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1. A multinational Delphi consensus to end the COVID-19 public health threat

Author

Lazarus, Jeffrey V., Romero, Diana, Kopka, Christopher J., Karim, Salim Abdool, Abu-Raddad, Laith J., Almeida, Gisele, Baptista-Leite, Ricardo, Barocas, Joshua A., Barreto, Mauricio L., Bar-Yam, Yaneer, Bassat, Quique, Batista, Carolina, Bazilian, Morgan, Chiou, Shu-Ti, del Rio, Carlos, Dore, Gregory J., Gao, George F., Gostin, Lawrence O., Hellard, Margaret, Jimenez, Jose L., Kang, Gagandeep, Lee, Nancy, Matičič, Mojca, McKee, Martin, Nsanzimana, Sabin, Oliu-Barton, Miquel, Pradelski, Bary, Pyzik, Oksana, Rabin, Kenneth, Raina, Sunil, Rashid, Sabina Faiz, Rathe, Magdalena, Saenz, Rocio, Singh, Sudhvir, Trock-Hempler, Malene, Villapol, Sonia, Yap, Peiling, Binagwaho, Agnes, Kamarulzaman, Adeeba, El-Mohandes, Ayman, Barreto, Mauricio, Abdulla, Salim, Addleman, Sarah, Aghayeva, Gulnara, Agius, Raymond, Ahmed, Mohammed, Ramy, Mohamed Ahmed, Aide, Pedro, Aleman, Soo, Alfred, Jean-Patrick, Ali, Shamim, Aliaga, Jorge, Aloudat, Tammam, Alqahtani, Saleh A., Al-Salman, Jameela, Amuasi, John H., Agrawal, Anurag, Anwar, Wagida, Araujo-Jorge, Tania, Artaza, Osvaldo, Asadi, Leyla, Awuku, Yaw, Baker, Michael, Barberia, Lorena, Bascolo, Ernesto, Belcher, Paul, Bell, Lizett, Benzaken, Adele, Bergholtz, Emil, Bhadelia, Nahid, Bhan, Anant, Bilodeau, Stephane, Bitrán, Ricardo, Bluyssen, Philomena, Bosman, Arnold, Bozza, Fernando A., Brinkmann, Melanie M., Brown, Andrew, Mellado, Bruce, Bukusi, Elizabeth, Bullen, Chris, Buonanno, Giorgio, Burgess, Rochelle, Butler, Matthew, Byakika-Kibwika, Pauline, Cabieses, Baltica, Carlsson, Gunilla, Cascini, Fidelia, Chabala, Chishala, Chakroun, Mohamed, Cheng, null, Chetty, Agnes, Chumachenko, Dmytro, Consalves, Gregg, Conway Morris, Andrew, Cordie, Ahmed, Corrah, Tumani, Crabtree-Ramírez, Brenda, Dashdorj, Naranjargal, Davidovitch, Nadav, de Souza, Luis Eugenio, Dhariwal, Akshay Chand, Druică, Elena, Ergonul, Onder, Erondu, Ngozi A., Essar, Mohammad Yasir, Ewing, Andrew, Fanjul, Gonzalo, Feierstein, Daniel, Feigl-Ding, Eric, Figueroa, Ramon, Figueroa, John Peter, Fisher, Dale, Flores, Walter, Forero-Peña, David A., Frumkin, Howard, Gamkrelidze, Amiran, Gandhi, Monica, Garcia, Patricia, Garcia-Basteiro, Alberto L., García-Sastre, Adolfo, Garg, Suneela, Gbeasor-Komlanvi, null, Gershenson, Carlos, Gilada, Ishwar, Giovanella, Ligia, González, Marino, Green, Manfred S., Greenhalgh, Trisha, Griffin, Paul, Griffin, Stephen, Grinsztejn, Beatriz, Anand, Tanu, Guerra, Germán, Guinto, Renzo, Gujski, Mariusz, Guner, Rahmet, Hamdy, Adam, Hâncean, Marian-Gabriel, Haniffa, Abusayeed, Hartigan-Go, Kenneth Y., Hassan, Hoda K., Hay, Simon I., Heino, Matti T. J., Hel, Zdenek, Hotez, Peter, Hu, Jia, Hukić, Mirsada, IJsselmuiden, Carel, Iroko, Davidson, Iskarous, Maged, Izugbara, Chimaraoke, Jacobs, Choolwe, Jadad, Alejandro