scholarly journals Covid-19 does not look like what you are looking for: clustering symptoms by nation and multi- morbidities reveal substantial differences to the classical symptom triad

2021 ◽  
Author(s):  
Balasundaram Kadirvelu ◽  
Gabriel Burcea ◽  
Jennifer Quint ◽  
Ceire E Costelloe ◽  
Aldo A. Faisal
Keyword(s):  
Chronic Disease ◽  
Lung Disease ◽  
Chronic Diseases ◽  
Geographical Location ◽  
Geographic Location ◽  
Underlying Disease ◽  
Symptom Profiles ◽  
Symptom Patterns ◽  
Underlying Diseases

COVID-19 is by convention characterised by a triad of symptoms: cough, fever and loss of taste/smell. The aim of this study was to examine clustering of COVID-19 symptoms based on underlying chronic disease and geographical location. Using a large global symptom survey of 78,299 responders in 190 different countries, we examined symptom profiles in relation to geolocation (grouped by country) and underlying chronic disease (single, co- or multi-morbidities) associated with a positive COVID-19 test result using statistical and machine learning methods to group populations by underlying disease, countries, and symptoms. Taking the responses of 7980 responders with a COVID-19 positive test in the top 5 contributing countries, we find that the most frequently reported symptoms differ across the globe: For example, fatigue 4108(51.5%), headache 3640(45.6%) and loss of smell and taste 3563(44.6%) are the most reported symptoms globally. However, symptom patterns differ by continent; India reported a significantly lower proportion of headache (22.8% vs 45.6%, p<0.05) and itchy eyes (7.0% vs. 15.3%, p<0.05) than other countries, as does Pakistan (33.6% vs 45.6%, p<0.05 and 8.6% vs 15.3%, p<0.05). Mexico and Brazil report significantly less of these symptoms. As with geographic location, we find people differed in their reported symptoms, if they suffered from specific underlying diseases. For example, COVID-19 positive responders with asthma or other lung disease were more likely to report shortness of breath as a symptom, compared with COVID-19 positive responders who had no underlying disease (25.3% vs. 13.7%, p<0.05, and 24.2 vs.13.7%, p<0.05). Responders with no underlying chronic diseases were more likely to report loss of smell and tastes as a symptom (46%), compared with the responders with type 1 diabetes (21.3%), Type 2 diabetes (33.5%) lung disease (29.3%), or hypertension (37.8%). Global symptom ranking differs markedly from the well-known and commonly described symptoms for COVID-19, which are based on a few localised studies. None of the five countries studied in depth recorded cough or temperature as the most common symptoms. The most common symptoms reported were fatigue and loss of smell and taste. Amongst responders from Brazil cough was the second most frequently reported symptom, after fatigue. Moreover, we find that across countries and based on underlying chronic diseases, there are significant differences in symptom profiles at presentation, that cannot be fully explained by the different chronic disease profiles of these countries, and may be caused by differences in climate, environment and ethnicities. These factors uncovered by our global comorbidity survey of COVID-19 positive tested people may contribute to the apparent large asymptotic COVID-19 spread and put patients with underlying disease systematically more at risk.

scholarly journals Illness-Death Model in Chronic Disease Epidemiology: Characteristics of a Related, Differential Equation and an Inverse Problem

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Ralph Brinks
Keyword(s):  
Differential Equation ◽  
Inverse Problem ◽  
Type 1 Diabetes ◽  
Chronic Disease ◽  
Chronic Diseases ◽  
Chronic Disease Epidemiology ◽  
Disease Epidemiology ◽  
Mathematical Relation

Chronic diseases impose a huge burden for mankind. Recently, a mathematical relation between the incidence and prevalence of a chronic disease in terms of a differential equation has been described. In this article, we study the characteristics of this differential equation. Furthermore, we prove the ill-posedness of a related inverse problem arising in chronic disease epidemiology. An example application for the inverse problem about type 1 diabetes in German women aged up to 35 years is given.

