ABSTRACT
In this case report, we describe a Kawasaki-like multisystem inflammatory syndrome (MIS-A) in a 33-year old man that occurred 19 days after a SARS-CoV-2 infection. The main features at presentation were profound myocarditis, bilateral non-purulent conjunctivitis, mediastinal lymphadenopathy, and acute kidney failure and laboratory evidence of hyperinflammation. He received ACE-inhibition and beta-blockers for his heart failure and made a fairly rapid spontaneous recovery over the subsequent 8 days.
ABSTRACT
Background Due to the COVID-19 pandemic, the Belgian government imposed two semi-lockdowns (LD) with different social behavioral restrictions in 2020. Our aim was to assess the impact of these COVID-19 pandemic-response measures on Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) figures in an STI clinic (low-threshold clinic, PrEP & HIV follow-up) in Antwerp, Belgium. Methods The overall number of CT/NG requests and positivity ratio during 2020 was compared with 2019. In addition, different periods of 2019 and 2020 were compared using mixed-effects logistic regression methods. 1. pre-lockdown (01/ 01-17/03, no restrictions), 2. LD1 (18/03-10/05, no social contact outside the household, only 'urgent' consultations), 3. after LD1 (11/05-01/11, varying between 2-10 additional social contacts) and 4. LD2 (02/11-31/12, maximum two social contacts). Results Overall, the number of CT/NG requests decreased by 27.7% (7170 in 2019 to 5183 in 2020). Whilst the number of patient contacts declined by 22.4%, positivity rate of CT (8.0% in 2019;7.8% in 2020) and NG (4.7% vs 5.5%) remained similar in both years. During LD1, a significant reduction in CT/NG requests was noted (decrease of 88.1%) and the number of consultations dropped by 60.1%. Whereas the positivity ratio of NG during period LD1 increased from 5.3% in 2019 to 9.3% in 2020, no significant change was found for CT (8.2% in 2019 to 7.8% in 2020). During the other time periods, the absolute number of requests and CT/ NG infections in 2020 were comparable with 2019. Nevertheless, higher positivity ratios were found during LD2 period 2020 compared to 2019 (CT: 9.9% vs 8.2% in 2019;NG: 6.1 vs 5.1% in 2019, p>0.05). Conclusion Despite a sharp drop in consultations, the proportion of CT/NG did not decrease in 2020 compared to 2019. We observed a trend towards higher positive CT/NG rates in LD2 which may depict social distancing fatigue..
ABSTRACT
Hospital visitor restriction policies prompted by Coronavirus Disease 2019 (COVID-19) may lead to a less comfortable or informed inpatient experience for oncology patients admitted for non-COVID-19 conditions. We surveyed oncology inpatients before (n = 47) and after (n = 65) implementation of a no-visitor policy using a validated questionnaire to measure patient experience. Results revealed no significant difference in the percentage of patients reporting "no problems" (P < .05) in all questions. Patient experience was not adversely impacted by visitor restrictions enacted in response to COVID-19 on an oncology service, as measured by a questionnaire capturing common concerns among inpatients.
ABSTRACT
Rationale: The COVID-19 pandemic dramatically changed daily routines as well as healthcare utilization and delivery patterns in the United States. We sought to identify changes in pediatric asthma-related healthcare utilization and levels of air pollution i.e. particulate matter (PM2.5, PM10) and gaseous chemicals (NO2, O3) during the COVID-19 pandemic in Philadelphia. We hypothesized that declining utilization of asthma care and changed pollution levels during the early stages of the pandemic rebounded after the relaxation of COVID-19-related public health measures. Methods: For the time period Mar 17 to Dec 17 during the years 2015-2020, asthmarelated encounters and weekly summaries of respiratory viral testing data were extracted from Children's Hospital of Philadelphia (CHOP) electronic health records. Daily average estimates of PM2.5, PM10, O3, and NO2 for the same time period were obtained from AirData, an EPA resource that provides quality-assured summary air pollution measures collected from outdoor regulatory monitors across the United States. Patterns in encounter characteristics and viral testing in Philadelphia from Mar 17 to Dec 17, 2020, were compared to data from 2015-2019 as a historical reference. Encounter pattern results were summarized as percentage changes. Controlled interrupted time series regression models were created to identify statistically significant differences in pollution levels that differed in 2020 compared with historical time periods. Results: We present data on asthma encounters, viral testing, and air pollution from Mar 2020 through Dec 2020. Contrary to the early stages of the pandemic when in-person asthma encounters decreased by 87% (outpatient) and 84% (emergency + inpatient), asthma-related encounters rebounded with the relaxation of COVID-19-related public health measures. During the initial months of the pandemic, the daily average of PM2.5, PM10, and NO2 levels decreased by 29.0% (2.17 μg/m3), 18.2% (3.13 μg/m3), and 44.1% (6.75 ppb), respectively, whereas ozone levels increased by 43.4% (10.08 ppb), changes that were not statistically significantly different compared to historical trends. Levels of all pollutants considered remained similar during subsequent 2020 months compared to the 2015-2019 reference period. Conclusion: The COVID-19 pandemic in Philadelphia was accompanied by initial decreases in pediatric asthma healthcare activity. Concurrent with the relaxation of COVID-19-related public health measures, there was a subsequent increase in asthma healthcare activity. No substantial change in air pollution levels compared with historical patterns was observed during the time period considered, suggesting that other factors influenced changes in asthma trends during the COVID-19 pandemic.