The Effect of Face Mask, Air Temperature, and Humidity on COVID-19 Transmission: A Systematic Review and Meta-analysis

Context: At the beginning of the COVID-19 pandemic, the effects of personal protective equipment (PPE) such as face masks, as well as environmental conditions, including temperature and humidity changes, were discussed due to the lack of effective medicine. Methods: The preferred reporting items for systematic reviews and meta-analysis (PRISMA) were implemented to conduct the present systematic review. The articles were selected from papers published by May 2020 in PubMed, Web of Science, Science Direct, Scopus, and Google Scholar databases. This meta-analysis estimated relative risk (RR) and pooled mean depicted as effect size (ES) using the random or fixed effects methods. Results: Ten studies met inclusion criteria, four of which addressed the effect of face masks and six of which dealt with temperature and humidity changes. This eta-analysis study showed that wearing face masks against the COVID-19 virus had a remarkable safety impact with RR (%95 CI) 8.56 (2.10 - 34.90), (I-2 = %0.0 P = 0.999), and the pooled mean changes in temperature and humidity were estimated to be with ES (%95 CI) 9.03 (4.32 - 13.74), (I-2 = %99.7, P = 0.0001) and with ES (%95 CI) 56.82 (46.12 - 67.51), ( I-2 = %99.3, P = 0.0001) during the outbreak of the COVID-19. Conclusions: The findings of this systematic review and meta-analysis illustrate the effectiveness of face masks, in general, in preventing the transmission of the COVID-19 virus. According to the findings, temperature and humidity changes do not increase the outbreak of the COVID-19 virus.

Prevalence of depression, anxiety, and stress among Iranian nurses during the COVID-19 outbreak and their related factors

Background: Psychological conditions such as stress, anxiety, and depression are emerging challenges in healthcare systems. These disorders are recognized as very common problems among the nursing staff. During the COVID-19 period, nursing staff has been exposed to the highest risk of psychological disorders. The study aimed to examine the prevalence of depression, anxiety, and stress amongst Iranian nurses throughout the pandemic and to explore the possible factors related to each mental condition. Methods: A cross-sectional and web survey done from September 15 to December 15, 2020 amongst 1135 Iranian nurses. Stress, anxiety, and depression were measured using the Depression Anxiety Stress Scale-21 Items (DASS-21) during the COVID-19 pandemic. A logistic regression analysis was performed to recognize the predictors. Results: The prevalence of stress, anxiety, and depression was 75.6%, 79.2%, and 59.1%, respectively, among nurses. The outcomes of the multivariable logistic regression indicated that potential factors contributing to stress included female gender (odds ratio [OR] = 1.52), younger age (OR = 0.48), and work overload (OR = 1.73). Female gender (OR = 1.56), younger age (OR=0.27), and lower levels of education (OR = 0.50) were associated with high levels of anxiety. Also, lower education (OR=0.56), longer working hours (OR = 1.81), and working in intensive care units (OR = 1.67) significantly predicted a higher risk of depression symptoms in nurses. Conclusion: The present results showed that stress, anxiety, and depression were common amongst nurses working in public hospitals throughout the COVID-19 pandemic. Preventive measures, like psychological interventions, are suggested to decrease the risk of stress, anxiety, and depression among nurses;the identification of risk factors may also allow for more targeted interventions. There is an imperative need for diverse implementation strategies at all levels to decrease the psychological effect of the pandemic such as social support and psychological support in the workplace Keywords: Anxiety, COVID-19, Depression, Mental health, Nurses, Psychological disorders, Stress. © 2022 Pravnehistoricke Studie. All rights reserved.

Axillary Lymph Node Core Biopsy Following SARS-CoV-2 Vaccination

Background: Atypical axillary lymph nodes identified on breast cancer screening often result in axillary lymph node core biopsy (ALNB). However, similar changes may occur after vaccination. Recent trends of mass vaccination for SARS-CoV-2 have resulted in new guidelines, specifically delay to biopsy following vaccination to avoid false positives and unnecessary biopsy, with notable exceptions in the context of breast cancer. We aimed to evaluate ALNB pathology, clinical and imaging features in patients who had received SARS-CoV-2 vaccination. Design: We evaluated ALNB specimens from patients who received SARS-CoV-2 vaccine before biopsy (1/2021 - 6/2021) at our enterprise (1 academic and 2 community hospital sites). Clinicopathologic features were assessed by chart and slide review, with pathology review by a dedicated hematopathologist and imaging review by dedicated breast radiologists. Results: Of 135 patients with ALNB, 48 (35.6%) had vaccination prior to biopsy. Patients were predominantly female (47/48;97.9%), with a mean age of 55.1 years (range 19.9-91.3). 34 of 48 (70.8%) were benign, 12 (25%) had metastatic carcinoma, 1 (2.1%) hematologic malignancy (CLL/SLL), and 1 (2.1%) metastatic melanoma. In non-vaccinated patients, the rate of malignancy was similar (24/87;27.6%) (p=0.73). All ALNB with metastatic carcinoma were from patients with concurrent breast carcinoma and the patient with metastatic melanoma had a history of melanoma. Of patients with benign ALNB, 10 (29.4%) had concurrent, 1 (2.9%) recent (within 2 years) and 3 (8.8%) remote (>2 years) history of breast cancer. Most (37/48;77.1%) ALNB specimens could be traced to abnormal breast imaging (Table 1). SARS-CoV-2 vaccine was ipsilateral in 18 (37.5%), contralateral in 14 (29.2%) and side was not documented in 16 (33.3%). Median time from 1st dose to ALNB was 10.6 weeks (range 1.9-23.9) and from 2nd dose to ALNB was 7.7 weeks (range 0-20.9). 16 (33.3%) had a dose within the prior 6 weeks. Benign ALNB in patients who underwent vaccination prior to biopsy comprised: 21 (61.8%) without specific features, 10 (29.4%) reactive follicular hyperplasia, 2 (5.9%) dermatopathic change and 1 (2.9%) tattoo pigment. Reactive follicular hyperplasia was significantly less frequent (4/63;6.3%) in patients who did not undergo vaccination prior to biopsy (p<.01). Conclusions: Some patients who underwent SARS-CoV-2 vaccination with reactive changes may have avoided ALNB if there were more time between imaging, vaccination and breast cancer diagnosis. (Table Presented).