Anemia of chronic disease

2021 ◽  
Author(s):  
В.Ю. Павлова ◽  
М.А. Смольков
Keyword(s):  
Chronic Disease ◽  
Iron Deficiency ◽  
Chronic Diseases ◽  
Iron Metabolism ◽  
Underlying Disease ◽  
Modern Medicine ◽  
Anemia Of Chronic Disease ◽  
Inflammatory Processes ◽  
The Difference

Анемический синдром имеет очень широкое распространение среди населения и достаточно часто встречается в практической деятельности любых специалистов. Среди различных патогенетических вариантов анемия хронических заболеваний занимает второе место и диагностируется при многих патологических состояниях, таких как злокачественные и длительные воспалительные процессы. Данный вид анемии обнаруживается в 27% случаев среди других анемий, но следует отметить, что частота встречаемости этой анемии при некоторых хронических заболеваниях может достигать 100%. В статье приведены основные сведения о ведущих звеньях патогенеза и лечения анемии хронических заболеваний. В основе патогенеза лежит нарушение обмена железа: обмена гепцидина, ферропортина. Факторами, стимулирующими выработку гепцидина, являются воспалительные цитокины. Для диагностики данного вида анемии необходим тщательный сбор анамнеза и поиск длительно текущего хронического заболевания, оценка состояния обмена железа и уровня трансферрина, также необходимо дифференцировать данный вид анемии от железодефицитной. Различие между анемией хронического заболевания и железодефицитной в том, что для последней характерен абсолютный недостаток железа и оно недоступно молодым предшественникам эритроида. Значимым фактором является определение типа железодефицита после постановки диагноза анемии хронического заболевания. Основой терапевтического подхода к ее лечению является лечение основного заболевания. В случае, когда это невозможно, необходимо компенсировать анемию иными методами. Современная медицина предлагает 4 рациональных подхода к лечению анемии хронического заболевания: заместительную терапию компонентами крови, ферротерапию, применение стимуляторов эритропоэза, направленную цитокинотерапию. Anemic syndrome is very widespread among the population. Among the pathogenetic variants, anemia of chronic diseases ranks second among various pathogenetic processes, such as prolonged inflammatory processes. This type of anemia occurs in 27% of cases among other anemias, but it should be noted that the incidence of this anemia in some chronic diseases can reach 100%. The article provides basic information about the leading links in the pathogenesis and treatment of anemia of chronic diseases. The pathogenesis is based on a violation of iron metabolism: the exchange of hepcidin, ferroportin, factors that stimulate the production of hepcidin, inflammatory cytokines. To diagnose this type of anemia, it is necessary to carefully collect anamnesis and search for a long-term chronic illness, assess the state of iron metabolism and the level of transferrin, and it is also necessary to differentiate this type of anemia from iron deficiency. The difference between anemia of chronic disease and iron deficiency is that the latter is characterized by an absolute lack of iron, and it is inaccessible to young erythroid precursors. A significant factor is the determination of the type of iron deficiency after the diagnosis of anemia of chronic disease. The basis of the therapeutic approach to the treatment of anemia of chronic disease is the treatment of the underlying disease. In the case when this is not possible, it is necessary to compensate for the anemia by other methods. Modern medicine offers 4 rational approaches to the treatment of anemia of chronic disease: replacement therapy with blood components; ferrotherapy; the use of erythropoiesis stimulants; targeted cytokine therapy.

scholarly journals Osteoporosis Complicating Some Inborn or Acquired Diseases

2018 ◽  
pp. S441-S454 ◽  
Author(s):  
I. ZOFKOVA ◽  
P. NEMCIKOVA
Keyword(s):  
Chronic Diseases ◽  
Metabolic Disorders ◽  
Structural Changes ◽  
Inflammatory Diseases ◽  
Underlying Disease ◽  
Cortical Porosity ◽  
Mechanisms Of Development

Osteoporosis in chronic diseases is very frequent and pathogenetically varied. It complicates the course of the underlying disease by the occurrence of fractures, which aggravate the quality of life and increase the mortality of patients from the underlying disease. The secondary deterioration of bone quality in chronic diseases, such as diabetes of type 1 and type 2 and/or other endocrine and metabolic disorders, as well as inflammatory diseases, including rheumatoid arthritis – are mostly associated with structural changes to collagen, altered bone turnover, increased cortical porosity and damage to the trabecular and cortical microarchitecture. Mechanisms of development of osteoporosis in some inborn or acquired disorders are discussed.