R., Jehan, Fyezah, Jordan, Ayana, Jroundi, Imane, Kain, Kevin, Kamberi, Fatjona, Karamov, Eduard, Karan, Abraar, Katz, Rebecca, Katzourakis, Aris, Kazembe, Abigail, Khamis, Faryal, Khamzayev, Komiljon, Khanyola, Judy, Khunti, Kamlesh, Kiguli-Malwadde, Elsie, Kim, Woo Joo, Kirenga, Bruce J., Klimovský, Daniel, Kmush, Brittany L., Knaul, Felicia, Kogevinas, Manolis, Kristensen, Frederik, Kumar, Dinesh, Kumar, Raman, Kvalsvig, Amanda, Lacerda, Marcus V., Lal, Arush, Lawton, Tom, Lemery, Jay, Leonardi, Anthony J., Li, Yuguo, Löttvall, Jan, Lounis, Mohamed, Maceira, Daniel, MacIntyre, C. Raina, Madani, Azzeddine, Magiorkinis, Gkikas, Malekzadeh, Reza, Choisy, Marc, Marcelin, Jasmine R., Marks, Guy B., Marr, Linsey, Marrazzo, Jeanne, Martina, Antonieta, Martín-Moreno, José M., Mateos, Carlos, Mayxay, Mayfong, Mazarati, Jean Bapiste, Mboup, Souleymane, McDonald, Jennifer, McMillan, Faye, Mechili, Enkeleint, Medici, Andre, Davis, Sarah L. M., Meier, Petra, Memish, Ziad A., Menon, Jaideep, Menon, Purnima, Mesiano-Crookston, Jonathan, Michie, Susan, Mikolasevic, Ivana, Milicevic, Ognjen, Mishra, Asit Kumar, Mohamed, Rahma, Mokdad, Ali H., Monroy-Valle, Michele, Morawska, Lidia, Moschos, Sterghios A., Motawea, Karam, Mousavi, Sayed Hamid, Mumtaz, Ghina, Munene, Peter K., Muñoz Almagro, Carmen, Muriuki, Janet, Muyingo, Sylvia, Naniche, Denise, Naylor, C. David, Ndembi, Nicaise, Nemec, Juraj, Nesteruk, Igor, Ngaruiya, Christine, Nguyen, Hung, Nikolova, Dafina, Nitzan, Dorit, Norheim, Ole, Noushad, Mohammed, Ntoumi, Francine, Nyborg, Gunhild Alvik, Ochodo, Eleanor, Odabasi, Zekaver, Okwen, Mbah Patrick, Olivia, Keiser, Ong, David S. Y., Opara, Ijeoma, Orozco, Miguel, Oshitani, Hitoshi, Pagel, Christina, Pai, Madhukar, Pálsdóttir, Björg, Papatheodoridis, Georgios, Paraskevis, Dimitrios, Leigh, Jeanna Parsons, Pécoul, Bernard, Peichl, Andreas, Perez-Then, Eddy, Duc, Phuc Pham, Philippe, Cécile, Pineda Rojas, Andrea, Pladsen, Courtney, Pozniak, Anton, Quiroga, Rodrigo, Qureshi, Huma, Rampal, Sanjay, Ranney, Megan, Rathe, Laura, Ratzan, Scott, Raventos, Henriette, Rees, Helen, Reis, Renata, Ricciardi, Walter, Rizk, Nesrine, Robalo, Magda, Robertson, Eleanor, Robinson, Leanne, Rokx, Casper, Ros, Tamsin, Røttingen, John-Arne, Rubin, Meir, Ruxrungtam, Kiat, Sadirova, Shakhlo, Saha, Senjuti, Salgado, Nelly, Sanchez, Lizet, Sangaramoorthy, Thurka, Santamaria-Ulloa, Carolina, Santos, Renata, Sawaf, Bisher, Schneider, Matthias F., Schooley, Robert T., Sener, Alper, Sepulveda, Jaime, Shah, Jaffer, Shibani, Mosa, Shoib, Sheikh, Sikazwe, Izukanji, Šimaitis, Aistis, Gill, Amandeep Singh, Skhvitaridze, Natia, Sokolović, Milka, Solomon, Roma, Solórzano, Xavier, Springer, Sandra A., Šrol, Jakub, Staines, Anthony, Stelfox, Henry T., Strathdee, Steffanie, Sulaiman, Lokman