Surge in Delayed Myocardial Infarction Presentations: An Inadvertent Consequence of Social Distancing During the COVID-19 Pandemic.
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ABSTRACT:
SUBMITTER: Shah K
PROVIDER: S-EPMC7438070 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundImplementing and lifting social distancing (LSD) is an urgent global issue during the COVID-19 pandemic, particularly when the travel ban is lifted to revive international businesses and economies. However, when and whether LSD can be considered is subject to the spread of SARS-CoV-2, the recovery rate, and the case-fatality rate. It is imperative to provide real-time assessment of three factors to guide LSD.ObjectiveA simple LSD index was developed for health decision makers to do real-time assessment of COVID-19 at the global, country, region, and community level.MethodsData on the retrospective cohort of 186 countries with three factors were retrieved from a publicly available repository from January to early July. A simple index for guiding LSD was measured by the cumulative number of COVID-19 cases and recoveries, and the case-fatality rate was envisaged. If the LSD index was less than 1, LSD can be considered. The dynamic changes of the COVID-19 pandemic were evaluated to assess whether and when health decision makers allowed for LSD and when to reimplement social distancing after resurgences of the epidemic.ResultsAfter large-scale outbreaks in a few countries before mid-March (prepandemic phase), the global weekly LSD index peaked at 4.27 in March and lasted until mid-June (pandemic phase), during which most countries were affected and needed to take various social distancing measures. Since, the value of LSD has gradually declined to 0.99 on July 5 (postpandemic phase), at which 64.7% (120/186) of countries and regions had an LSD<1 with the decile between 0 and 1 to refine risk stratification by countries. The LSD index decreased to 1 in about 115 days. In addition, we present the results of dynamic changes of the LSD index for the world and for each country and region with different time windows from January to July 5. The results of the LSD index on the resurgence of the COVID-19 epidemic in certain regions and validation by other emerging infectious diseases are presented.ConclusionsThis simple LSD index provides a quantitative assessment of whether and when to ease or implement social distancing to provide advice for health decision makers and travelers.
| S-EPMC7505695 | biostudies-literature
Project description:Do reminders to promote social distancing achieve the desired effects on behavior? Much of the existing literature analyses impacts on people's intentions to comply. We run a randomised controlled trial in Denmark to test different versions of a reminder to stay home at the beginning of the crisis. Using a two-stage design, we follow up with recipients and analyse their subsequent self-reported behaviour. We find that the reminder increases ex-ante intentions to comply when it emphasises the consequences of non-compliance for the subjects themselves and their families, while it has no effect when the emphasis is on other people or the country as a whole. We also find, however, that impacts on intentions do not translate into equivalent impacts on actions. Only people in poor health react to the reminder by staying home significantly more. Our results shed light on important gaps between people's intentions and their actions in responding to the recommendations of health authorities.
| S-EPMC8638903 | biostudies-literature
Project description:A 37-year-old woman was admitted into the coronary care unit following chest pain after using cocaine. She was found to have significant myocardial ischaemia on blood and ECG investigations despite a recent coronary angiogram that had not demonstrated flow-limiting coronary disease. This case report summarises the risks of myocardial ischaemia and/or infarction for patients taking cocaine and the pathophysiology behind it, focusing in particular on the risks of delayed reaction some time after cocaine ingestion.
| S-EPMC4158247 | biostudies-other
Project description:Higher education has been shifted toward blended learning during the COVID-19 pandemic. An increase in social media usage intensity and reduced face-to-face interaction due to the COVID-19 pandemic urged instructional communication researchers to revisit the dynamics of learners' group development in terms of their socialization and academic performance during the COVID-19 crisis. This research aimed to determine the mediating role of social media sociability between face-to-face socialization and academic performance of higher education students in blended learning environments during the COVID-19 pandemic. It was also the aim of the study to determine the moderating effect of social media usage intensity on social media sociability. A cross-sectional survey was conducted with the students (n = 340) enrolled in science teacher education departments of universities in Pakistan. Partial least squares structural equation modeling (PLS-SEM) was used for multivariate analysis. Results revealed that face-to-face socialization gave an essential start to develop a learning group. However, when face-to-face socialization was reduced due to the COVID-19 pandemic, it was mediated by social media usage in blended learning environments to increase their socialization and academic performance during the crisis. The findings of the study are useful for higher education institutions to adopt social media strategies for students' socialization during the crisis.
