Influence of epidemiological and clinical factors in the reactogenicity to Comirnaty® vaccine in health care workers of a Spanish university teaching hospital (COVIVAC study).

OBJECTIVE: Comirnaty® is an mRNA vaccine against COVID-19 which has been administered to millions of people since the end of 2020. Our aim was to study epidemiological and clinical factors influencing reactogenicity and functional limitation after the first two doses of the vaccine in health care workers (HCWs). METHODS: Prospective post-authorization cohort study to monitor safety and effectiveness of the vaccine. RESULTS: Local side effects were mild and presented both with first and second dose of Comirnaty. Systemic side effects were more frequent after 2nd dose. Nevertheless, previous SARS-CoV-2 infection was associated with systemic effects after the first dose of the vaccine (OR ranging from 2 to 6). No severe adverse effects were reported. According to multivariate analysis, the degree of self-reported functional limitation after the first dose increased with age, female sex, previous COVID-19 contact, previous SARS-CoV-2 infection, and Charlson Comorbidity Index (CCI). After the second dose, the degree of functional limitation observed was lower in those with previous SARS-CoV-2 infection, and it was positively associated to the degree of functional limitation after the first dose. CONCLUSIONS: Systemic adverse effects were more frequent after the second dose of Comirnaty. Previous SARS-CoV-2 infection was associated with systemic effects after the first dose. Age, female sex, previous COVID-19, previous isolation due to COVID-19 contact, and CCI showed to be independent predictors of the degree of functional limitation after the 1st dose of Comirnaty®. After the 2nd dose, the degree of functional limitation was lower in those who previously had SARS-CoV-2 infection.

Mobile banking affordances and constraints by the elderly

Purpose: The study explores the affordances and constraints perceived by older adults through their experiences using mobile banking apps. Design/methodology/approach: Twenty-five interviews via Skype were carried out with older adults aged 65 years and over between April and May 2021 (during the COVID-19 pandemic). Findings: Based on their usage experiences with mobile banking, older adults identified functional (saving time, avoiding physical risk and having control over their finances) and social affordances (supporting and bonding with family and friends), as well as non-technological (lack of useful information and patience from bank employees) and technological constraints (concerns about cybersecurity, data privacy and passwords). Originality/value: The study offers a novel approach to customer experience research in mobile banking by adopting a customer-centered perspective and applying the theoretical framework of affordances and constraints to analyze the experiences of older adults as active mobile banking users. © 2022, Emerald Publishing Limited.

Dealing with the unknown: perceptions and fears of SARS-CoV-2 infection among hospital workers : Mireia Utzet

Introduction This study aims to explore perceptions, fears and worries regarding SARS-CoV-2 risk of infection and transmission to relatives and/or co-workers and non-pharmacological preventive interventions among hospital workers. Materials and Methods The research used an explorative qualitative approach. Six focus groups and ten individual interviews across multidisciplinary workers (physicians, nurses, aides, cleaners, maintenance, and security staff) were conducted online and audio-recorded, transcribed verbatim and analysed using thematic analysis and mixed coding. Results Forty professionals participated in the study. Four common themes emerged in all groups: challenges related to the lack of pandemic preparedness, concerns about personal protective equipment, unclear guidelines for case and contact tracing, and communication-related difficulties. Conclusions This study emphasizes the key recommendations to improve non-pharmacological preventive interventions to reduce workers’ fears and worries about the risk of infection and spreading the infection to others, including families. Above all, these should include ensuring the availability, and correct use of adequate personal protective equipment, improve guidelines on case and contact tracing, and setting effective communication channels for all workers of the organization. These recommendations must be reinforced in maintenance and security personnel, as well as night shift nurses and aides, in order to reduce also health inequalities. Key messages • Lack of pandemic preparedness increased HCW’ fear of infection, which could be reduced by ensuring the availability and good use of proper PPE, and by clear guidelines on case/contact detection. • The improvement on non-pharmacological preventive interventions must be underpinned by effective communication channels and/or communication staff, and should reach all workers in the institution.