More Eggs, Less Sugar: A Sneak Peek into the Latest Dietary Guidelines for Americans

2018 ◽  
Vol 7 (1) ◽  
pp. 22-24
Author(s):  
Darlene Zimmerman
Keyword(s):  
Cardiovascular Disease ◽  
Chronic Disease ◽  
Chronic Diseases ◽  
Dietary Guidelines ◽  
Healthy Diet ◽  
Dietary Guidelines For Americans

ABSTRACT The 2015 – 2020 Dietary Guidelines for Americans provides guidance for choosing a healthy diet. There is a focus on preventing and alleviating the effects of diet-related chronic diseases. These include obesity, diabetes, cardiovascular disease, and stroke, among others. This article briefly reviews the primary guideline items that can be used to teach patients with respect to improving their diet. Clinical exercise physiologists who work with patients with chronic disease can use these guidelines for general discussions regarding a heart-healthy diet.

scholarly journals Detection of Pneumocystis jirovecii in Hospitalized Children Less Than 3 Years of Age

2021 ◽  
Vol 7 (7) ◽  
pp. 546
Author(s):  
Estelle Menu ◽  
Jean-Sélim Driouich ◽  
Léa Luciani ◽  
Aurélie Morand ◽  
Stéphane Ranque ◽  
...  
Keyword(s):  
Severe Combined Immunodeficiency ◽  
Hyaline Membrane Disease ◽  
Relevant Information ◽  
Underlying Disease ◽  
Pneumocystis Pneumonia ◽  
Pneumocystis Jirovecii ◽  
Respiratory Pathogens ◽  
Respiratory Sample ◽  
Few Data ◽  
Underlying Diseases

Few data are available in the literature regarding Pneumocystis jirovecii infection in children under 3 years old. This retrospective cohort study aimed to describe medically relevant information among them. All children under 3 years old treated in the same medical units from April 2014 to August 2020 and in whom a P. jirovecii evaluation was undertaken were enrolled in the study. A positive case was defined as a child presenting at least one positive PCR for P. jirovecii in a respiratory sample. Medically relevant information such as demographical characteristics, clinical presentation, microbiological co-infections, and treatments were collected. The objectives were to describe the characteristics of these children with P. jirovecii colonization/infection to determine the key underlying diseases and risk factors, and to identify viral respiratory pathogens associated. The PCR was positive for P. jirovecii in 32 children. Cardiopulmonary pathologies (21.9%) were the most common underlying disease in them, followed by severe combined immunodeficiency (SCID) (18.8%), hyaline membrane disease (15.6%), asthma (9.4%) and acute leukaemia (6.3%). All SCID children were diagnosed with pneumocystis pneumonia. Co-infection with Pj/Rhinovirus (34.4%) was not significant. Overall mortality was 18.8%. Paediatric pneumocystis is not restricted to patients with HIV or SCID and should be considered in pneumonia in children under 3 years old.

scholarly journals The impact of chronic disease and disability on the elderly

1999 ◽  
Vol 55 (3) ◽  
pp. 9-14
Author(s):  
C. J. Eales
Keyword(s):  
Health Care ◽  
Chronic Disease ◽  
Chronic Diseases ◽  
Health Care Systems ◽  
The Elderly ◽  
Therapeutic Interventions ◽  
Elderly Persons ◽  
Care Systems ◽  
And Function ◽  
The Impact

Health care systems for elderly people should aim to delay the onset of illness, reducing the final period of infirmity and illness to the shortest possible time. The most effective way to achieve this is by health education and preventative medicine to maintain mobility and function. Changes in life style even in late life may result in improved health, effectively decreasing the incidence of chronic diseases associated with advancing age. This paper presents the problems experienced by elderly persons with chronic diseases and disabilities with indications for meaningful therapeutic interventions.

scholarly journals Smoking, drinking, diet and physical activity—modifiable lifestyle risk factors and their associations with age to first chronic disease

2019 ◽  
Vol 49 (1) ◽  
pp. 113-130 ◽  
Author(s):  
Ryan Ng ◽  
Rinku Sutradhar ◽  
Zhan Yao ◽  
Walter P Wodchis ◽  
Laura C Rosella
Keyword(s):  
Risk Factors ◽  
Chronic Disease ◽  
Chronic Diseases ◽  
Lifestyle Factors ◽  
Competing Risk ◽  
Chronic Obstructive ◽  
Common Disease ◽  
Heavy Smoking ◽  
Lifestyle Risk Factors ◽  
Lifestyle Risk

