Dissemination of Anesthesia Information During the Coronavirus Disease 2019 Pandemic Through Twitter: An Infodemiology Study.

BACKGROUND: Twitter is a web-based social media platform that allows instantaneous sharing of user-generated messages (tweets). We performed an infodemiology study of the coronavirus disease 2019 (COVID-19) Twitter conversation related to anesthesiology to describe how Twitter has been used during the pandemic and ways to optimize Twitter use by anesthesiologists. METHODS: This was a cross-sectional study of tweets related to the specialty of anesthesiology and COVID-19 tweeted between January 21 and October 13, 2020. A publicly available COVID-19 Twitter dataset was filtered for tweets meeting inclusion criteria (tweets including anesthesiology keywords). Using descriptive statistics, tweets were reviewed for tweet and account characteristics. Tweets were filtered for specific topics of interest likely to be impactful or informative to anesthesiologists of COVID-19 practice (airway management, personal protective equipment, ventilators, COVID testing, and pain management). Tweet activity was also summarized descriptively to show temporal profiles over the pandemic. RESULTS: Between January 21 and October 13, 2020, 23,270 of 241,732,881 tweets (0.01%) met inclusion criteria and were generated by 15,770 accounts. The majority (51.9%) of accounts were from the United States. Seven hundred forty-nine (4.8%) of all users self-reported as anesthesiologists. 33.8% of all tweets included at least one word or phrase preceded by the # symbol (hashtag), which functions as a label to search for all tweets including a specific hashtag, with the most frequently used being #anesthesia. About half (52.2%) of all tweets included at least one hyperlink, most frequently linked to other social media, news organizations, medical organizations, or scientific publications. The majority of tweets (67%) were not retweeted. COVID-19 anesthesia tweet activity started before the pandemic was declared. The trend of daily tweet activity was similar to, and preceded, the US daily death count by about 2 weeks. CONCLUSIONS: The toll of the pandemic has been reflected in the anesthesiology conversation on Twitter, representing 0.01% of all COVID-19 tweets. Daily tweet activity showed how the Twitter community used the platform to learn about important topics impacting anesthesiology practice during a global pandemic. Twitter is a relevant platform through which to communicate about anesthesiology topics, but further research is required to delineate its effectiveness, benefits, and limitations for anesthesiology discussions.

General medical publications during COVID-19 show increased dissemination despite lower validation.

BACKGROUND: The COVID-19 pandemic has yielded an unprecedented quantity of new publications, contributing to an overwhelming quantity of information and leading to the rapid dissemination of less stringently validated information. Yet, a formal analysis of how the medical literature has changed during the pandemic is lacking. In this analysis, we aimed to quantify how scientific publications changed at the outset of the COVID-19 pandemic. METHODS: We performed a cross-sectional bibliometric study of published studies in four high-impact medical journals to identify differences in the characteristics of COVID-19 related publications compared to non-pandemic studies. Original investigations related to SARS-CoV-2 and COVID-19 published in March and April 2020 were identified and compared to non-COVID-19 research publications over the same two-month period in 2019 and 2020. Extracted data included publication characteristics, study characteristics, author characteristics, and impact metrics. Our primary measure was principal component analysis (PCA) of publication characteristics and impact metrics across groups. RESULTS: We identified 402 publications that met inclusion criteria: 76 were related to COVID-19; 154 and 172 were non-COVID publications over the same period in 2020 and 2019, respectively. PCA utilizing the collected bibliometric data revealed segregation of the COVID-19 literature subset from both groups of non-COVID literature (2019 and 2020). COVID-19 publications were more likely to describe prospective observational (31.6%) or case series (41.8%) studies without industry funding as compared with non-COVID articles, which were represented primarily by randomized controlled trials (32.5% and 36.6% in the non-COVID literature from 2020 and 2019, respectively). CONCLUSIONS: In this cross-sectional study of publications in four general medical journals, COVID-related articles were significantly different from non-COVID articles based on article characteristics and impact metrics. COVID-related studies were generally shorter articles reporting observational studies with less literature cited and fewer study sites, suggestive of more limited scientific support. They nevertheless had much higher dissemination.

