COVID-19 Morbidity Research Articles

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 < 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 < 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 < 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

Navigating the pandemic of a lifetime: COVID-19 morbidity, mortality, and vaccination through the eyes of a physician

No abstract available

Safeguarding nursing homes in a pandemic: lessons learnt and implications for future workforce planning and development.

Introduction: COVID-19 posed formidable challenges to Singapore’s nursing home (NH) sector. Singapore’s swift implementation of non-pharmaceutical interventions, staff management protocols, and rapid rollout of vaccinations and therapeutics successfully limited COVID-19 mortality and morbidity in the sector. Additionally, the pandemic highlighted the need to strengthen workforce resilience in a crisis. In this study, we identify challenges, opportunities and ways forward to inform the NH sector’s preparation for future outbreaks and ensure sustainability of actions. Here, we present findings on workforce capacity and capability-building.
 Methods: We conducted a qualitative study in two parts to characterise the pandemic response in NHs in Singapore: (i) A rapid review of peer-reviewed and grey literature, including media reports, policy documents, and advisories to synthesise the public health measures implemented from Jan 2020 to Jun 2021 and (ii) n=42 semi-structured in-depth interviews with key stakeholders working in the NH, public health, healthcare, and integrated care sectors, with interview data thematically analysed. 
 Findings: The key challenges identified were NH sector reliance on foreign manpower, early introduction of interventions to curb transmission risks that were maintained for longer than restrictions in community settings, and high resource demands to facilitate implementation of and compliance to restrictions. Care staff reported fatigue, fear, and anxiety. Alongside, strict border controls, quarantine measures, and staff segregation policies limited the NH sector’s ability to flexibly respond to manpower attrition. 
 To cope with these challenges, NHs upskilled junior staff and cross-trained non-nursing staff to take on reassigned tasks and built new capabilities across surveillance and testing. Public hospital manpower supported the NH sector with infection prevention and control advice, tele-consultations, and knowledge-sharing on case management and diagnostics. 
 Opportunities for COVID-19 collaboration between the NH sector and health and integrated care agencies were grounded in social capital accumulated over many years of inter-agency partnerships and collaboration. Boundarylessness and open communication between organisations/agencies facilitated timely decision-making, information sharing, and flexible deployment of resources, including additional funding support. 
 Ways forward: Moving forward, findings pointed to the pandemic providing impetus to build a strong local manpower core, invest in schemes to boost competitiveness and attractiveness, consider a review of existing staffing models, and increase resourcing support to enable the NH sector to keep up with policy changes and future demands. Findings also suggested the importance of greater investment into supporting healthier work environments and prioritising staff mental and physical health.

Clinical characteristics and variables associated with COVID-19 morbidity and mortality in Luanda, Angola, in the first year of the pandemic.

The impact of SARS-CoV-2 infection in Africa is still unclear. In comparison to Europe and North America, morbidity and death rates are lower. Several factors have been proposed, including geographical variation in virus impact, environmental factors, differences in age distribution, and the impact of infectious diseases such as malaria, HIV infection and tuberculosis. We investigated the clinical characteristics and putative determinants linked with COVID-19 in Angolan patients. Cross-sectional study undertaken at Military Hospital, Luanda, from March 2020 to March 2021. The survey collected sociodemographic and clinical information. The sample included 1,683 patients aged ≥18 years, 64% men, with mean age of 46.3 years. SARS-CoV-2 was positive in 39% of the cases with RT-PCR. Patients ≥46 years with a level of education of ≥12 years had a considerably higher likelihood of testing positive. About 58% of positive patients had at least one comorbidity, of which hypertension and Diabetes were associated with SARS-CoV-2 infection. HIV and pulmonary TB were putative protective factors. About 14% of positive patients died. Most deaths occurred in patients ≥46 years, with less education and unemployed. Working as a healthcare practitioner was linked to a protective effect. Malignant diseases were the most common comorbidities associated with death. We identified putative factors related to SARS-CoV-2 infection and mortality. HIV and TB were protective and not associated with mortality. Further study with a broader scope should be conducted to explain the main features related to COVID-19 mortality in Angola.

