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Elizabeth Rowley, Nanthalile Mugala
Lancet Infectious Diseases, 24.09.2021
Tilføjet 24.09.2021
The call for more gender-equitable tuberculosis programming, informed by systematically collected and analysed sex-disaggregated and age-disaggregated data, has intensified in recent years.1,2 Gender-equitable programming purposefully addresses inequities that are strongly affected by cultural and socially defined expectations, roles, responsibilities, norms, and power relationships based on sex, gender identity, or gender expression. For tuberculosis programmes, this means examining the intersectional gender context driving poor tuberculosis outcomes for men, women, and non-binary individuals (of all gender identities) and creating evidence-based strategies to address differential disease risk and service utilisation.
Læs mere Tjek på PubMedGBD 2019 Tuberculosis Collaborators
Lancet Infectious Diseases, 24.09.2021
Tilføjet 24.09.2021
As countries refine national tuberculosis programmes and strategies to end the tuberculosis epidemic, the excess burden experienced by males is important. Interventions are needed to actively communicate, especially to men, the importance of early diagnosis and treatment. These interventions should occur in parallel with efforts to minimise excess HIV burden among women in the highest HIV burden countries that are contributing to excess HIV and tuberculosis coinfection burden for females. Placing a focus on tuberculosis burden among HIV-negative males and HIV and tuberculosis coinfection among females might help to diminish the overall burden of tuberculosis.
Læs mere Tjek på PubMedIrina Isakova-Sivak, Victoria Matyushenko
Lancet Infectious Diseases, 24.09.2021
Tilføjet 24.09.2021
The H3N2 influenza subtype has been highly researched due to its rapid mutational variability, which allows it to escape a preexisting immune response, meaning that the effectiveness of the H3N2 vaccine component has been extremely low over the past few seasons, since the 2014–15 season.1 It is therefore not surprising that in seasons when the H3N2 virus predominates, many countries have markedly higher mortality rates than in other seasons, especially in older people, owing to their reduced immune functions.
Læs mere Tjek på PubMedVivek Shinde, Iksung Cho, Joyce S Plested, Sapeckshita Agrawal, Jamie Fiske, Rongman Cai, Haixia Zhou, Xuan Pham, Mingzhu Zhu, Shane Cloney-Clark, Nan Wang, Bin Zhou, Maggie Lewis, Patty Price-Abbott, Nita Patel, Michael J Massare, Gale Smith, Cheryl Keech, Louis Fries, Gregory M Glenn
Lancet Infectious Diseases, 24.09.2021
Tilføjet 24.09.2021
qNIV was well tolerated and produced qualitatively and quantitatively enhanced humoral and cellular immune response in older adults compared with IIV4. qNIV might enhance the effectiveness of seasonal influenza vaccination, and future studies to show clinical efficacy are planned.
Læs mere Tjek på PubMedThe Lancet
Lancet, 25.09.2021
Tilføjet 24.09.2021
There were some grounds for hope that the COVID-19 pandemic would be under control by now. Huge scientific advances have been made in our understanding of COVID-19, as well as its countermeasures. Countries have had 18 months to understand which policies work, and to develop strategies accordingly. Yet the pandemic is at a dangerous and shifting stage. Almost 10 000 deaths are reported globally every day. National responses to COVID-19 range from the complete lifting of restrictions in Denmark, to new state-wide lockdowns in Australia, and a growing political and public health crisis in the USA.
Læs mere Tjek på PubMedEun-Ju Lee, Alfred I Lee
Lancet, 7.08.2021
Tilføjet 24.09.2021
An important but rare complication of COVID-19 vaccination is vaccine-induced immune thrombotic thrombocytopenia (VITT) associated with the adenovirus vector vaccines, Ad26.COV2.S (Johnson & Johnson) and ChAdOx1 (Oxford–AstraZeneca).1–5 VITT occurs more commonly in women younger than 50 years who present within 5–24 days of vaccination with thrombosis in unusual sites—the majority with cerebral venous sinus thrombosis.1,6 Thrombocytopenia, elevated D-dimer, decreased fibrinogen, and positive antibodies against platelet factor 4 (PF4) are commonly observed.
Læs mere Tjek på PubMedThomas Radtke, Sarah R. Haile, Holger Dressel, Christian Benden
PLoS One Infectious Diseases, 23.09.2021
Tilføjet 24.09.2021
by Thomas Radtke, Sarah R. Haile, Holger Dressel, Christian Benden
Background We have recently reported reduced physical activity (PA) in people with cystic fibrosis (pwCF) with and without lung transplantation (LTX) during a 6-week stringent lockdown in Switzerland. This follow-up study explores the impact of coronavirus-2019 disease (COVID-19) related pandemic restrictions on individuals’ therapy regimens and health-related aspects in pwCF.
Methods We conducted a cross-sectional web-based national survey in Spring 2021. The survey included questions on daily PA, airway clearance and inhalation therapy, questions on COVID-19-compatible symptoms, diagnostic tests and vaccination status, and enquired health-related aspects covering the pandemic period between March 2020 to April 2021.
