Query: covid-19 risk

title: Clinical course and risk factors for mortality of adult inpatients with COVID 19 in Wuhan, China: a retrospective cohort study
abstract: Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID 19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS CoV 2) Epidemiological and clinical characteristics of patients with COVID 19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described.  In this retrospective, multicentre cohort study, we included all adult inpatients =18 years old) with laboratory confirmed COVID 19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in hospital death.  patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48% patients had a comorbidity, with hypertension being the most common (58 [30% patients) followed by diabetes (36 [19% patients) and coronary heart disease (15 [8% patients) Multivariable regression showed increasing odds of in hospital death associated with older age (odds ratio 1*10, 95% CI 1*03 1*17, per year increase; p=0*0043) higher Sequential Organ Failure Assessment (SOFA) score (5*65, 2*61 12*23; p<0*0001) and d dimer greater than 1 mg/mL (18*42, 2*64 128*55; p=0*0033) on admission. Median duration of viral shedding was 20*0 days (IQR 17*0 24*0) in survivors, but SARS CoV 2 was detectable until death in non survivors. The longest observed duration of viral shedding in survivors was 37 days.  The potential risk factors of older age, high SOFA score, and d dimer greater than 1 mg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future.

title: Covid 19: risk factors for severe disease and death
abstract: A long list is emerging from largely unadjusted analyses, with age near the top

title: The effect of coronavirus disease 19 (COVID 19) risk perception on behavioural intention towards 'untact' tourism in South Korea during the first wave of the pandemic (March 2020)
abstract: This study highlights 'untact' tourism as a health protective behaviour stemming from individuals' perceptions of COVID 19 risk. Based on the frameworks of the Health Belief Model and the extended Theory of Planned Behaviour, this study examines the effect of COVID 19 risk perception on behavioural intention towards untact tourism. The online survey was administered to South Korean citizens in March and April 2020. A total of 877 questionnaires were used for data analysis. The results indicate that affective risk perception is a significant antecedent of attitude, while cognitive risk perception was found to positively influence subjective norms. Despite the significant influence of both cognitive and affective risk perceptions on behavioural intention, affective risk perception exerts a negative influence on behavioural intention, which is in opposition to the original hypothesis. Attitude was found to be a significant mediator between affective risk perception and behavioural intention whereas subjective norms mediated the relationship between cognitive perception and behavioural intention. Gender and marital status partially moderated the hypothesized relationships among the constructs. This study provides timely and insightful implications for tourism practitioners who will be expected to prepare the post corona field for a new normal after the experience of restricted living during an unprecedented pandemic.

title: Understanding coronavirus disease (COVID 19) risk perceptions among the public to enhance risk communication efforts: a practical approach for outbreaks, Finland, February 2020
abstract: Understanding risk perceptions of the public is critical for risk communication. In February 2020, the Finnish Institute for Health and Welfare started collecting weekly qualitative data on coronavirus disease (COVID 19) risk perception that informs risk communication efforts. The process is based on thematic analysis of emails and social media messages from the public and identifies factors linked to appraisal of risk magnitude, which are developed into risk communication recommendations together with health and communication experts.

title: The COVID 19 risk perception: A survey on socioeconomics and media attention
abstract: This brief communication examines the role of socioeconomic factors and use of social media on the risk perception about COVID 19 in Vietnam, which shares a common border with China. Moreover, Vietnam was the first country to succeed in containment of severe acute respiratory syndrome (SARS) in 2003. From a sample of 391 Vietnamese respondents aged from 15 to 47 years, the present study found that geographical regions and behaviors in using social media have a positive impact on the risk perception of COVID 19 epidemic in Vietnam. It also adds to the significance of understanding the risk perception among people to communicate the public health response to COVID 19 to curb the spread of this deadly virus.

title: Age Differences in COVID 19 Risk Perceptions and Mental Health: Evidence From a National U.S. Survey Conducted in March 2020
abstract: Theories of aging posit that older adult age is associated with less negative emotions, but few studies have examined age differences at times of novel challenges. As COVID 19 spread in the United States, this study therefore aimed to examine age differences in risk perceptions, anxiety, and depression.  In March 2020, a nationally representative address based sample of 6,666 U.S. adults assessed their perceived risk of getting COVID 19, dying if getting it, getting quarantined, losing their job (if currently working) and running out of money. They completed a mental health assessment for anxiety and depression. Demographic variables and precrisis depression diagnosis had previously been reported.  In regression analyses controlling for demographic variables and survey date, older adult age was associated with perceiving larger risks of dying if getting COVID 19, but with perceiving less risk of getting COVID 19, getting quarantined, or running out of money, as well as less depression and anxiety. Findings held after additionally controlling for precrisis reports of depression diagnosis.  With the exception of perceived infection fatality risk, U.S. adults who were relatively older appeared to have a more optimistic outlook and better mental health during the early stages of the pandemic. Interventions may be needed to help people of all ages maintain realistic perceptions of the risks, while also managing depression and anxiety during the COVID 19 crisis. Implications for risk communication and mental health interventions are discussed.

