ABSTRACT
Background: Lateral flow immunoassays (LFIAs) are able to achieve affordable, large scale antibody testing and provide rapid results without the support of central laboratories. As part of the development of the REACT programme extensive evaluation of LFIA performance was undertaken with individuals following natural infection. Here we assess the performance of the selected LFIA to detect antibody responses in individuals who have received at least one dose of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine.
ABSTRACT
Background: With rising numbers of Covid-19 patients and patients requiring testing and quarantine, administrative burden increased and new challenges for existing communication pathways emerged. While at the beginning of the pandemic, communication between local health authorities and general practitioners in Germany heavily relied on telephone and fax machines, resources for the exchange of real-time information were limited. To explore whether an instant messaging app could affect communication structures between local healthcare players in the pandemic, we conceptualised a proof-of-concept study testing deployment of a communication tool in two regions in Germany. The study is funded by the German Federal Ministry for Research and Education and is part of the COVID-19- national research network. Research question: To identify the experiences of general practitioners and local health authorities with an app for safe instant communication. Methods: We conducted a proof-of-concept study comprising implementation and evaluation of an instant messenger app used by general practitioners, local health authorities and COVIDspecialists in the Rhein-Main-area in Germany. Participants started to use the app in November 2020. Online questionnaires are used to assess usability. We used a pretested German translation of the mobile health app usability questionnaire (MAUQ). Results: Participants will use the app in the following weeks and subsequently rate it. Results will be available at the congress. Conclusion: The results can provide further insights into the suitable deployment of communication apps in healthcare settings.
ABSTRACT
Introduction: Studies of risk factors for severe/fatal COVID-19 to date may not have identified the optimal set of informative predictors. Hypothesis: Use of penalized regression with stability analysis may identify new, sparse sets of risk factors jointly associated with COVID-19 mortality. Methods: We investigated demographic, social, lifestyle, biological (lipids, cystatin C, vitamin D), medical (comorbidities, medications) and air pollution data from UK Biobank (N=473,574) in relation to linked COVID-19 mortality, and compared with non-COVID-19 mortality. We used penalized regression models (LASSO) with stability analysis (80% selection threshold from 1,000 models with 80% subsampling) to identify a sparse set of variables associated with COVID-19 mortality. Results: Among 43 variables considered by LASSO stability selection, cardiovascular disease, hypertension, diabetes, cystatin C, age, male sex and Black ethnicity were jointly predictive of COVID-19 mortality risk at 80% selection threshold (Figure). Of these, Black ethnicity and hypertension contributed to COVID-19 but not non-COVID-19 mortality. Conclusions: Use of LASSO stability selection identified a sparse set of predictors for COVID-19mortality including cardiovascular disease, hypertension, diabetes and cystatin C, a marker of renalfunction that has also been implicated in atherogenesis and inflammation. These results indicate theimportance of cardiometabolic comorbidities as predisposing factors for COVID-19 mortality.Hypertension was differentially highly selected for risk of COVID-19 mortality, suggesting the need for continued vigilance with good blood pressure control during the pandemic.
ABSTRACT
OBJECTIVES: To understand SARS-Co-V-2 infection and transmission in UK nursing homes in order to develop preventive strategies for protecting the frail elderly residents. METHODS: An outbreak investigation involving 394 residents and 70 staff, was carried out in 4 nursing homes affected by COVID-19 outbreaks in central London. Two point-prevalence surveys were performed one week apart where residents underwent SARS-CoV-2 testing and had relevant symptoms documented. Asymptomatic staff from three of the four homes were also offered SARS-CoV-2 testing. RESULTS: Overall, 26% (95% CI 22-31) of residents died over the two-month period. All-cause mortality increased by 203% (95% CI 70-336) compared with previous years. Systematic testing identified 40% (95% CI 35-46) of residents as positive for SARS-CoV-2, and of these 43% (95% CI 34-52) were asymptomatic and 18% (95% CI 11-24) had only atypical symptoms; 4% (95% CI -1 to 9) of asymptomatic staff also tested positive. CONCLUSIONS: The SARS-CoV-2 outbreak in four UK nursing homes was associated with very high infection and mortality rates. Many residents developed either atypical or had no discernible symptoms. A number of asymptomatic staff members also tested positive, suggesting a role for regular screening of both residents and staff in mitigating future outbreaks.