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1.
Emergencias ; 34(3):222-224, 2022.
Article in Spanish | EMBASE | ID: covidwho-2030926

ABSTRACT

Background High-flow nasal cannulae (HFNC) deliver high flows of blended humidified air and oxygen via wide-bore nasal cannulae and may be useful in providing respiratory support for adults experiencing acute respiratory failure, or at risk of acute respiratory failure, in the intensive care unit (ICU). This is an update of an earlier version of the review. Objectives To assess the effectiveness of HFNC compared to standard oxygen therapy, or non-invasive ventilation (NIV) or non-invasive positive pressure ventilation (NIPPV), for respiratory support in adults in the ICU. Search methods We searched CENTRAL, MEDLINE, Embase, CINAHL, Web of Science, and the Cochrane COVID-19 Register (17 April 2020), clinical trial registers (6 April 2020) and conducted forward and backward citation searches. Selection criteria We included randomized controlled studies (RCTs) with a parallel-group or cross-over design comparing HFNC use versus other types of non-invasive respiratory support (standard oxygen therapy via nasal cannulae or mask;or NIV or NIPPV which included continuous positive airway pressure and bilevel positive airway pressure) in adults admitted to the ICU. Data collection and analysis We used standard methodological procedures as expected by Cochrane.

2.
Gut ; 71:A94, 2022.
Article in English | EMBASE | ID: covidwho-2005364

ABSTRACT

Introduction During the COVID-19 pandemic gastroscopy was halted with large burden on recovery and risk of late diagnosis. We established an early diagnosis service using Cytosponge to triage patients to timely gastroscopy and management Methods 2 patient cohorts were used: 1. Barrett's oesophagus (BO) on endoscopic surveillance 2. Patients with symptoms of gastro-oesophageal reflux referred for routine gastroscopy. Exclusions were patients with dysplasia on last gastroscopy, fundoplication, pregnancy and patient preference. Triage of patients on the waiting list was from endoscopy referrals, Barrett's surveillance database and telephone triage. 2 research nurses and 2 clinical nurse specialists were trained in delivering Cytosponge. A patient satisfaction survey was completed. All cytology specimens were analysed by Cyted. Results were relayed to patients within 4 weeks by consultant led nurse-run teleclinic and letter. Clinical triage was according to the table below. TFF3+ was used as a marker for intestinal metaplasia (IM), P53+ve and atypia for potential dysplastic change. Results 470 patients agreed to Cytosponge over 14 months November 2020-January 2022. 22 cancelled-mostly COVID related. 34 failed to swallow (5.5% of Barrett's, 8.9% reflux). of those successfully swallowing the sponge 6% were inadequate samples in Barrett's and 9% reflux. No major adverse events occurred. Conclusion We report on the largest single site series of Cytosponge in non-specialist clinical practice in England and its pragmatic use in patients management and pandemic recovery. Significant benefits in the Barrett's cohort were timely identification of dysplasia and those longer requiring surveillance. Benefits in the reflux group include identification of new BO, avoiding unnecessary gastroscopy and early discharge. Overall reduced endoscopy resulted in reduced cost, lower carbon footprint and improved patient experience. Careful follow up and longer-term outcomes will provide confidence to continue this new technique in routine clinical practice.

