Impact of the Covid-19 pandemic on the performance of amateur and professional players in swimming

Background: The overarching aim of the study in this thesis was to collect and use the answers of the respondents, which were designed to inspect opinions about the pandemic situation, that had occurred, and whether the pandemic had affected their sense of mental state. The paper is exploratory in nature and includes analysis of research on swimmer training during the Covid-19 pandemic. Material and methods: 30 primary school students in Toruń participated in the study. An online questionnaire was used in which students were asked about their involvement in physical activity classes such as swimming and psychological and pedagogical behavior of young people during the Covid-19 pandemic. Results: 53.3% (n=16) respondents believe the pandemic has had an impact on their athletic performance. The Corona virus had a significant impact on their starts in competitions. Fortunately, most of them have no fear of returning to activity after the pandemic period. Especially due to active participation in organized on-line activities. The students also lack interpersonal contacts, which were significantly limited during the epidemic. Conclusion: The COVID-19 pandemic has wreaked havoc on the swimming environment. Some young players thought about ending their careers, fortunately the vast majority are still willing to train. According to most of the students' responses, the epidemic did not increase the stress. On the other hand, the lack of contact with friends from the club had a negative impact on the emotional state of young swimmers. © JPES.

Clinical and Social Determinants of Change in Code Status among Patients Hospitalized with Covid-19

Background: Patients hospitalized with COVID-19 who develop cardiopulmonary arrest often have poor prognosis, prompting discussions with families about goals of care. The relationship between clinical and social determinants of code status change is poorly understood. Methods: This retrospective study included adult COVID-19 positive patients admitted to the intensive care unit with cardiac arrest in a multihospital center over the first 9 months of the pandemic (3/1/2020-12/1/2020). Data on medical and social factors was collected and adjudicated. Results: We identified 208 patients over the study timeline. The mean age was 63.7 ± 14.5 years and 54.3% (n=113) were male. The majority of patients with cardiopulmonary arrest had pulseless electrical activity (PEA) as their initial rhythm (91.3%, n=190). Code status was changed in 56.3% (n=117) of patients. The majority of COVID-19 patients with cardiac arrest were Hispanic (53.4%, n=111), followed by African American (27.9%, n=58), and White patients (13.5%, n=28). Race/ethnicity did not affect the rate of code status change. COVID-19 patients who had a code status change were statistically more likely to have a lower salary ($54,838 vs $62,374), have a history of stroke/transient ischemic attack (15.4 vs 4.4%, 18:4), or heart failure (28.2 vs 15.6%, 33:14), all with P<0.05. Patients with code status change had shorter courses of cardiopulmonary resuscitation (11.9 vs 16.9 minutes, P<0.05). Both groups had similar levels of aggressive care received including continuous renal replacement therapy, vasopressor and broad-spectrum antibiotics requirements. Insurance status, ethnicity, religion, and education did not lead to statistically significant changes in code status in COVID patients. Conclusion: Patients hospitalized with cardiopulmonary arrest and positive for COVID-19 are more likely to have a change in code status. This code status change is affected by cardiovascular comorbidities such as stroke and heart failure, along with lower income but not by insurance status, ethnicity, religion, and educational level.

A Machine Learning Approach in Evaluating Symptom Screening in Predicting COVID-19

COVID-19 is a disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that, to date, has over 245 million confirmed cases and claimed almost 5 million lives. This disease attacks the respiratory system and comes with a number of symptoms. The US Center for Disease Control and Prevention presents a set of symptoms. However, these symptoms only begin to manifest after a number of days, which prevents early detection of this disease. This absence of symptoms during the early stages is what is considered by many to be the very factor that caused the virus into becoming a pandemic. Nonetheless, symptoms checking has been used in practice by commercial and business establishments as an initial screening for COVID-19. The bothersome process of symptom checking are still in place at the entrances of malls and airports. In this study, we determine whether or not symptom screening is an effective system to be employed to assess individuals for COVID-19. Specifically, it aims to determine whether or not one or a set of symptoms are effective predictors of the RT-PCR test results, the gold standard in Covid-19 testing, using machine learning. Using data from the Philippine Red Cross, classification models are developed using LightGBM, AdaBoost, Gaussian Naïve-Bayes, MultiLayer Perceptron, Quadratic Discriminant Analysis and Decision Tree. These models were evaluated using the following metrics: precision, sensitivity, specificity and the type II error rate. Furthermore, for explainability, symptoms are analyzed as to whether or not they are relatively influential on the predicting whether or not a patient has COVID-19. The high type II error rate, low sensitivity and low relative predictor scores of the most significant predictor symptoms clearly show that symptoms do not correlate with the RT-PCR testing results. Thus, we conclude that symptom screening is not a medically suitable process for determining whether an individual has COVID-19. In fact, it even exposes us to the risk of viral transmission as people congregate at the entrances and lobbies of establishments. © 2022 IEEE.

