scholarly journals Individual-level Association of Influenza Infection With Subsequent Pneumonia: A Case-control and Prospective Cohort Study

2020 ◽  
Author(s):  
John Kubale ◽  
Guillermina Kuan ◽  
Lionel Gresh ◽  
Sergio Ojeda ◽  
Amy Schiller ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Integrated Management ◽  
Influenza Infection ◽  
Conditional Logistic Regression ◽  
Case Control ◽  
Influenza B ◽  
Logistic Regression Models ◽  
Individual Level

Abstract Background Pneumonia is a leading cause of mortality worldwide. Influenza may result in primary pneumonia or be associated with secondary bacterial pneumonia. While the association with secondary pneumonia has been established ecologically, individual-level evidence remains sparse and the risk period for pneumonia following influenza poorly defined. Methods We conducted a matched case-control study and a prospective cohort study among Nicaraguan children aged 0–14 years from 2011 through 2018. Physicians diagnosed pneumonia cases based on Integrated Management for Childhood Illness guidelines. Cases were matched with up to 4 controls on age (months) and study week. We fit conditional logistic regression models to assess the association between influenza subtype and subsequent pneumonia development, and a Bayesian nonlinear survival model to estimate pneumonia hazard following influenza. Results Participants with influenza had greater risk of developing pneumonia in the 30 days following onset compared to those without influenza (matched odds ratio [mOR], 2.7 [95% confidence interval {CI}, 1.9–3.9]). Odds of developing pneumonia were highest for participants following A(H1N1)pdm09 illness (mOR, 3.7 [95% CI, 2.0–6.9]), followed by influenza B and A(H3N2). Participants’ odds of pneumonia following influenza were not constant, showing distinct peaks 0–6 days (mOR, 8.3 [95% CI, 4.8–14.5] days) and 14–20 (mOR, 2.5 [95% CI, 1.1–5.5] days) after influenza infection. Conclusions Influenza is a significant driver of both primary and secondary pneumonia among children. The presence of distinct periods of elevated pneumonia risk in the 30 days following influenza supports multiple etiological pathways.

scholarly journals Development and clinical empirical validation of the Prognosis Prediction Model of Chronic Critical Illness

2020 ◽  
Author(s):  
Li Zhao ◽  
Wen-Kui Xu ◽  
Ying Wang ◽  
Wei-Yan Lu ◽  
Yong Wu ◽  
...  
Keyword(s):  
Cohort Study ◽  
Critical Illness ◽  
Prediction Model ◽  
Organ Failure ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Validation Cohort ◽  
Case Control ◽  
Chronic Critical Illness ◽  
Prognosis Prediction Model

Abstract Background A vast number of patients with chronic critical illness (CCI) have died of delayed organ failure in the intensive care unit (ICU). The weak organ function of patients needed appropriate tool to evaluate, which could provide reference for clinical decisions and communication with family members. The objective of this study was to develope and validate a prediction model for accurate, timely, simple, and objective identification of the critical degree of the patients' condition. Methods This study used a retrospective case–control and a prospective cohort study, with no interventions. Patients identified as CCI from a comprehensive ICU of a large metropolitan public hospital were selected. A total of 344 (case 172; control 172) patients were included to develop the Prognosis Prediction Model of Chronic Critical Illness (PPCCI Model) in this case-control study; 88 (case, 44; control 44) patients were included for the validation cohort in a prospective cohort study. The discrimination of the model was assessed by the area under the curve (AUC) of the receiver operating characteristic (ROC). Results The model comprised 9 predictors: age, prolonged mechanical ventilation (PMV), sepsis/other serious infections, Glasgow Coma Scale (GCS), mean artery pressure (MAP), heart rate (HR), respiratory rate (RR), oxygenation index (OI), and active bleeding.In both cohorts, the PPCCI Model could better identify the dead CCI patients (development cohort: AUC, 0.934; 95% CI, 0.908–0.960; validation cohort: AUC, 0.965; 95% CI, 0.931–0.999), and showed better discrimination than the Acute Physiology And Chronic Health Evaluation II (APACHE II), Modified Early Warning Score (MEWS), and Sequential Organ Failure Assessment (SOFA). Conclusions The PPCCI Model can provide a standardized measurement tool for ICU medical staff to evaluate the condition of CCI patients, to facilitate rational allocation of ward-monitoring resources or communicate with family members.

