remains limited. MethodsIn this retrospective cohort study, we analyzed data from administrative databases developed by Japan Medical Data Center and DeSC Healthcare Inc. The dataset comprised records of 2,612,511 children, totaling 60,224,888 person-months, from January 2020 to May 2022. Multivariate generalized estimation equations were used to examine the incidence rates of COVID-19 and associated health resource use. ResultsOur analysis revealed that the incidence rates of COVID-19 gradually increased from Wave I (2.2 cases per 100,000 person-months) to Wave V (177.8cases per 100,000 person-months), with a notable elevation during Wave VI (2367.7 cases per 100,000 person-months). While nucleic acid amplification tests were primarily used during Waves I–V, the use of rapid antigen tests markedly increased in Wave VI. The hospitalization rates increased gradually from 0.2 in Wave I to 10.2 events per 100,000 person-months in Wave VI, and the case-hospitalization risk decreased from 14.9% in Wave II to 0.7% in Wave VI. Additionally, we observed decreasing trends in the use of antibiotics (Wave I, 31.8%; Wave VI, 9.0%), whereas antipyretic use rose from Wave I (56.1%) to Wave VI (86.6%). ConclusionsOur study highlighted essential changes in the nationwide pediatric healthcare system's response to the COVID-19 pandemic. These findings provide valuable insights into the future pandemic planning and preparedness.

Systematic review of empiric studies on lockdowns, workplace closures, and other non-pharmaceutical interventions in non-healthcare workplaces during the initial year of the COVID-19 pandemic: benefits and selected unintended consequences

BackgroundWe conducted a systematic review aimed to evaluate the effects of non-pharmaceutical interventions within non-healthcare workplaces and community-level workplace closures and lockdowns on COVID-19 morbidity and mortality, selected mental disorders, and employment outcomes in workers or the general population.MethodsThe inclusion criteria included randomized controlled trials and non-randomized studies of interventions. The exclusion criteria included modeling studies. Electronic searches were conducted using MEDLINE, Embase, and other databases from January 1, 2020, through May 11, 2021. Risk of bias was assessed using the Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I) tool. Meta-analysis and sign tests were performed.ResultsA total of 60 observational studies met the inclusion criteria. There were 40 studies on COVID-19 outcomes, 15 on anxiety and depression symptoms, and five on unemployment and labor force participation. There was a paucity of studies on physical distancing, physical barriers, and symptom and temperature screening within workplaces. The sign test indicated that lockdown reduced COVID-19 incidence or case growth rate (23 studies, p < 0.001), reproduction number (11 studies, p < 0.001), and COVID-19 mortality or death growth rate (seven studies, p < 0.05) in the general population. Lockdown did not have any effect on anxiety symptoms (pooled standardized mean difference = -0.02, 95% CI: -0.06, 0.02). Lockdown had a small effect on increasing depression symptoms (pooled standardized mean difference = 0.16, 95% CI: 0.10, 0.21), but publication bias could account for the observed effect. Lockdown increased unemployment (pooled mean difference = 4.48 percentage points, 95% CI: 1.79, 7.17) and decreased labor force participation (pooled mean difference = -2.46 percentage points, 95% CI: -3.16, -1.77). The risk of bias for most of the studies on COVID-19 or employment outcomes was moderate or serious. The risk of bias for the studies on anxiety or depression symptoms was serious or critical.ConclusionsEmpiric studies indicated that lockdown reduced the impact of COVID-19, but that it had notable unwanted effects. There is a pronounced paucity of studies on the effect of interventions within still-open workplaces. It is important for countries that implement lockdown in future pandemics to consider strategies to mitigate these unintended consequences.Systematic review registrationPROSPERO registration # CRD42020182660.

The complex link between socioeconomic deprivation and COVID-19. Evidence from small areas of Catalonia

This ecological study assesses the association between the incidence rate of COVID-19 confirmed cases and socioeconomic deprivation in the Catalan small areas for the first six waves of the pandemic. The association is estimated using Poisson regressions and, in contrast to previous studies, considering that the relationship is not linear but rather depends on the degree of deprivation. The results show that the association between deprivation and incidence varied between waves, not only in intensity but also in its sign. Although it was insignificant in the first, third and fourth waves, the association was positive and significant in the second, becoming significantly negative in the fifth and sixth waves. Interestingly, the evidence suggests that the link between both magnitudes was not homogeneous throughout the distribution of deprivation, the pattern also varying between waves. The results are discussed in view of the role of non-pharmacological interventions and vaccination, as well as potential biases (for example that associated with differences between population groups in the propensity to be tested in each wave).

