A 16-month-long experience of COVID-19 in allogeneic haematopoietic stem cell transplantation recipients: An SFGM-TC multicentre cohort study.

This 16-month-long multicentre retrospective study of 225 allogeneic haematopoietic stem cell transplantation (alloHSCT) recipients with COVID-19 examines risk factors for severity and mortality, describing the successive waves of infections (from March to June 2020 and from August 2020 to June 2021). We confirm the negative role of low respiratory tract disease and immunosuppressive treatment. We highlight significantly lower percentages of severe forms and COVID-19-related mortality during the second wave. Monthly comparative evolution of cases in alloHSCT recipients and in the French population shows a higher number of cases in alloHSCT recipients during the first wave and a decrease from February 2021.

Pre-exposure prophylaxis with tixagevimab/cilgavimab (AZD7442) prevents severe SARS-CoV-2 infection in recipients of allogeneic hematopoietic stem cell transplantation during the Omicron wave: a multicentric retrospective study of SFGM-TC.

Since the emergence of the Omicron variant of SARS-CoV-2, though considered less virulent, hospitalization and death rates among immunocompromised patients remain high, especially for poor responders to vaccination. We conducted a retrospective multicentric study to evaluate pre-exposure prophylaxis with AZD7442 (tixagevimab/cilgavimab) for preventing COVID-19 in adult allogeneic hematopoietic stem cell transplant (allo-HSCT) recipients. Among the 161 patients of our cohort, 22 (14%) contracted COVID-19 after a median follow-up of 105 days, but no severe form was observed. Only one major adverse event was reported: an acute coronary syndrome, resolved without sequelae. Pending randomized controlled trial results, our data support the use of AZD7442 as pre-exposure prophylaxis for COVID-19 during Omicron wave in allo-HSCT patients who failed to develop humoral immunity to vaccination, to prevent severe and potentially lethal forms of SARS-CoV-2 infection.

"Pandemic Fatigue! It's Been Going On since March 2020": A Photovoice Study of the Experiences of BIPOC Older Adults and Frontline Healthcare Workers during the Pandemic.

The coronavirus disease 2019 (COVID-19) pandemic intensified the stressful and already difficult circumstances of communities of color. Yet, there is no current photovoice research highlighting the lived experiences of these communities from two perspectives-the older adults (OAs) and the frontline healthcare workers (FLHWs). This qualitative study used photovoice to visually portray the struggles of Black, Indigenous, and persons of color (BIPOC) OAs (n = 7) and younger FLHWs (n = 5) who worked with older adults during the pandemic and how they coped and recovered from the challenges of the pandemic. The investigators conducted a three-day training of ten research assistants (RAs) who were paired with either an OA or an FLHW for the photovoice sessions conducted in four stages. Upon examination of the narratives, focus group transcriptions, and photo stories, it became clear that participants faced different challenges during the pandemic, such as the fear of COVID-19 exposure, struggles to adopt COVID-19 mitigation strategies, workplace challenges, and social isolation. Amid this crisis of suffering, isolation, and sadness, participants employed two major strategies to deal with the challenges of the pandemic: positive reappraisal and self-care practices. The findings have implications for clinical social workers, mental health counselors, faith communities, nurse managers and administrators, and policymakers.

Les dispositifs groupaux à l’hôpital et en EHPAD durant la crise de la COVID-19

Résumé Introduction: La crise de la COVID-19 a exacerbé la demande de dispositifs groupaux dédiés aux soignants et aux personnels hospitaliers et médicosociaux. Objectif: Cet article souhaite faire apparaître, par la synthèse de multiples retours d’expérience de dispositifs groupaux menés par des psychologues cliniciennes et chercheuses durant la pandémie de la COVID-19, les enjeux de l’ouverture de dispositifs groupaux, entre offre et demande, ainsi que leurs principaux apports et limites organisationnels et psychologiques. Méthode: Six chercheuses-cliniciennes se sont réunies pour échanger sur leurs expériences vécues lors de la mise en place de dispositifs groupaux. L’analyse des retours d’expérience s’est faite au moyen des concepts de la psychodynamique du travail et de la psychanalyse des groupes, permettant de faire ressortir les caractéristiques organisationnelles et psychologiques des dispositifs groupaux dédiés aux professionnels. Résultats: Nos résultats mettent en évidence que le dispositif groupal, en permettant le partage des éprouvés, aide la reconnaissance mutuelle entre professionnels, et donc de nouvelles identifications afin d’éviter la fragmentation des collectifs de travail. Le point le plus central semble être la capacité des dispositifs de groupe à traiter l’agressivité et la colère ressenties face à l’impuissance à agir dans des situations de crise. Les limites de ces groupes concernent leur difficulté à laisser s’exprimer des paroles individuelles plutôt que collectives, et le risque d’être le terrain d’une répétition du trauma pour les professionnels qui attaquent ou fuient parfois ces dispositifs, par peur de ce qu’ils pourraient faire ressurgir. Conclusion: Plusieurs points de vigilance et préconisations des expériences rapportées dans cet article sont explicités, afin d’éclairer et guider les futurs meneurs de dispositifs de groupe construits avec et pour les professionnels du champ sanitaire. Introduction: The COVID-19 crisis has exacerbated the demand for group arrangements dedicated to healthcare professionals and more widely hospital and medicosocial staff. Objective: This article attempts to shhed light on the issues at stake in the opening of group settings, between supply and demand, as well as their main organizational and psychological contributions and limitations, through the synthesis of multiple feedbacks from group arrangements carried out by clinical psychologists and researchers during the COVID-19 pandemic. Method: Six female researcher-clinicians met to discuss their experiences in setting up group care facilities. The analysis of the feedback used the concepts of work psychodynamics and group psychoanalysis, making it possible to bring out the organizational and psychological characteristics of group arrangements dedicated to professionals in the healthcare sector. Results: Our results show that the group arrangement, by allowing the sharing of experiences, helps the mutual recognition between professionals, and thus new identifications in order to avoid the fragmentation of work collectives. The most central point seems to be the capacity of group arrangements to deal with the aggressiveness and anger felt when facing the powerlessness to act in crisis situations. The limits of these groups concern their difficulty in allowing individual rather than collective words to be expressed, and the risk of being the site of a repetition of the trauma for the professionals who sometimes attack or flee from these mechanisms, for fear of what they might bring back to the surface. Conclusion: Several points of vigilance and recommendations from the experiences reported in this article are explained, in order to enlighten and guide future group facilitators when offering group arrangements built with and for professionals in the healthcare field.