scholarly journals Clustering and longitudinal change in SARS-CoV-2 seroprevalence in school children in the canton of Zurich, Switzerland: prospective cohort study of 55 schools

BMJ ◽  
2021 ◽  
pp. n616
Author(s):  
Agne Ulyte ◽  
Thomas Radtke ◽  
Irene A Abela ◽  
Sarah R Haile ◽  
Christoph Berger ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Participation Rate ◽  
Credible Interval ◽  
School Level ◽  
Longitudinal Change ◽  
High Exposure ◽  
Logistic Regression Models ◽  
June July

Abstract Objectives To examine longitudinal changes in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence and to determine the clustering of children who were seropositive within school classes in the canton of Zurich, Switzerland from June to November 2020. Design Prospective cohort study. Setting Switzerland had one of the highest second waves of the SARS-CoV-2 pandemic in Europe in autumn 2020. Keeping schools open provided a moderate to high exposure environment to study SARS-CoV-2 infections. Children from randomly selected schools and classes, stratified by district, were invited for serological testing of SARS-CoV-2. Parents completed questionnaires on sociodemographic and health related questions. Participants 275 classes in 55 schools; 2603 children participated in June-July 2020 and 2552 in October-November 2020 (age range 6-16 years). Main outcome measures Serology of SARS-CoV-2 in June-July and October-November 2020, clustering of children who were seropositive within classes, and symptoms in children. Results In June-July, 74 of 2496 children with serological results were seropositive; in October-November, the number had increased to 173 of 2503. Overall SARS-CoV-2 seroprevalence was 2.4% (95% credible interval 1.4% to 3.6%) in the summer and 4.5% (3.2% to 6.0%) in late autumn in children who were not previously seropositive, leading to an estimated 7.8% (6.2% to 9.5%) of children who were ever seropositive. Seroprevalence varied across districts (in the autumn, 1.7-15.0%). No significant differences were found among lower, middle, and upper school levels (children aged 6-9 years, 9-13 years, and 12-16 years, respectively). Among the 2223 children who had serology tests at both testing rounds, 28/70 (40%) who were previously seropositive became seronegative, and 109/2153 (5%) who were previously seronegative became seropositive. Symptoms were reported for 22% of children who were seronegative and 29% of children who were newly seropositive since the summer. Between July and November 2020, the ratio of children diagnosed with SARS-CoV-2 infection to those who were seropositive was 1 to 8. At least one child who was newly seropositive was detected in 47 of 55 schools and in 90 of 275 classes. Among 130 classes with a high participation rate, no children who were seropositive were found in 73 (56%) classes, one or two children were seropositive in 50 (38%) classes, and at least three children were seropositive in 7 (5%) classes. Class level explained 24% and school level 8% of variance in seropositivity in the multilevel logistic regression models. Conclusions With schools open since August 2020 and some preventive measures in place, clustering of children who were seropositive occurred in only a few classes despite an increase in overall seroprevalence during a period of moderate to high transmission of SARS-CoV-2 in the community. Uncertainty remains as to whether these findings will change with the new variants of SARS-CoV-2 and dynamic levels of community transmission. Trial registration NCT04448717

scholarly journals Pre-pandemic Cognitive Function and COVID-19 Vaccine Hesitancy: Prospective Cohort Study

2021 ◽  
Author(s):  
George David Batty
Keyword(s):  
Cohort Study ◽  
Cognitive Function ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Full Range ◽  
Vaccine Hesitancy ◽  
Ability Test ◽  
Individual Level ◽  
New Findings ◽  
Successful Testing