3.
Open Forum Infectious Diseases ; 8(SUPPL 1):S395-S396, 2021.
Article in English | EMBASE | ID: covidwho-1746412

ABSTRACT

Background. Patients with lymphoid malignancies are at high risk of severe COVID-19 disease and were not included in the phase 3 mRNA vaccine trials. Many patients with lymphoid malignancies receive immunosuppressive therapies, including B-cell depleting agents, that may negatively impact humoral response to vaccination. Methods. We recruited patients with lymphoid malignancies and healthy participants who planned to receive two doses of SARS-CoV-2 mRNA vaccine (BNT162b2 or mRNA-1273). Blood was drawn at baseline, prior to second dose of vaccine, and 28 days after last vaccination. Disease characteristics and therapies were extracted from patients' electronic medical record. An ultrasensitive, single molecule array (Simoa) assay detected anti-Spike (S), anti-S1, anti-receptor binding domain (RBD), and anti-Nucleocapsid (N) IgG from plasma at each timepoint. Results. 23 healthy participants and 37 patients with lymphoid malignancies were enrolled (Table 1). Low titers of anti-N (Fig 1A) demonstrate no prior exposure or acquisition of COVID-19 before vaccination or during the study. 37.8% of the lymphoid malignancy cohort responded to the vaccine, using an internally validated AEB cutoff of 1.07. A significantly higher magnitude of anti-S (p< 0.0001), anti-S1 (p< 0.0001) and anti-RBD (p< 0.0001) are present in the healthy as compared to lymphoid malignancy cohort at the second dose and day 28 post-series (Fig 1B, Fig 1C and Fig 1D). Anti-S IgG titers were compared between the healthy cohort, treatment naI&Die;ve, and treatment experienced groups (Fig 2). The treatment naI&Die;ve cohort had high titers by series completion which were not significantly different from the healthy cohort (p=0.2259), although the treatment experienced group had significantly decreased titers (p< 0.0001). Of the 20 patients who had received CD20 therapy, there was no clear correlation of anti-S IgG response with time from CD20 therapy, although most patients who received CD20 therapies within 12 months from the vaccine had no response (Figure 3). Conclusion. The vaccine-induced immune response was poor among treatment-experienced patients with lymphoid malignancies, especially among those who received CD20 therapies within 12 months.

4.
Molecular Genetics and Metabolism ; 132:S290-S291, 2021.
Article in English | EMBASE | ID: covidwho-1735100

ABSTRACT

Background: The Medical Biochemical Genetics (MBG) Fellowship is an Accreditation Council of Graduate Medical Education (ACGME) subspecialty,one-year training program designed to prepare ClinicalMedical Genetics and Genomics graduates for practice in the diagnosis and treatment of inborn errors of metabolism (IEM). The ACGMErequires each program to provide “structured education, includingformal coursework in the basic sciences and clinical areas pertinent tobiochemical genetics”. There are currently 19 programs around theUnited States (US). Most have only one fellow per year. An average of18 MBG fellows every two years sit for the board examination. Eachprogram has a separate, individual curriculum. This puts a potentiallylarge burden on faculty to generate and teach didactic lectures for asingle fellow per year, and limits the fellow to learn in isolation,without interaction with the greater US IEM community. In 2020,amidst the COVID-19 pandemic, faculty at the University of Coloradoapproached the program directors of the individual MBG programsacross the US to establish a unified MBG curriculum to meet the“formal coursework” requirement. Twelve MBG programs opted totake part.Methods: A curriculum, designated as the MBG Clinical Core SeminarSeries (CCSS),was established to included 13 lectures covering contentfrom the American Board of Medical Genetics and GenomicsBiochemical Genetics Blueprint. Sessions were held weekly fromAugust through November of 2020 using a virtual platform (https://zoom.us/). Each session was designated to be 90 minutes: 75 min fordidactic teaching and 15 min for questions/interaction with the facultyspeaker and one another. Lectures were taught by expert faculty,boarded in Medical/Clinical Biochemical Genetics and well-known inthe field for the lecture subject matter. Invitations were sent out toMBG programs nationwide, and responding participants were addedto an email listserv that was kept through the MBG program at theUniversity of Colorado. Attendance was not limited to MBG fellows,but faculty were instructed to focus on MBG fellows as the primaryaudience. After each lecture, opportunity was given to all participantsto engage in a brief survey to evaluate the class using 3 generalquestions (see below) and response both by free text and using a Likertscale (5 = Strongly Agree to 1 = Strongly Disagree). Lectures wererecorded on ZOOM, and recordings with accompanying referencematerialwere distributed to the entire listserv using a Dropbox link, aswell as uploaded and stored on the Society for Inherited MetabolicDisease website.Results: The number of participants on the listservwas 217 by the endof the lecture series. Synchronous participation included an average of75 participants per session. In total, there were 98 responses to thethree questions in the survey. Respondents include both MBG andClinical Biochemical Genetics (CBG) fellows (22 responses), as well asattending physicians, genetics/pediatrics residents, genetic counselors,advanced practice providers, and nurses. Participants scored thethree questions as follows: “This session will improve my ability todiagnose and manage metabolic patients” (4.60 ± 0.59);“This sessionmade me feel more connected to the larger metabolic community”(4.62 ± 0.65);and “This session was high-yield given breadth anddepth of content and time allotted” (4.61 ± 0.65). Of note, MBG andCBG fellow responses to the three questions were 4.73 ± 0.54,4.36 ± 0.83, and 4.77 ± 0.41, respectively. Free text comments weregenerally positive, with the major critiques being the large amount ofcontent for time allotted and the desire for board-related practicequestions.Conclusions: The MBG-CCSS endeavored to create a unique opportunityfor trainees to network, facilitate teaching by nationallyrecognized experts, and minimize duplication of effort in individualtraining programs. These goals were all achieved with great success.An unexpected finding was the level of interest from a much largernumber of individuals than expected, far more than th US cohort ofMBG fellows. This points to a significant unmet demand for IEMfocusededucation at all levels around the country. Evaluation scoresfrom fellows, as well as comments, indicate several areas forimprovement including 1) less content per session 2) more participantinteraction 3) incorporated board practice questions and 4) formalassessment of knowledge using a written final exam. We will alsostrive to improve fellow-fellow and fellow-faculty dialogue through interactive questions and smaller fellow-faculty-only discussions.Moving forward, we will continue to build on the success of the firstyear, to prepare and inspire IEM providers for independent clinicalpractice

