ABSTRACT
Background: Previous studies have reported ongoing cardiac inflammation as assessed by cardiac magnetic resonance imaging (CMR) in a significant proportion of patients several months after recovery from SARSCoV- 2 infection, many of whom had no or minimal symptoms at the time of infection. Purpose(s): The aim of SETANTA was to investigate the prevalence of cardiac abnormalities by CMR in unselected patients in Ireland after acute SARS-CoV-2 infection and the correlation with immunological response and biomarkers of coagulation. Method(s): This was a prospective, observational, community-based study (clinicaltrials.gov identifier NCT04823182). Consecutive patients recovered from recent SARS-CoV-2 infection at 3 primary care sites were invited to participate. Key inclusion/exclusion criteria and outcomes of interest are shown in Figure 1. Result(s): 100 participants were enrolled (Feb-Sept 2021) at a median of 188 (IQR, 125, 246) days after positive SARS-CoV-2 swab. At index infection, 18% and 35% reported severe and moderate symptoms, respectively;14% were hospitalized;3% were admitted to intensive care for ventilatory support. At enrolment, 83% had ongoing symptoms. 85% had detectable SARS-CoV-2 antigens. CMR and laboratory findings are shown in Figure 1. Conclusion(s): Among an unselected cohort of patients recovered from acute SARS-CoV2 infection, we report a low prevalence of cardiac abnormalities by CMR, despite a high prevalence of moderate/severe symptoms at presentation and a high prevalence of persistent symptoms. Correlation with biomarkers of immunity and coagulation will be available at ESC 2022.
ABSTRACT
The education area is being deeply affected by COVID-19, and Brazilian students are trying to adapt. This chapter aims to research how postgraduate students are dealing with the challenges of the pandemic. From the following research question, "How did COVID-19 impact different dimensions of students' lives enrolled at master and doctorate programmes?" the chapter describes the challenges that students from Master and Doctorate programmes of two federal institutes are dealing with and the future perspectives in the context of the pandemic. The research methodology is based on an exploratory approach, grounded on a survey for data regarding the impacts of COVID-19 in three dimensions: private life, professional life, and academic life, aiming to understand if and how their research and educational products development were affected. The results show that, despite stress and efforts, the students could adapt their research for the pandemic situation.
ABSTRACT
Background: Intubation rates up to 33% have been found in patients diagnosed with COVID-19. Some cohorts have reported the presence of dyspnea in 84.1% of intubated patients, being this the only symptom associated with intubation. Oxygen saturation < 90% and increased respiratory rate have also been described as predictors of intubation.
ABSTRACT
Introduction Previous studies have reported ongoing cardiac inflammation as assessed by cardiac magnetic resonance imaging (CMR) in a significant proportion of patients several months after recovery from SARS-CoV-2 infection, many of whom had no or minimal symptoms at the time of infection. The aim of SETANTA was to investigate the prevalence of cardiac abnormalities by CMR in unselected patients in Ireland after acute SARS-CoV-2 infection and the correlation with immunological response and biomarkers of coagulation. Methods This was a prospective, observational, communitybased study (clinicaltrials.gov identifier NCT04823182). Consecutive patients recovered from recent SARS-CoV-2 infection at 3 primary care sites were invited to participate. Key inclusion/ exclusion criteria and outcomes of interest are shown in figure 1. Results 100 participants were enrolled (Feb-Sept 2021) at a median of 188 (IQR, 125, 246) days after positive SARSCoV- 2 swab. At index infection, 18% and 35% reported severe and moderate symptoms, respectively;14% were hospitalized;3% were admitted to intensive care for ventilatory support. At enrolment, 83% had ongoing symptoms. 85% had detectable SARS-CoV-2 antigens. CMR and laboratory findings are shown in Figure 1. Clinical follow up to 12 months is ongoing. Conclusion Among an unselected cohort of patients recovered from acute SARS-CoV2 infection, we report a low prevalence of cardiac abnormalities by CMR, despite a high prevalence of moderate/severe symptoms at presentation and a high prevalence of persistent symptoms. Correlation with biomarkers of immunity and coagulation add results of follow up at 12 months will be available for presentation at ICS 2022.