Leveraging mHealth to Mitigate the Impact of COVID-19 in Black American Communities: Qualitative Analysis.

COVID-19 remains an ongoing public health crisis. Black Americans remain underrepresented among those vaccinated and overrepresented in both COVID-19 morbidity and mortality. Medical misinformation, specifically related to COVID-19, has exacerbated the impact of the disease in Black American communities. Communication tools and strategies to build relationships and disseminate credible and trustworthy diagnostic and preventative health information are necessary to improve outcomes and equity for historically oppressed populations. As the initial phase of a larger mixed methods project to develop, pilot, and evaluate a mobile health (mHealth) intervention among a population at high risk for COVID-19 and cardiovascular comorbidities, this study sought to explore COVID-19 information behavior among Black Americans. Specifically, this study examined (1) preferences for COVID-19 education via mHealth, (2) barriers and facilitators to COVID-19 education and diagnostic testing and routine care for associated cardiovascular and respiratory comorbidities in the local community, and (3) key content for inclusion in a COVID-19 mHealth app. This qualitative study used principles of community-based participatory research and information systems research to conduct 7 focus groups across 3 sites. Focus groups were audio recorded and transcribed for thematic analysis using an abductive approach. The study sample included 54 individuals across sites with a mean age of 50.24 (SD 11.76; range 20-71) years. Participants were primarily female (n=42, 78%) and Black (n=54, 100%) with varied education levels. Over half (n=29, 54%) of the participants were employed full-time, and nearly three-fourths (n=40, 74%) had household incomes <US $65,000. Participants used both Android (n=23, 43%) and iOS devices (n=29, 54%) and were "very comfortable" (n=37, 69%) using their mobile devices. Participants reported using a variety of sources for health information. Content-related preferences reported focus on visual presentation, user-friendly design, and privacy and highlighted the importance of community relevance, access, and community-specific content. Key barriers identified included health literacy-limiting app use, access to technology and information, and lack of trust. Increasing community relevance through community-specific messaging and the inclusion of Black providers were noted as facilitators that may increase credibility and trust. Key content identified included user-specific information such as where to get vaccines and tests, updated local COVID-19 data, travel protocols, information about long COVID-19 (post COVID-19 condition), comorbidities, frequently asked questions, and testimonials or personal stories. Increasing transparency and building trust are 2 key strategies that may improve the impact of health information messaging in Black communities. Focusing on content over context fails in the provision of critical health information and perpetuates health inequities by reinforcing systemic and structural racism. COVID-19 messaging must consider contextual information, patient needs and preferences, and patient information-seeking and information-search behaviors to establish trust and credibility, positively impact patient health outcomes, and improve health equity.

“THE ONLY WAY FOR US TO STAY SAFE IS TO HIDE”: THE EXPERIENCES OF OLDER CHINESE IMMIGRANTS DURING COVID-19 IN NYC

Abstract The COVID-19 pandemic disproportionately affected older adults, who were at heightened risk for COVID-19 morbidity and mortality, as well as social isolation. Challenges to accessing health information and vaccine resources were amplified among older immigrants due to language barriers, lack of established social networks, and experiences of systemic discrimination. Considering the surge of anti-Asian violence across the country and the high-profile violent incidents targeting Asian older adults, our analysis focuses on the lived experiences of older Chinese immigrants during the pandemic in New York City (NYC). To describe the support needed during the pandemic to inform service delivery, we conducted in-depth interviews with 9 low-income Chinese adults over 65 about their experiences in coping with COVID-19. Interviews were transcribed and subjected to inductive thematic analysis. Results show that driven by the pro-vaccination and science norms in China, participants shared an overall positive attitude towards vaccines and exhibited extraordinary resilience to COVID-misinformation. However, COVID-19 and anti-Asian violence amplified each other. Fear of contracting COVID-19 due to perceived age-related vulnerability and fear of anti-Asian violence were prevalent, leading to self-protective withdrawal and deferred health care. Many expressed concerns about traveling to public places alone. Deeply frustrated with the government’s role in controlling violent crimes, some participants decided to stay home indefinitely to evade trouble. Mechanisms to draw out people who have socially withdrawn are needed. Senior service providers in NYC should initiate discussions about perceived safety and implement peer buddy systems to enhance post-pandemic quality of life for Asian older adults.

