ABSTRACT
BACKGROUND: Long-term sequelae due to Coronavirus disease 2019 (COVID-19) are now under investigation. Aim of this study was to evaluate the one-year clinical impact of COVID-19 on respiratory function and relation with physical activity. METHOD(S): One hundred four patients were evaluated 3, 6 and 12 months after SARS-CoV-2 diagnosis. Clinical conditions, symptomatology, 6-minute walking test (6MWT), pulmonary function test with spirometry and diffusing capacity of carbon monoxide (DLCO) were analyzed. RESULT(S): Eighty-six (82.7%) patients referred at least one symptom at 3 months, 46 (44.2%) at 6 months and 24 (23.1%) at 12 months. At the 3-months visit, patients with moderate COVID showed a slight decrease of distance at the 6MWT, with an improvement at 12 months (P=0.04). Patients with severe COVID-19 showed a recovery of SpO2 at rest (P<0.001), DLCO (P=0.001), DLCO/VA (P=0.002), forced vital capacity (P=0.01) and 6MWT distance (P=0.002) at 6 and 12 months. Patients with critical COVID-19 showed a remarkable reduction of DLCO at 3 months (65+/-21%). Then a subsequent gradual improvement of DLCO was recorded (78+/-18% at 6 months, 85+/-16% at 12 months, P=0.01). Patients with DLCO<80% of predicted at 12 months were older (P=0.02), with higher prevalence of cardio-vascular disease (P=0.006), diabetes (P=0.01) and critical COVID-19 (P=0.003). The improvement of 6MWT distance and DLCO during the three visits did not correlate with physical activity. CONCLUSION(S): Patients with COVID-19 lung involvement showed a progressive improvement in respiratory function and physical performance at 6 and 12 months after acute disease.Copyright © 2022 EDIZIONI MINERVA MEDICA.
ABSTRACT
Objective: Compare the global uptake of a neurology clinical reasoning conference between live sessions and asynchronous learning through different online platforms. Background: Online learning has emerged as an important component of medical education during the COVID-19 pandemic, allowing for both live and asynchronous learning. Podcasts have become a popular education resource, increasing the reach of educators. Design/Methods: In collaboration with The Clinical Problem Solvers (CPS) online medical education group, we developed a neurology virtual morning report (NVMR) in which cases are presented and discussed by trainees with a neurologist facilitator. These sessions are held live weekly on Zoom, then posted for asynchronous learning on the CPS website and YouTube. Some sessions are released as podcast episodes. We gathered data from August 25, 2020 to October 2, 2021 on: live conference attendance, views on the CPS website and Youtube, and podcast downloads to evaluate global uptake across platforms. Results: The first 50 NVMR had an average live attendance of 47 participants per session. All 50 episodes were posted on the CPS website (10,059 views;average 201.2 views/episode), 20 episodes were posted on YouTube (4,198 views;average 285.1 views/episode), and 8 episodes were released as podcasts (6954 downloads on Spotify;average 887.5 downloads/episode). Asynchronous viewing through all platforms (podcasts, website, and Youtube) increased the reach of NVMR 9.16 fold over live attendance. Podcasts represented the greatest increase in reach in comparison to live NVMR. Conclusions: Asynchronous learning, especially through podcasts, expands the global reach of live virtual conferences for neurology clinical reasoning education. As online education increases in neurology, options for asynchronous learning could improve global accessibility of educational content.
ABSTRACT
Objective: To describe the expansion of the @NMatch2022 project supporting medical students applying to Adult and Child Neurology Residency programs in the United States. Background: The COVID-19 pandemic created several challenges to the residency application process in 2020. Residency programs quickly adapted to this new reality through augmenting their online presence and transforming their traditional in-person interviews to connect with applicants virtually. (1) Last year, @NeurologyMatch2021 was founded, promoting networking, education, and information-sharing within the neurology community online. The online experience added notable value in facilitating fit between programs and applicants, and should continue beyond the pandemic. (2,3) This year, our leadership team continued to work on this project, now @NMatch2022, and expand this resource for applicants. Design/Methods: Timeline: May: @NMatch2022 leaders transitioned June: Mentorship program launched July: Program features and Virtual program calendar launched October: Data collection from Twitter and Instagram accounts Twitter: Since the transition of leadership in May 2021, we had an average of 147 tweets;210,000 impressions;76,500 profile visits;582 mentions;and 304 new followers per month. Instagram: Compared to April 2021, our Instagram analytics demonstrate a 132% increase in accounts reached in October 2021, with 2,549 accounts in the last 90 day period. We had a 26.3% increase in followers since April 2021, totaling 1767. Our top country of followers is from the USA (64.3%). Other countries include India (6.6%), and Brazil (5.2%). Programs Featured: 2020: 32/2021: 60 Conclusions: @NMatch2022 has shown an increase of followers, impressions, and visits per month since its transition of leadership, including a 46% increase in the number of programs featured. This substantial growth in engagement illustrates the imperative use of a supportive virtual community for neurology and child neurology applicants.
ABSTRACT
Objective: Report the development of a global, open-access clinical reasoning conference created to increase access to neurology education during the COVID-19 pandemic. Background: The COVID-19 pandemic led to a significant reduction in clinical exposure and bedside teaching for medical students, which risks furthering neurophobia amongst the current cohort of students. Innovations in virtual teaching/learning can increase active participation in neurology clinical reasoning worldwide. Design/Methods: Neurology Virtual Morning Report (NVMR) is a case-based clinical reasoning conference held weekly on Zoom, open to participants around the world. In NVMR, a volunteer learner presents an unknown neurology case to two volunteer learners and an attending neurologist. The attending facilitates the learners' discussion focusing on integrating underlying biomedical sciences with clinical semiology, formulating and refining a problem representation, developing and prioritizing a differential diagnosis, and performing and interpreting a hypothesis-driven neurologic examination. Results: The first 50 Neurology VMRs had a mean of 47 participants per session (IQ range: 13). Learners who have presented or discussed cases represented 15 countries with the majority being from the United States (49.4%), Peru (16.4%), and Brazil (7.5%). Women represented 43.4% of discussants, men 55.3% and one of the discussants identified as non binary. The majority of participants were medical students (72.4%), with the remaining participants being neurology residents (9.2%), internal medicine residents (9.2%), and non-neurologist attending physicians (9.2%). Conclusions: Virtual neurology clinical reasoning conferences allow for active participation from medical students and non-neurologists worldwide, and have the potential to increase global access to neurology education.