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1.
Early Intervention in Psychiatry ; 17(Supplement 1):317, 2023.
Article in English | EMBASE | ID: covidwho-20243386

ABSTRACT

Previous studies have demonstrated that low-intensity intervention is effective in improving mental health in young people. Whilst interventions have majorly been offered online during COVID-19 pandemic, it is not known whether low-intensity interventions delivered online can also help reduce the level of distress experienced by young people. The study aimed to determine whether a low-intensity online intervention (LiON) can reduce levels of distress in young people greater than those in similar initial distress levels but received no intervention. Young people aged 15 to 24 were recruited for the 4-weekly LiON intervention consisting of three modules namely sleep and relaxation, stress-coping and problem-solving. The reductions in distress level after intervention were compared to those that occurred over a period of 3 months among community young people with similar baseline K6 distress levels. Seventy-four young people (mean age 20.24 [SD 2.26] years, 71.6% female) received the LiON intervention from December 2021 to July 2022. We observed a greater improvement in their distress levels after receiving the intervention than those with no intervention in the community (beta -4.13, 95%CI -5.12, -3.07, p < .001, Cohen's f2 0.027). The findings offered evidence that the LiON intervention significantly reduced young people's distress level in addition to the improvement that may occur naturally. The use of LiON is adaptable to a wider variety of frontline community organizations. Future evaluation of its cost-effectiveness is warranted.

2.
Progress in Microbes and Molecular Biology ; 6(1), 2023.
Article in English | Scopus | ID: covidwho-2324554

ABSTRACT

The COVID-19 pandemic has plagued the world for over three years since discovering the causative virus, SARS-CoV-2, in China. The rampant spread of the virus led to the loss of livelihoods of millions across the globe. This public health emergency prompted the rapid development of vaccines and treatments to fight against viral infection. Vaccines against the viral infection started rolling out in late 2020, and the distribution of the vaccines worldwide managed to reduce the symptoms of COVID-19 and prevent outbreaks in local communities. However, COVID-19 infections are still prevalent, with patients suffering from severe symptoms which require oxygen support or mechanical ventilation. Thus, therapeutic agents for COVID-19 play a significant role in reducing the risk of disease progression into severe disease and improving hospitalized patients' clinical outcomes. Existing drugs such as remdesivir, molnupiravir, baricitinib, anakinra, and tocilizumab have been repurposed to treat COVID-19 earlier during the pandemic to meet the urgent demand for treatment. There are also novel antiviral and immunomodulating treatments (nirmatrelvir plus ritonavir, ensitrelvir, regdanvimab, sotrovimab, and vilobelimab) that were developed during the pandemic to fight against COVID-19 infections. These therapeutic agents have been reported to be effective and safe for use to treat COVID-19 infections of different severity. Nevertheless, continuous surveillance is imperative in ensuring that these treatment methods maintain efficacy and safety profiles in treating COVID-19 caused by different variants of the virus. © 2023, HH Publisher. All rights reserved.

3.
Taiwan Veterinary Journal ; 2023.
Article in English | EMBASE | ID: covidwho-2316593

ABSTRACT

Goats may suffer from rumen bloat for many reasons, e.g. improperly concentrated ratio or obstruction. The disease can be caused by eating undigested items, e.g. plastic rope or bags. Since the COVID-19 pandemic, it has often become mandatory for people to wear medical masks. People are generally unaware that masks left on the ground pose a risk to goats who may eat them. This case report describes the rumen bloat caused by medical masks in a male goat reared in an elementary school. After physical examination, the goat showed a bloated rumen, anorexia, depression, and weakness. The heart rate was normal, but respiratory patterns were fast and deep. Fewer defecated feces were noted by the owner. Furthermore, the owner's complaints and ultrasound images revealed that undigested items in the rumen were the cause. After performing a standard rumenotomy, we scooped out four medical masks, one plastic bag, and one high-density nylon rope from the rumen. We believe this was the first report describing the risk of medical masks in goats. Promoting life and animal welfare education is essential to inform others of the harm medical masks pose to animals.Copyright © 2023 World Scientific Publishing Co. Pte Ltd. All rights reserved.

