ABSTRACT
Heart transplant recipients are at a very high risk of adverse outcomes after SARS-CoV-2 infection. There is no clear guidance on how to manage immunosuppression (IS) on heart transplant patients with COVID-19;in most studies IS was decreased or held. At our center, however, we deliberately maintained IS with the premise that this would result in a reduced inflammatory response to COVID-19. In this study we present our single center experience of heart transplant recipients infected with COVID-19 in whom IS was maintained. Retrospective analysis from June 2020 to February 2022 of heart transplant recipients followed at our center that tested positive for COVID-19. Patient demographics, comorbidities, baseline IS, hospitalization, ICU need, O2 requirement, mechanical support requirement and mortality were recorded. During the study period, 581 transplants were followed at our center, we documented 65 cases of COVID-19 (Table 1). The average age was 58 years, 75% male, 51% Caucasian. 50% had DM, 69% HTN and 48% CKD. Median time since OHT was 4.6 years. 71% of the patients were on dual IS. All patients remained on their baseline immunosuppression. Of the 65 patients, 37% required hospitalization, 9% ICU-level of care. Median LOS was 5.5 days. Mortality was 8%, there were no events of rejection or allograph dysfunction. Our data suggest that maintenance of therapeutical levels of IS in patients with COVID-19 is safe in heart transplant recipients. Our outcomes were comparable to those of the existing literature. Larger studies are needed to further validate our results. [ 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.)
Subject(s)
COVID-19 , SARS-CoV-2 , COVID-19/complications , Child , Humans , Systemic Inflammatory Response Syndrome/diagnosisABSTRACT
Vaccines against COVID-19 are now available for adolescents in Hong Kong but vaccine hesitancy is a major barrier to herd immunity. This survey study explores Hong Kong adolescents' attitudes towards the COVID-19 vaccination. 2609 adolescents from across Hong Kong completed an online survey focused on the intent to vaccinate and the reasons for their choice. 39% of adolescents intended to take the COVID-19 vaccination and significant factors for this decision include: having at least one parent vaccinated, knowing somebody diagnosed with COVID-19 and receiving the influenza vaccine. Adolescents' major concerns were either the safety and efficacy of the vaccine or the risk of infection. This study has proved that even in adolescents the vaccine hesitancy model is prominent with adolescents' intentions highly related to confidence in the vaccine and perception of disease risk. Future interventions should target these specific concerns to ensure adolescents are well educated to overcome vaccine hesitancy.
Subject(s)
COVID-19 , Influenza Vaccines , Adolescent , Attitude , COVID-19 Vaccines , Cross-Sectional Studies , Humans , SARS-CoV-2 , VaccinationABSTRACT
Since the coronavirus disease 2019 (COVID-19) outbreak in late December 2019, and escalation of the public hospital infectious disease outbreak response level to the highest "emergency" level three days after two COVID-19 cases were diagnosed on 22 January 2020, all public hospitals implemented a series of isolation policies, rescheduled clinical services and mobilised resources to support frontline clinical staff. This article reviewed these multi-level policies adopted in the Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, which have ensured that the healthcare system was not overwhelmed and frontline staff was not over-stressed and infected.
Subject(s)
COVID-19 , Myocarditis , Adolescent , COVID-19 Vaccines , Humans , RNA, Messenger , SARS-CoV-2Subject(s)
COVID-19 , Communicable Disease Control/methods , Education, Distance/methods , Mental Health , Psychological Distress , Sedentary Behavior , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/psychology , Child , Child Health , Hong Kong/epidemiology , Humans , Psychology , SARS-CoV-2 , Screen Time , Social Isolation/psychology , Socioeconomic FactorsABSTRACT
Understanding the relationship between the built environment and the risk of COVID-19 transmission is essential to respond to the pandemic. This study explores the relationship between the built environment and COVID-19 risk using the confirmed cases data collected in Hong Kong. Using the information on the residential buildings and places visited for each case from the dataset, we assess the risk of COVID-19 and explore their geographic patterns at the level of Tertiary Planning Unit (TPU) based on incidence rate (R1) and venue density (R2). We then investigate the associations between several built-environment variables (e.g., nodal accessibility and green space density) and COVID-19 risk using global Poisson regression (GPR) and geographically weighted Poisson regression (GWPR) models. The results indicate that COVID-19 risk tends to be concentrated in particular areas of Hong Kong. Using the incidence rate as an indicator to assess COVID-19 risk may underestimate the risk of COVID-19 transmission in some suburban areas. The GPR and GWPR models suggest a close and spatially heterogeneous relationship between the selected built-environment variables and the risk of COVID-19 transmission. The study provides useful insights that support policymakers in responding to the COVID-19 pandemic and future epidemics.