Outcomes of patients with COVID-19 hospitalized during the fourth pandemic wave in relation to their clinical features and vaccination status

This study aims to observe the clinical characteristics and outcomes of recovered patients from coronavirus disease 2019 (COVID-19) related to the vaccination status. We examined results of 205 COVID-19-recovered patients from 15 December 2021 to 1 March 2022 in two hospitals of Local Health Authority of Alessandria (Italy) during the fourth pandemic wave. 77% of patients were hospitalized for acute respiratory failure (ARF) with radiological pneumonia pattern (recovered for COVID), 23% for other causes with occasional positivity finding (recovered with COVID). 32% of patients were not vaccinated for SARS-CoV-2, 37% had three doses, 25% two doses, 5% only one dose. All patients without vaccination were hospitalized for ARF and they had a 7 times higher risk of hospitalization than the vaccinated. 60% of all patients had =3 comorbidities, of these 50% was vaccinated with three doses. In the fourth pandemic wave compared to the other not all patients were hospitalized for ARF and pneumonia and the presence of comorbidities >= 3 is a risk factor for hospitalization regardless of vaccination status. This justifies the administration of the fourth dose to frail patients.

Occupational hazards and gender differences: a narrative review

Personalized medicine, and particularly gender medicine, is becoming essential in daily medical practice. This narrative review aims to assess sex and gender differences in occupational risks among workers. We point out that female workers are more exposed to biological risks (i.e., 70% of healthcare workers during the COVID-19 pandemic were women), but also seem to be more protected against microorganisms (i.e., for HBV vaccination: OR 1.21, p = 0.0023);with regard to physical risks, women are more susceptible to radiations (the estimated incidence of solid tu-mors for 0.1 Gy of exposure is 0.013% in females and 0.008% in males), while men are more susceptible to heat (infertility prevalence was 22.7% in exposed workers vs 3.0% in con-trols);female video terminal workers are more susceptible to both computer vision syndrome (aOR 2.57 and aOR 2.35) and musculoskeletal symptoms (OR 3.6). From a psychological point of view, women are more at risk for work-relat-ed stress and burnout, as well as workplace mobbing (65% of affected workers are women) and verbal violence, while physical violence was more common among men. In conclu-sion, important sex and gender differences are present with regard to occupational risks and hazards, thus showing the necessity to improve medical surveillance and to allow occupational physicians to personalize health surveillance. © 2022, Il Pensiero Scientifico Editore s.r.l.. All rights reserved.

"I Think That's the Most Beneficial Change That WIC Has Made in a Really Long Time": Perceptions and Awareness of an Increase in the WIC Cash Value Benefit.

During the COVID-19 pandemic, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Cash Value Benefit (CVB) for fruits and vegetables increased by roughly USD 25/month/person. We sought to understand WIC participant perceptions of this change and barriers and facilitators to using the CVB. We conducted 10 virtual focus groups (5 rural, 5 urban/suburban) with WIC participants (n = 55) in North Carolina in March 2022. Focus groups were recorded and transcribed. We open-coded the content and used thematic analysis to uncover consistencies within and between sampled groups. Participants expressed favorable perceptions of the CVB increase and stated the pre-pandemic CVB amount was insufficient. Barriers to using the increased CVB were identifying WIC-approved fruits and vegetables in stores and insufficient supply of fruits and vegetables. Barriers were more pronounced in rural groups. Facilitators of CVB use were existing household preferences for fruits and vegetables and the variety of products that can be purchased with CVB relative to other components of the WIC food package. Participants felt the CVB increase allowed their families to eat a wider variety of fruits and vegetables. The CVB increase may improve fruit and vegetable intake, particularly if made permanent, but barriers to CVB and WIC benefit use may limit the potential impact.

