Nyt fra tidsskrifterne
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Ingen søgeord valgt.
40 emner vises.
Jules Rimet Borges, Francesco Lacarrubba, Henrique Moura de Paula, Mayra Ianhez, Marco Tulio Antonio Garcia-Zapata
International Journal of Infectious Diseases, 18.09.2021
Tilføjet 18.09.2021
In vivo reflectance confocal microscopy (RCM) is a non-invasive technique that provides real-time images of the skin structures in a grey scale, at a resolution similar to histopathology, in planes parallel to the skin surface to the depth of the superficial dermis (Gonzalez, 2012). Highly reflective skin components such as melanin acts as an endogenous source of contrast and appear bright (white) in RCM images. Chromoblastomycosis is an infectious disease characterized by the occurrence of verrucous plaques on the limbs.
Læs mere Tjek på PubMedThomas G. Egwang, Tonny Jimmy Owalla, Emmanuel Okurut, Gonzaga Apungia, Alisa Fox, Claire De Carlo, Rebecca L. Powell
International Journal of Infectious Diseases, 18.09.2021
Tilføjet 18.09.2021
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide causing > 177,100,000 coronavirus disease 2019 (COVID-19) cases by June 18, 2021(World Health Organization, 2021). Uganda, like other African countries, has registered fewer COVID-19 cases and deaths per capita than non-African countries (World Health Organization, 2021). The lower numbers of cases and deaths in Africa by comparison with those in Western countries might be partly due to cross-immunity induced by circulating common cold human corona viruses (HCoVs) (Doshi, 2020).
Læs mere Tjek på PubMedKato Yuki, Shigehara Kazuyoshi, Nakagawa Tomomi, Nakata Hiroki, Iijima Masashi, Nakashima Kazufumi, Kawaguchi Shohei, Izumi Kouji, Kadono Yoshifumi, Mizokami Atsushi
International Journal of Infectious Diseases, 18.09.2021
Tilføjet 18.09.2021
A. Moreno, C. Vargas, F. Azocar, F. Villarroel, M. Cofré, H. Oppliger, F. Ríos, M. Raijmakers, I. Silva, C. Beltrán, F. Zamora
International Journal of Infectious Diseases, 18.09.2021
Tilføjet 18.09.2021
In Chile, the first patient with COVID-19 was diagnosed in March 2020. The disease spread rapidly, causing a first wave of infections that had its peak on epidemiological week 27, corresponding to the week of July 3rd, 2020, mainly affecting the capital, Santiago.
Læs mere Tjek på PubMedBanda A. Khalifa, Enoch J. Abbey, Samuel K. Ayeh, Hasiya E. Yusuf, Richard D Nudotor, Ngozi Osuji, Samiha Khan, Esosa Nosakhare, Modupe O. Oduwole, Emmanuella L. Salia, Oluwatobi Lasisi, Petros C. Karakousis
International Journal of Infectious Diseases, 18.09.2021
Tilføjet 18.09.2021
Sonia Vu, Nicolas Belaube, Ana Canestri, Michel Develoux, Alicia Moreno, Eric Fourniols, Minh Patrick Lê, Ludovic Lassel, Gilles Pialoux, Ruxandra Calin
International Journal of Infectious Diseases, 18.09.2021
Tilføjet 18.09.2021
Delphine Girlich, Souad Ouzani, Isabelle Langlois, Nicolas Fortineau, Thierry Naas, Laurent Dortet
International Journal of Infectious Diseases, 18.09.2021
Tilføjet 18.09.2021
Carbapenemase-producing Enterobacterales (CPE) have emerged as a worrying nosocomial issue worldwide. Rapid and accurate detection is crucial to limit the spread of these extremely drug resistant pathogens. Culture-based methods to detect CPEs are often time-consuming and take several days (2 to 5 days). Xpert® Carba-R (Cepheid, France), based on real-time PCR, is now widely used at the first day of admission of “high-risk” patients. The most obvious benefit of this test is that it can be performed directly on rectal swab sample or stools leading to available result in less than an hour after sample proceeding by the laboratory.
Læs mere Tjek på PubMedAna M Correia, Vítor Borges, Joana Isidro, Ana R Lima, Alberto Fernandes, Maria Leonor Godinho, Sílvia Duarte, José Ferrão, Luís Vieira, João P Gomes
International Journal of Infectious Diseases, 18.09.2021
Tilføjet 18.09.2021
On 27 May 2020, WHO updated criteria for releasing COVID-19 patients from isolation, exempting the need to perform a laboratory RT-PCR test [WHO, 2020; WHO, 2020], considering that, even if a positive result is obtained after symptoms resolution, patients are unlikely to be infectious and therefore are not able to originate secondary cases [WHO, 2020]. Aligned with this, the recovery of replication-competent virus from re-positive patients has been unsuccessful [Choi B, 2020; Corral-Lugo A, 2020] and no cases of infection among people who had contact with re-positive patients have been reported to date [Dao TL, 2020; ECDC, 2020; ECDC, 2020; Gao Z, 2020; Kang YJ, 2020].
Læs mere Tjek på PubMedPasa Sukson, Chalerm Liwsrisakun, Juthamas Inchai, Konlawij Trongtrakul, Pattraporn Tajarernmuang
International Journal of Infectious Diseases, 18.09.2021
Tilføjet 18.09.2021
Josef Finsterer
International Journal of Infectious Diseases, 18.09.2021
Tilføjet 18.09.2021
Napaporn Chantasrisawad, Watsamon Jantarabenjakul, Suvaporn Anugulruengkitt, Suda Punrin, Kornvika Limsuwun, Panadda Sawangsinth, Chayapa Phasomsap, Jiratchaya Sophonphan, Chitsanu Pancharoen, Thanyawee Puthanakit
International Journal of Infectious Diseases, 18.09.2021
Tilføjet 18.09.2021
Jing Bi, Qinglong Guo, Xiangdong Fu, Juan Liang, Lidong Zeng, Min Ou, Juanjuan Zhang, Zhaoqin Wang, Yicheng Sun, Lei Liu, Guoliang Zhang
International Journal of Infectious Diseases, 18.09.2021
Tilføjet 18.09.2021
Tuberculosis (TB) caused by the pathogenic agent of Mycobacterium tuberculosis (Mtb), remains a major global health threat. There were approximate 10 million new TB cases and 1.40 million deaths in the world in 2018 (World Health Organization, 2019). Moreover, about half a million of new cases were rifampicin-resistant TB, of which 78% had multidrug-resistant (MDR) TB (World Health Organization, 2019). Although the treatment success rate can reach up to 85% after standard 2HRZE/4HR (a 2-month intensive phase of isoniazid (H), rifampin (R), pyrazinamide (Z), and ethambutol (E), followed by a 4-month continuation phase of rifampin and isoniazid) anti-TB treatment, the treatment cycle is too long to obtain excellent compliance conducing to relapse and drug resistance.
