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Background: Previous studies had demonstrated that patients with hematologic malignancies had suboptimal antibody response after receiving COVID-19 vaccines, especially among those having previously treated with anti- CD20 monoclonal antibodies. Method(s): Adult patients with non-Hodgkin's lymphoma or chronic lymphocytic leukemia (CLL) were enrolled before receiving the second dose of SARS-CoV-2 vaccine. Determinations of anti-SARS-CoV-2 spike and nucleocapsid IgG titers were performed every 1-3 months, after they received the second and the third dose of SARS-CoV-2 vaccine, respectively. Patients were excluded from analysis if they were diagnosed with COVID-19. All serum samples were tested for anti-nucleocapsid antibody and those tested positive were excluded from subsequent analyses. Result(s): A total of 85 participants were enrolled, including 42 (49.4%) with diffused large B-cell lymphoma, and 13 (15.3) with follicular lymphoma and 9 with CLL. 72 (84.7%) participants had received anti-CD20 monoclonal antibodies, with a median interval of 24 months between last anti-CD20 treatment and the second dose of vaccine, and 21 (24.7%) had HIV infection. Factors associated with failure to achieve an anti-spike IgG titer >141 BAU/ mL within 12 weeks after the second dose of vaccine included HIV infection (adjusted odds ratio [aOR], 0.14;95% CI, 0.04-0.51), active hematologic disease (aOR, 5.50;95% CI 1.42-21.32), receipt of anti-CD20 monoclonal antibodies (aOR, 6.65;95% CI 1.52-29.07), and receipt of two doses of homologous mRNA vaccination (aOR, 0.17;95% CI 0.05-0.56). In the participants having previously treated with anti-CD20 regimen, only 8.6% achieved an antibody response ( >141 BAU/mL) in the first year, while 78.3% achieved anti-spike IgG titer > 141 BAU/mL after two years post B-cell depleting treatment. After the third dose of SARS-CoV-2 vaccine, 53.6% achieved an antispike IgG titer > 141 BAU/mL in the first year post anti-CD20 treatment. Conclusion(s): Our study demonstrated that previous treatment with anti-CD20 monoclonal antibodies was associated a lower antibody response among patients with lymphoproliferative disorders receiving two doses of SARS-CoV-2 vaccine. While two doses of SARS-CoV-2 vaccines might not be sufficient even one year apart from the last dose of rituximab, a third dose of vaccine may boost anti-spike IgG particularly in the subset of recent exposure to rituximab. Anti-spike IgG determined 1-3 months after the second (A) / third (B) dose of COVID-19 vaccine, stratified by the interval between last anti-CD20 regimen and the second / third dose of COVID-19 vaccine. (Figure Presented).
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Objectives: In this study, we explored major National Health Insurance (NHI) policies in Taiwan and residents' awareness about, support for, utilization rate of, and satisfaction with them during the COVID-19 pandemic to create a reference for health-care policymakers. Methods: We analyzed data collected through a survey conducted among the residents (age ≥18 years) of Taiwan using the 2021 NHI satisfaction questionnaire. The questionnaire comprised questions on NHI satisfaction, NHI MediCloud system, My Health Bank, referral system, premium payment deferral or installment, telemedicine, virtual NHI cards, and other topics. Results: A total of 3,266 and 2,226 valid samples were obtained through annual and thematic polls, respectively. The rate of satisfaction with NHI and medical institutions was >90%. Of the respondents, 86.3% were satisfied with the travel history, occupation, contact history, and cluster query reminder system;38.4% were aware that My Health Bank can be used to seek medical information;>86.4% were satisfied with their experience;88.8% were willing to participate in the referral system;33.5% did not seek medical care due to the pandemic;86.2% supported the policy related to deferred payment of premiums;and 70% supported telemedicine promotion and virtual NHI card policies. Conclusions: The COVID-19 pandemic appears to have had no negative effects on the general public's attitude toward major NHI policies, which showed an upward trend. In the future, technology may be used to facilitate epidemic prevention and provide immediate support to individuals during severe epidemics. © 2022, Taiwan Public Health Association. All rights reserved.
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Objectives: In this study, we explored major National Health Insurance (NHI) policies in Taiwan and residents' awareness about, support for, utilization rate of, and satisfaction with them during the COVID-19 pandemic to create a reference for health-care policymakers. Methods: We analyzed data collected through a survey conducted among the residents (age ≥18 years) of Taiwan using the 2021 NHI satisfaction questionnaire. The questionnaire comprised questions on NHI satisfaction, NHI MediCloud system, My Health Bank, referral system, premium payment deferral or installment, telemedicine, virtual NHI cards, and other topics. Results: A total of 3,266 and 2,226 valid samples were obtained through annual and thematic polls, respectively. The rate of satisfaction with NHI and medical institutions was >90%. Of the respondents, 86.3% were satisfied with the travel history, occupation, contact history, and cluster query reminder system;38.4% were aware that My Health Bank can be used to seek medical information;>86.4% were satisfied with their experience;88.8% were willing to participate in the referral system;33.5% did not seek medical care due to the pandemic;86.2% supported the policy related to deferred payment of premiums;and 70% supported telemedicine promotion and virtual NHI card policies. Conclusions: The COVID-19 pandemic appears to have had no negative effects on the general public's attitude toward major NHI policies, which showed an upward trend. In the future, technology may be used to facilitate epidemic prevention and provide immediate support to individuals during severe epidemics. © 2022, Taiwan Public Health Association. All rights reserved.
