Category: Covid-19

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Mostly its criminal dockets still affected at this point

Today at 1:00 a.m.

by Ron Wood

FAYETTEVILLE -- Courts around Northwest Arkansas have been playing catch-up since reopening after the covid-19 pandemic largely shuttered them for more than a year.

"I cannot say we're caught up, and I can't tell you how long it's going to be, but we're doing the best we can," said Washington County...

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Clearing the backlog: Some courts in Northwest Arkansas still feeling effect of pandemic slowdown | Arkansas ... - Arkansas Online

If you've tried to look up the number of COVID cases in your area recently, you may have found it a frustrating exercise.

The reporting frequency in states and territories has been slowing down, from daily to weekly, and now fortnightly or monthly.

On top of that, what do the numbers even mean now? And how many are being missed?

It's been a long time since we were asked to get a PCR test at the slightest sign of a tickly throat.

Now, the vast majority of cases are going undiagnosed or unreported.

That degradation in data quality is visible for everyone to see, and it's no surprise: it would've been a big ask for us to keep up the COVID surveillance effort of 2020 and 2021 forever.

Likewise, behind the scenes governments have been steadily dismantling many other elements of a surveillance system that we were so reliant on in the emergency period of the COVID-19 pandemic.

Some public health experts think it's a shame that we're apparently returning back to the pre-pandemic ways we handled respiratory disease, after we've learned so much.

The most recent thing to be discontinued is a weekly series of forecasts and "situational assessment reports" for federal and state officials.

The federal government had been contracting a group of mathematical modellers across multiple institutions to produce it, and it was one of the key regular pieces of advice they received.

The forecasts gave assessments of the COVID situation, including estimates for the effective reproduction number and transmission potential in each state and territory.

But the government has decided not to continue with that work, and in December, the contract ended.

The health department says the forecasting was in place for the emergency response phase, and has been ended given that COVID-19 is no longer a "Communicable Disease Incident of National Significance".

Professor James Wood from the UNSW school of population health was one of the researchers involved in the work. "I'm not surprised," he says. "For some time, the government hasn't been changing its decisions based on the epidemiological or modelling reports.

"Whether or not cases were going up might be of interest in terms of planning to some extent but hospital capacity wasn't being continuously strained and so on, so I think the value of it in the short term was less for government."

It's a return toward our pre-pandemic approach to respiratory disease, and that's precisely the strategy: ministers and health officers have been saying for a long time that COVID is now being managed consistent with other communicable diseases like flu.

But some experts argue that we could use the lessons from COVID to do a much better job of tracking and managing flu than we did before.

"It does leave a gap in terms of epidemic intelligence and what's happening not only with COVID, but flu and RSV and probably in the next year or two, whooping cough as well will be one we'll want to watch," Professor Wood says.

In 2022 the US went through a "tripledemic", where COVID, the flu and RSV all circulated simultaneously in high numbers.

The reality now is that when respiratory diseases are putting pressure on health systems, it won't be because of a single pathogen. It could be several at once.

In the journal Emerging Infectious Diseasesthis month, a group of public health experts called it a "critical time" to review disease surveillance practices, suggesting an "integrated model of surveillance" that considers multiple respiratory viruses.

"Resuming pathogen-specific surveillance approaches, such as those for monitoring influenza, would represent a missed opportunity to build on learnings from emergency response efforts," the authors wrote.

And ongoing surveillance is important if you want to catch emerging waves, new variants of concern, and entirely new pandemics early.

In order to monitor trends you have to monitor the inter-epidemic period as well the emergency period.

If you only stand things up when concerns arise overseas, you run the risk of acting too late.

Professor Wood states it more clearly: "We don't have a clear forward plan."

"We've missed a little bit of an opportunity while COVID was in front of everyone's minds to initiate more changes."

The government says something is in the works, and that a National Surveillance Plan for COVID-19, influenza, and RSV is being developed.

"As part of this development process, a comprehensive review of national viral respiratory infection surveillance is being undertaken, including an assessment of current gaps in surveillance, potential novel and/or enhanced surveillance systems and data sources to fill these gaps, and the benefits and limitations of each," the health department says.

"This will include an assessment of the cost-effectiveness and sustainability of population prevalence surveys within the Australian surveillance context."