COVID-19-recovered patients during the fourth pandemic wave regardless of vaccination status

Aim of this study is to observe the clinical characteristics of patients hospitalized for Coronavirus Disease 2019 (COVID-19) in relation to the vaccination status and the clinical outcome. We retrospectively examined 107 consecutive COVID-19 hospitalizations from December 2021 to February 2022 in Monsignor Galliano Hospital (Acqui Terme, ASL AL) during the fourth pandemic wave. 72% of patients were hospitalized for acute respiratory failure with radiological picture of pneumonia (for-COVID hospitalizations). 28% of patients were hospitalized for other causes with occasional finding of a positive Sars-Cov-2 swab (with-COVID hospitalizations). 42% of patients were not vaccinated, 29% had undergone a full vaccination course (3 doses), 23% had two doses and 3% only one dose. All patients without vaccination were hospitalized for acute respiratory failure. More than 3 comorbidities were present in 49% of patients, and arterial hypertension in 50%. Unexpectedly, mortality was higher in patients vaccinated with two doses. In conclusion in the fourth pandemic wave, in comparison to the others, not all patients were hospitalized for respiratory failure and pneumonia, and the presence of at least three comorbidities is a risk factor for hospitalization regardless of the vaccination status.

“I Think That’s the Most Beneficial Change That WIC Has Made in a Really Long Time”: Perceptions and Awareness of an Increase in the WIC Cash Value Benefit (preprint)

During the COVID-19 pandemic, WIC increased the Cash Value Benefit (CVB) for fruits and vegetables by roughly $25/month/person. We sought to understand WIC participant perceptions of this change and barriers and facilitators to using the CVB. We conducted 10 virtual focus groups (5 rural, 5 urban/suburban) with WIC participants (n=55) in North Carolina in March 2022. Focus groups were recorded and transcribed. We open coded the content and used thematic analysis to uncover consistencies within and between sampled groups. Participants expressed favorable perceptions of the CVB increase and stated the pre-pandemic CVB amount was insufficient. Barriers to using the increased CVB were identifying WIC approved fruits and vegetables in stores and insufficient supply of fruits and vegetables. Barriers were more pronounced in rural groups. CVB use facilitators were existing household preferences for fruits and vegetables and the variety of products that can be purchased with the CVB relative to other components of the WIC food package. Participants felt the CVB increase allowed their families to eat a wider variety of fruits and vegetables. The CVB increase may improve fruit and vegetable intake, particularly if made permanent, but barriers to CVB and WIC benefit use may be limiting the potential impact.

Absence of Anti-RBD Antibodies in SARS-COV-2 Infected or Naive Individuals Prior to Vaccination With CoronaVac Leads to Short Protection of Only Four Months Duration (preprint)

The COVID-19 pandemic is the biggest public health threat facing the globe today. Multiple vaccines have been approved, however the emergence of viral variants such as the recent Omicron, raises the possibility of booster doses to achieve adequate protection. In Brazil, the CoronaVac (Sinovac) vaccine was used, however it’s important to assess the immune response to this vaccine over time. This study aimed to monitor the anti-SARS-CoV-2 antibody responses in those immunized with CoronaVac and SARS-CoV-2 infected individuals. Samples were collected between August 2020 and August 2021. Within the vaccinated cohort, some individuals had history of infection by SARS-CoV-2 prior to immunization and others not. We analyzed RBD-specific and neutralizing- antibodies. Anti-RBD antibodies were detected in both cohorts, with a peak between 45-90 days post infection or vaccination, followed by a steady decline over time. In those with previous history of COVID-19, a higher, longer, more persistent response was observed. This trend was mirrored in the neutralization assays, where infection followed by immunization resulted in higher, longer lasting responses which were conditioned on the presence of levels of RBD antibodies right before the vaccination. This supports the necessity of booster doses of CoronaVac in due course to prevent serious disease.

Italian health care workers and Adverse skin reactions to personal protective equipment during Covid-19 pandemic

Introduction: During the pandemic, the use of personal protective equipment (PPE) has become essential for Healthcare Workers (HCWs) to fight safely against the virus. However, the extensive and prolonged use of PPE may cause various adverse skin reactions due to the use of alcohol hand cleanser and protracted use of masks and goggles. The aim of this study is to evaluate the skin problems caused by PPE in HCWs and the possible consequences on their work. Materials and methods: An online ad hoc questionnaire, composed by 35 questions about sociodemographic characteristics, work related issues and exposure/habits about PPE, was administered to a sample of Italian HCWs. Univariate and multivariate analyses were performed in order to explore possible associations between variables. Results: We tested 3 types of PPE: Gloves, Hair Bonnets and Masks for different time of utilization (<1, 1-3, 3-6, >6 hours). The sample included 1184 participants: 292 workers reported a dermatological pathology nested in four different pathological groups: 45 (15%) had Psoriasis, 54 (19%) Eczema, 38 (13%) Acne, 48 (16%), seborrheic dermatitis and 107 (36%) other. 25 workers had a loss of occupational days due to dermatological illness;56 occupational physician surveillance visits were asked for;in 30 cases were recognized limitations in working duties. Conclusions: Protecting HCWs requires the use of PPE, but occupational dermatitis is an emerging problem in the midst of the COVID-19 pandemic. National data for affected healthcare professionals could contribute to a better understanding of the problem and prevention initiatives in the workplace