Description of the COVID-19 epidemiology in Malaysia.

Since the COVID-19 pandemic began, it has spread rapidly across the world and has resulted in recurrent outbreaks. This study aims to describe the COVID-19 epidemiology in terms of COVID-19 cases, deaths, ICU admissions, ventilator requirements, testing, incidence rate, death rate, case fatality rate (CFR) and test positivity rate for each outbreak from the beginning of the pandemic in 2020 till endemicity of COVID-19 in 2022 in Malaysia. Data was sourced from the GitHub repository and the Ministry of Health's official COVID-19 website. The study period was from the beginning of the outbreak in Malaysia, which began during Epidemiological Week (Ep Wk) 4 in 2020, to the last Ep Wk 18 in 2022. Data were aggregated by Ep Wk and analyzed in terms of COVID-19 cases, deaths, ICU admissions, ventilator requirements, testing, incidence rate, death rate, case fatality rate (CFR) and test positivity rate by years (2020 and 2022) and for each outbreak of COVID-19. A total of 4,456,736 cases, 35,579 deaths and 58,906,954 COVID-19 tests were reported for the period from 2020 to 2022. The COVID-19 incidence rate, death rate, CFR and test positivity rate were reported at 1.085 and 0.009 per 1,000 populations, 0.80 and 7.57%, respectively, for the period from 2020 to 2022. Higher cases, deaths, testing, incidence/death rate, CFR and test positivity rates were reported in 2021 and during the Delta outbreak. This is evident by the highest number of COVID-19 cases, ICU admissions, ventilatory requirements and deaths observed during the Delta outbreak. The Delta outbreak was the most severe compared to other outbreaks in Malaysia's study period. In addition, this study provides evidence that outbreaks of COVID-19, which are caused by highly virulent and transmissible variants, tend to be more severe and devastating if these outbreaks are not controlled early on. Therefore, close monitoring of key epidemiological indicators, as reported in this study, is essential in the control and management of future COVID-19 outbreaks in Malaysia.

Incidence Rate of Covid-19 Infection in People with Fourth Dose of Vaccines Bivalent Mrna from October 2022 to October 2023 in A General Medicine Office in Toledo (Spain)

Background Incidence rate of covid-19 infection in people vaccinated with 4th dose of RNA covid-19 vaccine remain subject of debate and is not clearly known Objective Estimate the incidence rate of covid-19 in vaccinated 4th dose people in general practitioner care level. Methodology An incidence rates epidemiological analysis of covid-19 infection in people with 4th dose of bivalent mRNA vaccines based in a longitudinal study from October, 2022 to October, 2023, in a general practice setting in Toledo, Spain. Results 21 cases of covid-19 infection in vaccinated people with 4th dose were included. Incidence rate of covid-19 infection in total vaccinated people with 4th dose from October 2022 to October 2023 was 2%; it was greater in &gt; = 65 years vs. &lt; 65 years (3% vs. 1%), and in women vs. men (2% vs. 1%). Regarding incidence rate of covid-19 infection in vaccinated people with 4th dose in general population of the office was 1%; It was again older at &gt; = 65 years vs. &lt; 65 years (1% vs. 0.5%), but without differences between women and men (1% vs. 1%). Conclusion In general practice setting in Toledo, Spain, crude incidence rate of covid-19 infection in vaccinated people with 4th dose and in general population of the office was low. However, the population segments of &gt;= 65 years and women, even with fourth vaccine dose, have a higher risk of covid-19 infection, and consequently should continue receiving booster vaccine. But these results should be interpreted with caution since the number of tests carried out in the community was low

COVID-19 in City Council Civil Servants, 1 March 2020-31 January 2023: Risk of Infection, Reinfection, Vaccine Effectiveness and the Impact of Heterologous Triple Vaccination.

