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Background: Saskatchewan, a Canadian Prairie province, faces a complicated HIV epidemic characterized by high rates of transmission due to injection drug use (IDU) and disproportionate representation of younger persons, women, and persons of Indigenous ethnicity. HIV incidence in Saskatchewan in 2021 was 19.7 per 100,000, 4.5 times higher than the Canadian average. Concurrently, during the COVID-19 pandemic, the recreational use of synthetic opioids such as fentanyl increased, leading to high numbers of overdose events & deaths. We characterized the difference in cascade of care outcomes & mortality amongst people with HIV (PWH) living in southern Saskatchewan during the COVID-19 pandemic. Method(s): We conducted a retrospective cohort study for all PWH cared for in the Infectious Diseases Clinic (IDC) at Regina General Hospital between December 31/19 and June 10/22. Age, sex, ethnicity & primary mode of HIV acquisition were collected from the IDC database, along with cascade of care & mortality data. Deaths, including most likely cause of death were characterized via individualized case review. Result(s): On December 31/19, IDC cared for 518 PWH. This increased to 585 by June 10/22. Amongst the current cohort, 245 (42%) were female, 163 (28%) were <= 35 years old, 306 (52%) were Indigenous, and 318 (54%) had acquired HIV through IDU. Cascade of care indicators worsened during the COVID-19 pandemic. 58.1% of the cohort were retained in care & 76.1% virally suppressed (HIV RNA <= 200 copies/mL) in December 2019, decreasing to 51.3% retained (p=0.02) & 68.8% suppressed (p=0.06) by June 2022. There were 80 deaths during the study period, representing 15.4% of the cohort from the end of 2019. Most deaths (49, 61.3%) were due to suspected or confirmed drug overdose. 10 (12.5%) additional deaths occurred due to complications from IDU (i.e., sepsis). No deaths were directly attributable to COVID-19. Most who died acquired HIV from IDU (69/80, 86%). Conclusion(s): We describe intersecting epidemics of HIV and IDU disproportionately affecting high-risk populations, leading to significant morbidity & mortality during the COVID-19 pandemic. Contributing factors may have included disruption of safe opioid supply and disrupted access to harm reduction services due to COVID-19. Comprehensive population-level harm reduction and addictions management strategies are urgently needed to reduce morbidity & mortality from drug use amongst PWH in Saskatchewan.
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Introduction: While COVID-19 is predominantly a lung infection, it can cause systemic viremia in susceptible patients and lead to cardiac involvement and myocarditis (MC);an inflammation of the myocardium characterized by arrhythmias, cardiogenic shock, acute heart failure, and death. Although rare, there is evidence of a surge in MC-related admissions during the COVID-19 pandemic, implying a correlation. However, the risk factors associated with MC susceptibility in these patients remain unclear. This study aims to assess the comorbidities and demographic features associated with the development of MC in adult patients with COVID-19. Method(s): Data were obtained from the PearlDiver database (PearlDiver Technologies, Fort Wayne, IN). The database provides all-payers administrative claims data on the patient level. Using ICD-10-CM codes, a cohort of patients hospitalized with a primary diagnosis of COVID-19 was identified. The study included only patients admitted to the hospital between January and October 2020 to minimize bias associated with vaccine-related MC. Within this cohort, patients diagnosed with MC during and up to one month after admission were identified and their demographic features and comorbidities to were compared to those without MC. We calculated Risk Ratios with their respective 95% CI. A p-value <0.05 was deemed significant. Result(s): We found 627,465 admissions due to