Novel Coronavirus Pandemic: Public Health, Epidemiological, and Multi-Disciplinary Research

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Epidemiology & Public Health".

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 70284

Special Issue Editors


E-Mail Website1 Website2
Guest Editor
Institute for Preventive Medicine and Public Health, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
Interests: public health; mortality/trends; population surveillance/methods; epidemiology; time factors; multivariable analysis; statistical modelling

E-Mail Website1 Website2
Guest Editor
1. Research and Development Department, Maló Clinic, Lisbon, Portugal
2. Faculty of Medicine, University of Lisbon, 1649-004 Lisbon, Portugal
Interests: clinical epidemiology; risk factors; risk prediction; risk scores; multivariable analysis; dental implants; osseointegration; oral rehabilitation; oral pathology; peri-implant disease; clinical research
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Special Issue Information

Dear Colleagues,

Since the beginning of 2020, the world has been experiencing a pandemic due to the emergence of a novel coronavirus (severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)) that started in China but spread beyond, affecting the entire globe. Multiple efforts were and still are being implemented to address the study of all aspects of this pandemic. Epidemiology, as the cornerstone of public health and the branch of medicine responsible for the study of the distribution and determinants of health-related states or events (including disease) and the application of this study to the control of diseases and other health problems (World Health Organization) are key to overcoming this crisis and providing future guidelines.

For this Special Issue, we invite researchers to contribute original research articles, particularly providing insight on epidemiology and public health aspects of the coronavirus disease (COVID-19) pandemic: (1) global health; (2) health policy and management; (3) health promotion and communication; (4) social and behavioral science/health education; (5) environmental health; (6) epidemiological surveillance; (7) computational modeling of disease; (8) geotemporal analytical studies; (9) minority health and health disparities; (10) reproductive, perinatal, and pediatric epidemiology; (11) occupational epidemiology; (12) aging epidemiology; (13) veterinary epidemiology; (14) psychiatric epidemiology; (15) clinical epidemiology; (16) evidence production and translation; (17) health services research and management; and (18) social and economic aspects.

Dr. Paulo Jorge Nogueira
Dr. Miguel de Araújo Nobre
Guest Editors

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Keywords

  • novel coronavirus
  • severe acute respiratory syndrome coronavirus 2
  • SARS-CoV-2
  • COVID-19
  • coronavirus disease pandemic
  • population-based studies
  • clinical studies
  • public health science
  • public health policy
  • public health surveillance
  • public health guidance
  • public health interventions
  • risk assessment
  • epidemiological studies
  • computational modeling
  • screening
  • diagnosis
  • prognosis
  • infectious diseases
  • vector
  • environment
  • biostatistics in epidemiology
  • clinical practice
  • healthcare utilization

Published Papers (15 papers)

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12 pages, 1301 KiB  
Article
Impairment of Social-Related Quality of Life in COVID-19 Pneumonia Survivors: A Prospective Longitudinal Study
by Takahiro Ando, Sho Shimada, Jun Sugihara, Koji Takayama, Masayoshi Kobayashi, Yoshihiro Miyashita, Tatsuya Ito, Kaori Okayasu, Shun Tsuyuki, Takehiko Ohba, Masafumi Doi, Hiroaki Saito, Toshihide Fujie, Tomoshige Chiaki, Atsushi Nakagawa, Tatsuhiko Anzai, Kunihiko Takahashi, Sho Shibata, Tomoya Tateishi and Yasunari Miyazaki
J. Clin. Med. 2023, 12(24), 7640; https://doi.org/10.3390/jcm12247640 - 12 Dec 2023
Cited by 2 | Viewed by 1061
Abstract
The post-acute sequelae of SARS-CoV-2 (PASC) pose a threat to patients’ health-related quality of life (HRQOL). Here, the impact of COVID-19 on HRQOL and the clinical factors associated with impaired HRQOL were examined. Discharged COVID-19 patients were assessed at 3 and 6 months [...] Read more.