Physical activity as protective factor against COVID-19 disease

The Coronavirus Pandemic has forced millions of people around the world to look at home. This resulted, as a consequence, in a remodelling of the lifestyle;in this scenario the correct nutrition combined with regular physical activity becomes fundamental for health. Although the sedentary lifestyle of a few weeks involves risks such as lowering the immune system, it favours overweight and obesity, high blood pressure, metabolic disorders, depression and anxiety, and in some subjects they react to the risk of onset of cardiovascular disease, diabetes and other diseases. The importance of healthy lifestyle is crucial to prevent also viral infection. Indeed, as reported by many data literature, during lung infections, IL-6 and TNF-a create the pathway between adipose tissue and lung system demonstrating the important involvement of adipose tissue in lung diseases. In obese condition, adipose tissue endocrine function is altered. There is an imbalance in the production of pro-inflammatory cytokines such as IL-6 and TNF-a and anti-inflammatory mediators such as IL-10. In the light of these evidences, the immune response is influenced by nutritional status and by physical activity which are able to reduce pro-inflammatory mediators and increase anti-inflammatory mediators such as IL-10. In addition, the power of viral infection is influenced by host predisposition. For these reasons, a correct lifestyle, and physical activity are a valid strategy in the prevention and treatment of not metabolic diseases also of inflammatory diseases © Faculty of Education. University of Alicante

Legal resposability of vaccinating doctor

The legal responsibility of the vaccinating doctor is one of the central issues in the current setting of the Covid-19 pandemic. The aim of this statement is to outline the profiles of the medical legal liability, with a focus on the figure of the vaccinating physician, in criminal, civil, and disciplinary terms, based on the Italian legislation in force. The vaccinating doctor responds for his work in the field of vaccination in the same way as any other health service should perform (diagnostic, therapeutic, etc.). Helpful in this context is the adoption of the L. 76/2021;it was developed to find a balance between safeguarding the person privacy and greater guarantees for the doctor. This law introduces a criminal shield that can put a limit to litigation, curbing the phenomenon of so-called defensive medicine. The climate of uncertainty and fear of legal repercussions for the doctors, and the constant updating and redefinition of the indications of operability in the vaccination campaigns, underline the need to focus on the knowledge of the responsibilities and the safeguard of the vaccinating doctors. In addition to the regulatory cornerstones, the statement also addresses the issue of informed consent and the role of the occupational doctor as a central figure in the vaccination campaign in the workplace.

Emotion Recognition Ability as a Predictor of Well-Being During the COVID-19 Pandemic

This study examined emotion recognition ability (ERA) as a predictor of positive and negative affect in two Australian and one German-speaking samples (total N = 469) during the first 2 weeks of major public life restrictions in the COVID-19 pandemic in March/April 2020. Individuals with higher ERA did not report more positive affect, but they felt less burdened and reported less negative affect. This association was fully mediated by lower COVID-19-related media consumption and less negative affect after reading an eyewitness report from an Italian city with a high COVID-19 death toll. However, higher ERA was also related to arguing more with close others. For low-to-medium ERA, an adaptive cognitive emotion regulation style predicted lower media consumption and for medium-to-high ERA, a maladaptive regulation style marginally increased the perceived likelihood of experiencing a similar situation as in Italy, suggesting that regulation style may moderate the ERA?affect relationship.

