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Purpose: The Taiwan Central Epidemic Command Center raised the coronavirus disease 2019 (COVID-19) pandemic alert to level 3 throughout the nation since May 19, 2021, and asked hospitals to reduce patient intake. Surgical departments were the worst affected. The aim of this study is to share experiences of urological practice adjustment in a tertiary medical center during the pandemic and to evaluate the impact of the COVID-19 pandemic on the urological service in Taiwan under a level 3 epidemic alert. Materials and Methods: This observational study was conducted from June 1, 2021, to June 31, 2021, when a level 3 pandemic alert was declared. Data of patients visiting the urology department at the Taipei Veterans General Hospital were recorded and compared with data 1 year before the COVID-19 outbreak in Taiwan (June 1, 2020, to June 31, 2020). Data included outpatient visits, elective surgeries, emergent surgeries, functional urological examinations, and diagnostic procedures in outpatient settings. Results: There was no significant decrease in all types of uro-oncological surgeries, except bladder urothelial carcinoma (UCB)-related procedures. The total number of UCB-related procedures showed 66.67% reduction. Stone-related surgeries were reduced by 45.7%. Only 12% of all transurethral prostate resections were performed in the pandemic. There was a significant decrease in all types of functional urology and andrology procedures. More than 30% reduction was noted in the number of patients visiting the urology department in June 2021 compared to that in June 2020. Conclusion: Our data provide a reference of how the urological service was affected during the level 3 pandemic alert in Taiwan. We postponed most elective surgeries and outpatient visits or diagnostic outpatient examinations procedures according to prioritization guidelines. Uro-oncology-related service was less affected because oncology patients have a stronger motivation for treatment. Benign urological condition-related procedures were significantly influenced. After the epidemic slowdown, the backlog should be gradually managed based on priority.
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Background: Severe hyponatraemia can lead to serious neurological complications including coma, seizure and death. Hyponatraemia and the Syndrome of Inappropriate Antidiuretic Hormone (SIADH) has been previously described in cases of COVID-19, however there have been few reports post vaccination. We describe a case of severe hyponatraemia post second Pfizer BNT162b2 mRNA vaccination against COVID-19. Case presentation: A 48-year-old previously well woman presented to the emergency department with severe headaches and confusion one day after she received her second Pfizer COVID-19 vaccination. She reported no more than 2.5 L fluid intake. Vital signs were normal. Laboratory investigation revealed serum sodium 113 mmol/L, potassium 3.4 mmol/L, urea 3.5 mmol/L and serum osmolality 266 mmol/kg. TSH, random cortisol and C-reactive protein levels were normal. She was found to be in urinary retention and developed marked polyuria post in dwelling catheter insertion. Following this she underwent spontaneous and rapid correction of serum sodium without intervention. Retrospective analysis showed an inappropriately high copeptin of 4.4 pmol/L. Conclusions: It is important to be cautioned and aware of hyponatraemia as an immediate side effect of COVID-19 vaccination. The exact mechanism is unknown and further research is required to understand the acute endocrine effects which may arise in response to COVID-19 vaccination.
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This study investigated a SARS-CoV-2 virus detection mechanism using dry-stored disposable strips. The accuracy of this sensing platform is as good as polymerase chain reaction (PCR) with a detection time of fewer than 30 s. SARS-CoV-2 antibodies were biofunctionalized on disposable strips similar to glucose detection strips to detect the presence and concentrations of SARS-CoV-2 in saliva samples. Eight 1 ms electric pulses were sent through the sensor strip with a saliva sample in its microfluidic chamber. A circuit board embedded with MOSFET was also employed to amplify the detected signals and convert the signal to digital readings displayed on an LCD screen. The COV-antibody functionalized disposable strips were stored in a dry condition for at least one day before analyzing clinical human saliva samples with known cycling threshold (Ct) values confirmed with conventional PCR tests. Results demonstrate our system is capable of showing qualitative positive or negative results within 30 s and providing quantitative SARS-CoV-2 concentrations in terms of Ct values in 5 min. Published under an exclusive license by the AVS.
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The analytical specificity and microbial interference of a SARS-CoV-2 biosensor detection platform were elucidated in this work. A cost-effective and highly sensitive detection system for the virus has been developed with the capability of producing quantitative results comparable with polymerase chain reaction (PCR) within 30 s. This could meet the demand for a fast diagnosis solution needed for the ongoing global pandemic. Disposable strips were biofunctionalized and immobilized with monoclonal SARS-CoV-2 antibodies. A printed circuit board embedded with a metal-oxide-semiconductor field-effect transistor (MOSFET) was also designed. The strips were connected to the gate electrode of the MOSFET, which received a synchronous pulse along with the drain electrode. The resulting waveform from the drain was then converted to digital readouts corresponding to virus or spike protein concentrations. We investigated 26 common organisms which are likely presented in the respiratory system along with 5 pathogens from the same genetic family of the SARS-CoV-2 virus for having cross-reaction or microbial interference, either of which would hinder the efficacy of the system. None of these organisms decreased the virus detection effectiveness of the sensor system.