Professor Wood says this is all happening while COVID-19 continues to have a significant impact.

"Obviously, we're very glad that it's dropped from being something where we were worried about losing 100,000 lives a year in the initial phase, to 15,000 in the Omicron year to maybe 5,000 last year," he says.

"It's a lot better, but that's still worse than flu, right?"

"I do think we have an opportunity here to take that a bit more seriously in terms of how we view it, how we measure it, and how we advise the community on how to deal with it."

Outside Australia, governments have clearly recognised the value of forecasting in public health.

In the US, the Centers for Disease Control and Prevention announced more than US$250 million over five years to establish a network of infectious disease forecasting centres.

That's one of the actions of the CDC's Center for Forecasting and Outbreak Analytics.

It was launched in 2022, directly in response to the COVID-19 pandemic.

The European Union's equivalent to the American CDC, the ECDC, also launched a respiratory forecasting programlate last year.

It shows how other countries are investing in the intelligence that they saw had value through the pandemic, and seemingly prioritising it more than Australia.

The Australian government is in the process of setting up a CDC here. It exists in interim form right now, with staff recruitment expected to happen this year.

That body may have some role in respiratory forecasting, but it is still in its infancy.

The health department says it is now focusing on "the adoption of novel and cost-effective surveillance strategies, with a reduced focus on case notifications".

"The use of sentinel surveillance, healthcare utilisation data, genomic sequencing, and wastewater analysis will allow us to shift our surveillance approach to a more sustainable and integrated system that is more appropriate to the current epidemiological situation," the department said in response to the ABC's questions.

Wastewater analysis was one of the big new developments of the COVID pandemic, but Professor Wood says there's a bit of work to do before we can rely more heavily on it.

"Tools like wastewater or some of the surveys like flu tracking may be promising ways to do this, but they haven't been validated," he says.

"And until we invest in doing some actual prevalence surveys and comparing with a known technique where we know the percentage positive and so on, we're not really confident that this is actually consistently a good measure.

"We don't know. There's been some slightly weird results to wastewater in Europe in the most recent wave."

In the meantime, modellers and public health experts plan to continue some of their work.

"Myself and others in Australia are going to continue to do some forecasting this year," Wood says.

"But we have to set up new data agreements with state carriers, we have to rely on them being interested, and we'll have to find some way to make this something we can continue to fund."

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Governments have been steadily dismantling the COVID surveillance system, but is that a backward step? - ABC News

Study shows increase in STIs in adolescents during the COVID-19 pandemic: New Africa - stock.adobe.com

In the United States, nearly 1 in 4 female adolescents and young adults test positive for sexually transmitted infections (STIs) annually, a statistic made even more troubling by the fact that these young women often avoid health care due to cost, transportation, and confidentiality concerns. With more than 33% of adolescents reporting no primary care provider, this demographic often relies on emergency departments (EDs) and inpatient (IP) settings for their health care needs.

With the COVID-19 pandemic having decreased healthcare access in the United States, adolescents at risk for sexually transmitted diseases were further compromised. At the time, health experts warned of adverse outcomes on sexual and reproductive health (SRH) for adolescents.

Recently, a study published in Hospital Pediatrics compared changes in STI diagnoses during adolescent visits at childrens hospitals during the COVID-19 pandemic to diagnoses before the pandemic. Investigators conducted the retrospective cohort study using the Pediatric Health Information System database comparing adolescent (aged 11 to 18 years) hospital visits with an STI diagnosis by the International Classification of Diseases, 10th revision, during COVID-19 from 2020 to pre-COVID-19 (2017 through 2019).

A total of 2,747,135 adolescent visits from 44 hospitals in the United States were studied, of which 10,941 resulted in an STI diagnosis. The majority (54.5%) of the STI diagnoses were the primary diagnosis: an STI was the primary diagnosis for 36% of IP visits and 66% of ED visits. Where an STI was a secondary diagnosis, the most common primary diagnoses included urinary tract infections, sepsis, acute vaginitis, and unspecified abdominal pain.

During the summer of 2020, compared to the pre-COVID-19 period, there was an increase (30.4%) in median inpatient weekly visits overall with an STI diagnosis, as well as an increase in visits in fall 2020 (27.3%). Investigators also acknowledged that other recent studies have shown decreased STI testing and increased STI diagnoses in various clinical settings during COVID-19 periods of 2020. Our findings may be partially driven by changes in health care utilization (eg, loss of primary care access and school-based sexual education) and increased reliance on nontraditional settings for SRH care, including hospital-based care, noted the authors.

