Greater Risk For COVID-19 Research Articles

Incidence and outcome of SARS-CoV-2 infection on solid organ transplantation recipients: A nationwide population-based study.

Since February 21 2020, when the Italian National Institute of Health (Istituto Superiore di Sanità-ISS) reported the first autochthonous case of infection, a dedicated surveillance system for SARS-CoV-2-positive (COVID+) cases has been created in Italy. These data were cross-referenced with those inside the Information Transplant System in order to assess the cumulative incidence (CI) and the outcome of SARS-COV-2 infection in solid organ transplant recipients (SOTRs) who are assumed to be most at risk. We compared our results with those of COVID+ nontransplanted patients (Non-SOTRs) with follow-up through September 30, 2020. The CI of SARS-CoV-2 infection in SOTRs was 1.02%, higher than in COVID+ Non-SOTRs (0.4%, p<.05) with a greater risk in the Lombardy region (2.89%). The CI by type of organ transplant was higher for heart (CI 1.57%, incidence rate ratio [IRR] 1.36) and lower for liver (CI 0.63%, IRR 0.54). The 60-day CI of mortality was 30.6%, twice as much that of COVID+ Non-SOTRs (15.4%) with a 60-day gender and age adjusted odds ratio (adjusted-OR) of 3.83 for COVID+ SOTRs (95% confidence interval [3.03-4.85]). The lowest 60-day adjusted-OR was observed in liver SOTRs (OR 0.46, 95% confidence interval [0.25-0.86]). More detailed studies on disease management and evolution will be necessary in these patients at greater risk of COVID-19.

Declining Well-Being During the COVID-19 Pandemic Reveals U.S. Social Inequities

Background: The COVID-19 pandemic led to mental health fallout in the US; yet research about mental health and COVID-19 primarily rely on national and group-specific samples. However, betweencity comparisons may provide further insight into how the pandemic is disproportionately affecting atrisk groups. Purpose: This study leverages social media and COVID-19-city infection data to measure the longitudinal (January 22- July 31, 2020) mental health effects of the COVID-19 pandemic in 20 metropolitan areas. Methods: We used longitudinal VADER sentiment analysis of Twitter timelines (January-July 2020) for cohorts in 20 metropolitan areas to examine mood changes over time. We then conducted simple and multivariate Ordinary Least Squares (OLS) regressions to examine the relationship between COVID-19 infection city data, population, population density, and city demographics on sentiment across those 20 cities. Results: Longitudinal sentiment tracking showed declines in subjective well-being over time. The univariate OLS regression highlighted a negative linear relationship between COVID-19 city data and online sentiment (𝛽 = -0.017). Residing in predominantly white cities had a protective effect against COVID-19 driven negative mood (𝛽= .0629, pConclusion: The COVID-19 pandemic is a driver of declining US mood in 20 metropolitan cities. Other factors, including social unrest and local demographics, may compound and exacerbate mental health outlook in racially diverse cities.Funding Statement: This study was not supported by an external grant.Declaration of Interests: The authors declare no competing interest.

Latent class analysis of COVID-19 symptoms in Brazil: results of the PNAD-COVID19 survey.

The lack of mass testing for COVID-19 diagnosis creates the need to determine the magnitude of the disease based on its clinical symptoms. The study aimed to analyze the profile of COVID-19 symptoms and related aspects in Brazil. The author analyzed the sample of participants from the Brazilian National Household Sample Survey (PNAD-COVID19) conducted in May 2020. Latent class analysis (LCA) was performed with sociodemographic covariables and 11 symptoms reported by 346,181 individuals. Rao-Scott test and standardized residual analysis were used to measure the association with the pattern of health services use. Spatial scan analysis was performed to identify areas at risk of COVID-19 cases. LCA showed six classes of symptoms based on the pattern of answers by participants: (1) all the symptoms; (2) high prevalence of symptoms; (3) predominance of fever; (4) predominance of cough/sore throat; (5) mild symptoms with predominance of headache; and (6) absence of symptoms. Female sex, brown skin color, the North and Northeast regions of Brazil, and all three older age brackets showed stronger association with the class with all the symptoms (class 1). Most use of health services was also by this group of individuals, but with different profiles of use. Spatial analysis showed juxtaposition of this class with areas at greater risk of COVID-19. These finding underline the importance of investigating symptoms for the epidemiological identification of possible cases in a scenario with low population testing rates.

