Category: Corona Virus

ST. PETERSBURG, Fla. With the holiday season approaching and friends and family gathering to celebrate, your risk of catching COVID or the flu goes way up. Epidemiologists warn that both viruses are deadly, especially for older adults.

According to the Centers for Disease Control and Prevention, about 80% of seasonal flu-related deaths occur in older adults, and up to 70% of flu hospitalizations happen among adults 65 years and older.

Millie Reynolds knows about the dangers of catching COVID firsthand.

I caught COVID before they even knew what it was, and it was new," said Reynolds. "And there was no vaccine, no nothing for it.

Reynolds said she went in for a typical checkup in December 2020, but when she left, her doctor called and said she needed to go to a hospital immediately because she had contracted COVID.

I remember being sat in a wheelchair, rolled down the walkway into the hospital and up to the desk, and I dont remember anything from the middle of December to the middle of March, said Reynolds.

WFTS

Reynolds declining health also impacted her husband, Richard Breedlove.

It was upsetting, said Breedlove. Because I love her a lot, and we get along really well. So, it was one of them trying times of my life that I had to go through.

About 90% of the deaths during this year, alone, are among those 65 and over, said Kathleen Cameron with the National Council on Aging. Cameronsaid older adults are more vulnerable because many have chronic health conditions and deteriorated immune systems.

The good news is that the cost associated with the vaccines have been eliminated through a law that was passed last year, said Cameron. That law shes referring to is President Bidens Inflation Reduction Act.

The National Council on Aging is helping 150 senior centers across the United States provide updated COVID and flu vaccines. The idea is to make the potentially lifesaving vaccines more accessible to diverse and hard-to-reach populations of older adults.

We have seen an uptick in Covid here, said Sally Marvin with the Sunshine Center about the older adults who attend there.

The Sunshine Center in St. Petersburg is one of the senior centers benefitting from some of that funding from the National Council on Aging.

Were partnering with Walgreens in order to help us get the shots out there for our people. So, well be having them here to administer some of the shots, said Marvin.

As for Reynolds, she just wants to live her life to the fullest with her friends and husband, which is why shes doing everything she can to protect her health.

I have gotten every booster that needed to be done, said Reynolds.

And this message to her peers on why they should get vaccinated against COVID and the flu. And not only themselves, but for other people because if they get it, they can give it to anybody else, said Reynolds.

Read more:

Epidemiologists: COVID-19 still a threat this holiday season ... - ABC Action News Tampa Bay

Participants

Hospitalized patients with COVID-19 were recruited between May 2020 and March 2022 at the University Hospital Duesseldorf, Germany, to participate in the PROGNOSE study. Inclusion criterion was an ongoing infection with SARS-CoV-2, confirmed by real-time reverse-transcription polymerase chain reaction. Here, we only focus on patients with symptoms of COVID-19. Exclusion criteria were: (1) pregnancy, (2) previous or ongoing neurological conditions with possible influence on the study readouts, and (3) age<18years.

Patients with neurological preconditions that only affected some assessments (e.g., dementia) were excluded only for confounded investigations (e.g., neuropsychology). Study participation did not influence the clinical treatment, which was performed according to the best medical care available at the time of examination.

The study was approved by the ethical committee of the medical faculty of the Heinrich-Heine-University Dsseldorf (Study-Number 2020-979) and carried out in accordance with the declaration of Helsinki. Informed written consent was provided prior to participation by the patient or, in case of inability to consent, by relatives and post-hoc by the patient.

Since there is no COVID-19 specific score for classification of neurological symptoms and disability yet, the following established disability scores were adjusted to the COVID-19 pathology and determined by neurological examination: (1) Expanded Disability Status Scale (EDSS) based on the following Functional Systems (FS): brainstem, pyramidal, cerebral, cerebellar, sensory14, (2) Modified Rankin Scale15, (3) INCAT disability score16, (4) Barthel Index17. All scores are described in detail in the Supplementary Methods. The clinical status of the patient at the time of examination was assessed by the WHO clinical progression scale (WHO score), documenting disease severity from 0 (uninfected) to 10 (dead)18.

Blood samples were collected as part of the clinical routine during or shortly after admission, and the following laboratory markers were analyzed: C-reactive protein, urea, lymphocytes, procalcitonin, troponin, ferritin, lactate dehydrogenase, and D-dimers. At admission, the level of consciousness was assessed by the Glasgow Coma Scale19.

