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Documents  Coronavirus | enregistrements trouvés : 217

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The anti-inflammatory effects of a Mediterranean diet: a review | Novembre 2022 H

Article (Nutrition clinique)

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Purpose of review: Chronic noncommunicable diseases remain the leading cause of morbidity and mortality worldwide and the majority are preventable with a healthy diet and lifestyle, but controversy remains as to the best approach. Greater adherence to a traditional Mediterranean diet has consistently been associated with lower morbidity and mortality from cardiovascular disease, diabetes and many cancers, and lower all-cause mortality. Despite the well known benefits on chronic disease risk there remains some scepticism as to the effects of this dietary pattern across populations outside the Mediterranean and the mechanisms of action of this traditional plant-based dietary pattern.

This narrative review aims to summarize the latest evidence on the health protective effects of a traditional Mediterranean diet on chronic noncommunicable diseases, specifically focussing on the anti-inflammatory effects of this highly published dietary pattern.

Recent findings: Recent high-quality evidence now supports a Mediterranean diet in secondary prevention of cardiovascular disease with impacts on atherosclerosis progression, likely through reduction of systemic inflammation and irrespective of changes in cholesterol or weight. The Mediterranean diet has a low Dietary Inflammatory Index illustrating its anti-inflammatory potential. This dietary pattern beneficially modulates the gut microbiota and immune system, including emerging evidence for efficacy against severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019). Emerging evidence shows clinicians are not routinely recommending a Mediterranean diet despite well known evidence due to barriers such as lack of training, patient materials and concerns about potential patient adherence.

Summary: The physiological mechanisms of action of this healthy diet pattern are becoming better understood to be multisystem and involving the gut. Larger controlled trials investigating mechanistic effects in broader non-Mediterranean populations are warranted. Although reflected in therapeutic guidelines for chronic disease management worldwide there are individual, clinical practice and health system barriers to its implementation that need a multisectoral approach to address.
Purpose of review: Chronic noncommunicable diseases remain the leading cause of morbidity and mortality worldwide and the majority are preventable with a healthy diet and lifestyle, but controversy remains as to the best approach. Greater adherence to a traditional Mediterranean diet has consistently been associated with lower morbidity and mortality from cardiovascular disease, diabetes and many cancers, and lower all-cause mortality. Despite ...

COVID-19 ; Coronavirus ; Inflammation (Pathologie) - Diétothérapie ; Alimentation - Méditerranée, Région de la

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Phase angle, obtained by bioelectrical impedance, is an indicator of cellular integrity and has been proposed as a prognostic parameter in patients who are critically ill. This systematic review aimed to evaluate the association between phase angle and adverse clinical outcomes in hospitalized patients with coronavirus disease–2019 (COVID-19). An extensive literature search was performed in the MEDLINE/PubMed, Embase, and Web of Science databases, with interest in observational studies evaluating the association between phase angle and adverse clinical outcomes in individuals aged ≥18 years hospitalized with COVID-19. Studies were independently selected by two reviewers, according to eligibility criteria. Subsequently, data were extracted and presented in a qualitative synthesis. The evaluation of the quality of the studies was performed according to the Newcastle-Ottawa scale. The full methodology was published in PROSPERO (ID CRD42022306177). A total of 392 articles were identified, resulting in seven selected studies, of which six were prospective cohorts and one was retrospective. In the quality assessment, six studies obtained scores equal to or greater than seven, indicating a low risk of bias. A total of 750 participants composed the samples of the selected studies. Five studies reported an independent association between phase angle and adverse clinical outcomes during hospitalization for COVID-19, with emphasis on prolonged hospitalization and mechanical ventilation and higher mortality in patients with a lower phase angle. Thus, phase angle measurement can be useful in the early identification of risks in patients hospitalized with COVID-19, for the purpose of adequacy of clinical management.
Phase angle, obtained by bioelectrical impedance, is an indicator of cellular integrity and has been proposed as a prognostic parameter in patients who are critically ill. This systematic review aimed to evaluate the association between phase angle and adverse clinical outcomes in hospitalized patients with coronavirus disease–2019 (COVID-19). An extensive literature search was performed in the MEDLINE/PubMed, Embase, and Web of Science ...

Hospitalisation ; COVID-19 ; Coronavirus

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Purpose of review: Supportive and palliative care services have been an important component of the overall COVID-19 pandemic response. However, significant changes in the provision and models of care were needed in order to optimize the care delivered to vulnerable cancer patients. This review discusses the evolution of palliative and supportive care service in response to the pandemic, and highlights remaining challenges.

Recent findings: Direct competition for resources, as well as widespread implementation of safety measures resulted in major shifts in the mode of assessment and communication with cancer patients by supportive care teams. Telemedicine/virtual consultation and follow-up visits became an integral strategy, with high uptake and satisfaction amongst patients, families and providers. However, inequities in access to the required technologies were sometimes exposed. Hospice/palliative care unit (PCU) bed occupancy declined markedly because of restrictive visitation policies. Collection of patient-reported outcome (PRO) data was suspended in many cancer centers, with resulting under-recognition of anxiety and depression in ambulatory patients. As in many other areas, disparities in delivery of supportive and palliative care were magnified by the pandemic.