Background: The risk of COVID-19 increases in any occupation entailing intense social interactions. This study aimed to investigate the impact of COVID-19 among civil servants of Trieste city council (northeastern Italy) over the entire pandemic. Methods: The crude incidence rate of COVID-19 was estimated from 1 March 2020 to 31 January 2023 by explanatory factors, expressing the estimate as COVID-19 events x 10,000 person-days (P-d) at risk. A multivariable Cox proportional hazard regression model was fitted to examine the risk of primary COVID-19 infection and reinfections, reporting adjusted hazard ratios (aHR) with 95% confidence interval (95% CI). Results: The cohort of Trieste city council was mainly composed of administrative clerks (48.5%), nursery teachers (33%), technicians (9.9%) and local police officers (8.5%). Between 1 March 2020 and 31 January 2023, 1444 (62.4%) employees tested positive for SARS-CoV-2 at least once and 18.1% (=262/1444) at least twice. By the end of this study, 55% (N = 1272) of employees had received at least three doses of COVID-19 vaccine, whereas 19.7% (N = 457) remained unvaccinated. At multiple Cox regression analysis, the adjusted risk of primary COVID-19 events during the entire study period increased in employees aged 40-49 years (aHR = 1.65; 95% CI: 1.01; 2.71), females (aHR = 1.28; 95%CI: 1.12; 1.45), local police officers (aHR = 1.82; 95%CI: 1.50; 2.22) and nursery teachers (aHR = 1.27; 95%CI: 1.13; 1.43). However, whilst the risk of primary infections in police officers increased already during the Alpha transmission period (aHR = 6.82; 95%CI: 4.48; 10.40), progressively reducing across subsequent variants, for nursery teachers, it increased during the Delta wave (aHR = 2.42; 1.70; 3.44), reducing with Omicron (aHR = 1.23; 95%CI: 1.07; 1.40). Compared to unvaccinated colleagues, during the entire study period the risk of primary infections was significantly lower in employees immunized with three (aHR = 0.42; 95%CI: 0.36; 0.47) or four (aHR = 0.30; 95%CI: 0.23; 0.40) doses of COVID-19 vaccine, for a vaccine effectiveness (VE) of 58% and 70%, respectively. The protective effect of vaccination against primary infections was confirmed in the sub-group analysis by main pandemic waves, for a VE of 75% for one dose against 99% for two doses during the Alpha transmission period, slightly reducing to 59% and 70% in Delta time, respectively. During the Omicron wave, the risk of primary SARS-CoV-2 infections diminished significantly with three (aHR = 0.42; 95%CI: 0.36; 0.49) or four vaccine doses (aHR = 0.09; 95%CI: 0.05; 0.16), for a VE of 58% and 91%, respectively. Moreover, the risk of primary SARS-CoV-2 reinfections during the entire study period reduced with one (aHR = 0.47; 95%CI: 0.27; 0.82), two (aHR = 0.42; 95%CI: 0.30; 0.58), three (aHR = 0.32; 95%CI: 0.24; 0.44) or four vaccine doses (aHR = 0.14; 95%CI: 0.05; 0.46), for a VE of 53%, 58%, 68% and 86% against reinfections, respectively. No significant difference in VE was associated with heterologous versus homologous triple vaccination, both against primary infections or reinfections. Conclusions: Primary SARS-CoV-2 infections were more likely among nursery teachers and local police officers. The risk of both primary infections and reinfections reduced with higher number of doses of COVID-19 vaccine, regardless of the pandemic wave. Since city council civil servants were swab tested on demand or for contact tracing, the estimation of COVID-19 risk and VE largely missed aymptomatic SARS-CoV-2 infections. On the one hand, the present study confirmed the protective effect of COVID-19 vaccination against symptomatic SARS-CoV-2 infections; on the other hand, it highlighted not only the importance of continuous booster doses to keep up the humoral immunity over time but also the importance of updated vaccine formulations to prevent and control the spread of a highly mutable virus. Moreover, the protective effect of the first two doses against reinfections confirmed the efficacy of hybrid immunity during Omicron time.

General infection prevention, mitigation, and control procedures implemented in the university education during the COVID-19 pandemic to achieve classroom attendance: a successful community case study.

