ABSTRACT
Background. Nursing homes (NHs) are high risk settings for COVID. Staff are the primary source for introducing COVID into a NH. Preventing staff from working when ill is key to resident safety. NH staff face significant socioeconomic pressures that may influence their willingness to report COVID symptoms. Understanding the drivers behind unreported illness can inform ways to prevent working when ill. Methods. We conducted a confidential survey of 120 COVID-positive NH staff in Orange County, CA from Dec '20-Feb '22 to quantify the frequency and drivers of unreported COVID symptoms. We designed a 40-item survey to assess demographics, course of illness, symptom reporting behavior, and monetary, logistic, and emotional (stigma/fear) barriers to reporting using a 5-point Likert scale. Recruitment flyers were shared with all 70 NHs in the county and referrals were accepted from NH leadership. Participants received $50 for completing the 20-30 min phone-based survey. We calculated summary statistics, transformed all data to a 0-100 scale, assessed the reliability of each factor related to reporting at the group level using Cronbach's alpha, and assessed discriminant validity with t-tests comparing responses among subsets expected to differ. Results. Table 1 shows participant characteristics. 49% of surveys were during the 2020-21 winter wave and 51% were during the Delta/Omicron waves, with a relatively even distribution of certified nursing assistants (CNAs), nurses, and nonfrontline staff. Most cases (70%) were detected by routine testing at the NH and most (63%) had >=1 symptom prior to their test. Only 39% disclosed their symptom to a supervisor. It is unknown how many staff would have disclosed symptoms if they were not captured during routine testing. Responses were consistent across 15 discrete factors with Cronbach alpha >0.7. Overall, fear and encouragement from supervisors were the most salient factors for speaking up about COVID symptoms (Table 2). Responses varied between the two waves and between frontline vs nonfrontline workers. Conclusion. Frequent surveillance testing of NH staff during a pandemic is critical due to many factors that drive reluctance to speak up about potential symptoms. Encouragement from supervisors to report symptoms and stay home when ill may improve NH safety.
ABSTRACT
Background: Environmental contamination is suspected to play a key role in transmission of Candida auris in healthcare facilities. We recently showed that environmental surfaces near C. auris-colonized patients are commonly recontaminated within hours after disinfection. Clinical factors contributing to environmental contamination are not well characterized. Methods: We conducted a multi-regional (Chicago, IL;Irvine, CA) prospective study of environmental contamination associated with C. auris colonization at six long-term care facilities (LTCF) and 1 acute-care hospital (ACH). On day of sampling, 5 participant body sites were cultured once, followed by routine daily room cleaning by facility staff, then targeted disinfection of high-touch surfaces with hydrogen peroxide wipes by research staff. Surfaces were cultured for C. auris using pre-moistened sponge-sticks and neutralizer immediately pre- and post-disinfection, and 4, 8, and 12 hours post-disinfection. We calculated the odds of surface recontamination after disinfection as a function of body site colonization with C. auris using generalized estimating equations to account for clustering among multiple surfaces within timepoints, patients, and facilities. Models included an interaction between facility type and colonization. Results: C. auris was cultured from ≥1 body site in 41 participants (12 ACH and 29 LTCF patients, 205 body sites) on day of sampling. Proportion of body sites colonized did not vary by facility type (Table). Although environmental contamination rates were similar prior to disinfection [ACH 38% (n=60 samples) vs LTCF 29%, (n=145 samples), p=0.209)], the proportion of surfaces recontaminated between 4–12 hours after disinfection was higher in ACH vs LTCF (n=574 samples) (Figure). Number of body sites colonized with C. auris was associated with higher odds of environmental recontamination [ACH: OR 2.16 (95% CI 1.63–2.88), p< 0.001;LTCF: OR 1.40 (95% CI 1.07–1.84), p=0.015;Interaction ACH vs LTCF p< 0.001].Figure.Percent of Environmental Surfaces Recontaminated with C. auris within 12 hours of Cleaning by Facility Type Conclusion: The number of body sites colonized was associated with odds of C. auris environmental contamination. Differences in environmental recontamination by facility type may be related to greater provider-patient interactions in ACH as a driving factor. Disclosures: Gabrielle M. Gussin, MS, Medline: Conducted studies in which hospitals and nursing homes received contributed antiseptic and/or environmental cleaning products;Stryker: Conducted clinical studies in which hospitals and nursing homes received contributed antiseptic products;Xttrium Laboratories: Conducted clinical studies in which hospitals and nursing homes received contributed antiseptic products Raveena D. Singh, MA, Medline: Conducted studies in which hospitals and nursing homes received contributed antiseptic and/or environmental cleaning products;Stryker: Conducted clinical studies in which hospitals and nursing homes received contributed antiseptic products;Xttrium Laboratories: Conducted clinical studies in which hospitals and nursing homes received contributed antiseptic products Raheeb Saavedra, AS, Medline: Conducted studies in which hospitals and nursing homes received contributed antiseptic and/or environmental cleaning products;Stryker: Conducted clinical studies in which hospitals and nursing homes received contributed antiseptic products;Xttrium Laboratories: Conducted clinical studies in which hospitals and nursing homes received contributed antiseptic products Nicholas M. Moore, PhD, D(ABMM), Abbott Molecular: Grant/Research Support;Cepheid: Grant/Research Support Susan S. Huang, MD, MPH, Medline: Conducted studies in which hospitals and nursing homes received contributed antiseptic and/or environmental cleaning products;Molnlyke: Conducted clinical studies in which hospitals received contributed antiseptic product;Stryker: Conducted clinical studies in which hospitals and nursing homes received contributed antiseptic products;Xttri m Laboratories: Conducted clinical studies in which hospitals and nursing homes received contributed antiseptic product Mary K. Hayden, MD, Sanofi: Member, clinical adjudication panel for an investigational SARS-CoV-2 vaccine.
