ABSTRACT
Background/Aims To assess the incidence and vulnerability of rheumatology patients to COVID-19 infection in early stages of pandemic. Methods Self completed questionnaire was posted to patients. Results Patients diagnosed with rheumatic diseases were categorised as people at high risk of infection with COVID-19 (pharmacologically immunosuppressed) and with possible worsening outcomes than the general population. This study was a self-completed questionnaire which was sent to all patients registered under a National Health Services specialist rheumatology department in the UK, between May 2020 and May 2021. A total of 610 responses were received and data was analysed statistically. The aim from this survey was to assess COVID19 infection prevalence amongst rheumatology patients under the care of this department, and to examine the profiles of patients with reported COVID-19 infection, their comorbidities, rheumatoidrelated medications and infection severity and outcome. Of 610 responders diagnosed with rheumatoid diseases, 12 patients (1.96%) received a diagnosis of COVID-19 based on their clinical presentation. However, when patients undertaken a Polymerase Chain Reaction test, only 2 patients (16.6%) returned positive results. In both the COVID-19 and non-COVID groups 60% were shielding (n=361). In our sample infection rate was around 30 times (1 in 50 rheumatoid patients, 2% in the sample population) the prevailing rate for the general population in the region (75 in 100,000, 0.075% in the general population). Negative testing did not preclude the presence of disease, but this may reflect poor efficacy and reliability of testing in the early days of the pandemic. The sample means and SD+/- were 63.96/ 13.23 for age and 27.76/5.79 for BMI. Sample population characteristics presented in Table 1. Conclusion This patient group were more vulnerable to COVID-19 infection compared to the general population but appear not to be at greater risk of severe disease.
ABSTRACT
Objective: Published studies demonstrate that diagnosis with Type 2 diabetes (T2DM) places patients at risk of severe symptoms and increased mortality from COVID-19. The literature was reviewed to understand emerging evidence. Method: A review of pubÂlished studies on COVID-19 in patients with diabetes was conducted to identify the needs and optimal practice for the local pop-ulation diagnosed with diabetes at risk of COVID-19. Key Findings: The combined sample was n=18746 where all patients were diagnosed with T2DM and COVID-19. The severity of symptoms was reported in n=7646. Most reported were fever, (32%) cough (26%), and chest tightness (8%). The causes of death were reported in n=3260. The main causes of death were: COVID-19 (76%), acute respiratory distress (5%). Other comorbidities were reported in n= 6968. The most reported comorbidities were hypertension (38%), cardiovascular (10%), and pulmonary disease (3%). Other risk factors were reported in n= 6968. Those most reported were diabetes, (80%) cardiovascular abnormalities (10%), hyperglycemia not previously diagnosed as diabetes (9%). The reported effects of antidiabetic medications on COVID-19 disease were reviewed for emerging evidence. Conclusions: Published studies underline the importance of maintaining weight, glycemic control, good hydration, and exercising as much as possible. Patients need to be informed to present to hospital promptly if developing COVID-19 symptoms. Normal T2DM therapy can be maintained in patients with no, or mild, symptoms. On presentation to hospital with severe COVID-19 disease, diabetes control maybe maintained with insulin, concurrent with hydration and metabolic parameters maintenance until the patient is recovered.
ABSTRACT
Objective: Studies have shown that mental health is affected by poor physical health, with people living in the deprived area are the most affected. Community Pharmacists potentially have a new role in supporting people with mental illness and dementia to manage their medications. The aim of this local audit was to compare the local population to the national and global population, to inform the development and provision of local pharmacy mental health screening services, to support patients diagnosed with long-term conditions. Methods: This project was designed as an audit of anonymised local data, to inform the development of services offered by community pharmacies to improve adherence to therapy amongst patients diagnosed with long-term conditions in the Black Country, UK. It forms part of a larger study granted ethical approval by the Health Research Authority in 2018. It was carried out against the background of the Covid-19 epidemic. A total of 652 patients pharmacy records were reviewed between March and April 2020. No patient identifiers were included in the reviewed data. Results: This means that the results of this analysis might not be applicable to the entire local population outside the 31-90 y of age range. Conclusion: It is was demonstrated during COVID-19 that pharmacists are well-positioned as easily accessible health care facilities to support patients, especially when the other NHS facilities are stretched or closed. Community pharmacies are in a position to offer large-scale screening programs such as self-completed anxiety, depression and cognitive function screening surveys and refer to general practitioners for further investigations. It is also recommended that the New Medicines Service include mental health disorder patients prescribed pharmacological therapy and to allow the pharmacists appropriate access to medical records to facilitate safe, integrated and effective patient care.