Dataset Information

Coronavirus disease-2019: A tocsin to our aging, unfit, corpulent, and immunodeficient society.

ABSTRACT: Acute and chronic respiratory illnesses cause widespread morbidity and mortality, and this class of illness now includes the novel coronavirus severe acute respiratory syndrome that is causing coronavirus disease-2019 (COVID-19). The world is experiencing a major demographic shift toward an older, obese, and physically inactive populace. Risk factor assessments based on pandemic data indicate that those at higher risk for severe illness from COVID-19 include older males, and people of all ages with obesity and related comorbidities such as hypertension and type 2 diabetes. Aging in and of itself leads to negative changes in innate and adaptive immunity, a process termed immunosenescence. Obesity causes systemic inflammation and adversely impacts immune function and host defense in a way that patterns immunosenescence. Two primary prevention strategies to reduce the risk for COVID-19 at both the community and individual levels include mitigation activities and the adoption of lifestyle practices consistent with good immune health. Animal and human studies support the idea that, in contrast to high exercise workloads, regular moderate-intensity physical activity improves immunosurveillance against pathogens and reduces morbidity and mortality from viral infection and respiratory illnesses including the common cold, pneumonia, and influenza. The odds are high that infectious disease pandemics spawned by novel pathogens will continue to inflict morbidity and mortality as the world's population becomes older and more obese. COVID-19 is indeed a wake-up call, a tocsin, to the world that primary prevention countermeasures focused on health behaviors and hygiene demand our full attention and support.

SUBMITTER: Nieman DC

PROVIDER: S-EPMC7205734 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:ScopeSince the onset of COVID-19, several assays have been deployed for the diagnosis of SARS-CoV-2. The European Society of Clinical Microbiology and Infectious Diseases (ESCMID) published the first set of guidelines on SARS-CoV-2 in vitro diagnosis in February 2022. Because the COVID-19 landscape is rapidly evolving, the relevant ESCMID guidelines panel releases an update of the previously published recommendations on diagnostic testing for SARS-CoV-2. This update aims to delineate the best diagnostic approach for SARS-CoV-2 in different populations based on current evidence.MethodsAn ESCMID COVID-19 guidelines task force was established by the ESCMID Executive Committee. A small group was established, half appointed by the chair, and the remaining selected with an open call. The panel met virtually once a week. For all decisions, a simple majority vote was used. A list of clinical questions using the population, intervention, comparison, and outcome (PICO) format was developed at the beginning of the process. For each PICO, 2 panel members performed a literature search focusing on systematic reviews with a third panellist involved in case of inconsistent results. The panel reassessed the PICOs previously defined as priority in the first set of guidelines and decided to address 49 PICO questions, because 6 of them were discarded as outdated/non-clinically relevant. The 'Grading of Recommendations Assessment, Development and Evaluation (GRADE)-adoption, adaptation, and de novo development of recommendations (ADOLOPMENT)' evidence-to-decision framework was used to produce the guidelines.Questions addressed by the guidelines and recommendationsAfter literature search, we updated 16 PICO questions; these PICOs address the use of antigen-based assays among symptomatic and asymptomatic patients with different ages, COVID-19 severity status or risk for severe COVID-19, time since the onset of symptoms/contact with an infectious case, and finally, types of biomaterials used.

Project description:ImportanceAt the start of the coronavirus disease 2019 pandemic, medications repurposed for management of coronavirus disease 2019 were used in the absence of clinical trial evidence.ObjectivesTo describe the variation and evolution in use of repurposed medications for coronavirus disease 2019.Design setting and participantsObservational cohort study of adults hospitalized with coronavirus disease 2019 between February 15, 2020, and April 12, 2021, across 76 United States and international hospitals within the Society of Critical Care Medicine's Discovery Viral Infection and Respiratory Illness Universal Study coronavirus disease 2019 registry.Main outcomes and measuresHospital variation was quantified using multivariable adjusted random effects logistic regression models and unsupervised clustering. Repurposed medications included antivirals, corticosteroids, hydroxychloroquine, immunomodulators, and therapeutic dose anticoagulants.ResultsAmong 7,069 adults hospitalized with coronavirus disease 2019, 1,979 (28%) received antivirals, 2,876 (41%) received corticosteroids, 1,779 (25%) received hydroxychloroquine, 620 (9%) received immunomodulators, and 2,154 (31%) received therapeutic dose anticoagulants. Contribution of hospital site to risk-adjusted variation was 46% for antivirals, 30% for corticosteroids, 48% for hydroxychloroquine, 46% for immunomodulators, and 52% for therapeutic dose anticoagulants. Compared with the early pandemic, the later pandemic practice phenotypes converged with increased use of antivirals (odds ratio, 3.14; 95% CI, 2.40-4.10) and corticosteroids (odds ratio, 5.43; 95% CI, 4.23-6.97), with decreased use of hydroxychloroquine (odds ratio, 0.02; 95% CI, 0.01-0.04) and immunomodulators (odds ratio, 0.49; 95% CI, 0.34-0.70). There was no clinically significant change in the use of therapeutic dose anticoagulants (odds ratio, 1.01; 95% CI, 1.01-1.02). There were no differences in risk-adjusted mortality between hospitals with high rates of repurposed medication use compared with hospitals with low rates of use.Conclusions and relevanceHospital variation in the use of repurposed medications varied widely across hospitals early in the pandemic and later converged with the emergence of randomized clinical trials. Platforms developed for rapid activation and enrollment in clinical trials of repurposed medications are needed prior to the next pandemic to expedite effective, evidence-based practice.

Dataset Information

Coronavirus disease-2019: A tocsin to our aging, unfit, corpulent, and immunodeficient society.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets