scholarly journals Obesity, walking pace and risk of severe COVID-19: Analysis of UK Biobank

Author(s):  
Thomas Yates ◽  
Cameron Razieh ◽  
Francesco Zaccardi ◽  
Samuel Seidu ◽  
Melanie J Davies ◽  
...  

Obesity is an emerging risk factor for coronavirus disease-2019 (COVID-19). Simple measures of physical fitness, such as self-reported walking pace, could also be important risk factors, but have not been well documented. This analysis includes 414,201 UK Biobank participants with complete covariate and linked COVID-19 data. We analysed the risk of severe (in-hospital) COVID-19 across categories of obesity status and walking pace. As of June 20th 2020 there were 972 cases of severe COVID-19 that had occurred within the cohort. Compared to normal weight individuals, the adjusted odds ratio (OR) for severe COVID-9 in those with obesity was 1.49 (1.24, 1.78). Compared to those with a brisk walking pace, the OR in slow walkers was 1.84 (1.49, 2.27). Slow walkers had the highest risk of severe COVID-19 regardless of obesity status. For example, compared to normal weight brisk walkers, the odds of severe COVID-19 in obese brisk walkers was 1.39 (0.99, 1.98), whereas the odds in normal weight slow walkers was 2.48 (1.56, 3.93). Self-reported walking pace, a simple measure of functional fitness, appears to be a risk factor for severe COVID-19 that is independent of obesity. This may help inform simple pragmatic public health risk stratification and preventative strategies.

2020 ◽  
Author(s):  
Hyo Kyozuka ◽  
Tuyoshi Murata ◽  
Toma Fukuda ◽  
Shun Yasuda ◽  
Aya Kanno ◽  
...  

Abstract Background: Intrauterine inflammation affects short- and long-term neonatal outcomes. Histological chorioamnionitis and funisitis are acute inflammatory responses in the fetal membranes and umbilical cord, respectively. Although labor dystocia includes a potential risk of intrauterine inflammation, the risk of labor dystocia in histological chorioamnionitis and funisitis has not been evaluated yet. This study aimed to examine the association between labor dystocia and risk of histological chorioamnionitis and funisitis.Methods: In this retrospective cohort study, the patients who underwent histopathological examinations of the placenta and umbilical cord at Fukushima Medical University Hospital, Japan, between 2015 and 2020, were included. From the dataset, the pathological findings of the patients with labor dystocia and spontaneous preterm birth were reviewed. Based on the location of leukocytes, the inflammation in the placenta (histological chorioamnionitis) and umbilical cord (funisitis) was graded as 0–3. Multiple logistic regression analysis was performed to evaluate the risk of histological chorioamnionitis, histological chorioamnionitis stage ≥2, funisitis, and funisitis stage ≥2.Result: Of 317 women who met the study criteria, 83 and 144 women had labor dystocia and spontaneous preterm birth, respectively, and 90 women were included as controls. Labor dystocia was a risk factor for histological chorioamnionitis (adjusted odds ratio, 6.3; 95% confidential interval, 1.9-20.5), histological chorioamnionitis stage ≥2 (adjusted odds ratio, 6.0; 95% confidence interval, 1.7-21.8), funisitis (adjusted odds ratio, 9.4; 95% confidence interval, 1.8-48.2), and funisitis stage ≥2 (adjusted odds ratio, 23.5; 95% confidence interval, 2.3-23.8). Spontaneous preterm birth was also a risk factor for histological chorioamnionitis (adjusted odds ratio, 3.7; 95% confidence interval, 1.7-7.8), histological chorioamnionitis stage ≥2 (adjusted odds ratio, 3.0; 95% confidence interval, 1.2-7.9), and funisitis (adjusted odds ratio, 4.5; 95% confidence interval, 1.2-16.8). However, the adjusted odds ratio was smaller in spontaneous preterm births than in labor dystocia. Conclusion: Labor dystocia is a risk factor for severe histological chorioamnionitis and funisitis. Further studies are required to evaluate the effects of histological chorioamnionitis and funisitis on long-term neonatal outcomes.