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The movement restrictions of coronavirus had a significant impact on consumer behavior. The rise of cross-border e-commerce has also increased the risks in logistics activities. This work identified the critical threat of cross-border logistics. Additionally, artificial intelligence over Internet of Things (AIoT) technology was found to reduce logistics risk in this work beneficially. © 2022 IEEE.
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Objective: To investigate the patient experience of telemedicine for headache care during the COVID-19 pandemic. Background: The use of telemedicine has rapidly expanded and evolved since the beginning of the COVID-19 pandemic. However, few studies have assessed the patient perspective of telemedicine for headache care. Design/Methods: The American Migraine Foundation (AMF) designed a standardized electronic questionnaire to assess the patient experience of telemedicine for headache care between March and September 2020. The questionnaire was distributed electronically to more than 100,000 members of the AMF community through social media platforms and the AMF email database. Results: 1172 patients responded to our electronic questionnaire, with 1098 complete responses. 648/1127 (57.5%) patients reported that they had used telemedicine for headache care during the study period. Among those who participated in telehealth visits, 553/647 (85.5%) patients used it for follow-up visits;94/647 (14.5%) patients used it for new patient visits. During the telemedicine encounters, patients were evaluated by headache specialists, general neurologists, primary care providers, and headache nurse practitioners. Only 47/633 (7.4%) patients received a new headache diagnosis from telemedicine evaluation, whereas 586/633 (92.6%) patients did not have a change in their diagnoses. During these visits, a new treatment was prescribed for 358/636 (52.3%) patients, whereas 278/636 (43.7%) patients did not. The number (%) of patients who rated the telemedicine headache care experience as “very good,” “good,” “fair,” “poor,” and “other” were 396/638 (62.1%), 132/638 (20.7%), 67/638 (10.5%), 23/638 (3.6%), and 20/638 (3.1%), respectively. Most patients, 573/638 (89.8%), indicated that they would prefer to continue to use telemedicine for their headache care. Conclusions: Our study evaluating the patient perspective demonstrated that telemedicine facilitated headache care for many patients during the COVID-19 pandemic, resulting in high patient satisfaction rates, and a desire to continue to use telemedicine for future headache care among those who completed the online survey.
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Background/Introduction: Patients with COVID-19 are at increased risk for mortality during hospitalization. Better definition of the incidence, predictors, and outcomes of cardiac arrest during hospitalization for COVID-19 may support early identification and intervention. Purpose: To estimate the incidence of in-hospital cardiac arrest in patients with COVID-19, describe the temporal trends in incidence of and survival after cardiac arrest, summarise characteristics of those who experienced a cardiac arrest, and compare the characteristics of survivors versus nonsurvivors of cardiac arrest. Methods: We conducted a retrospective cohort study of patients admitted for COVID-19 to a tertiary medical center comprising three hospitals between March and November 2020. Data entry is ongoing for more than 2000 patients admitted through 2021. Clinical variables extracted via review of electronic medical records included age, sex, race/ethnicity, body mass index, history of cardiovascular disease (ie., coronary artery disease, congestive heart failure, atrial fibrillation, or cerebrovascular event), other comorbidities included in the Charlson comorbidity index, date of admission, duration of hospitalization, all cardiac arrest events during hospitalization, presenting rhythm during first cardiac arrest, and death. Data were described using summary statistics. Multivariable logistic regression was used to evaluate associations. Results: Among 1666 patients, 107 (6.4%) experienced at least one inhospital cardiac arrest event during hospitalization for COVID-19, of which 25 (23%) survived to hospital discharge. From March to October 2020, there was a decrease in estimated cardiac arrest incidence in-hospital from 8.2% to 3%, whereas estimated survival to hospital discharge after an arrest remained similar at approximately 20% (Figure). Compared to those who did not, patients who experienced in-hospital cardiac arrest were older and more likely to have existing cardiovascular disease, as well as other comorbidities. Similar factors were associated with lower chance of survival after cardiac arrest (Table). Patients with pulseless ventricular tachycardia/ fibrillation (VT/VF) as presenting rhythm in cardiac arrest had better survival to hospital discharge compared to those with other rhythms (OR 3.3, p=0.02). Younger age (per 10 years, OR=0.7, p=0.03) and fewer comorbidities (per one fewer comorbidity, OR=1.5, p=0.05) were associated with better survival after cardiac arrest in multivariable logistic regression. Conclusion: There was a decline in estimated incidence of cardiac arrest during hospitalization for COVID-19 since beginning of pandemic, with survival to hospital discharge after cardiac arrest estimated to be stable at around 20%. Younger age and fewer comorbidities especially cardiovascular disease were associated with better survival after an in-hospital cardiac arrest. (Figure Presented).