COVID-19 from January to October 2020, with 506 (0.08 %) diagnosis of MC. Patients with MC were more likely to be males (60%), younger (mean age 48, SD= 23 vs. 60, SD =17 - p<0.01), and they had more comorbidities (mean Elixhauser Comorbidity Index: 7.52, SD= 5 vs. 6.9, SD = 5 - p<0.001). The development of MC was significantly associated with a history of coagulopathies [0.55(0.46-0.66);p<0.0001], asthma [1.20 (1.06-1.23);p= 0.01], deep venous thrombosis [1.54(1.38-1.68);p<0.0001], renal disease[1.15 (1.02-1.27);p= 0.03], congestive heart failure [1.24 (1.12-1.34);p=0.006], ischemic heart disease [1.25 (1.14-1.35);p=0.0001], and arrhythmias [1.24 (1.14-1.32);p< 0.0001]. However, a history of diabetes [0.89 (0.67-0.99);p=0.02], hypertension [0.71 (0.62-0.80);<0.000.1], depression [0.71(0.52-0.88);p=0.0001], and hypothyroidism [0.42(0.08-0.69);p<0.0001] was associated with lower risk of MC-related hospitalization. Other preexistent conditions including, psychosis, rheumatoid arthritis, cerebrovascular disease, obesity, tobacco use, alcohol abuse, HIV, anemia, peripheral vascular disease, and non-metastatic solid tumor were not significantly correlated with MC. Discussion(s): MC is a rare yet serious complication of COVID-19. Therefore, a better knowledge of the pathophysiology of COVID-19 and the patient factors associated with development to MC is crucial for prognostication and providing risk-adjusted treatment. Conclusion(s): Patients with a history of cardiovascular disease, renal and pulmonary disease were more likely to develop MC as a result of COVID-19. However, hypertension and diabetes were associated with lower risk of MC, which warrants further investigation.Copyright © 2022
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Background: Myocarditis (MC) is an inflammatory condition of the myocardium often caused by a virus and can lead to hospitalization, heart failure, or death. Although rare, data suggest an increased incidence associated with the COVID-19 virus. However, the risk for COVID-19-induced MC remains poorly understood and debated. We sought to evaluate the prevalence of pandemic MC-related inpatient encounters during 2020 through a descriptive approach and compare it to the pre-pandemic era. Given that the first COVID-19 vaccine doses were administered on December 14, 2020, a significant increase in MC prevalence could be attributable to COVID-19 exposure. Method(s): Data were obtained from the PearlDiver database (PearlDiver Technologies, Fort Wayne, IN). The database provides all-payers administrative claims data on the patient level. Using ICD-10-CM codes, a cohort of patients who had their first inpatient encounter with MC was identified and divided into pre-pandemic (January- October 2019) and pandemic (January-October 2020) groups and classified by age, gender, and month of hospitalization. We described these patients' demographics, calculated the prevalence ratio (PR) and 95% CI of MC-related encounters during the pandemic, and compared it with the same period in the pre-pandemic period. A p-value <0.05 was deemed significant. Result(s): The median age, length of stay in previous hospitalizations, mean gender and Elixhauser Comorbidity Index were similar between groups. The prevalence of MC was 22/100,000 cases in 2019 and 25/100,000 in 2020. The overall PR of hospitalization due to MC was 13% higher in 2020 than it was in 2019 (PR=1.13, p<0.0001), with a significantly higher risk in age groups 5-9 (PR=1.41 p=0.02), 60-64 (PR=1.24 p<0.0001), 65-69 (PR=1.14 p=0.01), 70-74 (PR=1.28 P<0.0001), and 80-85 (PR=1.36 p<0.0001). The risk was significantly higher in March (PR=1.27 p<0.0001), July (PR=1.41 p<0.0001, and September (PR=1.52 p<0.0001) in 2020. In 2020, the risk of MC in males with respect to females decreased by 3% compared to 2019. Discussion(s): Our results suggest a temporal correlation between increased prevalence of inpatient encounters for MC since COVID-19's inception. The risk was significantly higher in older adults and during months with a higher COVID-19 incidence. These findings do not demonstrate causation between the COVID-19 virus and MC and are limited by the typical biases associated with retrospective studies. Conclusion(s): Although MC is a less common hospitalization condition, our data supports a significantly increased prevalence of MC-related encounters during the initial year of the COVID-19 pandemic. We found risk variations according to age, gender, and month.Copyright © 2022