Læs mere Tjek på PubMedGuglielmo Bonaccorsi, Sonia Paoli, Massimiliano Alberto Biamonte, Andrea Moscadelli, Lorenzo Baggiani, Marco Nerattini, Vieri Lastrucci, Patrizio Zanobini, Chiara Lorini
International Journal of Infectious Diseases, 18.09.2021
Tilføjet 18.09.2021
Marta Colaneri, Maria De Filippo, Amelia Licari, Alessia Marseglia, Laura Maiocchi, Alessandra Ricciardi, Angelo Corsico, Gianluigi Marseglia, Mario Umberto Mondelli, Raffaele Bruno
International Journal of Infectious Diseases, 18.09.2021
Tilføjet 18.09.2021
BMC Infectious Diseases, 17.09.2021
Tilføjet 18.09.2021
Abstract
Background
Legionella spp. are ubiquitous freshwater bacteria responsible for rare but potentially severe cases of Legionnaires’ disease (LD). Legionella sainthelensi is a non-pneumophila Legionella species that was first isolated in 1980 from water near Mt. St-Helens (USA). Although rare cases of LD caused by L. sainthelensi have been reported, very little data is available on this pathogen.
Case presentation
We describe the first documented case of severe bilateral pleuropneumonia caused by L. sainthelensi. The patient was a 35-year-old woman with Sharp’s syndrome treated with long-term hydroxychloroquine and corticosteroids who was hospitalized for an infectious illness in a university hospital in Reunion Island (France). The patient’s clinical presentation was complicated at first (bilateral pneumonia, multiloculated pleural effusion, then bronchopleural fistula) but her clinical condition eventually improved with the reintroduction of macrolides (spiramycin) in intensive care unit. Etiological diagnosis was confirmed by PCR syndromic assay and culture on bronchoalveolar lavage.
Conclusions
To date, only 14 documented cases of L. sainthelensi infection have been described worldwide. This pathogen is difficult to identify because it is not or poorly detected by urinary antigen and molecular methods (like PCR syndromic assays that primarily target L. pneumophila and that have only recently been deployed in microbiology laboratories). Pneumonia caused by L. sainthelensi is likely underdiagnosed as a result. Clinicians should consider the possibility of non-pneumophila Legionella infection in patients with a compatible clinical presentation when microbiological diagnostic tools targeted L. pneumophila tested negative.
Læs mere Tjek på PubMedBMC Infectious Diseases, 17.09.2021
Tilføjet 18.09.2021
Abstract
Background
Few studies on pharyngotonsillitis have examined the clinical presentation of different aetiologies where pathogens have been detected using molecular methods. We aimed to assess how well clinical signs and symptoms can predict (1) the presence or absence of a broad range of viruses and bacteria, and (2) reconsultations for a sore throat or a complication.
Methods
In this descriptive observational prospective study in primary health care 220 patients aged 15–45 with suspected pharyngotonsillitis were sampled from nose, throat and blood and screened for 20 bacteria and viruses using polymerase chain reaction (PCR), culture and serology. Odds ratios (OR) and predictive values with 95% confidence intervals (CI) were used to show association between microbiological findings and clinical signs and symptoms. Patients were followed up after 3 months by reviewing electronic medical records.
Results
Both cough and coryza were more common in patients with only viruses (67%) than in patients with only bacteria (21%) (p < 0.001), whereas tonsillar coating was more common in patients with only bacteria (53%) than in patients with only viruses (29%) (p = 0.006). Tonsillar coating (adjusted OR 6.0; 95% CI 2.5–14) and a lack of cough (adjusted OR 3.5; 95% CI 1.5–8.0) were significantly associated with Streptococcus pyogenes (group A streptococci; GAS) and with any bacterial finding. A Centor score of 3–4 had a positive predictive value of 49% (95% CI 42–57) for GAS and 66% (95% CI 57–74) for any bacterial findings. The use of rapid antigen detection test for GAS increased the positive predictive value for this group to 93%.
Conclusions
Signs and symptoms, both single and combined, were insufficient to rule in GAS or other pathogens. However, both cough and coryza were useful to rule out GAS. The results support the clinical approach of restricting rapid antigen detection testing to patients with 3–4 Centor criteria. The low carriage rate of bacteria among asymptomatic controls implied that most detections in patients represented a true infection.
Læs mere Tjek på PubMedBMC Infectious Diseases, 17.09.2021
Tilføjet 18.09.2021
Abstract
Background
The ongoing COVID-19 pandemic remains a major challenge for worldwide health care systems and in particular emergency medicine. An early and safe triage in the emergency department (ED) is especially crucial for proper therapy. Clinical symptoms of COVID-19 comprise those of many common diseases; thus, differential diagnosis remains challenging.
Method
We performed a retrospective study of 314 ED patients presenting with conceivable COVID-19 symptoms during the first wave in Germany. All were tested for COVID-19 with SARS-Cov-2-nasopharyngeal swabs. Forty-seven patients were positive. We analyzed the 267 COVID-19 negative patients for their main diagnosis and compared COVID-19 patients with COVID-19 negative respiratory infections for differences in laboratory parameters, symptoms, and vital signs.
Results
Among the 267 COVID-19 negative patients, 42.7% had respiratory, 14.2% had other infectious, and 11.2% had cardiovascular diseases. Further, 9.0% and 6.7% had oncological and gastroenterological diagnoses, respectively. Compared to COVID-19 negative airway infections, COVID-19 patients showed less dyspnea (OR 0.440; p = 0.024) but more dysgeusia (OR 7.631; p = 0.005). Their hospital stay was significantly longer (9.0 vs. 5.6 days; p = 0.014), and their mortality significantly higher (OR 3.979; p = 0.014).
Conclusion
For many common ED diagnoses, COVID-19 should be considered a differential diagnosis. COVID-19 cannot be distinguished from COVID-19 negative respiratory infections by clinical signs, symptoms, or laboratory results. When hospitalization is necessary, the clinical course of COVID-19 airway infections seems to be more severe compared to other respiratory infections.
Trial registration: German Clinical Trial Registry DRKS, DRKS-ID of the study: DRKS00021675 date of registration: May 8th, 2020, retrospectively registered.
Læs mere Tjek på PubMedBMC Infectious Diseases, 17.09.2021
Tilføjet 18.09.2021
Abstract
Background
SARS-CoV-2 poses a considerable threat to those living in residential aged care facilities (RACF). RACF COVID-19 outbreaks have been characterised by the rapid spread of infection and high rates of severe disease and associated mortality. Despite a growing body of evidence supporting airborne transmission of SARS-CoV-2, current infection control measures in RACF including hand hygiene, social distancing, and sterilisation of surfaces, focus on contact and droplet transmission. Germicidal ultraviolet (GUV) light has been used widely to prevent airborne pathogen transmission. Our aim is to investigate the efficacy of GUV technology in reducing the risk of SARS-CoV-2 infection in RACF.