Summary: Virtual care platforms have been widely adopted and will continue to be used to include a wider circle of family/friends and care providers in the provision of palliative and supportive care. To facilitate equitable delivery of supportive care within a pandemic, further research and resources are needed to train and support generalists and palliative care providers. Strategies to successfully collect PROs from all patients in a virtual manner must be developed and implemented.
Purpose of review: Supportive and palliative care services have been an important component of the overall COVID-19 pandemic response. However, significant changes in the provision and models of care were needed in order to optimize the care delivered to vulnerable cancer patients. This review discusses the evolution of palliative and supportive care service in response to the pandemic, and highlights remaining challenges.

Recent findings: ...

COVID-19 ; Coronavirus ; Soins palliatifs ; Oncologie

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Impact of COVID-19 on cancer screening: a global perspective | Septembre 2022 H

Article (Oncologie)

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Purpose of review: Cancer screening disruption due to COVID-19 may have a significant impact on patients, healthcare practitioners, and healthcare systems. In this present review, we aim to offer a comprehensive view of the effect of the COVID-19 pandemic on cancer screening programs worldwide.

Recent findings: The present review comprised 33 publications. During the COVID-19 pandemic, the rates of cancer screening investigations were drastically reduced worldwide. Screening rates plummeted for all types of cancer, all ages, and racial/ethnic groups. Reductions in screening percentages were higher in several underserved racial groups. Cancer screening was suspended for at least 30 days in 13 countries.

Summary: Screenings for all types of cancer fell sharply. In the chain of cancer management, delays in any step are liable to change the outcome of the next step. Further long-term research will be needed to fully comprehend the impact of the pandemic on cancer services and patient outcomes.
Purpose of review: Cancer screening disruption due to COVID-19 may have a significant impact on patients, healthcare practitioners, and healthcare systems. In this present review, we aim to offer a comprehensive view of the effect of the COVID-19 pandemic on cancer screening programs worldwide.

Recent findings: The present review comprised 33 publications. During the COVID-19 pandemic, the rates of cancer screening investigations were ...

Cancer ; Coronavirus ; COVID-19

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Older adults are a vulnerable group with a high need for coronavirus disease 2019 (COVID-19) vaccines, but these individuals are also more prone to the development of vaccine-related adverse events.

Older adults with frailty, disability, dementia or living in long-term care facilities need special attention in COVID-19 vaccination programs because supporting evidence for the safety and efficacy of COVID-19 vaccines in these individuals is limited.

The active involvement of geriatricians in vaccine development and related public-policy development is important for the success of adult vaccination strategies against COVID-19 and other communicable and noncommunicable diseases.

The completion of a primary series of COVID-19 vaccines with a heterologous booster dose remains the best strategy to reduce the impact of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infections and transmission.
Older adults are a vulnerable group with a high need for coronavirus disease 2019 (COVID-19) vaccines, but these individuals are also more prone to the development of vaccine-related adverse events.

Older adults with frailty, disability, dementia or living in long-term care facilities need special attention in COVID-19 vaccination programs because supporting evidence for the safety and efficacy of COVID-19 vaccines in these individuals is ...

COVID-19 ; Coronavirus ; Vaccination ; Personnes âgées

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Caring for older adults during the COVID-19 pandemic | Juin 2022 H

Article (Gériatrie - gérontologie)

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Background
Elderly patients represent a high-risk group with increased risk of death from COVID-19. Despite the number of published studies, several unmet needs in care for older adults exist.
Objectives
To discuss unmet needs of COVID-19 in this special population.
Sources
A literature review for studies on COVID-19 in elderly patients published between December 2019 and November 2021 was performed. Clinical questions were formulated to guide the literature search. The search was conducted in the MEDLINE database, combining specific search terms. Two reviewers independently conducted the search and selected the studies according to the prespecified clinical questions.
Content
Elderly patients with COVID-19 have peculiar characteristics. They may have atypical clinical presentation, with no fever and with delirium or neurological manifestations as the most common signs, with potential delayed diagnosis and increased risk of death. The reported fatality rates among elderly patients with COVID-19 are extremely high. Several factors, including comorbidities, atypical presentation, and exclusion from intensive care unit care, contribute to this excess of mortality. Age alone is frequently used as a key factor to exclude the elderly from intensive care, but there is evidence that frailty rather than age better predicts the risk of poor outcome in this category. Durability of vaccine efficacy in the elderly remains debated, and the need for a third booster dose is becoming increasingly evident. Finally, efforts to care for elderly patients who have survived after acute COVID-19 should be implemented, considering the high rates of long COVID sequelae and the risk of longitudinal functional and cognitive decline.
Implications
We highlight peculiar aspects of COVID-19 in elderly patients and factors contributing to high risk of poor outcome in this category. We also illuminated gaps in current evidence, suggesting future research directions and underlining the need for further studies on the optimal management of elderly patients with COVID-19.
Background
Elderly patients represent a high-risk group with increased risk of death from COVID-19. Despite the number of published studies, several unmet needs in care for older adults exist.
Objectives
To discuss unmet needs of COVID-19 in this special population.
Sources
A literature review for studies on COVID-19 in elderly patients published between December 2019 and November 2021 was performed. Clinical questions were formulated to guide ...

