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Background: BHIVA Standards of Care for people living with HIV (PLWH) include quality statements and auditable outcomes for peer-support pathways to improve selfmanagement and engagement in care. FTCI London convened 3-year 'improvement collaborative' projects between HIV charities and NHS clinics. Chelsea and Westminster Hospital (CWHFT) supported the implementation of this initiative to 4 London HIV clinics with a cohort of >10,000 PLWH. We here illustrate the results of this initiative to date. Method(s): Positively UK, NAZ Project, Plus Health and CWHFT trialled approaches to integrating in-clinic peersupport pathways, with the aim of having >90% of those accessing peer-support retained in care, with a VL<50. 3 peer-supporters (2 FTE posts) received NHS honorary contracts, emails and the ability to log interventions within the Trust's EPR. Data on peer-support attendance and outcomes were collected from the EPR into an encrypted NHS database. Result(s): Although planned as an in-person initiative, the COVID-19 pandemic led to a shift to fully remote support and delayed project initiation to 7/2020, when email referrals commenced for newly diagnosed and those identified as being at risk of lost to follow up (LTFU). Referrals reached 4.4/month within the first 3 months. Initiatives such as MDT, focus group participation, staff teaching, and physical presence in clinics increased referrals to 7/month by 4/2021 and 12/month by 11/2021. Median patient age was 45 years (range 16-74), 13% were female, and 47% from BAME background (vs 34.5% in the CWHFT HIV cohort). Median diagnosis length was 2 years (<1-31). Moving from opt-in to opt-out support for newly diagnosed increased uptake of support from 33% in 4/2021 to 67% by 12/2021. Overall, 287 people (66% of referrals) engaged with peersupport between 7/2020 and 11/2022, with 164 (57%) receiving ongoing support. Virtual appointments moved from 100% to 54% over time. Rates of having a VL<50 increased from 71% at referral to 90% following peer-support, including new diagnoses. Conclusion(s): Implementing in-clinic peer-support pathways significantly increased referrals and uptake of support for new HIV diagnosis and those at risk of LTFU, showing the potential of improving clinical outcomes and quality of life of PLWH.
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Background: Previous studies have reported ongoing cardiac inflammation as assessed by cardiac magnetic resonance imaging (CMR) in a significant proportion of patients several months after recovery from SARSCoV- 2 infection, many of whom had no or minimal symptoms at the time of infection. Purpose(s): The aim of SETANTA was to investigate the prevalence of cardiac abnormalities by CMR in unselected patients in Ireland after acute SARS-CoV-2 infection and the correlation with immunological response and biomarkers of coagulation. Method(s): This was a prospective, observational, community-based study (clinicaltrials.gov identifier NCT04823182). Consecutive patients recovered from recent SARS-CoV-2 infection at 3 primary care sites were invited to participate. Key inclusion/exclusion criteria and outcomes of interest are shown in Figure 1. Result(s): 100 participants were enrolled (Feb-Sept 2021) at a median of 188 (IQR, 125, 246) days after positive SARS-CoV-2 swab. At index infection, 18% and 35% reported severe and moderate symptoms, respectively;14% were hospitalized;3% were admitted to intensive care for ventilatory support. At enrolment, 83% had ongoing symptoms. 85% had detectable SARS-CoV-2 antigens. CMR and laboratory findings are shown in Figure 1. Conclusion(s): Among an unselected cohort of patients recovered from acute SARS-CoV2 infection, we report a low prevalence of cardiac abnormalities by CMR, despite a high prevalence of moderate/severe symptoms at presentation and a high prevalence of persistent symptoms. Correlation with biomarkers of immunity and coagulation will be available at ESC 2022.
ABSTRACT
Introduction Previous studies have reported ongoing cardiac inflammation as assessed by cardiac magnetic resonance imaging (CMR) in a significant proportion of patients several months after recovery from SARS-CoV-2 infection, many of whom had no or minimal symptoms at the time of infection. The aim of SETANTA was to investigate the prevalence of cardiac abnormalities by CMR in unselected patients in Ireland after acute SARS-CoV-2 infection and the correlation with immunological response and biomarkers of coagulation. Methods This was a prospective, observational, communitybased study (clinicaltrials.gov identifier NCT04823182). Consecutive patients recovered from recent SARS-CoV-2 infection at 3 primary care sites were invited to participate. Key inclusion/ exclusion criteria and outcomes of interest are shown in figure 1. Results 100 participants were enrolled (Feb-Sept 2021) at a median of 188 (IQR, 125, 246) days after positive SARSCoV- 2 swab. At index infection, 18% and 35% reported severe and moderate symptoms, respectively;14% were hospitalized;3% were admitted to intensive care for ventilatory support. At enrolment, 83% had ongoing symptoms. 85% had detectable SARS-CoV-2 antigens. CMR and laboratory findings are shown in Figure 1. Clinical follow up to 12 months is ongoing. Conclusion Among an unselected cohort of patients recovered from acute SARS-CoV2 infection, we report a low prevalence of cardiac abnormalities by CMR, despite a high prevalence of moderate/severe symptoms at presentation and a high prevalence of persistent symptoms. Correlation with biomarkers of immunity and coagulation add results of follow up at 12 months will be available for presentation at ICS 2022.
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The eating disorder specialists (TEDS) were coming into fruition amid the COVID-19 pandemic. With the aim of providing unique, integrated therapy packages to individuals living with eating disorders in the community, TEDS found itself launching a new service whilst the world was adapting. In response to imposed restrictions, TEDS changed course and decided to deliver their therapy packages exclusively online. This was in the hope of continuing their mission of providing accessible treatment to individuals and their families that fits with everyday life. Method(s): TEDS Client Evaluation Forms were distributed to clients. Qualitative and quantitative data were collected.
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Introduction In April 2020 a London sexual health clinic temporarily closed due to the Covid-19 pandemic. Full reopening of the service coincided with HIV PrEP becoming available on the NHS and the clinic continued using the Health Adviser (HA) model of PrEP delivery adopted during the IMPACT trial. We aimed to review how these events impacted HA activity. Method A retrospective review of patients booked into the HA clinic and those with an HA diagnosis code was undertaken. Information on number of attendances, diagnosis codes and income was compared for 2019, 2020 and 2021. Results There was a drop in attendances prior to the clinic closing in April 2020. After re-opening, activity levels in 2020 and early 2021 did not reach those of 2019. However, the average monthly activity increased by approximately 17% in the latter half of 2021. Average per patient income was 61% higher in December 2020 (£161.48) than December 2019 (£100.33). This increased further in 2021 to £171.57 per patient (74% increase on 2019). Discussion Although it took a year after the initial pandemic for attendances to reach pre Covid-19 levels, the income generated from the HA appointments increased before this, due to the model of PrEP delivery implemented. However this has had an impact on other aspects of Health Advising such as risk reduction and safeguarding, with fewer patients recorded as having specialist HA input in these areas. Further work is needed to determine the true impact of this change of focus and to ensure patients still receive optimal care. (Figure Presented).
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The complex decision-making regarding reopening of schools compels careful thought, planning, and collaboration, withinand across communities. Through this document, the COVID-19 Healthcare Coalition provides clarifications, interpretations,and estimates that can be used as a resource by school leaders to develop and implement plans for returning to on-campuslearning, in the context of the COVID-19 pandemic.
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The ongoing pandemic of SARS-CoV-2 calls for rapid and cost-effective methods to accurately identify infected individuals. The vast majority of patient samples is assessed for viral RNA presence by RT-qPCR. Our biomedical research institute, in collaboration between partner hospitals and an accredited clinical diagnostic laboratory, established a diagnostic testing pipeline that has reported on more than 252,000 RT-qPCR results since its commencement at the beginning of April 2020. However, due to ongoing demand and competition for critical resources, alternative testing strategies were sought. In this work, we present a clinically-validated procedure for high-throughput SARSCoV-2 detection by RT-LAMP in 25 minutes that is robust, reliable, repeatable, sensitive, specific, and inexpensive © 2021. Buck MD et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited
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32 Figure 1ConclusionThe SETANTA study will evaluate the prevalence and characteristics of abnormalities on cardiac MRI in primary care patients in Ireland following recovery from acute SARS-CoV-2 infection and assess correlation with immune response and coagulopathy. Data from the study will help inform the long-term management of patients recovered from SARS-CoV-2 and assist in planning of health care service provision.
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Background: In low-income countries, like Malawi, important public health measures including social distancing or a lockdown have been challenging to implement owing to socioeconomic constraints, leading to predictions that the COVID-19 pandemic would progress rapidly. However, due to limited capacity to test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, there are no reliable estimates of the true burden of infection and death. We, therefore, conducted a SARS-CoV-2 serosurvey amongst health care workers (HCWs) in Blantyre city to estimate the cumulative incidence of SARS-CoV-2 infection in urban Malawi.