Results 193 individuals with CF (53% female; 25% LTX recipients) participated. Among pwCF, 10 reported COVID-19 (n = 2 LTX recipients), two subjects were hospitalized, no invasive ventilation required, no deaths. The clinical course was generally mild. Overall, 46% reported less PA during the pandemic, mostly due to closed fitness facilities (85%), lack of motivation (34%), and changes in daily structures (21%). In contrast, 32/193 (17%) pwCF were able to increase their PA levels: 12 (38%) and 11 (34%) reported undertaking home-based training and outdoor activities more frequently; 6 (19%) reported an increase in routine PA, and another 3 (9%) started new activities. Among pwCF without LTX, 5% and 4% reported to undertake less airway clearance and inhalation therapy, respectively.
Conclusions Our study reveals unfavorable consequences of COVID-19 pandemic restrictions on PA of pwCF with unknown long-term consequences for their overall physical fitness and lung health. Strategies to overcome this undesirable situation are needed; increased uptake of telehealth PA programs and virtual exercise classes to promote PA participation might be one promising approach along with vaccination of pwCF and their close contacts.
Læs mere Tjek på PubMedNaomi Sultan, Irina Shchors, Marc V. Assous, Maskit Bar-Meir
PLoS One Infectious Diseases, 23.09.2021
Tilføjet 24.09.2021
by Naomi Sultan, Irina Shchors, Marc V. Assous, Maskit Bar-Meir
Objective Environmental surface sampling in healthcare settings is not routinely recommended. There are several methods for environmental surface sampling, however the yield of these methods is not well defined. The aim of the present study is to compare two methods of environmental surface sampling, to characterize the neonatal intensive care unit (NICU) flora, compare it with rates of infection and colonization and correlate it with the workload.
Design and setting First, the yield of the swab and the gauze-pad methods were compared. Then, longitudinal surveillance of environmental surface sampling was performed over 6 months,once weekly, from pre-specified locations in the NICU. Samples were streaked onto selective media and bacterial colonies were identified using matrix-assisted laser desorption-ionization time-of-flight (MALDI-TOF).
Results The number of colonies isolated using the gauze pad method was significantly higher compared with the swab method. Overall, 87 bacterial species of 30 different bacterial genera were identified on the NICU environmental surfaces. Of these, 18% species were potential pathogens, and the other represent skin and environmental flora. In 20% of clinical cultures and in 60% of colonization cultures, the pathogen was isolated from the infant’s environment as well. The number of bacteria in environmental cultures was negatively correlated with nurse/patient ratio in the day prior to the culture.
Conclusion The gauze pad method for environmental sampling is robust and readily available. The NICU flora is very diverse and is closely related with the infants’ flora, therefore it may serve as a reservoir for potential pathogens.
Læs mere Tjek på PubMedPhilippe Halfon, Guillaume Penaranda, Hacène Khiri, Vincent Garcia, Hortense Drouet, Patrick Philibert, Christina Psomas, Marion Delord, Frédérique Retornaz, Caroline Charpin, Thomas Gonzales, Hervé Pegliasco, Jérôme Allardet-Servent
PLoS One Infectious Diseases, 23.09.2021
Tilføjet 24.09.2021
by Philippe Halfon, Guillaume Penaranda, Hacène Khiri, Vincent Garcia, Hortense Drouet, Patrick Philibert, Christina Psomas, Marion Delord, Frédérique Retornaz, Caroline Charpin, Thomas Gonzales, Hervé Pegliasco, Jérôme Allardet-Servent
Background & aim We investigated the combination of rapid antigen detection (RAD) and RT-qPCR assays in a stepwise procedure to optimize the detection of COVID-19.
Methods From August 2020 to November 2020, 43,399 patients were screened in our laboratory for COVID-19 diagnostic by RT-qPCR using nasopharyngeal swab. Overall, 4,691 of the 43,399 were found to be positive, and 200 were retrieved for RAD testing allowing comparison of diagnostic accuracy between RAD and RT-qPCR. Cycle threshold (Ct) and time from symptoms onset (TSO) were included as covariates.
Results The overall sensitivity, specificity, PPV, NPV, LR-, and LR+ of RAD compared with RT-qPCR were 72% (95%CI 62%–81%), 99% (95% CI95%–100%), 99% (95%CI 93%–100%), and 78% (95%CI 70%–85%), 0.28 (95%CI 0.21–0.39), and 72 (95%CI 10–208) respectively. Sensitivity was higher for patients with Ct ≤ 25 regardless of TSO: TSO ≤ 4 days 92% (95%CI 75%–99%), TSO > 4 days 100% (95%CI 54%–100%), and asymptomatic 100% (95%CI 78–100%). Overall, combining RAD and RT-qPCR would allow reducing from only 4% the number of RT-qPCR needed.
Conclusions This study highlights the risk of misdiagnosing COVID-19 in 28% of patients if RAD is used alone. A stepwise analysis that combines RAD and RT-qPCR would be an efficient screening procedure for COVID-19 detection and may facilitate the control of the outbreak.
Læs mere Tjek på PubMedMeng-Jia Lau, Ary A. Hoffmann, Nancy M. Endersby-Harshman
PLoS One Infectious Diseases, 23.09.2021
Tilføjet 24.09.2021
by Meng-Jia Lau, Ary A. Hoffmann, Nancy M. Endersby-Harshman
Detection of the Wolbachia endosymbiont in Aedes aegypti mosquitoes through real-time polymerase chain reaction assays is widely used during and after Wolbachia releases in dengue reduction trials involving the wMel and wAlbB strains. Although several different primer pairs have been applied in current successful Wolbachia releases, they cannot be used in a single assay to distinguish between these strains. Here, we developed a new diagnostic primer pair, wMwA, which can detect the wMel or wAlbB infection in the same assay. We also tested current Wolbachia primers and show that there is variation in their performance when they are used to assess the relative density of Wolbachia. The new wMwA primers provide an accurate and efficient estimate of the presence and density of both Wolbachia infections, with practical implications for Wolbachia estimates in field collected Ae. aegypti where Wolbachia releases have taken place.