The post-acute sequelae of SARS-CoV-2 (PASC) pose a threat to patients’ health-related quality of life (HRQOL). Here, the impact of COVID-19 on HRQOL and the clinical factors associated with impaired HRQOL were examined. Discharged COVID-19 patients were assessed at 3 and 6 months after disease onset. The patients completed a medical examination and the SF-36 questionnaire at these two time points and underwent pulmonary function testing at 6 months after disease onset. All had undergone computed tomography (CT) imaging upon hospital admission. Of the 74 included patients, 38% reported respiratory symptoms at 3 months, and 26% reported respiratory symptoms at 6 months after disease onset. The aggregated SF-36 scores declined in the role/social component summary (RCS), a category related to social activity. Patients with lower RCS tended to have respiratory sequelae or a relatively lower forced vital capacity. The CT score that reflected the extent of COVID-19 pneumonia was inversely correlated with the RCS score (3 months, p = 0.0024; 6 months, p = 0.0464). A high CT score (≥10 points) predicted a low RCS score at 6 months (p = 0.013). This study highlights the impairment of RCS and its associations with respiratory sequelae. The study also emphasizes the importance of radiological findings in predicting long-term HRQOL outcomes after COVID-19. Full article
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13 pages, 271 KiB  
Article
Preventive Health Screening during the COVID-19 Pandemic: A Cross-Sectional Survey among 102,928 Internet Users in Poland
by Paulina Mularczyk-Tomczewska, Adam Żarnowski, Mariusz Gujski, Janusz Sytnik-Czetwertyński, Igor Pańkowski, Rafał Smoliński and Mateusz Jankowski
J. Clin. Med. 2022, 11(12), 3423; https://doi.org/10.3390/jcm11123423 - 14 Jun 2022
Cited by 8 | Viewed by 1685
Abstract
Preventive screening is a highly cost-effective public health intervention. The COVID-19 pandemic may impact preventive healthcare services. This study aimed to assess the frequency of preventive health screening, as well as to identify the factors associated with compliance with health screening guidelines among [...] Read more.
Preventive screening is a highly cost-effective public health intervention. The COVID-19 pandemic may impact preventive healthcare services. This study aimed to assess the frequency of preventive health screening, as well as to identify the factors associated with compliance with health screening guidelines among adults in Poland during the COVID-19 pandemic. This cross-sectional survey was carried out between October and December 2021, among Internet users in Poland. Respondents were asked about the last date that they performed seven different screening tests. Completed questionnaires were obtained from 102,928 adults aged 18–99 years, and 57.2% were female. The most common screening tests performed in the past 12 months were blood pressure measurement (83%), blood count (66.2%), and blood sugar (63.3%). Moreover, more than half of respondents had a urinalysis (53.1%) and lipid panel (55.1%) in the past 12 months. Out of 58,904 females, 69.2% had a cervical cytology in the past 3 years. Older age, having higher education, living in urban areas, being occupationally active, having at least one chronic disease, and visiting a doctor in the past 12 months were significantly associated (p < 0.001) with a higher level of compliance with screening guidelines. This study revealed a significant gap in the performance of preventive health screening. Full article
19 pages, 590 KiB  
Article
Multimorbidity Profile of COVID-19 Deaths in Portugal during 2020
by Paulo Jorge Nogueira, Miguel de Araújo Nobre, Cecília Elias, Rodrigo Feteira-Santos, António C.-V. Martinho, Catarina Camarinha, Leonor Bacelar-Nicolau, Andreia Silva Costa, Cristina Furtado, Liliane Morais, Juan Rachadell, Mário Pereira Pinto, Fausto Pinto and Antó Vaz Carneiro
J. Clin. Med. 2022, 11(7), 1898; https://doi.org/10.3390/jcm11071898 - 29 Mar 2022
Cited by 4 | Viewed by 2689
Abstract
Background: COVID-19 is caused by SARS-CoV-2 infection and has reached pandemic proportions. Since then, several clinical characteristics have been associated with poor outcomes. This study aimed to describe the morbidity profile of COVID-19 deaths in Portugal. Methods: A study was performed including deaths [...] Read more.