The COVID-19 pandemic entailed confinement and elimination of face-to-face university classes in Spain. The Francisco de Vitoria University in Madrid (UFV by its Spanish acronym) implemented risk management systems to enable on-campus university activity to avoid a negative impact on students, teachers, and faculties. A tracking/registry system was implemented to collect data, identify COVID-19-related cases, implement containment measures, and do follow-up in the UFV community (administration/services personnel [ASP], teaching/research personnel [TRP], and students), from September 2020 to April 2022. In addition, a prevention plan was implemented on campus to avoid COVID-19 spreading. Satisfaction with these measures was assessed through an online questionnaire. A total of 7,165 suspected COVID-19 cases (84.7% students, 7.7% ASP, 6.5% TRP) were tracked (62.5% female cases, mean age (±SD) 24.8 years (±9.2 years)), and 45% of them confirmed (82% symptomatic/16% asymptomatic), being the student group that with the highest percentage (38.3% total tracked cases). The source of infection was identified in 50.6% of the confirmed cases (90.2% located off-campus). Nineteen COVID-19 outbreaks were registered (inside-10/outside-9). COVID-19 incidence rates were similar or lower than those reported in the Community of Madrid, except in the last wave, corresponding to Omicron variant. The degree of satisfaction (scale 1-6) with the implemented measures was high (scores 4.48-5.44). During the COVID-19 pandemic, UFV control measures, periodic monitoring, and the effectiveness of the tracking system have contributed to maintaining classroom teaching, guaranteeing health and safety. UFV has adapted to a new reality as an example of good practice for future pandemics or emergency situations.

COVID-19 İnsidans Oranlarını Modelleme ve Öngörümleme: Fransa'da Gözetim Başlangıcından Beri Akut Solunum Enfeksiyonları (ARI) Zaman Serisi Analizi

Objective: This study aims to address the challenges of planning and managing the trajectory of the COVID-19 pandemic by evaluating the predictive abilities of three distinct forecasting models. The primary focus is on the ATA univariate forecasting method, ARIMA (AutoRegressive Integrated Moving Average), and ETS (Error-Trend-Seasonality) models. These models are applied to a meticulously collected dataset comprising Acute Respiratory Infections (ARI) incidence rates in France, systematically collected since the initiation of surveillance. Methods: The purpose of the study was to conduct a comprehensive evaluation of forecasting models using the selected dataset to achieve its objective. The focus was on comparing the accuracy and performance of ATA univariate forecasting, ARIMA, and ETS models in predicting COVID-19 incidence rates. Additionally, the study incorporated a combination approach proven to be effective in enhancing forecasting performance. Results: According to the results obtained regarding forecast performance, the univariate models indicate that the ATA method exhibits the highest performance, while observations reveal that combinations of ATA and ARIMA methods enhance forecast accuracy. Conclusions: In summary, the most accurate approach for forecasting future Covid-19 incidence rates, specifically those derived from Acute Respiratory Infections (ARI), has been a combination of the high-accuracy methods ATA and ARIMA. These findings enhance our understanding of the trajectory of the pandemic, providing a foundation for strategic planning and effective management.

Clinical epidemiology of COVID-19 in people of black ethnicity living with HIV in the UK.

To describe the clinical epidemiology of COVID-19 in people of black ethnicity living with HIV in the UK. We investigated the incidence and factors associated with COVID-19 in a previously established and well-characterized cohort of black people with HIV. Primary outcomes were COVID-19 acquisition and severe COVID-19 disease (requiring hospitalization and/or resulting in death). Cumulative incidence was analysed using Nelson-Aalen methods, and associations between demographic, pre-pandemic immune-virological parameters, comorbidity status and (severe) COVID-19 were identified using Cox regression analysis. COVID-19 status was available for 1847 (74%) of 2495 COVID-AFRICA participants (median age 49.6 years; 56% female; median CD4 cell count = 555 cells/μL; 93% HIV RNA <200 copies/mL), 573 (31%) of whom reported at least one episode of COVID-19. The cumulative incidence rates of COVID-19 and severe COVID-19 were 31.0% and 3.4%, respectively. Region of ancestry (East/Southern/Central vs. West Africa), nadir CD4 count and kidney disease were associated with COVID-19 acquisition. Diabetes mellitus [adjusted hazard ratio (aHR) = 2.39, 95% confidence interval (CI): 1.26-4.53] and kidney disease (aHR = 2.53, 95% CI: 1.26-4.53) were associated with an increased risk, and recent CD4 count >500 cells/μL (aHR = 0.49, 95% CI: 0.25-0.93) with a lower risk of severe COVID-19. Region of ancestry was associated with COVID-19 acquisition, and immune and comorbidity statuses were associated with COVID-19 disease severity in people of black ethnicity living with HIV in the UK.

Spatiotemporal association between COVID-19 incidence and type 1 diabetes incidence among children and adolescents: a register-based ecological study in Germany.