Effective Utilization of Data for Predicting COVID-19 Dynamics: An Exploration through Machine Learning Models

This study is centered around the COVID-19 pandemic which has posed a global health concern for over three years. It emphasizes the importance of effectively utilizing epidemic simulation models for informed decision-making concerning epidemic control. The challenge lies in appropriately choosing, adapting, and interpreting these models. The research constructs three statistical machine learning models to predict the spread of COVID-19 in specific regions and evaluates their performance using real COVID-19 incidence data. The paper presents short-term (3, 7, 14, 21, and 30 days) forecasts of COVID-19 morbidity and mortality for Germany, Japan, South Korea, and Ukraine. The precision of each model was scrutinized based on the type of input data used. Recommendations are provided on how various data sources can enhance the interpretation quality of machine learning models predicting infectious disease dynamics. The initial findings suggest the need for the comprehensive utilization of all available data, favoring cumulative data during holiday-rich periods and daily data otherwise. To minimize the absolute error, databases should be compiled using daily morbidity and mortality rates.

Health Care Resource Utilization and Costs Associated With COVID-19 Among Pediatrics Managed in the Community or Hospital Setting in England: A Population-based Cohort Study.

Although COVID-19 morbidity is significantly lower in pediatrics than in adults, the risk of severe COVID-19 may still pose substantial health care resource burden. This study aimed to describe health care resource utilization (HCRU) and costs associated with COVID-19 in pediatrics 1-17 years old in England. A population-based retrospective cohort study of pediatrics with COVID-19 using Clinical Practice Research Datalink (CPRD Aurum) primary care data and, where available, linked Hospital Episode Statistics Admitted Patient Care secondary care data. HCRU and associated costs to the National Health Service were stratified by age, risk of severe COVID-19 and immunocompromised status, separately for those with and without hospitalization records (hospitalized cohort: COVID-19 diagnosis August 2020-March 2021; primary care cohort: COVID-19 diagnosis August 2020-January 2022). This study included 564,644 patients in the primary care cohort and 60 in the hospitalized cohort. Primary care consultations were more common in those 1-4 years of age (face-to-face: 4.3%; telephone: 6.0%) compared with those 5-11 (2.0%; 2.1%) and 12-17 years of age (2.2%; 2.5%). In the hospitalized cohort, mean (SD) length of stay was longer [5.0 (5.8) days] among those 12-17 years old (n = 24) than those 1-4 [n = 15; 1.8 (0.9) days] and 5-11 years old [n = 21; 2.8 (2.1) days]. Most pediatrics diagnosed with COVID-19 were managed in the community. However, hospitalizations were an important driver of HCRU and costs, particularly for those 12-17 years old. Our results may help optimize the management and resource allocation of COVID-19 in this population.

An analysis of COVID-19 vaccination campaign in Ukraine.

