High SARS CoV2 antibody-prevalence among health care workers with variable exposure to COVID-19 patients: A cross-sectional university hospital study

Background: During the COVID-19 pandemic, the pattern of medical services changed to minimize transmission to health care workers (HCWs) or hospitalized patients. Despite the care of COVID-19 patients in a special ward, new cases are accidentally discovered. This study aimed at determining the antibody seroprevalence among asymptomatic HCWs and the associated risks. Methods: The study involved 190 participants, including physicians, nurses, technicians, and administrative staff. All were inquired for sociodemographic, specialty, previous isolation, and previous infection, and their blood was tested for SARS-CoV2 antibody. Results: Of 190 HCWs;72,1% were females, the mean age was 32.6±7.9 years, 10.5% were smokers, and 15.8% reported co-morbid illness. SARS CoV2 antibodies were found in 68 (35.8%);being IgG, IgM and both IgM and IgG in 47 (69.1%), 10 (14.7%) and 11 (16.2%) participants respectively. The prevalence was higher (47.6%) among HCWs of the COVID unit, [OR=1.7 (95% CI: 0.69-4.3)] and HCWs with previous COVID-19, OR:1.61 (95% CI:0.88-2.94). The prevalence was significantly lower among smokers (p=0.049), OR:0.29 (95% CI:0.08-1.01), and significantly higher in HCWs who recalled cough (p=0.036) OR: 1.97 (95% CI: 1.05-3.69). The likelihood of antibody seropositivity increased in technicians [OR:2.02 (95% CI: 0.92-4.44)], followed by physicians [OR:1.7 (95% CI: 0.7-4.33)] while the odds ratio was low among nurses [OR:0.58 (95% CI: 0.32-1.07). Conclusion: A considerable proportion of antibody positive HCWs had evidence of past SARS CoV2. Provision of adequate personal protective equipment and periodic screening of HCWs are urgently needed to lessen the transmission within the health care settings. © 2020 The author (s).

The impact of partial and complete lockdown during the COVID-19 pandemic on acute surgical services: a retrospective cohort study.

PURPOSE: The burden of the coronavirus disease of 2019 (COVID-19) pandemic on the healthcare sector has been overwhelming, leading to drastic changes in access to healthcare for the public. We aimed to establish the impact of implemented government partial and complete lockdown policies on the volume of surgical patient admissions at a tertiary referral center during the pandemic. METHODS: A database was retrospectively created from records of patients admitted to the surgical ward through the emergency department. Three 6-week periods were examined: The complete lockdown period (CLP), which included a ban on the use of cars with the exception of health service providers and essential sector workers; A pre-COVID period (PCP) 1 year earlier (no lockdown); and a partial lockdown period (PLP) that involved a comprehensive curfew and implementing social distancing regulations and wear of personal protective equipment (e.g., masks) in public places. RESULTS: The number of patients admitted to the surgery ward was significantly higher in the PCP cohort compared to the CLP and PLP cohorts (p = 0.009), with a 42.1% and 37% decline in patients' admissions, respectively. Admission rates for patients with biliary pathologies and vascular thrombotic events increased. 30-day mortality rates did not differ significantly between the three periods (p = 0.378). CONCLUSIONS: While COVID-19 lockdown regulations had a significant impact on patient admission rates, surgical outcomes were not affected and the standards of care were maintained. Future protocols should strive to improve access to healthcare to avoid complications caused by delayed diagnosis and treatment.

COVID-19 GIT affection: an updated review

Background: Although it was initially believed that the coronavirus disease 2019 (COVID-19) only attacked the respiratory system, reports over time demonstrated that this disease could attack the gastrointestinal tract (GIT) as well. The predominant presenting symptoms in patients infected with COVID-19 were gastrointestinal, resulting in gastrointestinal (GI) pathological changes. While clinicians' concerns are mostly related to respiratory system manifestations, GI symptoms should be monitored and managed appropriately. Objectives: This review summarizes the essential information about COVID-19 GIT infection in terms of pathogenesis, major pathological changes, microbiological bases of infection and the possibility of feco-oral transmission, the severity of associated symptoms, the major radiological findings, the impact on GI surgery, the role of therapeutic agents in induction or magnification of GI symptoms, and a pitfall on the nutritional supplementation in COVID-19 patients.

COVID-19 Gastrointestinal Tract Affection: An Updated Review

Although it was initially believed that the coronavirus disease 2019 (COVID-19) only attacked the respiratory system, reports over time demonstrated that this disease could attack the gastrointestinal tract (GIT) as well. The predominant presenting symptoms in patients infected with COVID-19 were gastrointestinal (GI), resulting in GI pathological changes. While clinicians' concerns are mostly related to respiratory system manifestations, GI symptoms should be monitored and managed appropriately. This review summarizes the essential information about COVID-19 GIT infection in terms of pathogenesis, major pathological changes, microbiological bases of infection, the possibility of feco-oral transmission, the severity of associated symptoms, the major radiological findings, the impact on GI surgery, the role of therapeutic agents in induction or magnification of GI symptoms, and a pitfall on the nutritional supplementation in COVID-19 patients.

The Effect of COVID 19 on Liver Parenchyma Detected and measured by CT scan Hounsfield Units.

Background: COVID 19 may affect organs other than lungs, including liver, leading to parenchymal changes. These changes are best assessed by unenhanced computed tomography (CT). We aim to investigate the effect of COVID 19 on liver parenchyma by measuring the attenuation in CT scan Hounsfield unit (HU). Materials and Methods: A cohort of patients, who tested COVID 19 polymerase chain reaction positive, were enrolled and divided into two groups: fatty liver (FL) group (HU ≤ 40) and nonfatty liver (NFL) group (HU > 40) according to liver parenchyma attenuation measurements by high resolution noncontrast CT scan. The CT scan was performed on admission and on follow up (10-14 days later). Liver enzyme tests were submitted on admission and follow up. Results: Three hundred and two patients were enrolled. Liver HU increased significantly from 48.9 on admission to 53.4 on follow up CT scan (P<0.001) in all patients. This increase was more significant in the FL group (increased from 31.9 to 42.9 [P =0.018]) Liver enzymes were abnormal in 22.6% of the full cohort. However, there was no significant change in liver enzymes between the admission and follow up in both groups. Conclusion: The use of unenhanced CT scan for assessment of liver parenchymal represents an objective and noninvasive method. The significant changes in parenchymal HU are not always accompanied by significant changes in liver enzymes. Increased HU values caused by COVID 19 may be due to either a decrease in the fat or an increase in the fibrosis in the liver.