ABSTRACT
This study examined the support for vaccine mandates and uptake among clinical and non-clinical staff at a tertiary hospital in northern Nigeria, focusing on variation of survey responses based on job position, socio-demographic characteristics, and perceived risk of infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Using an explanatory, sequential, mixed-methods design and deploying a pragmatic paradigm, 370 healthcare workers were administered structured questionnaires. This was followed by in-depth interviews with a sub-sample of respondents to further clarify the responses regarding support for the coronavirus disease 2019 (COVID-19) vaccine mandate. Findings demonstrated that less than one-half of respondents supported the COVID-19 mandate, and only one in three had received the recommended COVID-19 vaccine doses. Support for the vaccine mandate and vaccine uptake were predicted by profession, work experience, number of children, health status, and risk perception. Support for the vaccine mandate was ascribed to ethical and professional duty, whereas opposition was associated with respect for autonomy and human rights. This study documents the need to enhance support for vaccine mandates and uptake among healthcare workers through sustainable strategies, as Nigeria's healthcare workers are considered a source of trust and role models for the rest of society.
Subject(s)
COVID-19 Vaccines , COVID-19 , Child , Humans , COVID-19/epidemiology , COVID-19/prevention & control , SARS-CoV-2 , Health Personnel , Health WorkforceABSTRACT
STATEMENT OF PROBLEM/QUESTION: Will a telehealth initiative improve poorly controlled type 2 diabetes mellitus (DM) and unmet social determinants of health (SDOH) needs exacerbated by the COVID-19 pandemic? DESCRIPTION OF PROGRAM/INTERVENTION: Due to COVID-19, many patients with DM faced challenges accessing healthcare, as well as exacerbations of socioeconomic disparities regarding access to food, affordable housing, and safe places to exercise. To address these challenges, we adapted an existing student-faculty collaborative practice at Beth Israel Deaconess Medical Center, Boston, MA, to a telehealth platform to provide targeted DM management, and referrals to dietitians and community resource specialists. MEASURES OF SUCCESS: We assessed clinical outcomes, such as changes in hemoglobin A1c (HbA1c), LDL, and number of medication adjustments. Measured quality indicators included frequency of HbA1c, LDL, and microalbuminuria measurements, as well as prescription of cardiovascular/diabetic medications such as ACE inhibitors, statins, and aspirin within the year prior to enrollment and within 6 months after the final visit. To measure the role and intervenability of SDOH needs, we tracked the results of SDOH screens to identify key needs, as well as the number of dietitian and community resource specialist (CRS) referrals placed. FINDINGS TO DATE: Of 998 patients with non-insulin-dependent type 2 DM, 60 were enrolled in the program, of whom 42% were white and had a median BMI of 32.0 kg/m2 (IQR 28.3-36.1). Patients endorsed high motivation (8/10) and confidence (7/10) in managing their diabetes, but reported inadequate nutrition education (56.7% of cohort), as well as difficulty maintaining a healthy diet (76.7%) and exercising (78.3%). Analysis of baseline data and for those who completed the program thus far (n = 22, >6 months since last clinic visit), showed a significant decrease in mean HbA1c (mean ±SEM) from 8.72±0.15 to 8.09±0.22 (p = 0.03). LDL levels were not significantly different before and after the program, 90.3±5.4 vs 100.9±10.6 (p = 0.42). Lab draw frequency (HbA1c, LDL) and medication prescription (ACE inhibitors, statin, aspirin) and were not significantly different. Of patients who completed the program, 8 (36.4%) had their diabetes medications adjusted. 2 (9.1%) were referred to a CRS, and 2 (9.1%) were referred to a dietitian. KEY LESSONS FOR DISSEMINATION: Our ongoing study showed that the implementation of a telehealth diabetes program with SDOH screening can be an effective way to assist patients with uncontrolled diabetes. We identified significant patient needs for additional support and clinical care. Assessing socioeconomic burdens faced by patients and understanding the impact and key features of such a collaborative telehealth program can pave the way for the implementation of a similar model of care for other chronic conditions.
ABSTRACT
This paper discusses online student assessment which is one of the major concerns of higher education institutions during these pandemic times, forcing teachers to teach and assess in different ways and conditions than when using regular methods. Online assessment brings more challenges for the teachers and the fear that students could cheat more than in on-site or face-to-face conditions. More than a surveillance task, it is a question of having justice among different students’ socio-economic and learning conditions. Ethical issues, respect for the colleagues and trust in their own work and more suitable learning assessment methods could be strong reasons for the students not to cheat. For the teachers, this is a complex and controversial issue. Finding the best ways to prevent this from happening is not easy. This could demand a balance between less time and more complex online tests that require a lot of imagination and creativity. This paper gives some examples of face-to-face written tests and online tests, comparing grades of two cohorts of students (2019_20 and 2020_21) from three different courses. Those courses are lectured in the first and third year of Industrial Engineering and Management (IEM) Integrated Masters degree and the first year of the Masters in Engineering Project Management, at the University of Minho. Some practical tips and suggestions will be given to prepare online tests (e.g. diversity of assessment methods, type of questions included in the tests, tests could not be the only assessment method ...). © 2021 University of Minho. All rights reserved.