Mobile banking affordances and constraints by the elderly

Purpose: The study explores the affordances and constraints perceived by older adults through their experiences using mobile banking apps. Design/methodology/approach: Twenty-five interviews via Skype were carried out with older adults aged 65 years and over between April and May 2021 (during the COVID-19 pandemic). Findings: Based on their usage experiences with mobile banking, older adults identified functional (saving time, avoiding physical risk and having control over their finances) and social affordances (supporting and bonding with family and friends), as well as non-technological (lack of useful information and patience from bank employees) and technological constraints (concerns about cybersecurity, data privacy and passwords). Originality/value: The study offers a novel approach to customer experience research in mobile banking by adopting a customer-centered perspective and applying the theoretical framework of affordances and constraints to analyze the experiences of older adults as active mobile banking users. © 2022, Emerald Publishing Limited.

Predictive factors of six-week mortality in critically ill patients with SARS-CoV-2: A multicenter prospective study.

OBJECTIVE: The objective of the study is to identify the risk factors associated with mortality at six weeks, especially by analyzing the role of antivirals and munomodulators. DESIGN: Prospective descriptive multicenter cohort study. SETTING: 26 Intensive care units (ICU) from Andalusian region in Spain. PATIENTS OR PARTICIPANTS: Consecutive critically ill patients with confirmed SARS-CoV-2 infection were included from March 8 to May 30. INTERVENTIONS: None. VARIABLES: Variables analyzed were demographic, severity scores and clinical condition. Support therapy, drug and mortality were analyzed. An univariate followed by multivariate Cox regression with propensity score analysis was applied. RESULTS: 495 patients were enrolled, but 73 of them were excluded for incomplete data. Thus, 422 patients were included in the final analysis. Median age was 63 years and 305 (72.3%) were men. ICU mortality: 144/422 34%; 14 days mortality: 81/422 (19.2%); 28 days mortality: 121/422 (28.7%); 6-week mortality 152/422 36.5%. By multivariable Cox proportional analysis, factors independently associated with 42-day mortality were age, APACHE II score, SOFA score at ICU admission >6, Lactate dehydrogenase at ICU admission >470U/L, Use of vasopressors, extrarenal depuration, %lymphocytes 72h post-ICU admission <6.5%, and thrombocytopenia whereas the use of lopinavir/ritonavir was a protective factor. CONCLUSION: Age, APACHE II, SOFA>value of 6 points, along with vasopressor requirements or renal replacement therapy have been identified as predictor factors of mortality at six weeks. Administration of corticosteroids showed no benefits in mortality, as did treatment with tocilizumab. Lopinavir/ritonavir administration is identified as a protective factor.

Predictive factors of six-week mortality in critically ill patients with SARS-CoV-2: A multicenter prospective study Factores predictivos de la mortalidad a las seis semanas en pacientes críticos con SARS-CoV-2: estudio multicéntrico prospectivo

Objective The objective of the study is to identify the risk factors associated with mortality at six weeks, especially by analyzing the role of antivirals and munomodulators. Design Prospective descriptive multicenter cohort study. Setting 26 Intensive care units (ICU) from Andalusian region in Spain. Patients or participants Consecutive critically ill patients with confirmed SARS-CoV-2 infection were included from March 8 to May 30. Interventions None. Variables Variables analyzed were demographic, severity scores and clinical condition. Support therapy, drug and mortality were analyzed. An univariate followed by multivariate Cox regression with propensity score analysis was applied. Results 495 patients were enrolled, but 73 of them were excluded for incomplete data. Thus, 422 patients were included in the final analysis. Median age was 63 years and 305 (72.3%) were men. ICU mortality: 144/422 34%;14 days mortality: 81/422 (19.2%);28 days mortality: 121/422 (28.7%);6-week mortality 152/422 36.5%. By multivariable Cox proportional analysis, factors independently associated with 42-day mortality were age, APACHE II score, SOFA score at ICU admission >6, Lactate dehydrogenase at ICU admission >470 U/L, Use of vasopressors, extrarenal depuration, %lymphocytes 72 h post-ICU admission <6.5%, and thrombocytopenia whereas the use of lopinavir/ritonavir was a protective factor. Conclusion Age, APACHE II, SOFA > value of 6 points, along with vasopressor requirements or renal replacement therapy have been identified as predictor factors of mortality at six weeks. Administration of corticosteroids showed no benefits in mortality, as did treatment with tocilizumab. Lopinavir/ritonavir administration is identified as a protective factor.