Hakim, Sutton, Brett, Svanæs, Dag, Swed, Sarya, Sypsa, Vana, Sørensen, Kristine, Tajudeen, Raji, Tan, Amy, Tang, Julian, Tanner, Marcel, Sethi, Tavpritesh, Temmerman, Marleen, Than, Kyu Kyu, Tinto, Halidou, Tomètissi, Sênoudé Pacôme, Torres, Irene, Tshering, null, Tsiodras, Sotirios, Tsofa, Benjamin, Vahlne, Anders, Vargas, Juan Rafael, Bernal, Ivan Dario Velez, Ventura, Deisy, Vilasanjuan, Rafael, Vipond, Joe, Wamala-Andersson, Sarah, Wargocki, Pawel, West, Robert, Weyand, Angela, White, Trenton M., Wolff, Guntram, Yao, Maosheng, Yates, Christian A., Yeboah, Georgina, Yee-Sin, Leo, Yi, Siyan, Teo, Yik-Ying, Yong, Poovorawan, Zamora-Mesía, Victor, Øvrehus, Anne, 0000-0001-9618-2299, 0000-0002-4832-9564, 0000-0002-4986-2133, 0000-0003-0790-0506, 0000-0003-0875-7596, 0000-0002-6994-1891, 0000-0002-3869-615X, 0000-0001-5286-4044, 0000-0001-6203-1847, 0000-0002-0121-9683, 0000-0003-1793-6350, 0000-0003-2418-0037, 0000-0002-5095-748X, 0000-0003-4492-3256, 0000-0002-5964-8210, 0000-0002-6779-3151, 0000-0002-8074-4450, Lazarus, Jeffrey V [0000-0001-9618-2299], Romero, Diana [0000-0002-4832-9564], Karim, Salim Abdool [0000-0002-4986-2133], Abu-Raddad, Laith J [0000-0003-0790-0506], Bassat, Quique [0000-0003-0875-7596], Chiou, Shu-Ti [0000-0002-6994-1891], Gao, George F [0000-0002-3869-615X], Gostin, Lawrence O [0000-0001-5286-4044], Jimenez, Jose L [0000-0001-6203-1847], McKee, Martin [0000-0002-0121-9683], Oliu-Barton, Miquel [0000-0003-1793-6350], Pradelski, Bary [0000-0003-2418-0037], Rathe, Magdalena [0000-0002-5095-748X], Trock-Hempler, Malene [0000-0003-4492-3256], Yap, Peiling [0000-0002-5964-8210], Binagwaho, Agnes [0000-0002-6779-3151], Kamarulzaman, Adeeba [0000-0002-8074-4450], Apollo - University of Cambridge Repository, Helsinki Collegium for Advanced Studies, Research Group of Nelli Hankonen, Doctoral Programme in Social Sciences, Academic Disciplines of the Faculty of Social Sciences, RS: CAPHRI - R2 - Creating Value-Based Health Care, International Health, Performance analysis and optimization of LARge Infrastructures and Systems (POLARIS), Inria Grenoble - Rhône-Alpes, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Laboratoire d'Informatique de Grenoble (LIG), Université Pierre Mendès France - Grenoble 2 (UPMF)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Institut National Polytechnique de Grenoble (INPG)-Centre National de la Recherche Scientifique (CNRS)-Université Pierre Mendès France - Grenoble 2 (UPMF)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Institut National Polytechnique de Grenoble (INPG)-Centre National de la Recherche Scientifique (CNRS), Internal Medicine, Medical Microbiology & Infectious Diseases, Veritati - Repositório Institucional da Universidade Católica Portuguesa, and Lazarus J. V., Romero D., Kopka C. J., Karim S. A., Abu-Raddad L. J., Almeida G., Baptista-Leite R., Barocas J. A., Barreto M. L., Bar-Yam Y., et al.