COVID-19 ; Coronavirus ; Personnes âgées

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Objective
The aims of this study were to examine associations between frequency of telerehabilitation (TR) and outcomes of functional status (FS), number of visits, and patient satisfaction during COVID-19 and to compare FS outcomes by TR delivery mode for individuals with low back pain.

Methods
Propensity score matching was used to match episodes of care with or without TR exposure by the probability of receiving TR. FS, visits, and satisfaction were compared for individuals without TR and those who received care by TR for “any,” “few,” “most,” or “all” frequencies (4 matched samples), and FS was compared for individuals receiving synchronous, asynchronous, and mixed TR modes (3 matched samples). Standardized differences were used to compare samples before and after matching. Outcomes between matched samples were compared using z tests with 95% CI.

Results
The sample consisted of 91,117 episodes of care from 1398 clinics located in 46 states (58% women; mean age = 55 [SD = 18]). Of those, only 5013 episodes (5.5%) involved any amount of TR. All standardized differences between matched samples were <0.1. There was no significant difference in FS points (range = 0–100, with higher representing better FS) between matched samples, except for episodes that had ``few'' (−1.7) and ``all'' (+2.0) TR frequencies or that involved the asynchronous (−2.6) TR mode. These point differences suggest limited clinical importance. Episodes with any TR frequency involved significantly fewer visits (0.7–1.3) than episodes with no TR, except that those with the “most” TR frequency had non-significantly fewer visits (0.6). A smaller proportion of individuals with TR (−4.0% to −5.0%) than of individuals with no telerehabilitation reported being very satisfied with treatment results, except for those with the “all” TR frequency.

Conclusions
A positive association between TR and rehabilitation outcomes was observed, with a trend for better FS outcomes and fewer visits when all care was delivered through TR. Satisfaction tended to be lower with TR use. Overall, this observational study showed that for people with low back pain, physical therapy delivered through TR was equally effective as and more efficient than in-person care, with a trend of higher effectiveness when used for all visits during the episode of care. No differences in FS outcomes were observed between care delivered with synchronous and mixed TR delivery modes and care delivered with no TR. However, the asynchronous mode of TR was associated with worse functional outcomes than no TR. Although the majority of people were very satisfied with their treatment results with and without TR, very high satisfaction rates were reported by a slightly smaller proportion of individuals with TR versus those without TR. Our results suggest that TR is a viable option for rehabilitation care for individuals with low back pain and should also be considered in the post–COVID-19 era.
Objective
The aims of this study were to examine associations between frequency of telerehabilitation (TR) and outcomes of functional status (FS), number of visits, and patient satisfaction during COVID-19 and to compare FS outcomes by TR delivery mode for individuals with low back pain.

Methods
Propensity score matching was used to match episodes of care with or without TR exposure by the probability of receiving TR. FS, visits, and s...

COVID-19 ; Coronavirus ; Physiothérapie

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Long-term cardiovascular adverse events in very elderly COVID-19 patients | Mai-juin 2022 H

Article (Gériatrie - gérontologie)

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The number of deaths owing to coronavirus disease 2019 (COVID-19) is escalating. Apart from the known clinical presentation of respiratory failure precipitated by COVID-19, the cardiovascular complications induced by this viral infection have raised essential concerns. A retrospective study reported that the cardiovascular system was the most sensitive tissue after the respiratory tract in COVID-19 (Sandoval et al., 2020). As in other viral infections, it is well-known that cardiovascular complications can increase the severity of COVID-19, leading to the aggravation of clinical conditions (Clerkin et al., 2020). The National Health Commission of China informed that almost 12% of patients had a myocardial injury in hospitalization (Zheng et al., 2020). A retrospective study of 138 hospitalized COVID-19 patients reported 10% acute cardiac injury and 16% arrhythmia (Wang et al., 2020). In addition, coagulopathy is another life-threatening problem causing arterial and venous thromboembolism in COVID-19 patients (Bikdeli et al., 2020).