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Throughout the COVID-19 pandemic, international access to COVID-19 vaccines and other health technologies has remained highly asymmetric. This inequity has had a particularly deleterious impact on low- and middle-income countries, engaging concerns about the human rights to health and to the equal enjoyment of the benefits of scientific progress enshrined under articles 12 and 15 of the International Covenant on Economic, Social and Cultural Rights. In response, the relationship between intellectual property rights and public health has reemerged as a subject of global interest. In October 2020, a wholesale waiver of the copyright, patent, industrial design, and undisclosed information sections of the Agreement on Trade-Related Aspects of Intellectual Property (TRIPS Agreement) was proposed by India and South Africa as a legal mechanism to increase access to affordable COVID-19 medical products. Here, we identify and evaluate the TRIPS waiver positions of World Trade Organization (WTO) members and other key stakeholders throughout the waiver's 20-month period of negotiation at the WTO. In doing so, we find that most stakeholders declined to explicitly contextualize the TRIPS waiver within the human right to health and that historical stakeholder divisions on the relationship between intellectual property and access to medicines appear largely unchanged since the early 2000s HIV/AIDS crisis. Given the WTO's consensus-based decision-making process, this illuminates key challenges faced by policy makers seeking to leverage the international trading system to improve equitable access to health technologies.
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The years since 2000 have been a golden age in in situ ocean observing with the proliferation and organization of autonomous platforms such as surface drogued buoys and subsurface Argo profiling floats augmenting ship-based observations. Global time series of mean sea surface temperature and ocean heat content are routinely calculated based on data from these platforms, enhancing our understanding of the ocean's role in Earth's climate system. Individual measurements of meteorological, sea surface, and subsurface variables directly improve our understanding of the Earth system, weather forecasting, and climate projections. They also provide the data necessary for validating and calibrating satellite observations. Maintaining this ocean observing system has been a technological, logistical, and funding challenge. The global COVID-19 pandemic, which took hold in 2020, added strain to the maintenance of the observing system. A survey of the contributing components of the observing system illustrates the impacts of the pandemic from January 2020 through December 2021. The pandemic did not reduce the short-term geographic coverage (days to months) capabilities mainly due to the continuation of autonomous platform observations. In contrast, the pandemic caused critical loss to longer-term (years to decades) observations, greatly impairing the monitoring of such crucial variables as ocean carbon and the state of the deep ocean. So, while the observing system has held under the stress of the pandemic, work must be done to restore the interrupted replenishment of the autonomous components and plan for more resilient methods to support components of the system that rely on cruise-based measurements. © 2023 American Meteorological Society.