Subjects
Pandemics/economics, BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences, COVID-19 Vaccines, Delphi Technique, General Science & Technology, International Cooperation, Temel Bilimler (SCI), ÇOK DİSİPLİNLİ BİLİMLER, Public Health/economics, [SHS]Humanities and Social Sciences, SDG 3 - Good Health and Well-being, RA0421 Public health. Hygiene. Preventive Medicine, Medicine and Health Sciences, Humans, prevention and control, human, Settore MED/42 - IGIENE GENERALE E APPLICATA, Health Education, Pandemics, Multidisipliner, Organizations, Multidisciplinary, MULTIDISCIPLINARY SCIENCES, COVID-19/economics, Temel Bilimler, pandemic, Communication, Health Policy, BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti, Doğa Bilimleri Genel, COVID-19, 3142 Public health care science, environmental and occupational health, Delphi study, NATURAL SCIENCES, GENERAL, N/A, Public Opinion, Government, Natural Sciences (SCI), Public Health, Natural Sciences
Abstract

Despite notable scientific and medical advances, broader political, socioeconomic and behavioural factors continue to undercut the response to the COVID-19 pandemic . Here we convened, as part of this Delphi study, a diverse, multidisciplinary panel of 386 academic, health, non-governmental organization, government and other experts in COVID-19 response from 112 countries and territories to recommend specific actions to end this persistent global threat to public health. The panel developed a set of 41 consensus statements and 57 recommendations to governments, health systems, industry and other key stakeholders across six domains: communication; health systems; vaccination; prevention; treatment and care; and inequities. In the wake of nearly three years of fragmented global and national responses, it is instructive to note that three of the highest-ranked recommendations call for the adoption of whole-of-society and whole-of-government approaches , while maintaining proven prevention measures using a vaccines-plus approach that employs a range of public health and financial support measures to complement vaccination. Other recommendations with at least 99% combined agreement advise governments and other stakeholders to improve communication, rebuild public trust and engage communities in the management of pandemic responses. The findings of the study, which have been further endorsed by 184 organizations globally, include points of unanimous agreement, as well as six recommendations with >5% disagreement, that provide health and social policy actions to address inadequacies in the pandemic response and help to bring this public health threat to an end.

Published
2022
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2. Age and frailty are independently associated with increased covid-19 mortality and increased care needs in survivors: results of an international multi-centre study