A Multi-Center Retrospective Review of COVID-19 Outcomes in Patients with Lymphoid Malignancy

Background: Early reports suggested that cancer patients have a 1.7-fold increased risk of contracting SARS-CoV-2 and higher rates of severe events and mortality compared with general population. Patients with hematologic malignancies may have worse COVID-19 outcomes, due to an impaired humoral immune response from their underlying malignancy and concurrent anticancer therapy. In this multi-center, retrospective, observational study, we evaluate the associations of COVID-19 outcomes with patient and lymphoma disease characteristics. Methods: EMRs at 10 study centers across the USA identified 519 patients with a diagnosis of lymphoma, CLL, or other lymphoid malignancies, who had a documented positive result of SARS-CoV-2 PCR or nucleocapsid antibody testing. Descriptive statistics were used to summarize the demographic and clinical characteristics. Logistic regression was used to evaluate the associations of individual characteristics with COVID-19 outcomes, adjusted for center (NYU vs. other). The interactions between each of the variables was also included in these models;since the interactions were generally small and non-significant, only the main effect of center was included. Two-sided p-values ≤0.05 were considered significant;there were no adjustments for multiple variables or endpoints. Each analysis was based on complete data for that analysis. Results: Tables 1 and 2 provide demographic and clinical characteristics, respectively, of the 519 patients. The mean age was 61.9 years, with 296 (57%) male and 374 (72%) white patients. NYU had the largest cohort (318 patients), with the remaining centers contributing a range of 3 to 69 patients (median 14). Logistic regression models for the association of each COVID-19 outcome with individual clinical and patient characteristics included adjustments for the center (NYU/other). While center effects were statistically significant, center by covariate interaction effects were not and are not included in the final models. The odds ratio (OR) estimates and p-values for each patient and CLL/lymphoma clinical variable are shown in Tables 3 and 4, respectively. The risks of experiencing a severe event, death, and hospital admission increased with age;for each 10 years of age increase, the ORs were 1.58 for experiencing severe events, 1.78 for death, and 1.65 for hospital admission. The risks of poor outcome were higher in males than in females (OR 1.93 for severe events, 1.85 for death, and 1.47 for hospital admission). Patients with Charlson Comorbidity Index (CCI) >5 had a higher risk of severe events (OR 2.46), mortality (3.30) and hospital admission (2.73) compared to patients with CCI ≤5. Compared to patients with HL, patients with aggressive NHL had a higher risk of severe events (OR 4.05), mortality (4.68) and hospital admission (4.65). Patients with CLL similarly had a higher risk of severe events (OR 4.64), mortality (4.65) and hospital admission (5.93) compared to HL patients. Patients with indolent NHL had a higher risk of hospital admission (OR 3.95) but not a higher risk of mortality compared to HL. Patients in remission at the time of COVID-19 diagnosis had a lower