Researchers concluded that as a result of this increase in adolescent inpatient visits with an STI diagnosis in 2020, further work is needed to improve STI care, particularly for this demographic. In the study, the authors noted, Given our findings and recent literature on SRH care of adolescents during COVID-19, efforts are needed to optimize SRH care and offset risk for increased STIsto prepare for future pandemics. To optimize STI testing and treatment, innovative efforts are needed, including virtual and in-person outreach, to increase adolescent access to SRH education and care. These efforts are instrumental to reduce the risk for STIs among adolescents cared for in the hospital with the potential to improve related health outcomesin future health care crises.

Reference

Masonbrink AR, Abella M, Hall M, Gooding HC, Burger RK, Goyal MK. Sexually transmitted infection diagnoses at childrens hospitals during COVID-19. Hosp Pediatr. 2024;14(1):e1-35. doi:10.1542/hpeds.2022-006750

Read more from the original source:

Study shows increase in STIs in adolescents during the COVID-19 pandemic - Contemporary Obgyn

by Timothy McQuiston, Vermont Business Magazine COVID-19 cases and hospitalizations remained relatively low last week after a long period of edging higher from last summer through early January. Cases and hospitalizations increased slightly for the week. However, fatalities have not seen a related spike nor decline. Deaths reported by the Vermont Department of Health continue to average about 6 a week, for a pandemic total now of 1,112 as of January 20, 2024 (the most recent data available). Total deaths in January are 23 so far and are nearing a monthly level not seen in a full year.

The VDH reported January 31, 2024, that COVID-19 hospitalizations were up 7 last week to a statewide total of 46. COVID-19 activity remains in the "Low" range, according to the VDH. Reported cases last week were 307, up 32 for the week.

Of the total deaths to date, 895 have been of Vermonters 70 or older. There have been 3 deaths of Vermonters under 30 since the beginning of the pandemic.

CDC states that already an estimated 97% of Americans have some level of immunity, from either vaccination or infection or both, which they said will help keep down new transmission and lessen serious outcomes.

New COVID-19 variant JN.1: Experts explain symptoms, how to spot and treat the new strain

(see data tables below)

Report Timeframe: January 21 to January 27, 2024

The hospitalizations dataset contains day-level data reported from all Vermont hospitals each Tuesday. Reported numbers are subject to correction.

The number of reportable COVID-19 cases is still available in this report, below. Laboratory-confirmed and diagnosed COVID-19 cases and COVID-19 outbreaks must still be reported to the Vermont Department of Health.

There were 4 outbreaks last week, 1 at schools, and 3 at long-term care facilities (LTC). There were 9 outbreaks the week before.

Vermont Department of Health recommendations: Preventing COVID-19 (healthvermont.gov)

Vermont has the second lowest fatality rate in the US (128.7 per 100K; Hawaii 102.5/100K). Mississippi (441.1/100K) and Oklahoma (438.7/100K) have the highest rates. The US average is 294.1/100K (CDC data).

There has been a total of 1,174,626 COVID-related deaths to date in the US (CDC) and 7,023,271 globally (WHO).

Following an analysis of COVID-19 data, the VDH reported in January 2023 a cumulative 86 additional COVID-associated deaths that occurred over the course of the pandemic but had not been previously reported. Most of those deaths occurred in 2022.

COVID-19 Update for the United States

Early Indicators

Test Positivity

% Test Positivity

6.3%

(January 21 to January 27, 2024)

Trend in % Test Positivity

-4.6% in most recent week

Emergency Department Visits

% Diagnosed as COVID-19

2.0%

(January 21 to January 27, 2024)

Trend in % Emergency Department Visits

-11% in most recent week

These early indicators represent a portion of national COVID-19 tests and emergency department visits. Wastewater information also provides early indicators of spread.