Læs mere Tjek på PubMedNoorwati Sutandyo, Sri Agustini Kurniawati, Achmad Mulawarman Jayusman, Anisa Hana Syafiyah, Raymond Pranata, Arif Riswahyudi Hanafi
PLoS One Infectious Diseases, 23.09.2021
Tilføjet 24.09.2021
by Noorwati Sutandyo, Sri Agustini Kurniawati, Achmad Mulawarman Jayusman, Anisa Hana Syafiyah, Raymond Pranata, Arif Riswahyudi Hanafi
Background In this study, we aimed to investigate whether FIB-4 index is useful in predicting mortality in patients with concurrent hematological malignancies and COVID-19. We also aimed to determine the optimal cut-off point for the prediction.
Methods This is a single-center retrospective cohort study conducted in Dharmais National Cancer Hospital, Indonesia. Consecutive sampling of adults with hematological malignancies and COVID-19 was performed between May 2020 and January 2021. COVID-19 screening test using the reverse transcriptase polymerase chain reaction (RT-PCR) of nasopharyngeal samples were performed prior to hospitalization for chemotherapy. FIB-4 index is derived from [age (years) × AST (IU/L)]/[platelet count (109/L) × √ALT (U/L)]. The primary outcome of this study is mortality, defined as clinically validated death/non-survivor during a 3-months (90 days) follow-up.
Results There were a total of 70 patients with hematological malignancies and COVID-19 in this study. Median FIB-4 Index was higher in non-survivors (13.1 vs 1.02, p<0.001). FIB-4 index above 3.85 has a sensitivity of 79%, specificity of 84%, PLR of 5.27, and NLR of 0.32. The AUC was 0.849 95% CI 0.735–0.962, p<0.001. This cut-off point was associated with OR of 16.70 95% CI 4.07–66.67, p<0.001. In this study, a FIB-4 >3.85 confers to 80% posterior probability of mortality and FIB-4 3.85 was associated with shorter time-to-mortality (HR 9.10 95% CI 2.99–27.65, p<0.001). Multivariate analysis indicated that FIB-4 >3.85 (HR 4.09 95% CI 1.32–12.70, p = 0.015) and CRP> 71.57 mg/L (HR 3.36 95% CI 1.08–10.50, p = 0.037) were independently associated with shorter time-to-mortality.
Conclusion This study indicates that a FIB-4 index >3.85 was independent predictor of mortality in patients with hematological malignancies and COVID-19 infection.
Læs mere Tjek på PubMedSahar Saeed, Sheila F. O’Brien, Kento Abe, Qi-Long Yi, Bhavisha Rathod, Jenny Wang, Mahya Fazel-Zarandi, Ashleigh Tuite, David Fisman, Heidi Wood, Karen Colwill, Anne-Claude Gingras, Steven J. Drews
PLoS One Infectious Diseases, 23.09.2021
Tilføjet 24.09.2021
by Sahar Saeed, Sheila F. O’Brien, Kento Abe, Qi-Long Yi, Bhavisha Rathod, Jenny Wang, Mahya Fazel-Zarandi, Ashleigh Tuite, David Fisman, Heidi Wood, Karen Colwill, Anne-Claude Gingras, Steven J. Drews
Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence studies bridge the gap left from case detection, to estimate the true burden of the COVID-19 pandemic. While multiple anti-SARS-CoV-2 immunoassays are available, no gold standard exists.
Methods This serial cross-sectional study was conducted using plasma samples from 8999 healthy blood donors between April-September 2020. Each sample was tested by four assays: Abbott SARS-Cov-2 IgG assay, targeting nucleocapsid (Abbott-NP) and three in-house IgG ELISA assays (targeting spike glycoprotein, receptor binding domain, and nucleocapsid). Seroprevalence rates were compared using multiple composite reference standards and by a series of Bayesian Latent Class Models.
Result We found 13 unique diagnostic phenotypes; only 32 samples (0.4%) were positive by all assays. None of the individual assays resulted in seroprevalence increasing monotonically over time. In contrast, by using the results from all assays, the Bayesian Latent Class Model with informative priors predicted seroprevalence increased from 0.7% (95% credible interval (95% CrI); 0.4, 1.0%) in April/May to 0.7% (95% CrI 0.5, 1.1%) in June/July to 0.9% (95% CrI 0.5, 1.3) in August/September. Assay characteristics varied over time. Overall Spike had the highest sensitivity (93.5% (95% CrI 88.7, 97.3%), while the sensitivity of the Abbott-NP assay waned from 77.3% (95% CrI 58.7, 92.5%) in April/May to 64.4% (95% CrI 45.6, 83.0) by August/September.
Discussion Our results confirmed very low seroprevalence after the first wave in Canada. Given the dynamic nature of this pandemic, Bayesian Latent Class Models can be used to correct for imperfect test characteristics and waning IgG antibody signals.