risk of severe events (OR 0.42), mortality (0.36) and hospital admission (0.40) relative to those who were not in remission. Patients who received cytotoxic chemotherapy within 28 days of their COVID-19 diagnosis had a higher risk of severe events (OR 2.54), mortality (2.79), and hospital admission (2.31). Patients who received an anti-CD20 monoclonal antibody within 6 months of COVID-19 diagnosis had a higher risk of severe events (OR 2.60), mortality (2.17) and hospital admission (3.28). Conclusions: In addition to demographic and comorbidity risk factors identified in previous studies, our study shows that patients with aggressive NHL and CLL, or patients who have received recent cytotoxic chemotherapy or anti-CD20 mAB, may be at risk for poor COVID-19 outcome. The difference in risk between NHL and HL patients is likely associated with young age of HL patients but may also be related o differences in underlying innate and adaptive immune defects. Patients at high risk for poor outcome should be a priority for studies of monoclonal antibody prophylaxis. If defects in humoral immunity are at the root of poor outcome, this may be compounded by poor response to vaccination. Multivariate analysis of this data will be completed in advance of the meeting. [Formula presented] Disclosures: Olszewski: Celldex Therapeutics: Research Funding;PrecisionBio: Research Funding;TG Therapeutics: Research Funding;Acrotech Pharma: Research Funding;Genentech, Inc.: Research Funding;Genmab: Research Funding. Barta: Daiichi Sankyo: Honoraria;Seagen: Honoraria;Acrotech: Honoraria;Kyowa Kirin: Honoraria. Hernandez-Ilizaliturri: AbbVie: Other: Advisory Boards;Incyte: Other: Advisory Boards;Celgene: Other: Advisory Boards;BMS: Other: Advisory Boards;Pharmacyclics: Other: Advisory Boards;Amgen: Other: Advisory Boards;Kite: Other: Advisory Boards;Gilead: Other: Advisory Boards;Epyzime: Other: Advisory Boards. Leslie: Janssen: Consultancy, Speakers Bureau;Merck: Consultancy;Abbvie: Consultancy, Honoraria;Epizyme: Consultancy, Honoraria, Speakers Bureau;PCYC/Janssen: Consultancy, Honoraria, Speakers Bureau;Seagen: Consultancy, Honoraria, Speakers Bureau;TG Therapeutics: Consultancy, Honoraria, Speakers Bureau;Celgene/BMS: Consultancy, Honoraria, Speakers Bureau;Kite, a Gilead Company: Consultancy, Honoraria, Speakers Bureau;ADC Therapeutics: Consultancy;BeiGene: Consultancy, Honoraria, Speakers Bureau;Karyopharm Therapeutics: Honoraria, Speakers Bureau;AstraZeneca: Consultancy, Honoraria, Speakers Bureau;Pharmacyclics: Consultancy, Honoraria, Speakers Bureau. Diefenbach: Bristol-Myers Squibb: Consultancy, Honoraria, Research Funding;Merck Sharp & Dohme: Consultancy, Honoraria, Research Funding;Morphosys: Consultancy, Honoraria, Research Funding;Genentech, Inc./ F. Hoffmann-La Roche Ltd: Consultancy, Honoraria, Research Funding;Perlmutter Cancer Center at NYU Langone Health: Current Employment;Incyte: Research Funding;AbbVie: Research Funding;Trillium: Research Funding;IGM Biosciences: Research Funding;IMab: Research Funding;Janssen: Consultancy, Honoraria, Research Funding;Gilead: Current equity holder in publicly-traded company;MEI: Consultancy, Research Funding;Celgene: Research Funding;Seattle Genetics: Consultancy, Honoraria, Research Funding.