Severity Indicators

Hospitalizations

Hospital Admissions

22,636

(January 21 to January 27, 2024)

Trend in Hospital Admissions

-10.9% in most recent week

Deaths

% of All Deaths in U.S. Due to COVID-19

3.6%

(January 21 to January 27, 2024)

Trend in % COVID-19 Deaths

No change in most recent week

Total Hospitalizations

6,771,932

CDC | Test Positivity data through: January 27, 2024; Emergency Department Visit data through: January 27, 2024; Hospitalization data through: January 27, 2024; Death data through: January 27, 2024. Posted: February 2, 2024 12:00 PM ET

The Delta variant took off in August 2021, which resulted in the heaviest number of deaths before vaccines and their boosters helped alleviate serious COVID cases. Multiple Omicron variants are now circulating and appear more virulent than previous variants, but perhaps not more dangerous, according to the CDC.

AP April 5, 2023: WHO downgrades COVID pandemic, says it's no longer a global health emergency

Walk-in vaccination clinics run by the state closed on January 31, 2023. Learn more

Vermonters are reminded that all state COVID testing sites were closed as of June 25, 2022. PCR and take-home tests are available through doctors' offices, pharmacies and via mail from the federal government. The federal government officially ended its pandemic response as of May 11, 2023. See more information BELOW or here: https://www.healthvermont.gov/covid-19/testing.

Starting May 11, 2023, the CDC and Vermont Department of Health will no longer use the COVID-19 Community Level to measure COVID-19 activity in the U.S. and Vermont. Instead, Vermont's statewide COVID-19 level will be measured by the rate of COVID-19 in people being admitted to the hospital, per 100,000 residents.

Focusing on hospitalization data is a better estimate of how COVID-19 is impacting the community now that reported COVID-19 cases represent a smaller proportion of actual infections. This also allows us to compare Vermonts hospitalization levels with other parts of the country.

The Delta variant caused a surge in COVID-related fatalities last fall and into the winter.

The highest concentration of deaths was from September 2021 through February 2022. Overall, December 2020 and January 2022 were the worst months with 72 fatalities each.

The US confirmed its first case of COVID-19 on January 20, 2020.

Vermonters ages 6 months and older are eligible for COVID-19 vaccines. Getting vaccinated against COVID-19 is the safer way to build protection from serious illnesseven for those who have already had COVID-19. Learn more about COVID-19 vaccines (CDC)

COVID-19 vaccines are free and widely available. Anyone can get vaccinated in Vermont, including those who live in another state, are non-U.S. citizens, or who have no insurance. See Vermont's current vaccine rates

Know your rights when getting free vaccines.

You are considered up-to-date if you are over the age of 6 years old and have received a bivalent (updated) COVID-19 vaccine.Learn more about kid vaccines

If you are unable or choose not to get a recommended bivalent mRNA vaccine, you will be up to date if you received the Novavax COVID-19 vaccine doses approved for your age group.

Find more on recommended doses from CDC

COVID Vaccine Information for Health Care Professionals

More on COVID-19 Vaccines (CDC)

Recommended COVID Vaccine Doses (CDC)

Find a COVID-19 vaccine near you.

Image

Use Vaccines.gov to find a location near you, then call or visit the location's website to make an appointment.

Vaccines.gov

Everyone 6 months of age and older is eligible to get a COVID-19 vaccination.Most children are also now eligible for a bivalent dose that offers increased protection against the original strain and omicron variants.

See more on recommended vaccine doses by age group (CDC)

Resources for parents and caregivers

https://www.vermontfamilynetwork.org/ccfk/

Tips for Helping Kids Feel Ready for Any Vaccine (Vermont Family Network)

#factsheet

What Families with Children Should Know About COVID-19 Vaccines (translated)

https://www.youtube.com/watch?v=lWcqHOgQIVg&t=5s

Conversations About COVID-19 Vaccines for Children with Vermont Pediatricians (American Academy of Pediatrics)

If you cannot get vaccines through any of the options above, our local health offices

offer immunization clinics by appointment.

Need a ride? If you do not have transportation to get a free COVID-19 vaccine or booster, please contact your local public transportation provider or callVermont Public Transportation Association (VPTA)

at 833-387-7200.

English language learners, or immigrant or refugee community members, who would like to learn about more about vaccine clinics can contact theAssociation of Africans Living in Vermont

(AALV) at 802-985-3106.