Methods
A multicentre, two-arm double-crossover, randomised controlled trial will be conducted to determine the efficacy of GUV devices to reduce respiratory viral transmission in RACF, as an adjunct to existing infection control measures. The study will be conducted in partnership with three aged care providers in metropolitan and regional South Australia. RACF will be separated into paired within-site zones, then randomised to intervention order (GUV or control). The initial 6-week period will be followed by a 2-week washout before crossover to the second 6-week period. After accounting for estimated within-zone and within-facility correlations of infection, and baseline infection rates (10 per 100 person-days), a sample size of n = 8 zones (n = 40 residents/zone) will provide 89% power to detect a 50% reduction in symptomatic infection rate. The primary outcome will be the incidence rate ratio of combined symptomatic respiratory infections for intervention versus control. Secondary outcomes include incidence rates of hospitalisation for complications associated with respiratory infection; respiratory virus detection in facility air and fomite samples; rates of laboratory confirmed respiratory illnesses and genomic characteristics.
Discussion
Measures that can be deployed rapidly into RACF, that avoid the requirement for changes in resident and staff behaviour, and that are effective in reducing the risk of airborne SARS-CoV-2 transmission, would provide considerable benefit in safeguarding a highly vulnerable population. In addition, such measures might substantially reduce rates of other respiratory viruses, which contribute considerably to resident morbidity and mortality.
Trial registration Australian and New Zealand Clinical Trials Registry ACTRN12621000567820 (registered on 14th May, 2021).
Læs mere Tjek på PubMedBMC Infectious Diseases, 17.09.2021
Tilføjet 18.09.2021
Abstract
Background
Coccidioidomycosis is a systemic infection caused by dimorphic fungi Coccidioides spp. endemic to Southwestern United States and Central and South America. A history of residence and travel in these areas is essential for the diagnostic of coccidioidomycosis, which has highly variable symptoms ranging from asymptomatic to severe, disseminated infection, and even death. Immunocompromised patients of coccidioidomycosis experience a high risk of dissemination, chronic infection, and mortality. Meningitis is one of the most deleterious coccidioidomycosis and can cause various life-threatening complications.
Case presentation
Here we report a case of Coccidioides posadasii meningitis in a 49-year-old female who returned to China after one and a half years residence in Los Angeles, USA. The repeated routine cultures using CSF for bacteria or fungi were all negative. To hunt for an infectious etiology, the state-of-the-art technology metagenomic next-generation sequencing (mNGS) was then utilized, suggesting Coccidioides posadasii. Organizational pathological examination and polymerase-chain-reaction (PCR) results subsequently confirmed the mNGS detection.
Conclusion
To our knowledge, cases for coccidioidal meningitis have been rarely reported in China. While global travelling may spread this disease across continents and make the diagnosis more difficult. mNGS can detect almost all known pathogens with high sensitivity and specificity, especially for uncommon pathogen, such as Coccidioides posadasii in China.
Læs mere Tjek på PubMedBMC Infectious Diseases, 17.09.2021
Tilføjet 18.09.2021
Abstract
Background
Drug-resistant tuberculosis (DR-TB) remains a major public health concern worldwide. Bedaquiline, a novel diarylquinoline, was added to the WHO-recommended all-oral regimen for patients with multidrug-resistant tuberculosis. We performed a systematic review and meta-analysis to determine the effect of bedaquiline on tuberculosis treatment outcomes.
Methods
We searched the PubMed, Web of Science and EMBASE databases for relevant studies published up to March 12, 2021. We included studies in which some participants received bedaquiline and others did not. Stata version 16.0 (Stata Corp., College Station, Texas, USA) was used to analyze the results of the meta-analysis. Risk ratios (RRs) with 95% confidence intervals (95% CIs) were calculated to evaluate the effect of bedaquiline on drug-resistant tuberculosis. Between-study heterogeneity was examined by the I-squared test. Randomized controlled trials were assessed for quality using the Jadad scale, and cohort studies were assessed using the Newcastle–Ottawa scale.
Results
Eight studies, including 2 randomized controlled trials and 6 cohort studies involving a total of 21,836 subjects, were included. When compared with the control, bedaquiline treatment was associated with higher rates of culture conversion (risk ratio (RR):1.272 (1.165–1.389), P < 0.001). We found substantial evidence of a significant reduction in all-cause death (RR: 0.529 (0.454–0.616), P < 0.001)) in the bedaquiline treatment group. There was no significant reduction in treatment success (RR = 0.980 (0.948–1.013, P = 0.234)).
Conclusions
This study demonstrated that compared with patients who do not receive bedaquiline, this drug has the potential to achieve a higher culture conversion rate and a lower mortality risk among drug-resistant tuberculosis cases.
Læs mere Tjek på PubMedBMC Infectious Diseases, 17.09.2021
Tilføjet 18.09.2021
Abstract
Background
Ventilator associated pneumonia (VAP) caused by more than one microorganisms is not uncommon and may be potentially challenging, but the relevant data is scarce in ventilated neonates. We aimed to investigate the clinical characteristics and outcomes of polymicrobial VAP in the neonatal intensive care unit (NICU).
Methods
All neonates with definite diagnosis of VAP from a tertiary level neonatal intensive care unit (NICU) in Taiwan between October 2017 and September 2020 were prospectively observed and enrolled for analyses. All clinical features, therapeutic interventions and outcomes were compared between the polymicrobial VAP and monomicrobial VAP episodes. Multivariate regression analyses were used to find the independent risk factors for treatment failure.
Results
Among 236 episodes of neonatal VAP, 60 (25.4%) were caused by more than one microorganisms. Polymicrobial VAP episodes were more likely to be associated with multidrug-resistant pathogens (53.3% versus 34.7%, P = 0.014), more often occurred in later days of life and in neonates with prolonged intubation and underlying bronchopulmonary dysplasia. Otherwise most clinical characteristics of polymicrobial VAP were similar to those of monomicrobial VAP. The therapeutic responses and treatment outcomes were also comparable between these two groups, although modification of therapeutic antibiotics were significantly more common in polymicrobial VAP episodes than monomicrobial VAP episodes (63.3% versus 46.2%; P < 0.001). None of any specific pathogens was significantly associated with worse outcomes. Instead, it is the severity of illness, including presence of concurrent bacteremia, septic shock, and requirement of high-frequency oscillatory ventilator and underlying neurological sequelae that are independently associated with treatment failure.
Conclusions
Polymicrobial VAP accounted for 25.4% of all neonatal VAP in the NICU, and frequently occurred in neonates with prolonged intubation and underlying bronchopulmonary dysplasia. In our cohort, most clinical features, therapeutic responses and final outcomes of neonates with monomicrobial and polymicrobial VAP did not differ significantly.
