ABSTRACT
BACKGROUND AND OBJECTIVES: Despite the increasing evidence supporting the importance of airborne transmission in SARS-CoV-2 infection, it has not been considered relevant in the vast majority of reported nosocomial outbreaks of COVID-19. The aim of this study is to describe a nosocomial outbreak of SARS-CoV-2 infection whose features suggest that aerosol transmission had an important role. METHODS: This is a descriptive analysis of a nosocomial outbreak of SARS-CoV-2 infection in an internal medicine ward that occurred in December 2020. All cases were confirmed by a positive PCR test for SARS-CoV-2. RESULTS: From December 5 to December 17, 21 patients and 44 healthcare workers (HCWs) developed a nosocomial SARS-CoV-2 infection. Fifty-one of the 65 cases (78.5%) were diagnosed between December 6 and 9. The attack rate in patients was 80.8%. Among HCWs, the attack rate was higher in those who had worked at least one full working day in the ward (56.3%) than in those who had occasionally been in the ward (25.8%; pâ¯=â¯0.005). Three days before the first positive case was detected, two extractor fans were found to be defective, affecting the ventilation of three rooms. Sixteen cases were asymptomatic, 48 cases had non-severe symptoms, and 2 cases required admission to the intensive care unit. All patients eventually recovered. CONCLUSION: The high attack rate, the explosive nature of the outbreak, and the coincidence in time with the breakdown in air extractors in some rooms of the ward suggest that airborne transmission played a key role in the development of the outbreak.
ABSTRACT
INTRODUCTION: high-oxygen nasal cannulas in patients with respiratory failure secondary to SARS-CoV-2 pneumonia have not been studied from a cost-effectiveness point of view. METHODS: Retrospective analysis of patients who had entered the COVID-area of an intensive medicine service in a third reference hospital, between March-December 2020. An effectiveness cost analysis was carried out comparing 2therapeutic decisions: the experimental strategy was defined as a mixed strategy consisting of the initial application of high flow nasal oxygen (HFNO) and application of VMI only to HFNO failures. The optimal rational decision was defined as maximizing expected profit, and economic efficiency was assessed by calculating the Incremental Cost-Effectiveness Ratio (ICER) for years of life gained. RESULTS: Of the 185 patients tested, 101 (55%) received invasive mechanical ventilation immediately and 84 (45%) were treated with HFNO at the outset. In the cost-effectiveness analysis, comparing both therapeutic strategies, the probability that the experimental strategy would be more effective was 0.974, reaching statistical significance: Difference in average proportions -0.113; 95% CI:-0.018 to -0.208. This corresponds to an NNT of 9 patients. The optimal decision was HFNO's strategy followed by VMI in HFNO failures. This option had an RCEI of 5582 euros per year of life gained. CONCLUSIONS: It is important to establish in the future reliable markers in the use of HFNO so that this therapy improves its cost-effective benefits.
ABSTRACT
Background and objectives Despite the increasing evidence supporting the importance of airborne transmission in SARS-CoV-2 infection, it has not been considered relevant in the vast majority of reported nosocomial outbreaks of COVID-19. The aim of this study is to describe a nosocomial outbreak of SARS-CoV-2 infection whose features suggest that aerosol transmission had an important role. Methods This is a descriptive analysis of a nosocomial outbreak of SARS-CoV-2 infection in an internal medicine ward that occurred in December 2020. All cases were confirmed by a positive PCR test for SARS-CoV-2. Results From December 5 to December 17, 21 patients and 44 healthcare workers (HCWs) developed a nosocomial SARS-CoV-2 infection. Fifty-one of the 65 cases (78.5%) were diagnosed between December 6 and 9. The attack rate in patients was 80.8%. Among HCWs, the attack rate was higher in those who had worked at least one full working day in the ward (56.3%) than in those who had occasionally been in the ward (25.8%;p = 0.005). Three days before the first positive case was detected, two extractor fans were found to be defective, affecting the ventilation of three rooms. Sixteen cases were asymptomatic, 48 cases had non-severe symptoms, and 2 cases required admission to the intensive care unit. All patients eventually recovered. Conclusion The high attack rate, the explosive nature of the outbreak, and the coincidence in time with the breakdown in air extractors in some rooms of the ward suggest that airborne transmission played a key role in the development of the outbreak.