Neonatal hyperoxia enhances age-dependent expression of SARS-CoV-2 receptors in mice

The severity of COVID-19 lung disease is higher in the elderly and people with pre-existing co-morbidities. People who were born preterm may be at greater risk for COVID-19 because their early exposure to oxygen (hyperoxia) at birth increases the severity of respiratory viral infections. Hyperoxia at birth increases the severity of influenza A virus infections in adult mice by reducing the number of alveolar epithelial type 2 (AT2) cells. Since AT2 cells express the SARS-CoV-2 receptors angiotensin converting enzyme (ACE2) and transmembrane protease/serine subfamily member 2 (TMPRSS2), their expression should decline as AT2 cells are depleted by hyperoxia. Instead, ACE2 was detected in airway Club cells and endothelial cells at birth, and then AT2 cells at one year of age. Neonatal hyperoxia stimulated expression of ACE2 in Club cells and in AT2 cells by 2 months of age. It also stimulated expression of TMPRSS2 in the lung. Increased expression of SARS-CoV-2 receptors was blocked by mitoTEMPO, a mitochondrial superoxide scavenger that reduced oxidative stress and DNA damage seen in oxygen-exposed mice. Our finding that hyperoxia enhances the age-dependent expression of SARS-CoV-2 receptors in mice helps explain why COVID-19 lung disease is greater in the elderly and people with pre-existing co-morbidities.

The relationship between health mindsets and health protective behaviors: An exploratory investigation in a convenience sample of American Indian adults during the COVID-19 pandemic.

The Novel-coronavirus disease-2019 (COVID-2019) outbreak was declared a national emergency on March 13, 2020. To reduce the spread of the virus, Americans were asked to physically distance and to increase disinfecting behaviors such as hand washing. Previous research indicates that one’s mindset about health, or the degree to which they view health as fixed or modifiable, influences health behaviors. Current data indicates that American Indians (AIs) are at greater risk for COVID-19. As such, it is important to understand whether mindsets about health may affect behaviors which could prevent spread of the virus in AIs. In this exploratory investigation, a convenience sample of two hundred AI adults completed a questionnaire one month prior to the declaration of the COVID-19 pandemic as a national emergency. They provided demographic information and completed a measure of health mindsets. The second wave of data was collected approximately one month later, where we collected a measure of physical distancing behavior and a measure of disinfecting behaviors. In AI adults, health mindset predicted frequency of physical distancing behaviors and disinfecting behaviors, with individuals who viewed health as less fixed engaging in more physical distancing and disinfecting behaviors, while individuals who viewed health as more fixed reported less physical distancing and less disinfecting behaviors. In AIs, growth health mindsets predicted physical distancing and disinfecting behaviors, both of which are important in reducing the spread of COVID-19. Interventions which are designed to promote growth mindsets of health may promote health-protective behaviors in the context of the COVID-19 pandemic.

New pathogen, same disparities: why COVID-19 and HIV remain prevalent in U.S. communities of colour and implications for ending the HIV epidemic.

IntroductionThe U.S. Ending the HIV Epidemic (EHE) Initiative was launched nationally in February 2019. With a target of ending the HIV epidemic by 2030, EHE initially scales up effective HIV prevention and care in 57 localities that comprise the greatest proportion of annual HIV diagnoses in the United States (US). However, the EHE effort has been eclipsed by another infectious disease 11 months into the Initiative’s implementation. SARS‐COV‐2, a novel coronavirus, has infected more than eight million Americans and at least 223 000 (as of 23 October 2020) have succumbed to the disease. This commentary explores the social conditions that place communities of colour at greater risk for COVID‐19 and HIV, and assesses challenges to EHE in a post‐COVID‐19 universe.DiscussionOne of the many common threads between HIV and COVID‐19 is the disproportionate impact of each disease among communities of colour. A recent report by the National Academy of Sciences surmised that as much as 70% of health outcomes are due to health access, socio‐economic factors and environmental conditions. Social determinants of health associated with greater HIV burden in Black and Brown communities have re‐emerged in epidemiological studies of disproportionate COVID‐19 cases, hospitalizations and deaths in communities of colour. Using data from the scientific literature, this commentary makes direct comparisons between HIV and COVID‐19 racial disparities across the social determinants of health. Furthermore, I examine three sets of challenges facing EHE: (1) Challenges that hamper both the EHE and COVID‐19 response (i.e. insufficiently addressing the social determinants of health; amplification of disparities as new health technologies are introduced) (2) Challenges posed by COVID‐19 (i.e. diverting HIV resources to address COVID‐19 and tapering of EHE funding generally); and (3) Challenges unrelated to COVID‐19 (i.e. emergence of new and related health disparities; repeal of the Affordable Care Act and long‐term viability of EHE).ConclusionsRacism and discrimination place communities of colour at greater risk for COVID‐19 as well as HIV. Achieving and sustaining an end to the U.S. HIV epidemic will require structural change to eliminate conditions that give rise to and maintain disparities.