Importance: Whereas several predictors of COVID-19 vaccine hesitancy have been examined, the role of cognitive function following the widely publicised development of an inoculation is unknown. Objective: To test the association between scores from an array of cognitive function tests and self-reported vaccine hesitancy after the announcement of the successful testing of the Oxford University/AstraZeneca vaccine. Design, Setting, and Participants: We used individual-level data from a pandemic-focused study (COVID Survey), a prospective cohort study nested within Understanding Society (Main Survey). In the week immediately following the announcement of successful testing of the first efficacious inoculation (November/December 2020), data on vaccine intentionality were collected in 11740 individuals (6702 women) aged 16-95. Pre-pandemic scores on general cognitive function, ascertained from a battery of six tests, were captured in 2011/12 wave of the Main Survey. Main Outcomes and Measures: Self-reported intention to take up a vaccination for COVID-19. To summarise our results, we computed odds ratios with accompanying 95% confidence intervals for general cognitive function adjusted for selected covariates. Results: Of the study sample, 17.2% (N=1842) indicated they were hesitant about having the vaccine. After adjustment for age, sex, and ethnicity, study members with a lower baseline cognition score were markedly more likely to be vaccine hesitant (odds ratio per standard deviation lower score in cognition; 95% confidence interval: 1.76; 1.62, 1.90). Adjustment for mental and physical health plus household shielding status had no impact on these results, whereas controlling for educational attainment led to partial attenuation but the probability of hesitancy was still elevated (1.52; 1.37, 1.67). There was a linear association for vaccine hesitancy across the full range of cognition scores (p for trend: p<0.0001). Conclusions and Relevance: Erroneous social media reports might have complicated personal decision-making, leading to people with lower cognitive ability test scores being vaccine-hesitant. With people with lower cognition also experiencing higher rates of COVID-19 in studies conducted prior to vaccine distribution, these new findings are suggestive of a potential additional disease burden.

scholarly journals Prevalence of chronic chikungunya and associated risks factors in the French West Indies (La Martinique). A prospective cohort study

2019 ◽  
Author(s):  
Bertolotti Antoine ◽  
Thioune Marême ◽  
Abel Sylvie ◽  
Belrose Gilda ◽  
Calmont Isabelle ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Cohort Study ◽  
Acute Phase ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Regression Models ◽  
Functional Disability ◽  
Univariate Analysis ◽  
Logistic Regression Models ◽  
Adequate Hydration

AbstractBackgroundThe chikungunya virus (CHIKV) is a re-emerging alphavirus that can cause chronic rheumatic musculoskeletal disorders, named chronic chikungunya (CHIKC+), which may be long-term incapacitating. A chikungunya outbreak occurred in 2013 in La Martinique. We constituted the first prospective cohort study of CHIKV-infected subjects in the Caribbean to assess the prevalence of CHIKC+ at 12 months and to search for factors present at the acute stage significantly associated with chronicity.Methodology/Principal findingsA total of 193 patients who tested positive for RT-PCR CHIKV, were submitted to clinical investigations in the acute phase (<21 days), and 3, 6, and 12 months after their inclusion. A total of 167 participants could be classified as either suffering or not from CHIKC+. They were analyzed using logistic regression models. At 12 months, the overall prevalence of CHIKC+ was 52.1% (95%CI: 44.5-59.7). In univariate analysis, age (OR: 1.04; 95% CI: 1.02-1.07; p=0.0003), being male (OR: 0.51; 95%CI: 0.27-0.98; p=0.04), headache (OR: 1.90; 95%CI: 1.02-3.56; p=0.04), vertigo (OR: 2.06; 95%CI: 1.05-4.03; p=0.04), vomiting (OR: 2.51; 95%CI: 1.07-5.87; p = 0.03), urea (OR: 1.33; 95%CI: 1.05-1.70; p=0.02) were associated with CHIKC+. In final multivariate logistic regression models for 167 participants, predictors of CHIKC+ were age (OR 1.06; 95%CI: 1.03-1.08; p<0.0001), male sex (OR: 0.40; 95%CI: 0.19-0.84; p=0.015), vertigo (OR: 2.46; 95%CI: 1.16-5.20; p=0.019), hypotension (OR 4.72; 95% -CI: 1.19-18.79; p=0.028), recoloration time >3 seconds (OR: 3.79; 95%-CI: 1.01-14.25).ConclusionsThis cohort study in La Martinique confirms that CHIKC+ is a frequent complication of acute chikungunya disease. Analysis emphasized the importance of age and female sex for CHIKC occurrence, and pointed out the potential aggravating role of dehydration at the acute phase. Early and adequate hydration could reduce the risk chronic chikungunya disorders.Author SummaryChikungunya is a mosquito-borne virus found in tropical countries that has been re-emerging in the last decade. It has caused major epidemics in recent years, such as in Reunion Island and in Southeast Asia. Nearly 2.5 billion people around the world are at risk of contracting the virus. During the acute phase of the illness, patients experience a flu-like syndrome with fever, headache, myalgia, rash, and severe arthralgia. These symptoms can persist for several months in some patients, and can lead to significant functional disability. During the 2013 epidemic in Martinique, we followed nearly 200 patients who had contracted chikungunya. More than half of the patients had a chronic form of the disease—mainly women over 50 years of age. Our statistical analyses indicate that poor hydration during the acute phase may be a risk factor for developing chronic rheumatism. Therefore, in the context of a chikungunya epidemic, it seems important to encourage patients to drink plenty of fluids as soon as the first symptoms appear.

