Prevention Of Infectious Diseases Research Articles

Development of a standard evaluation method for microbial UV sensitivity using light-emitting diodes

Ultraviolet (UV) light is an effective disinfection method. In particular, UV light-emitting diodes (UV-LEDs) are expected to have many applications as light sources owing to their compact form factor and wide range of choices of wavelengths. However, the UV sensitivity of microorganisms for each UV wavelength has not been evaluated comprehensively because standard experimental conditions based on LED characteristics have not been established. Therefore, it is necessary to establish a standard evaluation method based on LED characteristics. Here, we developed a new UV-LED device based on strictly controlled irradiation conditions using LEDs for each wavelength (250–365 nm), checked the validity of the device characteristics and evaluated the UV sensitivity of Escherichia coli using this new evaluation method. For this new device, we considered accurate irradiance, accurate spectra, irradiance uniformity, accurate dose, beam angle, surrounding material reflections, and sample condition. From our results, the following UV irradiation conditions were established as standard: 1 mW/cm2 irradiance, bacterial solution with absorbance value of A600 = 0.5 diluted 10 times solution, solution volume of 1 mL, working distance (WD) of 100 mm. In order to compare the effects of irradiation under uniform conditions on inactivation of microorganisms, we assessed inactivation effect of E. coli by LED irradiation at each wavelength using the U280 LED as a standard wavelength. The inactivation effect for U280 LED irradiation was −0.95 ± 0.21 log at a dose of 4 mJ/cm2. Under this condition of dose, our results showed a high wavelength dependence of the inactivation effect at each UV wavelength peaking at 267 nm. Our study showed that this irradiation system was validated for the standard UV irradiation system and could be contributed to the establishment of food and water hygiene control methods and the development of equipment for the prevention of infectious diseases.

Medicaid Inmate Exclusion Policy and Infectious Diseases Care for Justice-Involved Populations.

The Medicaid Inmate Exclusion Policy (MIEP) prohibits using federal funds for ambulatory care services and medications (including for infectious diseases) for incarcerated persons. More than one quarter of states, including California and Massachusetts, have asked the federal government for authority to waive the MIEP. To improve health outcomes and continuation of care, those states seek to cover transitional care services provided to persons in the period before release from incarceration. The Massachusetts Sheriffs' Association, Massachusetts Department of Correction, Executive Office of Health and Human Services, and University of Massachusetts Chan Medical School have collaborated to improve infectious disease healthcare service provision before and after release from incarceration. They seek to provide stakeholders working at the intersection of criminal justice and healthcare with tools to advance Medicaid policy and improve treatment and prevention of infectious diseases for persons in jails and prisons by removing MIEP barriers through Section 1115 waivers.

CLINICAL SIGNIFICANCE AND IMPACT OF FUNGAL AND BACTERIAL INFECTIONS IN HUMAN HEALTH

Our study aims to explore the origins of infectious diseases and the responses of the human body to invading pathogens. Despite the development of antibiotics and vaccines, the threat of infection remains ever-present. Continuously emerging pathogens and antibiotic-resistant strains pose challenges to effective treatment, while diseases such as AIDS and rabies remain incurable. While infectious diseases have been recognized for millennia, comprehensive understanding of their causes has only emerged in the last century. We focus on elucidating the diverse array of disease-causing organisms and the underlying mechanisms that drive clinically apparent infections. This knowledge is essential for individuals and serves as a fundamental requirement for the diagnosis, treatment, and prevention of infectious diseases.

Quercetin as a Promising Antiprotozoan Phytochemical: Current Knowledge and Future Research Avenues.

Despite tremendous advances in the prevention and treatment of infectious diseases, only few antiparasitic drugs have been developed to date. Protozoan infections such as malaria, leishmaniasis, and trypanosomiasis continue to exact an enormous toll on public health worldwide, underscoring the need to discover novel antiprotozoan drugs. Recently, there has been an explosion of research into the antiprotozoan properties of quercetin, one of the most abundant flavonoids in the human diet. In this review, we tried to consolidate the current knowledge on the antiprotozoal effects of quercetin and to provide the most fruitful avenues for future research. Quercetin exerts potent antiprotozoan activity against a broad spectrum of pathogens such as Leishmania spp., Trypanosoma spp., Plasmodium spp., Cryptosporidium spp., Trichomonas spp., and Toxoplasma gondii. In addition to its immunomodulatory roles, quercetin disrupts mitochondrial function, induces apoptotic/necrotic cell death, impairs iron uptake, inhibits multiple enzymes involved in fatty acid synthesis and the glycolytic pathways, suppresses the activity of DNA topoisomerases, and downregulates the expression of various heat shock proteins in these pathogens. In vivo studies also show that quercetin is effective in reducing parasitic loads, histopathological damage, and mortality in animals. Future research should focus on designing effective drug delivery systems to increase the oral bioavailability of quercetin. Incorporating quercetin into various nanocarrier systems would be a promising approach to manage localized cutaneous infections. Nevertheless, clinical trials are needed to validate the efficacy of quercetin in treating various protozoan infections.

