Effect of Different Factors on the Quality of Life and Sequelae of COVID-19 Patients after Discharge

Background The continued spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains an international public health emergency, resulting in a significant global disease burden. The long-term effects of SARS-CoV-2 infection in humans and the long-term prognosis of patients with coronavirus disease 2019 (COVID-19) after discharge remain unclear. We aimed to assess the quality of life (QoL) and sequelae in patients with COVID-19 after discharge from the hospital by conducting multiple follow-up visits to understand the long-term effects of SARS-CoV-2 on patients' health and its possible influencing factors. Methods COVID-19 patients discharged from Huoshenshan Hospital (Wuhan, China) between February 15 and April 5, 2020, were followed up at 6, 9, and 12 months after discharge. They completed questionnaires on postdischarge QoL and sequelae under the guidance of medical staff with professional training. The demographic and clinical characteristics of the COVID-19 patients were analyzed using descriptive statistics. A generalized estimating equation model was used to analyze the QoL-related factors. The χ2 test (or Fisher exact test) and multivariate logistic regression analysis were used to analyze the sequelae and influencing factors. Results A total of 175 patients participated in at least 1 follow-up visit, and 120 completed all 3 follow-up visits. Patients diagnosed with severe and critically ill COVID-19 had worse mental conditions (χ2 = 7.653, P = 0.022) than those with the nonsevere type (not severe or critical) and were more likely to feel fatigued (χ2 = 4.836, P = 0.028). Female patients had a higher risk of sleep disturbance (χ2 = 10.026, P = 0.002) and dyspnea (χ2 = 5.672, P = 0.017) and had more difficulty returning to their original work and life (χ2 = 8.922, P = 0.003) than male patients. Patients with diabetes had a worse appetite (χ2 = 4.669, P = 0.031) and were more prone to sleep disturbance (χ2 = 4.417, P = 0.036) after discharge. The proportion of patients with at least 1 sequela increased from 29.76% (50/168) at 6 months to 51.11% (69/135) at 9 months (χ2 = 14.305, P < 0.001). Compared with the nonsevere type, patients diagnosed with severe and critically ill COVID-19 had an odds ratio (OR) of 4.325 (95% confidence interval [CI], 1.215-15.401) for memory decline. Female patients had an OR of 4.632 (95% CI, 1.716-12.501) for joint or muscle pain. Patients with hypertension had an OR of 3.014 (95% CI, 1.193-7.615) for joint or muscle pain. Conclusion One year after discharge, there were still some patients with varying degrees of decline in QoL and sequelae, which occurred in all follow-up visits. Moreover, QoL and sequelae after discharge were related to sex, clinical classification of COVID-19, and underlying diseases. © Wolters Kluwer Health, Inc. All rights reserved.

Mask detection algorithm based on YOLOv5 integrating attention mechanism

Wearing masks correctly during the COVID-19 pandemic can effectively prevent the spread of the virus. In response to the detection challenge posed by dense crowds and small detection targets in public places, a mask wearing detection algorithm based on the YOLOv5s model and integrating an attention mechanism was proposed. Four attention mechanisms were introduced into the backbone network of the YOLOv5s model to respectively suppress irrelevant information, enhance the ability of the feature map to express information, and improve the modelʹs detection ability for small-scale targets. Experimental results show that the introduction of the convolutional block attention module could increase the mAP value by 6.9 percentage points compared with the original network, with the greatest improvement among the four attention mechanisms. The normalization-based attention module also showed excellent performance, with the least quantity of parameters while losing a small amount of mAP. Through comparative experiments, the GIoU loss function was selected to calculate the bounding box regression loss, resulting in further improvements to positioning accuracy, resulting in an mAP value that was improved by 8.5 percentage points compared to the original network. The detection results of the improved model in different scenarios prove the accuracy and practicability of the algorithm for small target detection. © 2023, Editorial of Board of Journal of Graphics. All rights reserved.

HEALTH RELATED SOCIAL NEEDS IN THE TIME OF COVID-19 AMONG ADULT MEN - NEEDS ASSESSMENT AND RESPONSE

BACKGROUND: Health care systems are screening patients for unmet social risk factors and needs though there is variation in patients' interest in receiving assistance from health care systems in response to identified social risk. Understanding this variation would allow health systems to respond to patients' social and health needs more effectively. Our objective is to report findings from a large community outreach effort spurred by the COVID-19 epidemic. This effort sought to identify and meet the needs of men in our community and close the loop by documenting connections with resources. METHODS: We surveyed adult men who had previously participated in at least one community-focused annual health fair in Cleveland, Ohio. In this descriptive cohort study, we spoke with men up to three times (i.e. phases) from May - October 2020 by email and phone. Phase 1 was a needs assessment survey. Phase 2 was to outreach to those who identified a need to provide a resource. Phase 3 was to determine whether the resource met the individuals' needs. We described the demographic characteristics of the survey respondents, the percentage of men reporting a need and wanting a resource. Finally, we report whether that resource resolved their need. RESULTS: Of the 768 individuals contacted for the needs assessment, 275 men who lived in the state of Ohio completed the survey (36% response rate). The majority of respondents were 50-69 years old, African American, had at least a bachelor's degree, were employed, had a health care provider and health insurance, and reported good or higher health status. Eighty-five percent identified food, employment, financial, or health needs. Wellness, financial, and health care access were among the top reported needs. Among those that identified a need, 35%(n=82) respondents were interested in a referral. The remaining respondents were not interested in a referral (n=51) or were not able to be reached (n=100). Among those referred for an employment need (n=17), 70% connected with a resource, but none reported the resource meeting their need. Similarly, men with behavioral health, oral health, vision, substance use disorder, or wellness needs also felt the referred resources did not meet their need. A handful of respondents reported having their personal hygiene/food, financial, health care access, annual health screening, and medication needs resolved. CONCLUSIONS: Our needs assessment found that the vast majority of respondents identified food, employment, financial, or health needs. However, only a fraction of men were interested in a referral to a resource, and far fewer connected with a resource that resolved his need. A greater understanding of the effectiveness of social need screening and referrals for social needs by healthcare systems is warranted.