Læs mere Tjek på PubMedSteven Y.C. Tong, Roger J. Lewis, Susan C. Morpeth
Clinical Microbiology and Infection, 18.09.2021
Tilføjet 18.09.2021
Misclassification of a phenotype may have direct clinical consequences. Classifying an organism as susceptible to an antibiotic when it is in fact resistant to that antibiotic can result in treatment of individuals with an ineffective agent and may impact the interpretation of clinical trial results.
Læs mere Tjek på PubMedRobert Markewitz, Daniela Pauli, Justina Dargvainiene, Katja Steinhagen, Sarah Engel, Victor Herbst, Dorinja Zapf, Christina Krüger, Shahpour Sharifzadeh, Benjamin Schomburg, Frank Leypoldt, Jan Rupp, Siegfried Görg, Ralf Junker, Klaus-Peter Wandinger
Clinical Microbiology and Infection, 18.09.2021
Tilføjet 18.09.2021
To investigate the immune systems’ response (and its influencing factors) to vaccination with BNT162b2 or mRNA-1273.
Læs mere Tjek på PubMedBarbara A. Han, Adrian A. Castellanos, John Paul Schmidt, Ilya R. Fischhoff, John M. Drake
Trends in Parasitology, 17.09.2021
Tilføjet 18.09.2021
The order Carnivora includes over 300 species that vary many orders of magnitude in size and inhabit all major biomes, from tropical rainforests to polar seas. The high diversity of carnivore parasites represents a source of potential emerging diseases of humans. Zoonotic risk from this group may be driven in part by exceptionally high functional diversity of host species in behavioral, physiological, and ecological traits. We review global macroecological patterns of zoonotic parasites within carnivores, and explore the traits of species that serve as hosts of zoonotic parasites.
Læs mere Tjek på PubMedRiho Tateyama-Makino, Mari Abe-Yutori, Taku Iwamoto, Kota Tsutsumi, Motonori Tsuji, Satoru Morishita, Kei Kurita, Yukio Yamamoto, Eiji Nishinaga, Keiichi Tsukinoki
PLoS One Infectious Diseases, 17.09.2021
Tilføjet 18.09.2021
by Riho Tateyama-Makino, Mari Abe-Yutori, Taku Iwamoto, Kota Tsutsumi, Motonori Tsuji, Satoru Morishita, Kei Kurita, Yukio Yamamoto, Eiji Nishinaga, Keiichi Tsukinoki
SARS-CoV-2 enters host cells when the viral spike protein is cleaved by transmembrane protease serine 2 (TMPRSS2) after binding to the host angiotensin-converting enzyme 2 (ACE2). Since ACE2 and TMPRSS2 are expressed in the tongue and gingival mucosa, the oral cavity is a potential entry point for SARS-CoV-2. This study evaluated the inhibitory effects of general ingredients of toothpastes and mouthwashes on the spike protein-ACE2 interaction and the TMPRSS2 protease activity using an in vitro assay. Both assays detected inhibitory effects of sodium tetradecene sulfonate, sodium N-lauroyl-N-methyltaurate, sodium N-lauroylsarcosinate, sodium dodecyl sulfate, and copper gluconate. Molecular docking simulations suggested that these ingredients could bind to inhibitor-binding site of ACE2. Furthermore, tranexamic acid exerted inhibitory effects on TMPRSS2 protease activity. Our findings suggest that these toothpaste and mouthwash ingredients could help prevent SARS-CoV-2 infection.
Læs mere Tjek på PubMedBenjamin Tolchin, Carol Oladele, Deron Galusha, Nitu Kashyap, Mary Showstark, Jennifer Bonito, Michelle C. Salazar, Jennifer L. Herbst, Steve Martino, Nancy Kim, Katherine A. Nash, Max Jordan Nguemeni Tiako, Shireen Roy, Rebeca Vergara Greeno, Karen Jubanyik
PLoS One Infectious Diseases, 17.09.2021
Tilføjet 18.09.2021
by Benjamin Tolchin, Carol Oladele, Deron Galusha, Nitu Kashyap, Mary Showstark, Jennifer Bonito, Michelle C. Salazar, Jennifer L. Herbst, Steve Martino, Nancy Kim, Katherine A. Nash, Max Jordan Nguemeni Tiako, Shireen Roy, Rebeca Vergara Greeno, Karen Jubanyik
Background Sequential Organ Failure Assessment (SOFA) score predicts probability of in-hospital mortality. Many crisis standards of care suggest the use of SOFA scores to allocate medical resources during the COVID-19 pandemic.
Research question Are SOFA scores elevated among Non-Hispanic Black and Hispanic patients hospitalized with COVID-19, compared to Non-Hispanic White patients?
Study design and methods Retrospective cohort study conducted in Yale New Haven Health System, including 5 hospitals with total of 2681 beds. Study population drawn from consecutive patients aged ≥18 admitted with COVID-19 from March 29th to August 1st, 2020. Patients excluded from the analysis if not their first admission with COVID-19, if they did not have SOFA score recorded within 24 hours of admission, if race and ethnicity data were not Non-Hispanic Black, Non-Hispanic White, or Hispanic, or if they had other missing data. The primary outcome was SOFA score, with peak score within 24 hours of admission dichotomized as
Læs mere Tjek på PubMedHaocheng Wu, Chen Wu, Qinbao Lu, Zheyuan Ding, Ming Xue, Junfen Lin
PLoS One Infectious Diseases, 17.09.2021
Tilføjet 18.09.2021
by Haocheng Wu, Chen Wu, Qinbao Lu, Zheyuan Ding, Ming Xue, Junfen Lin
Background Zhejiang Province is one of the five provinces in China that had the highest incidence of novel coronavirus disease (COVID-19). Zhejiang, ranked fourth highest in COVID-19 incidence, is located in the Yangtze River Delta region of southeast China. This study was undertaken to identify the space-time characteristics of COVID-19 in Zhejiang.
Methods Data on COVID-19 cases in Zhejiang Province from January to July 2020 were obtained from this network system. Individual information on cases and deaths was imported, and surveillance information, including demographic characteristics and geographic and temporal distributions, was computed by the system. The Knox test was used to identify possible space-time interactions to test whether cases that are close in distance were also close in time. Network analysis was performed to determine the relationship among the cases in a transmission community and to try to identify the key nodes.
Results In total, 1475 COVID-19 cases and 1 fatal case were reported from January to July 2020 in Zhejiang Province, China. Most of the cases occurred before February 15th, which accounted for 90.10%. The imported cases increased and became the main risk in Zhejiang Province after February 2020. The risk areas showed strong heterogeneity according to the Knox test. The areas at short distances within 1 kilometer and at brief periods within 5 days presented relatively high risk. The numbers of subcommunities for the four clusters were 12, 9, 6 and 4. There was obvious heterogeneity in the modularity of subcommunities. The maximum values of the node centrality for the four clusters were 2.9474, 4.3706, 4.1080 and 2.7500.
