Hidden Threat During Quarantine and Transition Phase in Elderly: The Need for Special Precautions

2020 ◽  
Vol 70 (10) ◽  
pp. 190-193
Author(s):  
Maggie Nathania ◽  
Diana Sunardi
Keyword(s):  
Case Fatality Rate ◽  
Middle Age ◽  
Transmission Rate ◽  
Case Fatality ◽  
Risk Groups ◽  
The Elderly ◽  
Age Group ◽  
Global Pandemic ◽  
The World ◽  
Severity Of The Disease

A global pandemic, COVID-19, has struck 216 countries with more than 9 million cases and 420.000 deaths. In Indonesia alone, 49.000 people have been infected with more than 2.000 deaths. To reduce the transmission rate and break the chain of transmission, various countries in the world require people to limit and mitigate activities outside the house, especially for high-risk groups: the elderly and groups with comorbidities. Although there is no age group protected from SARS-CoV-2 infection, the elderly group shows significantly higher mortality and severity of the disease when compared with young and middle age. Case fatality rate in the elderly ranges between 8% in patients aged ≥80 years, 8% in patients aged 70-79 years, and up to 49% in critical cases. Other studies also show that the average age of patients who need the intensive care unit (ICU) is older than patients who do not require ICU.

scholarly journals The microbiota-related coinfections in COVID-19 patients: a real challenge

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Ranjan K. Mohapatra ◽  
Kuldeep Dhama ◽  
Snehasish Mishra ◽  
Ashish K. Sarangi ◽  
Venkataramana Kandi ◽  
...  
Keyword(s):  
Transmission Rate ◽  
Adaptive Immune System ◽  
The Elderly ◽  
Main Body ◽  
Local Immunity ◽  
The Public ◽  
Global Pandemic ◽  
Severity Of The Disease ◽  
Health Situation

Abstract Background The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of ongoing global pandemic of coronavirus disease 2019 (COVID-19), has infected millions of people around the world, especially the elderly and immunocompromised individuals. The infection transmission rate is considered more rapid than other deadly pandemics and severe epidemics encountered earlier, such as Ebola, Zika, Influenza, Marburg, SARS, and MERS. The public health situation therefore is really at a challenging crossroads. Main body The internal and external and resident microbiota community is crucial in human health and is essential for immune responses. This community tends to be altered due to pathogenic infections which would lead to severity of the disease as it progresses. Few of these resident microflora become negatively active during infectious diseases leading to coinfection, especially the opportunistic pathogens. Once such a condition sets in, it is difficult to diagnose, treat, and manage COVID-19 in a patient. Conclusion This review highlights the various reported possible coinfections that arise in COVID-19 patients vis-à-vis other serious pathological conditions. The local immunity in lungs, nasal passages, oral cavity, and salivary glands are involved with different aspects of COVID-19 transmission and pathology. Also, the role of adaptive immune system is discussed at the site of infection to control the infection along with the proinflammatory cytokine therapy.

scholarly journals Epidemiology of Diphtheria in Yemen, 2017-2018: Surveillance Data Analysis (Preprint)

2021 ◽  
Author(s):  
Suaad Ameen Moghalles ◽  
Basher Ahmed Aboasba ◽  
Mohammed Abdullah Alamad ◽  
Yousef Saleh Khader
Keyword(s):  
World Health Organization ◽  
Vaccination Coverage ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
World Health ◽  
Age Group ◽  
Fatality Rate ◽  
Probable Case ◽  
The World ◽  
Health Organization