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Chilblain, also known as pernio, has gained publicity in recent years as a result of its association with 'COVID toes' during the COVID-19 pandemic. Long before this, chilblain had left its mark throughout history and literature. The word 'chilblain' has Anglo-Saxon roots. 'Chil' comes from Old English ciele meaning 'chill' or 'frost', while 'blain' comes from the Old English blegen meaning 'inflammatory swelling' or 'sore'. The two words were brought together in the 1540s. The choice of words somehow acknowledges that cold is the aetiological factor that brings on this painful swelling. The Victorian novel Jane Erye, written by Charlotte Bronte in 1847, described the physical hardships that children had to struggle with through the winter at Lowood, the charity school for poor and orphaned girls. Her work masterfully sculptured the essence of chilblain and its effects on the children. Multiple notable figures proposed various remedies to treat the bothersome symptoms of chilblains. Pedanius Dioscorides was a Greek physician and botanist whose monumental work De Materia Medica in the first century AD compiled a list of topical remedies for chilblains, including quince oil, fenugreek oil, frankincense gum, burnt figs in wax, a mixture of gentian, crab ashes and honey, burnt ass hooves, bear grease and decoction of turnip as a warm pack. To cure chilblains, Nicholas Culpeper, an English herbalist, advised grating horseradish and applying it as a mustard plaster. We now know grated horseradish root produces a powerful mustard oil that acts as a rubefacient, which irritates the skin and increases its blood flow. Dr Lewis Johns was a recognized medical officer in the field of medical electricity in charge of the Electrical Department of St Bartholomew's Hospital. He noted a reduced incidence of chilblains in children with poliomyelitis who were treated with a warm electric footbath in 1899. The beneficial effects most likely originated from the warm bath rather than the electricity itself. Sir Thomas Lewis, a British cardiologist, investigated skin responses to injury and vascular reactions of the skin to cold exposure. His careful observations and descriptions of chilblains published in the British Medical Journal in 1941 remain true to this day. Practices such as praying to the statue of St Benignus of Dijon with chilblains, wearing electric patent socks (invented in 1882) and using an electrical vacuum tube in 1922 had also made their way into the lives of sufferers as a potential cure. Despite the epidemiological study of chilblain in over 3000 servicewomen, carried out by the Auxiliary Territorial Service in the winter of 1942, no specific remedy was found. When it comes to chilblain, prevention is better than cure by keeping the hands and feet warm and dry and staying active, and chilblains usually resolve spontaneously within a few weeks.
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The COVID-19 pandemic has drastically affected everyday life and business. To describe the impacts, 566 COVID-19-related articles were published between January 2020 and March 2022 in 18 hospitality and tourism journals. This study identifies the research streams, using content and bibliometric analyses. Content analysis and co-citation analysis revealed six research streams and four research clusters, respectively. A critical analysis was conducted to reflect the theoretical and practical implications and provide suggestions for future research directions. The identified research weaknesses include concerns relating to generalizability, sampling and measurement-related issues, online survey methods, failure to identify different stakeholders' views on the adoption of new technologies, lack of practical coping scheme studies, lack of effort to adopt multidisciplinary theories, and little exploration of customers' reactions to virtual events. Results of this study can help facilitate and consolidate the knowledge on the impacts of the pandemic and proactively prepare for future disease crises. © The Author(s) 2023.
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Background: Olfactory dysfunction (OD) is a common symptom of Corona Virus Disease 2019 (COVID-19). It is defined as the reduced or distorted ability to smell during sniffing (orthonasal olfaction) and represents one of the early symptoms in the clinical course of COVID-19 infection. A large online questionnaire-based survey has shown that some post-COVID-19 patients had no improvement 1 month after discharge from the hospital. Objective: To explore the efficacy of acupuncture for OD in COVID-19 infected patients and to determine whether acupuncture could have benefits over sham acupuncture for OD in post-COVID-19 patients. Methods: This is a single-blind, randomized controlled, cross-over trial. We plan to recruit 40 post-COVID-19 patients with smell loss or smell distortions lasting for more than 1 month. Qualified patients will be randomly allocated to the intervention group (real acupuncture) or the control group (sham acupuncture) at a 1:1 ratio. Each patient will receive 8 sessions of treatment over 4 weeks (Cycle 1) and a 2-week follow-up. After the follow-up, the control group will be subjected to real acupuncture for another 4 weeks (Cycle 2), and the real acupuncture group will undergo the 4-week sham acupuncture. The primary outcomes will be the score changes on the questionnaire of olfactory functioning and olfaction-related quality of life at week 6, 8, 12, and 14 from the baseline. The secondary outcomes will be the changes in the olfactory test score at week 6 and 12 from the baseline measured by using the Traditional Chinese version of the University of Pennsylvania Smell Identification Test (UPSIT-TC). Discussion: The results of this trial will help to determine the effectiveness of acupuncture for OD in post-COVID-19 patients. This may provide a new treatment option for patients.