4.
Vaccine ; 41(17): 2853-2859, 2023 04 24.
Article in English | MEDLINE | ID: covidwho-2304275

ABSTRACT

INTRODUCTION: The ChAdOx1 nCoV-19 (ChAd), mRNA-1273 (m1273), MVC-COV1901 (MVC), and BNT162b2 (BNT) COVID-19 vaccines received authorization for emergency use in Taiwan beginning in February 2021. We investigated acute reactions to homologous primary COVID-19 vaccination series in adults aged ≥ 18 years. METHODS: In this prospective observational study based on smartphone data (Taiwan V-Watch), we calculated the frequencies of self-reported local and systemic acute reactions within 7 days of a COVID-19 vaccination, and the health effects up to 3 weeks after each dose. Those who reported adverse reactions after both doses were assessed by the McNemar test. RESULTS: During 22 March 2021-13 December 2021, 77,468 adults were enrolled; 59.0 % were female and 77.8 % were aged 18-49 years. For both doses of all four vaccines, the local and systemic reactions were minor in severity and highest on days 1 and 2 after vaccination, and declined markedly until day 7. For 65,367 participants who provided data after the first and second doses, systemic reactions were more frequent after dose 2 of the BNT and m1273 vaccines (McNemar tests: both p < 0.001), while local reactions were more frequent after dose 2 of the m1273 and MVC vaccines (both p < 0.001), compared with dose 1 of the homologous vaccine. Among the participants aged 18-49 years, the percentage who missed work on the day after vaccination was slightly higher among women (9.3 %) than among men (7.0 %). CONCLUSIONS: Acute reactogenicity and impact of work absenteeism for the four COVID vaccines in the V-Watch survey were mild and of short duration.


Subject(s)
COVID-19 Vaccines , COVID-19 , Adult , Male , Humans , Female , COVID-19 Vaccines/adverse effects , 2019-nCoV Vaccine mRNA-1273 , BNT162 Vaccine , ChAdOx1 nCoV-19 , Taiwan/epidemiology , COVID-19/prevention & control , Vaccination/adverse effects
5.
European Respiratory Journal Conference: European Respiratory Society International Congress, ERS ; 60(Supplement 66), 2022.
Article in English | EMBASE | ID: covidwho-2277099

ABSTRACT

Rhinovirus (RV) is one of the pathogens causing acute and chronic respiratory illnesses worldwide in paediatric patients. Compulsory mask-wearing and high stringency of social distancing were executed in Hong Kong since the SARSCoV-2 outbreak. While other common respiratory viruses vanished in routine surveillance programme, two sudden upsurges of RV associated upper respiratory tract infections were observed from Oct. to Nov. 2020 after schools reopening, and Apr. to Aug. 2021. We aimed to investigate if these RVs have a prominent role in transmission by analysing the RV genotype composition, assessing their replication competence, and the clinical features of paediatric patients. RV specimens collected from the hospitalised patients were genotyped, with clinical features of the patient documented and compared to those obtained in the pre-COVID-19 period. The replication competence of the RVs was examined in the well-differentiated human nasopharyngeal epithelial cells (HNPEC), and the stability of the RVs on different materials was tested. We identified the monopoly of minor group RV in each of the study duration, namely RV-A47 (80%) and RV-A49 (51%), respectively. In contrast to a diversified RV genotype composition in 2018-19. Without prior in vitro adaptation, the two minor-group RVs replicated in the HNPECs effectively to a comparable level as in the laboratory strain RVA16. The rise of minor-group RVs and dominance of single RV genotype under strict social distancing and hand hygiene is remarkable. Further investigation of the viral determinant, with an assessment of transmissibility in an animal model, will be needed to validate the specific role of these RVs.

6.
European Respiratory Journal Conference: European Respiratory Society International Congress, ERS ; 60(Supplement 66), 2022.
Article in English | EMBASE | ID: covidwho-2269366

ABSTRACT

Background: Little is known about the induction of mucosal Ab after the 3rd dose. We reported that two doses of BNT162b2 induced mucosal Abs as early as 14-days after the 1st dose. As BNT162b2 only provides the RNA encoding a full-length spike (S) protein, a mixed-vaccine regime with a vaccine that provides inactivated but intact viral particles was executed in some countries to expand the diversity of SARS-CoV-2 Abs. Aim and objectives: To examine the mucosal and plasma Ab induction in vaccine recipients receiving their 3rd vaccine dose with single or mixed vaccine type. Method(s): 46 healthy subjects who had BNT162b2 (B) or CoronaVac (C) in a sequence of either BBB, BBC, CCC or CCB were recruited for a longitudinal sampling of nasal fluid and blood. The S1-specific Ab and neutralizing Ab against SARS-CoV-2 VOCs were measured. Result(s): All BBB recipients (n=28) had nasal specific S1-IgA and IgG after two doses, and the Abs lasted six months and were readily induced after the 3rd dose. In BBC recipients (n=4), though they had prior induction of nasal Abs after two doses of B, the inactivated vaccine did not boost their nasal Abs. In CCC recipients (n=5), there was no induction on nasal Abs. If they adopted the CCB regime (CCB, n=11), they acquired nasal Ab after the 3rd dose. The nasal neutralizing antibodies against the wild type were boosted in 20/28 of the BBB recipients and induced in 8/11 of the CCB recipients but not in CCC or BBC recipients. Lastly, all 46 subjects had a boosted specific S1-IgA and S1IgG in plasma. Conclusion(s): Our findings highlighted the uniqueness of BNT162b2 in induing nasal Ab regardless of the vaccination history.

7.
Vaccine ; 2023.
Article in English | EuropePMC | ID: covidwho-2282761

ABSTRACT

Introduction The ChAdOx1 nCoV-19 (ChAd), mRNA-1273 (m1273), MVC-COV1901 (MVC), and BNT162b2 (BNT) COVID-19 vaccines received authorization for emergency use in Taiwan beginning in February 2021. We investigated acute reactions to homologous primary COVID-19 vaccination series in adults aged ≥18 years. Methods In this prospective observational study based on smartphone data (Taiwan V-Watch), we calculated the frequencies of self-reported local and systemic acute reactions within 7 days of a COVID-19 vaccination, and the health effects up to 3 weeks after each dose. Those who reported adverse reactions after both doses were assessed by the McNemar test. Results During 22 March 2021–13 December 2021, 77,468 adults were enrolled;59.0% were female and 77.8% were aged 18–49 years. For both doses of all four vaccines, the local and systemic reactions were minor in severity and highest on days 1 and 2 after vaccination, and declined markedly until day 7. For 65,367 participants who provided data after the first and second doses, systemic reactions were more frequent after dose 2 of the BNT and m1273 vaccines (McNemar tests: both p < 0.001), while local reactions were more frequent after dose 2 of the m1273 and MVC vaccines (both p < 0.001), compared with dose 1 of the homologous vaccine. Among the participants aged 18–49 years, the percentage who missed work on the day after vaccination was slightly higher among women (9.3%) than among men (7.0%). Conclusions Acute reactogenicity and impact of work absenteeism for the four COVID vaccines in the T-Watch survey were mild and of short duration.

8.
Computers & Education ; 195, 2023.
Article in English | Web of Science | ID: covidwho-2230978

ABSTRACT

During the widespread COVID-19 pandemic, face-to-face teaching was not viable because many schools were forced to close as a preventive measure. Educators abruptly shifted to online classes without sufficient time and resources to prepare for such an enormous transition. Although shifting from traditional face-to-face format to modern e-learning approach ensured that students could be educated outside of the classroom, its impact on the quality of learning and teaching (L&T) can be mixed. This study aims to address the knowledge gap in conventional teacher training by developing a web-based program called T.E.A.C.H. to enhance preservice teachers' psychological and pedagogical competencies for conducting online L&T. The program consisted of five modules, each focused on one dimension of psychological competence (creativity, curiosity, love of learning, judgment, and perspective) and applied to the 'three foci' for online L&T (attendance and participation, engagement, and assessment). Adopting a quasi-experimental design with matched sampling, a total of 314 preservice teachers were allocated into the intervention or control group. The intervention group was given access to the web-based program to receive training materials, learn about the content, and take part in the online L&T exercises. Program effectiveness was evaluated using pretest and posttest questionnaires, a teaching design task, short quizzes, and a program quality assessment. The results showed that the T.E.A.C.H. program was effective in promoting preservice teachers' psychological competencies, positive attitudes toward online L&T, self-efficacy to teach in an online format, intentions to use technology for L&T, and online pedagogical skills. The successful implementation of T.E.A.C.H. encourages school leaders, teachers, and teacher professional development providers to utilize this web-based program to enhance online teaching practices.

