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MeSH Disease

Human Phenotype

Transmission

Seroprevalence
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    COVID-19 Pandemic and the South African Podiatrist

    Authors: Bernhard Zipfel; Nadia Dembskey

    id:10.20944/preprints202009.0425.v1 Date: 2020-09-18 Source: Preprints.org

    The Coronavirus disease MESHD 2019 (COVID-19) pandemic is clearly taking a firmer grip on South Africa and more podiatrists will face the potential transmission TRANS of SARS-CoV-2. Government response was swift with the implementation of a travel TRANS ban, strict national lockdown as well as social distancing and hygiene protocols in line with international health regulations. Co-morbidities such as tuberculosis MESHD and HIV MESHD/ AIDS MESHD, endemic to South Africa, are considered a dangerous combination with COVID-19, making many South Africans vulnerable to contracting the COVID-19. Patients with diabetes MESHD as well as the aged TRANS are vulnerable, both in terms of potential combined complications and challenges in continuity in foot care. The demands of the pandemic may outstrip the ability of the health systems to cope. Should this time arrive, all healthcare practitioners, including podiatrists, would have to step in and take on a role beyond their scope of practice in order to ensure that the healthcare system does not get overwhelmed. It is important for podiatrists to keep abreast with the developments around the COVID-19, in order that they may institute appropriate clinical practice which will ensure maximum protection for themselves, staff and patients as well as providing quality foot health care.

    Driving Force of Covid-19 Among People Living With HIV MESHD/ AIDS MESHD in Wuhan, China

    Authors: Wei Guo; Fangzhao Ming; Yu Dong; Qian Zhang; Lian Liu; Ming Gao; Xiaoxia Zhang; Pingzheng Mo; Yong Feng; Weiming Tang; Ke Liang

    doi:10.21203/rs.3.rs-53351/v1 Date: 2020-08-04 Source: ResearchSquare

    Background: Even people living with HIV MESHD/ AIDS MESHD (PLWHA) were considered to be at increased risk of SARS-CoV-2 infection MESHD, the driving force among this group of individuals is still not clear. Methods: We investigated 1,701 PLWHA through a telephone interview and found 11 COVID-19 patients in four districts of Wuhan, China. The demographic features and major clinical characteristics of these patients were retrieved from the information management systems for COVID-19 patients of four districts’ CDC. Statistical analysis was performed to find out the driving force of COVID-19 among PLWHA.Results: The incidence proportion of COVID-19 in PLWHA is 0.6% (95% CI: 0.2% - 1.0%), which is comparable to the overall population incidence rate in Wuhan city (0.6%). Nine out of the 11 COVID-19/ AIDS MESHD patients had relatively high CD4+ T lymphocyte count (>200/μl) and undetectable HIV viral load (<20 copies/ml), and ten of them were on antiretroviral therapy. PLWHA who were old, had low CD4+ T lymphocyte count, infected HIV MESHD through homosexual activity, and had been diagnosed for HIV MESHD for a long time, were more likely to develop COVID-19.Conclusions: PLWHA has comparable COVID-19 morbidity rates as the general population, and older age TRANS, low CD4 count, long length since HIV diagnosis, and treatment-naive were potential driving forces of COVID-19 occurrence among PLWHA. Strategies in preventing SARS-CoV-2 infection MESHD among PLWHA with worse immune responses are needed. Article Summary Line: As COVID-19 continues to spread around the world, people living with HIV MESHD/ AIDS MESHD (PLWHA) are also at risk of infection TRANS risk of infection TRANS with SARS-CoV-2. We investigated the factors associated with SARS-CoV-2 infection MESHD among PLWHA in Wuhan, China.

    The COVID-19 mortality effects of underlying health conditions in India: a modelling study

    Authors: Paul Novosad; Radhika Jain; Alison Campion; Sam Asher

    doi:10.1101/2020.07.05.20140343 Date: 2020-07-08 Source: medRxiv

    Objective: To model how known COVID-19 comorbidities will affect mortality rates and the age TRANS distribution of mortality in a large lower middle income country (India), as compared with a high income country (England), and to identify which health conditions drive any differences. Design: Modelling study. Setting: England and India. Participants: 1,375,548 respondents aged TRANS 18 to 99 to the District Level Household Survey-4 and Annual Health Survey in India. Additional information on health condition prevalence SERO on individuals aged TRANS 18 to 99 was obtained from the Health Survey for England and the Global Burden of Diseases, Risk Factors, and Injuries Studies (GBD). Main outcome measures: The primary outcome was the proportional increase in age TRANS-specific mortality in each country due to the prevalence SERO of each COVID-19 mortality risk factor ( diabetes MESHD, hypertension HP hypertension MESHD, obesity HP obesity MESHD, chronic heart disease MESHD, respiratory illness MESHD, kidney disease MESHD, liver disease MESHD, and cancer MESHD, among others). The combined change in overall mortality and the share of deaths under 60 from the combination of risk factors was estimated in each country. Results: Relative to England, Indians have higher rates of diabetes MESHD (10.6% vs. 8.5%), chronic respiratory disease MESHD (4.8% vs. 2.5%), and kidney disease MESHD (9.7% vs. 5.6%), and lower rates of obesity HP obesity MESHD (4.4% vs. 27.9%), chronic heart disease MESHD (4.4% vs. 5.9%), and cancer MESHD (0.3% vs. 2.8%). Population COVID-19 mortality in India relative to England is most increased by diabetes MESHD (+5.4%) and chronic respiratory disease MESHD (+2.3%), and most reduced by obesity HP obesity MESHD (-9.7%), cancer MESHD (-3.2%), and chronic heart disease MESHD (-1.9%). Overall, comorbidities lower mortality in India relative to England by 9.7%. Accounting for demographics and population health explains a third of the difference in share of deaths under age TRANS 60 between the two countries. Conclusions: Known COVID-19 health risk factors are not expected to have a large effect on aggregate mortality or its age TRANS distribution in India relative to England. The high share of COVID-19 deaths from people under 60 in low- and middle-income countries (LMICs) remains unexplained. Understanding mortality risk associated with health conditions prevalent in LMICs, such as malnutrition HP malnutrition MESHD and HIV MESHD/ AIDS MESHD, is essential for understanding differential mortality. Keywords: COVID-19, India, low- and middle-income countries, comorbidity

