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1.
Embase; 2022.
Preprint in English | EMBASE | ID: ppcovidwho-338064

ABSTRACT

Background: Vaccination is considered the most effective control measure against COVID-19. Vaccine hesitancy and equitable vaccine allocation are important challenges to disseminating developed vaccines. To promote COVID-19 vaccination coverage, the government of Japan established the workplace vaccination program. However, while it appears that the program was effective in overcoming vaccine hesitancy, the program may have hindered the equitable allocation of vaccines because it mainly focused on employees of large companies. We investigated the relationship between company size and COVID-19 vaccination completion status of employees and the impact of the workplace vaccination program on this relationship. Methods: We conducted an internet-based prospective cohort study from December 2020 (baseline) to December 2021. The data were collected using a self-administered questionnaire survey. Briefly, 27,036 workers completed the questionnaire at baseline and 18,560 at follow-up. After excluding ineligible respondents, we finally analyzed the data from 15,829 participants. At baseline, the participants were asked about the size of the company they worked for, and at follow-up they were asked about the month in which they received their second COVID-19 vaccine dose and the availability of a company-arranged vaccination opportunity. Results: In each month throughout the observation period, the odds of having received a second COVID-19 vaccine dose were significantly lower for small-company employees than for large-company employees in the sex- and age-adjusted model. This difference decreased after adjusting for socioeconomic factors, and there was no significant difference after adjusting for the availability of a company-arranged vaccination opportunity. Conclusions: The workplace vaccination program implemented in Japan to control the COVID-19 pandemic may have been effective in overcoming vaccine hesitancy in workers;however, it may have caused an inequitable allocation of vaccines between companies of different sizes. Because people who worked for small companies were less likely to be vaccinated, it will be necessary to enhance support of vaccination for this population in the event of future infectious disease outbreaks. Trial registration: Not applicable.

2.
Embase; 2021.
Preprint in English | EMBASE | ID: ppcovidwho-337392

ABSTRACT

The coronavirus disease 2019 (COVID-19) has been ravaging throughout the world for more than two years and has severely impaired both human health and the economy. The causative agent, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) employs the viral RNA-dependent RNA polymerase (RdRp) complex for genome replication and transcription, making RdRp an appealing target for antiviral drug development. Here, we reveal that RdRp can recognize and utilize nucleoside diphosphates (NDPs) as a substrate to synthesize RNAs with an efficiency of about two thirds of using nucleoside triphosphates (NTPs) as a substrate. NDPs incorporation is also template-specific and has high fidelity. Moreover, RdRp can incorporate β-d-N4-hydroxycytidine (NHC) into RNA while using diphosphate form molnupiravir (MDP) as a substrate. We also observed that MDP is a better substrate for RdRp than the triphosphate form molnupiravir (MTP).

3.
Embase; 2022.
Preprint in English | EMBASE | ID: ppcovidwho-335073

ABSTRACT

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is known to present with pulmonary and extra-pulmonary organ complications. In comparison with the 2009 pandemic (pH1N1), SARS-CoV-2 infection is likely to lead to more severe disease, with multi-organ effects, including cardiovascular disease. SARS-CoV-2 has been associated with acute and long-term cardiovascular disease, but the molecular changes govern this remain unknown. In this study, we investigated the landscape of cardiac tissues collected at rapid autopsy from SARS-CoV-2, pH1N1, and control patients using targeted spatial transcriptomics approaches. Although SARS-CoV-2 was not detected in cardiac tissue, host transcriptomics showed upregulation of genes associated with DNA damage and repair, heat shock, and M1-like macrophage infiltration in the cardiac tissues of COVID-19 patients. The DNA damage present in the SARS-CoV-2 patient samples, were further confirmed by γ−H2Ax immunohistochemistry. In comparison, pH1N1 showed upregulation of Interferon-stimulated genes (ISGs), in particular interferon and complement pathways, when compared with COVID-19 patients. These data demonstrate the emergence of distinct transcriptomic profiles in cardiac tissues of SARS-CoV-2 and pH1N1 influenza infection supporting the need for a greater understanding of the effects on extra-pulmonary organs, including the cardiovascular system of COVID-19 patients, to delineate the immunopathobiology of SARS-CoV-2 infection, and long term impact on health.