9.
Sleep Med ; 101: 50-57, 2022 Oct 23.
Article in English | MEDLINE | ID: covidwho-2237055

ABSTRACT

OBJECTIVE: To explore the impact of the COVID-19 pandemic on the sleep-wake patterns of preschool children. METHODS: A cohort of preschoolers established before the COVID-19 pandemic was invited to participate in this study. Data including children's demographics, their own and parental sleep-wake patterns, physical activities, and screen time were collected through an online questionnaire from August to September 2020. A comparison was made on the collected data from the same cohort of children before and during the pandemic. RESULTS: The cohort which was established before the pandemic consisted of 3720 preschoolers. For this current study, 642 (17%) participated, and 497 (13%) children who fulfilled the eligibility criteria were included in the final analysis. They showed a delay in their bedtime and wake time on both weekdays and weekends with a 15-30 min increase in nocturnal sleep duration. However, with a reduction in nap time, the average daily sleep duration was shortened by 16.3 ± 64.3 min (p < 0.001) and 27.5 ± 72.9 min (p < 0.001) during weekdays and weekends, respectively. Screen time was increased while outdoor activity duration was decreased. Parental sleep/wake times were also delayed with an increase in sleep duration. Children's sleep habits were associated with screen time and parental sleep/wake patterns. CONCLUSION: Despite school suspension during the COVID-19 pandemic, preschoolers were not sleeping longer. Screen time and parental sleep/wake patterns were the major factors driving the preschoolers' sleep habits. Health education is required to control screen time in children and to promote sleep hygiene among all family members.

10.
WSEAS Transactions on Information Science and Applications ; 19:264-271, 2022.
Article in English | Scopus | ID: covidwho-2206383

ABSTRACT

The outbreak of COVID-19 had brought a great challenge for the World Health Organization (WHO) in preventing the spreading of SARS-CoV-2. The Ministry of Health (MOH) of Malaysia introduced the MySejahtera mobile application for health monitoring and contact tracing. Wearing a face mask in public areas had been made compulsory by the Government. The overhead cost incurred in hiring the extra manpower to ensure all the visitors wear a face mask, check-in through MySejahtera and the status in MySejahtera is healthy before entering a premise. A low-cost solution is urgently needed to reduce the heavy overhead cost. An AI-Based Low-Cost Real-Time Face Mask Detection and Health Status Monitoring System (AFMHS) is proposed to perform real-time detection for the face mask and MySejahtera Check-In tickets by using artificial intelligence. MobileNetV2 was used for the detection and recognition of face and face masks. YOLOv3 was used for the detection of the region of interest for the MySejahtera Check-In ticket to locate the health and vaccination status of the visitor. Optical character recognition (OCR) is a technique that is used to detect the text captured in an image and encode the recognized text. OCR is implemented to recognize the text extracted from the ticket. Tesseract is used as the OCR engine in AFMHS. Raspberry-Pi-4B (Raspberry Pi Generation 4 Model B) with 4 GB RAM is used as the processing unit of AFMHS. The total cost of the AFMHS is only USD220. Extensive experimental tests were carried out to evaluate the performance of AFMHS. The optimum operation setup conditions are proposed to achieve 100% accuracy. The optimum operating distance for the face mask detector and MySejahtera Check-In ticket detector are 1.5m and 15cm respectively. © 2022 The authors.

11.
Paediatrics and Child Health (Canada) ; 27(Supplement 3):e23-e24, 2022.
Article in English | EMBASE | ID: covidwho-2190144