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BACKGROUND: The arrival of the Delta variant of SARS-CoV-2 was associated with increased transmissibility and illness of greater severity. Reports of nosocomial outbreaks of Delta variant COVID-19 in acute care hospitals have been described but control measures varied widely. AIM: Epidemiological investigation of a linked two-ward COVID-19 Delta variant outbreak was conducted to elucidate its source, risk factors, and control measures. METHODS: Investigations included epidemiologic analysis, detailed case review serial SARS-CoV-2 reverse transcriptase-polymerase chain reaction (RT-PCR) testing of patients and healthcare workers (HCWs), viral culture, environmental swabbing, HCW-unaware personal protective equipment (PPE) audits, ventilation assessments, and the use of whole genome sequencing (WGS). FINDINGS: This linked two-ward outbreak resulted in 17 patient and 12 HCW cases, despite an 83% vaccination rate. In this setting, suboptimal adherence and compliance to PPE protocols, suboptimal hand hygiene, multi-bedded rooms, and a contaminated vital signs cart with potential fomite or spread via the hands of HCWs were identified as significant risk factors for nosocomial COVID-19 infection. Sudden onset of symptoms, within 72 h, was observed in 79% of all Ward 2 patients, and 93% of all cases (patients and HCWs) on Ward 2 occurred within one incubation period, consistent with a point-source outbreak. RT-PCR assays showed low cycle threshold (CT) values, indicating high viral load from environmental swabs including the vital signs cart. WGS results with ≤3 SNP differences between specimens were observed. CONCLUSION: Outbreaks on both wards settled rapidly, within 3 weeks, using a `back-to-basics' approach without extraordinary measures or changes to standard PPE requirements. Strict adherence to recommended PPE, hand hygiene, education, co-operation from HCWs, including testing and interviews, and additional measures such as limiting movement of patients and staff temporarily were all deemed to have contributed to prompt resolution of the outbreak.
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Background: Advanced age and coronary artery disease (CAD) have been associated with a dismal prognosis in patients infected with COVID-19, most likely due to the virus's thrombogenic effects. Older adults with a history of CAD have routinely used low-dose Aspirin (LDA) as prevention due to their increased risk of cerebro-cardiovascular events. However, it is unclear if this population would benefit from LDA when infected with COVID-19. Methods: A retrospective study was conducted using the PearlDiver database (PearlDiver Technologies, Fort Wayne, IN). Using ICD codes, patients aged 65–75 and Elixhauser Comorbidity Score(ECI)>4 with a history of CAD admitted for COVID-19 were identified. The use of LDA for 1 month before the index event was used to split the cohort into two matched groups by age, gender, ECI, and other cardiovascular diseases. Records of groups were reviewed for multiple outcomes 30 days after admission. Pearson's chi-squared test was used to compare groups. The strength of association was reported as Risk Ratios (RR). Results: 4,017 patients with no difference in the mean age, gender, and ECI were included in each group. No differences present in 30-days all-cause readmission(RR=1.04, CI95% =0.92–1.17, p=0.49), mortality(RR=0.63, CI95%=0.30–1.29, p=0.28), ICU admission(RR=1.01, CI95%=0.89–1.15, p=0.79), gastrointestinal bleeding(RR=1.09, CI95% = 0.85–1.40, p=0.51), and intracranial hemorrhage(RR=0.69, CI95%=0.26–1.83, p=0.62) between groups. Conclusion: LDA didn't improve the evaluated outcomes in older persons 30 days after admission. A plausible explanation is that COVID-19's thrombogenic mechanism is likely atypical.