Background: COVID-19 is caused by SARS-CoV-2 infection and has reached pandemic proportions. Since then, several clinical characteristics have been associated with poor outcomes. This study aimed to describe the morbidity profile of COVID-19 deaths in Portugal. Methods: A study was performed including deaths certificated in Portugal with “COVID-19” (ICD-10: U07.1 or U07.2) coded as the underlying cause of death from the National e-Death Certificates Information System between 16 March and 31 December 2020. Comorbidities were derived from ICD-10 codes using the Charlson and Elixhauser indexes. The resident Portuguese population estimates for 2020 were used. Results: The study included 6701 deaths (death rate: 65.1 deaths/100,000 inhabitants), predominantly males (72.1). The male-to-female mortality ratio was 1.1. The male-to-female mortality rate ratio was 1.2; however, within age groups, it varied 5.0–11.4-fold. COVID-19 deaths in Portugal during 2020 occurred mainly in individuals aged 80 years or older, predominantly in public healthcare institutions. Uncomplicated hypertension, uncomplicated diabetes mellitus, congestive heart failure, renal failure, cardiac arrhythmias, dementia, and cerebrovascular disease were observed among COVID-19 deceased patients, with prevalences higher than 10%. A high prevalence of zero morbidities was registered using both the Elixhauser and Charlson comorbidities lists (above 40.2%). Nevertheless, high multimorbidity was also identified at the time of COVID-19 death (about 36.5%). Higher multimorbidity levels were observed in men, increasing with age up to 80 years old. Zero-morbidity prevalence and high multimorbidity prevalences varied throughout the year 2020, seemingly more elevated in the mortality waves’ peaks, suggesting variation according to the degree of disease incidence at a given period. Conclusions: This study provides detailed sociodemographic and clinical information on all certificated deaths from COVID-19 in Portugal during 2020, showing complex and extreme levels of morbidity (zero-morbidity vs. high multimorbidity) dynamics during the first year of the pandemic in Portugal. Full article
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15 pages, 7498 KiB  
Article
Exercise Ventilatory Inefficiency in Post-COVID-19 Syndrome: Insights from a Prospective Evaluation
by Álvaro Aparisi, Cristina Ybarra-Falcón, Mario García-Gómez, Javier Tobar, Carolina Iglesias-Echeverría, Sofía Jaurrieta-Largo, Raquel Ladrón, Aitor Uribarri, Pablo Catalá, Williams Hinojosa, Marta Marcos-Mangas, Laura Fernández-Prieto, Rosa Sedano-Gutiérrez, Iván Cusacovich, David Andaluz-Ojeda, Blanca de Vega-Sánchez, Amada Recio-Platero, Esther Sanz-Patiño, Dolores Calvo, Carlos Baladrón, Manuel Carrasco-Moraleja, Carlos Disdier-Vicente, Ignacio J. Amat-Santos and J. Alberto San Románadd Show full author list remove Hide full author list
J. Clin. Med. 2021, 10(12), 2591; https://doi.org/10.3390/jcm10122591 - 11 Jun 2021
Cited by 51 | Viewed by 4701
Abstract
Introduction: Coronavirus disease 2019 (COVID-19) is a systemic disease characterized by a disproportionate inflammatory response in the acute phase. This study sought to identify clinical sequelae and their potential mechanism. Methods: We conducted a prospective single-center study (NCT04689490) of previously hospitalized COVID-19 patients [...] Read more.
Introduction: Coronavirus disease 2019 (COVID-19) is a systemic disease characterized by a disproportionate inflammatory response in the acute phase. This study sought to identify clinical sequelae and their potential mechanism. Methods: We conducted a prospective single-center study (NCT04689490) of previously hospitalized COVID-19 patients with and without dyspnea during mid-term follow-up. An outpatient group was also evaluated. They underwent serial testing with a cardiopulmonary exercise test (CPET), transthoracic echocardiogram, pulmonary lung test, six-minute walking test, serum biomarker analysis, and quality of life questionaries. Results: Patients with dyspnea (n = 41, 58.6%), compared with asymptomatic patients (n = 29, 41.4%), had a higher proportion of females (73.2 vs. 51.7%; p = 0.065) with comparable age and prevalence of cardiovascular risk factors. There were no significant differences in the transthoracic echocardiogram and pulmonary function test. Patients who complained of