Læs mere Tjek på PubMedSuellen Hopfer, Emilia J. Fields, Yuwen Lu, Ganesh Ramakrishnan, Ted Grover, Quishi Bai, Yicong Huang, Chen Li, Gloria Mark
PLoS One Infectious Diseases, 23.09.2021
Tilføjet 24.09.2021
by Suellen Hopfer, Emilia J. Fields, Yuwen Lu, Ganesh Ramakrishnan, Ted Grover, Quishi Bai, Yicong Huang, Chen Li, Gloria Mark
Introduction Twitter represents a mainstream news source for the American public, offering a valuable vehicle for learning how citizens make sense of pandemic health threats like Covid-19. Masking as a risk mitigation measure became controversial in the US. The social amplification risk framework offers insight into how a risk event interacts with psychological, social, institutional, and cultural communication processes to shape Covid-19 risk perception.
Methods Qualitative content analysis was conducted on 7,024 mask tweets reflecting 6,286 users between January 24 and July 7, 2020, to identify how citizens expressed Covid-19 risk perception over time. Descriptive statistics were computed for (a) proportion of tweets using hyperlinks, (b) mentions, (c) hashtags, (d) questions, and (e) location.
Results Six themes emerged regarding how mask tweets amplified and attenuated Covid-19 risk: (a) severity perceptions (18.0%) steadily increased across 5 months; (b) mask effectiveness debates (10.7%) persisted; (c) who is at risk (26.4%) peaked in April and May 2020; (d) mask guidelines (15.6%) peaked April 3, 2020, with federal guidelines; (e) political legitimizing of Covid-19 risk (18.3%) steadily increased; and (f) mask behavior of others (31.6%) composed the largest discussion category and increased over time. Of tweets, 45% contained a hyperlink, 40% contained mentions, 33% contained hashtags, and 16.5% were expressed as a question.
Conclusions Users ascribed many meanings to mask wearing in the social media information environment revealing that COVID-19 risk was expressed in a more expanded range than objective risk. The simultaneous amplification and attenuation of COVID-19 risk perception on social media complicates public health messaging about mask wearing.
Læs mere Tjek på PubMedRogério Fernandes Carvalho, Monike da Silva Oliveira, Juliane Ribeiro, Isac Gabriel Cunha dos Santos, Katyane de Sousa Almeida, Ana Carolina Muller Conti, Bruna Alexandrino, Fabrício Souza Campos, Célia Maria de Almeida Soares, José Carlos Ribeiro Júnior
PLoS One Infectious Diseases, 23.09.2021
Tilføjet 24.09.2021
by Rogério Fernandes Carvalho, Monike da Silva Oliveira, Juliane Ribeiro, Isac Gabriel Cunha dos Santos, Katyane de Sousa Almeida, Ana Carolina Muller Conti, Bruna Alexandrino, Fabrício Souza Campos, Célia Maria de Almeida Soares, José Carlos Ribeiro Júnior
SARS-CoV-2 has spread worldwide and has become a global health problem. As a result, the demand for inputs for diagnostic tests rose dramatically, as did the cost. Countries with inadequate infrastructure experience difficulties in expanding their qPCR testing capacity. Therefore, the development of sensitive and specific alternative methods is essential. This study aimed to develop, standardize, optimize, and validate conventional RT-PCR targeting the N gene of SARS-CoV-2 in naso-oropharyngeal swab samples compared to qPCR. Using bioinformatics tools, specific primers were determined, with a product expected to be 519 bp. The reaction conditions were optimized using a commercial positive control, and the detection limit was determined to be 100 fragments. To validate conventional RT-PCR, we determined a representative sampling of 346 samples from patients with suspected infection whose diagnosis was made in parallel with qPCR. A sensitivity of 92.1% and specificity of 100% were verified, with an accuracy of 95.66% and correlation coefficient of 0.913. Under current Brazilian conditions, this method generates approximately 60% savings compared to qPCR costs. Conventional RT-PCR, validated herein, showed sufficient results for the detection of SARS-CoV-2 and can be used as an alternative for epidemiological studies and interspecies correlations.
Læs mere Tjek på PubMedVictoria Coathup, Claire Carson, Jennifer J. Kurinczuk, Alison J. Macfarlane, Elaine Boyle, Samantha Johnson, Stavros Petrou, Maria A. Quigley
PLoS One Infectious Diseases, 23.09.2021
Tilføjet 24.09.2021
by Victoria Coathup, Claire Carson, Jennifer J. Kurinczuk, Alison J. Macfarlane, Elaine Boyle, Samantha Johnson, Stavros Petrou, Maria A. Quigley
Background Children born preterm (
Læs mere Tjek på PubMedTomasz Daniel Jakubowski, Magdalena Maja Sitko-Dominik
PLoS One Infectious Diseases, 23.09.2021
Tilføjet 24.09.2021
by Tomasz Daniel Jakubowski, Magdalena Maja Sitko-Dominik
Background Teaching work is stressful, moreover during the pandemic teachers’ stress might have been intensified by distance education as well as by limited access to social support, which functions as a buffer in experiencing stress. The aim of the research was to investigate the relation between distance education and teachers’ well-being, and their close relations and other social relations during the first two waves of the COVID-19 pandemic.
