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  • Oxford University Press (OUP)  (9)
  • 1
    Online Resource
    Online Resource
    Characteristics and outcomes of an international cohort of 600 000 hospitalized patients with COVID-19
    Oxford University Press (OUP) ; 2023
    In:  International Journal of Epidemiology Vol. 52, No. 2 ( 2023-04-19), p. 355-376
    Details
    In: International Journal of Epidemiology, Oxford University Press (OUP), Vol. 52, No. 2 ( 2023-04-19), p. 355-376
    Abstract: We describe demographic features, treatments and clinical outcomes in the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) COVID-19 cohort, one of the world's largest international, standardized data sets concerning hospitalized patients. Methods The data set analysed includes COVID-19 patients hospitalized between January 2020 and January 2022 in 52 countries. We investigated how symptoms on admission, co-morbidities, risk factors and treatments varied by age, sex and other characteristics. We used Cox regression models to investigate associations between demographics, symptoms, co-morbidities and other factors with risk of death, admission to an intensive care unit (ICU) and invasive mechanical ventilation (IMV). Results Data were available for 689 572 patients with laboratory-confirmed (91.1%) or clinically diagnosed (8.9%) SARS-CoV-2 infection from 52 countries. Age [adjusted hazard ratio per 10 years 1.49 (95% CI 1.48, 1.49)] and male sex [1.23 (1.21, 1.24)] were associated with a higher risk of death. Rates of admission to an ICU and use of IMV increased with age up to age 60 years then dropped. Symptoms, co-morbidities and treatments varied by age and had varied associations with clinical outcomes. The case-fatality ratio varied by country partly due to differences in the clinical characteristics of recruited patients and was on average 21.5%. Conclusions Age was the strongest determinant of risk of death, with a ∼30-fold difference between the oldest and youngest groups; each of the co-morbidities included was associated with up to an almost 2-fold increase in risk. Smoking and obesity were also associated with a higher risk of death. The size of our international database and the standardized data collection method make this study a comprehensive international description of COVID-19 clinical features. Our findings may inform strategies that involve prioritization of patients hospitalized with COVID-19 who have a higher risk of death.
    Type of Medium: Online Resource
    ISSN: 0300-5771 , 1464-3685
    URL: Article
    DOI: 10.1093/ije/dyad012
    RVK:
    XF 4100
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 1494592-7
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  • 2
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    Neurological manifestations of COVID-19 in adults and children
    Oxford University Press (OUP) ; 2023
    In:  Brain Vol. 146, No. 4 ( 2023-04-19), p. 1648-1661
    Details
    In: Brain, Oxford University Press (OUP), Vol. 146, No. 4 ( 2023-04-19), p. 1648-1661
    Abstract: Different neurological manifestations of coronavirus disease 2019 (COVID-19) in adults and children and their impact have not been well characterized. We aimed to determine the prevalence of neurological manifestations and in-hospital complications among hospitalized COVID-19 patients and ascertain differences between adults and children. We conducted a prospective multicentre observational study using the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) cohort across 1507 sites worldwide from 30 January 2020 to 25 May 2021. Analyses of neurological manifestations and neurological complications considered unadjusted prevalence estimates for predefined patient subgroups, and adjusted estimates as a function of patient age and time of hospitalization using generalized linear models. Overall, 161 239 patients (158 267 adults; 2972 children) hospitalized with COVID-19 and assessed for neurological manifestations and complications were included. In adults and children, the most frequent neurological manifestations at admission were fatigue (adults: 37.4%; children: 20.4%), altered consciousness (20.9%; 6.8%), myalgia (16.9%; 7.6%), dysgeusia (7.4%; 1.9%), anosmia (6.0%; 2.2%) and seizure (1.1%; 5.2%). In adults, the most frequent in-hospital neurological complications were stroke (1.5%), seizure (1%) and CNS infection (0.2%). Each occurred more frequently in intensive care unit (ICU) than in non-ICU patients. In children, seizure was the only neurological complication to occur more frequently in ICU versus non-ICU (7.1% versus 2.3%, P & lt; 0.001). Stroke prevalence increased with increasing age, while CNS infection and seizure steadily decreased with age. There was a dramatic decrease in stroke over time during the pandemic. Hypertension, chronic neurological disease and the use of extracorporeal membrane oxygenation were associated with increased risk of stroke. Altered consciousness was associated with CNS infection, seizure and stroke. All in-hospital neurological complications were associated with increased odds of death. The likelihood of death rose with increasing age, especially after 25 years of age. In conclusion, adults and children have different neurological manifestations and in-hospital complications associated with COVID-19. Stroke risk increased with increasing age, while CNS infection and seizure risk decreased with age.