5.
Modern Food Science and Technology ; 38(1):88-93, 2022.
Article in Chinese | Scopus | ID: covidwho-1771824

ABSTRACT

A highly sensitive visualization method for SARS-CoV-2 detection, based on loop-mediated isothermal amplification (LAMP) and molecular light switch [Ru(phen)2dppz]2+, was established. In this design, insulation cups replaced laboratory thermostats and blue flashlights replaced blue transilluminators, to realize the rapid on-site visual LAMP detection of SARS-CoV-2. Specific primers were designed for the N gene of SARS-CoV-2. LAMP amplification products were detected by [Ru(phen)2dppz]2+ with molecular light switch characteristics. Red fluorescence could be directly detected by naked eye using blue light flashlight. Single copy number SARS-CoV-2 gene fragments were detected with high specificity. The detection was rapid, requiring only 40 minutes to visually observe the results. The LAMP detection results for food samples artificially contaminated with SARS-CoV-2 pseudovirus were 100% consistent with the current gold-standard real-time fluorescent quantitative PCR method for SARS-CoV-2 detection. This method requires only insulation cups and blue flashlight, and can be used to supplement the real-time fluorescent PCR method to provide a fast and efficient on-site screening of food for SARS-CoV-2. © 2022, Editorial Board of Modern Food Science and Technology. All right reserved.

6.
Zhonghua Liu Xing Bing Xue Za Zhi ; 43(3): 297-304, 2022 Mar 10.
Article in Chinese | MEDLINE | ID: covidwho-1765986

ABSTRACT

Objective: Based on the geographic information systems, we exploreed the spatiotemporal clustering and the development and evolution of COVID-19 epidemic at prefectural level in China from the time when the epidemic was discovered to the time when the lockdown ended in Wuhan. Methods: The information and data of the confirmed COVID-19 cases from December 8, 2019 to April 8, 2020 were collected from 367 prefectures in China for a spatial autocorrelation analysis with software GeoDa, and software ArcGIS was used to visualize the results. Software SatScan was used for spatiotemporal scanning analysis to visualize the hot-spot areas of the epidemic. Results: The incidence of new cases of COVID-19 had obvious global autocorrelation and the partial autocorrelation results showed that incidence of COVID-19 had different spatial distribution at different times from December 8, 2019 to March 4, 2020. There was no significant difference in global autocorrelation coefficient from March 5, 2020 to April 8, 2020. The statistical analysis of spatiotemporal scanning identified two kinds of spatiotemporal clustering areas, the first class clustering areas included 10 prefectures, mainly distributed in Hubei, from January 13 to February 25, 2020. The secondary class clustering areas included 142 prefectures, mainly distributed in provinces in the north and east of Hubei, from January 23 to February 1, 2020. Conclusions: There was a clear spatiotemporal correlation in the distribution of the outbreaks in the early phase of COVID-19 epidemic (December 8, 2019-March 4, 2020) in China. With the decrease of the case and effective prevention and control measures, the epidemics had no longer significant correlations among areas from March 5 to April 8. The study results showed relationship with time points of start and adjustment of emergency response at different degree in provinces. Furthermore, improving the early detection of new outbreaks and taking timely and effective prevention and control measures played an important role in blocking the transmission.


Subject(s)
COVID-19 , Epidemics , COVID-19/epidemiology , China/epidemiology , Communicable Disease Control , Humans , Spatio-Temporal Analysis
7.
PubMed; 2021.
Preprint in English | PubMed | ID: ppcovidwho-330698

ABSTRACT

SARS-CoV-2 infection of human cells is initiated by the binding of the viral Spike protein to its cell-surface receptor ACE2. We conducted a targeted CRISPRi screen to uncover druggable pathways controlling Spike protein binding to human cells. We found that the protein BRD2 is required for ACE2 transcription in human lung epithelial cells and cardiomyocytes, and BRD2 inhibitors currently evaluated in clinical trials potently block endogenous ACE2 expression and SARS-CoV-2 infection of human cells, including those of human nasal epithelia. Moreover, pharmacological BRD2 inhibition with the drug ABBV-744 inhibited SARS-CoV-2 replication in Syrian hamsters. We also found that BRD2 controls transcription of several other genes induced upon SARS-CoV-2 infection, including the interferon response, which in turn regulates the antiviral response. Together, our results pinpoint BRD2 as a potent and essential regulator of the host response to SARS-CoV-2 infection and highlight the potential of BRD2 as a novel therapeutic target for COVID-19.