persistent dyspnea had a significant decline in predicted peak VO2 consumption (77.8 (64–92.5) vs. 99 (88–105); p < 0.00; p < 0.001), total distance in the six-minute walking test (535 (467–600) vs. 611 (550–650) meters; p = 0.001), and quality of life (KCCQ-23 60.1 ± 18.6 vs. 82.8 ± 11.3; p < 0.001). Additionally, abnormalities in CPET were suggestive of an impaired ventilatory efficiency (VE/VCO2 slope 32 (28.1–37.4) vs. 29.4 (26.9–31.4); p = 0.022) and high PETCO2 (34.5 (32–39) vs. 38 (36–40); p = 0.025). Interpretation: In this study, >50% of COVID-19 survivors present a symptomatic functional impairment irrespective of age or prior hospitalization. Our findings suggest a potential ventilation/perfusion mismatch or hyperventilation syndrome. Full article
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13 pages, 614 KiB  
Article
Extensive Testing and Public Health Interventions for the Control of COVID-19 in the Republic of Cyprus between March and May 2020
by Annalisa Quattrocchi, Ioannis Mamais, Constantinos Tsioutis, Eirini Christaki, Costas Constantinou, Maria Koliou, Zoi-Dorothea Pana, Valentinos Silvestros, Fani Theophanous, Christos Haralambous, Androulla Stylianou, Sotiroula Sotiriou, Maria Athanasiadou, Theopisti Kyprianou, Anna Demetriou, Christiana A. Demetriou, Ourania Kolokotroni, Ioanna Gregoriou, Niki Paphitou, George Panos, Leontios Kostrikis, Peter Karayiannis, Georgios Petrikkos, Petros Agathangelou, George Mixides, Georgios Siakallis, Linos Hadjihannas, Lakis Palazis, Anna Vavlitou, Chrystalla Matsentidou-Timiliotou, Dimitris Koukios, Tonia Adamidi, Frangiskos Frangopoulos, Elizabeth Constantinou and Georgios Nikolopoulosadd Show full author list remove Hide full author list
J. Clin. Med. 2020, 9(11), 3598; https://doi.org/10.3390/jcm9113598 - 8 Nov 2020
Cited by 21 | Viewed by 4672
Abstract
Coronavirus disease 2019 (COVID-19) has significantly affected the well-being of individuals worldwide. We herein describe the epidemiology of COVID-19 in the Republic of Cyprus during the first epidemic wave (9 March–3 May 2020). We analyzed surveillance data from laboratory-confirmed cases, including targeted testing [...] Read more.
Coronavirus disease 2019 (COVID-19) has significantly affected the well-being of individuals worldwide. We herein describe the epidemiology of COVID-19 in the Republic of Cyprus during the first epidemic wave (9 March–3 May 2020). We analyzed surveillance data from laboratory-confirmed cases, including targeted testing and population screening. Statistical analyses included logistic regression. During the surveillance period, 64,136 tests (7322.3 per 100,000) were performed, 873 COVID-19 cases were diagnosed, and 20 deaths were reported (2.3%). Health-care workers (HCWs) represented 21.4% of cases. Overall, 19.1% of cases received hospital care and 3.7% required admission to Intensive Care Units. Male sex (adjusted Odds Ratio (aOR): 3.04; 95% Confidence Interval (CI): 1.97–4.69), increasing age (aOR: 1.56; 95%CI: 1.36–1.79), symptoms at diagnosis (aOR: 6.05; 95%CI: 3.18–11.50), and underlying health conditions (aOR: 2.08; 95%CI: 1.31–3.31) were associated with hospitalization. For recovered cases, the median time from first to last second negative test was 21 days. Overall, 119 primary cases reported 616 close contacts, yielding a pooled secondary attack rate of 12% (95%CI: 9.6–14.8%). Three population-based screening projects, and two projects targeting employees and HCWs, involving 25,496 people, revealed 60 positive individuals (0.2%). Early implementation of interventions with targeted and expanded testing facilitated prompt outbreak control on the island. Full article
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12 pages, 2881 KiB  
Article
Seroprevalence of SARS-CoV-2 IgG Antibodies in Corsica (France), April and June 2020
by Lisandru Capai, Nazli Ayhan, Shirley Masse, Jean Canarelli, Stéphane Priet, Marie-Hélène Simeoni, Remi Charrel, Xavier de Lamballerie and Alessandra Falchi
J. Clin. Med. 2020, 9(11), 3569; https://doi.org/10.3390/jcm9113569 - 5 Nov 2020
Cited by 11 | Viewed by 3138
Abstract
Our aim was to assess the seroprevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection after the lockdown in a sample of the Corsican population. Between 16 April and 15 June 2020, 2312 residual sera were collected from patients with a blood analysis [...] Read more.