It is well established that aged patients with COVID-19 are more likely to progress to severe disease (Liu et al., 2020, Li et al., 2020, Sun, 2020). A large study conducted with 4021 COVID-19 participants showed that patients over 60 years old had a significantly higher mortality rate than patients under 60 years (Yang et al., 2020). Another study stated robust relationships between older age and acute respiratory distress syndrome and death (Wu et al., 2020). The studies mentioned above have been performed during hospitalization, and data on post-discharge results are limited. Moreover, there is no data about long-term cardiovascular outcomes in very elderly (≥80 years) COVID-19 patients. Therefore, the primary goal of this research was to describe the long-term (>6 months) cardiovascular outcomes in very elderly COVID-19.
The number of deaths owing to coronavirus disease 2019 (COVID-19) is escalating. Apart from the known clinical presentation of respiratory failure precipitated by COVID-19, the cardiovascular complications induced by this viral infection have raised essential concerns. A retrospective study reported that the cardiovascular system was the most sensitive tissue after the respiratory tract in COVID-19 (Sandoval et al., 2020). As in other viral ...

COVID-19 ; Coronavirus ; Personnes âgées ; Accidents vasculaires cérébraux

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Background
The COVID-19 pandemic has posed an unprecedented threat to global mental health. Children and adolescents may be more susceptible to mental health impacts related to their vulnerable developmental stage, fear of infection, home confinement, suspension of regular school and extracurricular activities, physical distancing mandates, and larger scale threats such as global financial recessions and associated impacts. Our objective was to review existing evidence of the COVID-19 pandemic’s global impact on the mental health of children and adolescents <19 years of age and to identify personal and contextual factors that may enhance risk or confer protection in relation to mental health outcomes.

Methods
We conducted a search of peer-reviewed and preprint research published in English from January 1, 2020, to February 22, 2021. We included studies collecting primary data on COVID-19-related mental health impacts on children and adolescents. We graded the strength of included articles using the Oxford Centre for Evidence-Based Medicine rating scheme.

Results
Our search and review yielded 116 articles presenting data on a total of 127,923 children and adolescents; 50,984 child and adolescent proxy reports (e.g., parents, healthcare practitioners); and >3,000 chart reviews. A high prevalence of COVID-19-related fear was noted among children and adolescents, as well as more depressive and anxious symptoms compared with prepandemic estimates. Older adolescents, girls, and children and adolescents living with neurodiversities and/or chronic physical conditions were more likely to experience negative mental health outcomes. Many studies reported mental health deterioration among children and adolescents due to COVID-19 pandemic control measures. Physical exercise, access to entertainment, positive familial relationships, and social support were associated with better mental health outcomes.

Conclusions
This review highlights the urgent need for practitioners and policymakers to attend to and collaborate with children and adolescents, especially those in higher risk subgroups, to mitigate short- and long-term pandemic-associated mental health effects.
Background
The COVID-19 pandemic has posed an unprecedented threat to global mental health. Children and adolescents may be more susceptible to mental health impacts related to their vulnerable developmental stage, fear of infection, home confinement, suspension of regular school and extracurricular activities, physical distancing mandates, and larger scale threats such as global financial recessions and associated impacts. Our objective was to ...

Adolescents - Santé mentale ; Enfants - Santé mentale ; COVID-19 ; Pandémies ; Coronavirus

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Purpose of review: The COVID-19 pandemic has had a severe and widespread global impact but particularly for those with psychosis. This review summarizes recent evidence on the relationship between the COVID-19 pandemic and psychotic disorders, highlighting the risks faced by these individuals including the negative impacts on treatment services, complications from contracting COVID-19, and the acceptability of digital interventions.

Recent findings: Mortality, morbidity, and infection outcomes are among the worst for individuals with psychotic disorders. Presentation rates for psychotic disorders are elevated at emergency departments compared with before the COVID-19 pandemic; demand for inpatient services has increased, and there have been complications in access because of pandemic restrictions. COVID-19 related stressors have led to the exacerbation and incidence of psychotic symptoms among individuals with and without preexisting psychotic diagnoses. Digital interventions may be an acceptable method for maintaining patient contact and treatment during extended isolation.

Summary: More data is needed on the longitudinal trajectory for psychotic symptoms post-COVID-19 infection and pandemic restrictions to better support individuals with psychotic disorders. Development of a long-term pandemic management plan is needed to monitor and support psychiatric health across the population.
Purpose of review: The COVID-19 pandemic has had a severe and widespread global impact but particularly for those with psychosis. This review summarizes recent evidence on the relationship between the COVID-19 pandemic and psychotic disorders, highlighting the risks faced by these individuals including the negative impacts on treatment services, complications from contracting COVID-19, and the acceptability of digital interventions.

Recent ...

Psychoses ; COVID-19 ; Pandémies ; Vaccination ; Coronavirus ; Services de santé - Accessibilité

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Background
Multiple severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) superspreading events suggest that aerosols play an important role in driving the coronavirus disease 2019 (COVID-19) pandemic. To better understand how airborne SARS-CoV-2 transmission occurs, we sought to determine viral loads within coarse (>5 μm) and fine (≤5 μm) respiratory aerosols produced when breathing, talking, and singing.

Methods
Using a G-II exhaled breath collector, we measured viral RNA in coarse and fine respiratory aerosols emitted by COVID-19 patients during 30 minutes of breathing, 15 minutes of talking, and 15 minutes of singing.