Studies have shown an increased incidence of pediatric type 1 diabetes during the COVID-19 pandemic, but the detailed role of SARS-CoV-2 infection in the incidence increase in type 1 diabetes remains unclear. We investigated the spatiotemporal association of pediatric type 1 diabetes and COVID-19 incidence at the district level in Germany. For the period from March 2020 to June 2022, nationwide data on incident type 1 diabetes among children and adolescents aged <20 years and daily documented COVID-19 infections in the total population were obtained from the German Diabetes Prospective Follow-up Registry and the Robert Koch Institute, respectively. Data were aggregated at district level and seven time periods related to COVID-19 pandemic waves. Spatiotemporal associations between indirectly standardized incidence rates of type 1 diabetes and COVID-19 were analyzed by Spearman correlation and Bayesian spatiotemporal conditional autoregressive Poisson models. Standardized incidence ratios of type 1 diabetes and COVID-19 in the pandemic period were not significantly correlated across districts and time periods. A doubling of the COVID-19 incidence rate was not associated with a significant increase in the incidence rate of type 1 diabetes (relative risk 1.006, 95% CI 0.987; 1.019). Our findings based on data from the pandemic period indirectly indicate that a causal relationship between SARS-COV-2 infection and type 1 diabetes among children and adolescents is unlikely.

Associations between pre-infection serum vitamin D concentrations and Omicron COVID-19 incidence, severity and reoccurrence in elderly individuals.

Previous studies suggest a link between vitamin D status and COVID-19 susceptibility in hospitalised patients. This study aimed to investigate whether vitamin D concentrations in elderly individuals were associated with their susceptibility to Omicron COVID-19 incidence, the severity of the disease and the likelihood of reoccurrence during the era of the post-'zero-COVID-19' policies in China. In this retrospective study, participants were categorised into three groups based on their 25(OH)D concentrations: deficiency (< 20 ng/ml), insufficiency (20 to < 30 ng/ml) and sufficiency (≥ 30 ng/ml). The demographic and clinical characteristics, comorbidities and the incidence rate, reoccurrence rate and severity of Omicron COVID-19 were retrospectively recorded and analysed by using hospital information system data and an online questionnaire survey. China. 222 participants aged 60 years or older from a health management centre. Our findings revealed significant differences in the incidence (P = 0·03) and recurrent rate (P = 0·02) of Omicron COVID-19 among the three groups. Participants with lower 25(OH)D concentrations (< 20 ng/ml) exhibited higher rates of initial incidence and reoccurrence and a greater percentage of severe and critical cases. Conversely, individuals with 25(OH)D concentrations ≥ 30 ng/ml had a higher percentage of mild cases (P = 0·003). Binary and ordinal logistic regression models indicated that vitamin D supplementation was not a significant risk factor for COVID-19 outcomes. In the elderly population, pre-infection vitamin D deficiency was associated with increased susceptibility to incidence, severity of illness and reoccurrence rates of Omicron COVID-19.

Spatial, temporal, and demographic nonstationary dynamics of COVID-19 exposure among older adults in the U.S.

This study examines demographic disparities in COVID-19 exposures across older adults age 60-79 and older adults age 80 and over, and explores the factors driving these dynamics in the United States (U.S.) from January 2020 to July 2022. Spatial clusters were identified, and 14 main health determinants were synthesized from 62 pre-existing county-level variables. The study also assessed the correlation between these health determinants and COVID-19 incidence rates for both age groups during the pandemic years. Further examination of incidence rates in relation to health determinants was carried out through statistical and spatial regression models. Results show that individuals aged 80 and over had much higher hospitalization rates, death rates, and case-fatality rates in 2020-2022. Spatial results indicate that the geographical cluster of high incidence rates for both groups shifted from the Midwest at the beginning of the pandemic to the Southwest in 2022. The study revealed marked spatial, temporal, and demographic nonstationary dynamics in COVID-19 exposures, indicating that the health effects of contextual factors vary across age groups. COVID-19 incidence rates in older adults were strongly influenced by race, healthcare access, social capital, environment, household composition, and mobility. Future public health policies and mitigations should further their efforts by considering temporal and demographic nonstationarity as well as local conditions.