Increase in newly diagnosed type 1 diabetes among pediatric and adolescent patients during the COVID-19 pandemic in the United States: A multi-center analysis

Introduction: An increase in newly diagnosed type 1 diabetes (T1D) has been posited during the COVID-19 pandemic, but data have been conflicting. Objectives: We aimed to determine trends in newly diagnosed T1D and severity of presentation at diagnosis for pediatric and adolescent patients during COVID-19 year (2020) as compared to the previous year (2019) in a multi-center data analysis across the United States. Methods: This retrospective multi-center study included data from seven large U.S. clinical centers recruited from the T1D Exchange Quality Improvement Collaborative (T1DX-QI). Data on diagnosis, diabetic ketoacidosis (DKA), and clinical characteristics were collected from January 1 to December 31, 2020, compared to the prior year. Chi-square tests were used to compare differences in patient characteristics during the pandemic compared to the pre-pandemic comparison group. Results: Across seven member sites, there were 1399 newly diagnosed patients with T1D in 2020, compared to 1277 in 2019 (p=0.007). Of the newly diagnosed patients, a greater number, presented in DKA in 2020 compared to 2019 (599/1399 (42.8%) v. 493/1277 (38.6%), p<0.001), and a higher proportion of these patients presented with severe DKA (p=0.01) as characterized by a pH<7.1 or bicarbonate of <5mmol/L. The mean age at diagnosis was not different, but there were fewer females (p=0.004), and fewer NH White youth diagnosed in 2020 (p<0.001). Newly diagnosed T1D patients in 2020 were less likely to have private insurance (p=0.001). Monthly data trends demonstrated a higher number of new diagnoses of T1D over the spring and summer months (April to September) of 2020 compared to 2019 (p=0.007). Conclusions: We found an increase in newly diagnosed T1D and a greater proportion of newly diagnosed T1D patients presenting in DKA at diagnosis during the COVID-19 pandemic compared to the prior year. Future longitudinal studies are needed to confirm these findings with population level data and determine the long-term impact of COVID-19 on diabetes trends.

Initial Stroke Thrombectomy Experience in New York City during the COVID-19 Pandemic.

New York City has become the global epicenter of the coronavirus 2019 (COVID-19) pandemic. Despite a massive shift in health care resources, cerebrovascular disease continues to be a substantial burden. We review the first 10 patients undergoing thrombectomy following a series of governmental and institutional policy changes diverting resources to the care of critically ill patients with COVID-19. Ten patients with emergent large-vessel occlusion underwent thrombectomy between March 23 and April 1, 2020. Five patients tested positive for the COVID-19 virus. Successful reperfusion was achieved in 9 of 10 patients, at a median time of 37 minutes from vascular access. The postprocedural NIHSS score improved by an average of 7.7 points. Of the 5 patients positive for COVID-19, none have experienced a critical respiratory illness. We report the early incidence of COVID-19 positivity in patients with emergent large-vessel occlusion and demonstrate that thrombectomy continues to be an efficacious option, as well as safe for health care providers.

COVID-19 Is an Independent Risk Factor for Acute Ischemic Stroke.

BACKGROUND AND PURPOSE: Coronavirus disease 2019 (COVID-19) is an active worldwide pandemic with diverse complications. Stroke as a presentation has not been strongly associated with COVID-19. The authors aimed to retrospectively review a link between COVID-19 and acute stroke. MATERIALS AND METHODS: We conducted a retrospective case-control study of 41 cases and 82 control subjects matched by age, sex, and risk factors. Cases were patients who underwent stroke alert imaging with confirmed acute stroke on imaging between March 16 and April 5, 2020, at 6 hospitals across New York City. Control subjects were those who underwent stroke alertimaging during the same timeframe without imaging evidence of acute infarction. Data pertaining to diagnosis of COVID-19 infection, patient demographics, and risk factors were collected. A univariate analysis was performed to assess the covariate effect of risk factors and COVID-19 status on stroke imaging with positive findings. RESULTS: The mean age for cases and controls was 65.5 ± 15.3 years and 68.8 ± 13.2 years, respectively. Of patients with acute ischemic stroke, 46.3% had COVID-19 infection compared with 18.3% of controls (P = .001). After adjusting for age, sex, and risk factors, COVID-19 infection had a significant independent association with acute ischemic stroke compared with control subjects (OR, 3.9; 95% CI, 1.7-8.9; P = .001). CONCLUSIONS: We demonstrated that COVID-19 infection is significantly associated with imaging confirmation of acute ischemic stroke, and patients with COVID-19 should undergo more aggressive monitoring for stroke.