scholarly journals Long-term COVID-19 symptoms in a large unselected population

2020 ◽  
Author(s):  
Elizabeth T. Cirulli ◽  
Kelly M. Schiabor Barrett ◽  
Stephen Riffle ◽  
Alexandre Bolze ◽  
Iva Neveux ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Adult Population ◽  
Memory Loss ◽  
Population Level ◽  
Important Variable ◽  
Severe Illness ◽  
Initial Symptom ◽  
Increased Risk ◽  
General Adult Population

It is increasingly recognized that SARS-CoV-2 can produce long-term complications after recovery from the acute effects of infection. Here, we report the analysis of 32 self-reported short and long-term symptoms in a general adult population cohort comprised of 357 COVID-19+ cases, 5,497 SARS-CoV-2-negative controls, and 19,095 non-tested individuals. The majority of our COVID-19+ cases are mild, with only 9 of the 357 COVID-19+ cases having been hospitalized. Our results show that 36.1% of COVID-19+ cases have symptoms lasting longer than 30 days, and 14.8% still have at least one symptom after 90 days. These numbers are higher for COVID-19+ cases who were initially more ill, 44.9% at 30 days and 20.8% at 90 days, but even for very mild and initially asymptomatic cases, 21.3% have complications persist for 30 days or longer. In contrast, only 8.4% of participants from the general untested population develop new symptoms lasting longer than 30 days due to any illness during the same study period. The long-term symptoms most enriched in those with COVID-19 are anosmia, ageusia, difficulty concentrating, dyspnea, memory loss, confusion, chest pain, and pain with deep breaths. In addition to individuals who are initially more sick having more long-term symptoms, we additionally observe that individuals who have an initial symptom of dyspnea are significantly more likely to develop long-term symptoms. Importantly, our study finds that the overall level of illness is an important variable to account for when assessing the statistical significance of symptoms that are associated with COVID-19. Our study provides a baseline from which to understand the frequency of COVID-19 long-term symptoms at the population level and demonstrates that, although those most likely to develop long-term COVID-19 complications are those who initially have more severe illness, even those with mild or asymptomatic courses of infection are at increased risk of long-term complications.

scholarly journals Impact of Diagnosed and Undiagnosed Respiratory Pseudomonas on VAP and VAE During Long-Term Acute Care

2020 ◽  
Vol 41 (S1) ◽  
pp. s258-s259
Author(s):  
James Harrigan ◽  
Ebbing Lautenbach ◽  
Emily Reesey ◽  
Magda Wernovsky ◽  
Pam Tolomeo ◽  
...  
Keyword(s):  
Bacterial Community ◽  
Acute Care ◽  
Statistical Significance ◽  
Rrna Gene ◽  
Care Hospital ◽  
16S Sequencing ◽  
Increased Risk ◽  
Wide Range ◽  
The Impact

