ABSTRACT
Background: The 2020 COVID- 19 pandemic had various effects on local healthcare. The aim of this study was to assess the extent to which local healthcare and healthcare workers were affected by the COVID- 19 pandemic. Method(s): In this observational study we examined and compared intensive care units (ICUs) before (2019) and during (2020) the COVID- 19 pandemic to assess its effects. Emergency patient data were obtained from the Saitama Prefecture Emergency Medical Information System. The effect of COVID- 19 on emergency care responses was compared with the admission and refusal of patients in 2019 and 2020. We also examined the number of patients who were admitted to ICUs and required surgery. The effect on ICUs was examined with the number of Nurses' incident reports and severity percentages calculated from the integrated team medical care and safety system. We also compared the overtime hours of physicians on the basis of employment records. Result(s): In 2019, 2,136 emergency requests were made to admit patients, and 1,811 patients (85%) were admitted. In contrast, in 2020, 2,371 emergency requests were made, and 1,822 patients (76%) were admitted, representing a decrease to 76% (p = 0.931). The percentage of patients for whom admission was refused was significantly greater in 2020 (506 patients, 21.3%) than in 2019 (303 patients, 14.1%;p = 0.0004). In 2020, the number of neurosurgical, cardiac, and vascular operations increased and, over time, the number of operations increased for all surgical units. The number of incidents reported in ICUs increased significantly from 396 in 2019 to 510 in 2020 (p = 0.001). Conclusion(s): Although intensive care management was restricted, the numbers of patients and physician overtime hours were greater during the COVID- 19 pandemic than before, and the resulting environment led to an increase in the number of incidents. The ICU environments must be proactively improved to prepare for more severe situations in the future.Copyright © 2022 Jikei University School of Medicine. All rights reserved.
ABSTRACT
Background: The end of the pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for coronavirus disease-19 (COVID-19), is not foreseen. Vaccination using two subtypes of mRNA-based vaccines, BNT162b2 or mRNA-1273, is an effective public health measure to reduce the risk of infection and severe complications from COVID-19. However, COVID-19 vaccine response data for patients with myeloid malignancy, who are at severe risk in case of infection, has not emerged. Aims: We investigated the antibody titers of COVID-19 in patients with myeloid malignancies who received two doses of mRNA-based COVID-19 vaccine. Methods: Previously treated, currently treated, and newly diagnosed 46 patients with acute myeloid leukemia (AML) and 23 patients with myelodysplastic syndrome (MDS) were included in this study. Anti-spike SARS-CoV-2 antibody titers were measured at 3 months after the second vaccination and compared them to those in healthy controls. Results: Seroconversion rates for AML and MDS were 94.7% and 100%, without significant difference from healthy controls (100%). In AML patients, the median antibody titers of patients in complete remission (CR) (816.5 [interquartile range (IQR): 250.0-2063.5] U/ml vs 1023.0 [640.0-1535.0] U/ml, P=0.668), especially those who were under treatment-free observation in CR (1630.0 [806.0-2454.0] U/ml vs 1023.0 [640.0-1535.0] U/ml, P=0.1220), were comparable to those in healthy controls. On the other hand, even in CR, the antibody titer in AML patients under maintenance therapy was significantly lower than that in patients under treatment-free observation (154.0 [126.0-289.0] U/ml vs 1630.0 [806.0-2454.0] U/ml, P=0.0003). Among the AML patients in CR, patients receiving maintenance treatment had a significantly lower median absolute lymphocyte count (0.81 [0.71-1.46] x 109/l vs 1.58 [1.29-1.93] x 109/l, P=0.0094) and a significantly lower median absolute neutrophil count (1.45 [1.15-1.64] x 109/l vs 3.45 [2.68-4.28] x 109/l, P<0.0001) than that in patients under treatment-free observation. Significantly lower antibody titers were associated with current active treatment (92.2 [37.5-216.3] U/ml vs 1630.0 [806.0-2454.0] U/ml, P<0.0001), AML with myelodysplasia-related changes (50.8 U/ml [39.9-109.1] vs 816.5 [283.0-1935.3] U/ml, P=0.0022), advanced age more than the median age of 68 years (195.0 [43.3-743.0] U/ml vs 1630.0 [806.0-3391.0] U/ml, P=0.0002), and vaccine subtypes of BNT162b2 (285.0 [127.8-1045.3] U/ml vs 3037.0 [2198.50-4537.0] U/ml, P=0.0002) in AML patients and with current active treatment (41.0 [10.7-227.5] U/ml vs 623.5 [173.8-1613.3] U/ml, P=0.0233), subtypes of excess blasts (11.1 [4.8-34.1] U/ml vs 212.0 [81.7-600.0] U/ml, P=0.0293), and high and very high risk of the revised international prognostic scoring system in MDS patients (9.0 [3.4-41.0] U/ml vs 169.0 [48.5-327.0] U/ml, P=0.0380). Summary/Conclusion: This is one of the first studies on the effect of COVID-19 vaccines focusing on patients with AML and MDS, and there are many new findings. The response to COVID-19 vaccine appears to be related to disease and treatment status. Myeloid malignancies may have less impact than lymphoid malignancies on the vaccine response. AML patients under treatment-free observation in CR could be expected to have a vaccine effect that is comparable to that in healthy individuals. In contrast, since the response to vaccination might be insufficient in AML patients undergoing maintenance therapy, maintenance therapy should be continued with strict measures for prevention of infection even after vaccination.
