ABSTRACT
Introduction: The incorporation of telemedicine into the post-COVID-19 pandemic spine practice remains unclear. The objective of this study is to compare the likelihood of missing an appointment between scheduled telemedicine visits and in-person appointments for spine patients of varying socioeconomic status. Materials and Methods: Patients with scheduled outpatient appointments with the orthopaedic spine division between 2019 and 2021 were retrospectively evaluated. Patients were divided into the two cohorts by appointment type: telemedicine visit (N = 4,387) and in-person appointment (N = 3,810). Home addresses were used to calculate the Area Deprivation Index (ADI), a validated measure of socioeconomic status reported as a percentile with 100 representing the most disadvantaged neighborhood. ADI was also stratified into low (<25), medium (25-75), and high (>75) levels of deprivation. The primary outcome measure was missed clinic appointments, which was defined as having at least one appointment that was cancelled or labeled as 'no show'. Statistical analysis included Student's T-test or Wilcoxon's rank-sum test for continuous variables and Chi-square analysis for categorical variables. Results: Patients with in-person appointments were significantly more likely to miss an appointment compared with patients with telemedicine visits (51% versus 25%, p < 0.001). Patients with high ADI were also more likely to miss in-person appointments than patients with medium and low ADI (60% versus 52% and 48%, p < 0.001). However, there was no significant difference in the likelihood of missing a telemedicine visit between patients with high, medium, and low ADI (28% versus 25% versus 24%, p = 0.294). Patients who missed an appointment were 42% more likely to be high ADI (OR 1.42, 95% CI 1.20-1.68, p < 0.001) and 13% more likely to be medium ADI (OR 1.13, 95% CI 1.03-1.26, p = 0.015) and compared with patients with low ADI. Conclusion: Patients with low socioeconomic status were more likely to miss in-person appointments than patients of higher socioeconomic status. However, there was no difference in the likelihood of missing a telemedicine appointment among patients of different socioeconomic status, suggesting that telemedicine may aid in reducing the barriers to healthcare access. Spine surgeons should consider offering telemedicine as an option to patients, particularly those with low socioeconomic status.
ABSTRACT
We aimed to explore the association of national COVID-19 data with the objective and subjective mental health proxies (i.e. location variance, self-reported sleep quality, level of recovery, perceived risk of infection) in team and staff members of five professional Austrian Football clubs. Data were conveniently collected during the implementation of a novel monitoring concept. The concept was designed to enable safe continuation of professional Football during the COVID-19 pandemic. These data were matched with Austrian COVID-19 data and smartphone collected location data. Multivariable linear regression models explored the association of COVID-19, defined as daily novel or active Austrian cases of COVID-19, with the mental health proxies. An increasing number of novel Austrian COVID-19 cases was significantly associated with deteriorating sleep quality (B 0.48, 95% CI 0.05;1.00). An increasing number of active Austrian COVID-19 cases was significantly associated with an increase in perceived infection risk (B 0.04, 95% CI 0.00;0.07) and location variance (B 0.28, 95% CI 0.06;0.49). An increasing Austrian COVID-19 incidence is adversely associated with mental health in professional Footballers and staff members. During the ongoing pandemic, targeted mental care should be included in the daily routines of this population.
ABSTRACT
Introduction In the context of Covid-19, hyp- and anosmia are observed, which are different to the already known postviral olfactory dysfunction. With limited diagnostic test resources, the early detection of symptoms and their specificity for Covid-19 are of great importance, so that a better understanding of their characteristics is necessary. Material and methods As part of secondary prophylaxis, employees (n = 1734) from retirement and nursing homes were tested for SARS-CoV-2 and asked about subjective restrictions on the sense of smell and any nasal co-symptoms. In addition, patients (n = 41) after confirmed and healed Covid-19 infection were questioned and examined with regard to hyp-/anosmia using a questionnaire and olfactory testing (Sniffin 'sticks with SDI rating). Results Approx. 1% of the employees surveyed reported subjective hyposmia. Acute hyposmias were accompanied by nasal obstruction, chronic hyposmias showed no co-symptoms. In the patients after Covid-19 infections, the identification (Imed = 14) and the discrimination (Dmed = 12) of the odors were only slightly limited, but there was a persistent pathologically increased threshold value for odor perception (Smed = 1.75) in the median 75 days after the onset of infection. Discussion Acute hyp-/anosmia without nasal co-symptoms rarely occurs in the SARS-CoV-2 negative population, so that its occurrence is currently suspicious of a Covid-19 infection and should be examined further e.g. via nasopharyngeal swab. In the further course the odor restrictions can regress again, the different odor qualities seem to do this with different latencies, whereby the increased odor threshold persists the longest.