| S-EPMC8583489 | biostudies-literature
Project description:Background and Purpose:We aimed to investigate the acute stroke presentations during the coronavirus disease 2019 (COVID-19) pandemic.Methods:The data were obtained from a health system with 19 emergency departments in northeast Ohio in the United States. Baseline period from January 1 to March 8, 2020, was compared with the COVID period from March 9, to April 2, 2020. The variables included were total daily stroke alerts across the hospital emergency departments, thrombolysis, time to presentation, stroke severity, time from door-to-imaging, time from door-to-needle in thrombolysis, and time from door-to-puncture in thrombectomy. The 2 time periods were compared using nonparametric statistics and Poisson regression.Results:Nine hundred two stroke alerts during the period across the emergency departments were analyzed. Total daily stroke alerts decreased from median, 10 (interquartile range, 8–13) during baseline period to median, 8 (interquartile range, 4–10, P=0.001) during COVID period. Time to presentation, stroke severity, and time to treatment were unchanged. COVID period was associated with decrease in stroke alerts with rate ratio of 0.70 (95% CI, 0.60–0.28). Thrombolysis also decreased with rate ratio, 0.52 (95% CI, 0.28–0.97) but thrombectomy remained unchanged rate ratio, 0.93 (95% CI, 0.52–1.62)Conclusions:We observed a significant decrease in acute stroke presentations by ?30% across emergency departments at the time of surge of COVID-19 cases. This observation could be attributed to true decline in stroke incidence or patients not seeking medical attention for emergencies during the pandemic.
| S-EPMC7309646 | biostudies-literature
Project description:The 1918 influenza pandemic was characterized by multiple epidemic waves. We investigated reactive social distancing, a form of behavioral response where individuals avoid potentially infectious contacts in response to available information on an ongoing epidemic or pandemic. We modelled its effects on the three influenza waves in the United Kingdom. In previous studies, human behavioral response was modelled by a Power function of the proportion of recent influenza mortality in a population, and by a Hill function, which is a function of the number of recent influenza mortality. Using a simple epidemic model with a Power function and one common set of parameters, we provided a good model fit for the observed multiple epidemic waves in London boroughs, Birmingham and Liverpool. We further applied the model parameters from these three cities to all 334 administrative units in England and Wales and including the population sizes of individual administrative units. We computed the Pearson's correlation between the observed and simulated for each administrative unit. We found a median correlation of 0.636, indicating that our model predictions are performing reasonably well. Our modelling approach is an improvement from previous studies where separate models are fitted to each city. With the reduced number of model parameters used, we achieved computational efficiency gain without over-fitting the model. We also showed the importance of reactive behavioral distancing as a potential non-pharmaceutical intervention during an influenza pandemic. Our work has both scientific and public health significance.
| S-EPMC5507503 | biostudies-literature
Project description:BackgroundThe main strategy for alleviating heart disease has been to target individuals and encourage them to change their health behaviours. Although important, emphasis on individuals has diverted focus and responsibility away from neighbourhood characteristics, which also strongly influence people's behaviours. Although a growing body of research has repeatedly demonstrated strong associations between neighbourhood characteristics and cardiovascular health, it has typically focused on negative neighbourhood characteristics. Only a few studies have examined the potential health enhancing effects of positive neighbourhood characteristics, such as perceived neighbourhood social cohesion.MethodsUsing multiple logistic regression models, we tested whether higher perceived neighbourhood social cohesion was associated with lower incidence of myocardial infarction. Prospective data from the Health and Retirement Study--a nationally representative panel study of American adults over the age of 50--were used to analyse 5276 participants with no history of heart disease. Respondents were tracked for 4 years and analyses adjusted for relevant sociodemographic, behavioural, biological and psychosocial factors.ResultsIn a model that adjusted for age, gender, race, marital status, education and total wealth, each SD increase in perceived neighbourhood social cohesion was associated with a 22% reduced odds of myocardial infarction (OR=0.78, 95% CI 0.63 to 0.94. The association between perceived neighbourhood social cohesion and myocardial infarction remained even after adjusting for behavioural, biological and psychosocial covariates.ConclusionsHigher perceived neighbourhood social cohesion may have a protective effect against myocardial infarction.