Methods The research was conducted in two stages on 285 Polish primary and secondary school teachers who were recruited by means of the chain referral method. The following measures were used: The Depression Anxiety & Stress Scales-21, Berlin Social Support Scales, The Relationship Satisfaction Scale and The Injustice Experience Questionnaire.
Results The teachers experienced at least mild levels of stress, anxiety and depression, both during the first as well as the second waves of the COVID-19 pandemic in Poland. It has been confirmed that there is a negative relation between relationship quality change and social relations quality change, and stress, anxiety and depression. The variables taken into consideration in the research have provided the explanation for the variation of stress—from 6% in the first stage of the research to 47% in the second stage; for the variation of anxiety—from 21% to 31%; and for the variation of depression—from 12% to 46%, respectively.
Conclusions The research results show that due to distance work the distinction between professional work and family life might have been blurred, and as a consequence teachers’ well-being could have been worsened. The isolation put on to stop the spreading of the virus might have contributed to changes in social relations, in close relations in particular, and at the same time negatively influenced teachers’ abilities to effectively cope with the crisis situations.
Læs mere Tjek på PubMedYuhuan Yin, Fugui Shi, Yiyin Zhang, Xiaoli Zhang, Jianying Ye, Juxia Zhang
PLoS One Infectious Diseases, 23.09.2021
Tilføjet 24.09.2021
by Yuhuan Yin, Fugui Shi, Yiyin Zhang, Xiaoli Zhang, Jianying Ye, Juxia Zhang
Objective To evaluate the reporting quality of randomized controlled trials (RCTs) regarding patients with COVID-19 and analyse the influence factors.
Methods PubMed, Embase, Web of Science and the Cochrane Library databases were searched to collect RCTs regarding patients with COVID-19. The retrieval time was from the inception to December 1, 2020. The CONSORT 2010 statement was used to evaluate the overall reporting quality of these RCTs.
Results 53 RCTs were included. The study showed that the average reporting rate for 37 items in CONSORT checklist was 53.85% with mean overall adherence score of 13.02±3.546 (ranged: 7 to 22). The multivariate linear regression analysis showed the overall adherence score to the CONSORT guideline was associated with journal impact factor (P = 0.006), and endorsement of CONSORT statement (P = 0.014).
Conclusion Although many RCTs of COVID-19 have been published in different journals, the overall reporting quality of these articles was suboptimal, it can not provide valid evidence for clinical decision-making and systematic reviews. Therefore, more journals should endorse the CONSORT statement, authors should strictly follow the relevant provisions of the CONSORT guideline when reporting articles. Future RCTs should particularly focus on improvement of detailed reporting in allocation concealment, blinding and estimation of sample size.
Læs mere Tjek på PubMedDalia Omran, Mohamed Al Soda, Eshak Bahbah, Gamal Esmat, Hend Shousha, Ahmed Elgebaly, Muhammad Abdel Ghaffar, Mohamed Alsheikh, Enass El Sayed, Shimaa Afify, Samah Abdel Hafez, Khaled Elkelany, Ayman Eltayar, Omnia Ali, Lamiaa Kamal, Ahmed Heiba
PLoS One Infectious Diseases, 23.09.2021
Tilføjet 24.09.2021
by Dalia Omran, Mohamed Al Soda, Eshak Bahbah, Gamal Esmat, Hend Shousha, Ahmed Elgebaly, Muhammad Abdel Ghaffar, Mohamed Alsheikh, Enass El Sayed, Shimaa Afify, Samah Abdel Hafez, Khaled Elkelany, Ayman Eltayar, Omnia Ali, Lamiaa Kamal, Ahmed Heiba
Objectives We conducted the present multicenter, retrospective study to assess the epidemiological, clinical, laboratory, and radiological characteristics associated with critical illness among patients with COVID-19 from Egypt.
Methods The present study was a multicenter, retrospective study that retrieved the data of all Egyptian cases with confirmed COVID-19 admitted to hospitals affiliated to the General Organization for Teaching Hospitals and Institutes (GOTHI) through the period from March to July 2020. The diagnosis of COVID-19 was based on a positive reverse transcription-polymerase chain reaction (RT-PCR) laboratory test.
Results This retrospective study included 2724 COVID-19 patients, of whom 423 (15.52%) were critically ill. Approximately 45.86% of the critical group aged above 60 years, compared to 39.59% in the non-critical group (p = 0.016). Multivariate analysis showed that many factors were predictors of critically illness, including age >60 years (OR = 1.30, 95% CI [1.05, 1.61], p = 0.014), low oxygen saturation (OR = 0.93, 95% CI [0.91, 0.95], p<0.001), low Glasgow coma scale (OR = 0.75, 95% CI [0.67, 0.84], p<0.001), diabetes (OR = 1.62, 95% CI [1.26, 2.08], p<0.001), cancer (OR = 2.47, 95% CI [1.41, 4.35], p = 0.002), and serum ferritin (OR = 1.004, 95% CI [1.0003, 1.008], p = 0.031).
Conclusion In the present report, we demonstrated that many factors are associated with COVID-19 critical illness, including older age groups, fatigue, elevated temperature, increased pulse, lower oxygen saturation, the preexistence of diabetes, malignancies, cardiovascular disease, renal diseases, and pulmonary disease. Moreover, elevated serum levels of ALT, AST, and ferritin are associated with worse outcomes. Further studies are required to identify independent predictors of mortality for patients with COVID-19.