Anxiety and depression in pregnancy: associated variables during the covid-19 pandemic period

ObjectiveTo assess the association between age, parity, nationality, educational level, employment and partner support with depression and anxiety during pregnancy. To determine the impact of the evolution of the COVID-19 pandemic on the anxiety and depression levels of the participants. MethodCross-sectional descriptive correlational study carried out in the Osakidetza/Basque Health Service, Primary Care, Bizkaia (Spain). A total of 295 pregnant women between 8 and 41 weeks participated. The association between age, parity, nationality, educational level, employment, partner support and COVID-19 incidence rates during the study period and depression (measured with the Edinburgh Postnatal Depression Scale) and anxiety (measured with the State-Anxiety Inventory/STAI-S subscale) scores during pregnancy was measured. A logistic regression model was constructed and odds ratios and their 95% confidence intervals were estimated. ResultsThe mean score was 18.75 points for anxiety (SD = 8.69) and 6.45 points for depression (SD = 4.32). Women expecting their second or later child had higher scores for depression (OR 2.51[95%IC: 1.26-5.01)) and anxiety (OR 1.98 [95%IC: 1.01-3.89]). Having completed university studies was associated with lower scores in depression (OR 0.28 [95%IC: 0.11-0.77]) and in anxiety (OR 0,2 [95%IC: 0.08-0.54]). A good relationship with the partner was associated with lower levels of anxiety (OR 0.45 [95%IC: 0.24-0.81]). The mean anxiety and depression scores are related to the incidence of COVID-19 cases; the anxiety score was significantly higher in periods of higher incidence. ConclusionsGreater emotional care for pregnant women with low educational level, multiparous and with weak support from their partner, would reduce anxiety and depression in pregnancy. Health emergency situations affect mental health during gestation.

Global trends in COVID-19 incidence and case fatality rates (2019-2023): a retrospective analysis.

Analyzing and comparing COVID-19 infection and case-fatality rates across different regions can help improve our response to future pandemics. We used public data from the WHO to calculate and compare the COVID-19 infection and case-fatality rates in different continents and income levels from 2019 to 2023. The Global prevalence of COVID-19 increased from 0.011 to 0.098, while case fatality rates declined from 0.024 to 0.009. Europe reported the highest cumulative infection rate (0.326), with Africa showing the lowest (0.011). Conversely, Africa experienced the highest cumulative case fatality rates (0.020), with Oceania the lowest (0.002). Infection rates in Asia showed a steady increase in contrast to other continents which observed initial rises followed by decreases. A correlation between economic status and infection rates was identified; high-income countries had the highest cumulative infection rate (0.353) and lowest case fatality rate (0.006). Low-income countries showed low cumulative infection rates (0.006) but the highest case fatality rate (0.016). Initially, high and upper-middle-income countries experienced elevated initial infection and case fatality rates, which subsequently underwent significant reductions. COVID-19 rates varied significantly by continent and income level. Europe and the Americas faced surges in infections and low case fatality rates. In contrast, Africa experienced low infection rates and higher case fatality rates, with lower- and middle-income nations exceeding case fatality rates in high-income countries over time.

Rural Versus Urban Health Disparities in the COVID-19 Era Among Veterans With COPD.

Individuals living in rural areas in the U.S. experienced disparities in COVID-19 incidence and mortality rates, and people with COPD are at high risk of poor outcomes. We sought to determine whether Veterans with COPD living in rural areas experienced different perceptions and practices of COVID-19 mitigation strategies, access to care, and health disparities during the COVID-19 pandemic, compared to their urban-living counterparts. We performed a one-time survey of Veterans with COPD, collecting COVID-19 related information including individual perception and practice of mitigation practices, COVID-19 vaccination status, access to care, and respiratory symptoms stratified by rural-urban status. One hundred participants completed the survey with 47 living in rural and 53 living in urban areas. There were no significant differences in perception and practices related to COVID-19 mitigation strategies (including vaccination), access to care, or respiratory and mental health outcomes. This lack of disparity between rural and urban Veterans with COPD might be explained by the strength of the Veterans Health Administration in telemedicine or by increased uptake of mitigation practices in people with chronic respiratory illness.

Spatialized PM2.5 during COVID-19 pandemic in Brazil's most populous southern city: implications for post-pandemic era.