Comparing Public Sentiment Toward COVID-19 Vaccines Across Canadian Cities: Analysis of Comments on Reddit.

BACKGROUND: Social media enables the rapid consumption of news related to COVID-19 and serves as a platform for discussions. Its richness in text-based data in the form of posts and comments allows researchers to identify popular topics and assess public sentiment. Nonetheless, the vast majority of topic extraction and sentiment analysis based on social media is performed on the platform or country level and does not account for local culture and policies. OBJECTIVE: The aim of this study is to use location-based subreddits on Reddit to study city-level variations in sentiments toward vaccine-related topics. METHODS: Comments on posts providing regular updates on COVID-19 statistics in the Vancouver (r/vancouver, n=49,291), Toronto (r/toronto, n=20,764), and Calgary (r/calgary, n=21,277) subreddits between July 13, 2020, and June 14, 2021, were extracted. Latent Dirichlet allocation was used to identify frequently discussed topics. Sentiment (joy, sadness, fear, and anger) scores were assigned to comments through random forest regression. RESULTS: The number of comments on the 250 posts from the Vancouver subreddit positively correlated with the number of new daily COVID-19 cases in British Columbia (R=0.51, 95% CI for slope 0.18-0.29; P<.001). From the comments, 13 topics were identified. Two were related to vaccines, 1 regarding vaccine uptake and the other about vaccine supply. The levels of discussion for both topics were linked to the total number of vaccines administered (Granger test for causality, P<.001). Comments pertaining to either topic displayed higher scores for joy than for other topics (P<.001). Calgary and Toronto also discussed vaccine uptake. Sentiment scores for this topic differed across the 3 cities (P<.001). CONCLUSIONS: Our work demonstrates that data from city-specific subreddits can be used to better understand concerns and sentiments around COVID-19 vaccines at the local level. This can potentially lead to more targeted and publicly acceptable policies based on content on social media.

Increasing Use of Ambulatory Video Visits for Pediatric Patients by Using Quality Improvement Methods.

INTRODUCTION: Live video visits for ambulatory encounters offer potential benefits, including access to remote subspecialty services, care coordination between providers, and improved convenience for patients. We aimed to increase the utilization of video visits for pediatric patients at our medical center using an iterative quality improvement process. METHODS: A multispecialty improvement team identified opportunities to increase video visit utilization and prioritized interventions using benefit-effort analyses. Interventions focused on 6 key drivers. The outcome measure was the percentage of ambulatory encounters conducted by video. The process measure was the percentage of ambulatory pediatricians conducting video visits. The balancing measure was the percentage of no-shows among scheduled video visits. All measures were analyzed using statistical process control. RESULTS: Interventions were associated with increases in our outcome and process measures from 0.1% to 1.2% and 0.6% to 6.3%, respectively, during the first 8 months. Subsequently, the novel coronavirus (COVID-19) pandemic was associated with further increases in these measures to 41.8% and 73.5%, respectively, over 3 months. The balancing measure increased from 0% at baseline to 14.7% with no special cause variation during the intervention period. The most impactful interventions included clinician training outreach, providing equipment, and streamlining MyChart patient enrollment. CONCLUSIONS: This improvement project effectively increased pediatric ambulatory video visit utilization, although the most significant driver of utilization was the COVID-19 pandemic. Project interventions implemented before COVID-19 facilitated rapid video visit adoption during the pandemic. A similar improvement process may be beneficial for other medical centers aiming to improve video visit utilization.