5.
EuropePMC;
Preprint in English | EuropePMC | ID: ppcovidwho-327450

ABSTRACT

ABSTRACT Background SARS-CoV-2 emerged in the UK in January 2020 and spread rapidly in different communities. The UK Government introduced a series of measures including national ‘lockdowns’ and regional ‘tiers’ to control virus transmission. As the outbreak continued, new variants were detected through two national disease monitoring programmes. Longitudinal records of their emergence and spread provide information with which we investigate factors affecting disease spread and the effectiveness of interventions. Methods We analysed the spatio-temporal dynamics of positive tests for COVID-19 on Teesside, UK throughout 2020. We investigated putative risk factors for infection, specifically, socio-economic deprivation, weather, and government interventions (lockdown). We used a combination of disease mapping and mixed-effect modelling to investigate the dynamics of positive tests from two sampling strategies and the spread of particular variants of the virus as they emerged on Teesside. Results SARS-CoV-2 spread was related to the extent of social deprivation, lockdown interventions and weather conditions over the period of the study. Cases in the first wave appeared to be associated with the first lockdown, but interventions had less impact on the second wave. Conclusions There was spatial and temporal heterogeneity in the distribution of different lineages, with spread faster in some lineages than others and varying across the region. Positive tests within region appeared to be related to levels of socio-economic deprivation. The interventions appeared to have different effects in the two waves of disease, and were associated with reduced numbers of records in the first wave, but having no effect during the second.