Brazil has experienced one of the highest COVID-19 fatality rates globally. While numerous studies have explored the potential connection between air pollution, specifically fine particulate matter (PM2.5), and the exacerbation of SARS-CoV-2 infection, the majority of this research has been conducted in foreign regions-Europe, the United States, and China-correlating generalized pollution levels with health-related scopes. In this study, our objective is to investigate the localized connection between exposure to air pollution exposure and its health implications within a specific Brazilian municipality, focusing on COVID-19 susceptibility. Our investigation involves assessing pollution levels through spatial interpolation of in situ PM2.5 measurements. A network of affordable sensors collected data across 9 regions in Curitiba, as well as its metropolitan counterpart, Araucaria. Our findings distinctly reveal a significant positive correlation (with r-values reaching up to 0.36, p-value < 0.01) between regions characterized by higher levels of pollution, particularly during the winter months (with r-values peaking at 0.40, p-value < 0.05), with both COVID-19 mortality and incidence rates. This correlation gains added significance due to the intricate interplay between urban atmospheric pollution and regional human development indices. Notably, heightened pollution aligns with industrial hubs and intensified vehicular activity. The spatial analysis performed in this study assumes a pivotal role by identifying priority regions that require targeted action post-COVID. By comprehending the localized dynamics between air pollution and its health repercussions, tailored strategies can be implemented to alleviate these effects and ensure the well-being of the public.

Влияние вакцинации против гриппа, пневмококковой инфекции и SARS-CoV-2 на заболеваемость и тяжесть течения COVID‑19 у медицинских работников отдельного учреждения (эпидемиологические исследования)

Objective. To study the effect of influenza, pneumococcal and SARS-CoV-2 vaccination on the incidence and severity of COVID-19 course in health care workers. Patients and Methods. We examined 547 health care workers divided into group 1 (no history of influenza and pneumococcal vaccination, n = 281) and groups vaccinated between August and October 2020 (before SARS-CoV-2 epidemic II): Group 2 against influenza (n = 98), Group 3 against pneumococcal infection (n = 60), and Group 4 against influenza and pneumococcus (n = 108). Between March and August 2021 (before the SARS-CoV-2 epidemic III outbreak), 98.6% of all employees were vaccinated against COVID-19. We compared COVID-19 incidence rates during Periods II and III epidemic rises (2020–2022) as a function of influenza and pneumococcal vaccination. Results. It was found that with combined vaccination against influenza and pneumococcal infection in the group of medical workers at high risk of infection, the risk of COVID-19 morbidity within 4–5 months was 2 times lower (1.6% vs. 13.2%, p &lt; 0.05) compared to the unvaccinated. Comparative data on COVID-19 incidence in the II and III periods of epidemic rises showed that COVID-19 in medical workers in the III period was registered 36.1% lower in comparison with the index in the II period – 11.2 and 7.1%, respectively (p &lt; 0.05). We found that when comparing II and III periods of epidemic rises among medical workers, the proportion of persons with COVID-19 with moderate forms of disease who received combined vaccination against influenza and pneumococcal infection decreases more than 2-fold (p &lt; 0.05), including in the category with a high risk of infection. Conclusion. The presented data indicate a positive effect of combined vaccination against pneumococcal infection and influenza on the incidence and severity of COVID-19. The proposed approach can be used in public health practice as a method of nonspecific prevention of COVID-19 and other acute respiratory viral infections. Key words: influenza vaccine, pneumococcal vaccine, combined vaccination, epidemic rise, COVID-19

Evolution of Risk Measures of COVID-19 from 2020 to 2022 Versus in 2023 in a General Medicine Office in Toledo (Spain)

Background: The evolution of risk measures for COVID-19 infection from 2020 to 2023 is not clearly known. Objective: To know the evolution of risk measures of cases of COVID-19 from March 15, 2020 to October 1, 2023 in a general medicine consultation in Toledo, Spain. Methodology: Comparison of the COVID-19 incidence rate (IR), relative risk (RR) and attributable risk (AR) and in 2020, 2021 and 2022 and 2023 years versus covid-19 in 2023 (group with very broad hybrid immunity), based on data from previous longitudinal studies, all of them carried out in the same population of patients treated in a general medicine office in Toledo, Spain. Results: 712 COVID-19 cases from March 15, 2020 to October 31, 2022 (3 years at risk) and 76 covid-19 cases from October 2022 to October 2023 (1 year at risk) were included, for a population at risk of 2,000 people. In 2023 vs. 2020-2022, the following statistically significant differences were found: a lower IR, a protective RR, and a negative AR for the entire at-risk population (IR= 36% x 3 Years; 12% on average for 1 year versus IR= 4% x 1 year; a RR of 0.33 [p= .037056], and an AR= -8); a lower IR in &lt; 65 years [13% average x 1 year vs. 3%; p= .009149; RR= 0.23; RA= -10], and a lower IR in men [IR= 12% average for one year versus 4%; RR of 0.33 [p= .037056]; RA= -8. There was a lower IR in women, in cases with moderate-severe severity, and in socio-health workers, all with RRs that indicated protection factors, and negative ARs for the 2023 group vs. 2020-2022, but without statistical significance. However, the presence of chronic diseases meant a higher IR, a weak risk, and positive RA indicates that the incidence is greater for covid-19 in 2023 vs. in 2020-2022. Conclusion: In general practice setting in Toledo, Spain, in 2023 the population at risk with greater hybrid immunity is better prepared in 2023 vs. 2020-22 to avoid cases of COVID-19, but people with chronic diseases pose a greater risk in 2023.