Author

Alsahab, Mustafa, Beishon, Lucy, Brown, Bryony, Burn, Elinor, Burton, Jenni K, Cox, Natalie, Dani, Melanie, Elhadi, Muhammed, Freshwater, Sarah, Gaunt, Victoria, Gordon, Adam, Goujon, Marie, Hale, Matthew, Hughes, Terry, Jackson, Thomas A, Jelley, Benjamin, Khan, Asma, Khiroya, Heena, Lal, Rajni, Madden, Katy, Magill, Laura, Masoli, Jane, Masud, Tahir, McCluskey, Lauren, McNeela, Natalie, Mohammedseid-Nurhussien, Awolkhier, Moorey, Hannah, Lochlainn, Mary Ni, Nirantharakumar, Krishnarajah, Okoth, Kelvin, Osuafor, Christopher N, Patterson, Katherine, Pearson, Grace M E, Perry, Rita, Pettitt, Michala, Pigott, Jennifer, Pinkney, Thomas, Quinn, Terence, Reynolds, Abigail, Richardson, Sarah, Sanyal, Nik, Seed, Adam, Sleeman, Isobel, Soo, Chee, Steves, Claire, Strain, W David, Taylor, Joanne, Torsney, Kelli, Welch, Carly, Wilson, Daisy, Witham, Miles, Elazeem, Hossam Aldein S Abd, Abdelhafez, Mohammed H, Abdelmalak, Amir, Abdelwahab, Omar A, Abdulhadi, Osama M A S, Adewole, Olubayode, Ahmad, Mohammed, Ahmed, Eltayeb A, Ahmed, Hazem, Ahmed, Islam A, Akcay, Mertcan, Akdeniz, Yeşim, Akın, Emrah, Akladious, Carolyn, Alessandri, Francesco, Ali, Ali, Aljafari, Abdulmalek, Aljafari, Abdulmoiz, Al-Sadawi, Mohammed, Al-Sodani, Lobna, Altintoprak, Fatih, Amaratungaz, Gitanjali, Amer, Jocelyn, Amini, Sylvia, Amir, Taha, Anandarajah, Cheran, Anders, Rachael, Ansari, Muhammed H, Appiah, Kingsley, Atia, Jolene, Atkin, Catherine, Aujayeb, Avinash, Awad, Elsayed M, Azab, Mohammed A, Azam, Mohammad T, Aziz, Sally, Azzam, Ahmed Y, Babar, Laxmi, Babb, Laura, Badh, Manpreet, Baguneid, Clare, Bailey, Emily, Baili, Efstratia, Baldwin, Sarah, Baloyiannis, Ioannis, Bannerjee, Moulinath, Barnard, Anna, Barra, Fabio, Bashir, Hannah, Bawor, Monica, Bayhan, Zülfü, Belcher, James, Belgamwar, Ravindra, Bentley, Corrina, Birchenough, Amy, Bo, Yen Nee J, Boden, Hayley R, Bouhuwaish, Ahmad, Brachini, Gioia, Bremner, Laura, Bridgwater, Hannah, Bryant, Catherine, Budd, Gabrielle, Budd, Sharon, Budzikoski, Adam, Bulla, Reem, Buondonno, Antonio, Burden, Nicole, Butt, Hejab, Capoglu, Recayi, Caracostea, Andra, Cardoso, Rifa, Carr, Alexis, Carrasco-Prats, Milagros, Cattel, Caterina, Ceccarelli, Giancarlo, Cecere, Giuseppe, Charalabopoulos, Alexandros, Charsley, Evelyn, Cheney-Lowe, Hannah, Chevallier, Theodore, Choudhry, Asad J, Ciccarone, Flavia, Cicerchia, Pierfranco M, Cirillo, Bruno, Collins, Fatma D, Comerford, Victoria, Cordie, Ahmed, Coulter, Siobhan, Coulthard, Nick, Cox, Catrin, Cox, Victoria, Crowe, Andrew, Cullen, Jack, Cummings, Jean, Cunningham, Niamh, Curley, Daniel, Currie, Hannah, Daly, Madeleine, Darley, Jay, Dattani, Nikhita, Davakis, Spyridon, Davies, Rowan, De Paola, Gilda, De Toma, Giorgio, Del