scholarly journals Risk factors associated with severe outcomes of COVID-19: An updated rapid review to inform national guidance on vaccine prioritization in Canada

Author(s):  
Michelle Gates ◽  
Jennifer Pillay ◽  
Aireen Wingert ◽  
Samantha Guitard ◽  
Sholeh Rahman ◽  
...  

Background: To inform vaccine prioritization guidance by the National Advisory Committee on Immunization (NACI), we reviewed evidence on the magnitude of association between risk factors and severe outcomes of COVID-19. Methods: We updated our existing review by searching online databases and websites for cohort studies providing multivariate adjusted associations. One author screened studies and extracted data. Two authors estimated the magnitude of association between exposures and outcomes as little-to-no (odds, risk, or hazard ratio <2.0, or >0.50 for reduction), large (2.0-3.9, or 0.50-0.26 for reduction), or very large (>=4.0, or <=0.25 for reduction), and rated the evidence certainty using GRADE. Results: Of 7,819 unique records we included 111 reports. There is probably (moderate certainty) at least a large increase in mortality from COVID-19 among people aged 60-69 vs. <60 years (11 studies, n=517,217), with 2+ vs. no comorbidities (4 studies, n=189,608), and for people with (vs. without): Down syndrome (1 study, n>8 million), type 1 and 2 diabetes (1 study, n>8 million), end-stage kidney disease (1 study, n>8 million), epilepsy (1 study, n>8 million), motor neuron disease, multiple sclerosis, myasthenia gravis, or Huntingtons disease (as a grouping; 1 study, n>8 million). The magnitude of association with mortality is probably very large for Down syndrome and may (low certainty) be very large for age 60-69 years, and diabetes. There is probably little-to-no increase in severe outcomes with several cardiovascular and respiratory conditions, and for adult males vs. females. Interpretation: Future research should focus on risk factors where evidence is low quality (e.g., social factors) or non-existent (e.g., rare conditions), the pediatric population, combinations of comorbidities that may increase risk, and long-term outcomes. Systematic review registration: PROSPERO #CRD42021230185.

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S662-S663
Author(s):  
Jhon Camacho ◽  
Ivan Felipe Gutiérrez Tobar ◽  
Katherine Brand ◽  
Yeni Sosa ◽  
Pablo Vásquez ◽  
...  

Abstract Background The epidemiology of methicillin-resistant (MRSA) and methicillin-susceptible (MSSA) S. aureus in pediatrics has changed in recent years. MRSA infections have been reported to be more severe than MSSA. Methods Multicenter retrospective cohort, in 6 pediatric hospitals in Bogotá, Colombia, between January 1, 2014, and December 31, 2018, 1 isolate was included for patient from the same origin. Infections were classified into: SSTI, osteoarticular, bacteremia, or pneumonia.The objective is to establish differences between clinical, laboratory, and outcomes of MSSA and MRSA infections, according to origin of the infection in a pediatric population from Bogotá, Colombia. Results 551 patients were included; 211 (38%) MRSA and 340 (62%) MSSA, in total 703 cultures. Figure 1. Some risk factors were statistically associated with MSSA: Heart disease (3.3% Vs. 0.5%) neurologic disease (5.9% vs. 2.4%), surgery in last 6 months (11% vs. 5%), use of vascular or external devices (3% vs 11%) and previous hospitalization &gt;3 days (11% vs 17%) Table 2. In 84/159 (52%) cases, bacteremia was associated with osteoarticular infection (OI), 19/159 (13%) with pneumonia, 21/159 (13%) with SSTI, 14/159 (9%) with other foci, 21/159 (13%) were primary. Independently of the origin, PICU admittance was more frequent in MRSA (52% vs. 28), as well as mechanical ventilation (MV) (30% vs. 13%) and inotropic support (IS )(38% vs 17%). Of 136 osteoarticular infections, 59 (43,4%) were MRSA and 77 (56,6%) MSSA. MRSA isolates required more than 3 surgical procedures (45% vs 24%), more PICU admittance (36% vs. 12%) and IS (27% vs. 5%). Complicated pneumonia was more frequently associated to MRSA in comparison with MSSA (57% vs. 23%). In pneumonia, MRSA also was significantly associated with PICU. (74%vs 50%), MS (61%vs 32%), and VS (52% vs 27%). SSTI was not associated with greater severity or worse outcome (PICU, MV, IS) according to S. aureus susceptibility. Table 3b. Infection groups depending on the presence or not of resistance Conclusion MRSA was associated with more severe course in bacteremia, OI and pneumonia. It is interesting that some classically risk factors associated with MRSA infections were found to be related to MSSA. In general, with SSTI exception, MRSA increase risk of PICU, mechanical support and inotropic support in a pediatric population in Bogotá, Colombia. Disclosures Ivan Felipe Gutiérrez Tobar, n/a, Pfizer and MSD (Advisor or Review Panel member, Research Grant or Support, Speaker’s Bureau, Has received support from Pfizer and MSD for participation in congresses and has received conference payments from Pfizer)Pfizer and MSD (Speaker’s Bureau, Other Financial or Material Support, Has received support from Pfizer for participation in congresses) Sandra Beltran, n/a, Pfizer (Other Financial or Material Support, Has received support from Pfizer for participation in congresses)