If you lost your vaccine card or your information is wrong:

Recommendations for keeping your vaccination card and record up to date

Find more COVID-19 translations

COVID-19 resources for people who are deaf and hard of hearing

Report your COVID-19 test results

See the article here:

VDH: COVID deaths not seeing decline - Vermont Biz

A patient receiving a COVID-19 vaccine.

(Adobe Stock 639765475 by Talia Mdlungu/peopleimages.com)

Despite the appearance of the public emergency waning, the battle against COVID-19 persists. An integral aspect of this ongoing struggle involves the tireless global pursuit of novel vaccines. The quest for innovative and effective vaccine candidates remains crucial in fortifying our defenses against the virus, adapting to emerging variants, and achieving comprehensive immunity in the face of the pandemics evolving challenges. This commitment to exploring new vaccine possibilities underscores the collective determination to safeguard communities worldwide and mitigate the long-term impact of the COVID-19 threat.

Answering questions from Infection Control Today (ICT) about the groundbreaking approval of ARCT-154, the world's first self-amplifying mRNA (sa-mRNA) COVID-19 vaccine by Japan's Ministry of Health, Jonathan Edelman, MD, Senior VP of CSL's Vaccines Innovation Unit, discusses this historic milestone. Edelman elaborates on the vaccine's significance, clinical findings, collaboration with Meiji Seika Pharma, and how sa-mRNA technology addresses challenges, ushering in a new era for vaccine platforms.

ICT: Can you elaborate on the significance of Japan's Ministry of Health, Labour and Welfare granting approval for ARCT-154, the self-amplifying mRNA (sa-mRNA) COVID-19 vaccine, and how it reflects CSL's commitment to global public health?

Jonathan Edelman, MD: This approval in Japan is a historic milestone for CSL, as it marks the worlds first self-amplifying mRNA vaccine approved for COVID-19 in adults. The milestone underscores CSLs promise to develop and deliver innovations where there is a public health need. The approval also expands CSLs comprehensive portfolio of innovative vaccines that combat respiratory viral diseases and is the first sa-mRNA vaccine.

ICT: With ARCT-154 being the first sa-mRNA vaccine in the world to be registered, how does this milestone contribute to the evolution of mRNA vaccine technology and its potential impact on protecting against COVID-19 and other infectious diseases?

JE: We believe the technology behind our novel, self-amplifying messenger RNA vaccine, ARCT-154, has the potential to create more potent cellular immune responses with increased duration of protection, all with lower doses of mRNA.

ICT: The approval is based on positive clinical data, including studies conducted in Vietnam and a Phase 3 COVID-19 booster trial. Could you share key findings from these studies and how they demonstrate the efficacy and safety profile of ARCT-154 compared to standard mRNA COVID-19 vaccines?

JE: The efficacy of ARCT-154 was established in a Phase 1,2,3 study conducted in Vietnam during the height of the Delta wave of the pandemic, showing 95% protection against severe disease, including death, and 55% protection against all infections, published on MedRxiv and under peer review currently.

The Phase 3 booster study published in The Lancet Infectious Diseases found that ARCT-154 produced a higher (noninferior) immune response after 4 weeks against the original Wuhan-Hu-1 virus and, importantly, a superior immune response against the Omicron BA4/5 variant of COVID-19 compared to the standard mRNA vaccine Comirnaty. [This was a double-blind, multicenter, randomized, controlled, phase 3, non-inferiority trial.]

ICT: CSL Seqirus partnered exclusively with Meiji Seika Pharma to distribute ARCT-154 in Japan. How does this collaboration strengthen CSL's position in providing innovative vaccines for respiratory viral diseases, especially in the ongoing global efforts to combat COVID-19?

JE: Collaborating with Meiji Seika Pharma provides a partner with the infrastructure in Japan to market and distribute our self-amplifying mRNA COVID-19 vaccine and will mark CSLs entry into the COVID-19 vaccine market with differentiated, self-amplifying mRNA technology.

ICT: The sa-mRNA technology used in ARCT-154 can potentially create more potent cellular immune responses and increase the duration of protection. Could you discuss how this innovation addresses key challenges in vaccine development and administration and what implications it may have for future vaccine platforms and strategies?

