ABSTRACT
The National Heart, Lung, and Blood Institute (NHLBI) convened a workshop of international experts to discuss new research opportunities for the prevention, detection, and intervention of myocarditis in May 2021. These experts reviewed the current state of science and identified key gaps and opportunities in basic, diagnostic, translational, and therapeutic frontiers to guide future research in myocarditis. In addition to addressing community-acquired myocarditis, the workshop also focused on emerging causes of myocarditis including immune checkpoint inhibitors and SARS-CoV-2 related myocardial injuries and considered the use of systems biology and artificial intelligence methodologies to define workflows to identify novel mechanisms of disease and new therapeutic targets. A new priority is the investigation of the relationship between social determinants of health (SDoH), including race and economic status, and inflammatory response and outcomes in myocarditis. The result is a proposal for the reclassification of myocarditis that integrates the latest knowledge of immunological pathogenesis to refine estimates of prognosis and target pathway-specific treatments.
Subject(s)
COVID-19/complications , Macrophage Activation Syndrome/diagnosis , Systemic Inflammatory Response Syndrome/diagnosis , COVID-19/diagnosis , COVID-19/etiology , COVID-19/physiopathology , Female , Humans , Infant , Macrophage Activation Syndrome/etiology , Macrophage Activation Syndrome/physiopathology , Systemic Inflammatory Response Syndrome/etiology , Systemic Inflammatory Response Syndrome/physiopathologyABSTRACT
Background: The cases of Coronavirus disease-2019 (COVID-19) has been gradually increasing in Nepal. The objective of this study was to evaluate knowledge, attitude and practice regarding COVID-19 among healthcare workers in Chitwan, one of the districts located in central Nepal. Methods: It was a descriptive, cross-sectional study, conducted among healthcare workers from different health institutions of Chitwan, over the span of two weeks from 1st April, 2020 till 14th April, 2020. Bivariate analyses of knowledge, attitude and practice scores were done with different variables using appropriate tests in SPSS IBM version 25. Results: Out of 353 responses, 166 (47%) were nurses, 102 (28.9%) were doctors, 41 (11.6%) were health assistants, 7 (2%) were community medical assistants, and the remaining 37 (10.5%) were categorized as others. 290 (82.2%) healthcare workers obtained moderate to good knowledge scores, 295 (83.6%) obtained moderate to good practice scores, and 321 (90.9%) had positive attitude scores. Doctors had highest mean knowledge scores (23.70 ± 4.48, p value- 0.000) and health assistants had highest mean practice scores (15.10±3.61, p value- 0.007). Positive correlation was obtained between knowledge and practice scores (r= 0.476, p value- 0.000);and attitude and practice scores (r= 0.238, p value- 0.000). Only 20.4% healthcare workers were confident to handle the pandemic in their healthcare setup. Conclusions: The majority of healthcare workers had moderate to good knowledge and practice scores and had a positive attitude toward COVID-19. There was a significant association between knowledge, attitude and practice scores obtained by healthcare workers from Nepal.