BACKGROUND As a consequence of war and the collapse of the health system in Yemen, which prevented many people from accessing health facilities to obtain primary health care, vaccination coverage was affected, leading to a deadly diphtheria epidemic at the end of 2017. OBJECTIVE This study aimed to describe the epidemiology of diphtheria in Yemen and determine its incidence and case fatality rate. METHODS Data were obtained from the diphtheria surveillance program 2017-2018, using case definitions of the World Health Organization. A probable case was defined as a case involving a person having laryngitis, pharyngitis, or tonsillitis and an adherent membrane of the tonsils, pharynx, and/or nose. A confirmed case was defined as a probable case that was laboratory confirmed or linked epidemiologically to a laboratory-confirmed case. Data from the Central Statistical Organization was used to calculate the incidence per 100,000 population. A <i>P</i> value &lt;.05 was considered significant. RESULTS A total of 2243 cases were reported during the period between July 2017 and August 2018. About 49% (1090/2243, 48.6%) of the cases were males. About 44% (978/2243, 43.6%) of the cases involved children aged 5 to 15 years. Respiratory tract infection was the predominant symptom (2044/2243, 91.1%), followed by pseudomembrane (1822/2243, 81.2%). Based on the vaccination status, the percentages of partially vaccinated, vaccinated, unvaccinated, and unknown status patients were 6.6% (148/2243), 30.8% (690/2243), 48.6% (10902243), and 14.0% (315/2243), respectively. The overall incidence of diphtheria was 8 per 100,000 population. The highest incidence was among the age group &lt;15 years (11 per 100,000 population), and the lowest incidence was among the age group ≥15 years (5 per 100,000 population). The overall case fatality rate among all age groups was 5%, and it was higher (10%) in the age group &lt;5 years. Five governorates that were difficult to access (Raymah, Abyan, Sa'ada, Lahj, and Al Jawf) had a very high case fatality rate (22%). CONCLUSIONS Diphtheria affected a large number of people in Yemen in 2017-2018. The majority of patients were partially or not vaccinated. Children aged ≤15 years were more affected, with higher fatality among children aged &lt;5 years. Five governorates that were difficult to access had a case fatality rate twice that of the World Health Organization estimate (5%-10%). To control the diphtheria epidemic in Yemen, it is recommended to increase routine vaccination coverage and booster immunizations, increase public health awareness toward diphtheria, and strengthen the surveillance system for early detection and immediate response.

scholarly journals The Impact of COVID-19 on Radiation Oncology and Cancer Care: A Perspective from the Cancer Belt Region of India

2020 ◽  
Vol 6 (02) ◽  
pp. 47-52
Author(s):  
Sapna Marcus ◽  
Rohit Mahajan
Keyword(s):  
Cancer Patients ◽  
Radiation Oncology ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Multimodality Treatment ◽  
Respiratory Illness ◽  
Risk Groups ◽  
The Elderly ◽  
Fatality Rate ◽  
The Impact

AbstractA pandemic coronavirus, termed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causes a respiratory illness called coronavirus disease 2019 (COVID-19) that is often severe or life threatening. Considering the low immunity status of cancer patients due to multimodality treatment, they seem to be more prone to COVID-19. Given the rapidity with which the novel coronavirus (SARS-CoV-2) is spreading, we can expect an increased burden of cancer patients diagnosed with COVID-19 at oncology treatment clinics and a need to address the issues associated. As of the date of this writing, United States has been witnessing an increase in confirmed cases, not far behind are the large outbreaks of European countries. Patients with cancer may have compromised immunity due to their disease or its ongoing treatment, and early reports suggest cancer is a risk factor for severe COVID-19. Since the outbreak in Wuhan, Chinese researchers have published on their experience with COVID-19 and have highlighted high-risk groups, including the elderly and patients with comorbidities, including cancer. In one of the largest series reported from Wuhan, elderly patients were at a higher risk for disease severity with an 8.0% case fatality rate in those aged between 70 and 79 years, and 14.8% in those aged 80 years and older. The case fatality rate for cancer patients in that cohort was notably higher than noncancer patients at 5.6 versus 2.1% in the whole sample. This review focuses on the pandemic-driven strategies that need to be adopted to overcome the radiation oncology clinics burden, especially in this region of India popularly termed as the cancer belt. Although colleagues around the world have dealt with enormous service pressures in the face of natural disaster or infection previously, the global scale and challenge of COVID-19 are unprecedented. Our aim is to highlight the quintessential point that even within these circumstances the morbidity and mortality associated with cancer should not be taken lightly. Departmental protocols should be regularly upgraded to provide smooth and efficient functioning of the department.