Results
Thirteen participants (59%) emitted detectable levels of SARS-CoV-2 RNA in respiratory aerosols, including 3 asymptomatic and 1 presymptomatic patient. Viral loads ranged from 63–5821 N gene copies per expiratory activity per participant, with high person-to-person variation. Patients earlier in illness were more likely to emit detectable RNA. Two participants, sampled on day 3 of illness, accounted for 52% of total viral load. Overall, 94% of SARS-CoV-2 RNA copies were emitted by talking and singing. Interestingly, 7 participants emitted more virus from talking than singing. Overall, fine aerosols constituted 85% of the viral load detected in our study. Virus cultures were negative.

Conclusions
Fine aerosols produced by talking and singing contain more SARS-CoV-2 copies than coarse aerosols and may play a significant role in SARS-CoV-2 transmission. Exposure to fine aerosols, especially indoors, should be mitigated. Isolating viable SARS-CoV-2 from respiratory aerosol samples remains challenging; whether this can be more easily accomplished for emerging SARS-CoV-2 variants is an urgent enquiry necessitating larger-scale studies.
Background
Multiple severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) superspreading events suggest that aerosols play an important role in driving the coronavirus disease 2019 (COVID-19) pandemic. To better understand how airborne SARS-CoV-2 transmission occurs, we sought to determine viral loads within coarse (>5 μm) and fine (≤5 μm) respiratory aerosols produced when breathing, talking, and singing.

Methods
Using a G-II exhaled ...

COVID-19 ; Coronavirus ; Infection ; Appareil respiratoire - Infections ; Aérosols - Transmission

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Background
Our objective is to describe the presentation and complications, including relapses, of coronavirus disease 2019 (COVID-19) in patients under anti-CD20 treatments. In addition, to describe viral clearance and determine the safety of reintroducing anti-CD20 treatment.

Methods
Retrospective cohort study of 422 patients under anti-CD20 treatment that was administered from 1 January 2019 to 31 December 2020.

Results
Fifty-seven patients were diagnosed with COVID-19 (13.5%). Twenty-five patients (43.9%) required hospital admission. Five patients died (8.8%), and 10 developed severe COVID-19 and acute respiratory distress syndrome. Mortality rate was higher among patients infected during the first 3 months following the last dose of anti-CD20 (14.7% vs 0%, P = .046). The median time of persistence of positive reverse transcription polymerase chain reaction (RT-PCR) was 22 days (IQR 13–40).

Nine out of 52 survivors (17.3%) presented relapses. All of them received the last dose of anti-CD20 less than 6 months before the COVID-19 episode. Clinical presentation was fever (n = 8; 88.9%), dyspnea (n = 7; 77.8%), cough (n = 7; 77.8%), worsening of previous infiltrates (n = 5; 55.6%) and new pulmonary infiltrates (n = 8; 88.9%). An increase in lymphocytes with CD4/CD8 ratio inversion was observed in all cases. Among the 25 patients who resumed anti-CD20 drug, 4 (16.0%) presented relapses vs 5/28 among those who did not (17.9%), (P = .857).

Conclusions
Patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the 6 months after anti-CD20 administration had a worse outcome and a higher mortality rate. The duration of infectivity may be longer. Relapses of COVID-19 occurred in more than 15% and were associated with viral replication. Once the infection is resolved, it is safe to restart treatment with anti-CD20.
Background
Our objective is to describe the presentation and complications, including relapses, of coronavirus disease 2019 (COVID-19) in patients under anti-CD20 treatments. In addition, to describe viral clearance and determine the safety of reintroducing anti-CD20 treatment.

Methods
Retrospective cohort study of 422 patients under anti-CD20 treatment that was administered from 1 January 2019 to 31 December 2020.

Results
Fifty-seven patients ...

Appareil respiratoire - Infections ; COVID-19 ; Coronavirus ; Infection ; Anticorps

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Background
There is limited information on the risk of hospital-acquired coronavirus disease 2019 (COVID-19) among high-risk hospitalized patients after exposure to an infected patient or healthcare worker (HCW) in a nonoutbreak setting.

Methods
This study was conducted at a tertiary care cancer center in New York City from 10 March 2020 until 28 February 2021. In early April 2020, the study institution implemented universal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing at admission and retesting every 3 days through the hospital stay. Contact tracing records were reviewed for all exposures to SARS-CoV-2 positive patients and HCWs.

Results
From 10 March 2020 to 28 February 2021, 11 348 unique patients who were SARS-CoV-2 polymerase chain reaction (PCR) negative at the time of admission underwent 31 662 postadmission tests during their hospitalization, and 112 tested positive (0.98%). Among these, 49 patients housed in semiprivate rooms during admission resulted in 74 close contacts and 14 secondary infections within 14 days, for an overall attack rate of 18.9%. Among those exposed to a roommate undergoing an aerosol-generating procedure (AGP), the attack rate was 35.7%. Whole genome sequencing (WGS) corroborated transmission in 6/8 evaluated pairs. In addition, three transmission events occurred in 214 patients with significant exposure to 105 COVID-19 positive healthcare workers (1.4%).