Conclusions COVID-19 was brought under control over a short period in Zhejiang Province. Imported infections from outside of mainland China then became a new challenge. The effects of spatiotemporal interaction exhibited interval heterogeneity. The characteristics of transmission showed short range and short term risks. The importance to the cluster of each case was detected, and the key patients were identified. It is suggested that we should focus on key patients in complex conditions and in situations with limited control resources.
Læs mere Tjek på PubMedLes Jones, Abhijeet Bakre, Hemant Naikare, Ravindra Kolhe, Susan Sanchez, Yung-Yi C. Mosley, Ralph A. Tripp
PLoS One Infectious Diseases, 17.09.2021
Tilføjet 18.09.2021
by Les Jones, Abhijeet Bakre, Hemant Naikare, Ravindra Kolhe, Susan Sanchez, Yung-Yi C. Mosley, Ralph A. Tripp
The COVID-19 pandemic caused by the SARS-CoV-2 is a serious health threat causing worldwide morbidity and mortality. Real-time reverse transcription PCR (RT-qPCR) is currently the standard for SARS-CoV-2 detection. Although various nucleic acid-based assays have been developed to aid the detection of SARS-CoV-2 from COVID-19 patient samples, the objective of this study was to develop a diagnostic test that can be completed in 30 minutes without having to isolate RNA from the samples. Here, we present an RNA amplification detection method performed using reverse transcription loop-mediated isothermal amplification (RT-LAMP) reactions to achieve specific, rapid (30 min), and sensitive (
Læs mere Tjek på PubMedSolomon A. Narh-Bana, Mary Kawonga, Esnat D. Chirwa, Latifat Ibisomi, Frank Bonsu, Tobias F. Chirwa
PLoS One Infectious Diseases, 17.09.2021
Tilføjet 18.09.2021
by Solomon A. Narh-Bana, Mary Kawonga, Esnat D. Chirwa, Latifat Ibisomi, Frank Bonsu, Tobias F. Chirwa
Introduction Tuberculosis screening of people living with human immunodeficiency virus is an intervention recommended by the WHO to control the dual epidemic of TB and HIV. The extent to which the intervention is adhered to by the HIV healthcare providers (fidelity) determines the intervention’s effectiveness as measured by patient outcomes, but literature on fidelity is scarce. This study assessed provider implementation fidelity to national guidelines on TB screening at HIV clinics in Ghana.
Methods It was a cross-sectional study that used structured questionnaires to gather data, involving 226 of 243 HIV healthcare providers in 27 HIV clinics across Ghana. The overall fidelity score comprised sixteen items with a maximum score of 48 grouped into three components of the screening intervention (TB diagnosis, TB awareness and TB symptoms questionnaire). Simple summation of item scores was done to determine fidelity score per provider. In this paper, we define the level of fidelity as low if the scores were below the median score and were otherwise categorized as high. Background factors potentially associated with implementation fidelity level were assessed using cluster-based logistic regression. Odds ratio with 95% confidence interval (CI) was used as the measure of association.
Results Of the 226 healthcare providers interviewed, 60% (135) were females with a mean age of 34.5 years (SD = 8.3). Most of them were clinicians [63% (142)] and had post-secondary non-tertiary education [62% (141)]. Overall, 53% (119) of the healthcare providers were categorized to have implemented the intervention with high fidelity. Also, 56% (126), 53% (120), and 59% (134) of the providers implemented the TB diagnosis, TB awareness and TB symptoms questionnaire components respectively with high fidelity. After adjusting for cluster effect, female providers (AOR = 2.36, 95%CI: 1.09–5.10, p =
Læs mere Tjek på PubMedBenjamin Demah Nuertey, Kwame Ekremet, Abdul-Rashid Haidallah, Kareem Mumuni, Joyce Addai, Rosemary Ivy E. Attibu, Michael C. Damah, Elvis Duorinaa, Anwar Sadat Seidu, Victor C. Adongo, Richard Kujo Adatsi, Hisyovi Caedenas Suri, Abass Abdul-Karim Komei, Braimah Baba Abubakari, Enoch Weyori, Emmanuel Allegye-Cudjoe, Augustina Sylverken, Michael Owusu, Richard O. Phillips
PLoS One Infectious Diseases, 17.09.2021
Tilføjet 18.09.2021
by Benjamin Demah Nuertey, Kwame Ekremet, Abdul-Rashid Haidallah, Kareem Mumuni, Joyce Addai, Rosemary Ivy E. Attibu, Michael C. Damah, Elvis Duorinaa, Anwar Sadat Seidu, Victor C. Adongo, Richard Kujo Adatsi, Hisyovi Caedenas Suri, Abass Abdul-Karim Komei, Braimah Baba Abubakari, Enoch Weyori, Emmanuel Allegye-Cudjoe, Augustina Sylverken, Michael Owusu, Richard O. Phillips
Introduction Coronavirus disease-19 (COVID-19), which started in late December, 2019, has spread to affect 216 countries and territories around the world. Globally, the number of cases of SARS-CoV-2 infection has been growing exponentially. There is pressure on countries to flatten the curves and break transmission. Most countries are practicing partial or total lockdown, vaccination, massive education on hygiene, social distancing, isolation of cases, quarantine of exposed and various screening approaches such as temperature and symptom-based screening to break the transmission. Some studies outside Africa have found the screening for fever using non-contact thermometers to lack good sensitivity for detecting SARS-CoV-2 infection. The aim of this study was to determine the usefulness of clinical symptoms in accurately predicting a final diagnosis of COVID-19 disease in the Ghanaian setting.
Method The study analysed screening and test data of COVID-19 suspected, probable and contacts for the months of March to August 2020. A total of 1,986 participants presenting to Tamale Teaching hospital were included in the study. Logistic regression and receiver operator characteristics (ROC) analysis were carried out.
