The proportion of the world population aged 60 years or over is expected to increase from 12% in 2013 to 21% in 2050. This increase will represent more than 2 billion elderly individuals, including 400 million people aged 80 years or older and 3.4 million centenarians in 2050.¹ The population of individuals of advanced ages, including near-centenarians and centenarians, has become the fastest-growing segment of the population.² This growth has led to considerable concern about the social and economic burden of disease and disability in this age group, for the oldest old are vulnerable to multiple age-related chronic conditions and disabilities and are at a high risk of...

Background: To determine if alcohol consumption is a risk factor for obstructive sleep apnea (OSA) and nocturnal oxygen desaturation. Methods: This case–control study evaluated patients with confirmed OSA and a control group using polysomnography (PSG). Two doctors who have worked in this field for more than 5 years provided a blinded interpretation of the patients’ monitoring results. Logistic regression models were used to identify the odds ratio (OR) for alcohol consumption on OSA. Results: A total of 793 patients were enrolled in this study. Compared with those who did not consume alcohol, those consuming alcohol had a higher risk of OSA (OR 2.03, 95% CI 1.30–3.17) after adjustment. Regarding the risk of OSA after adjusting for former drinkers and current ones, the ORs were 1.96 (95% CI 1.19–3.22) and 2.22 (95% CI 1.06–4.63), respectively. And the P for trend = 0.002. The β of former drinkers and the current ones were 3.448 and 4.560 after adjustment; P for trend was 0.006. The relationship may have gender difference, and alcohol consumption was associated with AHI in female significantly (β = 10.190 and 15.395 for former and current drinkers, respectively, in females after adjustment, P for trend = 0.002). Conclusions: In this study, we found that alcohol consumption was an independent risk factor of OSA and OSA with hypoxia, and alcohol consumption was related to AHI significantly after adjustment, especially in female. In order to reduce the risk and severity of OSA, it is suggested that people should avoid drinking, and drinkers should abstain from drinking.

Introduction This study aimed to determine whether there is a difference in the risk of death/critical illness between different stages of hepatitis B virus (HBV) (resolved hepatitis B, HBeAg (−) chronic hepatitis B [CHB]/infection, HBeAg (+) CHB/infection, and HBV reactivation) coinfected with coronavirus disease 2019 (COVID-19); and if there is a difference, whether it is due to abnormal liver function and to what extent. Methods This cohort study included all COVID-19 inpatients of a single-center tertiary care academic hospital in Wuhan, Hubei, China, between February 4, 2020, and follow-up to April 14, 2020. A total of 2899 patients with COVID-19 were included as participants in this study, and they were divided into five groups based on hepatitis B infection status. Follow-up was conducted for mortality and ICU admission during hospitalization. Results The median follow-up time was 39 days (IQR, 30–50), with 66 deaths and 126 ICU admissions. After adjustment, compared with patients without CHB, the hazard ratio (HR) for ICU admission was 1.86 (95% CI: 1.05–3.31) for patients with HBeAg (+) CHB/infection. The HR for death was 3.19 (95% CI: 1.62–6.25) for patients with HBeAg (+) CHB/infection. The results for the mediating effect indicated that the total effect of HBeAg (+) CHB/infection on death/ICU stay was partially mediated by abnormal liver function, which accounted for 79.60% and 73.53%, respectively. Conclusion Patients with COVID-19 coinfected with HBV at the HBeAg (+) CHB/infection stage have an increased risk of poor prognosis, and abnormal liver function partially mediates this increased risk of poor prognosis caused by the coinfection.

Introduction In the present study, we aimed to describe the proportion of carbapenem-resistant Klebsiella pneumoniae bloodstream infection (CRKP-BSI) in KP-BSI in one Chinese tertiary hospital over 10 years and determine the risk factors and outcomes of CRKP-BSI. Methods We retrospectively analyzed clinical and microbiological data of patients with KP-BSI from January 2010 to December 2019 to identify risk factors, clinical features, and outcomes using multivariate logistic regression analysis. KP-BSI only included monomicrobial BSI and health care-acquired BSI. Results Among the total 687 isolates of KP-BSI in this study, the rate of CRKP was 39.0% (268/687); this rate in the intensive care unit (ICU) was 65.6% and that in seven high-risk departments (including four ICUs, respiratory medicine, gastroenterology medicine, and hepatobiliary surgery) was 74.6%. The annual rate of CRKP in KP-BSI ranged from 0.0% in 2010 to 54.5% in 2019. The 28-day mortality was 36.2% in patients with CRKP-BSI and 11.7% in those with carbapenem-susceptible K. pneumoniae (CSKP) BSI. Multivariable logistic regression analysis showed that prior ICU stay (odds ratio [OR] 2.485, P < 0.001), hospital stay ≥ 30 days prior to BSI (OR 1.815, P = 0.007), prior mechanical ventilation (OR 2.020, P = 0.014), prior urinary catheter (OR 1.999, P = 0.003), prior carbapenem use (OR 3.840, P < 0.001), hepatobiliary disease (OR 2.943, P < 0.001), pancreatitis (OR 2.700, P = 0.026), and respiratory disease (OR 2.493, P = 0.009) were risk factors of CRKP-BSI. Patients with a first admission (OR 0.662, P = 0.046) had a lower percentage of CRKP-BSI. Conclusion The rapidly rising rate of CRKP-BSI in KP with high mortality requires increased attention. Exposure to carbapenems, ICU stay, invasive mechanical ventilation or urinary catheter, prolonged hospital stay, hepatobiliary disease, pancreatitis, and respiratory disease were found to be risk factors for CRKP-BSI. Strict control measures should be implemented to prevent the emergence and spread of CRKP, especially in high-risk departments.

Background: Coronavirus Disease 2019 (COVID-19) is currently a global public health threat. Outside of China, Italy is one of the most suffering countries with the COVID-19 epidemic. It is important to predict the epidemics trend of COVID-19 epidemic in Italy to help develop public health strategies. Methods: We used time-series data of COVID-19 from Jan 22,2020 to Mar 16,2020. An infectious disease dynamic extended susceptible-infected-removed (eSIR) model, which covers the effects of different intervention measures in dissimilar periods, was applied to estimate the epidemic trend in Italy. The basic reproductive number was estimated using Markov Chain Monte Carlo methods and presented using the resulting posterior mean and 95% credible interval (CI). Hunan, with similar total number of populations in Italy, was used as a comparative item. Results: In the eSIR model, we estimated that the basic reproductive number for COVID-19 was respectively 4.10 (95% CI: 2.15–6.77) in Italy and 3.15(95% CI: 1.71–5.21) in Hunan. There would be totally 30 086 infected cases (95%CI:7920-81 869) under the current country blockade and the endpoint would be Apr 25 (95%CI: Mar 30 to Aug 07) in Italy. If the country blockade is imposed 5 day later, the total number of infected cases would expand the infection scale 1.50 times. Conclusion: Italy’s current strict measures can efficaciously prevent the further spread of COVID-19 and should be maintained. Necessary strict public health measures be implemented as soon as possible in other European countries with a high number of COVID-19 cases. The most effective strategy needs to be confirmed in further studies.