The neuropsychological assessment consisted of the Montreal Cognitive Assessment (MoCA, version 7)20 as a screening battery for mild cognitive impairment and the Symbol Digit Modalities Test (SDMT)21 as a measure of information processing speed (IPS). Delirium was assessed using the 4 As Test22 and Confusion Assessment Method for use in intensive care unit (ICU) patients23. MoCA and SDMT scores were transformed into demographically adjusted z-scores (see Supplementary Methods)24,25. In case of language barriers, neuropsychological assessment was limited to the SDMT or cancelled.

The EA included NCS of the right tibial, sural and ulnar nerves, BR of the bilateral ocular orbicular muscle, SSR, and motor and somatosensory evoked potentials (MEP/SSEP) to/from all extremities. If the right side could not be assessed in the NCS (e.g., due to an intravenous line) or patients specifically reported symptoms on the left side requiring clinical examination, the left side was measured instead. MEP were recorded from bilateral tibialis anterior and 1st dorsal interosseus muscles. Supramaximal stimuli of bilateral medial and tibial nerves with at least 200 averages were used for SSEP, recording responses at the poplitea/Erbs point, C5/T12 and Cp/Cz, respectively.

All measurements were carried out with a Nihon Kohden Neuropack X1 (Nihon Kohden Corporation, Tokyo, Japan) and AgAgCl surface electrodes (2820mm [MEP, SSR, and NCS]/ 2015mm [BR], Ambu, Ballerup, Denmark) and subdermal needle electrodes (SSEP/120.4mm, Ambu, Ballerup, Denmark) were used for recordings. MEP were evoked by single pulse transcranial magnetic stimulation via a standard circular coil (90mm outer diameter, The Magstim Company Ltd., Whitland, UK) connected to a Magstim 200 (The Magstim Company Ltd., Whitland, UK).

All EA were evaluated based on the clinical norms of the University Hospital Dsseldorf (Supplementary Tables S1S5) and affections were classified into PNS, CNS, and ANS (multiple selection possible).

PNS affection was defined as any abnormality in the NCS (distal motor latency [DML], F-wave latency, compound muscle action potential [CMAP], sensory nerve action potential [SNAP], motor/sensory conduction velocity [mCV/sCV]) or the following abnormalities in the BR: (1) R1, iR2 and cR2 exclusively delayed on one side, or (2) R1 and iR2 delayed on one side and cR2 delayed on the other side. Axonal pathology was defined as a reduction in CMAP/SNAP amplitude, whereas demyelinating pathology was defined as a reduction in mCV/sCV or prolongation of DML or F-wave latency.

CNS affection was defined as (1) reduced N20 and/or P40 in the SSEP and normal peripheral response (defined as normal N10 in the SSEP, if available, or as normal latency measured in the NCS), (2) increased central motor conduction time (CMCT) in the MEP, (3) increased cortical latency in the MEP and normal peripheral response (measured in the NCS), (4) delayed R1 exclusively on one side in the BR, (5) delayed R2 exclusively on one side in the BR, 6) delayed R2 on both sides in the BR.

ANS affection was defined as pathological latencies in the SSR. Please refer to Supplementary Tables S1S5 for applied cut-offs for each assessment.

Since the primary goal of the study was to investigate the unknown prevalence of (sub)clinical neurological affections, sample size was based on the number of patients willing to participate rather than statistical power calculation.

Clinical and demographic differences between surviving and deceased patients were assessed by Fishers exact test for categorical data and MannWhitney-U-test for continuous variables with non-normal distribution. P-values<0.05 were considered significant. Prevalence rates were calculated using crosstabulations (1) considering all patients, including those with missing data, and (2) including only patients who underwent the respective assessments. Exploratively, statistical analyses were repeated excluding patients with diabetes mellitus (DM) as the most prevalent potential confounding factor.

The relationship between abnormalities in the EA and death was assessed by Firth logistic regression models. Firth logistic regression models were also calculated for all predictive parameters for the patients outcome of the 4C Deterioration Model and 4C Mortality Score26,27, as well as for the WHO score18, sedation, and the Modified Rankin Scale15. Due to the exploratory nature of the study, we did not correct for multiple testing.