    Type of Medium: Online Resource
    ISSN: 0006-8950 , 1460-2156
    URL: Article
    DOI: 10.1093/brain/awac332
    RVK:
    XA 10000
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 1474117-9
    SSG: 12
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  • 3
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    Global Respiratory Syncytial Virus–Related Infant Community Deaths
    Oxford University Press (OUP) ; 2021
    In:  Clinical Infectious Diseases Vol. 73, No. Supplement_3 ( 2021-09-02), p. S229-S237
    Details
    In: Clinical Infectious Diseases, Oxford University Press (OUP), Vol. 73, No. Supplement_3 ( 2021-09-02), p. S229-S237
    Abstract: Respiratory syncytial virus (RSV) is a leading cause of pediatric death, with & gt;99% of mortality occurring in low- and lower middle-income countries. At least half of RSV-related deaths are estimated to occur in the community, but clinical characteristics of this group of children remain poorly characterized. Methods The RSV Global Online Mortality Database (RSV GOLD), a global registry of under-5 children who have died with RSV-related illness, describes clinical characteristics of children dying of RSV through global data sharing. RSV GOLD acts as a collaborative platform for global deaths, including community mortality studies described in this supplement. We aimed to compare the age distribution of infant deaths & lt;6 months occurring in the community with in-hospital. Results We studied 829 RSV-related deaths & lt;1 year of age from 38 developing countries, including 166 community deaths from 12 countries. There were 629 deaths that occurred & lt;6 months, of which 156 (25%) occurred in the community. Among infants who died before 6 months of age, median age at death in the community (1.5 months; IQR: 0.8−3.3) was lower than in-hospital (2.4 months; IQR: 1.5−4.0; P  & lt; .0001). The proportion of neonatal deaths was higher in the community (29%, 46/156) than in-hospital (12%, 57/473, P  & lt; 0.0001). Conclusions We observed that children in the community die at a younger age. We expect that maternal vaccination or immunoprophylaxis against RSV will have a larger impact on RSV-related mortality in the community than in-hospital. This case series of RSV-related community deaths, made possible through global data sharing, allowed us to assess the potential impact of future RSV vaccines.
    Type of Medium: Online Resource
    ISSN: 1058-4838 , 1537-6591
    URL: Article
    DOI: 10.1093/cid/ciab528
    RVK:
    XA 10000
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2002229-3
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  • 4
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    Online Resource
    Reducing Specimen Rejection Rates Using Concentration-Dependent Hemolysis Rejection Thresholds
    Oxford University Press (OUP) ; 2023
    In:  The Journal of Applied Laboratory Medicine Vol. 8, No. 2 ( 2023-03-06), p. 285-295
    Details
    In: The Journal of Applied Laboratory Medicine, Oxford University Press (OUP), Vol. 8, No. 2 ( 2023-03-06), p. 285-295
    Abstract: Using middleware solutions, it is possible to implement concentration-dependent analyte-specific hemolysis rejection limits. This makes day-to-day reporting of clinical specimens more efficient and potentially lowers sample rejection rates compared to a “one-size-fits-all” approach (i.e., solely based on a single cutoff provided in the package insert). Methods Hemolysis interference studies were performed at multiple analyte concentrations for three frequently ordered tests. For each assay, concentration-dependent hemolysis rejection limits were designed based on the total allowable error (TAE) for the analyte as well as the clinical significance of such incurred inaccuracy at the respective concentrations. In general, the following rationale was used: if the interference exceeds 10% (or package insert cutoffs), a comment is placed on the result. If the interference exceeds the TAE, the result will not be reported. Reduction in specimen rejection rates were estimated by comparing the incurred specimen rejection rates when package inserts’ vs concentration-dependent hemolysis interference limits were applied to a data set in our institute during a three-month period. Results Concentration-dependent analyte-specific hemolysis rejection thresholds were designed for three commonly ordered assays that are especially susceptible to hemolysis interference. It is estimated that these novel thresholds for aspartate aminotransferase (AST), lactate dehydrogenase (LDH), and direct bilirubin (DBIL) reduced specimen rejection rates from 9.3% to 1.3%, 31.4% to 4.8%, and 19.9% to 7.1%, respectively. Conclusions Concentration-dependent analyte-specific hemolysis rejection thresholds for three commonly ordered assays can reduce rejection rates without significantly compromising the quality of test results.
