Hospital and Intensive Care Admissions and Mortality Due to 24 Months of the Covid-19 Pandemic in Adult Patients >=40 Years with Haemophilia in Europe

Introduction: The Age-related DeVelopments ANd Comorbidities in haemophilia (ADVANCE) Working Group is a European collaboration of over 20 Haemophilia Treatment Centres (HTCs) that focuses on the management of PWH aged >=40 years. As it soon became apparent that the risk of severe outcomes from COVID-19 infection was increased in older adults, we aimed to identify the incidence, severity and outcomes of COVID-19 inPWHaged >=40 years treated at ADVANCE centres. Method(s): The number of hospital admissions, ICU admissions and deaths due to COVID-19 was recorded retrospectively via survey for all patients aged >=40 years with haemophilia A or B at ADVANCE HTCs throughout the pandemic over a 24-month period (until 30 April 2022). Patient numbers were recorded for the most serious outcome at month/year of first occurrence. Aggregated data was provided as requested by Ethical Committees. For reported cases, information on age, comorbidities and risk factors for severeCOVID-19 infection were collected where available. Result(s): Of the overall haemophilia A and B population, 36/4166 suffered a serious outcome due to COVID-19 infection;27 required hospital admission, 5 were admitted to the ICU and 4 died (3 with haemophilia A and 1 with haemophilia B). Nearly all patients with haemophilia A who were admitted to the ICU or died had >=1 comorbidity associated with worse outcomes. Most reported cases occurred early in the pandemic with no clear distinction according to haemophilia severity or age. Discussion/Conclusion: This is the first study to evaluate the impact of the pandemic on PWH >=40 years in terms of severe adverse clinical outcomes. Although only limited data were collected, the study provides reassurance that the haemophilia population was not at risk of more serious outcomes due to their haemophilia alone.

Tools for developing and measuring skills for clinical innovation: The case of telemedicine and the case of the eradication of the HCV virus

The experimentation of skills development and measurement tools for clinical innovation is presented in two case studies concerning telemedicine and HCV eradication. 71 professionals from 5 Healthcare Units of Lazio region were enrolled in an individual and team coaching course aimed at enhancing 5 core skills for service design competence: communication, result orientation, emotional intelligence, conflict management, networking. The 5 core skills and the use of the new techniques were measured at the beginning and at the end of the course (9 months), on which the Covid-19 emergency had an impact. 19.4% of professionals improved all the skills and reached the threshold of excellence, demonstrating the effectiveness of individual and team coaching, according to an objectively measurable structure. Copyright © FrancoAngeli

Prevention of the spread of SARS COV-2 by Rapid Antigenic Tests on the passengers entering an Italian seaport.

Abstract: Out of 38,282 passengers entering Italy at a major seaport, submitted to SARS-CoV-2 rapid antigenic test, 272 (0.6%) resulted positive and 212 (93.4%) were confirmed positive by qRT-PCR, leaving a 0.6% of false positive. Those resident in the area under control of the same Local Health Authority of the seaport were immediately submitted to isolation and investigated for contact tracing, the others notified to their Local Health Authority which did the same in the following day. This procedure was made possible by a full-time dedication of the local healthcare workers who managed all the passengers disembarking around the clock along the months of the emergency.

Vaccine prevention at the time of covid-19: the ASL Roma 4 experience

The end of January 2020 WHO sanctioned an international public health emergency and the Italian government issued directives with urgent measures to counter and manage the epidemiological emergency: bans, suspensions of activities have profoundly changed school, work and health social life which have an impact on vaccination prevention Vaccinations Service (VS) of ASL Roma 4 vaccinates people of all ages and the healthcare professional (HP) noticed that the fear in the population is making the accesses less frequent and the vaccination coverage decrease and the infectious diseases will re-emerge. DPCM 4/3/2020 has established rules to contain the virus, the ASL task force and VS adopted and adapted them for a protected vaccination activity. Results Surgeries are cleaned more frequently and fomites have been removed. The rules were published on the ASL website, social networks, displayed on posters posted before entering the clinic and waiting rooms: vigilantes lets you enter without crowding the waiting room;only one parent enters;the adult enters alone;if you have a cough or sneeze cover your nose and mouth with a tissue or ask for the surgical mask, wash your hands with the disinfectant gel, sit only in the spaced chair. Inside the children find a nice poster with drawings to explain how to avoid the virus to be colored at home. Health care workers wear masks designed to calm children. As long as the epidemiological situation allows the vaccine prevention activity must be maintained. HP must give messages of trust for activities that are carried out safely. An emergency plan within the VS also provides the behavior to be used in the event that many health workers fall ill. At the time of Covid-2019 infection all forms of prevention are to be remodeled, not just vaccine prevention. Reducing the preventive actions could in a short time lead to the emergence of infectious diseases and not only with consequent important damages, including economic ones Key messages Healthcare professionals must give messages of trust for activities that are carried out safely. At the time of Covid-2019 infection all forms of prevention are to be remodeled, not just vaccine prevention.

COVID-19 and staff mental health: is there an evidence? An Italian field study

Since the early months of the COVID-19 epidemic, a large number of scientific papers have considered the possibility that healthcare professionals (HCWs) were affected by depression, anxiety, post-traumatic stress, and psychological distress. The abundance of research has also made it possible to produce several systematic reviews and meta-analyzes. All the studies retrieved in these reviews, however, were cross-sectional. Depressive symptoms and anxiety in HCWs were compared to “normal values”, administrative staff, or external sample;moreover, some studies had no control group. No longitudinal study has been produced so far. Some studies had negative results. Overall, there is still little evidence of an increase in mental health problems and sleep disturbances in HCWs during the outbreak. To fill this gap, we investigated the mental health of workers who have been monitored for many years in an Italian local health unit. Mental health was investigated with standardized questionnaires. 82 HCWs who tested positive at the COVID-19 nasopharyngeal swab, 152 exposed workers who tested negative and 361 unexposed controls participated in the survey. Anxiety was reported by 16.6% of COVID-19 cases and depression by 20.3%, with a significant increase in the estimated risk (OR = 4.3;CI95%=2.4-7.4 for anxiety, OR = 3.5;CI95% =2.0-6.0 for depression). In test-positive cases, sleep was a significant moderating factor in the relationship between occupational stress or PJ and anxiety. Exposed, negative HCWS also had an increased OR for anxiety (1.84, CI95% 1.1-3.1) and depression (2.2 CI95% 1.4-3.5). The frequency of anxiety and depression disorders in the population examined was not higher than that recorded in the years preceding the epidemic during periodic occupational health checks in the workplace. Mental health support and organizational interventions must mainly concern workers with positive tests and should also tend to improve sleep quality. Key messages Health care workers who have had unprotected exposure to COVID-19 patients, and even more those who have contracted the infection, have sleep problems, anxiety and depression. The psychological support intervention for health care workers should include the promotion of sleep hygiene.