Our aim was to assess the seroprevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection after the lockdown in a sample of the Corsican population. Between 16 April and 15 June 2020, 2312 residual sera were collected from patients with a blood analysis conducted in one of the participating laboratories. Residual sera obtained from persons of all ages were tested for the presence of anti-SARS-CoV-2 Immunoglobulin G (IgG) using the EUROIMMUN enzyme immunoassay kit for semiquantitative detection of IgG antibodies against the S1 domain of viral spike protein (ELISA-S). Borderline and positive samples in ELISA-S were also tested with an in-house virus neutralization test (VNT). Prevalence values were adjusted for sex and age. A total of 1973 residual sera samples were included in the study. The overall seroprevalence based on ELISA-S was 5.27% (95% confidence interval (CI), 4.33–6.35) and 5.46% (4.51–6.57) after adjustment. Sex was not associated with IgG detection. However, significant differences were observed between age groups (p-value = 1 E-5). The highest values were observed among 10–19, 30–39, and 40–49 year-old age groups, ranging around 8–10%. The prevalence of neutralizing antibody titers ≥40 was 3% (2.28–3.84). In conclusion, the present study showed a low seroprevalence for COVID-19 in Corsica, a finding that is in accordance with values reported for other French regions in which the impact of the pandemic was low. Full article
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12 pages, 865 KiB  
Article
The Role of COVID-19 in the Death of SARS-CoV-2–Positive Patients: A Study Based on Death Certificates
by Francesco Grippo, Simone Navarra, Chiara Orsi, Valerio Manno, Enrico Grande, Roberta Crialesi, Luisa Frova, Stefano Marchetti, Marilena Pappagallo, Silvia Simeoni, Lucilla Di Pasquale, Annamaria Carinci, Chiara Donfrancesco, Cinzia Lo Noce, Luigi Palmieri, Graziano Onder, Giada Minelli and Italian National Institute of Health COVID-19 Mortality Group
J. Clin. Med. 2020, 9(11), 3459; https://doi.org/10.3390/jcm9113459 - 27 Oct 2020
Cited by 33 | Viewed by 19937
Abstract
Background: Death certificates are considered the most reliable source of information to compare cause-specific mortality across countries. The aim of the present study was to examine death certificates of persons who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to (a) [...] Read more.
Background: Death certificates are considered the most reliable source of information to compare cause-specific mortality across countries. The aim of the present study was to examine death certificates of persons who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to (a) quantify the number of deaths directly caused by coronavirus 2019 (COVID-19); (b) estimate the most common complications leading to death; and (c) identify the most common comorbidities. Methods: Death certificates of persons who tested positive for SARS-CoV-2 provided to the National Surveillance system were coded according to the 10th edition of the International Classification of Diseases. Deaths due to COVID-19 were defined as those in which COVID-19 was the underlying cause of death. Complications were defined as those conditions reported as originating from COVID-19, and comorbidities were conditions independent of COVID-19. Results: A total of 5311 death certificates of persons dying in March through May 2020 were analysed (16.7% of total deaths). COVID-19 was the underlying cause of death in 88% of cases. Pneumonia and respiratory failure were the most common complications, being identified in 78% and 54% of certificates, respectively. Other complications, including shock, respiratory distress and pulmonary oedema, and heart complications demonstrated a low prevalence, but they were more commonly observed in the 30–59 years age group. Comorbidities were reported in 72% of certificates, with little variation by age and gender. The most common comorbidities were hypertensive heart disease, diabetes, ischaemic heart disease, and neoplasms. Neoplasms and obesity were the main comorbidities among younger people. Discussion: In most persons dying after testing positive for SARS-CoV-2, COVID-19 was the cause directly leading to death. In a large proportion of death certificates, no comorbidities were reported, suggesting that this condition can be fatal in healthy persons. Respiratory complications were common, but non-respiratory complications were also observed. Full article
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9 pages, 248 KiB  
Article
SARS-CoV-2 Viral Load, IFNλ Polymorphisms and the Course of COVID-19: An Observational Study
by Emanuele Amodio, Rosaria Maria Pipitone, Stefania Grimaudo, Palmira Immordino, Carmelo Massimo Maida, Tullio Prestileo, Vincenzo Restivo, Fabio Tramuto, Francesco Vitale, Antonio Craxì and Alessandra Casuccio
J. Clin. Med. 2020, 9(10), 3315; https://doi.org/10.3390/jcm9103315 - 15 Oct 2020
Cited by 32 | Viewed by 3681
Abstract
The course of SARS-CoV-2 infection ranges from asymptomatic to a multiorgan disease. In this observational study, we investigated SARS-CoV-2 infected subjects with defined outcomes, evaluating the relationship between viral load and single nucleotide polymorphisms of genes codifying for IFNλs (interferon). The study enrolled [...] Read more.