Background: Clinically diagnosed ventilator-associated pneumonia (VAP) is common in the long-term acute-care hospital (LTACH) setting and may contribute to adverse ventilator-associated events (VAEs). Pseudomonas aeruginosa is a common causative organism of VAP. We evaluated the impact of respiratory P. aeruginosa colonization and bacterial community dominance, both diagnosed and undiagnosed, on subsequent P. aeruginosa VAP and VAE events during long-term acute care. Methods: We enrolled 83 patients on LTACH admission for ventilator weaning, performed longitudinal sampling of endotracheal aspirates followed by 16S rRNA gene sequencing (Illumina HiSeq), and bacterial community profiling (QIIME2). Statistical analysis was performed with R and Stan; mixed-effects models were fit to relate the abundance of respiratory Psa on admission to clinically diagnosed VAP and VAE events. Results: Of the 83 patients included, 12 were diagnosed with P. aeruginosa pneumonia during the 14 days prior to LTACH admission (known P. aeruginosa), and 22 additional patients received anti–P. aeruginosa antibiotics within 48 hours of admission (suspected P. aeruginosa); 49 patients had no known or suspected P. aeruginosa (unknown P. aeruginosa). Among the known P. aeruginosa group, all 12 patients had P. aeruginosa detectable by 16S sequencing, with elevated admission P. aeruginosa proportional abundance (median, 0.97; IQR, 0.33–1). Among the suspected P. aeruginosa group, all 22 patients had P. aeruginosa detectable by 16S sequencing, with a wide range of admission P. aeruginosa proportional abundance (median, 0.0088; IQR, 0.00012–0.31). Of the 49 patients in the unknown group, 47 also had detectable respiratory Psa, and many had high P. aeruginosa proportional abundance at admission (median, 0.014; IQR, 0.00025–0.52). Incident P. aeruginosa VAP was observed within 30 days in 4 of the known P. aeruginosa patients (33.3%), 5 of the suspected P. aeruginosa patients (22.7%), and 8 of the unknown P. aeruginosa patients (16.3%). VAE was observed within 30 days in 1 of the known P. aeruginosa patients (8.3%), 2 of the suspected P. aeruginosa patients (9.1%), and 1 of the unknown P. aeruginosa patients (2%). Admission P. aeruginosa abundance was positively associated with VAP and VAE risk in all groups, but the association only achieved statistical significance in the unknown group (type S error <0.002 for 30-day VAP and <0.011 for 30-day VAE). Conclusions: We identified a high prevalence of unrecognized respiratory P. aeruginosa colonization among patients admitted to LTACH for weaning from mechanical ventilation. The admission P. aeruginosa proportional abundance was strongly associated with increased risk of incident P. aeruginosa VAP among these patients.Funding: NoneDisclosures: None

scholarly journals Distribution of health anxiety in a general adult population and associations with demographic and social network characteristics

2020 ◽  
pp. 1-8
Author(s):  
Anja Davis Norbye ◽  
Birgit Abelsen ◽  
Olav Helge Førde ◽  
Unni Ringberg
Keyword(s):  
Exponential Distribution ◽  
Sex Education ◽  
Household Income ◽  
Adult Population ◽  
Health Anxiety ◽  
Care Utilization ◽  
Cross Sectional ◽  
Increased Risk ◽  
General Adult Population

Abstract Background Health anxiety (HA) is associated with increased risk of disability, increased health care utilization and reduced quality of life. However, there is no consensus on which factors are important for the level of HA. The aim of this study was to explore the distribution of HA in a general adult population and to investigate whether demographic and social factors were associated with HA. Methods This study used cross-sectional data from the seventh Tromsø study. A total of 18 064 participants aged 40 years or older were included in the analysis. The six-item Whiteley Index (WI-6) with a 5-point Likert scale was used to measure HA. Sociodemographic factors included age, sex, education, household income, quality of friendship and participation in an organized activity. Results HA showed an exponential distribution among the participants with a median score of 2 points out of 24 points. In total, 75% had a total score of 5 points or less, whereas 1% had a score >14 points. Education, household income, quality of friendship and participation in organized activity were significantly associated with HA. The variable quality of friendship demonstrated the strongest association with HA. Conclusion Our study showed an exponential distribution of HA in a general adult population. There was no evident cut-off point to distinguish participants with severe HA based on their WI-6 score, indicating the importance of analysing HA as a complex, continuous construct. HA demonstrated strong associations with quality of friendship and participation in an organized activity.

Trends in Childhood Obesity Research: A Brief Analysis of NIH-Supported Efforts

2007 ◽  
Vol 35 (1) ◽  
pp. 148-153 ◽  
Author(s):  
Terry T-K Huang ◽  
Mary N. Horlick
Keyword(s):  
Childhood Obesity ◽  
Behavioral Change ◽  
Population Level ◽  
Well Being ◽  
The United States ◽  
Obesity Epidemic ◽  
Obesity Research ◽  
Increased Risk ◽  
Economic Well Being

Childhood obesity continues to rise in the United States, with now over 17% of children and adolescents considered overweight. Childhood obesity predisposes an entire generation to increased risk of chronic diseases and disabilities and is a severe threat to the economic well-being of the nation. At first thought, the solution to the obesity epidemic may seem simple: encourage people to eat less and exercise more. However, the reality is that behavioral change is difficult to achieve without also considering the interplay of genetics, biological processes, and social and environmental mechanisms. As such, investment in obesity research has been considered an important tool to combat obesity and obesity-related diseases. Childhood obesity research, in particular, has drawn considerable attention, given the lower cost of prevention relative to treatment and the high potential for long-term benefits at a population level.