Conclusions
The overall risk of hospital-acquired COVID-19 is low for hospitalized cancer patients, even during periods of high community prevalence. However, shared occupancy with an unrecognized case is associated with a high secondary attack rate in exposed roommates.
Background
There is limited information on the risk of hospital-acquired coronavirus disease 2019 (COVID-19) among high-risk hospitalized patients after exposure to an infected patient or healthcare worker (HCW) in a nonoutbreak setting.

Methods
This study was conducted at a tertiary care cancer center in New York City from 10 March 2020 until 28 February 2021. In early April 2020, the study institution implemented universal severe acute ...

Coronavirus ; COVID-19 ; Cancer - Prévention ; Cancer ; Appareil respiratoire - Maladies

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OBJECTIVE: To describe trends and risk factors for pressure injuries (PIs) in adult critical care patients proned to alleviate acute respiratory distress syndrome secondary to COVID-19 and examine the effectiveness of products and strategies used to mitigate PIs.

METHODS: The authors conducted a retrospective chart review between April 9 and June 8, 2020. Demographic data were analyzed using descriptive statistics. Differences between groups with and without PIs were analyzed.

RESULTS: Among 147 patients, significant PI risk factors included male sex (P = .019), high body mass index (>40 kg/m2; P = .020), low Braden Scale score (<12; P = .018), and low-dose vasopressor therapy (P = .020). Taping endotracheal tubes (ETTs) caused significantly fewer facial PIs than commercial ETT holders (P < .0001). Maximum prone duration/session was a significant risk factor for anterior PIs (P = .016), which dropped 71% with newer pressure redistribution products. D-Dimer greater than 3,200 [mu]g/mL (P = .042) was a significant risk factor for sacrococcygeal PIs while supine. Mortality was 30%; significant risk factors included age older than 60 years (P = .005), Sequential Organ Failure Assessment score greater than 11 (P = .003), and comorbid congestive heart failure (P = .016).

CONCLUSIONS: Taping the ETT, limiting the maximum duration of prone positioning to less than 32 hours, and frequent repositioning while supine may reduce the number of modifiable risk factors for PIs. Standardized methods for testing products for PI prevention will inform individualized patient care.
OBJECTIVE: To describe trends and risk factors for pressure injuries (PIs) in adult critical care patients proned to alleviate acute respiratory distress syndrome secondary to COVID-19 and examine the effectiveness of products and strategies used to mitigate PIs.

METHODS: The authors conducted a retrospective chart review between April 9 and June 8, 2020. Demographic data were analyzed using descriptive statistics. Differences between groups ...

Appareil respiratoire - Maladies ; Coronavirus ; COVID-19

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Question
How effective and safe is telerehabilitation for people with COVID-19 and post-COVID-19 conditions?

Design
Systematic review of randomised trials.

Participants
People with COVID-19 and post-COVID-19 conditions.

Intervention
Any type of telerehabilitation.

Outcome measures
Satisfaction, quality of life, adverse events, adherence to telerehabilitation, dyspnoea, functional performance, readmissions, mortality, pulmonary function and level of independence.

Results
Database searches retrieved 2,962 records, of which six trials with 323 participants were included in the review. Breathing exercises delivered via telerehabilitation improved 6-minute walk distance (MD 101 m, 95% CI 61 to 141; two studies), 30-second sit-to-stand test performance (MD 2.2 repetitions, 95% CI 1.5 to 2.8; two studies), Multidimensional Dyspnoea-12 questionnaire scores (MD –6, 95% CI –7 to –5; two studies) and perceived effort on the 0-to-10 Borg scale (MD –2.8, 95% CI –3.3 to –2.3; two studies), with low certainty of evidence. Exercise delivered via telerehabilitation improved 6-minute walk distance (MD 62 m, 95% CI 42 to 82, four studies), 30-second sit-to-stand test performance (MD 2.0 repetitions, 95% CI 1.3 to 2.7; two studies) and Multidimensional Dyspnoea-12 scores (MD –1.8, 95% CI –2.5 to –1.1; one study), with low certainty of evidence. Adverse events were almost all mild or moderate and occurred with similar frequency in the telerehabilitation group (median 0 per participant, IQR 0 to 2.75) as in the control group (median 0 per participant, IQR 0 to 2); Hodges-Lehmann median difference 0 (95% CI 0 to 0), with low certainty of evidence.

Conclusion
Telerehabilitation may improve functional capacity, dyspnoea, performance and physical components of quality of life and does not substantially increase adverse events.
Question
How effective and safe is telerehabilitation for people with COVID-19 and post-COVID-19 conditions?

Design
Systematic review of randomised trials.

Participants
People with COVID-19 and post-COVID-19 conditions.

Intervention
Any type of telerehabilitation.