6.
Robson, S. C.; Connor, T. R.; Loman, N. J.; Golubchik, T.; Nunez, R. T. M.; Bonsall, D.; Rambaut, A.; Snell, L. B.; Livett, R.; Ludden, C.; Corden, S.; Nastouli, E.; Nebbia, G.; Johnston, I.; Lythgoe, K.; Torok, M. E.; Goodfellow, I. G.; Prieto, J. A.; Saeed, K.; Jackson, D. K.; Houlihan, C.; Frampton, D.; Hamilton, W. L.; Witney, A. A.; Bucca, G.; Pope, C. F.; Moore, C.; Thomson, E. C.; Harrison, E. M.; Smith, C. P.; Rogan, F.; Beckwith, S. M.; Murray, A.; Singleton, D.; Eastick, K.; Sheridan, L. A.; Randell, P.; Jackson, L. M.; Ariani, C. V.; Gonçalves, S.; Fairley, D. J.; Loose, M. W.; Watkins, J.; Moses, S.; Nicholls, S.; Bull, M.; Amato, R.; Smith, D. L.; Aanensen, D. M.; Barrett, J. C.; Aggarwal, D.; Shepherd, J. G.; Curran, M. D.; Parmar, S.; Parker, M. D.; Williams, C.; Glaysher, S.; Underwood, A. P.; Bashton, M.; Loveson, K. F.; Byott, M.; Pacchiarini, N.; Carabelli, A. M.; Templeton, K. E.; de Silva, T. I.; Wang, D.; Langford, C. F.; Sillitoe, J.; Gunson, R. N.; Cottrell, S.; O'Grady, J.; Kwiatkowski, D.; Lillie, P. J.; Cortes, N.; Moore, N.; Thomas, C.; Burns, P. J.; Mahungu, T. W.; Liggett, S.; Beckett, A. H.; Holden, M. T. G.; Levett, L. J.; Osman, H.; Hassan-Ibrahim, M. O.; Simpson, D. A.; Chand, M.; Gupta, R. K.; Darby, A. C.; Paterson, S.; Pybus, O. G.; Volz, E. M.; de Angelis, D.; Robertson, D. L.; Page, A. J.; Martincorena, I.; Aigrain, L.; Bassett, A. R.; Wong, N.; Taha, Y.; Erkiert, M. J.; Chapman, M. H. S.; Dewar, R.; McHugh, M. P.; Mookerjee, S.; Aplin, S.; Harvey, M.; Sass, T.; Umpleby, H.; Wheeler, H.; McKenna, J. P.; Warne, B.; Taylor, J. F.; Chaudhry, Y.; Izuagbe, R.; Jahun, A. S.; Young, G. R.; McMurray, C.; McCann, C. M.; Nelson, A.; Elliott, S.; Lowe, H.; Price, A.; Crown, M. R.; Rey, S.; Roy, S.; Temperton, B.; Shaaban, S.; Hesketh, A. R.; Laing, K. G.; Monahan, I. M.; Heaney, J.; Pelosi, E.; Silviera, S.; Wilson-Davies, E.; Adams, H.; du Plessis, L.; Johnson, R.; Harvey, W. T.; Hughes, J.; Orton, R. J.; Spurgin, L. G.; Bourgeois, Y.; Ruis, C.; O'Toole, Á, Gourtovaia, M.; Sanderson, T.; Fraser, C.; Edgeworth, J.; Breuer, J.; Michell, S. L.; Todd, J. A.; John, M.; Buck, D.; Gajee, K.; Kay, G. L.; Peacock, S. J.; Heyburn, D.; Kitchman, K.; McNally, A.; Pritchard, D. T.; Dervisevic, S.; Muir, P.; Robinson, E.; Vipond, B. B.; Ramadan, N. A.; Jeanes, C.; Weldon, D.; Catalan, J.; Jones, N.; da