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1.
Chest ; 162(4):A949, 2022.
Article in English | EMBASE | ID: covidwho-2060737

ABSTRACT

SESSION TITLE: What Lessons Will We Take From the Pandemic? SESSION TYPE: Rapid Fire Original Inv PRESENTED ON: 10/19/2022 11:15 am - 12:15 pm PURPOSE: Since the emergence of COVID-19, many serious complications have arisen especially in the setting of Acute Respiratory Distress Syndrome (ARDS) in the intensive care unit. Historically, ARDS and mechanical ventilation is associated with higher rates of pneumothorax. It has been well described that ARDS is the result of inflammatory lung injury, with increased activation of circulating neutrophils, complement and proinflammatory mediators leading to loss of surfactant, alveolar atelectasis, and fibrin deposition. This leads to a less compliant lung parenchyma, and higher airway pressures, which has been attributed as a risk factor for pneumothorax. The management of pneumothorax varies depending on the etiology of the pneumothorax. In the case of iatrogenic pneumothorax (i.e. mechanical ventilation), tube thoracostomy is generally recommended, however the size of the chest tube inserted remains less clear. METHODS: This is a multi-center retrospective cohort study of 88 hospitalized patients with a diagnosis of COVID-19 and pneumothorax or pneumomediastinum between the dates of 3/11/2020 to 01/26/2021. Patient demographics, comorbidities, laboratory and hemodynamic data were collected as well as ventilator settings, lung mechanics, and clinical patient outcome data including type of intervention and rate of resolution of pneumothorax. Final statistical analysis is pending. RESULTS: Our preliminary results reveal that there was a higher rate of resolution of pneumothorax with a large bore chest tube (LBCT) compared to a small bore chest tube (SBCT). There was no significant difference in lung compliance or tidal volume in cc/kg between the patients with a resolving pneumothorax compared to the patients with a nonresolving pneumothorax. Overall mortality rate among all patients was 70.4%. CONCLUSIONS: Patients with a large bore chest tube placed are more likely to have resolution of pneumothorax compared to small bore chest tube or serial X-ray. Lung compliance and tidal volume were not significantly different between patients that had a resolving pneumothorax compared to nonresolving pneumothorax. It is important to manage a pneumothorax early on to reduce associated morbidity. CLINICAL IMPLICATIONS: The development of pneumothorax in COVID patients with ARDS has significant associated morbidity and mortality. Utilization of a large bore chest tube may result in improved rates of resolution of pneumothorax. DISCLOSURES: No relevant relationships by Nathalie Antonios No relevant relationships by Colby Baker No relevant relationships by Jessica Johnson No relevant relationships by Karen Sayad

2.
International Journal of Contemporary Hospitality Management ; : 19, 2022.
Article in English | Web of Science | ID: covidwho-1868465

ABSTRACT

Purpose This study aims to explore the influence of different types of cleanliness information provided on the Airbnb platform (hosts' sanitation labels, Airbnb cleaning protocol and previous guests' reviews) on guests' trust and behavioral intentions. Design/methodology/approach This study uses an online scenario-based experimental design. A two-step approach was applied to discover the proposed relationships by assessing the measurement model fit and validity of the constructs with confirmatory factor analysis and testing study hypotheses with structural equation modeling. Findings The results demonstrate that three types of cleanliness information (i.e. provided by Airbnb's hosts, platform and customer reviews) had statistically significant effects on customers' trust and behavioral intentions. Practical implications The research results provide practical recommendations for Airbnb hosts and peer-to-peer accommodation platforms on using several types of textual and visual cleanliness information to influence guests' attitudes and behavioral intentions. Originality/value This study advances knowledge by introducing new factors affecting guests' trust and behavioral intentions in peer-to-peer accommodation settings and differentiating the effects of different sources of cleanliness information and different types of guests' trust.

3.
Washington International Law Journal ; 31(2):251-291, 2022.
Article in English | Web of Science | ID: covidwho-1865840

ABSTRACT

The COVID-19 pandemic poses grave threats to the life and health of asylum seekers in Europe. Many potential asylees are forced to reside in cramped, unsanitary facilities and do not have adequate access to medical treatment. On top of these dangers, many are likely to be denied asylum due to the stringency of international refugee law and European Union ("EU") asylum procedures. As a result, a number of these asylum seekers will turn to Article 3 of the European Convention on Human Rights, which provides broader non-refoulement protections. However, even Article 3, as currently interpreted by the European Court of Human Rights ("ECtHR"), is unlikely to protect the majority of these asylum seekers. This article proposes ways in which the ECtHR may refine its health-based non-refoulement jurisprudence to protect more individuals. It concludes that the Court may retain its current high standard for qualifying for health-based non-refoulement and provide relief for individuals who contract COVID-19 while detained by EU member states during the asylum application process. Significantly, the ECtHR should hold that EU member states who detain asylum seekers and thereby expose them to COVID-19 have assumed a duty toward them and may not refoule them for the duration of their illness and its lingering health effects.