To avoid confounding influences of sedation, regression analyses were repeated excluding sedated patients. Further, age and sex were included as potentially confounding factors. All analyses were repeated using the raw data of the EA as independent factor.

Probabilities of mortality were estimated using KaplanMeier analysis and Cox proportional hazard models were used to compare the probability of death between patients with and without pathological findings in the EA. Again, analyses were conducted separately for the whole sample and, subsequently, only for non-sedated patients.

All analyses were conducted using R Studio (version 2021.09.1+372), except for KaplanMeier analysis and Cox proportional hazard models which were conducted using IBM SPSS Statistics (version 26).

Read more here:

Prevalence and prognostic value of neurological affections in ... - Nature.com

TOPEKA The Kansas Department of Commerce today announced 15 Kansas communities would receive their share of $2 million from the Community Development Block Grant-COVID Resiliency (CDBG-CVR) competitive grant program. This program was funded via the Coronavirus Aid, Relief, and Economic Security (CARES) Act.

CDBG-CVR was designed to empower Kansas businesses to enhance their resiliency in the face of future community illnesses and public health emergencies.

These grants will be a game-changer for many Kansas businesses, Lieutenant Governor and Secretary of Commerce David Toland said. This investment in pandemic resiliency not only will help retain jobs but help our state attract new businesses, further boosting our emerging economy.

The grants support a wide range of projects, including technology and infrastructure upgrades, professional development, and other initiatives aimed at preventing future closures due to public health crises. The awardee communities will distribute their funds to local businesses previously identified in their proposals.

The CDBG-CVR competitive grant program focused on the following key areas:

The 15 awardees represent a diverse range of businesses across Kansas, each with projects that align with the programs objectives.

Fourteen communities each will receive $141,642 for distribution. They include the cities of Baldwin City, Holton, Horton, McPherson, Smith Center and WaKeeney, as well as Cloud, Graham, Lincoln, Mitchell, Rawlins, Rooks, Smith and Sumner counties. The city of Columbus was awarded $17,000.

The grants will help businesses survive challenging times and position them for long-term success.

CDBG-CVR is the fourth and final round of the Kansas CDBG-CV program, which has had a profound impact, providing essential assistance to 1,356 small businesses across the state. Since 2020, the program has disbursed more than $16.1 million in grant funds, demonstrating Commerces commitment to supporting the resilience of local enterprises. These investments were key to small business survival during and after the COVID-19 pandemic.

The Kansas Department of Commerce works tirelessly to advance the economic well-being of the state by promoting job creation, workforce development and business growth, Community Development Director Kayla Savage said. Through grants like CDBG-CVR, the department seeks to create a thriving and prosperous Kansas for all.

The Kansas Department of Commerce extends its congratulations to the awardees and commends their dedication to business resiliency.

See more here:

Commerce Announces $2M in CDBG-COVID Resiliency ... - the Kansas Department of Commerce!

Specialty

Please choose I'm not a medical professional. Allergy and Immunology Anatomy Anesthesiology Cardiac/Thoracic/Vascular Surgery Cardiology Critical Care Dentistry Dermatology Diabetes and Endocrinology Emergency Medicine Epidemiology and Public Health Family Medicine Forensic Medicine Gastroenterology General Practice Genetics Geriatrics Health Policy Hematology HIV/AIDS Hospital-based Medicine I'm not a medical professional. Infectious Disease Integrative/Complementary Medicine Internal Medicine Internal Medicine-Pediatrics Medical Education and Simulation Medical Physics Medical Student Nephrology Neurological Surgery Neurology Nuclear Medicine Nutrition Obstetrics and Gynecology Occupational Health Oncology Ophthalmology Optometry Oral Medicine Orthopaedics Osteopathic Medicine Otolaryngology Pain Management Palliative Care Pathology Pediatrics Pediatric Surgery Physical Medicine and Rehabilitation Plastic Surgery Podiatry Preventive Medicine Psychiatry Psychology Pulmonology Radiation Oncology Radiology Rheumatology Substance Use and Addiction Surgery Therapeutics Trauma Urology Miscellaneous

Read this article:

Examining the Dynamics of COVID-19 Misinformation: Social Media ... - Cureus

Specialty

Please choose I'm not a medical professional. Allergy and Immunology Anatomy Anesthesiology Cardiac/Thoracic/Vascular Surgery Cardiology Critical Care Dentistry Dermatology Diabetes and Endocrinology Emergency Medicine Epidemiology and Public Health Family Medicine Forensic Medicine Gastroenterology General Practice Genetics Geriatrics Health Policy Hematology HIV/AIDS Hospital-based Medicine I'm not a medical professional. Infectious Disease Integrative/Complementary Medicine Internal Medicine Internal Medicine-Pediatrics Medical Education and Simulation Medical Physics Medical Student Nephrology Neurological Surgery Neurology Nuclear Medicine Nutrition Obstetrics and Gynecology Occupational Health Oncology Ophthalmology Optometry Oral Medicine Orthopaedics Osteopathic Medicine Otolaryngology Pain Management Palliative Care Pathology Pediatrics Pediatric Surgery Physical Medicine and Rehabilitation Plastic Surgery Podiatry Preventive Medicine Psychiatry Psychology Pulmonology Radiation Oncology Radiology Rheumatology Substance Use and Addiction Surgery Therapeutics Trauma Urology Miscellaneous

See more here:

Emotions, Perceived Stressors, and Coping Strategies Among ... - Cureus

Australia appears to be on the cusp of an eighth COVID-19 wave, with an increase in cases across the country.

Victoria's acting chief health officer has suggested all Melburnians consider donning masks again as community transmission surges, whileNSW chief health officer Kerry Chantsays case numbers will likely rise in the lead-up to Christmas.

Here's a quick refresh on all of the key facts about coronavirus.

Health experts say COVID-19 has similar symptoms to the common cold or flu.

The Australian government lists the most common symptoms of COVID-19 as:

Some of the less common symptoms you could experience include:

For most people who are vaccinated against COVID-19, it is a mild illness that can be managed at home by resting, eating a balanced diet, and staying hydrated.

Isolation is no longer a legal requirementif you test positive for COVID-19.

But it is strongly recommended you stay home if positive.

If you have tested positive,the Australian government says you should not visit high-risk settings like hospitals and disability aged-care settings:

If you are planning on leaving your home while infected, consider the following:

There's no exact timeframe.

"The infectious period is dependent on individual factors such as age, severity of illness, vaccination status, including time since last vaccination against COVID-19, and whether someone is immunocompromised," a federal Department of Health spokesperson said.

"Some people can have a prolonged infectious period, however most people with mild-moderate illness are unlikely to be infectious for more than 10 days after symptom onset.

"Recent evidence suggests most children are likely no longer infectious by five days following a positive COVID-19 test."

Most people infected with COVID recover within a few weeks of their first symptoms.

However, some people can experience symptoms of the virus for several weeks after infection. This is known as long COVID.

People with long COVID report feeling extreme tiredness and fatigue, difficulty breathing, and problems with memory and concentration "brain fog".

The Australian government says long COVID recovery times will differ for each person, but most recover within three to four months.

Face masks are no longer mandatory in most places.

But each state and territory has its own advice about face coverings and COVID-19 so the advice is slightly different depending on where you are.

Here's a quick wrap of what each jurisdiction's health department says on masks:

Masks are strongly recommended in indoor public spaces for people who have tested positive to COVID-19 if they need to leave the home, and for household contacts of people with COVID-19.

ACT health website

You may be required to wear a mask in NSW when visiting high-risk settings such as aged and disability care. Masks are also recommended in general practices, medical centres and pharmacies.

NSW health website

In the NT, wearing a mask remains recommended in indoor and outdoor settings where physical distancing is not possible.

NT health website

You should consider wearing a mask:

QLD health website

It is recommended you wear a face mask in SAif you:

SA health website

Wearing a mask is recommended where physical distancing is not possible.

You should consider wearing a mask if you are at a higher risk of serious illness from COVID-19 or are in contact with people who are at a higher risk.

If you test positive for COVID-19 or have symptoms, you should wear a mask if you need to leave your home.

TAS health website

The government recommends wearing a mask:

VIC health website

Face masks are not mandatory in Western Australia, but they should be worn in crowded indoor spaces and where physical distancing is not possible.

WA health website

The Therapeutic Goods Administration (TGA) recommends against the use of expired rapid antigen tests (RATs).