Læs mere Tjek på PubMedBernt Hjertner, Claudia Lützelschwab, Elise Schieck, Benjamin Nzau, Sonal Henson, Marie Sjölund, Caroline Fossum, Ulf Magnusson
PLoS One Infectious Diseases, 23.09.2021
Tilføjet 24.09.2021
by Bernt Hjertner, Claudia Lützelschwab, Elise Schieck, Benjamin Nzau, Sonal Henson, Marie Sjölund, Caroline Fossum, Ulf Magnusson
Indiscriminate use of antibiotics to treat infections that are of viral origin contributes to unnecessary use which potentially may induce resistance in commensal bacteria. To counteract this a number of host gene transcriptional studies have been conducted to identify genes that are differently expressed during bacterial and viral infections in humans, and thus could be used as a tool to base decisions on the use of antibiotics. In this paper, we aimed to evaluate the potential of a selection of genes that have been considered biomarkers in humans, to differentially diagnose bacterial from viral infections in the pig. First porcine PBMC were induced with six toll-like receptor (TLR) agonists (FliC, LPS, ODN 2216, Pam3CSK4, poly I:C, R848) to mimic host gene expression induced by bacterial or viral pathogens, or exposed to heat-killed Actinobacillus pleuropneumoniae or a split influenza virus. Genes that were differentially expressed between bacterial and viral inducers were further evaluated on clinical material comprising eleven healthy pigs, and six pigs infected with A. pleuropneumoniae. This comprised three virally upregulated genes (IFI44L, MxA, RSAD2) and four bacterially upregulated genes (IL-1β, IL-8, FAM89A, S100PBP). All six infected pigs could be differentially diagnosed to healthy pigs using a host gene transcription assay based on the geometric average of the bacterially induced genes IL-8 and S100PBP over that of the virally induced gene MxA.
Læs mere Tjek på PubMedBouzanis, K., Joshi, S., Lokker, C., Pavalagantharajah, S., Qiu, Y., Sidhu, H., Mbuagbaw, L., Qutob, M., Henedi, A., Levine, M. A. H., Lennox, R., Tarride, J.-E., Kalina, D., Alvarez, E.
BMJ Open, 23.09.2021
Tilføjet 23.09.2021
Objectives
People who inject drugs (PWID) experience a high burden of injection drug use-related infectious disease and challenges in accessing adequate care. This study sought to identify programmes and services in Canada addressing the prevention and management of infectious disease in PWID.
Design
This study employed a systematic integrative review methodology. Electronic databases (PubMed, CINAHL and Web of Science Core Collection) and relevant websites were searched for literature published between 2008 and 2019 (last search date was 6 June 2019). Eligible articles and documents were required to address injection or intravenous drug use and health programmes or services relating to the prevention or management of infectious diseases in Canada.
Results
This study identified 1607 unique articles and 97 were included in this study. The health programmes and services identified included testing and management of HIV and hepatitis C virus (n=27), supervised injection facilities (n=19), medication treatment for opioid use disorder (n=12), integrated infectious disease and addiction programmes (n=10), needle exchange programmes (n=9), harm reduction strategies broadly (n=6), mobile care initiatives (n=5), peer-delivered services (n=3), management of IDU-related bacterial infections (n=2) and others (n=4). Key implications for policy, practice and future research were identified based on the results of the included studies, which include addressing individual and systemic factors that impede care, furthering evaluation of programmes and the need to provide comprehensive care to PWID, involving medical care, social support and harm reduction.
Conclusions
These results demonstrate the need for expanded services across a variety of settings and populations. Our study emphasises the importance of addressing social and structural factors that impede infectious disease care for PWID. Further research is needed to improve evaluation of health programmes and services and contextual factors surrounding accessing services or returning to care.
PROSPERO registration number
CRD42020142947.
Læs mere Tjek på PubMedMoss, S. J., Stelfox, H. T., Krewulak, K. D., Ahmed, S., Anglin, M. C., Bagshaw, S. M., Barnes, T., Burns, K. E. A., Cook, D. J., Crowe, S., Doig, C. J., Foster, N., Fox-Robichaud, A., Fowler, R., Kredenster, M., Murthy, S., Niven, D., Olafson, K., Parhar, K. K. S., Patten, S. B., Rewa, O., Rochwerg, B., Sept, B. G., Soo, A., Spence, K., Spence, S., Straus, S. E., West, A., Parsons Leigh, J., Fiest, K. M.
BMJ Open, 23.09.2021
Tilføjet 23.09.2021
Introduction
Flexible visitation policies in hospitals are an important component of care that contributes to reduced stress and increased satisfaction among patients and their family members. Early evidence suggests restricted visitation policies enacted in hospitals during the COVID-19 pandemic are having unintended consequences on patients, family members and healthcare providers. There is a need for a comprehensive summary of the impacts of restricted visitation policies on key stakeholders and approaches to mitigate that impact.
Methods and analysis
We will conduct a scoping review as per the Arksey-O’Malley 5-stage scoping review method and the Scoping Review Methods Manual by the Joanna Briggs Institute. We will search relevant electronic databases (eg, CINAHL, MEDLINE, PsycINFO), grey literature and preprint repositories. We will include all study designs including qualitative and quantitative methodologies (excluding protocols) as well as reports, opinions and editorials, to identify the broad impact of restricted hospital visitation policies due to the COVID-19 pandemic on patients, family members or healthcare providers of hospitalised patients, and approaches taken or proposed to mitigate this impact. Two reviewers will calibrate the screening criteria and data abstraction form and will independently screen studies and abstract the data. Narrative synthesis with thematic analysis will be performed.