The Coronavirus disease (COVID-19) pandemic is still an important problem of concern in Ukraine. The rapid deployment of the vaccination program is a key event for the formation of herd immunity and helps to prevent negative outcomes, overloading the public health system. The object of the retrospective-archival study was a depersonalized database of open panels on the management of the COVID-19 situation from the Ministry of Health of Ukraine. The total number of COVID-19 cases in Ukraine as of 25 December 2022 amounted to 5 314 388 individuals (12.83% of the population), and COVID-19-related deaths reached 110 029 individuals (0.26% of the population). The overall number of COVID-19 vaccinated persons in Ukraine as of 16 January 2022, with one dose was 36 198 per 100 000 persons (36% of the population), and with two doses, it was 34 703 per 100 000 persons (35% of the population). It was shown a decrease in the number of COVID-19 vaccinated persons among men and persons over the age of 70. In the dynamics of COVID-19 vaccination with one and two doses, an increase in the number of persons vaccinated with Pfizer/BioNTech and CoronaVac was noted. Despite the significant increase in the morbidity and mortality rates of COVID-19, the coverage of vaccination among the population remained insufficient in Ukraine. The effective COVID-19 vaccination strategy should include appropriate management and ensuring the public health system capacity, implementation of information technologies to address logistics issues, and clear communication strategies to maintain public trust.

Overview of Determining Morbidity and Mortality Codes for Covid-19 Patients at Imelda Hospital Medan

The COVID-19 morbidity code is used to determine the primary condition and secondary condition of a COVID-19 patient condition obtained during an episode of health care that is very important in hospital reporting, where from the morbidity data, the number of patients discharged (live and dead) and the formulation and health programs is obtained. At the same time, the COVID-19 death code is the main source for filling out patient death certificates. Death certificates will be used to report deaths, which are very useful for hospitals to evaluate service quality and the need for medical personnel and equipment to determine the morbidity and mortality code in COVID-19 patients at the Imelda Indonesian Workers General Hospital Medan in 2021. The method used in this research is observation and structured interviews. The results in this study are the number of patients from January to March 2021 who confirmed COVID-19, including 44 morbidity patients and 8 mortality patients, with suspected COVID-19 including 31 mortality patients. COVID-19 health workers, however, do not implement mortality coding for COVID-19 patients. The Imelda General Hospital of Indonesian Workers carries out the provision of a morbidity code for COVID-19 patients but does not carry out the provision of a mortality code for COVID-19 patients.

New SARS-CoV-2 Omicron subvariant. Is XBB.1.5 associated with an increase in COVID-19 morbidity?

As a result of genetic changes and mutations of SARS-CoV-2, new variants emerge that have different properties compared to the original strains of the virus, which is a challenge for public health. XBB.1.5, also known as Kraken, is a subvariant of Omicron, and it is the most infectious and transmissible strain of SARS-CoV-2 to date. XBB.1.5 is the dominant strain in the United States of America, spreading worldwide, including in Europe and Asia. XBB.1.5 has properties to evade the immune system and reinfect individuals who have had COVID-19 before due to its strong binding to angiotensin-converting enzyme 2, and antibody evasion. Treatment and postexposure prophylaxis using monoclonal antibodies are ineffective against the Kraken variant, which is especially problematic for immunocompromised individuals and those with contraindications for vaccination, for example due to severe anaphylaxis or anaphylactic shock after prior administration of the vaccine, who require additional preventive measures. However, antiviral drugs including remdesivir, molnupiravir, nirmatrelvir, and ensitrelvir are still effective in treating COVID-19 caused by the XBB.5 variant. Currently, vaccine efficacy against XBB.1.5 variant is yet unknown. However, according to early studies, XBB and its sublineages have a greater ability for immune evasion than other variants, and the protection against infection via vaccination is reduced.

Exploring the relationship between SARS-CoV-2 variants, illness severity at presentation, in-hospital mortality and COVID-19 vaccination in a low middle-income country: A retrospective cross-sectional study.