If you're unsure when the test you have at homeexpires, you can check the TGA's website to see theapproved shelf-life of specific brands of RATs.

As of October 25, 2023, there have been almost 7 million COVID-19 deaths globally reported to the World Health Organization (WHO).

Since the start of the pandemic, Australia has recorded more than 23,300 COVIDdeaths.

See original here:

COVID cases are rising across Australia. Here's a rundown of the latest advice - ABC News

5 hours ago

Image source, Getty Images

The Covid pandemic may have impacted brain health in people in the UK aged 50 and over, according to a new study.

More than 3,000 volunteers completed yearly questionnaires and online cognitive tests to measure changes in memory, and other faculties, as the pandemic unfolded.

The results revealed a decline, irrespective of Covid infection.

Stress, loneliness and alcohol consumption may explain some of the findings, experts say.

Coping with Covid fears, worries and uncertainties and disruption to routines may have had a "real, lasting impact" on brain health, they say.

The rate of the drop in cognitive function was accelerated during the first year of the pandemic, when lockdowns occurred, the study found.

For memory issues, the decline continued into the second year.

People who already had some mild memory problems before the pandemic began had the worst overall decline.

Image source, Science Photo Library

The study, called PROTECT - published in The Lancet Healthy Longevity - was set up to help understand how healthy brains age and why some people develop dementia.

It uses brain-training games to check memory skills and reasoning, while the questionnaire looks for possible risk factors that could harm brain health.

The plan is to keep the study running in the future to see how participants fare, and what lessons can be learned to help others.

Based on the current findings, lead investigator Prof Anne Corbett, from the University of Exeter and previously King's College London, says pandemic conditions may have hastened brain decline.

"Our findings suggest that lockdowns and other restrictions we experienced during the pandemic have had a real, lasting impact on brain health in people aged 50 or over, even after the lockdowns ended.

"This raises the important question of whether people are at a potentially higher risk of cognitive decline which can lead to dementia.

"It is now more important than ever to make sure we are supporting people with early cognitive decline, especially because there are things they can do to reduce their risk of dementia later on.

"So if you are concerned about your memory, the best thing to do is to make an appointment with your GP and get an assessment."

Dr Dorina Cadar, a dementia expert from Brighton and Sussex Medical School, said the effect of the pandemic on the general population had been "catastrophic".

"Many of the long-term consequences of Covid-19, or the restriction measures implemented around the world, remain unknown,"

She recommended more research, and said although the findings could not prove cause and effect, there is mounting evidence that some of the factors described, such as social isolation, can negatively impact brain health.

Dr Susan Mitchell from Alzheimer's Research UK said: "While our genetics play an important role in the health of our brains as we age, we know that a range of health and lifestyle factors can impact our brain health.

"Sadly, there's no sure-fire way to prevent dementia yet, but meanwhile, taking care of our brains can at least help stack the odds in our favour. It's never too early or too late to think about adopting healthy habits, which includes looking after your heart health, keeping connected and staying sharp."

Go here to read the rest:

Brain power dropped among over-50s during Covid-19 pandemic, study shows - BBC.com

Asking people to wear masks is linked to reduced coronavirus transmission

Richard B. Levine/Alamy

A review of the studies done so far has concluded that wearing masks really does help prevent the spread of covid-19. It is far from the first paper to come to this finding, so why does the issue remain so controversial? The problem is that it isnt easy to carry out individual studies of the highest standard during a pandemic.

That standard is a randomised controlled trial (RCT), in which people are randomly assigned to either get a treatment or intervention, in this case wearing a mask, or not. Because of the practical difficulties, only two RCTs have looked at whether wearing masks prevents the spread of covid-19 outside of healthcare settings.

One, in Denmark, was too small to produce a statistically significant result. The other, in Bangladesh, found that in villages randomly chosen to be supplied with masks, 35 per cent fewer people aged more than 60 years old and 10 per cent fewer people overall got symptomatic infections, compared with villages that werent supplied with masks.

As such, the much-criticised Cochrane review published in January, which looked only at RCTs, said it couldnt draw firm conclusions about the efficacy of masks. Some people then wrongly claimed that this review found that masks dont work.

