Publications by authors named "Manuel Fenech"

4 Publications

  • Page 1 of 1

The first wave of COVID-19 in Malta; a national cross-sectional study.

PLoS One 2020 15;15(10):e0239389. Epub 2020 Oct 15.

Department of Infectious Diseases, Mater Dei Hospital, Msida, Malta.

Introduction: The COVID-19 pandemic has posed major challenges to all aspects of healthcare. Malta's population density, large proportion of elderly and high prevalence of diabetes and obesity put the country at risk of uncontrolled viral transmission and high mortality. Despite this, Malta achieved low mortality rates compared to figures overseas. The aim of this paper is to identify key factors that contributed to these favorable outcomes.

Methods: This is a retrospective, observational, nationwide study which evaluates outcomes of patients during the first wave of the pandemic in Malta, from the 7th of March to the 24th of April 2020. Data was collected on demographics and mode of transmission. Hospitalization rates to Malta's main general hospital, Mater Dei Hospital, length of in-hospital stay, intensive care unit admissions and 30-day mortality were also analyzed.

Results: There were 447 confirmed cases in total; 19.5% imported, 74.2% related to community transmission and 6.3% nosocomially transmitted. Ninety-three patients (20.8%) were hospitalized, of which 4 were children. Patients with moderate-severe disease received hydroxychloroquine and azithromycin, in line with evidence available at the time. A total of 4 deaths were recorded, resulting in an all-cause mortality of 0.89%. Importantly, all admitted patients with moderate-severe disease survived to 30-day follow up.

Conclusion: Effective public health interventions, widespread testing, remote surveillance of patients in the community and a low threshold for admission are likely to have contributed to these favorable outcomes. Hospital infection control measures were key in preventing significant nosocomial spread. These concepts can potentially be applied to stem future outbreaks of viral diseases. Patients with moderate-severe disease had excellent outcomes with no deaths reported at 30-day follow up.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0239389PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7561161PMC
October 2020

Vitamin D status in chronic fatigue syndrome/myalgic encephalomyelitis: a cohort study from the North-West of England.

BMJ Open 2017 Nov 8;7(11):e015296. Epub 2017 Nov 8.

Department of Musculoskeletal Biology, Institute of Ageing and Chronic Disease, MRC-Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing, University of Liverpool, Liverpool, UK.

Objective: Severe vitamin D deficiency is a recognised cause of skeletal muscle fatigue and myopathy. The aim of this study was to examine whether chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is associated with altered circulating vitamin D metabolites.

Design: Cohort study.

Setting: UK university hospital, recruiting from April 2014 to April 2015.

Participants: Ninety-two patients with CFS/ME and 94 age-matched healthy controls (HCs).

Main Outcome Measures: The presence of a significant association between CFS/ME, fatigue and vitamin D measures.

Results: No evidence of a deficiency in serum total 25(OH) vitamin D (25(OH)D and 25(OH)D metabolites) was evident in individuals with CFS/ME. Liquid chromatography tandem mass spectrometry (LC-MS/MS) analysis revealed that total 25(OH)D was significantly higher (p=0.001) in serum of patients with CFS/ME compared with HCs (60.2 and 47.3 nmol/L, respectively). Analysis of food/supplement diaries with WinDiets revealed that the higher total 25(OH) vitamin D concentrations observed in the CFS/ME group were associated with increased vitamin D intake through use of supplements compared with the control group. Analysis of Chalder Fatigue Questionnaire data revealed no association between perceived fatigue and vitamin D levels.

Conclusions: Low serum concentrations of total 25(OH)D do not appear to be a contributing factor to the level of fatigue of CFS/ME.
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http://dx.doi.org/10.1136/bmjopen-2016-015296DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5695299PMC
November 2017

Authors' reply to Kremer and Van de Perre.

BMJ 2015 Mar 10;350:h1308. Epub 2015 Mar 10.

London School of Hygiene and Tropical Medicine, London, UK.

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http://dx.doi.org/10.1136/bmj.h1308DOI Listing
March 2015

Ebola virus disease.

BMJ 2014 Dec 10;349:g7348. Epub 2014 Dec 10.

London School of Hygiene and Tropical Medicine, London, UK.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4707720PMC
http://dx.doi.org/10.1136/bmj.g7348DOI Listing
December 2014