    Type of Medium: Online Resource
    ISSN: 2475-7241
    URL: Article
    DOI: 10.1093/jalm/jfac095
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
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  • 5
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    Sleep after learning aids the consolidation of factual knowledge, but not relearning
    Oxford University Press (OUP) ; 2021
    In:  Sleep Vol. 44, No. 3 ( 2021-03-12)
    Details
    In: Sleep, Oxford University Press (OUP), Vol. 44, No. 3 ( 2021-03-12)
    Abstract: Sleep strengthens and reorganizes declarative memories, but the extent to which these processes benefit subsequent relearning of the same material remains unknown. It is also unclear whether sleep-memory effects translate to educationally realistic learning tasks and improve long-term learning outcomes. Methods Young adults learned factual knowledge in two learning sessions that were 12 h apart and separated by either nocturnal sleep (n = 26) or daytime wakefulness (n = 26). Memory before and after the retention interval was compared to assess the effect of sleep on consolidation, while memory before and after the second learning session was compared to assess relearning. A final test 1 week later assessed whether there was any long-term advantage to sleeping between two study sessions. Results Sleep significantly enhanced consolidation of factual knowledge (p = 0.01, d = 0.72), but groups did not differ in their capacity to relearn the materials (p = 0.72, d = 0.10). After 1 week, a numerical memory advantage remained for the sleep group but was no longer significant (p = 0.21, d = 0.35). Conclusions Reduced forgetting after sleep is a robust finding that extends to our ecologically valid learning task, but we found no evidence that sleep enhances relearning. Our findings can exclude a large effect of sleep on long-term memory after 1 week, but hint at a smaller effect, leaving open the possibility of practical benefits from organizing study sessions around nocturnal sleep. These findings highlight the importance of revisiting key sleep-memory effects to assess their relevance to long-term learning outcomes with naturalistic learning materials.
    Type of Medium: Online Resource
    ISSN: 0161-8105 , 1550-9109
    URL: Article
    DOI: 10.1093/sleep/zsaa210
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2056761-3
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  • 6
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    Key Ethical Concepts and Their Application to COVID-19 Research
    Oxford University Press (OUP) ; 2020
    In:  Public Health Ethics Vol. 13, No. 2 ( 2020-07-01), p. 127-132
    Details
    In: Public Health Ethics, Oxford University Press (OUP), Vol. 13, No. 2 ( 2020-07-01), p. 127-132
    Abstract: During the WHO-GloPID COVID-19 Global Research and Innovation Forum meeting held in Geneva on the 11th and 12th of February 2020 a number of different ethical concepts were used. This paper briefly states what a number of these concepts mean and how they might be applied to discussions about research during the COVID-19 pandemic and related outbreaks. This paper does not seek to be exhaustive and other ethical concepts are, of course, relevant and important.
    Type of Medium: Online Resource
    ISSN: 1754-9973 , 1754-9981
    URL: Article
    DOI: 10.1093/phe/phaa017
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 2438463-X
    SSG: 5,1
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  • 7
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    Analytical and Clinical Evaluation of the Semiquantitative Elecsys Anti–SARS-CoV-2 Spike Protein Receptor Binding Domain Antibody Assay on the Roche cobas e602 Analyzer
    Oxford University Press (OUP) ; 2022
    In:  American Journal of Clinical Pathology Vol. 157, No. 1 ( 2022-01-06), p. 109-118
    Details
    In: American Journal of Clinical Pathology, Oxford University Press (OUP), Vol. 157, No. 1 ( 2022-01-06), p. 109-118
    Abstract: To analytically and clinically evaluate the semiquantitative Elecsys anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein antibody (S-Ab) assay on the Roche cobas e602 analyzer. Methods The S-Ab assay is a 1-step, double-antigen sandwich electrochemiluminescent immunoassay that semiquantitatively measures total IgG, IgM, and IgA antibodies specific for the receptor binding domain of SARS-CoV-2 spike protein in serum or plasma. The S-Ab assay was evaluated for precision, linearity, interference (by hemoglobin, bilirubin, triglycerides, and biotin), cross-reactivity, and clinical performance, and was compared to the qualitative Elecsys anti-nucleocapsid (N-Ab) immunoassay, a lateral flow device that qualitatively detects S-Ab and N-Ab, and an anti-spike enzyme-linked immunosorbent assay (ELISA). Results S-Ab assay is precise, exhibits linearity from 0.4 to 250 U/mL, is unaffected by significant cross-reactivity or interferences, and qualitatively demonstrates greater than 90% concordance with N-Ab assay and lateral flow device. Readouts of S-Ab assay correlate with ELISA, which in turn correlates strongly with SARS-CoV-2 virus neutralization assay, and exhibit 100% sensitivity and specificity for COVID-19 patient samples obtained at or more than 14 days after PCR positivity. Conclusions The S-Ab assay is a robust clinical test for qualitative and semiquantitative detection of seropositivity following SARS-CoV-2 infection or spike-encoding mRNA COVID-19 vaccination.