scholarly journals Getting ready for the next pandemic COVID-19: Why we need to be more prepared and less scared

2020 ◽  
Vol 18 (2) ◽  
pp. 87-89
Author(s):  
George W. Contreras, DrPH(c), MEP, MPH, MS, CEM
Keyword(s):  
United States ◽  
Disease Progression ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
The United States ◽  
Age Group ◽  
The Public ◽  
The Us ◽  
The World ◽  
Health Experts

As of March 2020, we are almost at the three-month mark of COVID-19 with 90,663 reported cases worldwide and 3,124 reported deaths spread over six continents and 67 countries. As of March 3, 2020, the United States announced its six COVID-19-related deaths with 103 confirmed cases spread throughout fourteen states.1 It is important to note, however, that even as the number of reported cases and deaths continue to increase, the COVID-19 overall case fatality rate thus far stands at 3.4 percent. It is important to keep in mind that case fatality rates will also vary by age group and geographic areas. Government leaders and health experts have repeatedly mentioned that it is expected that COVID-19 cases would increase and that it would inevitably reach the United States. I would go even a step further to predict that there will be more confirmed cases and deaths in the United States as well as other parts of the world. Unfortunately and inevitably, by the time this editorial is published, the number of reported cases and deaths will have increased worldwide. If there is one thing to take from all of this information is that we are just at the beginning of the disease progression and more people will get infected and some additional people will also die. As a society, we need not be alarmed simply because it is a novel infectious disease. In the twentieth century, the world has experienced several novel diseases and even pandemic-level diseases. The recent CDC announcement that COVID-19 may reach pandemic levels is not only expected but also scientifically accurate when it comes to normal disease progression. Such announcements should not surprise the public and it should also not instill panic. What the world and the United States need to do is get better prepared. I understand that the fear of the unknown can be daunting but we need to recall that we (the US and the world) have been through similar experiences and survived.

Impact of hydroxychloroquin/azithromycin protocol on COVID-19 case-fatality rate reduction in Algeria. (Preprint)

2020 ◽  
Author(s):  
Ahmed Youssef Kada
Keyword(s):  
Case Fatality Rate ◽  
Doubling Time ◽  
Case Fatality ◽  
World Health ◽  
Fatality Rate ◽  
Therapeutic Protocol ◽  
First Case ◽  
The World ◽  
The Impact ◽  
At Home