The course of SARS-CoV-2 infection ranges from asymptomatic to a multiorgan disease. In this observational study, we investigated SARS-CoV-2 infected subjects with defined outcomes, evaluating the relationship between viral load and single nucleotide polymorphisms of genes codifying for IFNλs (interferon). The study enrolled 381 patients with laboratory-confirmed SARS-CoV-2 infection. For each patient, a standardized form was filled including sociodemographic variables and clinical outcomes. The host’s gene polymorphisms (IFNL3 rs1297860 C/T and INFL4 rs368234815 TT/ΔG) and RtReal-Time PCR cycle threshold (PCR Ct) value on SARS-CoV-2 were assessed on nasal, pharyngeal or nasopharyngeal swabs. Higher viral loads were found in patients aged > 74 years and homozygous mutant polymorphisms DG in IFNL4 (adj-OR = 1.16, 95% CI = 1.01–1.34 and adj-OR = 1.24, 95% CI = 1.09–1.40, respectively). After adjusting for age and sex, a statistically significantly lower risk of hospitalization was observed in subjects with higher RtReal-Time PCR cycle threshold values (adj-OR = 0.95, 95% CI = 0.91, 0.99; p = 0.028). Our data support the correlation between SARS-CoV-2 load and disease severity, and suggest that IFNλ polymorphisms could affect the ability of the host to modulate viral infection without a clear impact on the outcome of COVID-19. Full article
14 pages, 567 KiB  
Article
Prevalence of Current and Past SARS-CoV-2 Infections among Police Employees in Poland, June–July 2020
by Mariusz Gujski, Mateusz Jankowski, Jarosław Pinkas, Waldemar Wierzba, Piotr Samel-Kowalik, Artur Zaczyński, Piotr Jędrusik, Igor Pańkowski, Grzegorz Juszczyk, Kamil Rakocy and Filip Raciborski
J. Clin. Med. 2020, 9(10), 3245; https://doi.org/10.3390/jcm9103245 - 11 Oct 2020
Cited by 12 | Viewed by 3701
Abstract
Background: Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We aimed to determine the prevalence of current and past SARS-CoV-2 infections among police employees. Methods: This cross-sectional survey was undertaken among 5082 police employees from Mazowieckie Province, [...] Read more.
Background: Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We aimed to determine the prevalence of current and past SARS-CoV-2 infections among police employees. Methods: This cross-sectional survey was undertaken among 5082 police employees from Mazowieckie Province, Poland. RT-PCR testing for current SARS-CoV-2 infection and serological tests (ELISA) for the presence of anti-SARS-CoV-2 IgM+IgA and IgG antibodies were performed. Results: All RT-PCR tests were negative. The anti-SARS-CoV-2 IgM+IgA index was positive (>8) in 8.9% of participants, including 11.2% women and 7.7% men (p < 0.001). Equivocal IgM+IgA index (6–8) was found in 9.8% of participants, including 11.9% women and 8.7% men (p < 0.001). The IgG index was positive (>6) in 4.3% and equivocal (4–6) in 13.2% of participants. A higher odds of positive IgM+IgA index was found in women vs. men (OR: 1.742) and police officers vs. civilian employees (OR: 1.411). Participants aged ≥60 years had a higher odds of positive IgG index vs. those aged 20–29 years (OR: 3.309). Daily vaping also increased the odds of positive IgG index (OR: 2.058). Conclusions: The majority of Polish police employees are seronegative for SARS-CoV-2 infection. Vaping and older age (≥60 years) were associated with a higher risk of SARS-CoV-2 infection. Full article
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10 pages, 679 KiB  
Article
Profile of Patients with Novel Coronavirus Disease 2019 (COVID-19) in Osaka Prefecture, Japan: A Population-Based Descriptive Study
by Taro Takeuchi, Tomoka Imanaka, Yusuke Katayama, Tetsuhisa Kitamura, Tomotaka Sobue and Takeshi Shimazu
J. Clin. Med. 2020, 9(9), 2925; https://doi.org/10.3390/jcm9092925 - 10 Sep 2020
Cited by 11 | Viewed by 3810
Abstract
Little is known about the epidemiological characteristics of patients with coronavirus disease 2019 (COVID-19) in Japan. This is a retrospective observational study of COVID-19 patients; study was conducted from February 1 to May 31, 2020. We used publicly collected data on cases of [...] Read more.