Human Amniotic MSC Response in LPS-Stimulated Ascites from Patients with Cirrhosis: FOXO1 Gene and Th17 Activation in Enhanced Antibacterial Activation.

Spontaneous bacterial peritonitis (SBP) is a severe complication in patients with decompensated liver cirrhosis and is commonly treated with broad spectrum antibiotics. However, the rise of antibiotic resistance requires alternative therapeutic strategies. As recently shown, human amnion-derived mesenchymal stem cells (hA-MSCs) are able, in vitro, to promote bacterial clearance and modulate the immune and inflammatory response in SBP. Our results highlight the upregulation of FOXO1, CXCL5, CXCL6, CCL20, and MAPK13 in hA-MSCs as well as the promotion of bacterial clearance, prompting a shift in the immune response toward a Th17 lymphocyte phenotype after 72 h treatment. In this study, we used an in vitro SBP model and employed omics techniques (next-generation sequencing) to investigate the mechanisms by which hA-MSCs modify the crosstalk between immune cells in LPS-stimulated ascitic fluid. We also validated the data obtained via qRT-PCR, cytofluorimetric analysis, and Luminex assay. These findings provide further support to the hope of using hA-MSCs for the prevention and treatment of infective diseases, such as SBP, offering a viable alternative to antibiotic therapy.

Pre-Transplantation Strategies for Infectious Disease Mitigation and Prevention.

Pediatric Infectious Disease (ID) clinicians play a critical role in helping prevent and mitigate infectious risks in children peri- and post-transplantation. Prevention starts during the pre-transplant evaluation and persists throughout the solid organ transplant and hematopoietic cell transplant continuum. The pre-transplant evaluation is an opportunity to screen for latent infections, plan preventative strategies, optimize immunizations, and discuss risk mitigation practices. An ideal pre-transplant evaluation establishes a relationship with the family that further promotes post-transplant infectious risk reduction. This manuscript builds on shared pediatric ID prevention strategies, introduces updated ID testing recommendations for transplant donors/candidates, highlights emerging data, and identifies ongoing knowledge gaps that are potential areas of research.

Epidemic trends and prevention and control of seasonal influenza in China after the COVID-19 pandemic

During the COVID-19 pandemic, a series of non-pharmaceutical interventions, which were implemented to curb the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), significantly modified the seasonal pattern of influenza. The intensity of influenza activity markedly decreased and B/Yamagata lineage was no longer detected. As the national influenza sentinel surveillance data shown, clear seasonal patterns were observed for influenza between 2012-2019, annually with an average of 14.57% of specimens tested positive for influenza virus. However, the seasonal pattern of influenza was disrupted after the outbreak of COVID-19. In the 2020-2021 season, influenza demonstrated an extremely low activity (yearly positivity rate<1.0%), followed by a resurgence of winter peak in the 2021-2022 season. Following the downgrade of management of COVID-19 to Class B in China in December 26, 2022, social activities gradually resumed, leading to the rebound of influenza activity with an out-of-season ciculation. After COVID-19 pademic, other respiratory infectious diseases caused by SARS-CoV-2, respiratory syncytial virus, and mycoplasma pneumonia were alternatively or concurrently circulated with influenza. The prevention and control of influenza and other respiratory infectious diseases emphasizes a multi-disease prevention strategy, including long-term and continuous monitoring the epidemic trends in influenza virus and SARS-CoV-2, promoting influenza and COVID-19 vaccination among key populations, and strengthening the knowledge and public awareness of prevention and control for respiratory infectious diseases, etc.

Antimicrobial Activity of Syzygium aromaticum Essential Oil in Human Health Treatment.

