ABSTRACT
Objective: To evaluate whether COVID19 vaccination during pregnancy confers immunological response to SARS-CoV-2 Delta variant. Study Design: Prospective cohort study of pregnant patients who had received any available COVID19 vaccine. Maternal and umbilical cord serum was collected at delivery. SARS-CoV-2 neutralization was measured with spike-pseudotyped viruses in HEK-293T-ACE2 cells as a function of reduction in Luc reporter activity using an env-deficient lentiviral system to produce viral particles pseudotyped with the B1.617.2 (Delta variant) spike. Neutralization titers represented the serum dilution at which relative luminescence units (RLU) were reduced by either 50%(ID50) or 80%(ID80) compared with virus control wells. RLU threshold for detection was 20. Result(s): Maternal and neonatal umbilical cord samples were collected from 20 individuals who received COVID19 vaccination during pregnancy. Most (n=16, 80%) received Pfizer, 2 Moderna, 2 Johnson&Johnson. One individual (5%) was vaccinated in first trimester, 11(55%) in second trimester, and 8(40%) in third trimester). Most individuals had detectable levels of neutralizing antibodies to SARS-CoV-2 Delta variant in maternal (n=15, 75%) and neonatal (n=17, 85%) serum. (Figure) No significant difference between maternal and neonatal serum titers. Conclusion(s): COVID19 vaccination during pregnancy yields an immunologic response in maternal serum that results in circulating neutralizing antibodies against SARS-CoV-2 Delta variant in maternal and neonatal serum at delivery. Disclosure: No [Formula presented] Copyright © 2022
ABSTRACT
Introduction: Reprioritisation of workforce resources during the coronavirus pandemic has resulted in the cancellation of elective operating lists and redeployment of surgical trainees. The implications on the perceived confidence and capability of trainees have been reported in qualitative studies, while quantitative effects on dexterity are alluded to but are harder to qualify. Our aim was to provide an indirect measure of the impact of the pandemic on technical skills, by comparing pre- and post-pandemic outcomes on surgical simulators. Methods: We analysed performance data of First year Urology registrars completing the European Basic Laparoscopic Urological Skills (E-BLUS) exercises as part of a course. Data from 2018 and 2019 were combined to measure “pre-pandemic group” performance, and data from 2021 used for “post-pandemic group”. Results: There were 103 and 48 trainees in the prepandemic and post-pandemic groups respectively. Prepandemic group performance was significantly better in 2 out of 4 E-BLUS tasks during the practice session. For Task 3 average time to completion was 175 seconds less (p<0.001) and for Task 4 the average time was faster by 107 seconds (p=0.003). During the assessment, prepandemic group performance was better (p=0.017) for Task 2 and significantly faster (p=003) for Task 4. Conclusion: Our Results provide evidence to support the notion that the pandemic has had a tangible detrimental effect on the technical skills of urology trainees. Going forwards more resources should be dedicated to 'catching up' trainees who have had a compromised experience during this time, either through local interventions or widespread curriculum change.
ABSTRACT
Over the last few years many of us have diverted our attention from advancing reproductive health to understanding SARS-CoV2;preventing, diagnosing, and treating COVID infection;caring for our families and friends;and stabilizing and supporting the careers and well-being of our students, residents, fellows, and postdoctoral associates. Academic scientists are beginning to routinely see their colleagues in person and cultivate collaboration again. Butwemust recognize that many of us continue to struggle with the consequences of the pandemic. As the COVID-19 crisis passes, it is imperative that we reassess, redefine, and successfully navigate the path to accomplishment in science. We will discuss the -ships to success and how to effectively navigate academia in a post-pandemic world.