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Due to the characteristics of COVID-19, the epidemic develops rapidly and overwhelms health service systems worldwide. Many patients suffer from life-threatening systemic problems and need to be carefully monitored in ICUs. An intelligent prognosis can help physicians take an early intervention, prevent adverse outcomes, and optimize the medical resource allocation, which is urgently needed, especially in this ongoing global pandemic crisis. However, in the early stage of the epidemic outbreak, the data available for analysis is limited due to the lack of effective diagnostic mechanisms, the rarity of the cases, and privacy concerns. In this paper, we propose a distilled transfer learning framework, DistCare, which leverages the existing publicly available online Electronic Medical Records to enhance the prognosis for inpatients with emerging infectious diseases. It learns to embed the COVID-19-related medical features based on massive existing EMR data. The transferred parameters are further trained to imitate the teacher model's representation based on distillation, which embeds the health status more comprehensively on the source dataset. We conduct Length-of-Stay prediction experiments for patients in ICUs on real-world COVID-19 datasets. The experiment results indicate that our proposed model consistently outperforms competitive baseline methods. In order to further verify the scalability of DistCare to deal with different clinical tasks on different EMR datasets, we conduct an additional mortality prediction experiment on End-Stage Renal Disease datasets. The extensive experiments demonstrate that DistCare can benefit the prognosis for emerging pandemics and other diseases with limited EMR.
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The COVID-19 epidemic has brought far- reaching influence to the teaching reform in colleges and universities. According to the instruction of the ministry of education in the background of epidemic situation, and based on the "Internet thinking" and the teaching objectives of engineering drawing, this paper expounds the idea of "Online hybrid" teaching in the background of epidemic situation. On the basis of the existing engineering drawing MOOC courses, teaching resources and network teaching environment, "Online hybrid" teaching model and online learning process of engineering drawing is established. In this paper, we carried out the moderate flipped online classroom teaching activities under the "Online hybrid" teaching mode, summarized the teaching effect and teacher-student evaluation of online "teaching" and "learning", compared the online teaching effect of engineering drawing with the offline entity classroom teaching effect during the epidemic period. Finally it concluded that there is no significant difference between the two in the learning effect, but the key to affect the online learning effect of students lies in Teachers' online teaching methods and students' learning methods. Through the summary, analysis and reflection of the implementation process of online teaching, this paper puts forward the implementation suggestions of online teaching hybrid teaching, in order to provide a reference for online teaching reform, and promote students' deep participation in online learning.
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Coronavirus disease 2019 (COVID-19) is public health emergency of international concern. Since December 2019, COVID-19 spread rapidly to 187 countries, leading to more than 10 million cases within 6 months. Currently, the effective antiviral drugs are limited and SARS-CoV-2 vaccine are under developed. Combating such emerging infectious disease, the best and feasible way is to strengthen and Implement specific infection prevention and control practice to control at the source, control along the path, control at the person, engineering and environmental controls. For healthcare facilities every visitor should be screened and triaged. Healthcare personnel working in facilities must properly use personal protective equipment and adheres to hand hygiene. Also, the hospital environment should undergo appropriate cleaning and surface disinfection. For the public, mask-wearing or social distancing is recommended if community spread is a concern. These Infection prevention and control measures are the cornerstones in the context of COVID-19 pandemic. © 2020 Society of Internal Medicine of Taiwan. All rights reserved.
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Objective: To analyze the clinical characteristics of cases of novel coronavirus pneumonia and a preliminary study to explore the relationship between different clinical classification and liver damage. Methods: Consecutively confirmed novel coronavirus infection cases admitted to seven designated hospitals during January 23, 2020 to February 8, 2020 were included. Clinical classification (mild, moderate, severe, and critical) was carried out according to the diagnosis and treatment program of novel coronavirus pneumonia (Trial Fifth Edition) issued by the National Health Commission. The research data were analyzed using SPSS19.0 statistical software. Quantitative data were expressed as median (interquartile range), and qualitative data were expressed as frequency and rate. Results: 32 confirmed cases that met the inclusion criteria were included. 28 cases were of mild or moderate type (87.50%), and four cases (12.50%) of severe or critical type. Four cases (12.5%) were combined with one underlying disease (bronchial asthma, coronary heart disease, malignant tumor, chronic kidney disease), and one case (3.13%) was simultaneously combined with high blood pressure and malignant tumor. The results of laboratory examination showed that the alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin (ALB), and total bilirubin (TBil) for entire cohort were 26.98 (16.88 ~ 46.09) U/L and 24.75 (18.71 ~ 31.79) U/L, 39.00 (36.20 ~ 44.20) g/L and 16.40 (11.34 ~ 21.15) µmol/L, respectively. ALT, AST, ALB and TBil of the mild or moderate subgroups were 22.75 (16.31 ~ 37.25) U/L, 23.63 (18.71 ~ 26.50) U/L, 39.70 (36.50 ~ 46.10) g/L, and 15.95 (11.34 ~ 20.83) µmol/L, respectively. ALT, AST, ALB and TBil of the severe or critical subgroups were 60.25 (40.88 ~ 68.90) U/L, 37.00 (20.88 ~ 64.45) U/L, 35.75 (28.68 ~ 42.00) g/L, and 20.50 (11.28 ~ 25.00) µmol/L, respectively. Conclusion: The results of this multicenter retrospective study suggests that novel coronavirus pneumonia combined with liver damage is more likely to be caused by adverse drug reactions and systemic inflammation in severe patients receiving medical treatment. Therefore, liver function monitoring and evaluation should be strengthened during the treatment of such patients.