2020 ◽  
Vol 16 ◽  
pp. 174550652095200
Author(s):  
Arsema Berhe ◽  
Abayneh Alamer ◽  
Kiflom Negash ◽  
Belete Assefa

Background: Urinary incontinence is any involuntary leakage of urine. It has serious negative health impacts on quality of life in pregnant women. According to the scientific committee of the International Continence Society report, worldwide prevalence of urinary incontinence estimated ranges between 32% and 64% among pregnant women. However, there is scarcity of evidence on prevalence and associated factors of urinary incontinence in Ethiopia. Objective: The aims of this study were to assess prevalence and associated factors of urinary incontinence among pregnant women attending antenatal care in public health facilities of Mekelle city, Tigray, Ethiopia. Methodology: Institution-based cross-sectional study design was conducted. Data were collected using an interviewer-administered structured questionnaire. Physical examination was done to assess the strength of pelvic floor muscles. The data were entered to EPI Info version 7 and analyzed using SPSS version 23. Bivariate and multivariate logistic regression analyses were done to investigate the factors associated with urinary incontinence. Results: Among 317 respondents, the prevalence of urinary incontinence was 23%. The contributing factors that had statistically significant association with urinary incontinence were gestational age (adjusted odds ratio: 9.6 (1.87–49.39, 95%), parity (adjusted odds ratio: 6.32 (1.48–27.05), 95% confidence interval), prior miscarriage (adjusted odds ratio: 6.28 (2.15–18.28), 95% confidence interval), constipation (adjusted odds ratio: 8.25 (3.12–21.84), 95% confidence interval), respiratory problem (adjusted odds ratio: 6.31 (2.05–19.43), 95% confidence interval), and weak pelvic floor muscle (adjusted odds ratio: 7.55 (2.51–22.67), 95% confidence interval). Conclusion: The prevalence of urinary incontinence is moderate compared to other studies. Gestational age, parity, prior miscarriage, having constipation, having respiratory problem, and weak pelvic floor muscle had significant association with urinary incontinence. This finding will help to increase the awareness of health care professionals involved in the care of pregnant women about urinary incontinence.


2021 ◽  
Vol 2 (6) ◽  
pp. 1477-1489
Author(s):  
Mateus de Miranda Gauza ◽  
Rodrigo Ribeiro e Silva ◽  
Júlia Opolski Nunes Da Silva ◽  
Matheus Leite Ramos De Souza ◽  
João Pedro Ribeiro Baptista ◽  
...  

Objetivo: Avaliar as características maternas e desfechos adversos perinatais relacionados ao baixo peso ao nascer. Métodos: Trata-se de um estudo caso controle, realizado na Maternidade Darcy Vargas em Joinville–SC, período de março de 2018 a fevereiro de 2019 através de amostra randomizada composta de 722 puérperas que realizaram o acompanhamento pré-natal exclusivamente em Atenção Primária à Saúde, divididas em 2 grupos: pacientes com recém-nascidos de baixo peso e pacientes com recém-nascidos de peso normal. No cálculo de razão de chance, os valores foram considerados significativos quando P<0,05. Adotou-se prematuridade como fator de confusão. Resultados: Dividiu-se a população em dois grupos, pacientes com recém-nascidos de baixo peso (33/4,57%) e com recém-nascidos de peso normal (689/95,43%). Características maternas diferiram quanto ao número de pessoas na casa, o número de consultas, o uso de tabaco e drogas na gestação e incidência de doença hipertensiva específica da gestação. Após o cálculo de razão de chance ajustado, observou-se que o fumo aumenta a chance de baixo peso ao nascer em 6,5 vezes (IC95% 1,375-31,250). Os recém-nascidos foram diferentes no capurro, peso, Apgar de 1º e 5º minuto, prematuridade, necessidade de UTI neonatal e Apgar baixo de 1º minuto. No cálculo de razão de chance ajustado, o baixo peso aumentou a chance de UTI neonatal em 5,3 vezes (IC95% 1,039-27,523). Conclusão: O fumo durante a gestação eleva a chance de baixo peso ao nascer em 6,5 vezes. Ademais, o baixo peso ao nascer eleva em 5,3 vezes as chances de internação em UTI neonatal.   Objective: To assess maternal characteristics and adverse outcomes related to low birth weight. Methods: This is a case control study, carried out at Maternidade Darcy Vargas in Joinville-SC, from March 2018 to February 2019 through a random sample composed of 722 puerperal women who underwent prenatal care exclusively in Primary Health Care, divided into 2 groups: patients with low birth weight newborns and patients with normal weight newborns. In calculating the odds ratio, values were considered significant when P <0.05. Prematurity was adopted as a confounding factor. Results: The population was divided into two groups, patients with low birth weight newborns (33 / 4.57%) and normal weight newborns (689 / 95.43%). Maternal characteristics differed in terms of the number of people in the household, the number of consultations, the use of tobacco and drugs during pregnancy and the incidence of pregnancy-specific hypertensive disease. After calculating the adjusted odds ratio, it was observed that smoking increases the chance of low birth weight 6.5 folds (95% CI 1.375-31.250). The newborns were different in capurro, weight, 1st and 5th minute Apgar, prematurity, need for neonatal ICU and low 1st minute Apgar. In the adjusted odds ratio calculation, low weight increased the chance of neonatal ICU 5.3 folds (95% CI 1.039-27.523). Conclusion: Smoking during pregnancy increases the chance of low birth weight 6.5 folds. Furthermore, low birth weight increases the chances of admission to the neonatal ICU 5.3 folds.