4.
PubMed; 2022.
Preprint in English | PubMed | ID: ppcovidwho-329261

ABSTRACT

Inflammation in response to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection drives severity of coronavirus disease 2019 (COVID-19), with effective versus dysregulated responses influenced by host genetics. To understand mechanisms of inflammation, animal models that reflect genetic diversity and clinical outcomes observed in humans are needed. We report a mouse panel comprising the diverse genetic backgrounds of the Collaborative Cross founder strains crossed to K18-hACE2 transgenic mice that confers high susceptibility to SARS-CoV-2. Infection of CC x K18-hACE2 F1 progeny resulted in a spectrum of weight loss, survival, viral replication kinetics, histopathology, and cytokine profiles, some of which were sex-specific. Importantly, survival was associated with early type I interferon (IFN) expression and a phased proinflammatory response distinct from mice with severe disease. Thus, dynamics of inflammatory responses observed in COVID-19 can be modeled in diverse mouse strains that provide a genetically tractable platform for understanding antiviral immunity and evaluating countermeasures. One Sentence Summary: Genetically diverse mice display a broad spectrum of clinically relevant responses to SARS-CoV-2 infection, reflecting variability in COVID-19 disease.

5.
Journal of Cystic Fibrosis ; 20:S67, 2021.
Article in English | EMBASE | ID: covidwho-1361556

ABSTRACT

Background: With the COVID-19 pandemic crisis, in the UK guidance on shielding to protect vulnerable individuals included minimising face-to-face (FTF) contact and visits to hospital for people with cystic fibrosis (pwCF). We undertook a UK-wide survey to study how CF centres adapted their practice during this time. Method: We contacted CF nurses to explore service changes to routine outpatient care, emergency consultations, annual reviews (AR), and use of remote monitoring between March - July 2020. Results: Nineteen centres (13 adult) caring for 34% of the UK CF population replied (response rate 35%). Eleven (58%) ceased routine FTF appointments until virtual clinics were implemented, in 1 centre solely by telephone. Six centres suspended AR, the remainder integrating them into virtual or emergency FTF appointments. All noted reduction in hospital admission rates, citing better treatment compliance, reluctance to admission, effect of shielding and initiation of CFTR modulators. Twelve centres (63%) reported increased demand for psychology input. Departmental spirometry was only performed at F2Fclinics and all centres distributed remote spirometry devices to suitable pwCF, with training delivered F2F or remotely. Multidisciplinary team (MDT) meetings continued virtually at all centres. Fourteen (73%) reported an increase in home visits for blood tests and IV antibiotic management. To cope, 20% reduced support visits and extended TIVAD flush duration intervals. Nine continued existing research activity. Most centres reported initial technical issues with virtual clinics that were subsequently addressed and have incorporated virtual appointments into their care. Conclusions: Despite need for rapid service change, all centres continued to support their pwCF. Virtual clinics and MDT meetings were adopted by all centres within the UK and this service will strengthen in time.

6.
Clinical Psychology Forum ; 2021(338):24-29, 2021.
Article in English | Scopus | ID: covidwho-1231736

ABSTRACT

This paper reports on a post Covid-19 clinic within an acute hospital environment. Of the 155 patients who attended clinic, 29 per cent required additional psychological support. We outline the psychological wellbeing and psychological care pathways identified for patients. © 2021, British Psychological Society. All rights reserved.