8.
Open Forum Infectious Diseases ; 8(SUPPL 1):S387-S388, 2021.
Article in English | EMBASE | ID: covidwho-1746427

ABSTRACT

Background. DNA vaccines are safe, tolerable, elicit humoral and cellular responses, allow for repeated dosing over time, are thermostable at room temperature, and are easy to manufacture. We present a compilation of Phase 1 and Phase 2 data of Inovio's US COVID-19 DNA Vaccine (INO-4800) targeting the full-length Spike antigen of SARS-CoV-2. A South Korean Phase 2 study is ongoing. Methods. Participants in the open-label Phase 1 trial received 0.5 mg, 1.0 mg or 2.0 mg intradermally (ID) followed by electroporation (EP) at Days 0 and 28. An optional booster dose was administered >6 months post-dose 2. The Phase 2 further compared the 1.0 mg and 2.0 mg doses against placebo in a total of 401 participants randomized at a 3:3:1:1 ratio. ClinicalTrials.gov identifiers: NCT04336410 and NCT04642638 Results. The majority of adverse events (AEs) related to INO-4800 across both trials were mild in severity and did not increase in frequency with age and subsequent doses. In Phase 1, 78% (14/18) and 84% (16/19) of subjects generated neutralizing antibody responses with geometric mean titers (GMTs) of 17.4 (95%CI 8.3, 36.5) and 62.3 (95% CI 36.4, 106.7) in the 1.0 and 2.0 groups, respectively (Figure 1). By week 8, 74% (14/19) and 100% (19/19) subjects generated T cell responses by Th1- associated IFNγ ELISPOT assay . Following a booster dose, neutralizing GMTs rose to 82.2 (95% CI 38.2, 176.9) and 124.7 (95% CI 62.8, 247.7) in the 1.0 mg and 2.0 mg groups, respectively, demonstrating the ability of INO-4800 to boost (Figure 2). In Phase 2, neutralizing antibody responses demonstrated GMTs of 93.6 (95%CI 77.3, 113.4) in the 1.0 mg dose group and 150.6 (95%CI 123.8, 183.1) in the 2.0 mg dose group (Figure 3). Conclusion. INO-4800 appears safe and tolerable as a primary series and as a booster with the induction of both humoral and cellular immune responses. In addition to eliciting neutralizing antibodies, INO-4800 also induced T cell immune responses as demonstrated by IFNγ ELISpot. Finally, as a homologous booster, INO-4800, when administered 6-10.5 months following the primary series, resulted in an increased immune response without increase in reactogenicity. The 2.0 mg dose was selected for Phase 3 evaluation.

9.
Embase; 2021.
Preprint in English | EMBASE | ID: ppcovidwho-330416

ABSTRACT

Background: Additional SARS-CoV-2 vaccines that are safe and effective as primary vaccines and boosters remain urgently needed to combat the COVID-19 pandemic. We describe the safety and durability of the immune responses following two primary doses and a homologous booster dose of an investigational DNA vaccine (INO-4800) targeting the full-length spike antigen. Methods: Three dosage strengths of INO-4800 (0.5 mg, 1.0 mg, and 2.0 mg) were evaluated in 120 age-stratified healthy adults. Intradermal injection of INO-4800 followed by electroporation at 0 and 4 weeks preceded an optional booster 6-10.5 months after the second dose. Results: INO-4800 appeared well tolerated, with no treatment-related serious adverse events. Most adverse events were mild and did not increase in frequency with age and subsequent dosing. A durable antibody response was observed 6 months following the second dose;a homologous booster dose significantly increased immune responses. Cytokine producing T cells and activated CD8+ T cells with lytic potential were significantly increased in the 2.0 mg dose group. Conclusion: INO-4800 was well tolerated in a 2-dose primary series and as a homologous booster in all adults, including the elderly. These results support further development of INO-4800 for use as a primary vaccine and as a booster.

11.
Journal of Clinical Oncology ; 40(4 SUPPL), 2022.
Article in English | EMBASE | ID: covidwho-1704253

ABSTRACT

Background: Primary care physicians (PCPs) provide essential support for cancer patients. Both primary and cancer care have been affected by the COVID-19 pandemic. In the US, cancer related encounters and screening decreased over 40% and 80% respectively in January to April 2020 compared to 2019 (London et al JCO Clin Cancer Inform 2020). However, the impact of the pandemic on primary care access for cancer patients remains unclear. Methods: This was a population-based, retrospective cohort study using administrative healthcare databases held at ICES in Ontario, Canada. Patients with a new gastrointestinal (GI) malignancy diagnosed within the year prior to the pandemic, between July 1 and Sept 30, 2019 (COVID-19 cohort), were compared to patients diagnosed in years unaffected by the pandemic, between July 1 - Sept 30, 2018 and July 1 - Sept 30, 2017 (pre-pandemic cohort). Both groups were followed for 12 months after initial cancer diagnosis. In the COVID-19 cohort, this allowed for at least 4 months of follow-up data occurring during the pandemic. The primary outcome was number of in-person and telemedicine visits with a PCP. Secondary outcomes were number of in-person and telemedicine visits with a medical oncologist, number of emergency department (ED) visits, and number of unplanned hospitalizations. Outcomes, reported as number of visits per person-year, were compared between the COVID-19 and pre-pandemic cohorts. Results: 2833 individuals diagnosed with a new GI malignancy in the COVID-19 cohort were compared to 5698 individuals in the pre-pandemic cohort. The number of in-person visits to PCPs per person-year significantly decreased from 7.13 [95% CI 7.05 - 7.20] in the pre-pandemic cohort to 4.75 [4.66 - 4.83] in the COVID-19 cohort. Telemedicine visits to PCPs increased from 0.06 [0.05 - 0.07] to 2.07 [2.01 - 2.12]. Combined in-person and telemedicine visits to PCPs decreased from 7.19 [7.11 - 7.26] to 6.82 [6.71 - 6.92]. In-person visits to medical oncologists decreased from 3.73 [3.68 - 3.79] to 2.87 [2.80 - 2.94], and telemedicine visits increased from 0.10 [0.10 - 0.11] to 0.95 [0.91 - 0.99]. Combined in-person and telemedicine visits to medical oncologists remained stable (3.84 [3.78 - 3.89] vs. 3.82 [3.74 - 3.90]). The number of ED visits per person-year decreased from 1.04 [1.01 - 1.07] in the pre-pandemic cohort to 0.93 [0.89 - 0.97] in the COVID-19 cohort. Unplanned hospitalizations did not show a significant change (0.56 [0.54 - 0.58] vs. 0.53 [0.50 - 0.56]). Conclusions: PCP visits for patients with newly diagnosed GI malignancies overall decreased during the pandemic, with a dramatic shift from in-person to telemedicine visits. Visits to medical oncologists also shifted from in-person to telemedicine, but the overall combined visits remained the same. While the number of ED visits decreased, the shift in ambulatory practices did not seem to impact the number of unplanned hospitalizations.

