Impact of the COVID-19 pandemic on cardiovascular disease mortality in a major metropolitan area.

Background: The mortality from COVID-19 alone cannot account for the impact of the pandemic. Cardiovascular disease (CVD) mortality has increased disproportionately in specific racial/ethnic populations. Objective: This study aimed to characterize how the COVID-19 pandemic impacted the association between CVD mortality and social and demographic factors as characterized by the Social Vulnerability Index (SVI). Methods: Medical Examiner Case Archive of Cook County, Illinois was utilized to identify CVD deaths in 2019 (pre-pandemic) and 2020 (pandemic). Rate ratios (RRs) were used to compare age-adjusted mortality rates (AAMRs). Addresses of deaths were geocoded to Chicago Community Areas. The Spearman's rank correlation coefficient (ρ) test was used to identify the association between SVI and CVD mortality. Results: AAMRs of CVD deaths significantly increased among non-Hispanic Black individuals (AAMRR, 1.1; 95 % CI, 1.1-1.2) and Hispanic individuals (AAMRR, 1.8; 95 % CI, 1.5-2.1) from 2019 to 2020. Among non-Hispanic White individuals, the AAMR did not significantly increase (AAMRR, 1.0; 95 % CI, 0.9-1.1). A significant positive association was observed between SVI and the percentage of non-Hispanic Black residents (ρ = 0.45; P < 0.05), while the inverse was observed with the percentage of non-Hispanic White residents (ρ = -0.77; P < 0.05). A significant positive association between SVI and CVD mortality rate increased (ρ = 0.24 and 0.28; P < 0.05). Conclusions: Significant association between SVI and CVD mortality was strengthened from 2019 to 2020, and CVD mortality increased among non-Hispanic Black and Hispanic populations. These findings demonstrate that the COVID-19 pandemic has led to an exacerbation of health inequities among different racial/ethnic populations resulting in increased CVD mortality.

Long-term treatment outcome of Castleman's disease: A real-world experience.

Background: Castleman disease (CD), classified as unicentric CD (UCD) or multicentric CD (MCD), is a rare non-neoplastic lymphoproliferative disorder of unknown origin. Owing to its rarity, the clinical characteristics, therapeutic modalities, treatment outcomes, and prognostic factors related to UCD or MCD are not well defined. Method: We retrospectively analyzed 88 patients with CD, including those with hyaline-vascular, plasma-cell, mixed type, hypervascular, and plasmablastic subtypes, for presenting symptoms, physical, laboratory, and radiologic findings, and treatment response in the Korean population. Results: The median patient age was 44 years (range: 18-84 years) with slight predominance of women (53.4%). UCD and MCD accounted for 38.6% (n=34) and 61.4% (n=54) of cases, respectively. Histopathologically, UCD patients were classified as 88.2% (n=30) hyaline-vascular and 11.8% (n=4) plasma cell types, whereas MCD patients were classified as 27.8% (n=15) hypervascular, 61.1% (n=33) plasma cell, 7.4% (n=4) mixed, and 3.7% (n=2) plasmablastic types. Twelve (13.6%) patients exhibited a poor performance status with an Eastern Cooperative Oncology Group score of 2. The most common presenting symptom was sustained fever, followed by fatigue, anorexia, peripheral edema, and weight loss. Furthermore, splenomegaly, pleural effusion, and ascites were observed to be associated with CD. Surgical resection and siltuximab were the preferred treatment modalities for UCD and MCD, respectively, with favorable symptomatic, laboratory, and radiologic outcomes and safety profiles. The overall survival was 90.2%, with no significant difference between the UCD and MCD groups (p=0.073), but progression-free survival was significantly poorer in the MCD group (p=0.001). Age ≥60 years and splenomegaly significantly affected the overall and progression-free survival rates. Conclusion: Patients with UCD had favorable outcomes with surgical resection of a solitary mass, whereas in patients with MCD, old age and splenomegaly were identified as independent prognostic factors. Further well-designed prospective studies under advancing knowledge of the pathophysiology of MCD are warranted to establish suitable guidelines for the discontinuation or prolonging infusion intervals of siltuximab and treatment modalities for HHV-8 positive MCD patients or patients with siltuximab failure.

A Potential Health Risk to Occupational User from Exposure to Biocidal Active Chemicals.

Biocidal active chemicals have potential health risks associated with exposure to retail biocide products such as disinfectants for COVID-19. Reliable exposure assessment was investigated to understand the exposure pattern of biocidal products used by occupational workers in their place of occupation, multi-use facilities, and general facilities. The interview-survey approach was taken to obtain the database about several subcategories of twelve occupational groups, the use pattern, and the exposure information of non-human hygiene disinfectant and insecticide products in workplaces. Furthermore, we investigated valuable exposure factors, e.g., the patterns of use, exposure routes, and quantifying potential hazardous chemical intake, on biocidal active ingredients. We focused on biocidal active-ingredient exposure from products used by twelve occupational worker groups. The 685 non-human hygiene disinfectants and 763 insecticides identified contained 152 and 97 different active-ingredient chemicals, respectively. The toxicity values and clinical health effects of total twelve ingredient chemicals were determined through a brief overview of toxicity studies aimed at estimating human health risks. To estimate actual exposure amounts divided by twelve occupational groups, the time spent to apply the products was investigated from the beginning to end of the product use. This study investigated the exposure assessment of occupational exposure to biocidal products used in workplaces, multi-use facilities, and general facilities. Furthermore, this study provides valuable information on occupational exposure that may be useful to conduct accurate exposure assessment and to manage products used for quarantine in general facilities.

Successful prevention and screening strategies for COVID-19: focused on patients with hematologic diseases

Hematologic patients are immunocompromised, particularly susceptible to life-threatening viral infections (Cho, et al 2018). Regarding the world-wide outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the first case was diagnosed in Korea on January 20, 2020 (Kim, et al 2020, Wang, et al 2020). With spreading of COVID-19, the number of new COVID-19 cases had increased exponentially with peak of 909 new infections on February 29 in Korea (Korean Society of Infectious Diseases, et al 2020). The World Health Organization declared COVID-19 pandemic on March 11, and as of May 6, 2020, more than 3.5 million cases have been confirmed around the world.