COVID-19 morbidity and mortality varied globally through the pandemic. We studied the relationship of SARS-CoV-2 variants of concern (VOC) with COVID-19 severity and mortality among hospitalized patients in Pakistan. A retrospective review of clinical, laboratory, and vaccination data of 197 COVID-19 adult patients at the Aga Khan University Hospital, Karachi between April 2021, and February 2022 was performed. SARS-CoV-2 VOC identified in respiratory samples were analyzed. Univariate and multivariate analysis was conducted to identify factors associated with COVID-19 outcomes. The median age of cases was 55 years and 51.8% were males. Twenty-four percent of females were pregnant. Of COVID-19 cases, 48.2% had nonsevere disease, while 52.8% had severe/critical disease. Hypertension (48%) and diabetes mellitus (41%) were common comorbids. SARS-CoV-2 VOC identified comprised; Omicron (55.3%), Beta (14.7%), Alpha (13.7%), Delta (12.7%), and Gamma (3.6%) variants. Most (59.7%) study subjects were unvaccinated. Of vaccines, 88% had received inactivated virus COVID-19 vaccines. Increased risk of severe disease was associated with age ≥50 years (odds ratio [OR]: 5.73; 95% confidence interval [CI]: [2.45-13.7]), as well as with diabetes mellitus (OR: 4.24; 95% CI: [1.82-9.85]). Full vaccination (OR: 0.25; 95% CI: [0.11-0.58]) or infection with Omicron (OR: 0.42; 95% CI: [0.23-0.74]) was associated with reduced disease severity. The risk of mortality increased with age ≥50 years (OR: 5.07; 95% CI: [1.92-13.42]) and a history of myocardial infarction (OR: 5.11; 95% CI: [1.45-17.93]) whilst, infection with Omicron was found to reduce the risk (OR: 0.22; 95% CI: [0.10-0.53]). Our study describes the relationship between the severity of COVID-19, in-hospital mortality in relation to SARS-CoV-2 variants, and the impact of COVID-19 vaccination in Pakistan. Outcomes were more favorable in younger individuals, after vaccinations and with Omicron variant infections. Most cases received inactivated virus vaccines therefore these data highlight the protection provided against severe COVID-19.

Sialylated Glycan Bindings from SARS-CoV-2 Spike Protein to Blood and Endothelial Cells Govern the Severe Morbidities of COVID-19.

Consistent with well-established biochemical properties of coronaviruses, sialylated glycan attachments between SARS-CoV-2 spike protein (SP) and host cells are key to the virus's pathology. SARS-CoV-2 SP attaches to and aggregates red blood cells (RBCs), as shown in many pre-clinical and clinical studies, causing pulmonary and extrapulmonary microthrombi and hypoxia in severe COVID-19 patients. SARS-CoV-2 SP attachments to the heavily sialylated surfaces of platelets (which, like RBCs, have no ACE2) and endothelial cells (having minimal ACE2) compound this vascular damage. Notably, experimentally induced RBC aggregation in vivo causes the same key morbidities as for severe COVID-19, including microvascular occlusion, blood clots, hypoxia and myocarditis. Key risk factors for COVID-19 morbidity, including older age, diabetes and obesity, are all characterized by markedly increased propensity to RBC clumping. For mammalian species, the degree of clinical susceptibility to COVID-19 correlates to RBC aggregability with p = 0.033. Notably, of the five human betacoronaviruses, the two common cold strains express an enzyme that releases glycan attachments, while the deadly SARS, SARS-CoV-2 and MERS do not, although viral loads for COVID-19 and the two common cold infections are similar. These biochemical insights also explain the previously puzzling clinical efficacy of certain generics against COVID-19 and may support the development of future therapeutic strategies for COVID-19 and long COVID patients.