| S-EPMC4600604 | biostudies-literature
Project description:During the coronavirus disease 2019 (COVID-19) pandmic, more patients are presenting with complications late after acute myocardial infarction. We report the case of a 71-year-old man who delayed seeking medical care for 2 weeks, despite progressive shortness of breath, cough, and tactile fever, for fear of contracting COVID-19 in the hospital. Clinical and echocardiographic evaluation revealed a ventricular septal rupture secondary to acute myocardial infarction. The patient underwent urgent cardiac catheterization, followed by successful saphenous vein grafting to the left anterior descending coronary artery and open surgical repair of the ventricular septal rupture with a bovine pericardial patch. This case highlights a potential long-lasting negative effect that the COVID-19 pandemic will have on the care-seeking behavior and health of patients with acute cardiovascular disease.
| S-EPMC8367284 | biostudies-literature
Project description:BACKGROUND: Public adherence to influenza vaccination recommendations has been low, particularly among younger adults and children under 2, despite the availability of safe and effective seasonal vaccine. Intention to receive 2009 pandemic influenza A (H1N1) vaccine has been estimated to be 50% in select populations. This report measures knowledge of and intention to receive pandemic vaccine in a population-based setting, including target groups for seasonal and H1N1 influenza. METHODOLOGY AND PRINCIPAL FINDINGS: On August 28-29, 2009, we conducted a population-based survey in 2 counties in North Carolina. The survey used the 30x7 two-stage cluster sampling methodology to identify 210 target households. Prevalence ratios (PR) and 95% confidence intervals (CI) were estimated. Knowledge of pandemic influenza A (H1N1) vaccine was high, with 165 (80%) aware that a vaccine was being prepared. A total of 133 (64%) respondents intended to receive pandemic vaccine, 134 (64%) intended to receive seasonal vaccine, and 109 (53%) intended to receive both. Reporting great concern about H1N1 infection (PR 1.55; 95%CI: 1.30, 1.85), receiving seasonal influenza vaccine in 2008-09 (PR 1.47; 95%CI: 1.18, 1.82), and intending to receive seasonal influenza vaccine in 2009-10 (PR 1.27; 95%CI: 1.14, 1.42) were associated with intention to receive pandemic vaccine. Not associated were knowledge of vaccine, employment, having children under age 18, gender, race/ethnicity and age. Reasons cited for not intending to get vaccinated include not being at risk for infection, concerns about vaccine side effects and belief that illness caused by pandemic H1N1 would be mild. Forty-five percent of households with children under 18 and 65% of working adults reported ability to comply with self-isolation at home for 7-10 days if recommended by authorities. CONCLUSIONS AND SIGNIFICANCE: This is the first report of a population based rapid assessment used to assess knowledge and intent to receive pandemic vaccine in a community sample. Intention to receive pandemic and seasonal vaccines was higher than previously published reports. To reach persons not intending to receive pandemic vaccine, public health communications should focus on the perceived risk of infection and concerns about vaccine safety.
| S-EPMC2887902 | biostudies-other
Project description:BackgroundLeft ventricular pseudoaneurysm (LVP) is an uncommon but serious mechanical complication of acute myocardial infarction (AMI). The immediate medical complications of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are well recognized, but its indirect effect on patients and healthcare systems is potentially less perceivable.Case summaryIn this report, a 72-year-old man who was anxious about attending hospital during the SARS-CoV-2 pandemic was eventually found to have a total right coronary artery occlusion after a delayed emergency department presentation. He ultimately developed severe symptomatic heart failure and cardiac magnetic resonance imaging (CMR) revealed that a large LVP with concomitant severe ischaemic mitral regurgitation had evolved from his infarct. The patient was successfully discharged home after the surgical replacement of his mitral valve and repair of his LVP.DiscussionThis case highlights a salient downstream effect of Coronavirus disease 2019 (COVID-19): the delay in presentation, diagnosis, and management of common treatable conditions such as AMI. It also underscores the importance of non-invasive multimodal imaging on the timely identification of the mechanical complications of AMI. In particular, CMR can play a crucial role in the characterization and management of LVP.
| S-EPMC8374318 | biostudies-literature