GunitaHu: A VR serious game with montessori approach for dementia patients during COVID-19

The study aims to explore VR Serious Games as a form of therapy for people with dementia. It seeks to establish the utility of VR-based interventions with the application of Montessori Method. This study also serves as a basis for researchers, healthcare professionals, and developers who plan to incorporate VR therapy with other therapeutic approaches and to create a system that may be replicated for other illnesses via telemedicine to address the most vulnerable sectors. The main beneficiaries of this study are people with dementia and those who directly interact with them such as their doctors, caregivers, and family members of the patient. © 2021 The authors and IOS Press.

Predicting Hospital Resource Use During COVID-19 Surges: A Simple but Flexible Discretely Integrated Condition Event Simulation of Individual Patient-Hospital Trajectories.

OBJECTIVES: To assist with planning hospital resources, including critical care (CC) beds, for managing patients with COVID-19. METHODS: An individual simulation was implemented in Microsoft Excel using a discretely integrated condition event simulation. Expected daily cases presented to the emergency department were modeled in terms of transitions to and from ward and CC and to discharge or death. The duration of stay in each location was selected from trajectory-specific distributions. Daily ward and CC bed occupancy and the number of discharges according to care needs were forecast for the period of interest. Face validity was ascertained by local experts and, for the case study, by comparing forecasts with actual data. RESULTS: To illustrate the use of the model, a case study was developed for Guy's and St Thomas' Trust. They provided inputs for January 2020 to early April 2020, and local observed case numbers were fit to provide estimates of emergency department arrivals. A peak demand of 467 ward and 135 CC beds was forecast, with diminishing numbers through July. The model tended to predict higher occupancy in Level 1 than what was eventually observed, but the timing of peaks was quite close, especially for CC, where the model predicted at least 120 beds would be occupied from April 9, 2020, to April 17, 2020, compared with April 7, 2020, to April 19, 2020, in reality. The care needs on discharge varied greatly from day to day. CONCLUSIONS: The DICE simulation of hospital trajectories of patients with COVID-19 provides forecasts of resources needed with only a few local inputs. This should help planners understand their expected resource needs.

Modalities of care and educational inequality in pandemic times: the Sierra Tarahumara experience

The purpose of this paper is to document the experiences faced by a group of basic education teachers in the Sierra Tarahumara in the State of Chihuahua, Mexico facing the health contingency caused by COVID-19. Data collection was carried out through a multiple response electronic questionnaire and a semi-structured interview to determine if the remedial strategies promoted by the Ministry of Public Education respond to the characteristics of a region distinguished by marginality, technological precariousness and communication problems. This study uses a mixed methodology based on the narrative technique, which is complemented with a description of absolute frequencies and percentages connected with the difficulties shared by the teachers. The research results reveal intensification in daily activities, a remarkable commitment to the profession and also reveals the challenges that teachers face in containing learning losses. Furthermore, the most critical findings can be used as input for the design of educational public policy measures aimed at inclusive care of students at risk of school failure.

Cardiac arrhythmias in COVID-19: Mechanisms, outcomes and the potential role of proarrhythmia

Cardiac arrhythmia seems to be a risk factor for mortality in coronavirus disease 2019 (COVID-19). However, the mechanisms, risk factors and outcomes of new arrhythmic events (NAEs) in this disease are unclear. Methods: All patients with confirmed COVID-19 were retrospectively included in this single centre study. Patients who were alive and admitted <30 days before the database lock were excluded. Results: 3416 consecutive patients were reviewed and 1476 finally enrolled (65.9 ± 20.9 years, 57.3% male). 76 (5.1%) patients had NAEs. Most of them were new atrial fibrillation episodes (48 patients, 3.2%), mostly seen in patients with no previous arrhythmia (38 patients, 79.2%). Atrial flutter (AFL) accounted for 20% of all NAEs. Ventricular arrhythmias were seen in 9 (0.6%) patients. Multivariable analysis showed that prior AFL, heart failure, dyslipidaemia, lopinavir/ritonavir, and combined hydroxychloroquine and azithromycin were independently associated with NAEs. 66 (86.8%) patients with NAEs died. The Kaplan-Meier analysis showed a lower survival of patients with NAEs (P < 0.001). Eight out of 9 (88.9%) and 41 out of 48 (85.4%) patients with ventricular arrhythmias and atrial fibrillation respectively died. Older age, male gender and NAEs were independently associated with death. NAEs and other outcomes, such as heart failure, thromboembolism, and bleeding independently predicted death. Conclusions: NAEs are relatively uncommon in COVID-19 patients and mainly have an atrial mechanism. AFL is particularly frequent in this disease. The use of hydroxychloroquine, azithromycin and lopinavir/ritonavir, is associated with them, especially when used in combination. NAEs are independently and strongly associated with death. (Figure Presnted).

