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      Public interest in musculoskeletal symptoms and disorders during the COVID-19 pandemic : Infodemiology study Translated title: Öffentliches Interesse an muskuloskeletalen Symptomen und Erkrankungen während der COVID-19-Pandemie : Infodemiologiestudie

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          Abstract

          Objective

          The goal was to assess public interest in a wide range of musculoskeletal symptoms and disorders during the coronavirus disease 2019 (COVID-19) pandemic.

          Methods

          We searched Google Trends for 118 search queries within the United States. We compared two timeframes of 2020 (March 15–July 4 and July 5–October 31) to similar timeframes over the four prior years (2016–2019).

          Results

          In the early pandemic, March 15–July 4, a statistically significant decrease in relative search volume of the majority of queries (60%) was detected, with a significant increase in only 2 queries (i.e. myalgia and toe swelling). In the phase July through October, a statistically significant decrease was detected in only 22% of search queries; there was no difference for 60% of search queries between 2020 and 2016–2019 suggesting a return to their prior levels for most of search queries. Interestingly, the search volume of 18% of search queries (i.e. fatigue, joint pain, muscle pain, myalgia, spondylosis, radiculopathy, myelopathy, neck pain, neck strain, lower back strain, sciatica, shoulder pain, frozen shoulder, elbow pain, lateral epicondylitis, wrist pain, carpal tunnel, hand pain, finger pain, trigger finger, and Morton’s neuroma) was significantly increased compared with the four prior years.

          Conclusion

          Public interest focused on COVID-19 and sought online information for COVID-19 symptoms in the early pandemic. In the period July through October, there was an upward trend in musculoskeletal symptoms and some colloquial terms/well-known musculoskeletal conditions coupled with a downward trend in general musculoskeletal disorder terms and certain specific diagnoses. This information may help rheumatologists understand public interest in musculoskeletal symptoms and disorders and address the needs of patients to mitigate the negative impact of the pandemic on outcomes.

          Supplementary Information

          The online version of this article (10.1007/s00393-021-00989-2) includes Table 1. Article and supplementary material are available at www.springermedizin.de. Please enter the title of the article in the search field, the supplementary material can be found under “Ergänzende Inhalte”.

          Translated abstract

          Ziel

          Das Ziel der Studie war, das öffentliche Interesse an einem breiten Spektrum von muskuloskeletalen Symptomen und Erkrankungen während der durch COVID-19 („coronavirus disease 2019“) bedingten Pandemie zu untersuchen.

          Methoden

          Dazu durchsuchten die Autor(inn)en Google Trends in Bezug auf 118 Suchanfragen innerhalb der USA. Sie verglichen 2 Zeitfenster im Jahr 2020 (15. März bis 4. Juli und 5. Juli bis 31. Oktober) mit ähnlichen Zeitfenstern der 4 Jahre davor (2016–2019).

          Ergebnisse

          Zu Beginn der Pandemie, 13. März bis 4. Juli, zeigte sich eine statistisch signifikante Abnahme des relativen Suchvolumens für die Mehrheit der Anfragen (60%), ein signifikanter Anstieg jedoch nur bei 2 Anfragen (d. h. Myalgie und Zehenschwellung). In der Phase Juli bis Oktober fand sich eine statistisch signifikante Abnahme nur bei 22% der Suchanfragen; es bestand kein Unterschied für 60% der Anfragen zwischen 2020 und 2016–2019, was auf ein Wiedererreichen des vorherigen Niveaus der meisten Suchanfragen schließen lässt. Interessant war, dass das Suchvolumen von 18% der Anfragen (d. h. zu Fatigue, Gelenkschmerzen, Muskelschmerzen, Myalgie, Spondylosis, Radikulopathie, Myelopathie, Nackenschmerzen, Nackenverspannung, Verspannung des unteren Rückens, Ischias, Schulterschmerzen, Schultersteife, Ellbogenschmerzen, laterale Epikondylitis, Handgelenkschmerzen, Karpaltunnel, Handschmerzen, Fingerschmerzen, schnellendem Finger und Morton-Neurom) im Vergleich zu den 4 vorangegangenen Jahren signifikant erhöht war.