ABSTRACT
Diwali is a festival of joy and happiness celebrated by displaying extensive fireworks across India for a week. In the present scenario of the COVID-19 pandemic, to curtail the concentration of air pollutants in the atmosphere for better health, a ban on fireworks during the Diwali festival was imposed by many State Governments of India. This study aimed to investigate the prohibition of fireworks on concentrations of air pollutants during the Diwali festival in metropolitan cities of India. For this study, eight major metropolitan cities- Delhi, Mumbai, Kolkata, Chennai, Bengaluru, Hyderabad, Jaipur and Lucknow and air pollutants (PM2.5, PM10, NOx, SO2 and O3) were taken and compared with the data of Diwali festival 2019. The analysis suggested that PM2.5, PM10, NOx, SO2, which were released from the bursting of firecrackers, were reduced on Diwali days in all the eight cities in 2020 in comparison to Diwali day of 2019. On the other hand, O3 was increased because of a reduction in NO concentration, which decreased the intake of O3. Overall, the ban improved the air quality of the different cities across India. © 2022 World Research Association. All rights reserved.
ABSTRACT
Background: Acute kidney injury (AKI) is both a consequence and determinant of outcomes in COVID-19. The kidney is one of the major organs infected by the causative virus SARS-CoV-2. The spike protein of SARS-CoV-2 is required for viral entry into cells and is present in the urine of patients with COVID-19 and AKI. The present study examined cellular effects that result from transfecting the spike protein of SARS-CoV-2 in HEK293 kidney cells. Methods: HEK293-ACE2+ cells stably overexpressing ACE2 were used. Codon optimized pcDNA encoding SARS-CoV-2 spike (7788bp) or empty vector (4033bp) plasmid was transfected using Lipofectamine LTX. For studies examining the effect of quercetin (an inducer of heme oxygenase-1, HO-1), full media containing quercetin or vehicle was added at 4-6 hours post transfection. mRNA and protein expression was assessed by quantitative real-time RT-PCR and western blot respectively. Syncytium formation was assessed by acquiring phase contrast images using Olympus CK40 microscope and the area covered by syncytia was measured using ImageJ software. Results: HEK293-ACE2+ cells expressed SARS-CoV-2 spike protein upon spike transfection. Such expression led to syncytia formation, the sloughing of sheets of cells, and focal denudation of the cell monolayer. Spike protein expression upregulated potentially nephrotoxic genes such as TNF-α, MCP-1, and ICAM1. Spike protein expression also upregulated potentially cytoprotective genes such as HO-1, as demonstrated by HO-1 mRNA and protein expression and relevant signaling pathways (p-Akt, p-STAT3, and p-p38) involved in inducing the HO-1 gene. Quercetin, a naturally occurring compound that induces HO-1, markedly reduced syncytia formation and spike protein expression. Conclusions: These findings introduce a clinically relevant, spike protein-induced, in vitro model for the study of AKI in COVID-19. The major conclusions of the study are: 1) Spike protein expression in kidney cells provides a useful and timely model for the study of maladaptive and adaptive responses in these cells relevant to AKI observed in COVID-19;2) spike protein expression in kidney cells upregulates HO-1;and 3) quercetin, an inducer of HO-1, may provide a clinically relevant/feasible protective strategy in AKI occurring in the setting of COVID-19.
ABSTRACT
The pandemic of coronavirus disease-19 (COVID-19) remains to nag human race with its more infectious second wave in most of highly populated countries including India. Till date, no specific antiviral drug is discovered or developed which is cent-per-cent effective against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the causative agent of COVID-19. The efficacy of developed vaccines are said to reduce severity of disease, but the mutation led to origin of more infectious variants. In such scenario, medical management of COVID-19 largely depends upon repurposed drugs like azithromycin, remdesivir, chloroquine, hydroxychloroquine and tocilizumab. However, none of these repurposed drugs is devoid of side effects or drug-induced toxicities which may be fatal too sometimes. Scientific research literature on phytochemicals hints that these miracle phytomolecules may not only be useful in direct therapeutic effect but also have potential to reduce or ameliorate the side-effects of current repurposed drugs used in treatment of COVID-19. This review critically elaborates the side-effects of COVID-19 drugs and the six potential phytochemicals, viz., quercetin, baicalein, kaempferol, curcumin, catechins and gingerols which have potentials to ameliorate such side-effects. The very purpose of the review paper is to promote the scientific studies on these phytomolecules in the management of COVID-19, as there are predictions that human kind has to learn to live with this disease.