ABSTRACT

BACKGROUND: Children living with chronic comorbid conditions are at increased risk for severe COVID-19 disease, though there is limited evidence regarding the risks associated with specific conditions and which children may benefit from targeted COVID-19 therapies. Age-specific baseline indicators of COVID-19 severity are also needed to evaluate the effectiveness of SARS-CoV-2 vaccination strategies in the paediatric population. OBJECTIVE(S): In this study, we aimed to 1) identify factors associated with severe COVID-19 in children, and 2) describe rates of hospitalization, intensive care unit (ICU) admission, and severe COVID-19 within specific pediatric age groups. DESIGN/METHODS: We conducted a national prospective study on hospitalized children with microbiologically confirmed SARS-CoV-2 infection via the Canadian Paediatric Surveillance Program from March 2020-May 2021. Cases were reported voluntarily by a network of >2800 paediatricians and paediatric subspecialists. SARS-CoV-2 hospitalizations were classified as COVID-19-related, incidental infection, or infection control/social admissions. Severe disease was defined as intensive care, ventilatory or hemodynamic requirements, select organ system complications, or death. Outcomes were described among children aged <6 months, 6-23 months, 2-4 years, 5-11 years, and 12-17 years. Risk factors for severe disease were identified using multivariable Poisson regression, adjusting for child age and sex, coinfections, and timing of hospitalization. RESULT(S): We identified 541 children hospitalized with SARS-CoV-2 infection, including 329 (60.8%) with COVID-19-related disease. Median age at admission was 2.8 years (IQR 0.3-13.5) and 42.9% (n=232) had at least one comorbidity. Among COVID-19-related hospitalizations, severe disease occurred in 29.5% of children (n=97/329), including a higher proportion of children aged 2-4 years (48.7%) and 12-17 years (41.3%) (Table 1). Comorbidities associated with severe disease are described in Figure 1, and included technology dependence (adjusted risk ratio [aRR] 1.96, 95% confidence interval [CI] 1.31-2.95), neurologic conditions (e.g. epilepsy and chromosomal/genetic conditions) (aRR 1.87, 95% CI 1.34-2.61), and pulmonary conditions (e.g. bronchopulmonary dysplasia and uncontrolled asthma) (aRR 1.66, 95% CI 1.13-2.42). CONCLUSION(S): While severe outcomes were detected at all ages and among patients with and without comorbidities, neurologic and pulmonary conditions as well as technology dependence were associated with increased risk of severe COVID-19. Children aged 2-4 years more commonly experienced severe COVID-19 in this study, which was conducted at a time when no children were eligible for SARS-CoV-2 vaccines. Notably, this high-risk group remains without access to approved vaccines. These findings may help guide vaccination programs and prioritize targeted COVID-19 therapies for children.

12.
Innov Aging ; 6(Suppl 1):809, 2022.
Article in English | PubMed Central | ID: covidwho-2189053

ABSTRACT

More than 2 million of older adults are homebound and 5 million need help leaving their homes. They often experience social isolation, food insecurity, and lack of connection to community resources, which for many has intensified since the pandemic. To date, home-based services for those aging in place are lacking. Using newly available data, this study examined the benefits of an intergenerational home-based service learning program in reducing psychological distress for a community-based sample of 190 homebound older adults during the COVID-19 pandemic. Multivariate regression analyses were conducted to examine the association of living in one's own home, disability status, presence of child and spousal caregivers, and length of services from the program with psychological distress. Findings indicated that length of service with the intergenerational in-home support program was associated with lower psychological distress (β = -0.16, p < 0.05). Having a child as a caregiver was associated with lower psychological distress (β = -0.15, p < 0.05). Poor health status was associated with higher levels of psychological distress (β = 0.16, p < 0.05). Living in one's own home, having a spouse as a caregiver, disability status, and having a long-term medical condition were not associated with psychological distress in the analysis. Results from this study suggest that intergenerational in-home support services can help reduce psychological distress for homebound older adults. Policies and practice can support a pipeline of geriatric health professionals through innovative service learning models to benefit older adults, caregivers, and students.

13.
United European Gastroenterology Journal ; 10(Supplement 8):208, 2022.
Article in English | EMBASE | ID: covidwho-2114129