Ethics and dissemination
Ethical approval is not applicable as this review will be conducted on published literature only. This scoping review will identify, describe and categorise impacts of restricted hospital visitation policies due to the COVID-19 pandemic on patients, family members and healthcare providers of hospitalised patients, and approaches that have been taken to mitigate impact. We will provide a comprehensive synthesis by developing a framework of restricted visitation policies and associated impacts. Our results will inform the development of consensus statements on restricted visitation policies to be implemented in future pandemics.
PROSPERO registration number
CRD42020221662.
Læs mere Tjek på PubMedKhan, S. M. S., Qurieshi, M. A., Haq, I., Majid, S., Ahmad, J., Ayub, T., Bhat, A. A., Fazili, A. B., Ganai, A. M., Jan, Y., Kaul, R.-u.-R., Khan, Z. A., Masoodi, M. A., Mushtaq, B., Nazir, F., Nazir, M., Raja, M. W., Rasool, M., Asma, A., Ayoub, S., Aziz, M., Bhat, A. A., Chowdri, I. N., Ismail, S., Kawoosa, M. F., Khan, M. A., Khan, M. S., Kousar, R., Lone, A. A., Nabi, S., Obaid, M., Qazi, T. B., Sabah, I., Sumji, I. A.
BMJ Open, 23.09.2021
Tilføjet 23.09.2021
Objectives
We designed a population-based survey in Kashmir to estimate the seroprevalence of SARS-CoV-2-specific IgG antibodies in the general population aged 18 years and above.
Setting
The survey was conducted among 110 villages and urban wards across 10 districts in Kashmir from 17 October 2020 to 4 November 2020.
Participants
Individuals aged 18 years and above were eligible to be included in the survey. Serum samples were tested for the presence of SARS-CoV-2-specific IgG antibodies using the Abbott SARS-CoV-2 IgG assay.
Primary and secondary outcome measures
We labelled assay results equal to or above the cut-off index value of 1.4 as positive for SARS-CoV-2-specific IgG antibodies. Seroprevalence estimates were adjusted for the sampling design and assay characteristics.
Results
Out of 6397 eligible individuals enumerated, 6315 (98.7%) agreed to participate. The final analysis was done on 6230 participants. Seroprevalence adjusted for the sampling design and assay characteristics was 36.7% (95% CI 34.3% to 39.2%). Seroprevalence was higher among the older population. Among seropositive individuals, 10.2% (247/2415) reported a history of COVID-19-like symptoms. Out of 474 symptomatic individuals, 233 (49.2%) reported having been tested. We estimated an infection fatality rate of 0.034%.
Conclusions
During the first 7 months of the COVID-19 epidemic in Kashmir Valley, approximately 37% of individuals were infected. The reported number of COVID-19 cases was only a small fraction of the estimated number of infections. A more efficient surveillance system with strengthened reporting of COVID-19 cases and deaths is warranted.
Læs mere Tjek på PubMedPhilippe Buchy, Yves Buisson, Otavio Cintra, Dominic E Dwyer, Michael Nissen, Raul Ortiz de Lejarazu, Eskild Petersen
International Journal of Infectious Diseases, 23.09.2021
Tilføjet 23.09.2021
Since the 1980s, at least 30 new infectious disease threats have emerged (Mukherjee, 2017). Of emerging infectious diseases (EIDs) identified since 1940, 60% were zoonotic in nature, of which 70% originated in wildlife (Jones et al., 2008). This trend is expected to rise because of increased human–animal contact, climate change, land use changes, global population growth, and increased global interconnectedness (Jones et al., 2008, Mukherjee, 2017, Petersen et al., 2018).
Læs mere Tjek på PubMedBetty Balikagala, Naoyuki Fukuda, Mie Ikeda, Osbert T. Katuro, Shin-Ichiro Tachibana, Masato Yamauchi, Walter Opio, Sakurako Emoto, Denis A. Anywar, Eisaku Kimura, Nirianne M.Q. Palacpac, Emmanuel I. Odongo-Aginya, Martin Ogwang, Toshihiro Horii, Toshihiro Mita
New England Journal of Medicine, 22.09.2021
Tilføjet 23.09.2021
New England Journal of Medicine, Volume 385, Issue 13, Page 1163-1171, September 2021.
Læs mere Tjek på PubMedMadeleine I. Matthiesen, Randheer Shailam, Holly Rothermel
New England Journal of Medicine, 22.09.2021
Tilføjet 23.09.2021
New England Journal of Medicine, Volume 385, Issue 13, Page 1220-1229, September 2021.
Læs mere Tjek på PubMedNicholas J. White
New England Journal of Medicine, 22.09.2021
Tilføjet 23.09.2021
New England Journal of Medicine, Volume 385, Issue 13, Page 1231-1232, September 2021.
Læs mere Tjek på PubMedEric J. Rubin, Lindsey R. Baden, Stephen Morrissey
New England Journal of Medicine, 22.09.2021
Tilføjet 23.09.2021
T. Jake Liang, Jordan J. Feld, Andrea L. Cox, Charles M. Rice
New England Journal of Medicine, 22.09.2021
Tilføjet 23.09.2021
New England Journal of Medicine, Volume 385, Issue 13, Page 1235-1240, September 2021.