          Schlussfolgerung

          In der Anfangszeit der Pandemie war das öffentliche Interesse auf COVID-19 fokussiert, und es wurde nach Online-Informationen über COVID-19-Symptome gesucht. Während der Phase von Juli bis Oktober gab es einen Aufwärtstrend bei muskuloskeletalen Symptomen und einigen umgangssprachlichen Begriffen/wohl bekannten muskuloskeletalen Krankheiten, gekoppelt mit einem Abwärtstrend bei allgemeinen Begriffen zu muskuloskeletalen Erkrankungen und bestimmten spezifischen Diagnosen. Diese Informationen verhelfen möglicherweise den Rheumatologen dazu, das öffentliche Interesse an muskuloskeletalen Symptomen und Erkrankungen zu verstehen und auf die Bedürfnisse der Patienten einzugehen, um die negativen Auswirkungen der Pandemie auf den Krankheitsverlauf abzumildern.

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          Most cited references35

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          Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

          Summary Background The Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) includes a comprehensive assessment of incidence, prevalence, and years lived with disability (YLDs) for 354 causes in 195 countries and territories from 1990 to 2017. Previous GBD studies have shown how the decline of mortality rates from 1990 to 2016 has led to an increase in life expectancy, an ageing global population, and an expansion of the non-fatal burden of disease and injury. These studies have also shown how a substantial portion of the world's population experiences non-fatal health loss with considerable heterogeneity among different causes, locations, ages, and sexes. Ongoing objectives of the GBD study include increasing the level of estimation detail, improving analytical strategies, and increasing the amount of high-quality data. Methods We estimated incidence and prevalence for 354 diseases and injuries and 3484 sequelae. We used an updated and extensive body of literature studies, survey data, surveillance data, inpatient admission records, outpatient visit records, and health insurance claims, and additionally used results from cause of death models to inform estimates using a total of 68 781 data sources. Newly available clinical data from India, Iran, Japan, Jordan, Nepal, China, Brazil, Norway, and Italy were incorporated, as well as updated claims data from the USA and new claims data from Taiwan (province of China) and Singapore. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between rates of incidence, prevalence, remission, and cause of death for each condition. YLDs were estimated as the product of a prevalence estimate and a disability weight for health states of each mutually exclusive sequela, adjusted for comorbidity. We updated the Socio-demographic Index (SDI), a summary development indicator of income per capita, years of schooling, and total fertility rate. Additionally, we calculated differences between male and female YLDs to identify divergent trends across sexes. GBD 2017 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting. Findings Globally, for females, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and haemoglobinopathies and haemolytic anaemias in both 1990 and 2017. For males, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and tuberculosis including latent tuberculosis infection in both 1990 and 2017. In terms of YLDs, low back pain, headache disorders, and dietary iron deficiency were the leading Level 3 causes of YLD counts in 1990, whereas low back pain, headache disorders, and depressive disorders were the leading causes in 2017 for both sexes combined. All-cause age-standardised YLD rates decreased by 3·9% (95% uncertainty interval [UI] 3·1–4·6) from 1990 to 2017; however, the all-age YLD rate increased by 7·2% (6·0–8·4) while the total sum of global YLDs increased from 562 million (421–723) to 853 million (642–1100). The increases for males and females were similar, with increases in all-age YLD rates of 7·9% (6·6–9·2) for males and 6·5% (5·4–7·7) for females. We found significant differences between males and females in terms of age-standardised prevalence estimates for multiple causes. The causes with the greatest relative differences between sexes in 2017 included substance use disorders (3018 cases [95% UI 2782–3252] per 100 000 in males vs s1400 [1279–1524] per 100 000 in females), transport injuries (3322 [3082–3583] vs 2336 [2154–2535]), and self-harm and interpersonal violence (3265 [2943–3630] vs 5643 [5057–6302]). Interpretation Global all-cause age-standardised YLD rates have improved only slightly over a period spanning nearly three decades. However, the magnitude of the non-fatal disease burden has expanded globally, with increasing numbers of people who have a wide spectrum of conditions. A subset of conditions has remained globally pervasive since 1990, whereas other conditions have displayed more dynamic trends, with different ages, sexes, and geographies across the globe experiencing varying burdens and trends of health loss. This study emphasises how global improvements in premature mortality for select conditions have led to older populations with complex and potentially expensive diseases, yet also highlights global achievements in certain domains of disease and injury. Funding Bill & Melinda Gates Foundation.
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            Google Trends in Infodemiology and Infoveillance: Methodology Framework