COVID-19 vaccination in urban American Indian and Alaska Native children: Parental characteristics, beliefs and attitudes associated with vaccine acceptance

BackgroundLittle is known about vaccination rates for American Indian and Alaska Native (AI/AN) parents and their children, or parental decisions in this regard. Improving vaccination rates is a serious concern due to the disproportionate incidence and morbidity of COVID-19 in AI/AN people. PurposeOur goal was to describe urban AI/AN parental attributes associated with COVID-19 vaccination of their children. MethodsSurvey participants (n = 572) were ≥18 years of age, had children ≥5 years of age, AI/AN, and seen at one of six urban health organizations serving primarily AI/AN people within the prior year. They were asked about gender, age, education, marital status, perceived stress, trauma history, whether they had received the COVID-19 vaccine, tested positive for COVID-19 in the past, and if their child was vaccinated. They were also asked about 16 vaccine hesitancy reasons. ResultsParental vaccination rate was 82%, with 59% of their children vaccinated. Parents who vaccinated their children were older, had higher education, lower stress and trauma, and were more likely to be vaccinated compared to parents who did not vaccinate their children. Forty-two percent of parents indicated they would likely vaccinate their unvaccinated child in the future. Sixteen vaccine hesitancy reasons revealed four factors: distrust, inconvenience, lack of concern about the pandemic, and AI/AN concerns. Parents who had no plans to vaccinate their children had the highest vaccine distrust and lack of concern about the pandemic. Parents with greater vaccine distrust and AI/AN specific concern reported significantly greater trauma history and higher levels of education. ConclusionEven though vaccination rates for AI/AN parents and children are high, the consequences of COVID-19 for AI/AN people are more severe than for other US populations. Providers should use trauma-informed, trust-building and culturally competent communication when discussing choices about vaccination with AI/AN parents.

The influence of air pollutants on COVID-19 severity in the administrative and industrial city of Kharkiv

Background. Despite the official statement by the World Health Organization regarding the end of coronavirus disease (COVID-19) pandemic, the risk of an epidemic rise in morbidity remains due to the active circulation of the pathogen and its mutation. Social, natural, environmental, and other factors can contribute to the spread of COVID-19. Air pollutants are extremely dangerous for humans, and a mixture of aerosols and dust particles in the air can serve as factors for the severe acute respiratory syndrome coronavirus 2 transmission. So, the purpose of the study was to reveal the impact of air pollutants on COVID-19 severity in Kharkiv. Materials and methods. The influence of environmental factors on the manifestations of COVID-19 epidemic was assessed for 425 days. 16,723 cases of hospitalizations, 1,883 deaths, and 15,146 confirmed cases of COVID-19 in various age groups were studied. There were on average 4,663 active cases every day. Statistical analysis on assessing the impact of environmental factors on COVID-19 morbidity with different degrees of severity was performed using the non-parametric Kruskal-Wallis test in the IBM SPSS Statistics software package, and the normality of the distribution was checked using the Kolmogorov-Smirnov test. Microsoft Office Excel 2016 spreadsheet tools were used for some auxiliary calculations and graphing. Results. The influence of sulfur dioxide, nitrogen dioxide, nitrous oxide, hydrogen sulfide, phenol, soot, and formaldehyde on COVID-19 morbidity in different severity of infection course with incubation periods of 3–4, 6–7, and 10–14 days was revealed. The effect of high concentrations of nitrogen dioxide, nitrogen oxide, and formaldehyde was most significant on active, confirmed, hospitalized, and fatal cases of COVID-19. At the same time, a rise in active cases of COVID-19 was observed with increasing concentrations of sulfur dioxide and hydrogen sulfide, and high concentrations of phenol and soot had an impact on severe forms. Conclusions. Air pollution can contribute to the spread of COVID-19 and lead to its severe forms, which should be considered when predicting morbidity at different levels (national, regional, local) of epidemiological surveillance. Further research is needed to reveal causal relationships between the incidence of COVID-19 and air pollutants, considering the influence of social and natural factors.