Results Overall SARS-CoV-2 positivity rate was 16.8%. Those with symptoms had significantly higher positivity rate (21.6%) compared with asymptomatic (17.0%) [chi-squared 15.5, p-value,
Læs mere Tjek på PubMedRhiannon Edge, Josh Meyers, Gabriella Tiernan, Zhicheng Li, Alexandra Schiavuzzi, Priscilla Chan, Amy Vassallo, April Morrow, Carolyn Mazariego, Claire E. Wakefield, Karen Canfell, Natalie Taylor
PLoS One Infectious Diseases, 17.09.2021
Tilføjet 18.09.2021
by Rhiannon Edge, Josh Meyers, Gabriella Tiernan, Zhicheng Li, Alexandra Schiavuzzi, Priscilla Chan, Amy Vassallo, April Morrow, Carolyn Mazariego, Claire E. Wakefield, Karen Canfell, Natalie Taylor
The COVID-19 pandemic has dramatically impacted cancer care worldwide. Disruptions have been seen across all facets of care. While the long-term impact of COVID-19 remains unclear, the immediate impacts on patients, their carers and the healthcare workforce are increasingly evident. This study describes disruptions and reorganisation of cancer services in Australia since the onset of COVID-19, from the perspectives of people affected by cancer and healthcare workers. Two separate online cross-sectional surveys were completed by: a) cancer patients, survivors, carers, family members or friends (n = 852) and b) healthcare workers (n = 150). Descriptive analyses of quantitative survey data were conducted, followed by inductive thematic content analyses of qualitative survey responses relating to cancer care disruption and perceptions of telehealth. Overall, 42% of cancer patients and survivors reported experiencing some level of care disruption. A further 43% of healthcare workers reported atypical delays in delivering cancer care, and 50% agreed that patient access to research and clinical trials had been reduced. Almost three quarters (73%) of patients and carers reported using telehealth following the onset of COVID-19, with high overall satisfaction. However, gaps were identified in provision of psychological support and 20% of participants reported that they were unlikely to use telehealth again. The reorganisation of cancer care increased the psychological and practical burden on carers, with hospital visitation restrictions and appointment changes reducing their ability to provide essential support. COVID-19 has exacerbated a stressful and uncertain time for people affected by cancer and healthcare workers. Service reconfiguration and the adoption of telehealth have been essential adaptations for the pandemic response, offering long-term value. However, our findings highlight the need to better integrate psychosocial support and the important role of carers into evolving pandemic response measures. Learnings from this study could inform service improvements that would benefit patients and carers longer-term.
Læs mere Tjek på PubMedMarcello Barbosa Otoni Gonçalves Guedes, Sanderson José Costa de Assis, Geronimo José Bouzas Sanchis, Diego Neves Araujo, Angelo Giuseppe Roncalli Da Costa Oliveira, Johnnatas Mikael Lopes
PLoS One Infectious Diseases, 17.09.2021
Tilføjet 18.09.2021
by Marcello Barbosa Otoni Gonçalves Guedes, Sanderson José Costa de Assis, Geronimo José Bouzas Sanchis, Diego Neves Araujo, Angelo Giuseppe Roncalli Da Costa Oliveira, Johnnatas Mikael Lopes
Background Brazil, as many other countries, have been heavily affected by COVID-19. This study aimed to analyze the impact of Primary health care and the family health strategy (FHS) coverage, the scores of the National Program for Improving Primary Care Access and Quality (PMAQ), and socioeconomic and social indicators in the number of COVID-19 cases in Brazilian largest cities.
Methods This is an ecological study, carried out through the analysis of secondary data on the population of all Brazilian main cities, based on the analysis of a 26-week epidemiological epidemic week series by COVID-19. Statistical analysis was performed using Generalized Linear Models with an Autoregressive work correlation matrix.
Results It was shown that greater PHC coverage and greater FHS coverage together with an above average PMAQ score are associated with slower dissemination and lower burden of COVID-19.
Conclusion It is evident that cities with less social inequality and restrictions of social protection combined with social development have a milder pandemic scenario. It is necessary to act quickly on these conditions for COVID-19 dissemination by timely actions with high capillarity. Expanding access to PHC and social support strategies for the vulnerable are essential.
Læs mere Tjek på PubMedTheophilus Quaye, Patrick Williams Narkwa, Seth A. Domfeh, Gloria Kattah, Mohamed Mutocheluh
PLoS One Infectious Diseases, 17.09.2021
Tilføjet 18.09.2021
by Theophilus Quaye, Patrick Williams Narkwa, Seth A. Domfeh, Gloria Kattah, Mohamed Mutocheluh
Hepatitis B vaccination is the most effective preventive measure in reducing the incidence of chronic hepatitis B virus (HBV) infection and its consequences such as cirrhosis, hepatocellular carcinoma, liver failure and death. Ghana introduced the universal HBV vaccination in the national Expanded Programme on Immunization in 2002. The current study sought to determine the sero-protection rate and the prevalence of HBV infection among fully vaccinated children in the West Gonja District in the Savanna Region of Ghana. This cross-sectional study recruited three hundred and fifty (350) fully vaccinated children who visited West Gonja Catholic Hospital from September to December 2019 for healthcare. Structured questionnaires were administered to obtain information on the demographics. The clinical history of the participants was obtained from the hospital records. Sera were separated from 2-5ml of blood sample collected from each participant after informed consent had been sought from their parents/guardians. Sera were tested for HBsAg, anti-HBs and anti-HBc using ELISA. Samples positive for HBsAg or anti-HBc were tested for HBV DNA by Real-Time Polymerase Chain Reaction. The overall sero-protection rate (anti-HBs titers ≥ 10 mIU/mL) among the studied participants was 56% with anti-HBs geometric mean titer (GMT) of 95.7 mIU/mL (± 6.0; 95% CI) compared with GMT of 2.8 mIU/mL (± 0.2; 95% CI) among non-seroprotected participants. There was no statistically significant difference in sero-protection rate between males and females (p-value = 0.93) and in relation to age (p-value = 0.20). The prevalence of HBV infection among studied participants as determined by the HBV DNA/HBsAg positivity was 1.4% while anti-HBc sero-positivity was 2%. Even though the sero-protection rate and HBV infection rate reported in the current study compares with that of other international studies further studies need to be conducted to understand the factors related to sero-protection and HBV infection rate in the Savanna Region of Ghana.
Læs mere Tjek på PubMedGregg Hartvigsen
PLoS One Infectious Diseases, 17.09.2021
Tilføjet 18.09.2021
by Gregg Hartvigsen
There remains a great challenge to minimize the spread of epidemics, especially in high-density communities such as colleges and universities. This is particularly true on densely populated, residential college campuses. To construct class and residential networks data from a four-year, residential liberal arts college with 5539 students were obtained from SUNY College at Geneseo, a rural, residential, undergraduate institution in western NY, USA. Equal-sized random networks also were created for each day. Different levels of compliance with mask use (none to 100%), mask efficacy (50% to 100%), and testing frequency (daily, or every 2, 3, 7, 14, 28, or 105 days) were assessed. Tests were assumed to be only 90% accurate and positive results were used to isolate individuals. The effectiveness of contact tracing, and the effect of quarantining neighbors of infectious individuals, was tested. The structure of the college course enrollment and residence networks greatly influenced the dynamics of the epidemics, as compared to the random networks. In particular, average path lengths were longer in the college networks compared to random networks. Students in larger majors generally had shorter average path lengths than students in smaller majors. Average transitivity (clustering) was lower on days when students most frequently were in class (MWF). Degree distributions were generally large and right skewed, ranging from 0 to 719. Simulations began by inoculating twenty students (10 exposed and 10 infectious) with SARS-CoV-2 on the first day of the fall semester and ended once the disease was cleared. Transmission probability was calculated based on an R0 = 2.4. Without interventions epidemics resulted in most students becoming infected and lasted into the second semester. On average students in the college networks experienced fewer infections, shorter duration, and lower epidemic peaks when compared to the dynamics on equal-sized random networks. The most important factors in reducing case numbers were the proportion masking and the frequency of testing, followed by contact tracing and mask efficacy. The paper discusses further high-order interactions and other implications of non-pharmaceutical interventions for disease transmission on a residential college campus.
