Impact of Hygiene Measures on the Incidence of CARV in LTR Before and During the First Year of Covid-19

CARV infections pose a serious risk for lung transplant recipients as they are prone to develop severe complications. When the COVID-19 pandemic hit Switzerland in 2020, the Swiss government, along with many other governments around the world, implemented hygiene measures such as hand hygiene, social distancing and the use of face masks for the general population. In this study we investigated the impact of these hygiene measures on the transmission of community acquired respiratory viruses in lung transplant recipients. In this multicentric, retrospective study of lung transplant recipients we investigated two time periods: The year before the COVID-19 pandemic (01.03.2019-29.02.2020) and the first year of the pandemic (01.03.2020-28.02.2021). Data collection occurred with the help of the Swiss Transplant Cohort Study (STCS) database. A CARV infection was defined as the detection of one of the community acquired respiratory viruses by a PCR test in respiratory samples. Descriptive statistics were used to analyze our results. Data from 221 lung transplant recipients from the Swiss lung transplant cohort was evaluated. In the year before the COVID-19 pandemic 157 infections were diagnosed compared to 71 infections in the first year of the pandemic, showing a statistically significant decline of 54% (p<0.001). Additionally, influenza virus infections alone showed a remarkable decline from 17 infections per year prior to COVID-19, to 2 infections after the beginning of the pandemic. The hygiene measures seemed to have the least impact on the transmission of Rhino-/Enteroviruses. No significant difference was found in testing behavior when comparing the two years: 803 vs 925 tests were obtained by two of the three centers during the respective years. We found a significant decline in the number of CARV infections in the Swiss lung transplant cohort during the first year of the COVID-19 pandemic. The results suggest a relevant impact of the hygiene measures implemented in the population due to the COVID-19 pandemic on the incidence of CARV infections. [ FROM AUTHOR] Copyright of Journal of Heart & Lung Transplantation is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Impact of lockdown during the COVID-19 outbreak on ophthalmological emergencies in a referral center in France.

PURPOSE: In March 2020, the sudden rise in the number of SARS-CoV-2 infections in France led the government to impose a strict lockdown during which all non-urgent medical consultations were postponed. From March 17 to May 10, 2020, private medical practices were closed, and telemedicine was encouraged. The consequences on ophthalmic care were dramatic, with over 90% of scheduled consultations canceled. The goal of this study was to describe consultations during the 2-month strict lockdown in Paris and to analyze its impact on the visual outcomes of patients consulting in the ophthalmology emergency department (OED). METHODS: Data of patients who presented to the OED of the A. de Rothschild Foundation Hospital (RFH), a tertiary ophthalmology center in Paris, France, during the lockdown period and its immediate aftermath were analyzed. The results were compared to the same time periods in the years 2018 and 2019. Four time periods were defined and numbered chronologically: March 17 to May 10, 2018 (period 1); March 17 to May 10, 2019 (period 2); March 17 to May 10, 2020 (period 3, the lockdown period); May 11 to June 9, 2020 (period 4, the post-lockdown period). RESULTS: The number of consultations was reduced by more than 50% during the lockdown period (n=2909 patients) and by 30% during the post-lockdown period (n=2622) when compared to periods 1 (n=7125) and 2 (n=8058). Even though LP4 saw an increase in the number of patients consulting, there was no increase in the rate of severe diseases (12.8% during LP3 vs. 11.1% during LP4), and the proportion of patients who were admitted was statistically similar (4.3% vs. 3.6%). Neuro-ophthalmic diseases were the most common during LP3 and LP4. Neovascular glaucoma was twice as common during post-LP4 (P=0.08). We noted a significant increase in patients with graft rejection consulting in our OED during the post-LP4 (P<0.001). These results were likely related to a delay in follow-up consultations due to the lockdown measures. CONCLUSION: The reduction in the number of consultations in our OED during the lockdown period affected both minor emergencies and severe ophthalmic diseases, but with no significant delay in diagnosis. More longitudinal and longer study is needed to confirm this and to retrospectively analyze the effects of the COVID-19 outbreak and lockdown.

COVID-19 in cystic fibrosis patients with and without lung transplantation: the Zurich cohort

Objectives: Reports on short- and long-term presentations of COVID-19 in CF patients is limited. We aimed to describe clinical features and outcomes of all our CF patients with laboratory confirmed COVID-19 between March 2020 and January 2021 (ongoing observation). Methods: Retrospective review of clinical data and treatment of CF patients with COVID-19 confirmed by RT-PCR or serological evidence (n = 11). Results: Mean age at presentation was 32 (23–48) years, 27% (n = 3) were female. Six patients (55%) had a previous lung transplantation (post-Ltx). Two patients were on modulator therapy (Trikafta® and Symdeco®). The most common presenting symptoms were cough (36%), fever (27%), headache (27%) and dyspnea (18%). Nine patients (82%) had mild disease and were treated as outpatients. Two patients (18%) were post-LTx and were hospitalised with severe disease (1 on the normal ward, 1 in the intensive care unit). The most notable laboratory findings were lymphopenia, and elevated levels of C-reactive protein. In the two hospitalised patients, computed tomography of the chest showed ground-glass opacities with consolidations;1 patient additionally had a small pleural effusion. These 2 patients were treated with remdesivir, as well as broad-spectrum antibiotics (meropenem). The patients with mild disease were treated with co-amoxicillin (n = 3, 27%). Dexamethasone was given in selected cases. Mechanical ventilation was not necessary for any of these patients. The hospitalised patients received oxygen by nasal cannula and high-flow oxygen therapy. All patients recovered. Residual symptoms are being monitored. Conclusion: This is the first study of an adult CF-COVID-19 cohort in Switzerland, which included patients who underwent lung transplantation. Cough, fever, headache and dyspnea were the most common symptoms. Two patients (27%) had severe disease. The majority had a benign course and long-term symptoms are still under investigation.