COVID-19 y las enfermeras La maldita pandemia: una oportunidad para la Atención Primaria de Salud

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Tracheotomies in critical patients during the COVID-19 pandemia. Preliminary study of our experiences at La Paz University Hospital of Madrid

The outbreak caused by the SARS-CoV-2 virus is currently very active in Spain. Many infected people still require to be hospitalized. Around 10-15 % of hospitalized patients require intensive care, where they are intubated for a prolonged period, needing tracheotomies some weeks after the intubation. We will be conducting an observational study of the tracheotomies performed by our oral and maxillofacial Department to COVID-19 patients on intensive care units between March 17th and April 17th, 2020. This study will be analyzing the patients’ epidemiological and clinical aspects, surgical technique employed, surgical time, type of cannula used, postoperative complications and the patients’ clinical monitoring. A total of 22 patients underwent open elective tracheotomy. There were twenty-two males and three females aged between 40 and 77 (mean: 64,9 years-old). In all cases tracheotomy was carried out due to pulmonary process caused by COVID-19 bilateral pneumonia. Two patients presented pneumothorax in the immediate postoperatory care as a complication, one perished during the procedure and another did so after arriving to the Intensive Care Unit after the tracheotomy surgery. Even though tracheotomy is a ruled surgical technique, the special characteristics of COVID-19 patients make of this procedure a critical situation, mainly due to lung instability and quick desaturation of the patients. This requires the surgery to be carried out by experienced physicians in order to reduce operative time and to be able to react to any eventualities that may arise. © 2020 SECOM.

[COVID-19 and cardiovascular and kidney disease: Where are we? Where are we going?] / COVID-19 y enfermedad cardiovascular y renal: ¿Dónde estamos? ¿Hacia dónde vamos?

The SARS-CoV-2 pandemic is a global health emergency and we need to know more about it. Patients with cardiovascular risk and previous kidney risk have been identified as especially vulnerable for greater morbidity and mortality when they suffer from COVID-19. A considerable proportion of patients can develop a vascular lesion in the context of the disease that entails a greater lethality. Cardiovascular and renal complications represent a problem and, probably in the near future, may pose a threat to patients who have survived COVID-19. As physicians, we cannot forget that during an epidemic like this, other chronic diseases are present, and patients continue to require care. We are obliged to monitor even more intensely their treatments and control degree. Furthermore, we must not forget that urgent situations continue to arise in this pandemic situation and require prompt attention. In this current situation, it is very likely that many patients, out of fear, have not sought medical attention. The situation during the epidemic and the uncertainty of the post-COVID-19 period, requires intensification in the control and monitoring of cardiovascular and kidney disease in our patients. Primary care constitutes a key level of care for the care of the population with cardiovascular disease. Likewise, and in the face of this new health scenario, we need to promote the prevention and control measures that emanate from the studies currently underway. Now, more than ever, we need research, crucial to improve the cardiovascular and renal prognosis of our patients.

Restarting care-related activities in the context of COVID-19: Prioritization, protocols, and procedures. experience of a gastroenterology outpatient unit in Bogotá, Colombia

The Colombian Government ordered a mandatory nationwide quarantine in March 2020 due to the spread of the SARS-CoV-2 virus. Since then, outpatient endoscopy units were closed and only urgent procedures were performed in the hospital setting, resulting in a repression of sensitive, priority and elective outpatient endoscopic procedures. The rate of spread of the virus was contained and it did not progress exponentially as in other countries;in the meantime, gastroenterology services were provided in the form of teleconsultation. The mitigation measures and the containment of the virus allowed the Mayor’s Office of Bogotá and the National Government to issue notices with recommendations for the provision of some regulated outpatient services in May 2020, thus creating a window of opportunity to care for patients with sensitive diseases. Under this legal and epidemiological framework, the provision of digestive endoscopy services was restarted at EMDIAGNOSTICA S.A.S. This study presents the strategies for scheduling and performing endoscopic procedures in an outpatient gastroenterology unit during COVID-19 pandemia in Colombia and describes a system for prioritizing procedures according to medical criteria, ranging from care by teleconsultation and/ or an application of a telephone survey and the use of a medically necessary, time-sensitive (MENTS) scale adapted for digestive endoscopy. It also describes changes in infrastructure, methodology implemented for protection of human talent and patients, and post procedure follow-up for feedback, safety and satisfaction degree evaluation in care. © 2020 Asociación Colombiana de Gastroenterología.