2021 ◽  
Author(s):  
Sarah Daniels ◽  
Hua Wei ◽  
Yang Han ◽  
Heather Catt ◽  
David W. Denning ◽  
...  

ABSTRACTBackgroundWorkplace transmission is a significant contributor to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreaks. Previous studies have found that infectious illness presenteeism could contribute to outbreaks in occupational settings and identified multiple occupational and organizational risk factors. Amid the COVID-19 pandemic, it is imperative to investigate presenteeism particularly in relation to respiratory infectious disease (RID). Hence, this rapid review aims to determine the prevalence of RID-related presenteeism, including COVID-19, and examines the reported reasons and associated risk factors.MethodsThe review followed a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) search approach and focused on studies published in English and Chinese. Database searches included MEDLINE, EMBASE, Web of Science, China Knowledge Resource Integrated Database (CNKI) and preprint databases MedRxiv and BioRxiv.ResultsThe search yielded 54 studies, of which four investigated COVID-19-related presenteeism. Prevalence of work presenteeism ranged from 14.1% to 55% for confirmed RID, and 6.6% to 100% for those working with suspected or subclinical RID. The included studies demonstrated that RID-related presenteeism is associated with occupation, sick pay policy, age, gender, health behaviour and perception, vaccination and organisational factors including workplace culture and peer pressure.ConclusionsThis review demonstrates that presenteeism or non-adherence to isolation guidance is a real concern and can contribute to workplace transmissions and outbreaks. Policies which would support workers financially and improve productivity, should include a range of effective non-pharmaceutical inventions such as workplace testing, promoting occupational health services, reviewing pay and bonus schemes and clear messaging to encourage workers to stay at home when ill. Future research should focus on the more vulnerable and precarious occupational groups, and their inter-relationships, to develop comprehensive intervention programs to reduce RID-related presenteeism.


2001 ◽  
Vol 12 (12) ◽  
pp. 2838-2847 ◽  
Author(s):  
Ann O’Hare ◽  
Kirsten Johansen

ABSTRACT. Peripheral arterial occlusive disease (PAOD) accounts for significant morbidity and mortality among end-stage renal disease (ESRD) patients but has not been as extensively studied as other kinds of atherosclerotic disease in this population. The current epidemiology and management of PAOD in ESRD patients is here reviewed and target areas for future research are identified. The prevalence of PAOD appears to be much higher among ESRD patients than in the general population. Risk factors for disease among ESRD patients are not well understood but probably include both conventional and dialysis or uremia-associated risk factors. Standard diagnostic techniques used to identify PAOD in the general population may not be as helpful in ESRD patients because many of these tests are inaccurate in the settings of vascular calcification and small-vessel disease. Despite the fact that this is a common disease in ESRD patients, most of these patients are not screened for PAOD. Interventions that have proven effective in the prevention and treatment of PAOD in the general population, such as smoking cessation, preventive foot care, and exercise, have not been systematically applied to ESRD patients. Furthermore, the optimal management of ischemic ulceration and gangrene in ESRD patients is quite controversial, and better algorithms for the prevention and management of PAOD in ESRD patients are needed. In conclusion, PAOD is common in ESRD patients. Future research should identify risk factors for disease in this population, and efforts should be made to develop strategies for the effective prevention and management of limb ischemia in this population.


2021 ◽  
pp. 113-134
Author(s):  
Benjamin B. Lahey

All of the dimensions of psychological problem described previously in this book are positively correlated. This means that each dimension of psychological problems has some unique characteristics but also shares important things in common with all other dimensions. The patterns of varying magnitudes of correlations among psychological problems help identify causes and the best ways to prevent and reduce psychological problems. This chapter discusses a formal and testable causal taxonomy of psychological problems to stimulate future research. It is posited that all dimensions of psychological problems are correlated in a hierarchical manner because there is a hierarchy of causes of these problems—and a corresponding hierarchy of the psychological and biological mechanisms through which the causal influences operate. The first level of the proposed causal hierarchy is causal risk factors that are highly nonspecific in the sense of increasing the risk of having some kind of psychological problem but not which specific kind of problem. At the second level of the causal hierarchy, other genetic and environmental risk factors nonspecifically increase risk for any and all dimensions within only one second-order domain of psychological problems, such as only within the internalizing or only within the externalizing problems. Causal factors at the third level are unique to each specific dimension of psychological problems. This testable hypothesis of a hierarchy of causes and mechanisms represents a radical departure from the thinking underlying the putatively distinct diagnostic categories in the Diagnostic and Statistical Manual of Mental Disorders.