Silva Filipe, A.; Williams, C.; Fuchs, M.; Miskelly, J.; Jeffries, A. R.; Oliver, K.; Park, N. R.; Ash, A.; Koshy, C.; Barrow, M.; Buchan, S. L.; Mantzouratou, A.; Clark, G.; Holmes, C. W.; Campbell, S.; Davis, T.; Tan, N. K.; Brown, J. R.; Harris, K. A.; Kidd, S. P.; Grant, P. R.; Xu-McCrae, L.; Cox, A.; Madona, P.; Pond, M.; Randell, P. A.; Withell, K. T.; Williams, C.; Graham, C.; Denton-Smith, R.; Swindells, E.; Turnbull, R.; Sloan, T. J.; Bosworth, A.; Hutchings, S.; Pymont, H. M.; Casey, A.; Ratcliffe, L.; Jones, C. R.; Knight, B. A.; Haque, T.; Hart, J.; Irish-Tavares, D.; Witele, E.; Mower, C.; Watson, L. K.; Collins, J.; Eltringham, G.; Crudgington, D.; Macklin, B.; Iturriza-Gomara, M.; Lucaci, A. O.; McClure, P. C.; Carlile, M.; Holmes, N.; Moore, C.; Storey, N.; Rooke, S.; Yebra, G.; Craine, N.; Perry, M.; Fearn, N. C.; Goudarzi, S.; Lyons, R. A.; Williams, T.; Haldenby, S. T.; Durham, J.; Leonard, S.; Davies, R. M.; Batra, R.; Blane, B.; Spyer, M. J.; Smith, P.; Yavus, M.; Williams, R. J.; Mahanama, A. I. K.; Samaraweera, B.; Girgis, S. T.; Hansford, S. E.; Green, A.; Beaver, C.; Bellis, K. L.; Dorman, M. J.; Kay, S.; Prestwood, L.; Rajatileka, S.; Quick, J.; Poplawski, R.; Reynolds, N.; Mack, A.; Morriss, A.; Whalley, T.; Patel, B.; Georgana, I.; Hosmillo, M.; Pinckert, M. L.; Stockton, J.; Henderson, J. H.; Hollis, A.; Stanley, W.; Yew, W. C.; Myers, R.; Thornton, A.; Adams, A.; Annett, T.; Asad, H.; Birchley, A.; Coombes, J.; Evans, J. M.; Fina, L.; Gatica-Wilcox, B.; Gilbert, L.; Graham, L.; Hey, J.; Hilvers, E.; Jones, S.; Jones, H.; Kumziene-Summerhayes, S.; McKerr, C.; Powell, J.; Pugh, G.; Taylor, S.; Trotter, A. J.; Williams, C. A.; Kermack, L. M.; Foulkes, B. H.; Gallis, M.; Hornsby, H. R.; Louka, S. F.; Pohare, M.; Wolverson, P.; Zhang, P.; MacIntyre-Cockett, G.; Trebes, A.; Moll, R. J.; Ferguson, L.; Goldstein, E. J.; Maclean, A.; Tomb, R.; Starinskij, I.; Thomson, L.; Southgate, J.; Kraemer, M. U. G.; Raghwani, J.; Zarebski, A. E.; Boyd, O.; Geidelberg, L.; Illingworth, C. J.; Jackson, C.; Pascall, D.; Vattipally, S.; Freeman, T. M.; Hsu, S. N.; Lindsey, B. B.; James, K.; Lewis, K.; Tonkin-Hill, G.; Tovar-Corona, J. M.; Cox, M.; Abudahab, K.; Menegazzo, M.; Taylor, B. E. W.; Yeats, C. A.; Mukaddas, A.; Wright, D. W.; de