    COVID-19 in Uganda: Predicting the impact of the disease and public health response on disease burden

    Authors: David Bell; Kristian Schultz Hansen; Agnes N Kiragga; Andrew Kambugu; John Kissa; Anthony K Mbonye

    doi:10.1101/2020.05.14.20102202 Date: 2020-05-20 Source: medRxiv

    Objective COVID-19 transmission TRANS and the public health lock-down response are now established in sub-Saharan Africa, including Uganda. Population structure and prior morbidities differ markedly between these countries from those where outbreaks were previously established. We predicted the relative impact of COVID-19 and the response in Uganda to understand whether the benefits could be outweighed by the costs. Design and setting Age TRANS-based COVID-19 mortality data from China were applied to the population structures of Uganda and countries with previously established outbreaks, comparing theoretical mortality and disability-adjusted life years (DALYs) lost. Based on recent Ugandan data and theoretical scenarios of programme deterioration, we predicted potential additional disease burden for HIV/AIDS, malaria MESHD and maternal mortality. Main outcome measures DALYs lost and mortality. Results Based on population age TRANS structure alone Uganda is predicted to have a relatively low COVID-19 burden compared to equivalent transmission TRANS in China and Western countries, with mortality and DALYs lost predicted to be 12% and 19% that of Italy. Scenarios of lockdown impact predict HIV/ AIDS MESHD and malaria MESHD equivalent to or higher than that of an extensive COVID-19 outbreak. Emerging HIV/ AIDS MESHD and maternal mortality data indicate that such deterioration could be occurring. Conclusions The results predict a relatively low COVID-19 impact on Uganda associated with its young population, with a high risk of negative impact on non-COVID-19 disease burden from a prolonged lockdown response. The results are likely to reflect the situation in other sub-Saharan populations, underlining the importance of tailoring COVID-19 responses to population structure and potential disease vulnerabilities.

    How many are at increased risk of severe COVID-19 disease? Rapid global, regional and national estimates for 2020

    Authors: Andrew Clark; Mark Jit; Charlotte Warren-Gash; Bruce Guthrie; Harry HX Wang; Stewart W Mercer; Colin Sanderson; Martin McKee; Christopher Troeger; Kanyin I Ong; Francesco Checchi; Pablo Perel; Sarah Joseph; Hamish P Gibbs; Amitava Banerjee; LSHTM CMMID COVID-19 working group; Rosalind M Eggo

    doi:10.1101/2020.04.18.20064774 Date: 2020-04-22 Source: medRxiv

    Background The risk of severe COVID-19 disease is known to be higher in older individuals and those with underlying health conditions. Understanding the number of individuals at increased risk of severe COVID-19 illness, and how this varies between countries may inform the design of possible strategies to shield those at highest risk. Methods We estimated the number of individuals at increased risk of severe COVID-19 disease by age TRANS (5-year age groups TRANS), sex and country (n=188) based on prevalence SERO data from the Global Burden of Disease MESHD ( GBD MESHD) study for 2017 and United Nations population estimates for 2020. We also calculated the number of individuals without an underlying condition that could be considered at-risk because of their age TRANS, using thresholds from 50-70 years. The list of underlying conditions relevant to COVID-19 disease was determined by mapping conditions listed in GBD to the guidelines published by WHO and public health agencies in the UK and US. We analysed data from two large multimorbidity studies to determine appropriate adjustment factors for clustering and multimorbidity. Results We estimate that 1.7 (1.0 - 2.4) billion individuals (22% [15-28%] of the global population) are at increased risk of severe COVID-19 disease. The share of the population at increased risk ranges from 16% in Africa to 31% in Europe. Chronic kidney disease HP Chronic kidney disease MESHD ( CKD MESHD), cardiovascular disease MESHD ( CVD MESHD), diabetes MESHD and chronic respiratory disease MESHD ( CRD MESHD) were the most prevalent conditions in males TRANS and females TRANS aged TRANS 50+ years. African countries with a high prevalence SERO of HIV MESHD/ AIDS MESHD and Island countries with a high prevalence SERO of diabetes MESHD, also had a high share of the population at increased risk. The prevalence SERO of multimorbidity (>1 underlying conditions) was three times higher in Europe than in Africa (10% vs 3%). Conclusion Based on current guidelines and prevalence SERO data from GBD, we estimate that one in five individuals worldwide has a condition that is on the list of those at increased risk of severe COVID-19 disease. However, for many of these individuals the underlying condition will be undiagnosed or not severe enough to be captured in health systems, and in some cases the increase in risk may be quite modest. There is an urgent need for robust analyses of the risks associated with different underlying conditions so that countries can identify the highest risk groups and develop targeted shielding policies to mitigate the effects of the COVID-19 pandemic.

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MeSH Disease
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Transmission
Seroprevalence


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