White Counties Stand Apart: The Primacy of Residential Segregation in COVID-19 and HIV Diagnoses

Emerging epidemiological data suggest that white Americans have a lower risk of acquiring COVID-19. Although many studies have pointed to the role of systemic racism in COVID-19 racial/ethnic disparities, few studies have examined the contribution of racial segregation. Residential segregation is associated with differing health outcomes by race/ethnicity for various diseases, including HIV. This commentary documents differing HIV and COVID-19 outcomes and service delivery by race/ethnicity and the crucial role of racial segregation. Using publicly available Census data, we divide US counties into quintiles by percentage of non-Hispanic white residents and examine HIV diagnoses and COVID-19 per 100,000 population. HIV diagnoses decrease as the proportion of white residents increase across US counties. COVID-19 diagnoses follow a similar pattern: Counties with the highest proportion of white residents have the fewest cases of COVID-19 irrespective of geographic region or state political party inclination (i.e., red or blue states). Moreover, comparatively fewer COVID-19 diagnoses have occurred in primarily white counties throughout the duration of the US COVID-19 pandemic. Systemic drivers place racial minorities at greater risk for COVID-19 and HIV. Individual-level characteristics (e.g., underlying health conditions for COVID-19 or risk behavior for HIV) do not fully explain excess disease burden in racial minority communities. Corresponding interventions must use structural- and policy-level solutions to address racial and ethnic health disparities.

Front-line healthcare staff at greater risk of COVID-19 than public

Front-line healthcare staff at greater risk of COVID-19 than public

Living with Chronic Fatigue Syndrome during lockdown and a global pandemic

ABSTRACT Objective : Chronic Fatigue Syndrome, a condition characterised by extreme fatigue that is not explained by other medical conditions, places individuals at greater risk of COVID-19. The condition is also associated with a lack of social support and social isolation. These individuals may, therefore, have a unique experience of lockdown and the pandemic. The present study investigates the experiences of those with Chronic Fatigue Syndrome during the COVID-19 pandemic. Design : In the present study, we identified fifty online forum (Reddit) posts, discussing the personal lived experience of Chronic Fatigue Syndrome during lockdown and the global pandemic. These posts were subject to inductive thematic analysis. Results : Four themes were extracted from the data. These were (i) Symptom Change, (ii) Social Interactions, (iii) Comparing Experiences, and (iv) Positive Consequences. Themes highlighted both positive and negative experiences of the COVID-19 pandemic. For example, whilst some people reported more severe symptoms, lockdown also provided more accessible opportunities to interact (i.e. online videocalls). Conclusion : Chronic Fatigue Syndrome influenced physical, psychological, and social experiences, with both positive and negative outcomes of the lockdown and pandemic apparent. Findings have the potential to support those with Chronic Fatigue Syndrome and those who experience post-COVID-19 fatigue.

COVID-19 in Parkinson's Disease Patients Living in Lombardy, Italy.

BackgroundIt is unknown whether patients with PD are at greater risk of COVID‐19, what their risk factors are, and whether their clinical manifestations differ from the general population.ObjectivesThe study aimed to address all these issues.MethodsIn a case‐controlled survey, we interviewed 1,486 PD patients attending a single tertiary center in Lombardy, Italy and 1,207 family members (controls).ResultsOne hundred five (7.1%) and 92 controls (7.6%) were identified as COVID‐19 cases. COVID‐19 patients were younger, more likely to suffer from chronic obstructive pulmonary disease, to be obese, and vitamin D nonsupplemented than unaffected patients. Six patients (5.7%) and 7 family members (7.6%) died from COVID‐19. Patients were less likely to report shortness of breath and require hospitalization.ConclusionsIn an unselected large cohort of nonadvanced PD patients, COVID‐19 risk and mortality did not differ from the general population, but symptoms appeared to be milder. The possible protective role of vitamin D supplementation warrants future studies. © 2020 International Parkinson and Movement Disorder Society

Incidence and Immunologic Analysis of Coronavirus Disease (COVID-19) in Hemodialysis Patients: A Single-Center Experience