title: COVID 19 risk and outcomes in patients with substance use disorders: analyses from electronic health records in the United States
abstract: The global pandemic of COVID 19 is colliding with the epidemic of opioid use disorders (OUD) and other substance use disorders (SUD) in the United States (US) Currently, there is limited data on risks, disparity, and outcomes for COVID 19 in individuals suffering from SUD. This is a retrospective case control study of electronic health records (EHRs) data of 73,099,850 unique patients, of whom 12,030 had a diagnosis of COVID 19. Patients with a recent diagnosis of SUD (within past year) were at significantly increased risk for COVID 19 (adjusted odds ratio or AOR 8.699 [8.411 8.997] P 10 30 an effect that was strongest for individuals with OUD (AOR 10.244 [9.107 11.524] P 10 30 followed by individuals with tobacco use disorder (TUD) (AOR 8.222 [7.925 8.530] P 10 30 Compared to patients without SUD, patients with SUD had significantly higher prevalence of chronic kidney, liver, lung diseases, cardiovascular diseases, type 2 diabetes, obesity and cancer. Among patients with recent diagnosis of SUD, African Americans had significantly higher risk of COVID 19 than Caucasians (AOR 2.173 [2.01 2.349] P 10 30 with strongest effect for OUD (AOR 4.162 [3.13 5.533] P 10 25 COVID 19 patients with SUD had significantly worse outcomes (death: 9.6% hospitalization: 41.0% than general COVID 19 patients (death: 6.6% hospitalization: 30.1% and African Americans with COVID 19 and SUD had worse outcomes (death: 13.0% hospitalization: 50.7% than Caucasians (death: 8.6% hospitalization: 35.2% These findings identify individuals with SUD, especially individuals with OUD and African Americans, as having increased risk for COVID 19 and its adverse outcomes, highlighting the need to screen and treat individuals with SUD as part of the strategy to control the pandemic while ensuring no disparities in access to healthcare support.

title: Distribution of ACE2, CD147, CD26 and other SARS CoV 2 associated molecules in tissues and immune cells in health and in asthma, COPD, obesity, hypertension, and COVID 19 risk factors
abstract: Morbidity and mortality from COVID 19 caused by novel coronavirus SARS CoV 2 is accelerating worldwide, and novel clinical presentations of COVID 19 are often reported. The range of human cells and tissues targeted by SARS CoV 2, its potential receptors and associated regulating factors are still largely unknown. The aim of our study was to analyze the expression of known and potential SARS CoV 2 receptors and related molecules in the extensive collection of primary human cells and tissues from healthy subjects of different age and from patients with risk factors and known comorbidities of COVID 19.

title: COVID 19: Risk perception and Coping strategies.
abstract: This paper presents preliminary results of a representative survey of the German population focusing on perceptions of risk and ways of coping with COVID 19. Results show that older people estimate the risk of COVID 19 as being less than younger people. Women are more concerned about COVID 19 than men. People especially worry about being infected in places with high public traffic such as public transport and shops or restaurants. Coping strategies are highly problem focused and most respondents listen to experts' advice and try to behave calmly and appropriately. People accept that measures to tackle COVID 19 will take time to be effective. Bulk buying and storing of food is mainly justified by a combination of convenience and a perceived need to be prepared for potential quarantine.

title: Trends in COVID 19 Risk Adjusted Mortality Rates.
abstract: Early reports showed high mortality from coronavirus disease 2019 (COVID 19) Mortality rates have recently been lower, raising hope that treatments have improved. However, patients are also now younger, with fewer comorbidities. We explored whether hospital mortality was associated with changing demographics at a 3 hospital academic health system in New York. We examined in hospital mortality or discharge to hospice from March through August 2020, adjusted for demographic and clinical factors, including comorbidities, admission vital signs, and laboratory results. Among 5,121 hospitalizations, adjusted mortality dropped from 25.6% (95% CI, 23.2 28.1) in March to 7.6% (95% CI, 2.5 17.8) in August. The standardized mortality ratio dropped from 1.26 (95% CI, 1.15 1.39) in March to 0.38 (95% CI, 0.12 0.88) in August, at which time the average probability of death (average marginal effect) was 18.2 percentage points lower than in March. Data from one health system suggest that mortality from COVID 19 is decreasing even after accounting for patient characteristics.