ABSTRACT
BACKGROUND: During the COVID-19 pandemic, public health and hospital policies were enacted to decrease virus transmission and increase hospital capacity. Our aim was to understand the association between COVID-19 positivity rates and patient presentation with EGS diagnoses during the COVID pandemic compared to historical controls. METHODS: In this cohort study, we identified patients ≥ 18 years who presented to an urgent care, freestanding ED, or acute care hospital in a regional health system with selected EGS diagnoses during the pandemic (March 17, 2020 to February 17, 2021) and compared them to a pre-pandemic cohort (March 17, 2019 to February 17, 2020). Outcomes of interest were number of EGS-related visits per month, length of stay (LOS), 30-day mortality and 30-day readmission. RESULTS: There were 7908 patients in the pre-pandemic and 6771 in the pandemic cohort. The most common diagnoses in both were diverticulitis (29.6%), small bowel obstruction (28.8%), and appendicitis (20.8%). The lowest relative volume of EGS patients was seen in the first two months of the pandemic period (29% and 40% decrease). A higher percentage of patients were managed at a freestanding ED (9.6% vs. 8.1%) and patients who were admitted were more likely to be managed at a smaller hospital during the pandemic. Rates of surgical intervention were not different. There was no difference in use of ICU, ventilator requirement, or LOS. Higher 30-day readmission and lower 30-day mortality were seen in the pandemic cohort. CONCLUSIONS: In the setting of the COVID pandemic, there was a decrease in visits with EGS diagnoses. The increase in visits managed at freestanding ED may reflect resources dedicated to supporting outpatient non-operative management and lack of bed availability during COVID surges. There was no evidence of a rebound in EGS case volume or substantial increase in severity of disease after a surge declined.
ABSTRACT
OBJECTIVES: To study the clinical features of children infected with the Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS: The medical data of 19 children who were diagnosed with SARS-CoV-2 Omicron variant infection from January 28 to March 3, 2022 in Hangzhou were retrospectively reviewed. RESULTS: Among the 19 children, there were 7 boys (37%) and 12 girls (63%), and their age ranged from 6 months to 16 years, with a median age of 2 years and 1 month. Most of these children were infants and young children (aged ≤3 years, accounting for 53%). Among these children, 11 (58%) were unvaccinated with SARS-CoV-2 vaccine and 8 (42%) were vaccinated with SARS-CoV-2 vaccine, and 3 children (16%) had a history of underlying diseases. All 19 children had a clear history of close contact with persons infected with SARS-CoV-2, and 10 children (53%) were involved in the cluster outbreak in a maternal and infant care center. In terms of clinical classification, 13 children (68%) had mild coronavirus disease 2019 (COVID-19) and 6 (32%) had common COVID-19, with no severe cases of COVID-19. The most common clinical symptoms were cough (100%) and fever (63%). The children with a normal peripheral white blood cell count accounted for 84%, and those with a normal lymphocyte count accounted for 68%. There were no significant abnormalities in platelet count, procalcitonin, liver function parameters (alanine aminotransferase and aspartate aminotransferase), and renal function parameters (creatinine and urea). Six children (32%) had obvious signs of pneumonia on chest CT. All 19 children were given symptomatic treatment, and 12 children (63%) were given aerosol inhalation of interferon α. All children were cured and discharged. CONCLUSIONS: Children infected with Omicron variant strains are more common in infants and young children, with mild symptoms and good prognosis. Most of the children have a history of close contact with persons infected with SARS-CoV-2, and epidemic prevention and control should be strengthened in places with many infants and children, such as maternal and infant care centers.
Subject(s)
COVID-19 , SARS-CoV-2 , Child , Infant , Male , Female , Humans , Child, Preschool , Retrospective Studies , COVID-19 Vaccines , China/epidemiologyABSTRACT
Disposable wipes and masks have come to be considered as underestimated sources of microfiber generation since the emergence of COVID-19. However, research into the creation of microfibers due to wiping with these non-woven products is scarce, and the potential effects of fabric properties on shedding behavior are unclear. This study investigated microfiber release from 7 wet wipes, 5 dry wipes, and 4 masks in response to the use of simulated daily wiping conditions on artificial skin. The dry wipes (77-568 p per sheet) shed more microfibers than the wet ones (21-190 p per sheet) after 2, 10, or 50 wiping cycles under a 9.8 N wiping force. In addition, an average of 56 microfibers could be released from per gram of wipe, and each square centimeter of wipe could release about 1.18 microfibers during wiping. Masks shed fewer microfibers than wipes due to the excellent shedding resistance of spunbond nonwoven fabrics and the strengthened mechanical properties granted by bonding points. Cellulose, polyethylene terephthalate (PET), and polypropylene (PP) were the major polymers in the microfibers shed by wipes, and the microfibers from masks were all PP. With regard to the influencing factors, the number of microfibers shed from wipes was positively associated with the number of wiping cycles (r = 0.983 and 0.960, p < 0.01) and wiping force (r = 0.980, p < 0.05), while it was negatively correlated with the moisture content (r = -0.992, p < 0.01). Interestingly, a stronger fiber entanglement degree in the wipes significantly improved the resistance to microfiber generation (r = -0.664, p < 0.05). The results highlighted for the first time that the bending coefficient (ß = -5.05; 95% CI: -7.71, -2.40; p = 0.002) and fiber extraction force (ß = -0.077; 95% CI: -0.123, -0.030; p = 0.005) significantly reduced the tendency for microfiber shedding. Although the number of microfibers shed from wiping was lower than those from domestic washing, there is still an urgent need to control the microfiber shedding tendencies of non-woven products through improving the manufacturing processes.