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Introduction: Cardiovascular disease patients with COVID-19 present prolonged hospitalization and increased mortality. Cardiovascular complications including myocarditis have been reported in association with COVID-19. We recently reported that levels of cardiac low-density lipoprotein receptor (LDLR) are elevated in patients with heart failure. We hypothesized that LDLR may play a role in COVID-19-induced myocarditis. Method(s): K18 hACE2tg mice were inoculated with SARS-CoV-2 Washington (WA-1) native strain, replication-competent chimeric (ch) SARS-CoV-2, or PBS and lung viral load and histopathology were compared (N=4). We interrogated the LDLR in 4-month-old K18 hACE2tg mice via intravenous injection of AAV9-cTnT-hLDLR (gain of function), AAV9-cTnT-hIDOL (Induced Degrader of LDLR, loss of function), or AAV9-cTnT-Luciferase (control). After 4 weeks, mice were inoculated intratracheally with chSARS-CoV-2. Five days after inoculation, mice were sacrificed, and blood and tissues collected for histopathological analysis and RNA/protein studies to evaluate myocarditis. Myocarditis was established by histological analysis according to the Dallas criteria. Result(s): Both native SARS-CoV-2 and chSARS-CoV-2 had ~60% infectivity as measured by qPCR and immunostaining. Over-expression (OE) of cardiomyocyte-specific hLDLR together with chSARS-CoV-2 induced myocarditis with prominent cardiomyocyte degeneration, necrosis, and immune cell infiltration: T cells (59 cells/mm ;p<0.05) and Macrophages (109 cells/mm ;p=0.0002) compared to the single control groups. In addition, hLDLR-OE increased heart expression of Osteopontin (12.6 vs 1.2%;p<0.05), pAKT(Ser473) (14.4 vs 3.5;p<0.05) and ICAM-1 (9.0 vs 3.3%;p<0.05). OE of cardiac-specific hIDOL mice infected with chSARS-CoV-2 reduced macrophage infiltration into the heart compared to hLDLR-OE myocarditis and control chSARS-CoV-2 groups (p<0.0001 and p<0.05), respectively. hIDOL-OE reduced cardiac ICAM-1 compared to myocarditis and control chSARS-CoV-2 groups (p<0.01 and p<0.05), respectively. Conclusion(s): Cardiac LDLR drives COVID-19-associated myocarditis in a new mouse model of SARS-CoV-2 infection.
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Background. Environmental surveillance of SARS-CoV-2 via wastewater has become an invaluable tool for population-level surveillance of COVID-19. More highly resolved environmental sampling approaches may also be useful for surveillance. Built environment sampling may provide a spatially refined approach for surveillance of COVID-19 in congregate living settings. Methods. We conducted a prospective study of 10 long-term care homes (LTCHs) in both urban and rural settings in Ontario Canada between September 2021 and April 2022. Floor surfaces were sampled weekly at multiple locations within each building and were analyzed for the presence of SARS-CoV-2 using qPCR. The exposure variable was detection of SARS-CoV-2 on floors. The primary outcome was the presence of a COVID-19 outbreak. We calculated the test characteristics of the presence of SARS-CoV-2 on floors for detection of COVID-19 outbreaks. Results. We followed 10 LTCHs for 214 cumulative weeks, and collected 3,219 swabs from 183 unique locations. Overall, 15 COVID-19 outbreaks occurred with 74.9 cumulative weeks of outbreaks. During time periods when there were outbreaks of COVID-19 the proportion of floor swabs positive for SaRS-CoV-2 was 50.8% (95% CI: 47.7-53.9). During time periods where there were no outbreaks of COVID-19 the proportion of floor swabs positive was 15.8% (95% CI:14.3-17.3). Using the proportion of positive floor swabs for SARS-CoV-2 to predict COVID-19 outbreak status for a given week, the area under the receiver operating curve was 0.84 (95% CI: 0.76-0.92). Using thresholds of >=10%, >=30%, and >=50%, the prevalence of floor swabs positive for SARS-CoV-2 yielded positive predictive values for outbreak of 0.52 (0.43-0.61), 0.65 (0.53-0.75), and 0.72 (0.58-0.83) respectively, and negative predictive values of 0.93 (0.86-0.97), 0.85 (0.78-0.91), and 0.80 (0.73-0.86) respectively (Figure 1). 13 outbreaks had floor sampling performed in the week prior to them being identified, and of these 7 (54%) had positive swab proportions exceeding 30% in the week prior to the outbreak. Figure 1. Test characteristics of built environment floor swabs for predicting COVID-19 outbreaks in LTCH. Figure 1. Test characteristics of different thresholds for percentage of floor swabs positive for SARS-CoV-2 at a given LTCH for predicting active COVID-19 outbreak in the same building in the same week. NPV = negative predictive value, PPV = positive predictive value, Sens = sensitivity, Spec = specificity. Conclusion. Detection of SARS-CoV-2 on floors is strongly associated with COVID-19 outbreaks in LTCHs. These data suggest a potential role for floor sampling in improving early outbreak detection and management.