scholarly journals Paracetamol: not as safe as we thought? A systematic literature review of observational studies

2015 ◽  
Vol 75 (3) ◽  
pp. 552-559 ◽  
Author(s):  
Emmert Roberts ◽  
Vanessa Delgado Nunes ◽  
Sara Buckner ◽  
Susan Latchem ◽  
Margaret Constanti ◽  
...  
Keyword(s):  
Literature Review ◽  
Systematic Literature Review ◽  
Dose Response ◽  
Observational Studies ◽  
Relative Rate ◽  
Adult Population ◽  
Assessment Development ◽  
Increased Risk ◽  
General Adult Population ◽  
Paracetamol Toxicity

ObjectivesWe conducted a systematic literature review to assess the adverse event (AE) profile of paracetamol.MethodsWe searched Medline and Embase from database inception to 1 May 2013. We screened for observational studies in English, which reported mortality, cardiovascular, gastrointestinal (GI) or renal AEs in the general adult population at standard analgesic doses of paracetamol. Study quality was assessed using Grading of Recommendations Assessment, Development and Evaluation. Pooled or adjusted summary statistics were presented for each outcome.ResultsOf 1888 studies retrieved, 8 met inclusion criteria, and all were cohort studies. Comparing paracetamol use versus no use, of two studies reporting mortality one showed a dose–response and reported an increased relative rate of mortality from 0.95 (0.92 to 0.98) to 1.63 (1.58 to 1.68). Of four studies reporting cardiovascular AEs, all showed a dose–response with one reporting an increased risk ratio of all cardiovascular AEs from 1.19 (0.81 to 1.75) to 1.68 (1.10 to 2.57). One study reporting GI AEs reported a dose–response with increased relative rate of GI AEs or bleeds from 1.11 (1.04 to 1.18) to 1.49 (1.34 to 1.66). Of four studies reporting renal AEs, three reported a dose–response with one reporting an increasing OR of ≥30% decrease in estimated glomerular filtration rate from 1.40 (0.79 to 2.48) to 2.19 (1.4 to 3.43).DiscussionGiven the observational nature of the data, channelling bias may have had an important impact. However, the dose–response seen for most endpoints suggests a considerable degree of paracetamol toxicity especially at the upper end of standard analgesic doses.

scholarly journals Obesity, food intake and exercise: Relationship with ghrelin

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Gul Tiryaki-Sonmez ◽  
Serife Vatansever ◽  
Burcin Olcucu ◽  
Brad Schoenfeld
Keyword(s):  
Food Intake ◽  
Energy Homeostasis ◽  
Adult Population ◽  
Peptide Hormone ◽  
Adverse Health Outcomes ◽  
General Adult Population ◽  
Orexigenic Peptide ◽  
Term Energy ◽  
Short And Long Term

SummaryObesity, a disorder of body composition, is defined by a relative or absolute excess of body fat. In general adult population, obesity has been associated with a diverse array of adverse health outcomes, including major causes of death such as cancer, diabetes, cardiovascular disease, as well as functional impairment from problems such as osteoarthritis and sleep apnea. Ghrelin is a newly discovered peptide hormone which plays an important role in obesity. It is a powerful, endogenous orexigenic peptide and has a crucial function in appetite regulation, as well as short – and long-term energy homeostasis. In the presence of increased obesity, decreased physical activity, and high food consumption, the relationship between exercise, appetite, food intake and ghrelin levels has important implications. In this review, we discuss the effect of acute and chronic exercise performance on appetite, food intake and ghrelin and their relationships.

scholarly journals The evolution of depressive symptomatology across three waves of the COVID-19 pandemic: A 17-month representative longitudinal study of the adult population