Clinical trials history & trends in Qatar

Background: Clinical trial registries ensure the transparency and accountability of clinical trials (CTs) internationally1-2. It is important to safeguard the public's safety through the delivery of quality clinical research. Since the start of the COVID-19 pandemic there has been a tremendous increase in the number of CTs globally. The MENA region has an opportunity to increase its overall contribution to CTs, which is less than 1%3, in particular, through Qatar given its substantial economical growth and healthcare advancements. This review aims to explore the characteristics of clinical trials performed in Qatar, registered on ClinicalTrials.gov. Methods: The ClinicalTrials.gov registry was searched for trials conducted in Qatar using the appropriate keywords and advanced search options. Data retrieved was downloaded and sorted within Microsoft Excel then reviewed by two independent co-investigators. Results: The preliminary search yielded 143 entries with 32.1% (46) registered as multisite trials. The first trial in Qatar was registered in 2005. There has been a noticeable increase in CTs with its peak in 2020 (Figure 1), with currently 39.1% (9) of registered CTs on COVID-19;83% of the completed studies were published, with the highest number of publications (8) in 2020 (Figure 1). Several specialties contributed to the CTs, with the highest participation and contribution rate of 31 CTs being in the field of pediatrics. Furthermore, some variations were found in recruitment status as reflected in Figure 2 with∼65% (93) of studies being interventional and∼35% being observational. Conclusion: The CTs conducted in Qatar are still relatively low despite the rapidly evolving healthcare system. Immediate updates and follow-ups could be considered by research investigators in Qatar with regards to CTs registration and updating. Further analysis is needed to elucidate the discrepancy of CTs reporting and to increase the contribution of CTs from Qatar to improve the health of its people.

Predictive factors of six-week mortality in critically ill patients with SARS-CoV-2: A multicenter prospective study.

OBJECTIVE: The objective of the study is to identify the risk factors associated with mortality at six weeks, especially by analyzing the role of antivirals and munomodulators. DESIGN: Prospective descriptive multicenter cohort study. SETTING: 26 Intensive care units (ICU) from Andalusian region in Spain. PATIENTS OR PARTICIPANTS: Consecutive critically ill patients with confirmed SARS-CoV-2 infection were included from March 8 to May 30. INTERVENTIONS: None. VARIABLES: Variables analyzed were demographic, severity scores and clinical condition. Support therapy, drug and mortality were analyzed. An univariate followed by multivariate Cox regression with propensity score analysis was applied. RESULTS: 495 patients were enrolled, but 73 of them were excluded for incomplete data. Thus, 422 patients were included in the final analysis. Median age was 63 years and 305 (72.3%) were men. ICU mortality: 144/422 34%; 14 days mortality: 81/422 (19.2%); 28 days mortality: 121/422 (28.7%); 6-week mortality 152/422 36.5%. By multivariable Cox proportional analysis, factors independently associated with 42-day mortality were age, APACHE II score, SOFA score at ICU admission >6, Lactate dehydrogenase at ICU admission >470U/L, Use of vasopressors, extrarenal depuration, %lymphocytes 72h post-ICU admission <6.5%, and thrombocytopenia whereas the use of lopinavir/ritonavir was a protective factor. CONCLUSION: Age, APACHE II, SOFA>value of 6 points, along with vasopressor requirements or renal replacement therapy have been identified as predictor factors of mortality at six weeks. Administration of corticosteroids showed no benefits in mortality, as did treatment with tocilizumab. Lopinavir/ritonavir administration is identified as a protective factor.