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Background: Older adults are afflicted more severely by COVID-19. SARS-CoV-2 can be complicated by myocarditis (MC), and the incidence of MC has been shown to correlate linearly with severity. However, data on comorbidities associated with MC in this population is scarce. Methods: Data were obtained from the PearlDiver database (PearlDiver Technologies, Fort Wayne, IN). The study used ICD codes to include patients hospitalized with a primary diagnosis of COVID-19, aged 65–75, and Elixhauser Comorbidity index(ECI)>4. Within this cohort, we identified patients diagnosed with MC 60 days after admission and compared their baseline comorbidities upon admission to those without MC. Pearson's chi-squared test was used to compare groups. The strength of association was reported by Risk Ratios (RR). A p-value < 0.05 was deemed significant. Results: 412,582 patients admitted with COVID-19 as the primary diagnosis were identified. 0.12% of this cohort developed MC over the following 60 days. The MC group was more likely to be male(57%, p=0.0001), with similar mean age(70.4, p=0.86) and mean ECI(9.4, p=0.07) to the no-MC group. Patients who developed MC have significantly higher rates of prior heart failure(RR= 1.30, CI95%=1.07–1.57, p=0.008). There was no difference between groups in terms of history of arrhythmias(p=0.36), cerebrovascular disease(p=0.09), chronic kidney disease(p=0.13), CAD(P=0.19), diabetes(p=0.48), ischemic heart disease(p=0.06), tobacco use(p=0.39), alcohol use(p=0.17), HIV(p=0.79), and severe liver disease(p=0.14). Conclusion: A history of heart failure increased the likelihood of developing MC in older adults.
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Background: Age, atrial fibrillation (AF), and COVID-19 infection predispose patients to hypercoagulability and poor outcomes. It is unclear if older adults with AF and COVID-19 infection would benefit from oral anticoagulants (OACs). Methods: A retrospective study was conducted using the PearlDiver database (PearlDiver Technologies, Fort Wayne, IN). Using ICD-10 codes, adults aged 65–75 and Elixhauser Comorbidity index(ECI) >4 with a history of AF admitted for COVID-19 were identified. The use of OACs for 6 months before the index event was used to split the cohort into two propensity score-matched groups considering age, gender, and ECI. Records from both groups were reviewed for multiple outcomes during the same admission. Pearson's chi-squared test was used to compare groups. The strength of association was reported using Risk Ratios (RR). A p-value < 0.05 was deemed significant. Results: We compared 16,967 individuals in both anticoagulated and non-anticoagulated groups. Anticoagulated patients had a lower risk of mortality (RR=0.11, p=0.026), and a higher risk of 30-day all-cause readmission(RR=1.12, p < 0.0001). However, there were no differences in ICU admission, gastrointestinal bleeding, intracranial hemorrhage, thromboembolic events, or length of hospitalization. Conclusion: Compared to non-anticoagulated patients, older adults with a history AF on chronic oral anticoagulants had a lower risk of all-cause mortality, and higher risk of 30-day all-cause readmission. This information would help clinicians decide whether to prescribe OACs to this population of patients.