The use of natural compounds to prevent and treat infective diseases is increasing its importance, especially in the case of multidrug-resistant (MDR) microorganisms-mediated infections. The drug resistance phenomenon is today a global problem, so it is important to have available substances able to counteract MDR infections. Syzygium aromaticum (L.) Merr. & L.M. Perry (commonly called clove) is a spice characterized by several biological properties. Clove essential oil (EO) consists of numerous active molecules, being eugenol as the principal component; however, other compounds that synergize with each other are responsible for the biological properties of the EO. S. aromaticum is traditionally used for bowel and stomach disorders, cold and flu, oral hygiene, tooth decay, and for its analgesic action. Its EO has shown antioxidant, antimicrobial, anti-inflammatory, neuro-protective, anti-stress, anticancer, and anti-nociceptive activities. This review aims to investigate the role of E. S. aromaticum EO in the counteraction of MDR microorganisms responsible for human disorders, diseases, or infections, such as Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Salmonella typhi, Candida albicans, Giardia lamblia, Streptococcus mutans, Porphyromonas gingivalis, and Klebsiella pneumoniae. This study might orient clinical researchers on future therapeutic uses of S. aromaticum EO in the prevention and treatment of infectious diseases.

Kano Model for Apartment-Unit Specialized Planning Guidelines to Prevent Infectious Diseases

Owing to the continued occurrence of infectious diseases, proactive prevention and management plans are required. This study aimed to develop design guidelines to effectively respond to infectious diseases based on the needs of apartment residents, which focused on a South Korean setting. The research method included a literature review to identify apartment planning concepts for preventing and managing infectious diseases, a survey of 300 participants using the Kano model, and an analysis of the quality attributes (QAs) of the survey results to prioritize design guidelines. After reviewing 20 studies, 65 items related to apartment-unit planning for infectious disease prevention, including 108 keywords, were identified. Using thematic analysis, the keywords converged into three planning concepts: hygiene, convenience, and comfort. Based on the literature review, 27 survey questions were derived, and a Kano model QA analysis was performed. As a result, 17 attractive QAs, two one-dimensional QAs, seven indifferent QAs, and one reverse QA were identified. Among these, 13 items that had a significant impact on residents’ satisfaction were classified as essential requirements, and the remaining 14 items were classified as recommended design guidelines. The results of this study provide insights into an evidence-based framework for complex building design guidelines to prevent the spread of infectious diseases.

Evaluation morphofunctional state of broiler chickens body's under the applica-tion of various doses of Combiiod

One of the key and mandatory prerequisites for the creation and approbation of new veterinary preparations, both in the context of national legislation and the requirements of the International Community for Registration of Veterinary Medicines, is clinical studies in compliance with the provisions of “Good clinical practice” (GCP). This primarily concerns medicines with a new substance, pharmacology, and efficiency, which have not yet been studied. The technology of growing poultry requires the use of veterinary drugs not only for the prevention of infectious diseases but also for the improvement of metabolic functions and correction of the body’s resistance. One of the priority tasks is to ensure the complete work of the digestive system since it depends on the body's absorption of the nutrients required for the growth of poultry. Among poultry farms, there is considerable interest in drugs with antibacterial, general stimulating action, and coccidiostatics, especially those that do not have an elimination period. The company “Brovafarma” LLC has developed a new form of drug based on Povidone-iodine and sodium selenite for oral use of poultry for the treatment and prevention of diseases caused by bacteria, viruses, myxomycetes, protozoa organisms sensitive to iodine, and for metabolic disorders. That is why the purpose of our experimental studies was to study the safety of a new veterinary drug “Combiiod”, a “solution for oral use”, for healthy broiler chickens. According to the results of the study, it was found that the feeding of the drug “Combiiod” chickens-broiler at a therapeutic dose (0.2 ml per 1 liter of water) and in 5 multiple therapeutic doses (1.0 ml per 1 liter of water) within 5 days for two courses with weekly interval was well tolerated by the experimental poultry, did not cause death and violation of the morphofunctional state of broiler chickens bodies. In the blood of broiler chickens, which received the drug “Combiiod” at the therapeutic dose, most studied morphological and biochemical indicators were within the physiological values for this type of poultry. They did not differ significantly from the indicators of the control group. In the serum of poultry, which used 5 multiple therapeutic doses, a significant decrease in the content of erythrocytes, hemoglobin, and uric acid and an increase in the activity of alanine aminotransferase (ALT), alkaline phosphatase (ALP), and the content of bile acids were revealed. Analyzing the coefficients of individual internal organs and mass of broiler chickens, no significant difference in indicators between experimental and control groups has been noted. Pathomorphological examination has not established a violation of the morphofunctional state of broiler chickens ’ bodies, which received a therapeutic dose. Histological changes in the structure of the kidneys, liver, and heart, which were reversed, were found in the poultry that received 5 multiple therapeutic doses of the drug.