ABSTRACT

Introduction: Gut microbiota have been shown to be associated with COVID- 19 and influenza vaccine immunogenicity. While antibiotic-induced gut microbiota perturbation leads to suboptimal antibody production among influenza vaccine recipients, little is known about the effect of preexposure antibiotics on COVID-19 vaccine immunogenicity. Aims & Methods: We aimed to determine whether recent antibiotics use impaired COVID-19 immunogenicity. This was a prospective cohort study recruiting adult BNT162b2 recipients from five vaccination centers in Hong Kong. Exclusion criteria included prior COVID-19 infection, history of gastrointestinal surgery, inflammatory bowel disease, immunocompromised status (post-organ transplantation, immunosuppressants, chemotherapy), cancer, hematological, rheumatological and autoimmune diseases. Subjects received two doses of BNT162b2 at three weeks apart. Blood samples were collected at three time-points (before vaccination, day 21 and 56after first dose), and were tested for neutralising antibody (NAb) against receptor-binding domain (RBD) of wild type SARS-CoV-2 virus using a one-step competitive chemiluminescence immunoassay. NAb seroconversion was defined as 15 AU/mL. Primary outcomes were seroconversion rates of NAb at day 21 and 56 after first dose of vaccine. Exposure was pre-vaccination antibiotic use, defined as ever use of any antibiotics (including 11 different classes) within 6 months before vaccination. The adjusted odds ratio (aOR) of seroconversion with antibiotic use was derived by multivariable logistic regression model by adjusting for age, sex, diabetes mellitus (DM), overweight (BMI >23 kg/m2for Asians), hypertension, raised LDL (>=3.4 mmol/L), moderate-to-severe hepatic steatosis (defined as controlled attenuated parameter >= 268 dB/M on transient elastography), smoking and alcohol. Result(s): Of 316 BNT162b2 recipients (100 [31.6%] male;median age 50.1 [IQR:40.0-57.0] years), all and 284 (89.9%) had NAb level measured at day 21 and 56, respectively. There were 29 (9.2%) antibiotic users (median duration of use: 7 [IQR:7-13] days). There was no significant difference in baseline characteristics between antibiotic users and non-users. At day 21, there was a trend towards lower seroconversion rate among antibiotic users compared with non-users (82.8% vs 91.3%;p=0.135). Independent factors negatively associated with seroconversion after one dose of BNT162b2 were antibiotics use (aOR:0.26, 95% CI:0.08-0.96), age >60 years (aOR:0.34, 95% CI:0.13-0.95) and male sex (aOR:0.14, 95% CI:0.05-0.34). At day 56, there was no more significant difference in seroconversion rate between antibiotic users and non-users (96.6% vs 99.3%;p=0.149). Conclusion(s): Recent antibiotic use before BNT162b2 vaccination was associated with lower early seroconversion rate after a single dose of vaccine but not two doses of vaccine. Further research on the association between antibiotics, gut microbiota and COVID-19 early vaccine immunogenicity is warranted.

14.
Annals of the Academy of Medicine Singapore ; 49(6):415-416, 2020.
Article in English | EMBASE | ID: covidwho-2114109
16.
129th ASEE Annual Conference and Exposition: Excellence Through Diversity, ASEE 2022 ; 2022.
Article in English | Scopus | ID: covidwho-2044813

ABSTRACT

This paper examines the evolution of a first-year engineering mechanics course, Solid Mechanics I, over the two iterations that it has been flipped. It discusses the teaching strategies that have and haven't worked when delivering the course in both an online and hybrid approach. These include recommended durations for lecture videos, types of assessments, grade distributions, etc. Flipping the classroom was a result of the forced transition online due to Covid-19. To best support the students in the unprecedented times, the instructor opted to combine components from both asynchronous and synchronous teaching styles. Asynchronous lecture videos were accompanied by synchronous class time where the instructor clarified concepts, demonstrated real-life applications, solved higher-level problems, and implemented group activities. A combination of these active learning strategies was the key to structuring the course to keep the students engaged despite being online for all, or part, of the term as delivered in Fall 2020 and Fall 2021, respectively. In the Fall 2020 iteration, the course was delivered fully online to roughly 325 students in civil, environmental, geological, and architectural engineering. Since then, the course had been improved and adjusted in response to the students' feedback collected from an end-of-term survey. Approximately 270 students were enrolled in the course in the subsequent Fall 2021 term which took a hybrid approach as Covid-19 restrictions began to lighten. With students being able to learn in-person again, the course had shifted to emphasize student-to-student and student-to-instructor interactions. Feedback became immediate, allowing for the course to be molded to the students' satisfaction as the term progressed. Changes between the two years have been documented in the paper along with recommendations for future adaptations. © American Society for Engineering Education, 2022