Valle-Ruiz, Sergio, Deldar, Benyamin, Demir, Hakan, Desai, Arjun, Desai, Nirali, Devaney, Alice, Dew, Lindsey, Dhesi, Jugdeep, Dias, Maria, Dick, Gordon, Doddamani, Parveen, Dogra, Gurinder, Doll, Tina, Dooley, Hannah C, Dost, Samiullah, Dotchin, Catherine, Dowell, Hannah, Draghita, Ioan M, Dundas, James M, Duranti, Giulia, Dusara, Hiren, Dwivedi, Rajesh, Dyer, Adam H, Eastaugh, Alison, Edwards, Elinor, Elghazaly, Shrouk M, Elmehrath, Ahmed O, Elrick, Hope, El-Shazly, Mostafa, Emery, Alexander, Etchill, Eric W, Evans, Sarah, Evison, Felicity, Fairhead, Cassandra, Faulkner, Margherita, Felska, Agnieszka, Fernandez, Antia, Fernández-Fernández, Pedro V, Ferraiolo, Antonella, Ferrero, Simone, Fiori, Enrico, Firat, Necattin, Fisk, Gracie, Fleck, Anna, Fonsi, Giovanni B, Gabre-Kidan, Alodia, Gallo, Gaetano, Gandhi, Ratnam, Garner, Madeleine, Georgiou, Nikolaos, Gerretsen, Hannah, Ghannam, Nourhan A A, Ghobrial, Andrew, Ghobrial, Hedra, Ghufoor, Zaynub, Gibbon, Jake, Gilbert, Georgia F, Giles, Marie, Giménez-Francés, Clara, Gonullu, Emre, Gray, Amy, Gray, Joshua H, Green, Deirdre, Greene, Charlotte, Griffin, Ellanna, Griffith, Karla, Grubb, Anthony, Guan, Yue, Guerero, Daniel N, Gupta, Ayushi, Gustavino, Claudio, Guzman, Laurenny, Hadreiez, Ahmed K M, Hajiioannou, Jiannis, Hanji, Deevia, Madhavan, Deepthy Hari, Harmantepe, Tarık, Harrison, Patrick, Hart, Barbara, Haslam, Aidan, Haunton, Victoria, Haut, Elliott R, Heinsohn, Torben, Hennah, Lindsay, Hetta, Helal F, Hickman, Alexander, Hobill, Abigail, Hogan, Patrick C P, Hogan, Vesna, Holmes, Elizabeth, Honney, Katie, Hood, Katharine, Hopkinson, Katherine, Howells, Lara, Hrouda, Nicole, Hunsley, Danielle, Hurst, William, Hussein, Rand A, Ibrahim, Mohamed Eltaher A A, Ibtida, Ishmam, Ibukunoluwakitan, Aina, Ishlek, Irem, Iyer, Rishi, Jackson, Karl, Jackson, Rosie, James, Ellen, Jarvis, Hayley, Jeffs, Sophie, Jenko, Nathan, Jeyakumar, Sasha, Kabir, Shahriar, Kainth, Harjinder, Kalloo, Jason, Kanzaria, Akhil, Karapanou, Amalia, Kardaman, Nuha, Karthikeyan, Sandeep, Karunatilleke, Anne, Kelly, Mairead, Kelly, Nicola I, Khalid, Hesham, Khan, Haris, Khan, Muhammad S, King, Matthew, Kneen, Thomas, Kok, Li, Kratochwila, Chiara, Kuzeva, Aneliya, Lapolla, Pierfrancesco, Lau, Rebecca, Law, Kar Yee, Leadbetter, Aimee, Lee, Gabriel, Lee, Helena, Levinson, Gavriella, Lewis, Grace, Liakakos, Theodore, Lim, Stephen, Lis, Danielle, Livesey, Emma, López-Morales, Pedro, Lowes, Lily, Lunt, Eleanor, Lyon, Emily, Madan, Suvira, Majid, Zeinab, Malapati, Harsha, Man, Jade, Mandane, Baguiasri, Manning, Sarah H, Mantoglu, Baris, Martínez-Sanz, Nuria, Marx, William, Masood, Almontacer E B, Maughan, Tom, Mawhinney, Jamie, Maxfield, Dominic, Mayer, Jordan, Maynard, Henry, McDonald, Claire, McGovern, Aine, Mclachlan, Sophie, Medina-Manuel, Esther, Meneghini, Simona, Metcalf, Michelle, Millwood-Hargrave, John, Mingoli, Andrea, Miu, Kelvin, Mohamed, Fawsiya, Mohamed, Soha