Estimation of trajectory of protective efficacy in infectious disease prevention trials using recurrent event times.

In studies of infectious disease prevention, the level of protective efficacy of medicinal products such as vaccines and prophylactic drugs tends to vary over time. Many products require administration of multiple doses at scheduled times, as opposed to one-off or continual intervention. Accurate information on the trajectory of the level of protective efficacy over time facilitates informed clinical recommendations and implementation strategies, for example, with respect to the timing of administration of the doses. Based on concepts from pharmacokinetic and pharmacodynamic modeling, we propose a non-linear function for modeling the trajectory after each dose. The cumulative effect of multiple doses of the products is captured by an additive series of the function. The model has the advantages of parsimony and interpretability, while remaining flexible in capturing features of the trajectories. We incorporate this series into the Andersen-Gill model for analysis of recurrent event time data and compare it with alternative parametric and non-parametric functions. We use data on clinical malaria disease episodes from a trial of four doses of an anti-malarial drug combination for chemoprevention to illustrate, and evaluate the performance of the methods using simulation. The proposed method out-performed the alternatives in the analysis of real data in terms of Akaike and Bayesian Information Criterion. It also accurately captured the features of the protective efficacy trajectory such as the area under curve in simulations. The proposed method has strong potential to enhance the evaluation of disease prevention measures and improve their implementation strategies.

Understanding global research trends in the control and prevention of infectious diseases for children: Insights from text mining and topic modeling.

The emergence of novel infectious diseases has amplified the urgent need for effective prevention strategies, especially ones targeting vulnerable populations such as children. Factors such as the high incidence of both emerging and existing infectious diseases, delays in vaccinations, and routine exposure in communal settings heighten children's susceptibility to infections. Despite this pressing need, a comprehensive exploration of research trends in this domain remains lacking. This study aims to address this gap by employing text mining and modeling techniques to conduct a comprehensive analysis of the existing literature, thereby identifying emerging research trends in infectious disease prevention among children. A cross-sectional text mining approach was adopted, focusing on journal articles published between January 1, 2003, and August 31, 2022. These articles, related to infectious disease prevention in children, were sourced from databases such as PubMed, CINAHL, MEDLINE (Ovid), Scopus, and Korean RISS. The data underwent preprocessing using the Natural Language Toolkit (NLTK) in Python, with a semantic network analysis and topic modeling conducted using R software. The final dataset comprised 509 journal articles extracted from multiple databases. The study began with a word frequency analysis to pinpoint relevant themes, subsequently visualized through a word cloud. Dominant terms encompassed "vaccination," "adolescent," "infant," "parent," "family," "school," "country," "household," "community," "HIV," "HPV," "COVID-19," "influenza," and "diarrhea." The semantic analysis identified "age" as a key term across infection, control, and intervention discussions. Notably, the relationship between "hand" and "handwashing" was prominent, especially in educational contexts linked with "school" and "absence." Latent Dirichlet Allocation (LDA) topic modeling further delineated seven topics related to infectious disease prevention for children, encompassing (1) educational programs, (2) vaccination efforts, (3) family-level responses, (4) care for immunocompromised individuals, (5) country-specific responses, (6) school-based strategies, and (7) persistent threats from established infectious diseases. The study emphasizes the indispensable role of personalized interventions tailored for various child demographics, highlighting the pivotal contributions of both parental guidance and school participation. The study provides insights into the complex public health challenges associated with preventing and managing infectious diseases in children. The insights derived could inform the formulation of evidence-based public health policies, steering practical interventions and fostering interdisciplinary synergy for holistic prevention strategies.

Kenyan Free-Tailed Bats Demonstrate Seasonal Birth Pulse Asynchrony with Implications for Virus Maintenance

Ecological information on wildlife reservoirs is fundamental for research targeting prevention of zoonotic infectious disease, yet basic information is lacking for many species in global hotspots of disease emergence. We provide the first estimates of synchronicity, magnitude, and timing of seasonal birthing in Mops condylurus, a putative ebolavirus host, and a co-roosting species, Mops pumilus (formerly Chaerephon pumilus). We show that population-level synchronicity of M. condylurus birthing is wide (~ 8.5 weeks) and even wider in M. pumilus (> 11 weeks). This is predicted to promote the likelihood of filovirus persistence under conditions of bi-annual birthing (two births per year). Ecological features underlying the magnitude of the birth pulse—relative female abundance (higher than expected for M. condylurus and lower for M. pumilus, based on literature) and reproductive rate (lower than expected)—will have countering effects on birthing magnitude. Species-specific models are needed to interpret how identified birth pulse attributes may interact with other features of molossid ebolavirus ecology to influence infection dynamics. As a common feature of wildlife species, and a key driver of infection dynamics, detailed information on seasonal birthing will be fundamental for future research on these species and will be informative for bat-borne zoonoses generally.