2021 ◽  
Author(s):  
Omid V. Ebrahimi ◽  
Daniel J. Bauer ◽  
Asle Hoffart ◽  
Sverre Urnes Johnson
Keyword(s):  
Longitudinal Study ◽  
Depressive Symptomatology ◽  
Adult Population ◽  
Population Level ◽  
Change Score ◽  
Critical Fluctuations ◽  
Symptom Trajectories ◽  
Large Heterogeneity ◽  
Lower Education

This 17-month longitudinal study on a representative sample of 4,361 Norwegian adults employs an observational ABAB design across six repeated assessments and three pandemic waves to systematically investigate the evolution of depressive symptomatology across all modifications of viral mitigation protocols (VMPs) from their onset to termination. Using Latent Change Score Models to analyze 26,166 observations, the study empirically corroborates that critical fluctuations in depressive symptomatology within and across individuals occur during the first three months of the pandemic, after which symptom trajectories are predominantly consolidated throughout the pandemic period. Contrary to established belief, female sex, young age, lower education and preexisting psychiatric diagnosis only served as adequate predictors of the initial shocks to symptomatology observed during the onset of the pandemic, and did not adequately predict subsequent change and the critical fluctuations observed in symptoms within and across individuals. Population-level trajectories demonstrated that symptom levels increased in accordance with the presence and strictness of VMPs. Upon predominant termination of VMPs, population-level symptoms began declining, while large heterogeneity was present across the adult population. Detrimental long-term adversities were revealed by 10% of the adults. These individuals displayed chaotic adaptation to the pandemic and its VMPs, exhibiting substantial increases in clinical levels of symptomatology ensuing partial re-opening of society and through the remainder of the pandemic, with these deleterious symptoms further projected to remain heightened ahead. Number of times exposed to quarantine was incrementally tied with increases in contemporaneously experienced and long-term depressive adversities, while information obtainment through unmonitored sources was associated with contemporaneous but not long-term states of heightened symptomatology.

Violent Death Rates and Risk for Released Prisoners in North Carolina

2015 ◽  
Vol 30 (6) ◽  
pp. 1019-1036 ◽  
Author(s):  
Steven Edward Lize ◽  
Anna M. Scheyett ◽  
Candice R. Morgan ◽  
Scott K. Proescholdbell ◽  
Tammy Norwood ◽  
...  
Keyword(s):  
North Carolina ◽  
Multinomial Logistic Regression ◽  
Adult Population ◽  
Study Data ◽  
Violent Death ◽  
Death Rates ◽  
The North ◽  
Increased Risk ◽  
General Adult Population ◽  
Abuse Treatment

Released prisoners face high risk of early mortality. The risk of violent death, specifically homicide and suicide, are addressed in this study. Data on inmates released from the North Carolina Division of Adult Corrections (N= 476) matched to the Violent Death Reporting System are analyzed to estimate rates and demographic and criminal justice–related predictors. Violent death rates for persons released from prison were more than 7 times higher than for the general adult population. Results from multinomial logistic regression indicate decreased homicide risk for every year of age, whereas male gender and minority race increased risk. For suicide, minority race, release without supervision, and substance abuse treatment in prison decreased fatality risk. By contrast, a history of mental illness increased suicide risk. Implications for practice and research are discussed.

scholarly journals The Maudsley long-term follow-up of child and adolescent depression

2002 ◽  
Vol 180 (1) ◽  
pp. 19-23 ◽  
Author(s):  
Martin Knapp ◽  
Paul McCrone ◽  
Eric Fombonne ◽  
Jennifer Beecham ◽  
Gail Wostear
Keyword(s):  
Conduct Disorder ◽  
Adolescent Depression ◽  
Service Use ◽  
Adult Population ◽  
Service Utilisation ◽  
Related Data ◽  
Specialist Services ◽  
General Adult Population ◽  
Long Term Follow Up

BackgroundDepression in childhood or adolescence often has morbidity implications continuing into adulthood, generating needs for specialist services and support.AimsTo estimate the patterns of service use and costs in adulthood of former patients.MethodService use and other cost-related data were collected from former patients. Comparisons were made between those people with and without comorbid conduct disorder in childhood and with data for the general population.ResultsData on 91 people with depression (only) and 49 with comorbid conduct disorder revealed high adulthood service utilisation rates and costs. Inpatient care and criminal justice services were used more frequently by the comorbid group and total costs were significantly higher. There were also indications of higher service use by the comorbid group than the general adult population.ConclusionsThe high and enduring long-term costs associated with childhood depression and conduct disorder give further reason for early and effective intervention.