M, Hussein, Aliae A R Mohamed, Mohammad, Abdulkader, Mohammed, Aaliya, Momen, Ahmed A, Moomo, Farhana, Mora-Guzmán, Ismael, Moriarty, Lizzie, Morrin, Hamilton, Morris, Claire, Moss, Nicholas, Moustafa, Mohamed M, Mpoura, Maria, Mubin, Mohammed, Muhtaroglu, Ali, Muir, Georgina, Mulhern, Stephanie, Muller, Daniel, Murphy, Declan C, Muzammil, Bushra, Nadkarni, Varun, Nageh, Mariam Albatoul, NasrEldin, Yasmin K, Nawaz, Wasim, Nguyen, Hanna, Cheallaigh, Cliona Ni, Noar, Alexander, North, Samuel, Nwolu, Favour, O’Docherty, Alice, Odutola, Omoteniola, O’Dwyer, Sinead, Ogochukwu, Olebu, O’Mahony, Catherine, Orlando, Lia, Osterdahl, Marc, Page, Christina, Panayotidis, Ismini, Pancholi, Shivam, Parkin, Jessica, Passby, Lauren C, Pastor-Pérez, Patricia, Patel, Harnish, Patel, Shefali, Penfold, Rose, Perinpanathan, Rupini, Perivoliotis, Konstantinos, Perra, Teresa, Pinkney, Martha, Pinotti, Enrico, Porcu, Alberto, Price, Angeline, Pugliese, Francesco, Puri, Prabhleen, Pytraczyk, Sylvia, Qaiser, Yusra, Qurashi, Maria, Radenkovic, Dina, Rajeswaran, Thurkka, Rapaport, Sarah F, Razzak, Tahmina, Reilly, Lara, Reynolds, Paul, Richardson, Alexandra, Roberts, Amelia, Roberts-Rhodes, Charlotte, Robinson, Tanya, Rocca, Aldo, Ross-Skinner, Emily, Ruiz-Marín, Miguel, Ryall, Rebecca, Saad, Alshaimaa M, Saad, Mahmoud M, Sadiq, Ambreen, Sammarco, Giuseppe, Sampanis, Michail A, Sanghvi, Hazel, Sapienza, Paolo, Sayers, Ross, Scott, Luca, Sen, Michael, Shaban, Mosab A A, Shakespeare, Kathleen T, Shaw, Ellie, Shaw, Hannah, Sheldrake, Jonathan, Sim, Sing Yang, Simonelli, Luigi, Sipsas, Nikolaos V, Sivam, Jarita, Sivarajan, Sri, Smith, Jennifer, Speranza, Fabio, Spice, Claire, Stafford, Amanda, Stambollouian, Katharine, Stevens, Kent A, Stewart, Jack, Stratton, Emma, Street, Hannah, Surtees, Michael, Swinnerton, Emma, Taher, Ahmed S A, Tait, Caroline, Taylor, Amybel, Thake, Miriam, Thin, Katie, Thould, Hannah, Thyn, Thyn, To, Benjaman, Tobiss, Hannah, Toppley, Kathryn, Townsend, Liam, Tullo, Ellen, Tzovaras, George, Umeadi, Anthony, Vaidya, Hrisheekesh, Valero-Soriano, María, Varden, Rosanna, Vergani, Vittoria, Vervoort, Dominique, Vescio, Giuseppina, Vettasseri, Mark, Virk, Madiha, Vyas, Vaishali, Wagland, Joanne, Wallis, Stephanie, Warner, Chloe, Watkins, Eleanor, Watson, Hannah, Webb, Rachael, Welsh, Sarah H, West, Ruth, Whelan, Elisha, Whitney, Julie, Whitsey, Mark, Wilcock, Catherine, Wilkinson, Iain, Williams, David, Williamson, Megan, Willott, Ruth H, Wimalasundera, Mettha, Win, Yu Lelt, Winter, Laura, Worrall, Stephanie, Wright, Rebecca, Yeo, Natalie, Yeung, Eirene, Yigit, Merve, Yildiz, Yasin A, Yusuf, Humza, Zambon, Martina, Zaw, Hein, and Elabedeen, Omar Zein