Prediction of transmission routes of respiratory infectious diseases in indoor environment: Based on droplet evaporation and sedimentation analysis

Many respiratory infectious diseases are believed to be transmitted from person to person through droplet nuclei in the air or contact with droplet-contaminated surfaces. Most studies related to droplet evaporation only focus on the evaporation process, without dividing the transmission routes of diseases caused by droplet evaporation. In this paper, the actual size of droplet nuclei was analyzed, and droplet evaporation and the changes in component content were predicted. Especially considering the dynamic effect of evaporation on droplets size change, a more realistic sedimentation model was established, and the probability of pathogen transmission through different routes and the corresponding droplet size distribution range were analyzed. The results showed that the size of droplet nuclei and the rate of the evaporation process together determined the time required for droplet evaporation. The number of droplets still suspended in the air after the end of evaporation is much higher than the number of droplets settling on the ground. In addition, the differences in component content during the evaporation process may affect the inactivation of pathogens in droplets. This study provided a reference for the prevention and control strategies of respiratory infectious diseases in indoor environments.

‘A system that is struggling’: understanding health protection resilience in England during the COVID-19 pandemic through the experiences of local health protection responders

BackgroundLocal health protection systems play a crucial role in infectious disease prevention and control and were critical to COVID-19 pandemic responses. Despite this vital function, few studies have explored the lived experience of health protection responders managing COVID-19. We provide new insights by examining how COVID-19 shaped infectious disease prevention and control in local health protection systems in England.MethodsSemi-structured interviews were conducted with twenty local health protection responders from three contrasting local authority areas, and Public Health England (PHE) health protection teams, in England between June 2021 - March 2022. Participants were from: PHE health protection teams (n=6); local authority public health teams (n=5); local authority Public Protection Services (n=7); and local authority commissioned Infection Prevention and Control Teams (n=2). Data were analysed using reflexive thematic analysis.ResultsFirst, participants acknowledged the pandemic caused an unprecedented workload and disruption to local health protection service delivery. There was not enough capacity within existing local health protection systems to manage the increased workload. PHE health protection teams therefore transferred some COVID-19 related health protection tasks to other staff, mainly those employed by local authorities. Second, health protection responders highlighted how COVID-19 drew attention to the weaknesses in local health protection systems already stressed by reduced funding in the years leading up to the pandemic. Injecting money into the COVID-19 response did not completely overcome former losses in specialist health protection workforce. Third, health protection responders described how pandemic management raised the profile of public health, especially infectious disease prevention and control. Managing COVID-19 strengthened collaborative working, resulting in enhanced capacity of local health protection systems at the time.ConclusionThe COVID-19 pandemic challenged the public health preparedness of all countries. Health protection responders in this study also expressed many challenges. There was insufficient resilience in these local health protection systems and an inability to scale up the specialist health protection workforce, as required in a pandemic situation. The UK needs to learn from the pandemic experience by acknowledging and addressing the challenges faced by local health protection responders so that it can more effectively respond to future threats.

Assessing the impact of isolation policies on epidemic dynamics through swarm entropy.

Isolation policies are an effective measure in epidemiological models for the prediction and prevention of infectious diseases. In this paper, we use a multi-agent modeling approach to construct an infectious disease model that considers the influence of isolation policies. The model analyzes the impact of isolation policies on various stages of epidemic from two perspectives: the external environment and agents behavior. It utilizes multiple variables to simulate the extent to which isolation policies influence the spread of the pandemic. Empirical evidence indicates that the progression of the epidemic is primarily driven by factors such as public willingness and regulatory intensity. The improved model, in comparison to traditional infectious disease models, offers greater flexibility and accuracy, addressing the need for frequent modifications in fundamental models within complex environments. Meanwhile, we introduce "swarm entropy" to evaluate infection intensity under various policies. By linking isolation policies with swarm entropy, considering population structure, we quantify the effectiveness of these isolation measures. It provides a novel approach for complex population simulations. These findings have facilitated the enhancement of control strategies and provided decision-makers with guidance in combating the transmission of infectious diseases.

Uncertainty directed factorial clinical trials.