Outcome measures
Satisfaction, quality of life, adverse events, adherence to telerehabilitation, dyspnoea, functional performance, readmissions, mortality, pulmonary function and ...

COVID-19 ; Coronavirus ; Physiothérapie ; Dyspnée

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Objective
To analyze the psychological and functional sequelae of the COVID-19 pandemic among older adults living in long term care facilities (LTCFs).
Design
Cohort longitudinal study
Setting ant participants
A total of 215 residents ≥ 65 years without moderate-to-severe cognitive impairment, living in five LTCFs in Albacete (Spain).
Measurements
Baseline on-site data were collected between March - June 2020 and three-month follow-up between June to September 2020. Symptoms of depression, anxiety, posttraumatic stress disorder (PTSD), and sleep disturbances were measured as psychological variables. Disability in basic activities of daily living (BADL), ambulation and frailty were assessed as functional variables. Differences were analyzed in relation to level of comorbidity and test positivity for COVID-19.
Results
At baseline, residents with COVID-19 presented worse functionality, higher frailty levels and malnutrition risk compared to non-COVID-19 residents. At three-month follow-up, higher rates of clinically significant depressive symptoms (57.7%), anxiety symptoms (29.3%), PTSD symptoms (19.1%) and sleep disturbances (93.0%) were found among residents regardless of COVID status. Thus, among 215 residents, 101 (47%) experienced a decline in BADL from baseline to the 3-month follow-up (median functional loss = 5 points in Barthel Index). In multivariate analyses, COVID-19 status did not explain either the functional or the ambulation loss. By contrast, residents with low comorbidity and COVID-19 presented higher PTSD symptoms (effect 2.58; 95% CI 0.93 to 4.23) and anxiety symptoms (effect 2.10; 95% CI 0.48 to 3.73) compared to the low comorbidity/non-COVID19 group.
Conclusion
COVID-19 pandemic was associated, after three-months, with high psychological impact in older adults in LTCFs., specifically with higher post-traumatic stress and anxiety symptoms. Functional decline did not differ in relation to COVID-19 status but could be related to isolation strategies used for pandemic control.
Objective
To analyze the psychological and functional sequelae of the COVID-19 pandemic among older adults living in long term care facilities (LTCFs).
Design
Cohort longitudinal study
Setting ant participants
A total of 215 residents ≥ 65 years without moderate-to-severe cognitive impairment, living in five LTCFs in Albacete (Spain).
Measurements
Baseline on-site data were collected between March - June 2020 and three-month follow-up between ...

Personnes âgées ; Coronavirus ; COVID-19

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Impact of Coronavirus Disease 2019 on Geriatric Psychiatry | Mars 2022 H

Article (Gériatrie - gérontologie)

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The twenty-first century has seen a resurgence of infectious diseases causing epidemics and pandemics. Initially seen as a regional disease, the coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), quickly and relentlessly spread across the globe. Unlike other recent viral diseases, COVID-19 was not circumscribed to a particular population or region. It affected everyone and caused unprecedented changes in day-to-day life for the entire world. As a new disease, it also brought with it a tremendous amount of uncertainty about how it spreads, who is more susceptible, and the possible harms it could cause.

Much has been learned about the virus since it first appeared in 2019. According to the World Health Organization (WHO), there have been more than 200 million confirmed cased of COVID-19 and more than 5 million deaths from the disease.1 According to the Centers for Disease Control and Prevention (CDC), the United States has had almost 40 million cases and more than 600,000 deaths.2 Older adults and those with comorbid medical disorders have higher mortalities. As older adults tend to have more chronic illnesses than younger adults, they have been significantly impacted by COVID-19. Eight out of 10 deaths from COVID-19 in the United States occurred in adults aged 65 years and older.3

Meeting the mental health needs of older adults has always been challenging, and coupled with the pandemic, it became very difficult. Previously sound and clinically impactful recommendations for mental and physical well-being, such as regular socialization, group exercises, adult day programs, and so forth, were no longer available and placed this population at increased risk of infection. Telepsychiatry was adopted as a way of maintaining treatment relationships with patients. However, this supposes that older adults have access to an Internet-capable device (eg, computer, tablet, or smartphone), live in an area with reliable broadband connectivity and are able to afford it, and that they are able to navigate the different telehealth services used by their providers. The challenge moving forward is to continually adapt to the changing landscape of care while simultaneously providing quality care for patients and support for their loved ones.
The twenty-first century has seen a resurgence of infectious diseases causing epidemics and pandemics. Initially seen as a regional disease, the coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), quickly and relentlessly spread across the globe. Unlike other recent viral diseases, COVID-19 was not circumscribed to a particular population or region. It affected everyone and caused ...

Coronavirus ; COVID-19 ; Personnes âgées - Santé mentale

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Background: The novel coronavirus (COVID-19) has plagued countries worldwide. This pandemic has greatly affected healthcare delivery and those providing care to vulnerable, immunocompromised patients undergoing cancer treatment, who are at a higher risk for poorer outcomes related to COVID-19.