BACKGROUND Covid-19 is an emerging infectious disease like viral zoonosis caused by new coronavirus SARS CoV 2. On December 31, 2019, Wuhan Municipal Health Commission in Hubei province (China) reported cases of pneumonia, the origin of which is a new coronavirus. Rapidly extendable around the world, the World Health Organization (WHO) declares it pandemic on March 11, 2020. This pandemic reaches Algeria on February 25, 2020, date on which the Algerian minister of health, announced the first case of Covid-19, a foreign citizen. From March 1, a cluster is formed in Blida and becomes the epicentre of the coronavirus epidemic in Algeria, its total quarantine is established on March 24, 2020, it will be smoothly alleviated on April 24. A therapeutic protocol based on hydroxychloroquine and azithromycin was put in place on March 23, for complicated cases, it was extended to all the cases confirmed on April 06. OBJECTIVE This study aimed to demonstrate the effectiveness of hydroxychloroquin/azithromycin protocol in Algeria, in particular after its extension to all patients diagnosed COVID-19 positive on RT-PCR test. We were able to illustrate this fact graphically, but not to prove it statistically because the design of our study, indeed in the 7 days which followed generalization of therapeutic protocol, case fatality rate decrease and doubling time increase, thus confirming the impact of wide and early prescription of hydroxychloroquin/azithromycin protocol. METHODS We have analyzed the data collected from press releases and follow-ups published daily by the Ministry of Health, we have studied the possible correlations of these data with certain events or decisions having a possible impact on their development, such as confinement at home and its reduction, the prescription of hydroxychloroquine/azithromycin combination for serious patients and its extension to all positive COVID subjects. Results are presented in graphics, the data collection was closed on 31/05/2020. RESULTS Covid-19 pandemic spreads from February 25, 2020, when a foreign citizen is tested positive, on March 1 a cluster is formed in the city of Blida where sixteen members of the same family are infected during a wedding party. Wilaya of Blida becomes the epicentre of coronavirus epidemic in Algeria and lockdown measures taken, while the number of national cases diagnosed begins to increases In any event, the association of early containment measures combined with a generalized initial treatment for all positive cases, whatever their degree of severity, will have contributed to a reduction in the fatality rate of COVID 19 and a slowing down of its doubling time. CONCLUSIONS In Algeria, the rapid combination of rigorous containment measure at home and early generalized treatment with hydroxychloroquin have demonstrated their effectiveness in terms of morbidity and mortality, the classic measures of social distancing and hygiene will make it possible to perpetuate these results by reducing viral transmission, the only unknown, the reopening procedure which can only be started after being surrounded by precautions aimed at ensuring the understanding of the population. CLINICALTRIAL Algeria, Covid-19, pandemic, hydroxychloroquin, azithromycin, case fatality rate

Abstract P614: Effect Sizes of Vascular Risk Factors for Stroke Occurrence by Age Among West Africans

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Mayowa Owolabi ◽  
FRED S SARFO ◽  
Onoja Akpa ◽  
Joshua Akinyemi ◽  
Albert Akpalu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Middle Age ◽  
Meat Consumption ◽  
The Elderly ◽  
Vascular Risk Factors ◽  
Effect Sizes ◽  
Modifiable Risk Factors ◽  
Age Group ◽  
Vascular Risk ◽  
Elderly Age

Background: Age is a non-modifiable risk factor for stroke occurrence due its influence on vascular risk factor acquisition. In sub-Saharan Africa, the effect sizes of vascular risk factors for stroke occurrence by age is unknown. Objective: To quantify the magnitude and direction of the effect sizes of key modifiable risk factors of stroke according to three age groups: <50years(young), 50-65 years(middle age) and >65 years(elderly) in West Africa. Methods: The Stroke Investigative Research and Educational Network (SIREN) is a multicenter, case-control study involving 15 sites in Ghana and Nigeria. Cases include adults aged ≥18 years with evidence of an acute stroke. Controls were age-and-gender matched stroke-free adults. Detailed evaluations for vascular, lifestyle, stroke severity and outcomes were performed. We used conditional logistic regression to estimate adjusted odds ratios (aOR) of vascular risk factors of stroke. Results: Among 3,553 stroke cases, 813(22.9%) were young, 1441(40.6%) were middle-aged and 1299(36.6%) were elderly. Five modifiable risk factors were consistently associated with stroke occurrence regardless of age namely hypertension, dyslipidemia, diabetes mellitus, regular meat consumption and non-consumption of green vegetables. Among the 5 co-shared risk factors, the effect size, aOR(95%CI) of dyslipidemia, 4.13(2.64-6.46), was highest among the young age group, hypertension, 28.93(15.10-55.44) and non-consumption of vegetables 2.34(1.70-3.23) was highest among the middle-age group while diabetes, aOR of 3.50(2.48-4.95) and meat consumption, 2.40(1.76-3.26) were highest among the elderly age group. Additionally, among the young age group cigarette smoking and cardiac disease were associated with stroke. Furthermore, physical inactivity and salt intake were associated with stroke in the middle-age group while cardiac disease was associated with stroke in the elderly age group. Conclusions: Age has a profound influence on the profile, magnitude and direction of effect sizes of vascular risk factors for stroke occurrence among West Africans. Population-level prevention of stroke must target both co-shared dominant risk factors as well as factors that are unique to specific age bands in Africa.