Cardiovascular, oncological and rheumatological disease, its behavior in COVID-19 patients Prognostic factors, complications and treatment

SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection clinical course can present its own manifestations, but it can also exacerbate those of pre-existing diseases or cause manifestations that simulate said pathologies. Cardiovascular, cancer or rheumatological diseases are examples of this. These types of pathologies share risk factors for poor prognosis and death due to infection, the possibility of developing long-term complications, and they imply a challenge when establishing follow-up and treatment measures requiring multidisciplinary assessment. Therefore, our objective was to raise the difficulties in the short and long-term follow-up of this type of patients and to evaluate how the pandemic affects their treatment. The pandemic has changed the usual medical practice, promoting new forms of patient follow-up, such as telemedicine, imposing a hierarchy of the need for face-to-face care and procedures, forcing budget items to be reallocated to be able to deal with it, with consequences that are likely to it will have to be analyzed in the long term.

Incidence of COVID-19 in patients treated with infliximab com-pared to patients treated with rituximab

Background: The prevalence of anti-SARS-CoV-2 IgG antibodies in the Geneva population was estimated at 9.7% end of April 2020.Immuno-suppressed patients may be at increased risk of developing severe forms of COVID-19. It is unknown whether the increasing risk is due to immune-mediated diseases by themselves or to specific immunosuppressive therapies. We postulated that long-lasting cell-depleting therapies may increase the risk of severe COVID-19 more than targeted anti-cytokine therapies. Objectives: To determine whether patients treated with rituximab (RTX) have more severe forms of COVID-19 compared to patients treated with anti-cytokine therapies, such as infliximab (IFX). Methods: We included all patients who received infliximab or rituximab at the Rheumatology Division of the Geneva University Hospitals be-tween January 1 and February 28,2020. We called each patient and ad-ministrated a questionnaire with predefined questions on COVID-19 symptoms and COVID-19 diagnosis occurring between 01.03.2020 and the 15.05.2020, which represents the first wave of the COVID 19 pan-demic in Switzerland.We compared baseline characteristics using de-scriptive statistics. Results: During the study period, 86 patients received either rituximab (RTX, n = 31) or infliximab (IFX, n = 55).We were able to retrieve com-plete COVID-19 information from 77 (90%) patients. Baseline character-istics in the two groups were balanced, but for significant differences in the underlying diagnoses (more RA with RTX and more spondyloarthritis (SpA) with IFX). Overall, 12(16%) patients have reported symptoms of plausible COVID-19;9(18%) on IFX and 3(12%) on RTX(p = 0.74). Only one patient suffered from a severe evolution( death) after a nasopharyn-geal Swab PCR confirmed SARS-COV-2 infection, 6 weeks after receiv-ing RTX. During this first wave of COVID-19 epidemic, the incidence rate of plausible COVID-19 was 2.7 (95% CI: 1.4-5.4) cases/1000 patients-days on IFX, compared to 1.61 (0.53-4.93) cases/1000 patients-days on RTX,a similar rate( Crude p = 0.43, ajusted P = 0.15).The incidence rate of severe COVID-19 was null on IFX compared to 0.52 (0.07-3.68) cases/1000 patients-days on RTX. Conclusion: The incidence and prevalence of COVID-19 was similar in both group;however further research is needed to evaluate a potentially increased risk for severe evolution of COVID-19 on RTX,as suggested in our sample. The study is ongoing, with an analysis of a broader patient sample.

Loneliness and Well-Being During the Covid-19 Pandemic: Associations with Personality and Emotion Regulation.

The present study examined how neuroticism, extraversion, and emotion regulation were related to loneliness and well-being during 6 weeks of major public life restrictions in the Covid-19 pandemic in Switzerland. Cross-sectional results from 466 participants showed that neuroticism and emotion regulation strategies were associated with higher loneliness and lower well-being. However, in contrast to prior research, associations of extraversion with loneliness and well-being were weak and were qualified by interactions with emotion regulation. For introverts, maladaptive cognitive strategies such as rumination or catastrophizing were related to higher levels of loneliness. For extraverts, emotion suppression was related to lower levels of affective well-being. Individuals with low maladaptive regulation reported higher well-being the longer the public life restrictions were in place at the time of study participation. These findings suggest that first, extraversion may lose some of its protective value for loneliness and well-being when opportunities to engage in social activities are limited; second, that loneliness and well-being do not decrease over 6 weeks of public life restrictions; and third, that future studies should further investigate the moderating role of emotion regulation on the link between personality, loneliness, and well-being.