Oliveira Martins, L.; Colquhoun, R.; Hill, V.; Jackson, B.; McCrone, J. T.; Medd, N.; Scher, E.; Keatley, J. P.; Curran, T.; Morgan, S.; Maxwell, P.; Smith, K.; Eldirdiri, S.; Kenyon, A.; Holmes, A. H.; Price, J. R.; Wyatt, T.; Mather, A. E.; Skvortsov, T.; Hartley, J. A.; Guest, M.; Kitchen, C.; Merrick, I.; Munn, R.; Bertolusso, B.; Lynch, J.; Vernet, G.; Kirk, S.; Wastnedge, E.; Stanley, R.; Idle, G.; Bradley, D. T.; Poyner, J.; Mori, M.; Jones, O.; Wright, V.; Brooks, E.; Churcher, C. M.; Fragakis, M.; Galai, K.; Jermy, A.; Judges, S.; McManus, G. M.; Smith, K. S.; Westwick, E.; Attwood, S. W.; Bolt, F.; Davies, A.; De Lacy, E.; Downing, F.; Edwards, S.; Meadows, L.; Jeremiah, S.; Smith, N.; Foulser, L.; Charalampous, T.; Patel, A.; Berry, L.; Boswell, T.; Fleming, V. M.; Howson-Wells, H. C.; Joseph, A.; Khakh, M.; Lister, M. M.; Bird, P. W.; Fallon, K.; Helmer, T.; McMurray, C. L.; Odedra, M.; Shaw, J.; Tang, J. W.; Willford, N. J.; Blakey, V.; Raviprakash, V.; Sheriff, N.; Williams, L. A.; Feltwell, T.; Bedford, L.; Cargill, J. S.; Hughes, W.; Moore, J.; Stonehouse, S.; Atkinson, L.; Lee, J. C. D.; Shah, D.; Alcolea-Medina, A.; Ohemeng-Kumi, N.; Ramble, J.; Sehmi, J.; Williams, R.; Chatterton, W.; Pusok, M.; Everson, W.; Castigador, A.; Macnaughton, E.; Bouzidi, K. El, Lampejo, T.; Sudhanva, M.; Breen, C.; Sluga, G.; Ahmad, S. S. Y.; George, R. P.; Machin, N. W.; Binns, D.; James, V.; Blacow, R.; Coupland, L.; Smith, L.; Barton, E.; Padgett, D.; Scott, G.; Cross, A.; Mirfenderesky, M.; Greenaway, J.; Cole, K.; Clarke, P.; Duckworth, N.; Walsh, S.; Bicknell, K.; Impey, R.; Wyllie, S.; Hopes, R.; Bishop, C.; Chalker, V.; Harrison, I.; Gifford, L.; Molnar, Z.; Auckland, C.; Evans, C.; Johnson, K.; Partridge, D. G.; Raza, M.; Baker, P.; Bonner, S.; Essex, S.; Murray, L. J.; Lawton, A. I.; Burton-Fanning, S.; Payne, B. A. I.; Waugh, S.; Gomes, A. N.; Kimuli, M.; Murray, D. R.; Ashfield, P.; Dobie, D.; Ashford, F.; Best, A.; Crawford, L.; Cumley, N.; Mayhew, M.; Megram, O.; Mirza, J.; Moles-Garcia, E.; Percival, B.; Driscoll, M.; Ensell, L.; Lowe, H. L.; Maftei, L.; Mondani, M.; Chaloner, N. J.; Cogger, B. J.; Easton, L. J.; Huckson, H.; Lewis, J.; Lowdon, S.; Malone, C. S.; Munemo, F.; Mutingwende, M.; et al..
Embase;
Preprint in English | EMBASE | ID: ppcovidwho-326811