            Internet data are being increasingly integrated into health informatics research and are becoming a useful tool for exploring human behavior. The most popular tool for examining online behavior is Google Trends, an open tool that provides information on trends and the variations of online interest in selected keywords and topics over time. Online search traffic data from Google have been shown to be useful in analyzing human behavior toward health topics and in predicting disease occurrence and outbreaks. Despite the large number of Google Trends studies during the last decade, the literature on the subject lacks a specific methodology framework. This article aims at providing an overview of the tool and data and at presenting the first methodology framework in using Google Trends in infodemiology and infoveillance, including the main factors that need to be taken into account for a strong methodology base. We provide a step-by-step guide for the methodology that needs to be followed when using Google Trends and the essential aspects required for valid results in this line of research. At first, an overview of the tool and the data are presented, followed by an analysis of the key methodological points for ensuring the validity of the results, which include selecting the appropriate keyword(s), region(s), period, and category. Overall, this article presents and analyzes the key points that need to be considered to achieve a strong methodological basis for using Google Trends data, which is crucial for ensuring the value and validity of the results, as the analysis of online queries is extensively integrated in health research in the big data era.
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              Severe COVID-19, multisystem inflammatory syndrome in children, and Kawasaki disease: immunological mechanisms, clinical manifestations and management

              Multisystem inflammatory syndrome (MIS-C) is a pediatric hyperinflammation disorder caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). It has now been reported from several countries the world over. Some of the clinical manifestations of MIS-C mimic Kawasaki disease (KD) shock syndrome. MIS-C develops 4–6 weeks following SARS-CoV-2 infection, and is presumably initiated by adaptive immune response. Though it has multisystem involvement, it is the cardiovascular manifestations that are most prominent. High titres of anti-SARS-CoV-2 antibodies are seen in these patients. As this is a new disease entity, its immunopathogenesis is not fully elucidated. Whether it has some overlap with KD is still unclear. Current treatment guidelines recommend use of intravenous immunoglobulin and high-dose corticosteroids as first-line treatment. Mortality rates of MIS-C are lower compared to adult forms of severe COVID-19 disease. Electronic supplementary material The online version of this article (10.1007/s00296-020-04749-4) contains supplementary material, which is available to authorized users.
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                Author and article information

                Contributors
                sinan.kardes@istanbul.edu.tr
                Journal
                Z Rheumatol
                Z Rheumatol
                Zeitschrift Fur Rheumatologie
                Springer Medizin (Heidelberg )
                0340-1855
                1435-1250
                29 March 2021
                : 1-5
                Affiliations
                GRID grid.9601.e, ISNI 0000 0001 2166 6619, Department of Medical Ecology and Hydroclimatology, Istanbul Faculty of Medicine, , Istanbul University, ; Topkapı, Turgut Özal Millet Cd, 34093 Fatih/İstanbul, Turkey
                Author notes
                [Redaktion]

                U. Müller-Ladner, Bad Nauheim

                U. Lange, Bad Nauheim

                Author information
                http://orcid.org/0000-0002-6311-8634
                http://orcid.org/0000-0002-5521-9806
                http://orcid.org/0000-0002-9706-7847
                Article
                989
                10.1007/s00393-021-00989-2
                8006118
                33779835
                7dc90fb4-e672-451b-b8ad-62c8be8c6f2c
                © Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2021

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                : 25 February 2021
                Categories
                Originalien

                Rheumatology
                google trends,internet,rheumatology,musculoskeletal diseases,rheumatic diseases,soft tissue rheumatism,rheumatologie,muskuloskeletale erkrankungen,rheumatische erkrankungen,weichteilrheumatismus

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