The development and evaluation of novel treatment combinations is a key component of modern clinical research. The primary goals of factorial clinical trials of treatment combinations range from the estimation of intervention-specific effects, or the discovery of potential synergies, to the identification of combinations with the highest response probabilities. Most factorial studies use balanced or block randomization, with an equal number of patients assigned to each treatment combination, irrespective of the specific goals of the trial. Here, we introduce a class of Bayesian response-adaptive designs for factorial clinical trials with binary outcomes. The study design was developed using Bayesian decision-theoretic arguments and adapts the randomization probabilities to treatment combinations during the enrollment period based on the available data. Our approach enables the investigator to specify a utility function representative of the aims of the trial, and the Bayesian response-adaptive randomization algorithm aims to maximize this utility function. We considered several utility functions and factorial designs tailored to them. Then, we conducted a comparative simulation study to illustrate relevant differences of key operating characteristics across the resulting designs. We also investigated the asymptotic behavior of the proposed adaptive designs. We also used data summaries from three recent factorial trials in perioperative care, smoking cessation, and infectious disease prevention to define realistic simulation scenarios and illustrate advantages of the introduced trial designs compared to other study designs.

Chlamydia trachomatis upregulates lncRNA CYTOR to mediate autophagy through miR-206/MAPK1 axis.

Chlamydia trachomatis infection can be regulated by autophagy-related genes. LncRNA CYTOR has been proven to be involved in autophagy. In this research, we investigated the role of CYTOR in autophagy induced by C. trachomatis and the potential mechanisms. After C. trachomatis infection, CYTOR and MAPK1 were up-regulated and miR-206 was down-regulated, meanwhile, the autophagy-related protein Beclin1 and LC3-Ⅱ/LC3-Ⅰ ratio were increased. Interference with CYTOR or overexpression with miR-206 downregulated the autophagy-related protein Beclin1 and the number of autophagic spots LC3, decreased the protein ratio of LC3-II/LC3-I, and upregulated the expression of P62 protein. The luciferase reporter assay confirmed that CYTOR acted as a sponge for miR-206 to target MAPK1. In addition, CYTOR promoted autophagy induced by C. trachomatis infection through the MAPK1/ERK signaling pathway activation. Taken together, we have identified a novel molecular mechanism that the CYTOR/miR-206/MAPK1 axis was involved in the regulation of autophagy in C. trachomatis infection. This work provides an experimental basis for elucidating the pathogenesis of C. trachomatis for the treatment, prevention and control of related infectious diseases.

Research on an intelligent assessment method for the physical health of preschool children based on the Artificial Neural Network (ANN) model

This study aims to use the BP neural network model to predict the monthly total number of reported symptoms in preschool children, thereby achieving early warning for the total number of cases in the current month. By analyzing the training results of the neural network and the fitting of the model, the feasibility and effectiveness of the BP neural network in monitoring the physical health of preschool children are validated. The predictive model is of great significance for the prevention of infectious diseases in a border region of a certain province, providing important information for the local incidence situation. The research results indicate that the established BP neural network model demonstrates good accuracy and practicality in predicting the monthly total number of reported symptoms in preschool children’s physical health.

Impact of the COVID-19 pandemic on COPD exacerbations in Japanese patients: a retrospective study

Various infection control measures implemented during the coronavirus disease (COVID-19) pandemic have reduced the number of respiratory infections, which are the most common cause of chronic obstructive pulmonary disease (COPD) exacerbations. Here, we investigated whether infectious disease prevention during the COVID-19 pandemic reduced COPD exacerbations and the characteristics of patients exhibiting exacerbations before and during the COVID-19 pandemic. We included outpatients and inpatients with moderate or severe COPD exacerbations who required systemic steroids between April 1, 2018 and March 31, 2022. Their medical records were retrospectively compared and analyzed in 2-year intervals (before and during the COVID-19 pandemic). During the 4-year observation period, 70,847 outpatients and 2,772 inpatients were enrolled; 55 COPD exacerbations were recorded. The number of COPD exacerbations decreased from 36 before to 19 during the COVID-19 pandemic. Regarding the characteristics of patients with exacerbations, the % forced expiratory volume in one second (52.3% vs. 38.6%, P = 0.0224) and body mass index (BMI) (22.5 vs. 19.3, P = 0.0127) were significantly lower during the COVID-19 pandemic than before the pandemic. The number of COPD exacerbations during the pandemic decreased. Additionally, the tendency for a reduction in COPD exacerbation was greatest in patients with preserved lung function or above-standard BMI patients.