Many highly effective policies, such as speed limits and the wearing of seatbelts, have never been assessed by RCTs, as pointed out by Shama Cash-Goldwasser at the Resolve to Save Lives initiative in New York. When few RCTs have been done, it is appropriate to look at other kinds of evidence, she and her colleagues write in their review.

To start with, lab studies show that masks help block the relatively large droplets and aerosols that can carry viruses, with higher-quality N95 masks filtering out more than lower-quality masks.

Then there are so-called observational studies, which look back at events and try to work out what effect certain measures may have had. For instance, during an outbreak on a ship called the USS Theodore Roosevelt early in the pandemic, crew members who reported wearing masks were 30 per cent less likely to have been infected than those who reported not wearing them.

The question of whether people who wear masks are less likely to be infected isnt the same as that of whether authorities asking people to wear masks known as a mask mandate reduces infection rates more widely, including among those who dont actually wear masks themselves. In Germany, a study that compared regions that introduced mask mandates at different times found a 45 per cent reduction in infections.

A similar US study found a 25 per cent reduction four weeks after a mask mandate was introduced. Varying levels of adherence mean the effectiveness of mask mandates will vary from place to place and over time, the team notes.

Available evidence strongly suggests that masking in the community can reduce the spread of SARS-CoV-2, the review concludes.

I think theyve got it right, says Christopher Dye at the University of Oxford, whose team has done an even more comprehensive review as part of a Royal Society report. In our review, we found essentially the same results in healthcare settings as in communities, he says.

As observational studies arent randomised, it is difficult to ensure there is no bias, says Dye. However, when many different observational studies all come to the same conclusion, we can have more confidence in the findings.

Cash-Goldwasser and her colleagues also note that no public health intervention is 100 per cent effective and the benefits of masks have to be weighed against any adverse effects. For instance, it has been suggested wearing masks might affect the development of young children.

Authorities need to be clear about the evidence so they can make the best decisions in the event of another pandemic, the review concludes. Masking with the highest-quality masks that can be made widely available should play an important role in controlling whatever pandemic caused by a respiratory pathogen awaits us.

Topics:

See the article here:

Face masks ward off covid-19, so why are we still arguing about it? - New Scientist

Pfizer has priced Paxlovid at $1,390 for the five-day treatment course, the company confirmed to AARP. If all goes according to plan, however, most people will not have to pay that amount, Kates says.

Pfizer has said it will offer a copay program for eligible privately insured patients through 2028, though details of this program, including who might be eligible and how much assistance people can expect to receive, have not been released.

Health & Wellness

Target Optical

Savings on eye exams and eyewear at national retailers

See more Health & Wellness offers >

HHS says it expects there to be commercial coverage for Lagevrio as well. The drugs maker hasnt yet set a price for its pills, but the company told AARP it will be releasing that in the near future.

If you come down with COVID-19 in the next few weeks and need treatment, you may not see a bill at all. During the transition, the government is encouraging health care providers and pharmacies to continue to use federally acquired product until it is depleted or until it expires, at no cost to patients.

You shouldnt have to pay out of pocket for treatment in the next few years if youre uninsured. Pfizer says Paxlovid will remain free for people without health insurance through 2028, and beginning in 2025 it will be free for people who are underinsured, also through 2028. More information will be available soon at paxlovid.com or by calling 1-877-219-7225.

Merck has said that it will have a patient assistance program for eligible patients who, without assistance, could not otherwise afford the product. More information on this program will be available after Nov. 17 at merckhelps.com or by calling 1-800-727-5400.

Its not unusual for transitions to come with a few glitches and hiccups. But any wrinkles are a particular concern when it comes to COVID-19 treatments, health experts say, since timely access to the antivirals is key.

The medications work best when started right away within five days of the onset of symptoms. Any delays due to cumbersome copay programs or confusion over coverage could risk a persons ability to benefit from the treatment, Kates says.

If it creates any holdups or backups, which does happen in the health care system, that could mean the difference between being able to access this medication that is highly important for some people, and not getting it, Kates adds.

Here is the original post:

Is Paxlovid Free? New Costs of COVID Treatments - AARP

In a recent study published in the British Journal of Psychiatry, researchers evaluated mortality in individuals with severe mental illness (SMI) following coronavirus disease 2019 (COVID-19) infection.