ABSTRACT
Objective: Experts have suggested that earlier delivery, even in non-severe cases, may be beneficial for patients with COVID, and that patients with COVID have higher rates of cesarean section. Factors associated with this increase are currently unclear. We sought to assess demographic and clinical factors associated with cesarean section (CS) in pregnant patients diagnosed with COVID. Study Design: Retrospective cohort of PCR-confirmed COVID positive pregnant patients in a single health system who delivered between March-December of 2020. Fetal death or planned CS excluded. Demographic data, pregnancy characteristics, and specifics of COVID infection ed and compared between patients who had vaginal delivery(SVD) and CS. Secondary analysis performed for symptomatic(sx) and asymptomatic(asx) patients separately. Bivariate statistics used to analyze the data. Multivariate Poisson regression performed to estimate adjusted relative risks. Results: Of 109 COVID positive patients, 19(17.4%) had planned CS. Of 91 with labor, 22(24%) had CS. CS was associated with overall BMI > 39.9(Table1). Non-private insurance and higher maternal age were associated with significantly higher rates of CS. Multiparity was not associated with SVD. Hypertensive disorders(PEC) of pregnancy and intraamniotic infection(IAI) were also associated with CS(Table 1). In regression analyses, symptomatic disease was associated with SVD [aRR 0.41, 95%CI 0.18, 0.93]. Relative risk of CS was 3-fold higher in patients with IAI[95% CI 1.6, 5.5], and 2.3-fold-higher in BMI > 39.9[95% CI 1.1, 5.0](Table2). Among sx patients, BMI > 39.9 was associated with 4-fold increase risk of CS;while in asx patients, IAI was associated with 4-fold increase risk of CS(Table 2). Maternal age and PEC were not associated with mode of delivery. Conclusion: Some known risk factors for severe and critical COVID, including higher BMI, were associated with CS in COVID positive pregnant patients. Symptomatic disease at time of delivery was more associated with SVD. [Formula presented] [Formula presented]
ABSTRACT
Objective: The impact of 2021 vaccination and social restriction reversal on preterm birth (PTB) is unclear. We sought to compare the rates of PTB during the COVID pre- and post- vaccination periods with pre-pandemic rate. Study Design: Retrospective cohort comparing all deliveries over 20 weeks at a single tertiary center during ‘early’ COVID (ECOVID 3/2020-6/2020) vs. ‘late’ COVID (LCOVID 3/2021–6/2021), and LCOVID vs. pre-COVID (3-6/2014-2019). PTB < 37weeks, < 34weeks and < 28weeks were compared and stratified by race/ethnicity. Results: There were 20334 deliveries including 2647 ECOVID, 2114 LCOVID and 15574 pre-COVID. We noted 87 (0.03%) and 37 (0.02%) COVID infections in pregnancy during ECOVID and LCOVID, respectively. PTB rate during LCOVID (12.1%) was lower compared to ECOVID (14.5%), p=0.02. Rate of PTB < 34 was also lower during LCOVID (4.4% vs 5.7%, p=0.04). PTB < 28 did not differ (Table1). When controlling for prior PTB, LCOVID was associated with a decreased risk of PTB, adjusted odds ratio (aOR) 0.83[95% confidence interval (CI) 0.70, 0.99]. Among the small number of American Indian patients, PTB increased during LCOVID vs. ECOVID. There were no other significant differences based on race/ethnicity. Overall, PTB rates did not differ in LCOVID vs. pre-COVID. When stratified by race and ethnicity, White individuals had reduced PTB < 37 during LCOVID compared to pre-COVID, aOR 0.70 [95% CI 0.63, 0.99]. PTB rate was unchanged comparing LCOVID vs. pre-COVID in all other racial groups. Among small numbers of Hispanic Puerto Rican patients, PTB rate increased LCOVID vs. pre-COVID (Table 2). Conclusion: During 2021, PTB rates decreased from rates observed in 2020 at the height of COVID restrictions. Among White birthing individuals, PTB decreased in 2021 compared to pre-COVID rates. This decrease was not observed in Black and Hispanic birthing individuals. These data highlight the continued racially disparate impact of the COVID pandemic on PTB rates. [Formula presented] [Formula presented]