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Background: The COVID-19 pandemic dramatically disrupts health care around the globe. The recent COVID-CU study performed at urticaria centers of reference and excellence (UCAREs) demonstrated that the rate of face-to- face consultations decreased from 90% to less than half, whereas the rate of remote consultations increased by more than 600%, from one in 10 to more than two thirds. As of now, it is largely unclear how this affects patients with chronic urticaria. Method(s): We assessed a UCARE video clinic for chronic spontaneous urticaria (CSU) for applicability and satisfaction by patients. Result(s): From January of to October of 2021, 78 patients (mean age 39.7 yrs, 73.3% female) with CSU participated in this survey study. More than 90% patients perceived the image transmission and sound quality as smooth and without distortion. Virtually all patients (96.9%) found that the previously provided explanations and instructions on technical handling were easy to understand and accurate. Patients rated the scheduling and planning of the video consultation as good (98.5%) and stated that it was effortless and within reasonable time (93.8%). Overall, 90.8% felt safe and well informed when using the technology. Most patients reported that the specified time of 20 minutes was sufficient (75.4%), that they were able to address all relevant points (68.8%), and that they received sufficient information about their disease (70.8%) during the video consultation. Almost 80% reported that they felt they were being treated professionally and that they were satisfied with how the conversation with their treating physician unfolded. The majority of patients adjusted quickly and easily to the situation of a video consultation (84.6%) and felt well treated with regard to their medical needs (73.9%). In general, the concept of a video clinic and remote treatment were well perceived and easy to use for most patients (81.5%), and the majority could imagine being treated regularly in this setting in the future (75.4%). Conclusion(s): UCARE video clinic consultations are well received by patients with CSU, which suggests that this instrument may be useful during and beyond the COVID-19 pandemic in the management of patients with chronic urticaria by specialized centers.
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Background: Chronic urticaria (CU) is a common chronic inflammatory disease. Vaccination against viral infections including COVID-19 can induce increased CU disease activity. As of now, it is unclear how often CU exacerbations occur after COVID-19 vaccination. Method(s): COVAC-CU is an international, multicenter, observational, cross-sectional study of the global network of urticaria centers of reference and excellence (UCAREs). COVAC-CU evaluates the effects of COVID-19 vaccination in patients with CU including rates and risk factors of CU exacerbation. Here, we analyzed 1857 patients with CU who had received at least one COVID-19 vaccination. Data were collected via a questionnaire and retrieved from patient charts. Result(s): Of 1857 patients with CU (median age: 42 years;range: 18-91 years), 72.1% were female and 71.2%, 14.4% and 14.4% had chronic spontaneous urticaria, chronic inducible urticaria, or both, respectively. Most patients had received two doses of COVID-19 vaccine (79.1%), compared to one (9.7%), three (11%), or four (0.3%). Vaccine type included: BTN162b2 (58.4%;BioNTech/Pfizer), ChAdOx1 nCOV-19 (13.8%;AstraZeneca), BBIBP-CorV (8.2%;Sinopharm), Gam-COVID- Vac (8%;Sputnik), mRNA-1273 (5.3%;Moderna), and Ad26.COV 2.5 (4.7%;Janssen/J&J). Less than 10% of patients used premedication, and less than half of patients (44.4%) reported one or more adverse reactions after vaccination. The most common adverse reactions were local injection site reactions (29.6%), fatigue (19.7%), fever (19%), muscle pain (17.9%), headache (14%), and exacerbation of CU (15%). Severe allergic reactions/anaphylaxis were reported by 0.4% of CU patients. In almost all patients who experienced exacerbation of their CU, this occurred within one week after receiving the vaccine, i.e. after 1 to 12 hours (25.8 %), after 12 hours to 48 hours (31.1%) or after 2-7 days (37.9%). Conclusion(s): Most CU patients tolerate COVID-19 vaccination well;severe allergic reaction (anaphylaxis) rates were similar or lower than the self-reported rates reported in the general population. Exacerbation of urticaria was reported in one in five patients, mostly in a week after receiving the vaccine.
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Supervised machine learning (SML) provides us with tools to efficiently scrutinize large corpora of communication texts. Yet, setting up such a tool involves plenty of decisions starting with the data needed for training, the selection of an algorithm, and the details of model training. We aim at establishing a firm link between communication research tasks and the corresponding state-of-the-art in natural language processing research by systematically comparing the performance of different automatic text analysis approaches. We do this for a challenging task - stance detection of opinions on policy measures to tackle the COVID-19 pandemic in Germany voiced on Twitter. Our results add evidence that pre-trained language models such as BERT outperform feature-based and other neural network approaches. Yet, the gains one can achieve differ greatly depending on the specific merits of pre-training (i.e., use of different language models). Adding to the robustness of our conclusions, we run a generalizability check with a different use case in terms of language and topic. Additionally, we illustrate how the amount and quality of training data affect model performance pointing to potential compensation effects. Based on our results, we derive important practical recommendations for setting up such SML tools to study communication texts.