ABSTRACT
Background and objectives: Despite the increasing evidence supporting the importance of airborne transmission in SARS-CoV-2 infection, it has not been considered relevant in the vast majority of reported nosocomial outbreaks of COVID-19. The aim of this study is to describe a nosocomial outbreak of SARS-CoV-2 infection whose features suggest that aerosol transmission had an important role. Methods: This is a descriptive analysis of a nosocomial outbreak of SARS-CoV-2 infection in an internal medicine ward that occurred in December 2020. All cases were confirmed by a positive PCR test for SARS-CoV-2. Results: From December 5 to December 17, 21 patients and 44 healthcare workers developed a nosocomial SARS-CoV-2 infection. Fifty-one of the 65 cases (78.5%) were diagnosed between December 6 and 9. The attack rate in patients was 80.8%. Among workers, the attack rate was higher in those who had worked at least one full working day in the ward (56.3%) than in those who had occasionally been in the ward (25.8%, p = 0.005). Three days before the first positive case was detected, 2 extractor fans were found to be defective, affecting the ventilation of 3 rooms. Sixteen cases were asymptomatic, 48 cases had non-severe symptoms, and 2 cases required admission to the intensive care unit. All patients eventually recovered. Conclusion: The high attack rate, the explosive nature of the outbreak, and the coincidence in time with the breakdown in air extractors in some rooms of the ward suggest that airborne transmission played a key role in the development of the outbreak.
ABSTRACT
Introduction & Objectives: The TMPRSS2 protein has been found to be involved as a critical host cell factor in severe acute respiratory syndrome caused by coronavirus 2(SARS-CoV-2). The production of this protein is regulated by the androgen receptor (AR), also in non-prostatic tissues, including the lung. There is the speculation that androgen deprivation therapy (ADT) may protect patients affected by prostate cancer (PC) from SARS-CoV-2 infection. Our goal is to analyze the severity of COVID-19 in PC patients and the possible influence of ADT on this infection. Materials & Methods: Retrospective study of patients treated for COVID-19 between March 15th and May 15th 2020 in our institution who had previous diagnosis of PC. Patients were divided into two: Those treated with ADT during the infection or the year before, and those who were not treat with ADT on that period. Differences between groups in demographic characteristics, parameters of PC disease, risk factors for SARS-CoV-2 pneumonia, the presence of severe COVID-19 and mortality rates were analyzed. Results: During the study period, a total of 1365 patients were treated in our center for COVID-19 documented with positive PCR. From a total of 1349 subjects registered in our PC database, 156 were on ADT treatment and 1193 were not. Out of the total, 61 (4.52%) PC patients suffered from COVID-19, 11 (18.0%) belonged to the ADT group and 50(82.0%) to the non-ADT group. The mean age of the series was 77.6 years (SD:7.7). The cumulative incidence recorded of COVID-19 in total PC patients was 4.5% (95%CI: 3.5-5.8). Demographic variables, comorbidities and risk factors for infection were quite homogeneous in both groups. Although a worse tendency was observed in the non-ADT group, no statistically significant differences were found in any of the variables analyzed. Regarding the influence of ADT on the course of the disease, no statistically significant differences were found neither in the exitus rate (27.3% vs. 34.0%;p 0.481), nor in the presence of severe COVID-19: need for intubation or ICU admission(0% vs 6.3%;p 0.561) and need for corticoid treatment, interferon beta or tocilizumab (60% vs. 34.7%;p 0.128). In the univariate analysis, treatment with ADT was not found to be a protective factor for worse clinical evolution (RR 1.11;95%CI 0.67-1.85;p=0.68) or exitus (RR 0.8;95%CI 0.28-2.27;p=0.68). We also found no statistically significant differences when multivariate analysis adjusted for clinically relevant comorbidities was performed. Conclusions: In our study, the use of ADT has not been shown to be a protective factor against serious COVID-19. In view of the results published to date, more research in this area is definitely needed to draw firm conclusions.
ABSTRACT
To ensure high-quality educational processes, more educational research should be developed about student experiences during the COVID-19 pandemic. Furthermore, the student's perception about distance learning education (under the current situation) could be used as input for instructors and educational institutions to guide their distance learning process. The primary aim of this research is to explore engineering undergraduate student's perceptions about the online assessment methods during the COVID-19 age. This paper presents an exploratory-descriptive study based on content and quantitative analysis tools. The main findings of this research concern the factors perceived as the main differences between the face-to-face and online assessment by a group of engineering students during the current pandemic. These factors are: teaching presence, self-efficacy, autonomy, teamwork, and coherence between assessment and class. Furthermore, in the analyzed state-of-the-art, the last three factors have not been reported. These results will be used to guide the improvement of future online assessment methods in our engineering school. © 2022, Rajarambapu Institute Of Technology. All rights reserved.