Impact of vaccination against severe COVID-19 in the French population aged 50 years and above: a retrospective population-based study

BackgroundGiven the widespread implementation of COVID-19 vaccination to mitigate the pandemic from the end of 2020, it is important to retrospectively evaluate its impact, in particular by quantifying the number of severe outcomes prevented through vaccination.MethodsWe estimated the number of hospitalizations, intensive care unit (ICU) admissions and deaths directly averted by vaccination in France, in people aged ≥ 50 years, from December 2020 to March 2022, based on (1) the number of observed events, (2) vaccination coverage, and (3) vaccine effectiveness. We accounted for the effect of primary vaccination and the first booster dose, the circulating variants, the age groups, and the waning of vaccine-induced protection over time.ResultsAn estimated 480,150 (95% CI: 260,072–582,516) hospitalizations, 132,156 (50,409–157,767) ICU admissions and 125,376 (53,792–152,037) deaths were directly averted by vaccination in people aged ≥ 50 years, which corresponds to a reduction of 63.2% (48.2–67.6), 68.7% (45.6–72.4) and 62.7% (41.9–67.1) respectively, compared to what would have been expected without vaccination over the study period. An estimated 5852 (2285–6853) deaths were directly averted among the 50–59 years old, 16,837 (6568–19,473) among the 60–69 years old, 32,136 (13,651–36,758) among the 70–79 years old and 70,551 (31,288–88,953) among the ≥ 80 years old.ConclusionsThe vaccination campaign in France considerably reduced COVID-19 morbidity and mortality, as well as stress on the healthcare system.

A Cross-Sectional Comparative Study of Morbidity and Mortality of COVID-19 Disease in four Cities of Northern Khorasan Province using Ratio of Coefficient of Variation.

In December 2019, the spread of a new infectious disease was reported in Wuhan, caused by a new coronavirus named COVID-19 by the World Health Organization. This study aims to compare the dispersion of COVID-19 disease among four Iranian cities in North Khorasan named Bojnord, Farooj, Jajarm, and Shirvan. This cross-sectional study includes information about the daily morbidity and mortality of COVID-19 in 1124 patients from March to May 2021. The analysis of variance method, Scheffe post hoc technique and Leven's test are used to compare the means and the variances of daily morbidity and mortality of these cities. Finally, the coefficients of variation (CVs) of the morbidity and mortality are compared. The means of daily morbidity in Bojnord, Farooj, Jajarm, and Shirvan cities are 6.387, 0.946, 1.150, and 2.193, respectively. Furthermore, the means of daily mortality in Bajnourd, Farooj, Jajarm, and Shirvan are 0.763, 0.193, 0.161, and 0.290, respectively. The means and the variances of both daily mortality and morbidity are significantly different in all four cities (P < 0.05). Furthermore, CVs of daily morbidity in the cities of Bojnord, Farooj, Jajarm, and Shirvan are 0.665, 1.026, 1.032, and 0.787, respectively. The CVs of daily mortality in these cities are 1.196, 2.052, 2.468, and 1.728, respectively. The CVs of both daily mortality and morbidity are significantly different in all four cities (P < 0.05). The ratio of CVs is a good option for comparing the spread of COVID-19 in different regions with different means and variances.

The functioning of call-center in conditions of COVID-19 pandemic

The statistical (descriptive statistics) and descriptive methods were applied. The indicators of functioning of the call-center of the Ministry of Health Care of the Udmurt Republic in 2020-2022 were analyzed. The psychological characteristics of telephone counseling were studied. The satisfaction of medical organizations and citizens with services of call-center operators was assessed. The main principles of telephone counseling are confidentiality, maintenance of framework of working conversation, respect to personality of addressee. In 2020 the call center phone line received 34160 calls, in 2021 - 128339 calls, in 2022 - 65618 calls. In 25 months of operation the call-center operators received 228,117 calls from citizens related to issues of new coronavirus infection. The number of patient calls to the hot-line increases significantly when incidence of new coronavirus infection increases (r=0.885; p<0.05). Most frequently (25.1%) citizens contacted the call-center of the Ministry of Health Care of the Udmurt Republic due to inability to reach the polyclinic and on issues related to primary before-doctor care. The second place in terms of frequency (18.5%) took issues related to PCR-test results. The third place (14.1%) took issues related to duration of quarantine for patients and persons residing with them, possibility for children to attend preschool and educational institutions. The number of outgoing calling in 2020 was 16146, in 2021 - 89269 and in 2022 9936 calls. During 25 months of operation, call-center operators made 204,782 calls to citizens to monitor their health status and invite them to vaccinations and health screenings. More than half of outgoing calls (58.3%) were related to audio-monitoring of patients undergoing outpatient treatment with making-up of electronic protocol. During the period of increasing of COVID-19 morbidity, the call-center becomes an independent structural unit of organizing patient care. The medical organizations and citizens are satisfied with functioning of the call-center of the Ministry of Health Care of the Udmurt Republic organized in order of improving the organization of medical care of patients with COVID-19.