JE: One challenge with the original mRNA vaccines for COVID-19 is that their protection seems to wane within 6 months of administration, requiring frequent revaccination. A second challenge is that they have limited ability to protect against emerging variants until the vaccine is updated to that new variant. We believe sa-mRNA technology found in ARCT-154 can address both of these limitations by providing protection that lasts up to 1 year from vaccination and offering a broader range of coverage for variants of concern as evidenced by the Japan booster study and other data presented at the recent mRNA meeting in Berlin last year.

Read more from the original source:

CSL's ARCT-154: The World's First Self-Amplifying mRNA Vaccine Approved for COVID-19 in Adults - Infection Control Today

With Pandemic Exacerbating Negative Youth Mental Health, Pressley Calls for Comprehensive, Trauma-Informed Plan

Pressleys Letter is the Latest in Her Longstanding Advocacy to Address Childhood Trauma

Text of Letter (PDF)

WASHINGTON Congresswoman Ayanna Pressley (MA-07) urged Department of Health and Human Services (HHS) Secretary Xavier Becerra to address the growing crisis of childhood trauma that was exacerbated by the COVID-19 pandemic. The letter is the latest in the Congresswomans longstanding advocacy on childhood trauma since her days on the Boston City Council.

In her letter, Rep. Pressley called attention to the worsening mental health disparities and increases in traumatic stress for socioeconomically disadvantaged youth, adolescents of color, and LGBTQ youth, and requested the agency address the crisis through trauma-informed, healing-centered, community-based, gender-responsive, culturally-specific, and reparative approaches. Young people, particularly in the middle of learning, building relationships, and developing their sense of self, were affected by the challenges of grief and isolation caused by the pandemic.

Too many children have been impacted by grief, depression, and neglect, but their trauma has not been met with significant federal action, wrote Rep. Pressley. This crisis existed before the pandemic, but things are now far worse. We cannot continue to allow cycles of trauma to remain unaddressed.

We have all faced and continue to be impacted by the pandemic, an economic recession, the climate crisis, and a national reckoning on police brutality and racial justice, among other overwhelming stressors all branches of government must act urgently and intentionally in our efforts to protect the mental health and wellbeing of our children, Rep. Pressley continued. It is incumbent on us as policymakers to recognize that the status quo approach will not bring about the meaningful and equitable care our children need and deserve.

As a Boston City Councilor, Rep. Pressley convened the first ever listening-only session in the City of Boston on trauma. During her first term in Congress, she partnered with former Committee on Oversight and Reform Chairman Elijah Cummings to hold the first-ever series of Congressional hearings dedicated to combating childhood trauma. Rep. Pressley has also introduced legislation to take a holistic and community-based approach to the childhood trauma and written to President Biden laying out a series of steps he should take to confront the far-reaching hurt plaguing our communities and our nation.

The letter is endorsed by Campaign for Trauma-Informed Policy & Practice (CTIPP), Child and Adolescent Health Measurement Initiative (CAHMI), ChildrensHome Society of America (CHSA), Family Focused Treatment Association (FFTA), Futures without Violence, and the National Prevention Science Coalition to Improve Lives (NPSC).

A copy of the letter can be found here.

Throughout her career, Congresswoman Pressley has been a tireless advocate for trauma-conscious policymaking.

###

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Pressley Urges HHS to Address Spike in Childhood Trauma Following COVID-19 Pandemic - Representative Ayanna Pressley

In a recent study published in Frontiers in Public Health, researchers from the United States of America (US) investigated the racial and ethnic variation in symptoms, activity level, health status, and missed work.

They assessed this via follow-ups post-initial infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although the symptoms were equally prevalent among the groups, they found that three and six months post-infection, Hispanic participants reported poorer health and reduced activity compared to non-Hispanic participants.

Further, racial minority participants reported more negative impacts on health status, activity, and absence from work as compared to the White population.

The coronavirus disease 2019 (COVID-19) pandemic highlighted disparities, wherein ethnic and racial minoritized populations were observed to face greater infection risks due to the essential nature of their work, limited remote work options, and challenges in practicing social distancing.

The infected individuals faced barriers to care, including underinsurance and lack of primary care, with economic consequences. Disparities persisted in health outcomes, for example, higher hospitalization and mortality rates among Black and Hispanic populations.

Despite these challenges, recovery-related differences after SARS-CoV-2 infection remained understudied, with existing studies having limitations like varied follow-up durations, inconsistent findings, and insufficient consideration of social health determinants.