ABSTRACT
Introduction Severe asthma patients were assumed to be at greater risk of morbidity from infection with the novel severe acute respiratory syndrome coronavirus (COVID-19), hence, in the UK, were advised to shield. Community data on COVID-19 infection in severe asthmatics is lacking. We assessed the burden of shielding, the impact of COVID-19 and the effect of asthma medication on the UK severe asthma population. Methods Adults previously consented to inclusion in the UK Severe Asthma Registry (UKSAR) across 14 centres were contacted in June 2020 to collect data on potential COVID-19 infection, asthma control and shielding. Electronic records, where available, were reviewed for confirmation. Data was combined with clinical data from the UKSAR. Univariate and multivariate logistic regression analyses were performed to identify risk factors for COVID-19 infection. Results 1365 patients were included. 1268 (93%) were advised to shield, 1131 (89%) patients who received shielding advice followed it. Men (OR 0.4, p=0.045) and those in non-shielding households (OR 0.27, p=0.001) were less likely to follow shielding advice. 544 (47%) of patients advised to shield reported worsening of mental health;females (OR 1.59, p=0.001) and those with history of anxiety or depression (OR 2.12 p=0.001) were at greater risk. 97 (7.1%) patients had suspected/confirmed COVID-19 infection, 19 (1.39%) PCR/serology confirmed infection, 13(0.95%) were hospitalised and 2 patients (0.15%) died (table 1). 918 (67%) were on biologic therapy, 515 (37%) maintenance oral corticosteroid (mOCS). Multivariate analysis showed neither biologic therapy (OR 0.73, p=0.165) nor mOCS (OR 1.18, p=0.427) increased the risk of COVID-19 infection. Patients on biologics were less likely to require an acute course of corticosteroids for asthma symptoms (OR 0.6, p=0.002) while patients on mOCS were more likely (OR 1.96 p£0.001). Inhaled corticosteroids (ICS) were not associated with COVID-19 infection, including high dose (2000 mcg BDP equivalent) (OR 0.64, p=0.234). Hospitalised patients were on lower median doses of ICS vs non-hospitalised patients (1000 vs 2000 mcg BDP equivalent, p=0.002). Conclusion Hospitalisation and death occurred in small numbers in our severe asthma population. From this observational data, biologic agents for asthma were not associated with increased risk of COVID-19 infection or hospitalisation.
ABSTRACT
S25 Table 1Characteristics of severe asthma patients with suspected or confirmed mild (ambulatory) or severe (hospitalised) COVID-19 infection Mild COVID-19 (n=84)Hospitalised with COVID-19 (n=13)p-valueAge (Years) (mean [SD])50.5 (13.8)55.6 (13.7)0.215Male Gender (n [%])39 (46.4%)4 (30.8%)0.290BMI (kg-m2) (mean [SD])31.3 (6.3)31.3 (4.9)0.967Non-Caucasian Ethnicity (n [%])15 (17.9%)3 (25.0%)0.553Atopic Disease (n [%])48 (62.3%)10 (76.9%)0.310FEV1% Predicted (mean [SD])67.9 (59.9,82.8)73.7 (60.1,84.8)0.555ICS Dose (BDP equivalent-ug) (median [IQR])2000 (1600,2000)1000 (800,1600)0.002On Maintenance OCS (n [%])35 (47.9%)3 (23.1%)0.872Evidence of Poor Adherence (n [%])18 (24.7%)7 (53.8%)0.033Maintenance Macrolides (n [%])7 (9.9%)2 (16.7%)0.428On Asthma Biologic (n [%])57 (67.9%)8 (61.5%)0.652Shielding against COVID-19Followed Shielding Advice (n [%])64 (84.2%)9 (90.0%)0.631Shielding affected mental health (n [%])33 (46.5%)5 (50.0%)0.835Contracted COVID-19 Before Shielding (n [%])40 (60.6%)4 (40.0%)0.219ConclusionHospitalisation and death occurred in small numbers in our severe asthma population. From this observational data, biologic agents for asthma were not associated with increased risk of COVID-19 infection or hospitalisation.