ABSTRACT

The scale of data produced during the SARS-CoV-2 pandemic has been unprecedented, with more than 5 million sequences shared publicly at the time of writing. This wealth of sequence data provides important context for interpreting local outbreaks. However, placing sequences of interest into national and international context is difficult given the size of the global dataset. Often outbreak investigations and genomic surveillance efforts require running similar analyses again and again on the latest dataset and producing reports. We developed civet (cluster investigation and virus epidemiology tool) to aid these routine analyses and facilitate virus outbreak investigation and surveillance. Civet can place sequences of interest in the local context of background diversity, resolving the query into different 'catchments' and presenting the phylogenetic results alongside metadata in an interactive, distributable report. Civet can be used on a fine scale for clinical outbreak investigation, for local surveillance and cluster discovery, and to routinely summarise the virus diversity circulating on a national level. Civet reports have helped researchers and public health bodies feedback genomic information in the appropriate context within a timeframe that is useful for public health.

7.
Transfusion Medicine ; 31(SUPPL 1):20, 2021.
Article in English | EMBASE | ID: covidwho-1457715

ABSTRACT

Heparin induced thrombocytopenia (HIT) occurs when patients generate an antibody response against the heparin/platelet factor 4 (PF4) complex. In some cases, these antibodies cause platelet activation and clinical thrombosis. The 'Four-T's' score assesses clinical likelihood of HIT. Anti-PF4 antibodies have been detected in patients suffering from vaccine-induced immune thrombotic thrombocytopenia (VITT) following SARS-CoV-2 vaccination and testing by ELISA is recommended. Various platelet activation and pF4/heparin complex antigen assays are employed to detect HIT antibodies. High test sensitivity increases likelihood of detecting of antibodies that do not cause clinical HIT. We compared the BioRad ID-PGIA test with the Werfen Acustar assay and the Werfen immunoassay in a comparative study of 12? HIT patients and two UKNEQAS supplementary exercises. The specificity of the BioRad ID-PGIA Heparin/PF4 gel filtration test is considered poor, although its negative predictive value is more reliable. The Werfen Acustar chemiluminescence assay and the Werfen HaemosIL HIT-ab latex immunoassay have comparable sensitivity and superior specificity to the BioRad test. Preliminary studies suggest all three assays have limited sensitivity to VITT. BioRad HIT results were positive for 10/12 patient samples. The two negative samples were also negative by Acustar and immunoassay. One additional sample was negative by Acustar but positive by immunoassay. Four further samples were negative by immunoassay but positive by Acustar. Patients deemed HIT positive by Acustar were switched to fondaparinux or argatroban. Continued heparin infusion did not cause clinical deterioration in the patient who tested HIT positive by immunoassay but not Acustar. The BioRad method obtained expected results for UKNEQAS distributions S20 and S21. Both Werfen methods obtained expected results for S20 but demonstrated poor sensitivity to VITT and HIT in S21. Agreement between results of the three HIT assays is limited but typical of expected patterns. Heparin is variable in terms of chain length and degree of sulphation, which affects degree of conformational change, and therefore antigenic presentation, of PF4 in complex with heparin. Variable antigenic profile in different assays leads to poor comparability of results. It is important to distinguish between HIT and VITT for the purposes of assay selection.

8.
Journal of the American Geriatrics Society ; 69:S57-S57, 2021.
Article in English | Web of Science | ID: covidwho-1195085
9.
Trends in Urology & Mens Health ; 12(1):22-25, 2021.
Article in English | Web of Science | ID: covidwho-1077566

ABSTRACT

Men living in deprivation are much more likely to die from all causes, and specifically as a result of COVID-19 infection, than men who are least deprived. Here the author argues that both short-term and long-term measures are needed to address this inequality, and that the pandemic has created a real opportunity to 'build back better'.

10.
Intertax ; 48:805-813, 2020.
Article in English | Scopus | ID: covidwho-1077220

ABSTRACT

This discussion piece considers some of the potential consequences for international taxation of the Covid-19pandemic and the economic recession. It considers tax measures that states may wish to take, as well as the impact onthe institutional structure of international taxation and the way in which we do international taxation. It considersthe introduction of excess profit taxes and progressive wealth taxes, as well as changes to the OECD agenda. Finally,it considers whether some of the new ways of working developed during lock-down will have long-term implications for international taxation. © 2020 Kluwer Law International BV, The Netherlands