Researchers in the present study aimed to address this gap. The study assessed symptoms and health-related effects following SARS-CoV-2 infection across ethnicities and races, aiming to guide equitable health interventions effectively.

In the present study, a secondary analysis was performed using data from a US-based, prospective, multicenter, longitudinal cohort study named Innovative Support for Patients with SARS-CoV-2 Infections Registry (INSPIRE). The primary cohort involved adults positive for SARS-CoV-2 infection enrolled from December 2020 to July 2022, along with a SARS-CoV-2-negative group for considering non-SARS-CoV-2-related effects.

A total of 3,161 participants completed enrollment and reported symptoms and other outcomes every three months via surveys. Out of these participants, 2,402 were SARS-CoV-2-positive and 759 SARS-CoV-2-negative.

Among the SARS-CoV-2-positive participants, 14.0% were Hispanic, 11.0% were Asian, 7.9% were Black, 9.9% were categorized as Other/Multiple races, and 71.1% were White. Among the SARS-CoV-2-negative participants, 16.5% were Hispanic, 14.8% were Asian, 13.1% were Black, 8.1% were categorized as Other/Multiple races, and 64% were White.

The researchers evaluated 21 COVID-19-like symptoms and "other symptoms" at enrollment and three and six months post-infection using the Centers for Disease Control and Prevention's symptom list.

During the follow-ups, health status (rated on a 5-point scale from excellent to poor), activity level compared to pre-SARS-CoV-2 symptoms (same, somewhat less, much less), and missed work in the past three months (categorized into workdays) were assessed.

Data were collected on ethnicity and race. Interactions between ethnicity or race and SARS-CoV-2 infection status were considered.

Generalized estimating equations (GEE) logistic regression was used to estimate marginal odds ratios (ORs) for various outcomes, adjusting for SARS-CoV-2 infection status, demographic factors, substance use, social determinants of health, pre-existing health conditions, COVID-19 vaccination status, and survey time point.

Post SARS-CoV-2 infection, symptoms were found to be mostly similar across ethnic and racial groups over time. At three months, Hispanic individuals had higher odds of reporting fair/poor health (OR = 1.94) and reduced activity compared to their non-Hispanic counterparts. No significant differences by ethnicity were observed at six months.

At three months, participants of Other/Multiple races had higher odds of reporting fair/poor health (OR = 1.9) and reduced activity compared to White participants. At six months, Asian participants had a greater probability of reporting fair/poor health (OR = 1.88), Black individuals reported more missed work (OR = 2.83), and Other/Multiple race participants reported more health issues (OR = 1.83), reduced activity, and missed work (OR = 2.25).

The findings help to improve our understanding of the ethnic and racial disparities in outcomes after SARS-CoV-2 infection and could be used to inform clinical and public health initiatives and policy.

However, the study is limited by small sample sizes in ethnic and racial subgroups, lack of adjustment for insurance and frontline worker status, potential participant representativeness issues, variations in response rates, lack of exploration of neurological and mental health sequelae, recruitment at different pandemic stages, and the absence of adjustments for multiple comparisons.

In conclusion, the findings suggest that while the symptom prevalence was similar among the groups, the ethnic and racial minority groups suffered adverse effects on health status, activity level, and absence from work as compared to non-Hispanic and White populations, respectively.

Examining the underlying factors contributing to these differences could aid the efforts to promote health equity and improve our preparedness for future pandemics.

Journal reference:

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COVID-19 recovery disparities uncovered among racial and ethnic groups - News-Medical.Net

We made history with safe and effective vaccines and well keep working as long as there are people to protect, variants emerging, and research answers needed to keep us all safe. That means we still need you!

NIAID is conducting and supporting clinical trials evaluating therapies and vaccine candidates against severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19), as well as studies of people who have recovered from infection.

Read more from the original source:

Volunteer for COVID-19 Clinical Trials | NIAID: National Institute of Allergy and Infectious Diseases - niaid.nih.gov

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Originally posted here:

Small Bowel Obstruction Due to Abdominal Cocoon Syndrome in Post-COVID-19 Patients - Cureus

Study design and participants

In this study, we retrieved data of patients initially diagnosed with HCC between January 2018 and December 2021 from the REAL database12. The collected data included anthropometric parameters, viral hepatitis parameters, antiviral treatment history before each admission, hepatic encephalopathy status, ascites, esophageal and gastric varices, tumor characteristics, treatment modalities for PLC and DC, and laboratory data (total bilirubin, serum albumin, serum creatinine, platelet count, and prothrombin time)12. We intended to enroll as many patients as possible; only those with missing information on the initial treatment were excluded.