Subjects
Male, Aging, medicine.medical_specialty, Frail Elderly, COVID-19, delirium, frailty, mortality, transitions of care, Cohort Studies, AcademicSubjects/MED00280, Interquartile range, Internal medicine, medicine, Dementia, Humans, Survivors, Aged, Proportional hazards model, business.industry, SARS-CoV-2, Hazard ratio, Odds ratio, General Medicine, medicine.disease, Confidence interval, frailty,COVID-19, Ageing, Delirium, Female, medicine.symptom, Geriatrics and Gerontology, business, Cohort study, Research Paper
Abstract

Introduction Increased mortality has been demonstrated in older adults with coronavirus disease 2019 (COVID-19), but the effect of frailty has been unclear. Methods This multi-centre cohort study involved patients aged 18 years and older hospitalised with COVID-19, using routinely collected data. We used Cox regression analysis to assess the impact of age, frailty and delirium on the risk of inpatient mortality, adjusting for sex, illness severity, inflammation and co-morbidities. We used ordinal logistic regression analysis to assess the impact of age, Clinical Frailty Scale (CFS) and delirium on risk of increased care requirements on discharge, adjusting for the same variables. Results Data from 5,711 patients from 55 hospitals in 12 countries were included (median age 74, interquartile range [IQR] 54–83; 55.2% male). The risk of death increased independently with increasing age (>80 versus 18–49: hazard ratio [HR] 3.57, confidence interval [CI] 2.54–5.02), frailty (CFS 8 versus 1–3: HR 3.03, CI 2.29–4.00) inflammation, renal disease, cardiovascular disease and cancer, but not delirium. Age, frailty (CFS 7 versus 1–3: odds ratio 7.00, CI 5.27–9.32), delirium, dementia and mental health diagnoses were all associated with increased risk of higher care needs on discharge. The likelihood of adverse outcomes increased across all grades of CFS from 4 to 9. Conclusion Age and frailty are independently associated with adverse outcomes in COVID-19. Risk of increased care needs was also increased in survivors of COVID-19 with frailty or older age.

Published
2021

3. Transarterial Chemoembolization Combined with Either Radiofrequency or Microwave Ablation in Management of Hepatocellular Carcinoma

Author

Abdelaziz, Ashraf Omar, Abdelmaksoud, Ahmed Hosni, Nabeel, Mohamed Mahmoud, Shousha, Hend Ibrahim, Cordie, Ahmed Abdelmonem, Mahmoud, Sherif Hamdy, Medhat, Eman, Omran, Dalia, and Elbaz, Tamer Mahmoud

Subjects
Hepatocellular carcinoma, microwave ablation, radiofrequency ablation, Research Article
Abstract

Introduction: Local ablative therapy and trans arterial chemoembolization (TACE) are applied to ablate non resectable hepatocellular carcinoma (HCC). Combination of both techniques has proven to be more effective. We aimed to study combined ablation techniques and assess survival benefit comparing TACE with radiofrequency (RFA) versus TACE with microwave (MWA) techniques. Methods: We retrospectively studied 22 patients who were ablated using TACE-RFA and 45 with TACE-MWA. All were classified as Child A-B and lesions did not exceed 5 cm in diameter. TACE was followed within two weeks by either RFA or MWA. We recorded total and partial ablation rates and complication rates. Survival analysis was then performed. Results: TACE-MWA showed a higher tendency to provide complete response rates than TACE-RFA (P 0.06). This was particularly evident with lesions sized 3-5 cm (P 0.01). Rates of complications showed no significant difference between the groups. Overall median survival was 27 months. The overall actuarial probability of survival was 80.1% at 1 year, 55% at 2 years, and 36.3% at 3 years. The recurrence free survival at 1 year, 2years and 3 years for the TACE-RFA group was 70%, 42% and 14% respectively and for TACE-MWA group 81.2%, 65.1% and 65.1% without any significant difference (P 0.1). In relation to the size of focal lesions, no statistically significant difference in the survival rates was detected between the groups. Conclusion: TACE-MWA led to better response rates than TACE-RFA with tumors 3-5 cm, with no difference in survival rates.

Published
2017

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