Author(s):  
Rindra Randremanana ◽  
Soa-Fy Andriamandimby ◽  
Jean Marius Rakotondramanga ◽  
Norosoa Razanajatovo ◽  
Reziky Mangahasimbola ◽  
...  

Background: Following the first detection of SARS-CoV-2 in passengers arriving from Europe on 19 March 2020, Madagascar took several mitigation measures to limit the spread of the virus in the country. Methods: Nasopharyngeal and/or oropharyngeal swabs were collected from travellers to Madagascar, suspected SARS-CoV-2 cases, and contact of confirmed cases. Swabs were tested at the national reference laboratory using real-time RT-PVR. Data collected from patients were entered in an electronic database for subsequent statistical analysis. All distribution of laboratory confirmed cases were mapped and six genomes of viruses were fully sequenced. Results: Overall, 26,415 individuals were tested for SARS-CoV-2 between 18 March and 18 September 2020, of whom 21.0% (5,553/26,145) returned positive. Among laboratory-confirmed SARS-CoV-2 positive patients, the median age was 39 years (CI95%: 28-52), and 56.6% (3,311/5,553) were asymptomatic at the time of sampling. The probability of testing positive increased with age with the highest adjusted odds ratio of 2.2 [95% CI: 1.9-2.5] for individuals aged 49 years and more. Viral strains sequenced belong to clades 19A, 20A, and 20B in favour of several independent introduction of viruses. Conclusions. Our study describes the first wave of the COVID-19 in Madagascar. Despite early strategies in place Madagascar could not avoid the introduction and spread of the virus. More studies are needed to estimate the true burden of disease and make public health recommendations for a better preparation to another wave.


2018 ◽  
Vol 36 (10) ◽  
pp. 1039-1044 ◽  
Author(s):  
Annie M. Dude ◽  
Ashley Battarbee ◽  
Lynn M. Yee

Objective We determined whether time between deliveries is associated with developing diabetes at the time of a subsequent delivery. Study Design This is a case–control study of women who had two consecutive singleton births at the same institution with no pregestational diabetes in the baseline pregnancy. Cases were defined as women who were diagnosed with any type of diabetes at the time of the subsequent delivery. Controls were defined as women who had no diagnosis of diabetes at the time of the subsequent delivery. Interdelivery interval (IDI) was categorized as < 18, 18 to 60, or > 60 months. Results Of 12,263 women, 4.1% (N = 501) were diagnosed with diabetes at the subsequent delivery. Women with diabetes were more likely to have an IDI of >60 months than women without diabetes (9.0 vs. 4.2%, p < 0.001). After controlling for confounding factors, an IDI > 60 months remained associated with development of pregestational or gestational diabetes by the conclusion of the subsequent pregnancy (adjusted odds ratio = 2.13 compared with an IDI of 18–60 months, 95% confidence interval 1.44–3.15). Conclusion A longer IDI is an independent risk factor for the development of diabetes at the time of a subsequent delivery.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hyo Kyozuka ◽  
Tuyoshi Murata ◽  
Toma Fukuda ◽  
Erina Suzuki ◽  
Riho Yazawa ◽  
...  

