ABSTRACT
Background: Thyroiditis and Graves’ disease have been reported after COVID-19 vaccination. Patients with hypothyroidism due to various etiologies may be at risk of thyroid-specific outcomes. We aimed to evaluate the risks of thyroid-specific outcomes and adverse events after COVID-19 vaccination among patients treated for hypothyroidism. Methods: In this population-based cohort from Hong Kong Hospital Authority electronic health records with Department of Health vaccination records linkage, levothyroxine users were categorized into unvaccinated, vaccinated with BNT162b2 (mRNA vaccine) or CoronaVac (inactivated vaccine) between 23 February and 9 September 2021. Propensity score (PS) weighting with inverse probability of treatment weighting (IPTW) was applied to balance the baseline characteristics among the three groups, which included age, sex, history of COVID-19, health care utilization, comorbidities, baseline thyroid-stimulating hormone (TSH) level (within the 6 months before the index date), and recent use of medications including anti-hypertensive, anti-diabetic and lipid-lowering agents. Study outcomes were dosage reduction or escalation in levothyroxine, emergency department visit, unscheduled hospitalization, adverse events of special interest (AESI) according to World Health Organization's Global Advisory Committee on Vaccine Safety, and all-cause mortality. Results: In total, 47,086 levothyroxine users were identified (BNT162b2: n=12,310;CoronaVac: n=11,353;unvaccinated: n=23,423). After PS weighting, all baseline characteristics had standardised differences of less than 0.2, implying a balance of covariates among the three groups. COVID-19 vaccination was not associated with increased risks of levothyroxine dosage reduction (BNT162b2: HR=0.971, 95% CI 0.892–1. 058;CoronaVac: HR=0.968, 95% CI 0.904–1. 037) or escalation (BNT162b2: HR=0.779, 95% CI 0.519–1.169;CoronaVac: HR=0.715, 95% CI 0.481–1. 062). Besides, COVID-19 vaccination was not associated with a higher risk of emergency department visits (BNT162b2: HR=0.944, 95% CI 0.700-1.273;CoronaVac: HR=0.851, 95% CI 0.647-1.120) or unscheduled hospitalization (BNT162b2: HR=0.905, 95% CI 0.539-1.520;CoronaVac: HR=0.735, 95% CI 0.448-1.207). There were two (0. 016%) deaths and six (0. 062%) AESI recorded for BNT162b2 recipients, and one (0. 009%) and three (0. 035%) for CoronaVac recipients, respectively. Sensitivity analyses were performed by stratifying the groups according to age, sex and pre-vaccination thyroid status. The results were largely consistent with the main analysis. Conclusion: BNT162b2 or CoronaVac vaccination is not associated with unstable thyroid status or an increased risk of adverse outcomes among patients treated for hypothyroidism. These reassuring data should encourage them to get vaccinated against COVID-19 for protection from potentially worse COVID-19-related outcomes.Presentation: No date and time listed
ABSTRACT
To explore the effect of Multi-Disciplinary Team (MDT) mode in the diagnosis and treatment of Coronavirus Disease 2019 (COVID-19) Pneumonia. A total of 65 patients with suspected COVID-19 pneumonia were included. On February 8, 2020, our hospital officially became a designated hospital for the treatment of COVID-19, and the MDT mode was implemented throughout the diagnosis and treatment for newly admitted patients with suspected COVID-19. The patients were divided into control group and observation group according to whether received MDT mode. Our results showed that the diagnosis time in the observation group was significantly shortened than that in the control group (2.51 days vs. 3.47 days) (p < 0.05). The average daily hospitalization costs in the observation group was significantly decreased in comparison with the control group (¥766.1 vs. ¥1190.4) (p < 0.001). The average daily cost of protective materials in the observation group was significantly reduced in comparison with the control group (¥4226.90 vs. ¥5308.20) (p < 0.001). Compared with the control group, the subjective symptoms of patients in the observation group were significantly improved (p < 0.001). In conclusion, the MDT mode shortens the diagnosis time of, reduces the hospitalization costs, and improves the subjective symptoms of COVID-19. © 2022, Sociedade Brasileira de Ciencia e Tecnologia de Alimentos, SBCTA. All rights reserved.
ABSTRACT
Purpose: This study presented the experience of improving the nucleic acid sample collection and transportation service in response to the epidemic. The main purpose is that through intelligent path planning, combined with the time scheduling of sample points, the process of obtaining results to determine the state of COVID-19 patients could be speeding up. Design/methodology/approach: The research optimized the process, including finding an optimal path to traverse all sample points in the hospital area via intelligent path planning method and standardizing the operation through the time sequence scheduling of each round of support staff to collect and send samples in the hospital area, so as to ensure the shortest time in each round. And the study examines these real-time experiments through retrospective examination. Findings: The real-time experiments' data showed that the proposed path planning and scheduling model could provide a reliable reference for improving the efficiency of hospital logistics. Testing is a very important part of diagnosis and prompt results are essential. It shows the possibility of applying the shortest-path algorithms to optimize sample collection processes in the hospital and presents the case study that gives the expected outcomes of such a process. Originality/value: The value of the study lies in the ion of a very practical and urgent problem into a TSP. Combining the ant colony algorithm with the genetic algorithm (ACAGA), the performance of path planning is improved. Under the intervention and guidance, the efficiency of hospital regional logistics planning was greatly improved, which may be of greater benefit to critical patients who must go through fever clinic during the epidemic. By detailing how to more rapidly obtain results through engineering method, the paper contributes ideas and plans for practitioners to use. The experience and lessons learned from Tongji Hospital are expected to provide guidance for supporting service measures in national public health infrastructure management and valuable reference for the development of hospitals in other countries or regions. © 2022, Emerald Publishing Limited.