Læs mere Tjek på PubMedSaman Hewamana, Thurairajah Skandarajah, Chathuri Jayasinghe, Samadhi Deshapriya, Dhananjani Senarathna, Gehan Arseculeratne, Mahesh Harischandra, Gnani Somasundaram, Vadivelu Srinivasan, Surjit Somiah, Nihal Munasinghe, Sangeetha Hewawasam, Lalith Ekanayake, Rohini Wadanamby, Geethani Galagoda, Thet Thet Lin, Jayantha Balawardena
PLoS One Infectious Diseases, 17.09.2021
Tilføjet 18.09.2021
by Saman Hewamana, Thurairajah Skandarajah, Chathuri Jayasinghe, Samadhi Deshapriya, Dhananjani Senarathna, Gehan Arseculeratne, Mahesh Harischandra, Gnani Somasundaram, Vadivelu Srinivasan, Surjit Somiah, Nihal Munasinghe, Sangeetha Hewawasam, Lalith Ekanayake, Rohini Wadanamby, Geethani Galagoda, Thet Thet Lin, Jayantha Balawardena
Background The Covid-19 pandemic has caused significant morbidity and mortality among patients with cancer. Most countries employed measures to prevent spread of Covid-19 infection which include shielding, quarantine, lockdown, travel restrictions, physical distancing and the use of personal protective equipment. This study was carried out to assess the change in patient attendance and the efficacy of newly implemented strategies to mitigate the impact of Covid-19 on services at the Lanka Hospital Blood Cancer Centre (LHBCC) in Colombo, Sri Lanka.
Methodology Telephone consultation, infection control, personal protective measures and emergency admission policy were implemented with the aim of having a Covid-19 free ward and to prevent cross-infections. This descriptive cross-sectional study was conducted with 1399 patient episodes (in-patient care or day-case review). We analysed patients treated as in-patient as well as day-case basis between 01st April 2020 and 31st December 2020.
Results There were 977 day-case based episodes and 422 in-patient based episodes. There was a 14% drop in episode numbers compared to same period in 2019. There was no cross infection and no patients with Covid-19 related symptoms or positive test results entered the LHBCC during the study period.
Conclusion Services in blood cancer care were maintained to prevent late stage presentation and adverse outcome. Measures implemented to prevent Covid-19 were effective to allow continuation of treatment. This study highlights the importance of implementing strict protocols, clinical screening, use of appropriate personal protective equipment in delivering blood cancer care during the Covid-19 pandemic. This is the only documented study relating to outcome and successful applicability of measures to prevent spread of Covid-19 infection and maintaining services among blood cancer patients in Sri Lanka.
Læs mere Tjek på PubMedAnastase Tchicaya, Nathalie Lorentz, Kristell Leduc, Gaetan de Lanchy
PLoS One Infectious Diseases, 17.09.2021
Tilføjet 18.09.2021
by Anastase Tchicaya, Nathalie Lorentz, Kristell Leduc, Gaetan de Lanchy
Background The 2019 coronavirus (COVID-19) epidemic began in Wuhan, China in December 2019 and quickly spread to the rest of the world. This study aimed to analyse the associations between the COVID-19 mortality rate in hospitals, the availability of health services, and socio-spatial and health risk factors at department level.
Methods and findings This spatial cross-sectional study used cumulative mortality data due to the COVID-19 pandemic in hospitals until 30 November 2020 as a main outcome, across 96 departments of mainland France. Data concerning health services, health risk factors, and socio-spatial factors were used as independent variables. Independently, we performed negative binomial, spatial and geographically weighted regression models. Our results revealed substantial geographic disparities. The spatial exploratory analysis showed a global positive spatial autocorrelation in each wave indicating a spatial dependence of the COVID-19 deaths across departments. In first wave about 75% of COVID-19 deaths were concentrated in departments of five regions compared to a total of 13 regions. The COVID-19 mortality rate was associated with the physicians density, and not the number of resuscitation beds. Socio-spatial factors were only associated with the COVID-19 mortality rate in first wave compared to wave 2. For example, the COVID-19 mortality rate increased by 35.69% for departments densely populated. Health risk factors were associated with the COVID-19 mortality rate depending on each wave. This study had inherent limitations to the ecological analysis as ecological bias risks and lack of individual data.
Conclusions Our results suggest that the COVID-19 pandemic has spread more rapidly and takes more severe forms in environments where there is already a high level of vulnerability due to social and health factors. This study showed a different dissemination pattern of COVID-19 mortality between the two waves: a spatial non-stationarity followed by a spatial stationarity in the relationships between the COVID-19 mortality rate and its potential drivers.
Læs mere Tjek på PubMedRagheb, J., McKinney, A., Zierau, M., Brooks, J., Hill-Caruthers, M., Iskander, M., Ahmed, Y., Lobo, R., Mentz, G., Vlisides, P. E.
BMJ Open, 17.09.2021
Tilføjet 17.09.2021
Objective
To characterise the clinical course of delirium for patients with COVID-19 in the intensive care unit, including postdischarge neuropsychological outcomes.
Design
Retrospective chart review and prospective survey study.
Setting
Intensive care units, large academic tertiary-care centre (USA).
Participants
Patients (n=148) with COVID-19 admitted to an intensive care unit at Michigan Medicine between 1 March 2020 and 31 May 2020 were eligible for inclusion.
Primary and secondary outcome measures
Delirium was the primary outcome, assessed via validated chart review method. Secondary outcomes included measures related to delirium, such as delirium duration, antipsychotic use, length of hospital and intensive care unit stay, inflammatory markers and final disposition. Neuroimaging data were also collected. Finally, a telephone survey was conducted between 1 and 2 months after discharge to determine neuropsychological function via the following tests: Family Confusion Assessment Method, Short Blessed Test, Patient-Reported Outcomes Measurement Information System Cognitive Abilities 4a and Patient-Health Questionnaire-9.
Results
Delirium was identified in 108/148 (73%) patients, with median (IQR) duration lasting 10 (4–17) days. In the delirium cohort, 50% (54/108) of patients were African American and delirious patients were more likely to be female (76/108, 70%) (absolute standardised differences >0.30). Sedation regimens, inflammation, delirium prevention protocol deviations and hypoxic-ischaemic injury were likely contributing factors, and the most common disposition for delirious patients was a skilled care facility (41/108, 38%). Among patients who were delirious during hospitalisation, 4/17 (24%) later screened positive for delirium at home based on caretaker assessment, 5/22 (23%) demonstrated signs of questionable cognitive impairment or cognitive impairment consistent with dementia and 3/25 (12%) screened positive for depression within 2 months after discharge.