Effects of influenza vaccination on the morbidity and severity of COVID-19 in children

The pandemic of a new coronavirus infection COVID-19 initiated research to find methods of non-specific influence on the immune system that can change the course of infectious diseases. Adult study results have been demonstrated the positive effect of seasonal influenza vaccination on morbidity, hospitalization rates, and reducing the severe forms of SARS-CoV-2 infection. That suggests a similar action in children. The aim of the study: to establish the possible impact of influenza vaccination on the morbidity and severity of COVID-19 in children in Volgograd. Materials and methods. The 303 children 3-17 years old without a history of chronic diseases were included in comparative prospective cohort study on the impact of influenza vaccination (235/303) on morbidity and severity of a new coronavirus infection COVID-19 vs non-vaccinated group (68/303). Results. All children with new coronavirus infection COVID-19 (diagnosis confirmed by laboratory testing - U07.1) had mild symptoms of the disease. In all age groups, the morbidity and the severity of the new coronavirus infection COVID-19 among children vaccinated against influenza did not have significant differences with non-vaccinated group. Conclusion. The results of our study did not support the hypothesis of a protective role of seasonal influenza vaccination on the morbidity and severity of COVID-19 in healthy children. Further research is needed to establish the effect of influenza vaccination on the severity of COVID-19 in children with chronic diseases.

Socioeconomic inequalities in the uptake of COVID-19 vaccination in Hungary; context and public health implications

Abstract Background Eastern Europe witnessed substantial life expectancy losses in 2021. COVID-19 vaccination coverage was lower, and mortality was higher than in Western Europe. Research suggests an important factor behind lower vaccination coverage is vaccine hesitancy. Our studies aimed to explore spatial inequalities in COVID-19 morbidity, mortality, and vaccination coverage in Hungary and the reasons behind vaccine hesitancy during the 3rd and 4th pandemic waves. Methods We characterized COVID-19 morbidity, mortality, and vaccination coverage by indirectly standardized ratios at the municipality level and investigated the association with deprivation. Attitudes towards vaccination were measured by a nationally representative monthly questionnaire survey. Results In Hungary, people in the most deprived municipalities had 17-58% higher relative COVID-19 mortality than the national average, although morbidity was significantly lower. COVID-19 vaccination coverage among the least deprived was 9.2% (95% CI 9-9.5%) higher, while in the most deprived areas, it was 38.2% (95% CI 38.0-38.4%) below the national average at the end of the 3rd pandemic wave. In the 10 districts with the highest proportion of the Roma population, vaccination coverage was 56.0% of the national average (95% CI 55.0-64.0%). Inequalities persisted by the end of the 4th pandemic wave. Younger age, lower education, and lower income were major determinants of vaccine refusal. Reasons for refusal mostly resulted from barriers to accessing reliable information and mistrust. Although Hungary has traditionally had high social acceptance of vaccination, the campaign failed to close the gap in COVID-19 mortality. Hungary demonstrates how social inequalities, misinformation, and mistrust can undermine a vaccination program's success. Consistent, credible communication can dispel misconceptions and build trust, which is key to the acceptance of public health measures.