scholarly journals Leptospirosis

2016 ◽  
Vol 8 (3) ◽  
Author(s):  
Novie H. Rampengan
Keyword(s):  
Gold Standard ◽  
Case Fatality Rate ◽  
Severe Disease ◽  
Case Fatality ◽  
Agglutination Test ◽  
Microscopic Agglutination Test ◽  
Moderate Risk ◽  
Rat Urine ◽  
The World ◽  
Different Parts

Abstract: Leptospirosis is a zoonotic disease that usually occurs during the flood and is generally transmitted through rat urine. Indonesia is a country with a moderate risk of transmission of leptospirosis. Leptospirosis has a broad manifestation varying from self-limited to severe disease. The gold standard examination of leptospirosis is microscopic agglutination test. Diagnosis is divided into suspected, probable, and confirmed. Treatment consists of antibiotics and supportive agents. Generally, the prognosis is good, albeit, sequelae can occur. Case-fatality rate in different parts of the world ranging from less than 5% to 30%.Keywords: leptospirosis, diagnosis,Abstrak: Leptospirosis merupakan penyakit zoonosis yang umumnya timbul saat banjir dan umumnya ditularkan melalui kencing tikus. Indonesia merupakan negara dengan risiko sedang penularan leptospirosis. Leptospirosis memiliki manifestasi luas dari self limited hingga sakit berat. Pemeriksaan baku emas leptospirosis ialah dengan microscopic agglutination test. Diagnosis dibagi atas suspek, probable, dan konfirmasi. Terapi diberikan medikamentosa dengan antibiotik dan suportif. Prognosis umumnya baik namun bisa juga terjadi gejala sisa. Tingkat fatalitas kasus di berbagai belahan dunia berkisar <5%-30%.Kata kunci: leptospirosis, diagnosis

scholarly journals SOSIALISASI PENCEGAHAN DAN PENGADAAN SAPRAS PENCEGAHAN COVID 19 DI KECAMATAN KEMILING KOTA BANDAR LAMPUNG

2021 ◽  
Vol 5 (1) ◽  
pp. 87
Author(s):  
Novita Sari ◽  
M. Saputra ◽  
Aswin Aswin ◽  
Avitha P ◽  
Mega C
Keyword(s):  
Respiratory Disease ◽  
Community Service ◽  
The Elderly ◽  
Hand Washing ◽  
Service Work ◽  
Acute Respiratory Disease ◽  
Global Pandemic ◽  
The People ◽  
The World ◽  
New Type