Objective: The aim of this study was to explore the impact of COVID-19 on oncology healthcare professionals (OHCPs).

Methods: An exploratory study design was employed using semistructured interviews. A thematic analysis was completed using Atlas.ti software.

Results: Of 30 OHCP participants, most were female (90%), registered nurses (70%), and bachelor's prepared (66%). The following themes emerged: (1) pandemic-related restrictions and stress on personal lives impacted the ability of OHCPs to rejuvenate and reenergize for work; (2) fear of exposure and transmission and concern for high-risk status for contracting COVID-19; (3) limited resources and inconsistent communication about organizational policies caused additional stress, affecting OHCP trust and confidence in the system; (4) concern for the mental health of fellow OCHPs; (5) adaptation and resilience were required amidst shifting workloads, workflow, and new restrictions; and (6) importance of self-care to reduce personal/professional stressors.

Conclusions: Oncology healthcare professionals continue to face challenges of COVID-19 on their personal and professional lives yet have shown resilience during these unprecedented times.

Implications for Practice: Oncology healthcare professionals need to advocate for appropriate personal protective equipment and reliable mental health support services through employers. They should be engaged in COVID-19 task forces to ensure their challenges are heard and needs are addressed to provide quality oncology care.
Background: The novel coronavirus (COVID-19) has plagued countries worldwide. This pandemic has greatly affected healthcare delivery and those providing care to vulnerable, immunocompromised patients undergoing cancer treatment, who are at a higher risk for poorer outcomes related to COVID-19.

Objective: The aim of this study was to explore the impact of COVID-19 on oncology healthcare professionals (OHCPs).

Methods: An exploratory study ...

Cancer ; Coronavirus ; COVID-19 ; Oncologie

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Omicron variant and booster COVID-19 vaccines | Février 2022 H

Article (Santé publique et COVID-19)

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Type
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Date de parution
Descripteurs

Coronavirus [217]

COVID-19 [54]

Médicaments [31]

Pharmacologie [26]

Personnes âgées [20]

Pandémies [18]

Vaccination [18]

Infection [13]

Physiothérapie [10]

Rehabilitation [8]

Oncologie [5]

Médicaments - Usage [4]

Pneumologie [4]

Santé publique [4]

Soins palliatifs [4]

Télémédecine [4]

Appareil respiratoire - Infections [3]

Cancer [3]

Maladies infectieuses - Transmission [3]

Poumons - Maladies [3]

Psychologie clinique [3]

Stress [3]

Vitamines [3]

Anti-inflammatoires [2]

Anticorps [2]

Appareil respiratoire - Maladies [2]

Bien-être [2]

Cardiologie [2]

Démence [2]

Deuil - Aspect psychologique [2]

Dyspnée [2]

Efficacité organisationnelle [2]

Épidémiologie [2]

Éthique [2]

Gestion [2]

Interactions médicamenteuses [2]

Maladie de Parkinson [2]

Masques [2]

Neuropsychologie [2]

Personnes âgées - Usage des médicaments [2]

Population [2]

Recherche [2]

Résilience [2]

SANTÉ [2]

Santé mentale [2]

Sciences [2]

Soins de santé primaires [2]

Urologie [2]

Vitaminothérapie [2]

Accidents vasculaires cérébraux [1]

Adolescents - Santé mentale [1]

Aérosols - Transmission [1]

Aidants naturels [1]

Alimentation - Méditerranée, Région de la [1]

Anesthésie [1]

Anesthésie locorégionale [1]

Anticoagulants [1]

Antiviraux [1]

Anxiété [1]

Arthroplastie [1]

Asthme [1]

Asthme - Traitement [1]

BANDES DESSINÉES [1]

Biotechnologie [1]

Cancer - Prévention [1]

Cardiaques [1]

Cerveau - Maladies [1]

Chirurgie [1]

Confinement (Politique sanitaire) - Aspect psychologique [1]

Confinement (Politique sanitaire) - Ouvrages pour la jeunesse [1]

COVID-19 - Prévention - Ouvrages pour la jeunesse [1]

Dépendance (Psychologie) [1]

Distanciation sociale [1]

Dysphasie [1]

Éducation [1]

Éducation des enfants [1]

Éducation sanitaire [1]

ENFANTS [1]

Enfants - Développement [1]

Enfants - Santé mentale [1]

Épidémie [1]

Famille - Santé et hygiène [1]

Famille - Santé mentale [1]

Fractures [1]

Gériatrie [1]

Gestion de crise [1]

Grossesse [1]

Gynécologie [1]

Hanche [1]

Hématologie [1]

Hémorragies [1]

Hospitalisation [1]

Hygiène [1]

Immunologie [1]

Immunomodulateurs [1]

Infection - Prévention [1]

Infections nosocomiales [1]

Infirmières - Rôle professionnel [1]

Inflammation (Pathologie) - Diétothérapie [1]

INFORMATION [1]

Insuffisance cardiaque [1]

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