7.
Br J Oral Maxillofac Surg ; 59(2): 249-250, 2021 02.
Article in English | MEDLINE | ID: covidwho-809376
9.
Journal of the American College of Cardiology ; 76(17):B96, 2020.
Article in English | EMBASE | ID: covidwho-887090

ABSTRACT

Background: Coronavirus disease-2019 (COVID-19) poses a risk for health care workers necessitating modifications to existing medical pathways. In particular, managing patients with suspected COVID-19 represents a risk to the delivery of a primary percutaneous coronary intervention (PPCI) pathway where time-dependent revascularization is key. Methods: We sought to evaluate the effect of the COVID-19 pandemic on an established ambulance-triggered PPCI program involving 2 high-volume heart attack centers in London, United Kingdom. A systematic analysis was performed in patients with ST-segment elevation myocardial infarction undergoing PPCI comparing the COVID-19 pandemic period March 1, 2020, to April 30, 2020, with a control group from the previous year. Results: During the study period, admissions through the PPCI pathway decreased by 34%. The time from symptoms onset to first call for help (2020: 11 min vs. 2019: 12 min;p = 0.90) and from symptom onset to arrival at PPCI center (2020: 183 min vs. 2019: 178 min;p = 0.99) were comparable;however, the time from arrival at PPCI center to revascularization decreased (2020: 44 min vs. 2019: 53 min;p = 0.0004). In-hospital mortality during the study period was significantly lower (5% vs. 15%;p = 0.04). COVID-19–positive patients (n = 8) had higher rates of cardiogenic shock (25%), intensive care unit admission (50%), and inpatient mortality (38%). [Formula presented] Conclusion: Our data show that the modifications to the existing PPCI pathway were not associated with treatment delay or adverse outcome. The reduction in ST-segment elevation myocardial infarction presentations raises concern that patients may not be seeking appropriate medical attention for chest pain. Importantly, we demonstrate that PPCI can be delivered safely and efficiently during the COVID-19 pandemic. Categories: OTHER: COVID-19

10.
Médecine et Maladies Infectieuses ; 50(6, Supplement):S99-S100, 2020.
Article | WHO COVID | ID: covidwho-726756

ABSTRACT

Introduction La pandémie à COVID-19 a touché presque tous les pays du monde, dont la France. Tous les départements français ont ouvert des unités dédiées pour la gestion de la phase aiguë de l’épidémie. Au sein de notre site, notre structure a été la seule à accueillir une unité pour gérer des patients confirmés COVID-19 positifs. En l’absence de soins intensifs sur place, ces patients étaient triés au SAU et ne venaient que les patients sans indication de soins intensifs en raison du bénéfice/risque attendu (âge, comorbidités). Pour activer cette unité, une équipe mutualisée a été mise en place que ce soit au niveau du personnel médical PM (seniors, internes, externes) que personnel non médical (PNM) détachés des services de médecine interne, pédiatrie, médecine du sport, consultation, endocrinologie, hépatologie de notre CHU. Un support psychologique a été proposé aux soignants et aux familles par une équipe mobile de psychiatrie. L’activité quotidienne a été réorganisée après la création de plusieurs binômes junior-senior, en service de 8h à 19h, 7 j/7. La continuité des soins a été assurée chaque jour par 3 staffs pour permettre respectivement les transmissions de la nuit entre PM et PNM ;l’état des lieux après la visite du matin ;les projets pour le lendemain. Tous les patients ont été réévalués chaque jour et réorientés selon une échelle de gravité structurée par 5 codes-couleurs. Les externes ont eu pour mission de contacter les familles du fait de la limitation des visites, ainsi que les médecins traitants afin d’améliorer la gestion après le RAD. Les patients ont été traités par oxygénothérapie et protocoles d’antibiothérapie et morphine. Matériels et méthodes Analyse descriptive des données personnelles, de la mortalité brute et des issues de l’hospitalisation. Résultats Entre le 13 mars et le 19 mai, 147 patients, 56 % d’eux de sexe féminin, ont été hospitalisés dans cette unité d’une capacité maximale de 25 lits. L’âge moyen était de 69 ans [18 ;97]. La durée moyenne du séjour a été de 5jours [0 : 29]. La mortalité totale était du 20,4 %, dont 51 % des patients sont rentrés vers leur domicile ou vers des EHPAD. Ensuite, 14,3 % des patients ont été transférés vers un autre service de médecine aiguë, et 12,2 % des patients a poursuit les soins dans un SSR. Conclusion L’organisation de ce service montre comme une équipe de PM et PNM avec fonds de travail différentes peut être rapidement mise en place pendant une période de crise. La présence d’un service dédié à la gestion des cas de COVID-19 sans indication à soins intensifs peut soulager des autres services au sein d‘un groupe hospitalier qui travaille en coordination. La mortalité des patients hospitalisés dans ce service reste baisse considérant les comorbidités et l’âge des patients. La durée courte du séjour a permis d’accueillir un grand nombre de patients et de garantir de places en médecine aiguë standard au sein du GH.

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