Efficacy and safety of decontamination for N95 respirator reuse: a systematic literature search and narrative synthesis.

PURPOSE: Under times of supply chain stress, the availability of some medical equipment and supplies may become limited. The current pandemic involving severe acute respiratory syndrome coronavirus 2 has highlighted limitations to the ordinary provision of personal protective equipment (PPE). For perioperative healthcare workers, N95 masks provide a stark example of PPE in short supply necessitating the creation of scientifically valid protocols for their decontamination and reuse. METHODS: We performed a systematic literature search of MEDLINE, Embase, Cochrane CENTRAL databases, and ClinicalTrials.gov to identify peer-reviewed articles related to N95 mask decontamination and subsequent testing for the integrity of mask filtration and facial seal. To expand this search, we additionally surveyed the official statements from key health agencies, organizations, and societies for relevant citations. RESULTS: Our initial database search resulted in five articles that met inclusion criteria, with 26 articles added from the expanded search. Our search did not reveal any relevant randomized clinical trials or cohort studies. We found that moist mask heating (65-80°C at 50-85% relative humidity for 20-30 min) and vaporous hydrogen peroxide treatment were supported by the literature to provide consistent viral decontamination without compromising mask seal and filtration efficiency. Other investigated decontamination methods lacked comprehensive scientific evidence for all three of these key criteria. CONCLUSIONS: N95 mask reprocessing using either moist heat or vaporous hydrogen peroxide is recommended to ensure healthcare worker safety.

RéSUMé: OBJECTIF: Lorsque les chaînes d'approvisionnement sont mises sous pression, la disponibilité de certains équipements et fournitures médicaux pourrait devenir restreinte. La pandémie actuelle du syndrome respiratoire aigu sévère du coronavirus 2 a mis en lumière les limites de l'approvisionnement usuel des équipements de protection individuelle (EPI). Pour les travailleurs de la santé périopératoires, les masques N95 sont un exemple frappant d'EPI pouvant rapidement venir à manquer et nécessitant l'élaboration de protocoles scientifiquement rigoureux pour leur décontamination et leur réutilisation. MéTHODE: Nous avons réalisé une recherche de littérature systématique dans les bases de données MEDLINE, Embase, Cochrane CENTRAL et sur ClinicalTrials.gov afin d'identifier les articles révisés par les pairs portant sur la décontamination des masques N95 et les tests subséquents pour vérifier l'intégrité de la filtration du masque et son étanchéité sur le visage. Afin d'étendre notre recherche, nous avons également passé en revue les énoncés officiels émanant des agences de santé, ainsi que des organismes et sociétés médicales majeurs pour en extraire les citations pertinentes. RéSULTATS: Notre recherche initiale des bases de données nous a permis d'extraire cinq articles respectant nos critères d'inclusion, et 26 articles ont été ajoutés à la suite de notre recherche étendue. Notre recherche n'a pas découvert d'études cliniques randomisées ou d'études de cohorte pertinentes. Nous avons observé que la décontamination du masque par chaleur humide (65­80°C à une humidité relative de 50­85 % pendant 20-30 min) et le traitement par vapeur de peroxyde d'hydrogène constituaient les deux mesures endossées par la littérature. En effet, ces modalités offrent une décontamination virale constante sans pour autant compromettre l'étanchéité du masque ou son efficacité de filtration. Les autres méthodes de décontamination étudiées ne possédaient pas de données probantes scientifiques exhaustives quant à ces trois critères clés. CONCLUSION: Le retraitement des masques N95 à l'aide de chaleur humide ou de vapeur de peroxyde d'oxygène est recommandé pour assurer la sécurité des travailleurs de la santé.