Little is known about the epidemiological characteristics of patients with coronavirus disease 2019 (COVID-19) in Japan. This is a retrospective observational study of COVID-19 patients; study was conducted from February 1 to May 31, 2020. We used publicly collected data on cases of COVID-19 confirmed by polymerase chain reaction (PCR) testing in Osaka Prefecture, Japan. We described the patient characteristics. The Cox proportional-hazards model was applied to evaluate the association between factors (sex, onset month, age group, city of residence) and mortality, and hazard ratios (HRs) with 95% confidence intervals were estimated. During the study period, 5.7% (1782/31,152) of individuals who underwent PCR testing for COVID-19 showed positive results. Among 244 patients with information on symptoms, the most common symptom was fever (76.6%), followed by cough (44.3%). Of the 1782 patients, 86 patients died. Compared with those aged 0–59 years, higher mortality was observed among those aged 60–69 years (HR: 12.02 [3.37–42.93]), 70–79 years (HR: 44.62 [15.16–131.30]), 80–89 years (HR: 68.38 [22.93–203.89]), and ≥90 years (HR: 144.71 [42.55–492.15]). In conclusion, in Osaka Prefecture, Japan, the most common symptom was fever, and older adults had higher mortality among COVID-19 patients. Full article
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16 pages, 993 KiB  
Article
The Role of Health Preconditions on COVID-19 Deaths in Portugal: Evidence from Surveillance Data of the First 20293 Infection Cases
by Paulo Jorge Nogueira, Miguel de Araújo Nobre, Andreia Costa, Ruy M. Ribeiro, Cristina Furtado, Leonor Bacelar Nicolau, Catarina Camarinha, Márcia Luís, Ricardo Abrantes and António Vaz Carneiro
J. Clin. Med. 2020, 9(8), 2368; https://doi.org/10.3390/jcm9082368 - 24 Jul 2020
Cited by 29 | Viewed by 6297
Abstract
Background: It is essential to study the effect of potential co-factors on the risk of death in patients infected by COVID-19. The identification of risk factors is important to allow more efficient public health and health services strategic interventions with a significant impact [...] Read more.
Background: It is essential to study the effect of potential co-factors on the risk of death in patients infected by COVID-19. The identification of risk factors is important to allow more efficient public health and health services strategic interventions with a significant impact on deaths by COVID-19. This study aimed to identify factors associated with COVID-19 deaths in Portugal. Methods: A national dataset with the first 20,293 patients infected with COVID-19 between 1 January and 21 April 2020 was analyzed. The primary outcome measure was mortality by COVID-19, measured (registered and confirmed) by Medical Doctors serving as health delegates on the daily death registry. A logistic regression model using a generalized linear model was used for estimating Odds Ratio (OR) with 95% confidence intervals (95% CI) for each potential risk indicator. Results: A total of 502 infected patients died of COVID-19. The risk factors for increased odds of death by COVID-19 were: sex (male: OR = 1.47, ref = female), age ((56–60) years, OR = 6.01; (61–65) years, OR = 10.5; (66–70) years, OR = 20.4; (71–75) years, OR = 34; (76–80) years, OR = 50.9; (81–85) years, OR = 70.7; (86–90) years, OR = 83.2; (91–95) years, OR = 91.8; (96–104) years, OR = 140.2, ref = (0–55)), Cardiac disease (OR = 2.86), Kidney disorder (OR = 2.95), and Neuromuscular disorder (OR = 1.58), while condition (None (absence of precondition); OR = 0.49) was associated with a reduced chance of dying after adjusting for other variables of interest. Conclusions: Besides age and sex, preconditions justify the risk difference in mortality by COVID-19. Full article
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17 pages, 2985 KiB  
Article
Modelling the Evolution of COVID-19 in High-Incidence European Countries and Regions: Estimated Number of Infections and Impact of Past and Future Intervention Measures
by Juan Fernández-Recio
J. Clin. Med. 2020, 9(6), 1825; https://doi.org/10.3390/jcm9061825 - 11 Jun 2020
Cited by 9 | Viewed by 3398
Abstract
A previously developed mechanistic model of COVID-19 transmission has been adapted and applied here to study the evolution of the disease and the effect of intervention measures in some European countries and territories where the disease has had a major impact. A clear [...] Read more.
