ABSTRACT
Background: Since the beginning of the COVID-19 pandemic, there has been a growing recognition of its psychiatric implications. Anxiety, stress and sleep disorders are the main issues faced by healthcare professionals but less is known on the general population. We sought to determine the prevalence of neuro-psychiatric disorders, pain and fatigue in COVID-19 patients compared to healthy controls. The secondary outcome was to define the determinants of such disorders. Method(s): This single centre, prospective, observational, cohort study enrolled adult patients referring to the postCOVID-19 outpatient clinic of our University hospital from January 2021 to June 2021. Anthropometrical and functional respiratory data were collected, pain and fatigue were evaluated through a VAS scale while stress, anxiety, quality of sleep and the impact of the event were evaluated through questionnaires: perceived stress scale, ZUNG 1971, Pittsburgh and impact of events scale. Result(s): 301 cases and 115 controls were enrolled. The COVID-19 group had a higher prevalence of stress (scale points 18 vs 3, p<0.01), anxiety (ZUNG score 39 vs 21, p<0.01), and poor sleep (68.1% vs 6.1%, p<0.01). Alongside they had a significantly higher VAS pain score (2 vs 0, p<0.001) and VAS fatigue (3 vs 0, p<0.001). Female gender was the only feature that could predict fatigue, pain, anxiety, poor sleep quality and post-traumatic stress disorder syndrome. COVID-19 severity wasn't associated with any psichological sequelae. Conclusion(s): In an outpatient setting, stress, anxiety, sleep quality, pain and fatigue should be assessed in the holistic view of post-COVID-19 patients, especially in females.
ABSTRACT
Background In vitro diagnostic tests for SARS-COV2 have rapidly spread. However mostly single-center technical and diagnostic performance's evaluations have been carried out without an intralaboratory validation process and a HTA systematic approach. Therefore, the HTA for evaluating antibody tests for SARS-COV-2 was applied and the following objectives have been pursued: -Comparison of tests through the antibody titer in the SARS-CoV-2 vaccination campaign. -Assessment of the strategy implemented in the SARSCoV- 2 vaccination campaign. Materials & Methods A multidisciplinary team conducted the HTA following the DoHTA method. The three methodological and analytical steps used in the HTA were: the selection of the tests to be evaluated;the research and collection of information to support the adoption and appropriateness of the technology;and the drafting of the final report which allows its dissemination and communication. In addition, alternative vaccination strategies were evaluated through the application of an algorithm that takes into account the ability to reduce the number of deaths and general containment of the pandemic. Results Serological tests allow to evaluate antibody response at different time points. In particular, disaggregating the data by sex and by age shows that the antibody response is high in women <48 years and is lower in men >60 years. The algorithm showed a better performance of the TEST&VACCINE strategy compared to the VACCINE strategy (94.34%vs 83.87%). Conclusions Thanks to the availability of real world data relating to the serological analysis it was possible to investigate the evolution of the antibody response to vaccination against SARS-CoV-2 in a large cohort of subjects, and the possibility of a harmonization process of the serological laboratory data, through the use of a conversion factor. Finally, the possibility of defining differential temporal priorities in the target population constitute an important element in optimizing the vaccination campaign, due to the ability to reduce the number of deaths and general containment of the pandemic.
ABSTRACT
Technology plays an important role into the life of older people. With the increase of age, they are experiencing physical and cognitive frailties and they require assistance for the management of their daily activities. In this sense, digital technologies could offer a holistic ecosystem which could empower their daily life 24 h decreasing the caregiver burden. Multi-domains researchers are joining their efforts to propose a selection of services. In this context, this paper introduces the large scale pilot Pharaon project, pointing out the attention on the Italian pilot site. Within the Italian pilot, a personalized and integrated care service was and will be investigated in the forthcoming years to meet the challenge of older population. Particularly, the paper introduces the methodology and the actions performed to face the covid-19 pandemic which affect the first stage of the process, the service domains, and the methodology applied. Additionally, the paper presents and discusses the key performance indicators related to impact, business, social and clinical domains and how the technology is used within the Italian pilot to support the population during the pandemic emergency. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.
ABSTRACT
Background: Neurological disability progression occurs across the spectrum of people living with multiple sclerosis (PwMS). Currently, no treatments exist that substantially modify the course of clinical progression in MS, one of the greatest unmet needs in clinical practice. Characterizing the determinants of clinical progression is essential for the development of novel therapeutic agents and treatment approaches that target progression in PwMS. Objectives: The overarching aim of CanProCo is to evaluate a wide spectrum of factors associated with the onset and rate of disease progression in MS, and to describe how these factors interact with one another to influence progression. Methods: CanProCo is a prospective, observational cohort study aiming to recruit 1000 individuals with radiologically-isolated syndrome (RIS), relapsing-remitting MS (RRMS), and primary-progressive MS (PPMS) within 10-15 years of disease onset, and 50 healthy controls (HCs) from five large academic MS centers in Canada. Participants undergo detailed clinical evaluations annually. A subset of participants enrolled within 5-10 years of disease onset (n=500) also have blood, cerebrospinal fluid, and MRIs collected facilitating study of biological measures (e.g. single-cell RNAsequencing[ scRNASeq]), MRI-based microstructural assessment, participant characteristics (self-reported, performance-based, clinician- assessed, health-system based), and environmental factors as determinants contributing to the differential progression in MS. Results: Recruitment commenced in April/May 2019 and n=536 patients have been recruited to date (RRMS=457, PPMS=35, RIS=25, HC=19). Baseline age, sex distribution, and Expanded Disability Status Scale (EDSS) scores (median, range) of each subgroup are: RRMS=38 years, 73% female, EDSS=1.5 (0-6.0);PPMS=52 years, 40% female, EDSS=4.0 (1.5-6.5);RIS=41 years, 68% female, EDSS=0 (0-3.0);HC=37 years, 63% female. Recruitment has surpassed the 50% target but has been paused due to the COVID-19 pandemic. scRNASeq on frozen blood samples has been validated. Conclusions: Halting the progression of MS is a fundamental clinical need to improve the lives of PwMS. Achieving this requires leveraging transdisciplinary approaches to better characterize mechanisms underlying clinical progression. CanProCo is the first prospective cohort study aiming to characterize these determinants to inform the development and implementation of efficacious and effective interventions.