Abstract Background Intrauterine inflammation affects short- and long-term neonatal outcomes. Histological chorioamnionitis and funisitis are acute inflammatory responses in the fetal membranes and umbilical cord, respectively. Although labor dystocia includes a potential risk of intrauterine inflammation, the risk of histological chorioamnionitis and funisitis of labor dystocia has not been evaluated yet. This study aimed to examine the association between labor dystocia and risk of histological chorioamnionitis and funisitis. Methods In this retrospective cohort study, the cases who underwent histopathological examinations of the placenta and umbilical cord at Fukushima Medical University Hospital, Japan, between 2015 and 2020, were included. From the dataset, the pathological findings of the patients with labor dystocia and spontaneous preterm birth were reviewed. Based on the location of leukocytes, the inflammation in the placenta (histological chorioamnionitis) and umbilical cord (funisitis) was staged as 0–3. Multiple logistic regression analysis was performed to evaluate the risk of histological chorioamnionitis, histological chorioamnionitis stage ≥2, funisitis, and funisitis stage ≥2. Result Of 317 women who met the study criteria, 83 and 144 women had labor dystocia and spontaneous preterm birth, respectively, and 90 women were included as controls. Labor dystocia was a risk factor for histological chorioamnionitis (adjusted odds ratio, 6.3; 95% confidential interval, 1.9–20.5), histological chorioamnionitis stage ≥2 (adjusted odds ratio, 6.0; 95% confidence interval, 1.7–21.8), funisitis (adjusted odds ratio, 15.4; 95% confidence interval, 2.3–101.3), and funisitis stage ≥2 (adjusted odds ratio, 18.5; 95% confidence interval, 2.5–134.0). Spontaneous preterm birth was also a risk factor for histological chorioamnionitis (adjusted odds ratio, 3.7; 95% confidence interval, 1.7–7.8), histological chorioamnionitis stage ≥2 (adjusted odds ratio, 3.0; 95% confidence interval, 1.2–7.9), and funisitis (adjusted odds ratio, 6.6; 95% confidence interval, 1.4–30.6). However, the adjusted odds ratio was smaller in spontaneous preterm births than in labor dystocia. Conclusion Labor dystocia is a risk factor for severe histological chorioamnionitis and funisitis. Further studies are required to evaluate the effects of histological chorioamnionitis and funisitis on long-term neonatal outcomes.


2021 ◽  
Vol 9 ◽  
pp. 205031212110328
Author(s):  
Zelalem Jabessa Wayessa ◽  
Girma Tufa Melesse ◽  
Elias Amaje Hadona ◽  
Wako Golicha Wako

Objectives: Globally, novel coronavirus disease 2019 (COVID-19) has spread rapidly since it was first identified and challenging the provision of essential services for low-resource countries. Healthcare workers involved in providing care are at high risk of developing mental health problems. The aim of this was to determine the prevalence of depressive symptoms due to COVID-19 and associated factors among healthcare workers in the West Guji zone in public health facilities, southern Ethiopia. Methods: A facility-based cross-sectional study was conducted in public health facilities found in the West Guji zone. A simple random sampling technique was employed to select 283 study subjects. This study was used to assess the prevalence of depression symptoms using Depression, Anxiety and Stress Scale-21, a depression subscale. Descriptive statistics, binary and multiple logistic regressions were used. Adjusted odds ratios (AORs) with 95% confidence interval will be estimated to assess the strength of associations and statistical significance will be declared at a p-value < 0.05. Results: Out of 283 eligible healthcare workers, 275 respondents had participated in this study with a 97.2% response rate. The prevalence of depressive symptoms was 21.5%. The independent predictors associated with depressive symptoms due to COVID-19 were age (adjusted odds ratio = 2.35, 95% confidence interval = 1.126–3.95), family size (adjusted odds ratio = 3.56, 95% confidence interval = 1.09–11.62), alcohol use (adjusted odds ratio = 4.31, 95% confidence interval = 1.76–10.55), medical illness (adjusted odds ratio = 9.56, 95% confidence interval = 3.71–24.59), having training on COVID-19 (adjusted odds ratio = 0.37, 95% confidence interval = 0.17–0.81), and lack of knowledge on COVID-19 (adjusted odds ratio = 15.34, 95% confidence interval = 6.32–37.21). Conclusion: The prevalence of depressive symptoms among healthcare workers due to COVID-19 was high. Factors associated with depressive symptoms were age, family size, alcohol use, medical illness, having training on COVID–19, and lack of knowledge on COVID-19.


2021 ◽  
Vol 9 ◽  
pp. 205031212110384
Author(s):  
Shewangizaw Hailemariam ◽  
Besufekad Mekonnen ◽  
Nigusie Shifera ◽  
Biruk Endalkachew ◽  
Molla Asnake ◽  
...  