AbstractBackgroundThis study examined the incidence of a person’s first diagnosis of a selected chronic disease, and the relationships between modifiable lifestyle risk factors and age to first of six chronic diseases.MethodsOntario respondents from 2001 to 2010 of the Canadian Community Health Survey were followed up with administrative data until 2014 for congestive heart failure, chronic obstructive respiratory disease, diabetes, lung cancer, myocardial infarction and stroke. By sex, the cumulative incidence function of age to first chronic disease was calculated for the six chronic diseases individually and compositely. The associations between modifiable lifestyle risk factors (alcohol, body mass index, smoking, diet, physical inactivity) and age to first chronic disease were estimated using cause-specific Cox proportional hazards models and Fine-Gray competing risk models.ResultsDiabetes was the most common disease. By age 70.5 years (2015 world life expectancy), 50.9% of females and 58.1% of males had at least one disease and few had a death free of the selected diseases (3.4% females; 5.4% males). Of the lifestyle factors, heavy smoking had the strongest association with the risk of experiencing at least one chronic disease (cause-specific hazard ratio = 3.86; 95% confidence interval = 3.46, 4.31). The lifestyle factors were modelled for each disease separately, and the associations varied by chronic disease and sex.ConclusionsWe found that most individuals will have at least one of the six chronic diseases before dying. This study provides a novel approach using competing risk methods to examine the incidence of chronic diseases relative to the life course and how their incidences are associated with lifestyle behaviours.

Immunotherapy: Building a bridge to a cure for type 1 diabetes

Science ◽  
2021 ◽  
Vol 373 (6554) ◽  
pp. 510-516
Author(s):  
Jeffrey A. Bluestone ◽  
Jane H. Buckner ◽  
Kevan C. Herold
Keyword(s):  
Type 1 Diabetes ◽  
Immune Cell ◽  
Cell Types ◽  
Underlying Disease ◽  
Β Cells ◽  
Current State ◽  
Islet Inflammation ◽  
Genetic And Environmental Factors ◽  
Key Events

Type 1 diabetes (T1D) is an autoimmune disease in which T cells attack and destroy the insulin-producing β cells in the pancreatic islets. Genetic and environmental factors increase T1D risk by compromising immune homeostasis. Although the discovery and use of insulin have transformed T1D treatment, insulin therapy does not change the underlying disease or fully prevent complications. Over the past two decades, research has identified multiple immune cell types and soluble factors that destroy insulin-producing β cells. These insights into disease pathogenesis have enabled the development of therapies to prevent and modify T1D. In this review, we highlight the key events that initiate and sustain pancreatic islet inflammation in T1D, the current state of the immunological therapies, and their advantages for the treatment of T1D.

A New Path to Address Multimorbidity? Longitudinal Analyses of Retirement Sequences and Chronic Diseases in Old Age

2021 ◽  
pp. 073346482110310
Author(s):  
Esteban Calvo ◽  
Ariel Azar ◽  
Robin Shura ◽  
Ursula M. Staudinger
Keyword(s):  
Chronic Disease ◽  
Labor Force ◽  
Chronic Diseases ◽  
Old Age ◽  
Full Time ◽  
Longitudinal Analyses ◽  
Employment Opportunities ◽  
Time Work ◽  
Aging Populations ◽  
Retirement Study

Chronic disease and multimorbidity are growing health challenges for aging populations, often coinciding with retirement. We examine late-life predictors of multimorbidity, focusing on the association between retirement sequences and number of chronic diseases. We modeled the number of chronic diseases as a function of six types of previously identified 10-year retirement sequences using Health and Retirement Study (HRS) data for 7,880 Americans observed between ages 60 to 61 and 70 to 71. Our results show that at baseline, the adjusted prevalence of multimorbidity was lowest in sequences characterized by late retirement from full-time work and highest in sequences characterized by early labor-force disengagement. Age increases in multimorbidity varied across retirement sequences, though overall differences in prevalence persisted at age 70 to 71. Earlier life disadvantages did not moderate these associations. Findings suggest further investigation of policies that target health limitations affecting work, promote continued beneficial employment opportunities, and ultimately leverage retirement sequences as a novel path to influence multimorbidity in old age.

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