People with SMI have a 15-to-20-year reduced life expectancy relative to the general public, which has remained consistently high over decades before the COVID-19 pandemic, regardless of ethnicity and race. Further, reports suggest that individuals with SMI have an excess death risk due to COVID-19 and other causes and, generally, have a higher risk of hospitalization, with concerns that pre-existing conditions might contribute to this (excess) risk.

The COVID-19 pandemic has exacerbated pre-existing inequalities, especially in relation to ethnicity/race. The intersection of ethnicity/race with SMI on COVID-19 outcomes remains unclear. Moreover, some racial minority groups have a higher prevalence of multimorbidity, and there are concerns that these groups may experience delayed access to testing and vaccination. Further, how SMI in racial minorities contributes to excess mortality risk after COVID-19 remains unknown.

In the present study, researchers investigated whether mortality risk was higher in people with SMI post-COVID-19 and whether multimorbidity and ethnicity/race had any effect on this risk. Data from family practices in Northern Ireland and England were obtained from the Aurum database. Patients in this database broadly represented the United Kingdom (UK) population by age, sex, area-level deprivation, and geographical distribution.

The SMI group included patients aged 5 with an SMI and a definitive infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) between February 2020 and March 2021. They defined SMI as having at least one record for bipolar disorder, schizoaffective disorder, schizophrenia, or other affective disorders with psychosis. The population control group included SARS-CoV-2-positive patients without an SMI diagnosis.

Patients were followed up until death, registration termination, or study end date. Notably, patients with an SMI diagnosis after COVID-19 were excluded to reduce reverse causation risk. The studys outcome was all-cause mortality. Covariate factors used to find determinant factors were demographic factors like age, sex, ethnicity, area deprivation, and geographical regions. Area deprivation was a composite metric of area-level skills, education, income, crime, disability, health, housing, training, and employment.

Data on admission to intensive care unit (ICU), multimorbidity linked with higher COVID-19 risk, and corticosteroid drug and immunological therapy were also included. Clinical variables included body mass index (BMI) and smoking status. Multivariable Cox proportional hazards regression was used to estimate differences in mortality between SMI and control groups.

The study included 7,146 patients in the SMI group and 653,024 controls. Patients in the SMI group were older than controls; the SMI group had a higher proportion of patients with obesity and multimorbidity, current smokers, and people of Black African/Caribbean ethnicity. The study period spanned two COVID-19 waves.

The SMI group had a higher likelihood of death from COVID-19 than controls. COVID-19 deaths in the UK surged from March/April 2020, and no casualties were observed initially within the first 60 days post-COVID-19. There were fewer deaths within 60 to 90 days post-infection. The researchers observed steeper declines in survival probabilities in the SMI group during both COVID-19 waves, which were reproduced in covariate-adjusted survival probabilities.

Patients in the SMI group were at a higher risk of all-cause mortality in gender- and age-adjusted models, which was consistent in models with further adjustment for smoking status, BMI, area deprivation, multimorbidity, and ethnicity/race. There were no interactions between ethnicity/race and SMI.

Nonetheless, Black African/Caribbean groups had a higher mortality risk following COVID-19 than White people. The adjusted hazard ratio for all-cause mortality in the SMI group was 1.71 and 1.4 in the first and second waves, respectively, compared to controls. Notably, the researchers observed a statistical interaction between SMI and multimorbidity.

Data indicated that the additional, multiplicative effect of multimorbidity was significant in both groups but greater in controls. Sensitivity analyses, in which SMI and control patients were matched on the number of multimorbid conditions, produced similar results as the primary analysis. Additionally, results were comparable when SMI patients under 18 were excluded.

Taken together, the study demonstrated that SMI patients experienced a substantially greater risk of death from COVID-19. Mortality among SMI patients increased steeply during the first wave of COVID-19 compared to controls. Both groups showed a steep decline in survival probability at about 400 days. Furthermore, the SMI group had a greater and longer risk of all-cause mortality during the second wave than controls.

Black people were at a higher risk of death from COVID-19 than White people. The findings highlighted the effect of multimorbidity on mortality risk in both groups. Overall, the study underscored that SMI patients experienced substantial inequalities in mortality outcomes during COVID-19, magnified by multimorbidity.

Link:

Understanding COVID-19 mortality in people with severe mental ... - News-Medical.Net