ABSTRACT
The diagnosis of coronavirus disease 2019 (COVID-19) is made by the detection of viral RNA by polymerase chain reaction on nasopharyngeal swabs. In some patients the test is falsely negative, while other biological samples are positive. The aim of the study is to identify characteristics and prognostic factors for swab negativity in COVID-19 patients with deep aspirate bronchus (BA)-confirmed disease. Multicentric retrospective case-control study of patients admitted for COVID-19 between March and November 2020 in two internal medicine units of the AOU Careggi and in the Internal Medicine of the Hospital of Varese. Were enrolled patients aged =18 years hospitalized for COVID-19 with viral RNA isolation on biological specimen, considering as cases the patients negative to swab but positive to BA. For each case, four controls with positive swab at admission were enrolled. The study included 95 patients, 19 cases and 76 controls. The mean time between symptoms onset and swab was 2.65 +/- 1.9 days in cases, with a statistically significant (P=0.003) difference compared to controls (5.53 +/- 3.0 days). Patients with negative swab had a longer mean length of stay and more frequent adverse outcome than controls. Swabbing within a short time of symptoms onset is a predictor for false negative. Patients with repeated negative swabs have a worse clinical picture with longer hospital stay, greater need for non-invasive ventilation and higher frequency of adverse outcome.
ABSTRACT
Background: Coronavirus disease 2019 (COVID-19) pandemic imposed enormous burdens of morbidity and mortality while severely disrupting people, especially frontline healthcare working in hospitals.The vaccine discovery gives hope to the world population, but it was received with skepticism and fear stressed by the great media coverage. Materials and Methods: We conducted an anonymous survey of the quality of life during pandemic era and the likelihood of COVID- 19 vaccine acceptance on a sample of healthcare at the Italian Hospital more involved by COVID-19 pandemic. Results: 3134 survey respondents represented a random sample in which was represented different health workers.Of these survey participants, 644 contracted SARS-CoV-2.Healthcare workers could be psychologically stressed by covid-19 pandemic.A considerable proportion of participants reported symptoms of depression and sadness (52%), anxiety (40.9%), insomnia (33.02%) and distress (55.4%).Most healthcare workers have documented vaccination through scientific articles 1423 (45.4%) by social media news 348 (11.1%) while 152 (4.8%) haven't documented at all.They would take a vaccine if it were proven safe and effective. Conclusions: Health workers who have to be on the front line during an epidemic are more exposed to psychological distress as, in addition to guaranteeing the necessary care and assistance, they are constantly in the condition of being affected by the epidemic itself.Specific projects aimed at the prevention of burn-out and distress of health workers will be carried out to improve the entire care process.