    Type of Medium: Online Resource
    ISSN: 0002-9173 , 1943-7722
    URL: Article
    DOI: 10.1093/ajcp/aqab092
    RVK:
    YV 2000
    RVK:
    XA 18700
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2039921-2
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  • 8
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    Influence of mid-afternoon nap duration and sleep parameters on memory encoding, mood, processing speed, and vigilance
    Oxford University Press (OUP) ; 2023
    In:  Sleep Vol. 46, No. 4 ( 2023-04-12)
    Details
    In: Sleep, Oxford University Press (OUP), Vol. 46, No. 4 ( 2023-04-12)
    Abstract: To determine how mid-afternoon naps of differing durations benefit memory encoding, vigilance, speed of processing (SOP), mood, and sleepiness; to evaluate if these benefits extend past 3 hr post-awakening and to examine how sleep macrostructure during naps modulate these benefits. Methods Following short habitual sleep, 32 young adults underwent four experimental conditions in randomized order: wake; naps of 10 min, 30 min, and 60 min duration verified with polysomnography. A 10-min test battery was delivered at a pre-nap baseline, and at 5 min, 30 min, 60 min, and 240 min post-nap. Participants encoded pictures 90 min post-nap and were tested for recognition 210 min later. Results Naps ranging from 10 to 60 min increased positive mood and alleviated self-reported sleepiness up to 240 min post-nap. Compared to waking, only naps of 30 min improved memory encoding. Improvements in vigilance were moderate, and benefits for SOP were not observed. Sleep inertia was observed for the 30 min to 60 min naps but was resolved within 30 min after waking. We found no significant associations between sleep macrostructure and memory benefits. Conclusions With short habitual sleep, naps ranging from 10 to 60 min had clear and lasting benefits for positive mood and self-reported sleepiness/alertness. Cognitive improvements were moderate, with only the 30 min nap showing benefits for memory encoding. While there is no clear “winning” nap duration, a 30 min nap appears to have the best trade-off between practicability and benefit. Clinical Trial ID Effects of Varying Duration of Naps on Cognitive Performance and Memory Encoding, https://www.clinicaltrials.gov/ct2/show/NCT04984824, NCT04984824.
    Type of Medium: Online Resource
    ISSN: 0161-8105 , 1550-9109
    URL: Article
    DOI: 10.1093/sleep/zsad025
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 2056761-3
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  • 9
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    Bidirectional associations between the duration and timing of nocturnal sleep and daytime naps in adolescents differ from weekdays to weekends
    Oxford University Press (OUP) ; 2024
    In:  SLEEP ( 2024-06-28)
    Details
    In: SLEEP, Oxford University Press (OUP), ( 2024-06-28)
    Abstract: Previous studies examining bidirectional relationships between nocturnal sleep and napping have focused on sleep duration, leaving a gap in our understanding of how sleep timing contributes. Here, we assessed duration and timing for night sleep and daytime naps, to evaluate how the previous night’s sleep influences next day napping, and how napping influences same-night nocturnal sleep. Methods We analysed sleep diary and actigraphy data from 153 teens (males = 43.8%, mean age = 16.6 years). Participants who never napped were excluded. Nocturnal sleep-nap relationships were investigated using logistic and linear regression models separately for weekdays and weekends. Results Participants napped an average of 2.3 times a week. 167 school day naps and 107 weekend were recorded. Naps were on average 82.12 ± 53.34 mins and average nap onset was 14:58 ± 3.78 h. Their duration, start and end times did not significantly differ between weekdays and weekends. Nocturnal sleep duration did not predict next day nap occurrence or duration. However, on school days, earlier wake times significantly increased the likelihood of napping that day, and advanced nap timing. On weekends, later bedtimes and wake times delayed nap timing. On school days, napping longer than one’s average shortened nocturnal sleep whereas on weekends, waking from a nap later than one’s average delayed bedtimes. Conclusions Early wake times increase the likelihood of napping and advance the time of a nap that day. Naps may be detrimental to the same-night’s sleep only if they are long and occur late, as these can delay bedtimes and shorten nocturnal sleep duration, especially on school days.
    Type of Medium: Online Resource
    ISSN: 0161-8105 , 1550-9109
    URL: Article
    DOI: 10.1093/sleep/zsae147
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2024
    detail.hit.zdb_id: 2056761-3
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