11.
BJOG ; 127(10): 1229-1240, 2020 09.
Article in English | MEDLINE | ID: covidwho-614342

ABSTRACT

OBJECTIVES: To investigate the mental status of pregnant women and to determine their obstetric decisions during the COVID-19 outbreak. DESIGN: Cross-sectional study. SETTING: Two cities in China--Wuhan (epicentre) and Chongqing (a less affected city). POPULATION: A total of 1947 pregnant women. METHODS: We collected demographic, pregnancy and epidemic information from our pregnant subjects, along with their attitudes towards COVID-19 (using a self-constructed five-point scale). The Self-Rating Anxiety Scale (SAS) was used to assess anxiety status. Obstetric decision-making was also evaluated. The differences between cities in all of the above factors were compared and the factors that influenced anxiety levels were identified by multivariable analysis. MAIN OUTCOME MEASURES: Anxiety status and its influencing factors. Obstetric decision-making. RESULTS: Differences were observed between cities in some background characteristics and women's attitudes towards COVID-19 in Wuhan were more extreme. More women in Wuhan felt anxious (24.5 versus 10.4%). Factors that influenced anxiety also included household income, subjective symptom and attitudes. Overall, obstetric decisions also revealed city-based differences; these decisions mainly concerned hospital preference, time of prenatal care or delivery, mode of delivery and infant feeding. CONCLUSIONS: The outbreak aggravated prenatal anxiety and the associated factors could be targets for psychological care. In parallel, key obstetric decision-making changed, emphasising the need for pertinent professional advice. Special support is essential for pregnant mothers during epidemics. TWEETABLE ABSTRACT: The COVID-19 outbreak increased pregnant women's anxiety and affected their decision-making.


Subject(s)
Anxiety , Coronavirus Infections , Delivery, Obstetric , Pandemics , Pneumonia, Viral , Pregnancy Complications , Pregnant Women/psychology , Prenatal Care , Adult , Anxiety/diagnosis , Anxiety/epidemiology , Anxiety/etiology , Betacoronavirus , COVID-19 , China/epidemiology , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Coronavirus Infections/psychology , Cross-Sectional Studies , Delivery, Obstetric/methods , Delivery, Obstetric/psychology , Delivery, Obstetric/statistics & numerical data , Diagnostic Self Evaluation , Female , Humans , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Pneumonia, Viral/psychology , Pregnancy , Pregnancy Complications/diagnosis , Pregnancy Complications/epidemiology , Pregnancy Complications/etiology , Prenatal Care/methods , Prenatal Care/psychology , Prenatal Care/statistics & numerical data , Qualitative Research , SARS-CoV-2
12.
Anaesthesia ; 75(11): 1437-1447, 2020 11.
Article in English | MEDLINE | ID: covidwho-591680

ABSTRACT

Healthcare workers involved in aerosol-generating procedures, such as tracheal intubation, may be at elevated risk of acquiring COVID-19. However, the magnitude of this risk is unknown. We conducted a prospective international multicentre cohort study recruiting healthcare workers participating in tracheal intubation of patients with suspected or confirmed COVID-19. Information on tracheal intubation episodes, personal protective equipment use and subsequent provider health status was collected via self-reporting. The primary endpoint was the incidence of laboratory-confirmed COVID-19 diagnosis or new symptoms requiring self-isolation or hospitalisation after a tracheal intubation episode. Cox regression analysis examined associations between the primary endpoint and healthcare worker characteristics, procedure-related factors and personal protective equipment use. Between 23 March and 2 June 2020, 1718 healthcare workers from 503 hospitals in 17 countries reported 5148 tracheal intubation episodes. The overall incidence of the primary endpoint was 10.7% over a median (IQR [range]) follow-up of 32 (18-48 [0-116]) days. The cumulative incidence within 7, 14 and 21 days of the first tracheal intubation episode was 3.6%, 6.1% and 8.5%, respectively. The risk of the primary endpoint varied by country and was higher in women, but was not associated with other factors. Around 1 in 10 healthcare workers involved in tracheal intubation of patients with suspected or confirmed COVID-19 subsequently reported a COVID-19 outcome. This has human resource implications for institutional capacity to deliver essential healthcare services, and wider societal implications for COVID-19 transmission.


Subject(s)
Betacoronavirus , Coronavirus Infections/transmission , Health Personnel , Intubation, Intratracheal , Occupational Exposure/adverse effects , Pneumonia, Viral/transmission , Adult , COVID-19 , Coronavirus Infections/epidemiology , Female , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/epidemiology , Proportional Hazards Models , Prospective Studies , Risk , SARS-CoV-2
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