Crisis ◽  
2014 ◽  
Vol 35 (1) ◽  
pp. 60-66 ◽  
Author(s):  
Amanda Venta ◽  
Carla Sharp

Background: Identifying risk factors for suicide-related thoughts and behaviors (SRTB) is essential among adolescents in whom SRTB remain a leading cause of death. Although many risk factors have already been identified, influential theories now suggest that the domain of interpersonal relationships may play a critical role in the emergence of SRTB. Because attachment has long been seen as the foundation of interpersonal functioning, we suggest that attachment insecurity warrants attention as a risk factor for SRTB. Aims: This study sought to explore relations between attachment organization and suicidal ideation, suicide attempts, and self-harm in an inpatient adolescent sample, controlling for demographic and psychopathological covariates. Method: We recruited 194 adolescents from an inpatient unit and assigned them to one of four attachment groups (secure, preoccupied, dismissing, or disorganized attachment). Interview and self-report measures were used to create four variables reflecting the presence or absence of suicidal ideation in the last year, single lifetime suicide attempt, multiple lifetime suicide attempts, and lifetime self-harm. Results: Chi-square and regression analyses did not reveal significant relations between attachment organization and SRTB, although findings did confirm previously established relations between psychopathology and SRTB, such that internalizing disorder was associated with increased self-harm, suicide ideation, and suicide attempt and externalizing disorder was associated with increased self-harm. Conclusion: The severity of this sample and methodological differences from previous studies may explain the nonsignificant findings. Nonsignificant findings may indicate that the relation between attachment organization and SRTB is moderated by other factors that should be explored in future research.


2020 ◽  
Author(s):  
Jay Joseph Van Bavel ◽  
Elizabeth Ann Harris ◽  
Philip Pärnamets ◽  
Steve Rathje ◽  
Kimberly Doell ◽  
...  

The spread of misinformation, including “fake news,” propaganda, and conspiracy theories, represents a serious threat to society, as it has the potential to alter beliefs, behavior, and policy. Research is beginning to disentangle how and why misinformation is spread and identify processes that contribute to this social problem. We propose an integrative model to understand the social, political, and cognitive psychology risk factors that underlie the spread of misinformation and highlight strategies that might be effective in mitigating this problem. However, the spread of misinformation is a rapidly growing and evolving problem; thus scholars need to identify and test novel solutions, and work with policy makers to evaluate and deploy these solutions. Hence, we provide a roadmap for future research to identify where scholars should invest their energy in order to have the greatest overall impact.


2014 ◽  
pp. 26-30
Author(s):  
Huu Thinh Nguyen ◽  
Thi Thuy Hang Nguyen ◽  
Bui Bao Hoang

Background: Cardiovascular disease is the major cause of death in dialysis patients, as well as in kidney transplant patients. Assessment of cardiovascular risks of renal transplant candidates to prevent or slow the progression of cardiovascular abệnh nhânormalities. Aim: 1) Evaluating cardiovascular risk factors, electrocardiographic and echocardiographic abnormalities in renal transplant candidates. 2) Identifying the correlation between cardiac morphological parameters with a number of factors involved. Subjects and Methods: We assessed 57 patients (73.7% male, mean age 32.4±8.8) with end-stage renal disease waiting for renal transplantation at Cho Ray Hospital between Jan 2012 and Jan 2013. All patients received a physical examination, blood pressure measurement, Hb, blood glucose test, lipid profile, ECG, echocardiography. Results: The percentage of hypertension was 98.2%, smoking (69.2%), dyslipidemia 40.4% and diabetes 12.3%. All patients had sinus rhythm, left ventricular hypertrophy 61.4% in ECG. Pericardial effusion 5.3%, mitral valve insufficiency 56.1%, aortic valve insufficiency 12.3%, left ventricular hypertrophy 94.7% in echocardiography. IVSd, LVPWd, LVMI positively correlated with kidney failure time (p <0.01, p<0.001), with DBP and SBP (p <0.05) and the degree of anemia (p <0.05). Percentage the degree of hypertension associated with proportion of left ventricular hypertrophy (p <0.05). Conclusions: Identification of cardiovascular risk factors for the prevention or intervention to reduce mortality in renal transplantation. Keywords: Cardiovascular risk factors, end-stage chronic renal failure, renal transplantation.


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