Objective: Ethiopia is planning to vaccinate 20% of its population against the coronavirus disease 2019 pandemic by the end of 2021—however, there is no single piece of evidence regarding pregnant women’s intention to be vaccinated against coronavirus disease 2019; hence, the objective of this study was to investigate predicting factors of intention to be vaccinated against coronavirus disease 2019 among pregnant women in Bench-Sheko Zone, southwest Ethiopia. Methods: Facility-based cross-sectional study was undertaken from 1 February to 1 March 2021 in southwest Ethiopia. The study was carried out among pregnant women who came for antenatal care service in the selected public health facilities. Interviewer-administered structured tool was used to collect the data. Data were entered into EpiData (version 3.1) and then analyzed using SPSS (version 20). Results: The study revealed that only 31.3% (95% confidence interval: 26.7–35.2) of the participants had an intention to be vaccinated against coronavirus disease 2019 when the vaccine will be made available in Ethiopia. Participants’ intention to be vaccinated against coronavirus disease 2019 was significantly associated with attaining secondary school and above (adjusted odds ratio = 4.24, 95% confidence interval: 2.23–9.32), residing in urban areas (adjusted odds ratio = 2.57, 95% confidence interval: 1.22–5.40), being compliant with coronavirus disease 2019 guidelines (adjusted odds ratio = 5.86, 95% confidence interval: 3.40–10.09), and having good perception toward coronavirus disease 2019 vaccine (adjusted odds ratio = 3.04, 95% confidence interval: 1.64–5.62). Conclusion: Above all, in this study, pregnant women’s intention to vaccinate against coronavirus disease 2019 was very low when compared with previous studies. Hence, before commencing the coronavirus disease 2019 vaccination program in Ethiopia, it is essential to launch a widespread public health education campaign that could improve people’s perception of the vaccine. Besides, the upcoming public health intervention programs better put special emphasis on community members with lower educational attainment backgrounds and rural residents.


2007 ◽  
Vol 28 (2) ◽  
pp. 123-130 ◽  
Author(s):  
Steven J. Lawrence ◽  
Laura A. Puzniak ◽  
Brooke N. Shadel ◽  
Kathleen N. Gillespie ◽  
Marin H. Kollef ◽  
...  

Objective.To evaluate the epidemiology, outcomes, and importance of Clostridium difficile colonization pressure (CCP) as a risk factor for C. difficile–associated disease (CDAD) acquisition in intensive care unit (ICU) patients.Design.Secondary analysis of data from a 30-month retrospective cohort study.Setting.A 19-bed medical ICU in a midwestern tertiary care referral center.Patients.Consecutive sample of adult patients with a length of stay of 24 hours or more between July 1, 1997, and December 31, 1999.Results.Seventy-six (4%) of 1,872 patients were identified with CDAD; 40 (53%) acquired CDAD in the ICU, for an incidence of 3.2 cases per 1,000 patient-days. Antimicrobial therapy, enteral feeding, mechanical ventilation, vancomycin-resistant enterococci (VRE) colonization or infection, and CCP (5.5 vs 2.0 CDAD case-days of exposure for patients with acquired CDAD vs no CDAD; P = .001) were associated with CDAD acquisition in the univariate analysis. Only VRE colonization or infection (45% of patients with acquired CDAD vs 16% of patients without CDAD; adjusted odds ratio, 2.76 [95% confidence interval, 1.36-5.59]) and a CCP of more than 30 case-days of exposure (20% with acquired CDAD vs 2% with no CDAD; adjusted odds ratio, 3.77 [95% confidence interval, 1.14-12.49]) remained statistically significant in the multivariable analysis. Lengths of stay (6.1 vs 3.0 days; P < .001 by univariate analysis) and ICU costs ($11,353 vs $6,028; P < .001 by univariate analysis) were higher for patients with any CDAD than for patients with no CDAD.Conclusions.In this nonoutbreak setting, the CCP was an independent risk factor for acquisition of CDAD in the ICU at the upper range of exposure duration. Having CDAD in the ICU was a marker of excess healthcare use.


Sexual Abuse ◽  
2016 ◽  
Vol 30 (4) ◽  
pp. 343-366 ◽  
Author(s):  
Edmond Pui Hang Choi ◽  
Janet Yuen Ha Wong ◽  
Daniel Yee Tak Fong

Smartphone dating applications (apps) have become popular in recent years. However, the association between the use of dating apps and sexual abuse remains uninvestigated. The aim of this study was to examine the association between using dating apps and the sexual abuse of males and females. Six hundred sixty-six participants were recruited in four universities in Hong Kong in 2015. Overall, the 1-year prevalence of sexual abuse was 12.4% (95% confidence interval [CI]: [9.8, 14.9]) and the lifetime prevalence was 14.2% (95% CI: [11.5, 16.9]). Multiple logistic regressions found that users of dating apps (adjusted odds ratio [aOR]: 2.13, p < .05) were more likely to be sexually abused in the past year than non-users. Using dating apps was also a risk factor of lifetime sexual abuse (aOR: 1.83, p < .05). Our findings suggest that app users should deserve more attention in risk assessment, risk stratification, and sexual abuse prevention programs.


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