The study was conducted in accordance with the principles of the Declaration of Helsinki. This study complied with the ethical guidelines for medical and health research involving human subjects established by the Japanese Ministry of Education, Culture, Sports, Science, and Technology and the Ministry of Health, Labour, and Welfare. The study protocol was approved by the Research Ethics Committee of the Faculty of Medicine at the University of Tokyo (approval number: 2018053NI). The requirement for individual informed consent was waived by the Research Ethics Committee of the Faculty of Medicine at the University of Tokyo due to the retrospective design of the study. All personal information was anonymized at data entry and an individual identifier was created with a hash function using the patients names and birth dates. The study was registered in the University Hospital Medical Information Network Clinical Trial Registry (UMIN000035000). All authors had access to the study data and reviewed and approved the final manuscript.

We classified the patients into four etiologies: hepatitis B virus (HBV), hepatitis C virus (HCV), coinfection with HBV and HCV, and non-B, non-C12. Patients were classified as HBV-positive if they were positive for HBs antigen at least once at initial diagnosis or at any admission. Furthermore, patients were classified as having HBV infection if they had a history of receiving antiviral therapy for HBV. Patients were classified as having HCV if they had a positive HCV antibody result at initial diagnosis or at any admission. Furthermore, patients were classified as having HCV infection if they had a history of receiving antiviral therapy. Patients coinfected with HBV and HCV met the criteria for both HBV and HCV infections. The remaining patients were classified as non-B, non-C12.

PLC were classified based on the World Health Organization (WHO) classification of Tumours of the Digestive System13. HCC was diagnosed pathologically or using imaging criteria based on the Japanese Clinical Practice Guidelines14. Hyperattenuation during the arterial phase with washout during the late phase on dynamic computed tomography or dynamic magnetic resonance imaging images was considered a specific finding.

COVID-19 was first documented in December 201915 and the WHO declared the COVID-19 outbreak as a global pandemic on March 11, 2020. The study period was divided into the pre-COVID-19 era (January 2018 to December 2019) and the COVID-19 era (January 2020 to December 2021).

Among the various indicators of tumor characteristics, we selected tumor size, the most robust and reliable indicator of tumor growth, as the primary outcome measure. We compared the diameter of the maximal intrahepatic lesion at initial diagnosis before and during the COVID-19 era. The following variables were also assessed: number of intrahepatic tumors, vascular invasion, extrahepatic spread, tumor rupture, Barcelona Clinic Liver Cancer (BCLC) stage16, duration from diagnosis to initial treatment for HCC, etiology, ChildPugh score17, status of hepatic encephalopathy, ascites, esophageal and gastric varices, tumor characteristics, treatment modalities for HCC, anthropometric parameters, and laboratory data (total bilirubin, serum albumin, serum creatinine, platelet count, and prothrombin time). We further conducted a subgroup analysis stratified by etiology, including HBV, HCV, and non-B, non-C.

Data are presented as means and standard deviations (SD) or medians and interquartile ranges (IQR) for quantitative variables and as numbers and percentages for qualitative variables. The body mass index (BMI), ChildPugh score, and BCLC stage were calculated using the obtained data (Supplementary Fig.S1). The following unrealistic outliers were treated as missing. Height less than 100cm, weight less than 10kg, prothrombin activity less than 10%, and diameter of the maximal intrahepatic lesion greater than 30cm. BMI, ChildPugh score, and BCLC stage calculated from these values were also treated as missing.

For comparisons between before and during the COVID-19 era, for continuous variables, Welchs t-test was used to assess the statistical significance. The CochranArmitage trend test was used for statistical analyses of the change in ChildPugh class, number of intrahepatic tumors, BCLC stage, and tumor markers, and The Chi-squared test was used for other categorical variables. In this study, p<0.05 was considered statistically significant, and all tests were two-tailed. All statistical analyses were performed using the R software version 4.1 and later (R Foundation, Vienna, Austria, http://www.r-project.org/).

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