DYNAMIC CHANGES IN HEALTH INDICATORS OF THE POPULATION OF THE SIBERIAN FEDERAL DISTRICT

HighlightsThe results of the study revealed a recent increase in the mortality of the rural population in the Siberian Federal District, and in Russia in general, which required a separate study to identify its causes. Thus, new management solutions should be developed to improve the resource capacity of the healthcare system in the context of the COVID-19 pandemic. AbstractBackground. Currently, the main strategic goals include increasing life expectancy, reducing mortality rates of the country`s population and improving medical and demographic indicators. This task is becoming especially relevant in rural areas.Aim. To analyze changes in public health indicators of the rural population in the context of the COVID-19 pandemic using the Siberian Federal District data.Methods. The research methods that were used in this study are as follows: statistical and comparative analysis, and generalization on the basis of prior experience. For the analysis the statistical data and reports from the Ministry of Health of Russia, Federal State Statistics Service, and the Siberian Federal District were selected.Results. The analysis of demographic indicators in the Siberian Federal District for the period from 2018 to 2021 showed higher mortality rates compared to the national average, especially in the Altai Territory (1.2 times higher). In 2020 the overall incidence in rural areas both in the Russian Federation as a whole and in the Siberian Federal District decreased for almost all types of diseases (respiratory diseases -2.4%, digestive diseases -13.4%, diseases of the circulatory system -5.3%, infectious and parasitic diseases -11.8%, malignancies -5.3%, injuries and poisoning -5.2%) compared to 2019, whereas there was a growth of the indicator in 2021 in the district being 14% higher than in the Russian Federation. The incidence rate of new coronavirus infection (COVID-19) and life expectancy at birth in the rural population are given, but it should be noted that although the incidence rate of COVID-19 in 2021 in the Omsk region was lower than the national average, mortality from this disease remains the highest in the Siberian Federal District and it exceeded the national average by 1.4 times. To assess the availability of medical care in rural areas, the indicators of the availability of medical personnel and hospital beds were analyzed, showing a steady downward trend.Conclusion. The results of this study make it possible to identify new directions and initiatives for the development of management strategies to improve the resource capacity of the healthcare system at the federal and regional levels.

Ansiedad y depresión en el embarazo. Variables asociadas durante el periodo de pandemia COVID-19

ObjectiveTo assess the association between age, parity, nationality, educational level, employment and partner support with depression and anxiety during pregnancy. To determine the impact of the evolution of the COVID-19 pandemic on the anxiety and depression levels of the participants. MethodCross-sectional descriptive correlational study carried out in the Osakidetza/Basque Health Service, Primary Care, Bizkaia (Spain). A total of 295 pregnant women between 8 and 41 weeks participated. The association between age, parity, nationality, educational level, employment, partner support and COVID-19 incidence rates during the study period and depression (measured with the Edinburgh Postnatal Depression Scale) and anxiety (measured with the State-Anxiety Inventory/STAI-S subscale) scores during pregnancy was measured. A logistic regression model was constructed and odds ratios and their 95% confidence intervals were estimated. ResultsThe mean score was 18.75 points for anxiety (SD 8.69) and 6.45 points for depression (SD 4.32). Women expecting their second or later child had higher scores for depression (OR 2.51 [95%IC: 1.26-5.01]) and anxiety (OR 1.98 [95%IC: 1.01-3.89]). Having completed university studies was associated with lower scores in depression (OR 0.28 [95%IC: 0.11-0.77]) and in anxiety (OR 0,2 [95%IC: 0.08-0.54]). A good relationship with the partner was associated with lower levels of anxiety (OR 0.45 [95%IC: 0.24-0.81]). The mean anxiety and depression scores are related to the incidence of COVID-19 cases; the anxiety score was significantly higher in periods of higher incidence. ConclusionsGreater emotional care for pregnant women with low educational level, multiparous and with weak support from their partner, would reduce anxiety and depression in pregnancy. Health emergency situations affect mental health during gestation.