ABSTRACT
Background: Telemedicine use has expanded rapidly during the COVID-19 pandemic. There is limited data on patient satisfaction with teledermatology;therefore, we examined patient teledermatology experiences at a large academic center. Methods: After Weill Cornell Medicine Institutional Review Board approval, patients scheduled for teledermatology visits (1/2021-4/2021) were enrolled and sent pre/postconsultation questionnaires about telemedicine satisfaction, expectations, and concerns (5-point Likert scale) (82% response rate). Results: Of 202 participants, 120 (59%) were female with mean age 49 years. Participants were largely White (78%) and non-Hispanic (86%). The majority had at least a college degree (94%) and were employed (66%). Younger patients (21-40) were more satisfied with telemedicine (P =.016), and its convenience (P =.001), compared with older participants (>66) (P =.001, P =.019). Those with shorter travel times (<30 min) preferred in-person visits (P =.031). Nonwhite race was associated with greater concerns for conversation privacy and inappropriate information access (both P =.004). White race was associated with greater confidence in telemedicine diagnosis (P =.032). Participants had less trouble hearing and seeing than anticipated (P ≤.001 and P =.005). Patients were more interested in using telemedicine and preferred it over in-person appointments post- vs. preconsultation (P<.001 both). Conclusion: Our study demonstrates overall positive attitudes towards teledermatology. However, decreased satisfaction and confidence were found amongst older and nonwhite patients. Patients with longer vs. shorter clinic proximity preferred telemedicine to in-person visits, which may improve access to care in areas without dermatologists. Our study clarified specific concerns that may be used to devise strategies to encourage universal utilization of teledermatology where appropriate.
ABSTRACT
Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder characterized by abnormal activity of the immune system, producing the autoantibodies directed against nuclear and cytoplasmic antigens1. Infection is known as one of the common trigger factors for SLE. Coronavirus disease in 2019 (COVID-19), a severe acute respiratory syndrome, is now spreading rapidly throughout the world2.Though previous studies have addressed the susceptibility of lupus patients to the virus but how patients with SLE deal with COVID-19 is unclear up until now Objectives: To clarify the common pathogenesis of SLE and COVID-19, and find the appropriate treatment for Lupus and prevent COVID-19. Methods: The transcription profile of SLE (GSE38351) and COVID-19 (GSE161778) were obtained from the Gene Expression Omnibus database (GEO). R package was used to find differentially expressed genes (DEGs) between lupus patients and HCs. After background adjustment and other pre-procession, DEGs were extracted from the peripheral blood of patients with COVID-19 at three different disease progression(moderate, severe and remission status). The Short Time-series Expression Miner (STEM) was used to cluster and compare average DEGs with coherent changes. The different expression patterns of time-series genes (TSGs) were also compared among these patients. GO and KEGG pathway enrichment analysis of TSGs and DEGs were performed by Metascape. Results: Compared with HC, patients with SLE expressed 977 DEGs, which were mainly associated with defense response to virus, Epstein-Barr virus infection and response to interferon-γ(INF-γ) (Figure 1a). As for COVID-19 patients, there were 1584 DEGs obtained when compared with those of HCs (P < 0.05) (Figure 1b). Gene landscapes suggested the signatures of COVID-19 patients gradually changed during the disease progression, and gradually converge to HCs signatures. Time-series genes in the three stage of disease had different expression patterns and functions. A total of 959 TSGs in profile 3 showed a stable-stable-decreasing expression trend and significantly associated with INF signaling pathway (Figure 1c,1d). Interestingly, patients with SLE and COVID-19 shared common pathways such as INF-γ related functional pathway. Conclusion: INF-γ is an important common node of SLE and COVID-19. Controlling the production of INF-γ not only has therapeutic effect on SLE patients, but also may prevent COVID-19.
ABSTRACT
In recent times, SARS-Cov-2 infection has changed the way we view global public health. Patients with coronavirus may have no symptoms or present mild, moderate, severe, or critical symptoms. Patients can be managed on an outpatient basis (66%) or hospital (34%);in the hospital context, they may require an intensive care unit. It has been documented that 3% of those hospitalized need mechanical ventilation. Sedation, analgesia, and management of the acute confusional state present interesting considerations;in COVID-19, cardiac, coagulatory, renal, nervous, cognitive changes, among others, may occur. The purpose of this document is to provide information for the clinician.