scholarly journals Intentional weight loss as a predictor of type 2 diabetes occurrence in a general adult population

2020 ◽  
Vol 8 (1) ◽  
pp. e001560
Author(s):  
Laura Sares-Jäske ◽  
Paul Knekt ◽  
Antti Eranti ◽  
Niina E Kaartinen ◽  
Markku Heliövaara ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss ◽  
Adult Population ◽  
Self Report ◽  
Intentional Weight Loss ◽  
Increased Risk ◽  
General Adult Population ◽  
Incident Cases

IntroductionObservational and intervention studies have verified that weight loss predicts a reduced type 2 diabetes (T2D) risk. At the population level, knowledge on the prediction of self-report intentional weight loss (IWL) on T2D incidence is, however, sparse. We studied the prediction of self-report IWL on T2D incidence during a 15-year follow-up in a general adult population.Research design and methodsThe study sample from the representative Finnish Health 2000 Survey comprised 4270 individuals, aged 30–69 years. IWL was determined with questions concerning dieting attempts and weight loss during the year prior to baseline. Incident T2D cases during a 15-year follow-up were drawn from national health registers. The strength of the association between IWL and T2D incidence was estimated with the Cox model.ResultsDuring the follow-up, 417 incident cases of T2D occurred. IWL predicted an increased risk of T2D incidence (HR 1.44; 95% CI 1.11 to 1.87, p=0.008) in a multivariable model. In interaction analyses comparing individuals with and without IWL, a suggestively elevated risk emerged in men, the younger age group, among less-educated people and in individuals with unfavorable values in several lifestyle factors.ConclusionsSelf-report IWL may predict an increased risk of T2D in long-term, probably due to self-implemented IWL tending to fail. The initial prevention of weight gain and support for weight maintenance after weight loss deserve greater emphasis in order to prevent T2D.

scholarly journals Dietary micronutrients intake and plasma fibrinogen levels in the general adult population

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Alicia Padron-Monedero ◽  
Fernando Rodríguez-Artalejo ◽  
Esther Lopez-Garcia
Keyword(s):  
Vitamin E ◽  
Nutrient Intake ◽  
Statistical Significance ◽  
Adult Population ◽  
Population Based ◽  
Plasma Fibrinogen ◽  
Dietary Intakes ◽  
Small Magnitude ◽  
General Adult Population ◽  
Quality Checks

AbstractPlasma fibrinogen predicts cardiovascular and nonvascular mortality. However, there is limited population-based evidence on the association between fibrinogen levels and dietary intakes of micronutrients possibly associated with inflammation status. Data were taken from the ENRICA study, conducted with 10,808 individuals representative of the population of Spain aged ≥ 18 years. Nutrient intake (vitamin A, carotenoids, vitamin B6, vitamin C, vitamin D, vitamin E, magnesium, selenium, zinc and iron) was estimated with a validated diet history, and plasma fibrinogen was measured under appropriate quality checks. Statistical analyses were performed with linear regression and adjusted for main confounders. The geometric means of fibrinogen (g/L) across increasing quintiles of nutrient intake were 3.22, 3.22, 3.22, 3.16, and 3.19 (p-trend = 0.030) for vitamin E; 3.23, 3.22, 3.20, 3.19, and 3.19 (p-trend = 0.047) for magnesium; and 3.24, 3.22, 3.19, 3.21, and 3.19 (p-trend = 0.050) for iron. These inverse associations were more marked in participants with abdominal obesity and aged ≥ 60 years, but lost statistical significance after adjustment for other nutrients. Although dietary intakes of vitamin E, magnesium and iron were inversely associated with fibrinogen levels, clinical implications of these findings are uncertain since these results were of very small magnitude and mostly explained by intake levels of other nutrients.

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