Obstetric services in the UK during the COVID-19 pandemic: A national survey.

BACKGROUND: The management of obstetric patients with coronavirus disease 2019 (COVID-19) due to human-to-human transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) requires unique considerations. Many aspects of labour and delivery practice required adaptation in response to the global pandemic and were supported by guidelines from the Royal College of Obstetrics and Gynaecologists. The adoption and adherence to these guidelines is unknown. METHODS: Participating centres in "Quality of Recovery in Obstetric Anaesthesia study-a multicentre study" (ObsQoR) completed an electronic survey based on the provision of services and care related to COVID-19 in October 2021. The survey was designed against the Royal College of Obstetricians and Gynaecologists COVID-19 guidelines. RESULTS: One hundred and five of the 107 participating centres completed the survey (98% response rate representing 54% of all UK obstetric units). The median [IQR] annual number of deliveries among the included sites was 4389 [3000-5325]. Ninety-nine of the 103 (94.3%) sites had guidelines for the management of peripartum women with COVID-19. Sixty-one of 105 (58.1%) sites had specific guidance for venous thromboembolism (VTE) prophylaxis. Thirty-seven of 104 (35.6%) centres restricted parturient birthing plans if a positive diagnosis of COVID-19 was made. A COVID-19 vaccination referral pathway encouraging full vaccination for all pregnant women was present in 63/103 centres (61.2%). CONCLUSION: We found variability in care delivered and adherence to guidelines related to COVID-19. The clinical implications for this related to quality of peripartum care is unclear, however there remains scope to improve pathways for immunisation, birth plans and VTE prophylaxis.

The effects of COVID-19 epidemic on regional economy and industry in China

To scientifically assess the effects of major public health emergencies on economic system, regulate its negative effect and improve the resilience of the economic system is an important national strategic requirement. Currently, the novel coronavirus disease (COVID-19) epidemic has been effectively contained in China, while exogenous and regional risks remain. Systematical identification of influence path and strength of COVID-19 epidemic on economic system has guiding significance for economic system recovery. Based on the improved multi-regional computable general equilibrium model for China, this research measures the output changes in economic system and major industries in China under different COVID-19 epidemic prevention and control scenarios with different changes in factors supply and products demand. The results show that the provincial economic growth in China falls by 0.4%-0.8% compared with the normal situation in 2020, and residential consumption and employment falls by about 2% and 0.7% respectively, while commodity prices rise by about 0.9% in the short term. From the perspective of industrial economy, consumption-oriented and labor-intensive industries are the most adversely affected in the short term. For example, the output value of the service sector will decrease by 6.3% compared with normal levels. Besides, regarding the regional differences of the effects of COVID-19 epidemic on the economic system and industrial economy, Hubei province, as one of the regions with first-level epidemic prevention and control risk, faces the greatest challenge. The effects of COVID-19 epidemic present a spatial spreading pattern with Hubei province as the center. The major industries that suffer from the impacts of COVID-19 epidemic vary in different regions. In addition, this research assesses the intensity of the regional economic recovery under the resumption of work and production scenario and the proactive fiscal policy scenario respectively. The results show that compared with the resumption of work and production, the effect of increasing fiscal stimulus has more potential for economic system recovery, up by 0.3% in GDP and by 1.8% in commodity price, while resumption of work and production has a wider range of spatial pulling effects on industries. © 2021, Science Press. All right reserved.

Factors associated with hospitalization length of stay in patients with COVID-19, a multivariable analysis

Background: Coronavirus disease 2019 (COVID-19) is the cause of a global pandemic which has strained the resources of health systems around the world. Health systems, patients, and healthcare providers may benefit from knowledge regarding which factors predict length of stay (LOS), and therefore healthcare resource allocation, in patients presenting with COVID-19. Methods: 559 patients were retrospectively identified who were admitted to Temple University Hospital in Philadelphia, PA between February and May of 2020. All patients tested positive for COVID-19 by nasopharyngeal swab and received computed tomography screening for viral pneumonia. We collected data present at time of hospital admission and performed a retrospective analysis to determine factors associated with hospital LOS. Results: Mean hospital LOS for our cohort was 9.0 days. In this cohort, most patients received antibiotics. 100% of patients received glucocorticoids and 8.1% received remdesivir. 31.2% participated in clinical trials of monoclonal antibodies. 26.8% of patients required intensive care during their hospitalization, 17.4% required invasive or noninvasive mechanical ventilation, and 11.1% died. On multivariable linear regression analysis, increasing leukocyte count and a diagnosis of diabetes mellitus predicted decreased LOS. Increased respiratory support within the first 24 hours, patient age, creatinine, and total bilirubin were associated with increased LOS. Conclusion: Patient past medical history, admission laboratory values, and severity of hypoxemia at hospital admission may predict LOS in patients hospitalized for COVID-19. (Table Presented).