ABSTRACT
Introduction: Rates of sleep disturbance and sleep medication use have increased during the COVID-19 pandemic, at a time when face-to-face delivery of behavioral insomnia treatments is severely limited. To support research during the pandemic, the FDA released guidelines promoting the use of “alternative methods” to conduct trials in a virtual or decentralized manner. Currently, few data exist regarding the impact of virtual trial enrollment during a pandemic. This abstract presents data from a decentralized, open-label, single-arm real-world clinical trial of the Somryst prescription digital therapeutic for insomnia, which provides insight on who seeks care for insomnia using virtual research methods. Methods: In alignment with FDA guidance, the DREAM trial began enrolling patients in March, 2020 with an expected final sample size of 350 adults (Clinical Trial # NCT04325464). This abstract presents data from participants seeking enrollment into the trial via an online screening. Demographic and sleep variables were collected to confirm eligibility. Results: Of 1,063 respondents, the majority were female (62%) and the most common age brackets were ages 30-39 (22%);40-49 (20%);and 50-59 (20%). Most respondents (63.8%) did not report being under the care of a healthcare provider for their insomnia. Respondents reported sleep problems for an average of 12.9 years;sleep problems 5 nights/week;and sleeping an average of 5.4 hours/night. Geographic diversity was high with respondents from 45 states and Washington DC. Of those passing initial screening (N=270), 5.5% reported having another diagnosed sleep disorder, 14.4% reported a comorbid psychological condition, 58.9% reported taking a medication for insomnia, and 30.7% reported taking a medication for depression. Using the Insomnia Severity Index, 16.7% had subthreshold/mild insomnia (score 8-14), 60.0% had moderate insomnia (score 15-21), and 23.7% had severe insomnia (score > 21). Conclusion: Respondents to this decentralized trial reported moderate-severe, long-lasting insomnia with high rates of medication use for sleep and depression. Results demonstrate that virtual trials can quickly draw a highly geographically diverse research population, overcoming logistical challenges inherent in a pandemic and resulting in recruiting appropriate, but more geographically diverse, samples than those typically observed in randomized trials of cognitive behavioral therapy for insomnia (CBT-I).
ABSTRACT
In the normal phenomenon, the restaurant industry strategic planning and future development trends are diverse, therefore, it is difficult to choose for. Existing literature does not provide effective guidance for the implementation of strategic plans in the catering industry under coVID-19. Taking RJ Restaurant in Chongqing as an example, this paper uses the method of combining qualitative and quantitative methods to study the difficulties that restaurants are facing now. This study clarifies that at the strategic level, the belief of medium-sized private restaurants to survive coVID-19 needs be based on identifying their deficiencies to establish cost strategy and differentiation strategy, which includes emphasizing the future development trends of intelligent use and "customized"services. There are two contributions to this study. First of all, this study provides a stereotyped municipal infrastructure framework for the study of private restaurants. In addition, this study studied the literature on strategic analysis of the catering industry from the perspective of coVID-19. © The Authors, published by EDP Sciences, 2021.
ABSTRACT
Recent outbreaks of severe acute respiratory syndrome and Middle East respiratory syndrome, along with the threat of a future coronavirus-mediated pandemic, underscore the importance of finding ways to combat these viruses. The trimeric spike transmembrane glycoprotein S mediates entry into host cells and is the major target of neutralizing antibodies. To understand the humoral immune response elicited upon natural infections with coronaviruses, we structurally characterized the SARS-CoV and MERS-CoV S glycoproteins in complex with neutralizing antibodies isolated from human survivors. Although the two antibodies studied blocked attachment to the host cell receptor, only the anti-SARS-CoV S antibody triggered fusogenic conformational changes via receptor functional mimicry. These results provide a structural framework for understanding coronavirus neutralization by human antibodies and shed light on activation of coronavirus membrane fusion, which takes place through a receptor-driven ratcheting mechanism. Structural analysis of the SARS-CoV S and MERS-CoV S glycoproteins in complex with neutralizing antibodies from human survivors sheds light into the mechanisms of membrane fusion and neutralization
ABSTRACT
The new coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), first reported in Wuhan, China, is causing a pandemic. With an increased understanding of the disease, the diagnosis and treatment guidelines are being updated and improved. In addition to nucleic acid detection, antibody detection kits are also being developed and approved. A medical worker suspected of having COVID-19 in our hospital had fatigue and loss of appetite and pulmonary infection indicated by CT, but the nucleic acid test was negative three times. Finally, she was confirmed to have COVID-19 by a serological antibody test. After rest and oral antiviral treatment, she recovered and returned to work. This is a case report that focuses on suspected mild patients who tested negative for nucleic acids. Such a group of patients had to choose home isolation treatment during the outbreak. The majority of them did not make a definitive diagnosis or rule out COVID-19 by the time they recovered. The antibody test is of great significance to identify infected patients with multiple negative nucleic acid tests. It can complement nucleic acid testing to enhance diagnostic efficiency. We have reviewed the literature and realized that further validation and standardization of serological tests are needed for more mature application of antibody tests to clinical diagnosis and vaccine development.