COVID-19 is a great threat to the modern world and significant threat to immunocompromised patients, including patients with chronic renal failure. We evaluated COVID-19 incidence among our hemodialysis patients and investigated the most probable immune mechanisms against COVID-19. Başkent University has 21 dialysis centers across Turkey, with 2420 patients on hemodialysis and 30 on peritoneal dialysis. Among these, we retrospectively evaluated 602 patients (257 female/345 male) with chronic renal failure receiving hemodialysis as renal replacement therapy; 7 patients (1.1%) were infected with SARS-CoV-2. We retrospectively collected patient demographic characteristics, clinical data, and immunological factors affecting the clinical course of the disease. We divided patients into groups and included 2 control groups (individuals with normal renal functions): group I included COVID-19-positive patients with normal renal function, group II included COVID-19-positive hemodialysis patients, group III included COVID-19-negative hemodialysis patients, and group IV included COVID-19-negative patients with normal renal function. Lymphocyte subsets in peripheral blood and typing of human leukocyte antigens were analyzed in all groups, with killer cell immunoglobulin like receptor genes analyzed only in COVID-19-positive patients and healthy controls. No deaths occurred among the 7 COVID-19-positive hemodialysis patients. Group I patients were significantly older than patients in groups II and III (P = .039, P = .030, respectively) but not significantly different from group IV (P = .060). Absolute counts of natural killer cells in healthy controls were higherthan in other groups (but not significantly). ActivatedT cells were significantly increased in both COVID-19-positive groups versus COVID-19-negative groups. Groups showed significant differences in C and DQ loci with respect to distribution of alleles in both HLA classes. Although immunocompromised patients are at greater risk for COVID-19, we found lower COVID-19 incidence in our hemodialysis patients, which should be further investigated in in vitro and molecular studies.

The time is now: expedited HIV differentiated service delivery during the COVID-19 pandemic.

The time is now: expedited HIV differentiated service delivery during the COVID-19 pandemic.

Healthcare workers at greater risk of COVID-19 despite 'adequate' PPE, finds research

Healthcare workers at greater risk of COVID-19 despite 'adequate' PPE, finds research

Knowledge, Attitude, and Practices towards Covid-19 in the Midst of Pandemics among Jakarta Residents

Background: Jakarta, capital city of Indonesia, had been extremely hit by the COVID-19 pandemic. Public consistence with control measures was important, which was greatly affected by knowledge, attitudes and practices towards COVID-19. This study aimed to investtigate knowledge, attitudes and practices of Jakarta residents for COVID-19. Subjects and Method: This was an analytic observational study with a cross-sectional design. Sample was gathered online from 221 Jakarta residents, range in age 10 to 60 years, which use self-reported questionnaires consisting of consent, questions about sociodemographics, knowledge, attitudes and practices relevant to COVID-19 and analyzed using t-test and ANOVA. A linear regression analysis was conducted to identify factors associated with knowledge, attitude and practice. Results: Participants showed moderate level of knowledge (mean= 71.20; SD= 8.37), positive attitudes (mean= 53.47; SD= 5.10) and moderate practice (mean= 78.63; SD= 12.73). Results demonstrated that women have better knowledge (mean= 72.1; SD= 9.0; p= 0.360), optimistic attitudes (mean= 55.1; SD = 6.2; p= 0.005) and great practices (mean= 80.1; SD= 11.6; p= 0.316) towards COVID-19 than men. Elderly have better knowledge (mean= 75.6; SD= 5.0; p= 0.001), optimistic attitude (mean= 56.3; SD= 3.8; p= 0.033) and good practices (mean= 82.4; SD= 14.3; p= 0.301) than younger individuals. Conclusion: Directed approaches in health promotion should be integrated for vulnerable populations, such as men, younger people, and low-income earners who would be at greater risk of COVID-19. Keywords: COVID-19, knowledge, attitude, practice Correspondence: Andree Kurniawan. Department of Internal Medicine, Faculty of Medicine Pelita Harapan University. Boulevard Jenderal Sudirman, Karawaci, Tangerang, Banten, Indonesia 15811. Email: andree.kurniawan@uph.edu. Mobile: +62-815-8891-655. Journal of Epidemiology and Public Health (2020), 05(04): 477-488 https://doi.org/10.26911/jepublichealth.2020.05.04.10

Obesidade infantil e quarentena: crianças obesas possuem maior risco para a COVID-19?

A Residência Pediátrica (RP) é uma revista eletrônica trimestral, em publicação contínua, da Sociedade Brasileira de Pediatria (SBP), disponível em português e inglês, destinada aos médicos residentes de nossa especialidade, áreas afins e aos pediatras. O conteúdo da revista pode ser acessado livremente. A missão da RP é contribuir para a formação acadêmica dos residentes e incentivá-los a uma participação ativa na produção científica sobre temas pediátricos e relacionados à adolescência.