ABSTRACT
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is rapidly spreading globally. Early diagnosis plays an essential role in controlling the infection. Therefore, early and accurate SARS-CoV-2 detection assays along with easy operation are required. The aim of this study was to compare the clinical performance of the Ampdirect™ 2019-nCoV Detection Kit (SHIMADZU assay), which does not require RNA purification steps, with that of the preexisting SARS-CoV-2 detection assays, which use a purified RNA template. A total of 71 samples (65 nasopharyngeal specimens and 6 sputum specimens) were collected from 32 individuals, including patients infected with SARS-CoV-2 and those with suspected infection. The sensitivity and kappa (κ) coefficient were assessed between the SARS-CoV-2 detection assays using the reference standard, which was defined as a true positive result by any one of the four SARS-CoV-2 detection assays. The overall sensitivity and κ coefficient of the SHIMADZU assay were 86.0% (95% confidence interval [CI]: 77.9-94.2) and 0.83 (95% CI: 0.69-0.96), respectively. In particular, among the 18 samples collected within 10 days from symptom onset, the sensitivity and κ coefficient of the SHIMADZU assay were 100% and 1.0, respectively. Although a relatively small number of samples was evaluated, the SHIMADZU assay showed good analytical performance and as such would be highly useful for the detection of SARS-CoV-2. The test can be performed easily and quickly and has the potential for future applications in situations where a highly sensitive diagnosis is required. © 2021
ABSTRACT
Recent spread of the COVID-19 forces governments around the world to have temporarily closed educational institutions. Although many studies were published to announce the best practice under the school closure, we need to understand the impact of school close on students' learning before that. In this paper, we evaluate the impact of the school closure on our online teaching-learning environment. We use CausalImpact model to infer the impact on our learning analytics system using the learning log stored in the system. The results show that the school closure increased the number of logs on LMS by 163%, but decreased the number of logs on e-book reader by 77%. However, focusing on a particular course, we found that students' learning engagement on online system increased both in LMS and e-book reader. We discussed that it is caused by the following reasons: 1) Changes in major users on our online learning platform, and 2) Limited functions of our e-book reader which was developed for face-to-face learning, not online learning. Further, the results also suggested that CausalImpact model is useful for evaluating the effectiveness of a specific event from learning logs collected by learning analytics systems. © ICCE 2020 - 28th International Conference on Computers in Education, Proceedings. All rights reserved.
ABSTRACT
To combat severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) and any unknown emerging pathogens in the future, the development of a rapid and effective method to generate high-affinity antibodies or antibody-like proteins is of critical importance. We here report high-speed in vitro selection of multiple high-affinity antibody-like proteins against various targets including the SARS-CoV-2 spike protein. The sequences of monobodies against the SARS-CoV-2 spike protein were successfully procured within only 4 days. Furthermore, the obtained monobody efficiently captured SARS-CoV-2 particles from the nasal swab samples of patients and exhibited a high neutralizing activity against SARS-CoV-2 infection (half-maximal inhibitory concentration, 0.5 nanomolar). High-speed in vitro selection of antibody-like proteins is a promising method for rapid development of a detection method for, and of a neutralizing protein against, a virus responsible for an ongoing, and possibly a future, pandemic.