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1.
J Am Coll Emerg Physicians Open ; 2(2): e12399, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-2324731

ABSTRACT

STUDY OBJECTIVE: The 2019-20 coronavirus pandemic is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19). This study was undertaken to identify and compare findings of chest radiography and computed tomography among patients with SARS-CoV-2 infection. METHODS: This retrospective study was undertaken at a tertiary care center. Eligible subjects included consecutive patients age 18 and over with documented SARS-CoV-2 infection between March and July 2020. The primary outcome measures were results of chest radiography and computed tomography among patients with documented SARS-CoV-2 infection. RESULTS: Among 724 subjects, most were admitted to a medical floor (46.4%; N = 324) or admitted to an ICU (10.9%; N = 76). A substantial number of subjects were intubated during the emergency department visit or inpatient hospitalization (15.3%; N = 109). The majority of patients received a chest radiograph (80%; N = 579). The most common findings were normal, bilateral infiltrates, ground-glass opacities, or unilateral infiltrate. Among 128 patients who had both chest radiography and computed tomography, there was considerable disagreement between the 2 studies (52.3%; N = 67; 95% confidence interval: 43.7% to 61.0%).). The presence of bilateral infiltrates (infiltrates or ground-glass opacities) was associated with clinical factors including older age, ambulance arrivals, more urgent triage levels, higher heart rate, and lower oxygen saturation. Bilateral infiltrates were associated with poorer outcomes, including higher rate of intubation, greater number of inpatient days, and higher rate of death. CONCLUSIONS: Common radiographic findings of SARS-CoV-2 infection include infiltrates or ground-glass opacities. There was considerable disagreement between chest radiography and computed tomography. Computed tomography was more accurate in defining the extent of involved lung parenchyma. The presence of bilateral infiltrates was associated with morbidity and mortality.

2.
J Healthc Risk Manag ; 41(2): 46-55, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1372744

ABSTRACT

As one of the initial ten sites in Ohio designated to receive and distribute the first COVID-19 vaccines in December 2020, we initiated a self-reported IRB-approved research survey to describe the demographics, side-effects, and missed work time experienced by front-line health care workers in an urban tertiary care center and a rural regional hospital. First responders from both the urban and rural surrounding communities were also included in the initial Tier 1A vaccine distribution. The primary outcome measure was to identify the most frequently experienced side effects from the Pfizer and Moderna vaccines, based on type of vaccine, first or second dose, age, gender, race and occupation. The secondary outcome measure was to document the total number of work shifts missed after receiving the vaccine. Of interest to health care risk managers, the survey identified the most common side effects and resulting missed time from work broken down by type of vaccine and first or second dose. This information will be helpful for those institutions who have not yet vaccinated a majority of their work force, employees who still need their second dose, and for strategic scheduling of employees when booster doses become available later in the year.


Subject(s)
COVID-19 , Emergency Responders , Vaccines , COVID-19 Vaccines , Humans , Personnel, Hospital , Prospective Studies , SARS-CoV-2 , Tertiary Care Centers
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