Conclusion
Patients with COVID-19 commonly experience a prolonged course of delirium in the intensive care unit, likely with multiple contributing factors. Furthermore, neuropsychological impairment may persist after discharge.
Læs mere Tjek på PubMedMachado, M. L. d. L., Souza, A. T. B., Linhares, P. V. A., Martins Ferreira, C. F., Oliveira Silva, D. F., Martins, R. R., Cobucci, R. N.
BMJ Open, 17.09.2021
Tilføjet 17.09.2021
Introduction
Ivermectin is a drug with antiviral properties and has been proposed as an alternative treatment for patients with COVID-19, in some countries; however, there is limited evidence to support its clinical use. Accordingly, the aim of this review and meta-analysis is to obtain superior evidence on the effectiveness and safety of ivermectin in treatment of COVID-19.
Methods and analysis
We will search in the medical databases and International Clinical Trials Registry Platform databases for randomised clinical trials and quasi-randomised trials published from December 2019. The criteria for inclusion are that infection needs to be confirmed by a real-time PCR or serology test, and the effect of ivermectin has been compared with placebo, symptomatic treatment or no treatment. We will exclude observational studies and clinical trials that involved patients with symptoms suggestive of COVID-19, but without a laboratorial diagnosis. Outcomes of interest include mortality, time to symptom resolution, time of hospitalisation, frequency of invasive mechanical ventilation and extracorporeal membrane oxygenation, incidence of severe acute respiratory syndrome, admission to intensive care unit, viral load, PCR-negative status, percentage of infection after prophylactic use, and total incidence of adverse and side effects. Study selection will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Two reviewers will independently select the studies and assess their eligibility. Two other reviewers will independently extract data from each study. Meta-analysis will then be carried out using fixed-effects or random-effects model, using the mean difference for continuous outcomes and the relative risk for dichotomous outcomes. Bias risk will be assessed using the Cochrane risk-of-bias tool. The quality of evidence for each outcome will be assessed using GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology. Review Manager V.5.3.5 will be used for synthesis and subgroup analysis.
Ethics and dissemination
Owing to the nature of the review, ethical approval is not required. The results will be disseminated through peer-reviewed publications.
PROSPERO registration number
CRD42020197395.
Læs mere Tjek på PubMedLunny, C., Antony, J., Rios, P., Williams, C., Ramkissoon, N., Straus, S. E., Tricco, A. C.
BMJ Open, 17.09.2021
Tilføjet 17.09.2021
Background
The objective of this rapid scoping review was to identify studies of dose-sparing strategies for administration of intramuscular seasonal influenza vaccines in healthy individuals of all ages.
Methods
Comprehensive literature searches were executed in MEDLINE, Embase and the Cochrane library. The grey literature was searched via international clinical trial registries for relevant studies published in English in the last 20 years. We included studies in healthy humans of any age that used any dose-sparing strategy to administer intramuscular seasonal influenza vaccines. Title/abstract and full-text screening were carried out by pairs of reviewers independently. Data extraction was conducted by a single reviewer and verified by a second reviewer. Our outcomes were influenza infections, intensive care unit admission, pneumonia, hospitalisations, adverse events and mortality. Results were summarised descriptively.
Results
A total of 13 studies with 10 351 participants were included in the review and all studies were randomised controlled trials (RCTs) conducted between 2006 and 2019. The most common interventions were the trivalent influenza vaccine (n=10), followed by the quadrivalent influenza vaccine (n=4). Nine studies included infants/toddlers 6–36 months old and one of these studies also included children and adolescents. In these nine studies, no clinical effectiveness outcomes were reported. Of the four adult studies (≥18 years), two studies reported on effectiveness outcomes, however, only one RCT reported on laboratory-confirmed influenza.
Conclusions
Due to the low number of studies in healthy adults and the lack of studies assessing confirmed influenza and influenza-like illness, there remains a need for further evaluation.
Læs mere Tjek på PubMedWoolf, K., Melbourne, C., Bryant, L., Guyatt, A. L., McManus, I. C., Gupta, A., Free, R. C., Nellums, L., Carr, S., John, C., Martin, C. A., Wain, L. V., Gray, L. J., Garwood, C., Modhwadia, V., Abrams, K. R., Tobin, M. D., Khunti, K., Pareek, M., on behalf of the UK-REACH Study Collaborative Group+, Pareek, Al-Oraibi, Gupta, Guyatt, Melbourne, John, Martin, McManus, Orton, Garwood, Ford, Dove, Wobi, Hood, Khunti, Woolf, Abrams, Gray, Nellums, Wain, Teece, Bryant, Tobin, Gogoi, Hassan, Free, Reed-Berendt, Carr, Modhwadia
BMJ Open, 17.09.2021
Tilføjet 17.09.2021
Introduction
The COVID-19 pandemic has resulted in significant morbidity and mortality and devastated economies globally. Among groups at increased risk are healthcare workers (HCWs) and ethnic minority groups. Emerging evidence suggests that HCWs from ethnic minority groups are at increased risk of adverse COVID-19-related outcomes. To date, there has been no large-scale analysis of these risks in UK HCWs or ancillary workers in healthcare settings, stratified by ethnicity or occupation, and adjusted for confounders. This paper reports the protocol for a prospective longitudinal questionnaire study of UK HCWs, as part of the UK-REACH programme (The United Kingdom Research study into Ethnicity And COVID-19 outcomes in Healthcare workers).
Methods and analysis
A baseline questionnaire will be administered to a national cohort of UK HCWs and ancillary workers in healthcare settings, and those registered with UK healthcare regulators, with follow-up questionnaires administered at 4 and 8 months. With consent, questionnaire data will be linked to health records with 25-year follow-up. Univariate associations between ethnicity and clinical COVID-19 outcomes, physical and mental health, and key confounders/explanatory variables will be tested. Multivariable analyses will test for associations between ethnicity and key outcomes adjusted for the confounder/explanatory variables. We will model changes over time by ethnic group, facilitating understanding of absolute and relative risks in different ethnic groups, and generalisability of findings.
Ethics and dissemination
The study is approved by Health Research Authority (reference 20/HRA/4718), and carries minimal risk. We aim to manage the small risk of participant distress about questions on sensitive topics by clearly participant information that the questionnaire covers sensitive topics and there is no obligation to answer these or any other questions, and by providing support organisation links. Results will be disseminated with reports to Government and papers submitted to pre-print servers and peer reviewed journals.
Trial registration number
ISRCTN11811602; Pre-results.
Læs mere Tjek på PubMed