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In the published article, there was an error. The Methods section incorrectly states the number of interviews analyzed as 74. A correction has beenmade to Section 2.Methods, “2.3 Interview,” Paragraph 1. This sentence previously stated: “The total number of individuals contacted for interviews was 356 and the total number of completed interviews was 74.” The corrected sentence appears below: “The total number of individuals contacted for interviews was 356 and the total number of completed interviews was 72.” The authors apologize for this error and state that this does not change the scientific conclusions of the article in any way. The original article has been updated. © 2022 Maurer, Cook, Yoon, Visnic, Orlove, Culligan and Mailloux.
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Cardiac microthrombi are postulated to underlie cardiac injury in critical COVID-19. To determine pathogenic mechanism(s) of cardiac injury in fatal COVID-19, we conducted a single-center prospective cohort study of 69 consecutive COVID-19 decedents. Microthrombi was the most commonly detected acute cardiac histopathologic feature (n=48, 70%). We tested associations of cardiac microthrombi with biomarkers of inflammation, cardiac injury, and fibrinolysis and with inhospital antiplatelet therapy, therapeutic anticoagulation, and corticosteroid treatment, while adjusting for multiple clinical factors, including COVID-19 therapies. Higher peak ESR and CRP during hospitalization were independently associated with higher odds of microthrombi (ESR, Pnonlinearity 0.015, Passociation=0.008;CRP per 20mg/L increase, OR 1.17, 95%CI 1.00-1.36). Using single nuclei RNA-sequence analysis, we discovered an enrichment of prothrombotic, anti-fibrinolytic, and extracellular matrix signaling amongst cardiac fibroblasts in microthrombi-positive COVID-19 hearts, compared with microthrombi-negative COVID-19 hearts and non-COVID-19 donor hearts. Our cumulative findings identify these specific transcriptomic changes in cardiac fibroblasts as salient features of COVID-19-associated cardiac microthrombi.
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This work investigates the use of interactively updated label suggestions to improve upon the efficiency of gathering annotations on the task of opinion mining in German Covid-19 social media data. We develop guidelines to conduct a controlled annotation study with social science students and find that suggestions from a model trained on a small, expert-annotated dataset already lead to a substantial improvement - in terms of inter-annotator agreement (+.14 Fleiss' kappa) and annotation quality - compared to students that do not receive any label suggestions. We further find that label suggestions from interactively trained models do not lead to an improvement over suggestions from a static model. Nonetheless, our analysis of suggestion bias shows that annotators remain capable of reflecting upon the suggested label in general. Finally, we confirm the quality of the annotated data in transfer learning experiments between different annotator groups. To facilitate further research in opinion mining on social media data, we release our collected data consisting of 200 expert and 2,785 student annotations.(1)
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Purpose In the era of COVID-19, the televisit has become a critical means of providing healthcare for patients unable to attend in-person visits. Transthyretin and light chain amyloidosis are complex diseases, that require frequent and close follow up. The aim of this study was to assess the utility and effectiveness of televisit encounters for patients with cardiac amyloidosis (CA) during the COVID-19 pandemic. Methods This was a prospective cohort study of consecutive patients with CA who were evaluated by televisit between March and May, 2020, at a large academic medical center. Patient demographics, baseline medications and details of televisit encounters were collected from electronic medical records. Patients were followed for 3 months from their first televisit for medication changes, in-person clinic visits, hospital admissions, and mortality. Results Ninety-eight patients with CA were included. Mean age was 76.5±9.1 yrs and 79 were male (80.6%). The number of televisits per patient is shown in Figure 1a. Over 3-months follow-up, 26 patients (26.5%) were seen for either an in-person clinic visit or right heart catheterization. There were 7 emergency room visits, of which 4 (4.1%) resulted in hospital admission, 1 patient (1.0%) had multiple admissions and no patient died (Figure 1b). None of the hospital admissions occurred within two weeks of a televisit. Hospital admissions were due to heart failure exacerbation, sepsis, acute kidney injury and dehydration secondary to diarrhea. During follow-up, 23 patients (23.5%) had medication adjustments, most commonly changes in diuretic (56.5%) and mineralocorticoid receptor antagonist (56.5%) doses. Two patients were newly initiated on tafamidis, for treatment of transthyretin CA. Conclusion The use of televisits for the management of patients with CA is feasible, and the low admission rate indicates that televisits are a safe and effective way to manage CA patients in the outpatient setting.