scholarly journals Red Blood Cells in The First Trimester and The Risk of Gestational Diabetes: A Prospective Cohort Study

2021 ◽  
Author(s):  
Jiajing Jia ◽  
Ying Yang ◽  
Minjin Zhang ◽  
Li Lin ◽  
Yequn Chen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Gestational Diabetes ◽  
Blood Cell ◽  
Pregnant Women ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Hematological Parameters ◽  
First Trimester ◽  
Logistic Regression Models ◽  
Increased Risk

Abstract Background: This research aimed to assess the potential association of gestational diabetes (GDM) with early trimester hematological parameters including hemoglobin (Hb), red blood cell (RBC), white blood cell (WBC), and platelet count (PLT) through a prospective cohort study.Methods: The prospective cohort included pregnant women subjected to prenatal examination at Shantou and Beijing hospitals in China from March 2014 to December 2015. Data were collected since the first perinatal visit in obstetrics clinics, and then participants were followed up at 24, 32, 36 gestational weeks and the time of delivery, respectively. Multivariable adjusted logistic regression models were conducted to estimate odds ratio (OR) and its corresponding 95% confidence interval (95% CI).Results: A total of 1004 pregnant women with singletons, less than 12 gestational weeks, and without history of chronic disease were eligible for analysis. The incidence of GDM was 18.82%, and the mean age was 29.50 ± 3.84 years. Total of 187 (18.63%) women who had abnormal RBC level and 222 (22.11%) had abnormal Hb in the first trimester of pregnancy. After multivariable adjustment, each unit increment in numeric RBC or Hb was associated with 177% and 4% increased risk for GDM. The risk for GDM was significantly increased with higher RBC (OR: 2.00 for RBC>4.55×1012 /L) and Hb (OR: 2.14 for Hb>139 g/L) levels in the first trimester.Conclusions: Elevated RBC and Hb in the first trimester are associated with increasing risk of GDM. Further evidence are warranted to confirm these possible causal relationships.

scholarly journals Prematurity at birth and adolescent depressive disorder

2004 ◽  
Vol 184 (5) ◽  
pp. 446-447 ◽  
Author(s):  
George C. Patton ◽  
Carolyn Coffey ◽  
John B. Carlin ◽  
Craig A. Olsson ◽  
Ruth Morley
Keyword(s):  
Cohort Study ◽  
Depressive Disorder ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Low Birthweight ◽  
Control Design ◽  
Case Control ◽  
Confounding Factors ◽  
Physiological Adaptations ◽  
Regression Adjustment

SummaryAssociation between prematurity/low birthweight and adolescent depressive disorder studied using a case–control design within a prospective cohort study of 2032 adolescents. Odds for depressive disorder were 11-fold (95% C12–62) higher for the premature/low-birthweight participants after regression adjustment for major confounding factors. For premature/low-birthweight females, cumulative rates of depressive disorder over 30 months were 15.2% (95% C111.1–20.5) v. 1.8% (95% C11.6–2.1) in those with normal deliveries. Physiological adaptations in utero before full term may be implicated causally in some cases of depression in adolescence.

Sign in / Sign up

Export Citation Format

Share Document