ABSTRACT
Objective: To evaluate the adherence to antihypertensive treatment during the COVID-19 pandemic and associated variables. Design and method: Cross-sectional study was performed with outpatient, from a Hospital in São Paulo, Brazil. Inclusion criteria were: age >18 years old, telephone number, in treatment for at least six months. Pregnant women were excluded. The period defined to characterize the assessment of social distance due to the COVID-19 pandemic was from March, 24 until August, 31. Hypertensive patients were interviewed by telephone. The adherence to treatment was assessed by Morisky and Green scale and the BP control was systolic BP <140 mmHg and diastolic BP <90 mmHg. Biosocial data, habits and lifestyles and attitudes towards social distancing measures were evaluated. The study was approved by the Research Ethics Committee. The significance level was p<=0.05. Results: The sample was 281 hypertensive patients: 62.3% women;66 (14) years old;348,7 (255,8) $USA monthly income;43.8% completed high school;60.5% white;47.0% married;and 59.1% retired. It was found that 58.7% were adherent to antihypertensive treatment and BP control was 51.6%. The systolic BP was 138.5 (22.7) mmHg and diastolic BP was 77.3 (14.4) mmHg. As for drug treatment, 55.2% of hypertensive patients received the drugs sent by the hospital pharmacy via mail, 63.9% reported that during the COVID-19 pandemic there was a problem in receiving the drugs and 10% was without antihypertensive sometime at home. The variables associated with treatment adherence were: race black (OR 0.40;95% CI: 0.21-0.73), education elementary school II (OR 2.97;95% CI: 1.24-7.06), stayed without antihypertensive at home someday from quarantine (OR 0.40;95% CI: 0.17-0.95) and diastolic BP (OR 0.98;CI: 0.96-0.99). During the period of the pandemic evaluated, it was also observed that 77.6% reported leaving home, 13.5% had contact with people with the disease and 91.8% reported not feeling safe to leave the house after the end of quarantine. Conclusions: The rate of non-adherence to antihypertensive treatment during the COVID-19 pandemic was high and was associated with unfavorable biosocial variables.
ABSTRACT
The current severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) pandemic has highlighted the need for personal protective equipment, specifically filtering facepiece respirators like N95 masks. While it is common knowledge that polypropylene (PP) is the industry standard material for filtration media, trial and error is often required to identify suitable commercial precursors for filtration media production. This work aims to identify differences between several commercial grades of PP and demonstrate the development of N95 filtration media with the intent that the industry partners can pivot and help address N95 shortages. Three commercial grades of high melt flow index PP were melt blown at Oak Ridge National Laboratory and broadly characterized by several methods including differential scanning calorimetry (DSC), X-ray diffraction (XRD), and neutron scattering. Despite the apparent similarities (high melt flow and isotacticity) between PP feedstocks, the application of corona charging and charge enhancing additives improve each material to widely varying degrees. From the analysis performed here, the most differentiating factor appears to be related to crystallization of the polymer and the resulting electret formation. Materials with higher crystallization onset temperatures, slower crystallization rates, and larger number of crystallites form a stronger electret and are more effective at filtration. © XXXX American Chemical Society.
ABSTRACT
BACKGROUND: Cancer patients are at increased risk of death from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Cancer and its treatment affect many haematological and biochemical parameters, therefore we analysed these prior to and during coronavirus disease 2019 (COVID-19) and correlated them with outcome. PATIENTS AND METHODS: Consecutive patients with cancer testing positive for SARS-CoV-2 in centres throughout the United Kingdom were identified and entered into a database following local governance approval. Clinical and longitudinal laboratory data were extracted from patient records. Data were analysed using Mann-Whitney U test, Fisher's exact test, Wilcoxon signed rank test, logistic regression, or linear regression for outcomes. Hierarchical clustering of heatmaps was performed using Ward's method. RESULTS: In total, 302 patients were included in three cohorts: Manchester (n = 67), Liverpool (n = 62), and UK (n = 173). In the entire cohort (N = 302), median age was 69 (range 19-93 years), including 163 males and 139 females; of these, 216 were diagnosed with a solid tumour and 86 with a haematological cancer. Preinfection lymphopaenia, neutropaenia and lactate dehydrogenase (LDH) were not associated with oxygen requirement (O2) or death. Lymphocyte count (P < 0.001), platelet count (P = 0.03), LDH (P < 0.0001) and albumin (P < 0.0001) significantly changed from preinfection to during infection. High rather than low neutrophils at day 0 (P = 0.007), higher maximal neutrophils during COVID-19 (P = 0.026) and higher neutrophil-to-lymphocyte ratio (NLR; P = 0.01) were associated with death. In multivariable analysis, age (P = 0.002), haematological cancer (P = 0.034), C-reactive protein (P = 0.004), NLR (P = 0.036) and albumin (P = 0.02) at day 0 were significant predictors of death. In the Manchester/Liverpool cohort 30 patients have restarted therapy following COVID-19, with no additional complications requiring readmission. CONCLUSION: Preinfection biochemical/haematological parameters were not associated with worse outcome in cancer patients. Restarting treatment following COVID-19 was not associated with additional complications. Neutropaenia due to cancer/treatment is not associated with COVID-19 mortality. Cancer therapy, particularly in patients with solid tumours, need not be delayed or omitted due to concerns that treatment itself increases COVID-19 severity.