Admission ECG may predict short-term mortality among adults hospitalized with covid-19 infection

Introduction: Cardiovascular complications of novel SARS-CoV-2 infection remain poorly understood with outcomes limited to index hospitalizations. Methods: This retrospective cohort study included patients with proven COVID-19 who received care at a single hospital network in Massachusetts from March 11, 2020 to May 23, 2020 and received an electrocardiogram (ECG) within 24 hours of hospital presentation. We investigated mortality and cardiovascular complications within 90 days from initial COVID-19 diagnosis. Data were electronically ed and confirmed by manual chart review. Results: A total of 1,744 patients tested positive within the hospital network during the study period. Nearly half of them (49.3%) were hospitalized and 15.5% died within 90 days. A total of 278 patients received an ECG within 24 hours, representing 23.6% of all hospitalized patients. These patients were disproportionately older (38.5 vs 58.1% over the age of 60, p < 0.01), male (49.6 vs 56.2%, p = 0.05), and white (48.1 vs 56.2, p < 0.01). Admission ECGs demonstrating ischemic changes (STelevations, ST-depressions, and T-wave inversions) or new arrhythmias (atrial fibrillation/flutter, bradyarrhythmia, supraventricular tachycardia) were identified among 10.1% and 9.0% of the patients, respectively. Heart failure and cardiomyopathy were rare findings (<1%). After adjusting for age, sex, and past medical history, ischemic changes or new-onset arrhythmias were associated with nearly five-times greater risk of death (OR: 4.9;95% CI 1.7-14.4). Conclusions: In this retrospective study among hospitalized adults with a proven COVID-19 infection, admission ECGs demonstrating ischemic changes or new-onset dysrhythmia predict a higher risk of death in the short-term.

Designing for neurodiversity: Reimagining the home for a covid normal life

As cities went into lockdown in response to COVID-19, for many, the role of the home in everyday life expanded. Activities that would normally occur at another venue, including work, study, recreation, and health appointments, were reconfigured to be done in the home. Among the legacies from this experience is a clearer understanding of the spatial and phenomenological quality of the spaces in which we live. Housing design already assigns private and public areas within dwellings, such as bedrooms and living rooms, but these are often rigidly defined and largely inflexible for alternative uses. Research on designing housing suitable for people with cognitive disabilities, including autism spectrum disorder (ASD), (such as a 'sensory design' approach, where it is necessary to move beyond public vs private, and recognise other dicotisms, light/ dark, warm/cool, loud/quiet, hard/soft, work/rest, and so on, and the transition between modes), may provide lessons for more general COVID-normal housing design. This study analyses three case studies of residential accommodation for people with ASD as opportunities for developing more responsive housing that can adapt to the demand for a greater range of activities to be fulfilled in the home. © 2021 Proceedings of the 37th Annual ARCOM Conference, ARCOM 2021. All Rights Reserved.

Beyond the pandemic: the role of the built environment in supporting people with disabilities work life

Purpose: The COVID-19 pandemic has engendered changes in previously unimaginable timeframes, leading to new ways of working, which can quickly become the “ordinary” way of working. Many traditional workplace and educational practices and environments, however, are disadvantageous to people with disability and consequently are under-represented in the workforce and higher education. Design/methodology/approach: Contributing factors include exclusionary societal and employer attitudes and inaccessible built environments including lack of attention to paths of travel, amenities, acoustics, lighting and temperature. Social exclusion resulting from lack of access to meaningful work is also problematic. COVID-19 has accelerated the incidence of working and studying from home, but the home environment of many people with disability may not be suitable in terms of space, privacy, technology access and connection to the wider community. Findings: However, remote and flexible working arrangements may hold opportunities for enhancing work participation of people with disabilities. Instigating systemic conditions that will empower people with disability to take full advantage of ordinary working trajectories is key. As the current global experiment in modified work and study practices has shown, structural, organisational and design norms need to change. The future of work and study is almost certainly more work and study from home. An expanded understanding of people with disabilities lived experience of the built environment encompassing opportunities for work, study and socialisation from home and the neighbourhood would more closely align with the UNCRPD's emphasis on full citizenship. Originality/value: This paper examines what is currently missing in the development of a distributed work and study place continuum that includes traditional workplaces and campuses, local neighbourhood hubs and homes. © 2020, Emerald Publishing Limited.