Covid-19 merupakan penyakit pernapasan akut yang disebabkan oleh virus corona jenis baru. Penyakit ini pertama kali merebak di Wuhan, Cina lalu menyebar hampir ke seluruh dunia dan menyebabkan pandemi global. Penyakit ini menyerang semua golongan, dewasa, lansia, maupun anak-anak. Semua lapisan masyarakat dari mulai dewasa hingga anak-anak perlu mendapatkan edukasi yang mudah dipahami mengenai Covid19 dan cara-cara pencegahannya. Hal ini yang menjadi dasar dilaksanakannya praktek kerja pengabdian masyarakat IIB Darmajaya. Tujuan kegiatan ini adalah untuk ikut aktif dalam upaya pencegahan virus Covid-19 dengan memberikan sosialisasi tentang Covid-19 dan upaya pencegahannya melalui pembagian APD dan juga pembagian tempat cuci tangan kepada masyarakat Kelurahan Pinang Jaya, Kecamatan Kemiling, Kota Bandar Lampung. Kegiatan ini dilakukan bermitra dengan masyarakat Kelurahan Pinang Jaya . metode yang dipergunakan adalah dengan cara penyuluhan dan sosialisasi tentang pencegahan Covid-19, pengadaan  sarana prasarana pencegahan Covid 19. Hasil dari pengabdian ini adalah masyarakat dapat memahami lebih jauh mengenai virus Covid 19 ini sehingga masyarakat dapat turut serta melakukan upaya pencegahan penularan Covid-19 dimulai dari diri mereka masing-masing. Kata Kunci: Pengabdian, Covid-19, Pandemik, Sosialisasi, Edukasi ABSTRACT Covid-19 is an acute respiratory disease caused by a new type of corona virus. This disease first broke out in Wuhan, China then spread almost throughout the world and caused a global pandemic. This disease attacks all groups, adults, the elderly, and children. All levels of society from adults to children need to get education that is easy to understand about Covid19 and ways to prevent it. This is the basis for implementing IIB Darmajaya community service work practices. The purpose of this activity is to actively participate in efforts to prevent the Covid-19 virus by providing socialization about Covid-19 and prevention efforts through the distribution of PPE and also the distribution of hand washing facilities to the people of Pinang Jaya Village, Kemiling District, Bandar Lampung City. This activity is carried out in partnership with the people of Pinang Jaya Village. The method used is by means of counseling and socialization about the prevention of Covid-19, the provision of infrastructure for preventing Covid-19. of themselves. Keywords: Community Service, Covid-19, Pandemic, Socialization, Education

scholarly journals 2019 Novel Coronavirus (COVID-19) pneumonia: an unusual lung ultrasound presentation.

2020 ◽  
Author(s):  
Letizia Consoli ◽  
Vittorio Bendotti ◽  
Sara Cicchinelli ◽  
Federico Gaioni ◽  
Paola Prandolini ◽  
...  
Keyword(s):  
Case Fatality Rate ◽  
Lung Ultrasound ◽  
Case Fatality ◽  
Ground Glass Opacity ◽  
Public Health Emergency ◽  
Fatality Rate ◽  
Chest Computed Tomography ◽  
Ultrasound Findings ◽  
The World ◽  
Novel Coronavirus

Abstract In December 2019, a novel coronavirus (SARS-Cov-2) was first reported in Wuhan, China, and rapidly spread around the world, leading to an international emerging public health emergency. As reported from Chinese experiences, approximately 20% of patients had a severe course, requiring intensive care, with an overall case fatality rate of 2.3%. In diagnosis, chest computed tomography most commonly showed ground-glass opacity with or without consolidative patterns.Herein we report a case of a patient affected by COVID-19 pneumonia referred in the emergency department of our institution on 4 April 2020 with peculiar lung ultrasound findings.

Effects Of The COVID -19 Pandemıc On The Elderly: A Grounded Theory Study From Turkey

2021 ◽  
Vol 8 (1) ◽  
pp. 252-266
Author(s):  
Ahmet Koşar ◽  
Aytul Kasapoglu
Keyword(s):  
Qualitative Research ◽  
Grounded Theory ◽  
The Elderly ◽  
Age Group ◽  
Core Concept ◽  
Grounded Theory Methodology ◽  
Grounded Theory Study ◽  
The Core ◽  
Starting Point ◽  
The World

More than 95 percent of those who lost their lives as a result of the spread of the Covid-19 virus to the world since the beginning of 2020 are over the age of 60 (WHO, 2020). The main purpose of this article is to reveal the vital difficulties of the 65-75 age group in Turkey, who were quarantined due to the Covid-19 pandemic, as a result of deprivation of their former normal lives and how they overcame them. The theoretical starting point of this study is the relational sociologist H. White and his “uncertainty” classification. In the study, Grounded Theory Methodology was chosen as one of the qualitative research approaches and open, axial and selective codings were made as a requirement of this. In this context, interviews were made with 12 individuals from the 65-75 age group and the data were presented in figures. As a result of open, axial and selective coding, the core concept of the study was determined as "solidarity". In accordance with the grounded theory, at the end of the study, the "solidarity process" was narrated using the "river" metaphor.

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