ABSTRACT
Background Since the outbreak of COVID-19, a significant decline in endoscopic procedures has been observed. Aims We investigated the change of incidence, clinical characteristics, disease stage and mortality of patients with gastric cancer (GC) or colorectal cancer (CRC) diagnosed in 2020 compared to the pre-pandemic year 2019. Methods Demographic, clinical and laboratory data on all patients diagnosed with GC or CRC at the Soroka University Medical Center were retrospectively collected and compared. Number of cases, time of diagnosis, clinical presentation, staging at diagnosis and mortality rates were compared. Results Two hundred sixteen patients were diagnosed with CRC in 2019, whereas only 162 were diagnosed in 2020 (25% reduction), while 36 GC diagnoses were made in 2019 compared to 24 in 2020 (33% reduction). The age-adjusted incidence was calculated to be 24.28 for CRC and 5.0 for GC in 2020 compared to 29.93 and 5.32 in 2019, respectively. CRC patients had a significantly lower rate of rectal bleeding as their presenting symptom in 2020 compared with 2019, 8.1 vs. 19% (p = 0.003), but higher rate of diarrhea as their presenting symptom, 4.3 vs. 1% (p = 0.044). No significant differences regarding other presenting symptoms, comorbidities, surgery or mortality rates were found between the groups diagnosed in 2019 or 2020. Conclusion A decrease in GC and CRC incidence was observed during the year 2020;lower rate of rectal bleeding and higher rate of diarrhea as presenting symptoms were noted in 2020, but no significant difference was found regarding other presenting symptoms, disease stage, surgery or mortality.
ABSTRACT
BACKGROUND: SARS-CoV-2 is a novel human pathogen causing Coronavirus Disease 2019 that has caused widespread global mortality and morbidity. Since health workers in Israel were among the first to be vaccinated, we had a unique opportunity to investigate the post-vaccination level of IgG anti-S levels antibodies (Abs) and their dynamics by demographic and professional factors. METHODS: Prospective Serological Survey during December 2020-August 2021 at Barzilai Medical Center among 458 health care workers (HCW) followed for 6 months after the second BNT162b2 vaccine dose. RESULTS: Antibody levels before the second dose, and 30, 90 and 180 days after were 57.1 ± 29.2, 223 ± 70.2, 172.8 ± 73.3 and 166.4 ± 100.7 AU/mL, respectively. From GEE analysis, females had higher Abs levels (ß = 26.37 AU/mL, p = 0.002). Age was negatively associated with Abs, with a 1.17 AU/mL decrease for each additional year (p < 0.001). Direct contact with patients was associated with lower Abs by 25.02 AU/mL (p = 0.009) compared to working with no such contact. The average decline rate overall for the study period was 3.0 ± 2.9 AU/mL per week without differences by demographic parameters and was faster during the first 3 months after vaccination than in the subsequent 3 months. CONCLUSIONS: All demographic groups experienced a decline in Abs over time, faster during the first 3 months. Findings of overall Abs lower in males, workers with direct contact with patients, and older workers, should be considered for policy-making about choosing priority populations for additional vaccine doses in hospital settings.
ABSTRACT
Importance: Social restrictions intended to limit the transmission of SARS-CoV-2 may have also been associated with decreased rates of other communicable diseases. Evidence suggests that infection incidence rates (IRs) are rebounding after easing of social restrictions (eg, mask mandates). The reemergence of infectious disease complicates efforts to manage the ongoing COVID-19 pandemic. Objective: To examine IRs of frequently occurring infectious diseases after a successful SARS-CoV-2 vaccination campaign in Israel and cessation of social restrictions. Design, Setting, and Participants: This cross-sectional study was conducted using records for respiratory and gastrointestinal infectious diseases at 209 community clinics in southern Israel from 2017 to 2021. Included patients attended community clinics from January 1, 2017, to June 30, 2021. Exposures: Incidence of infectious diseases was estimated in the first 3 months after the easing of social restrictions (ie, April-June 2021) across age groups. Main Outcomes and Measures: Age-specific and disease-specific weekly IRs per 100â¯000 population for April to June were compared between 2017 and 2021 and expected current IR was estimated using segmented linear regression. Growth rates of respiratory infections across years and weekly diagnoses detected by real-time polymerase chain reaction testing were also compared. Results: Among 386â¯711 patients with a total of 1â¯221â¯568 visits to community clinics, the mean (SD) age was 27.29 (23.93) years, and there were 202â¯494 (52.3%) male patients and 184â¯217 (47.7%) female patients. Children aged 0 to 3 years had significantly increased rates of respiratory and gastrointestinal infection diagnoses (IR ratio, 2.64; 95% CI, 2:30-2.91; P < .001). In addition, incidence of non-SARS-CoV-2 respiratory infections were significantly increased across age groups (IR ratio, 1.74; 95% CI, 1.56-1.94; P < .001). Conclusions and Relevance: These morbidity trends observed in Israel suggest that similar trends could occur in coming months in other countries after easing of COVID-19-related restrictions, particularly with the ongoing challenges of SARS-CoV-2 variants.