Læs mere Tjek på PubMedJamie L. Stokke, Linda J. Szymanski, Bettina Bankamp, Franklin Pratt, Roosecelis Martines, Jennifer Dien-Bard, Sindhu Mohandas
New England Journal of Medicine, 22.09.2021
Tilføjet 23.09.2021
New England Journal of Medicine, Volume 385, Issue 13, Page 1246-1248, September 2021.
Læs mere Tjek på PubMedTamara Pilishvili, Ryan Gierke, Katherine E. Fleming-Dutra, Jennifer L. Farrar, Nicholas M. Mohr, David A. Talan, Anusha Krishnadasan, Karisa K. Harland, Howard A. Smithline, Peter C. Hou, Lilly C. Lee, Stephen C. Lim, Gregory J. Moran, Elizabeth Krebs, Mark T. Steele, David G. Beiser, Brett Faine, John P. Haran, Utsav Nandi, Walter A. Schrading, Brian Chinnock, Daniel J. Henning, Frank Lovecchio, Jane Lee, Devra Barter, Monica Brackney, Scott K. Fridkin, Kaytlynn Marceaux-Galli, Sarah Lim, Erin C. Phipps, Ghinwa Dumyati, Rebecca Pierce, Tiffanie M. Markus, Deverick J. Anderson, Amanda K. Debes, Michael Y. Lin, Jeanmarie Mayer, Jennie H. Kwon, Nasia Safdar, Marc Fischer, Rosalyn Singleton, Nora Chea, Shelley S. Magill, Jennifer R. Verani, Stephanie J. Schrag
New England Journal of Medicine, 22.09.2021
Tilføjet 23.09.2021
Hana M. El Sahly, Lindsey R. Baden, Brandon Essink, Susanne Doblecki-Lewis, Judith M. Martin, Evan J. Anderson, Thomas B. Campbell, Jesse Clark, Lisa A. Jackson, Carl J. Fichtenbaum, Marcus Zervos, Bruce Rankin, Frank Eder, Gregory Feldman, Christina Kennelly, Laurie Han-Conrad, Michael Levin, Kathleen M. Neuzil, Lawrence Corey, Peter Gilbert, Holly Janes, Dean Follmann, Mary Marovich, Laura Polakowski, John R. Mascola, Julie E. Ledgerwood, Barney S. Graham, Allison August, Heather Clouting, Weiping Deng, Shu Han, Brett Leav, Deb Manzo, Rolando Pajon, Florian Schödel, Joanne E. Tomassini, Honghong Zhou, Jacqueline Miller
New England Journal of Medicine, 22.09.2021
Tilføjet 23.09.2021
Jian Wu, Mariza Bortolanza, Guanghua Zhai, Anquan Shang, Zongxin Ling, Bin Jiang, Xiaochen Shen, Yiwen Yao, Jiong Yu, Lanjuan Li, Hongcui Cao
Journal of Medical Virology, 22.09.2021
Tilføjet 23.09.2021
Leonard B. Weinstock, Jill B. Brook, Arthur S. Walters, Ashleigh Goris, Lawrence B. Afrin, Gerhard J. Molderings
International Journal of Infectious Diseases, 23.09.2021
Tilføjet 23.09.2021
Haijun Tong
Frontiers in Immunology, 26.10.2022
Tilføjet 23.09.2021
Dendritic cells (DCs) are composed of multiple lineages of hematopoietic cells and orchestrate immune responses upon detecting the danger and inflammatory signals associated with pathogen and damaged tissues. Under steady-state, DCs are maintained at limited numbers and the functionally quiescent status. While it is known that a fine balance in the DC homeostasis and activation status is also important to prevent autoimmune diseases and hyperinflammation, mechanisms that control DC development and activation under stead-state remain not fully understood. Here we show that DC-specific ablation of CBL and CBL-B (CBL-/-CBL-B-/-) leads to spontaneous liver inflammation and fibrosis and early death of the mice. The mutant mice have a marked expansion of classic CD8α+/CD103+ DCs (cDC1s) in peripheral lymphoid organs and the liver. These DCs exhibit atypical activation phenotypes characterized by an increased production of inflammatory cytokines and chemokines but not the cell surface MHC-II and costimulatory ligands. While the mutant mice also have massive T cell activation, lymphocytes are not required for the disease development. The CBL-/-CBL-B-/- mutation enhances FLT3-mTOR signaling, due to defective FLT3 ubiquitination and degradation. Blockade of FLT3-mTOR signaling normalizes the homeostasis of cDC1s and attenuates liver inflammation. Our result thus reveals a critical role of CBLs in the maintenance of DC homeostasis and immune quiescence. This regulation could be relevant to liver inflammatory diseases and fibrosis in humans.
Læs mere Tjek på PubMedOr Shalev, Christoph Ratzke
Trends in Microbiology, 22.09.2021
Tilføjet 23.09.2021
Microbes often live associated with other organisms. Whereas the impact of microbes on their hosts is well studied, what such a lifestyle means for the microbes is poorly understood. To address this gap, Bansept et al. explore how microbes could evolve to cope with altering between host-associated and host-free lifestyles.
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