17.
Innovation in Aging ; 5:275-275, 2021.
Article in English | Web of Science | ID: covidwho-2011079
18.
Journal of Clinical Oncology ; 40(16), 2022.
Article in English | EMBASE | ID: covidwho-2009521

ABSTRACT

Background: Understanding how cancer system responded to the first wave of the COVID-19 pandemic has crucial implications to de-escalation measures in future waves. Here we examined the pandemic impact on the provision of diagnostic imaging (MRI, CT, and ultrasound) and physician visits (virtual and in-person) at cancer diagnosis in Ontario, Canada. Methods: For each week of June 26, 2016-September 26, 2020, we identified cancer diagnoses whose time around diagnosis (91 days +/- the date of diagnosis) fell into this week and restricted those diagnoses to be one per person-day and to patients aged 18+ at the beginning of that week. For these cancer patients, we used physician claims database to identify diagnostic imaging and visits received around cancer diagnosis. In separate segmented negative binomial regression procedures, we assessed the trends in weekly volume of these services per thousand cancer patients in pre-pandemic (June 26, 2016 to March 14, 2020), the change in mean volume at the start of the pandemic, and the additional change in weekly volume in the pandemic (March 15, 2020 to September 26, 2020). Results: Among 403,561 cancer patients in the cohort, 41,476 (10.3%) were diagnosed in the pandemic. As COVID-19 arrived, mean diagnostic imaging volume decreased by 12.3% (95% CI: 6.4%-17.9%) where ultrasound decreased the most by 31.8% (95% CI: 23.9%-37.0%) and MRI did not change (p-value = 0.27). Afterwards, the volume of all scans increased further by 1.6% per week (95% CI: 1.3%-2.0%), where ultrasound increased the fastest by 2.4% for each week (95% CI: 1.8%-2.9%). Mean in-person visits dropped by 47.4% when COVID-19 started (95% CI: 41.6%-52.6%) while virtual visits rose by 5515% (95% CI: 4927%- 6173%). In the pandemic era, in-person visits increased each week by 2.6% (95% CI: 2.0%-3.2%), but no change was observed for virtual visits (p-value = 0.10). Conclusions: Provision of diagnostic imaging and virtual visits at cancer diagnosis has been increasing since the start of COVID-19 and already exceeded pre-pandemic utilization levels. These findings imply the feasibility of combining virtual consultations with diagnostic imaging to manage new cancer patients and highlight the need to monitor the quality of these services.

19.
Hong Kong Journal of Gynaecology Obstetrics and Midwifery ; 22(2):125-128, 2022.
Article in English | EMBASE | ID: covidwho-2006523
20.
Hong Kong Journal of Paediatrics ; 27(1):67, 2022.
Article in English | EMBASE | ID: covidwho-2003052

ABSTRACT

Vaccines that elicit mucosal immune responses against SARS-CoV-2 could potent ially be of exceptional importance in providing first line defence at the site of viral entry. In order to understand the mucosal immune response profiles of SARS-CoV-2 vaccines, we examined both the mucosal and systemic responses of subjects vaccinated by two different vaccination platforms: mRNA (Comirnaty) and inactivated virus (CoronaVac). Nasal epithelial lining fluid (NELF) and peripheral blood samples were collected in subjects who had received two doses of CoronaVac or Comirnaty. We quantified IgA and IgG specific to SARS-CoV-2 S1 protein, neutralisation antibody by ELISA in NELF and plasma samples. Only Comirnaty induced nasal S1-specific IgA and IgG responses, which were evident as early as on 14±2 days after the first dose. The NELF samples of 72% of subjects became IgA+IgG+, while in 62.5% of subjects the samples were neutralising by 7±2 days after the second dose. In 45% of the subjects their NELF remained neutralising 50 days after the booster. In plasma, 91% and 100% Comirnaty subjects possessed S1-specific IgA+IgG+ on 14±2 days after the first dose and 7±2 days after booster, respectively. The plasma collected on 7±2 days after booster was 100% neutralising. The induction of S1-specific antibody by CoronaVac was IgG dominant, and 70% of the subjects possessed specific IgG by 7±2 days after booster and were all neutralising. This study reveals that Comirnaty is able to induce S1-specific IgA and IgG r esponse with neutralising activity in the nasal mucosa in addition to a consistent systemic response.

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