A previously developed mechanistic model of COVID-19 transmission has been adapted and applied here to study the evolution of the disease and the effect of intervention measures in some European countries and territories where the disease has had a major impact. A clear impact of the major intervention measures on the reproduction number (Rt) has been found in all studied countries and territories, as already suggested by the drop in the number of deaths over time. Interestingly, the impact of such major intervention measures seems to be the same in most of these countries. The model has also provided realistic estimates of the total number of infections, active cases and future outcomes. While the predictive capabilities of the model are much more uncertain before the peak of the outbreak, we could still reliably predict the evolution of the disease after a major intervention by assuming the subsequent reproduction number from the current study. A greater challenge is to foresee the long-term impact of softer intervention measures, but this model can estimate the outcome of different scenarios and help to plan changes for the implementation of control measures in a given country or region. Full article
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11 pages, 524 KiB  
Article
Knowledge, Attitudes, Practices, and Burden During the COVID-19 Pandemic in People with Parkinson’s Disease in Germany
by Hannah M. Zipprich, Ulrike Teschner, Otto W. Witte, Aline Schönenberg and Tino Prell
J. Clin. Med. 2020, 9(6), 1643; https://doi.org/10.3390/jcm9061643 - 29 May 2020
Cited by 53 | Viewed by 4870
Abstract
Background: Adherence to measures that have been adopted during the COVID-19 pandemic is crucial to control the spread of the coronavirus. Methods: Semi-structured telephone interviews were performed with 99 patients with Parkinson’s disease (PD) and 21 controls to explore knowledge, attitudes, practices, and [...] Read more.
Background: Adherence to measures that have been adopted during the COVID-19 pandemic is crucial to control the spread of the coronavirus. Methods: Semi-structured telephone interviews were performed with 99 patients with Parkinson’s disease (PD) and 21 controls to explore knowledge, attitudes, practices, and burden in order to elucidate nonadherence to preventive measures. Results: The majority of patients understood the preventive measures and felt sufficiently informed. Analysis of qualitative answers, however, showed that about 30% of patients had an insufficient level of knowledge, which was not associated with educational level, cognitive disorders, or depression. Changes in behaviour were reported by 73 patients (99% performed at least one specific preventive behavior, and 86.9% have reduced social contacts and stayed home). A closer analysis of qualitative answers showed that 27.3% of patients continued to meet relatives face-to-face almost daily. Anxiety and worries about the current situation were reported by 58.6% of patients; 31.3% complained about a decrease in their mobility since the beginning of the restrictions, mainly because of worsening of PD and because regular therapies (e.g., physiotherapy) were canceled. Conclusions: About 30% of PD patients are nonadherent to preventive measures. Use of simple dichotomous questions overestimates adherence to preventive measures in patients with PD. Full article
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2 pages, 187 KiB  
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Reply to Comment on Nogueira, P.J., et al. “The Role of Health Preconditions on COVID-19 Deaths in Portugal: Evidence from Surveillance Data of the First 20293 Infection Cases”. J. Clin. Med. 2020, 9, 2368
by Paulo Jorge Nogueira, Miguel de Araújo Nobre, Andreia Costa, Ruy M. Ribeiro, Cristina Furtado, Leonor Bacelar Nicolau, Catarina Camarinha, Márcia Luís, Ricardo Abrantes and António Vaz Carneiro
J. Clin. Med. 2020, 9(11), 3449; https://doi.org/10.3390/jcm9113449 - 27 Oct 2020
Cited by 4 | Viewed by 1811
Abstract
We thank Costa-Santos C [...] Full article
2 pages, 200 KiB  
Comment
The Hidden Factor—Low Quality of Data is a Major Peril in the Identification of Risk Factors for COVID-19 Deaths: A Comment on Nogueira, P.J., et al. “The Role of Health Preconditions on COVID-19 Deaths in Portugal: Evidence from Surveillance Data of the First 20293 Infection Cases”. J. Clin. Med. 2020, 9, 2368
by Cristina Costa-Santos, Inês Ribeiro-Vaz and Matilde Monteiro-Soares
J. Clin. Med. 2020, 9(11), 3442; https://doi.org/10.3390/jcm9113442 - 27 Oct 2020
Cited by 2 | Viewed by 2489
Abstract
We read with great interest the article by Nogueira P [...] Full article
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