12.
Embase;
Preprint in English | EMBASE | ID: ppcovidwho-327005

ABSTRACT

Highly transmissible SARS-CoV-2 Omicron variant has posted a new crisis for COVID-19 pandemic control. Within a month, Omicron is dominating over Delta variant in several countries probably due to immune evasion. It remains unclear whether vaccine-induced memory responses can be recalled by Omicron infection. Here, we investigated host immune responses in the first vaccine-breakthrough case of Omicron infection in Hong Kong. We found that the breakthrough infection rapidly recruited potent cross-reactive broad neutralizing antibodies (bNAbs) against current VOCs, including Alpha, Beta, Gamma, Delta and Omicron, from unmeasurable IC50 values to mean 1:2929 at around 9-12 days, which were higher than the mean peak IC50 values of BioNTech-vaccinees. Cross-reactive spike- and nucleocapsid-specific CD4 and CD8 T cell responses were detected. Similar results were also obtained in the second vaccine-breakthrough case of Omicron infection. Our preliminary findings may have timely implications to booster vaccine optimization and preventive strategies of pandemic control.

13.
Embase;
Preprint in English | EMBASE | ID: ppcovidwho-326959

ABSTRACT

Background: Nearly 4 billion doses of the BioNTech-mRNA and Sinovac-inactivated vaccines have been administrated globally, yet different vaccine-induced immunity against SARS-CoV-2 variants of concern (VOCs) remain incompletely investigated. Methods: We compare the immunogenicity and durability of these two vaccines among fully vaccinated Hong Kong people. Findings: Standard BioNTech and Sinovac vaccinations were tolerated and induced neutralizing antibody (NAb) (100% and 85.7%) and spike-specific CD4 T cell responses (96.7% and 82.1%), respectively. The geometric mean NAb IC50 and median frequencies of reactive CD4 subsets were consistently lower among Sinovac-vaccinees than BioNTech-vaccinees. Against VOCs, NAb response rate and geometric mean IC50 against B1.351 and B.1.617.2 were significantly lower for Sinovac (14.3%, 15 and 50%, 23.2) than BioNTech (79.4%, 107 and 94.1%, 131). Three months after vaccinations, NAbs to VOCs dropped near to detection limit, along with waning memory T cell responses, mainly among Sinovac-vaccinees. Interpretation: Our results indicate that Sinovac-vaccinees may face higher risk to pandemic VOCs breakthrough infection.

14.
Circulation ; 144(SUPPL 1), 2021.
Article in English | EMBASE | ID: covidwho-1638304

ABSTRACT

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has influenced epidemiology through direct and indirect effects, yet the impact on out-of-hospital cardiac arrest (OHCA) is unclear. We aimed to evaluate the impact of the pandemic on the incidence, characteristics, and clinical outcomes of OHCA. Hypothesis: We hypothesized that compared to the pre-pandemic period, the COVID-19 pandemic period was associated with increased incidence and case fatality rate (CFR) of OHCA, as well as decreased rates of intermediate clinical outcomes (termination of resuscitation [TOR], return of spontaneous circulation [ROSC], survival to hospital admission, and survival to hospital discharge). We further postulated that there was a change in the etiologies of OHCA during the pandemic as well as a decline in the rate of shockable rhythm as the initial presenting rhythm. Methods: In this systematic review and meta-analysis, five scientific databases were searched from inception to May 3, 2021. Meta-analyses were performed for the primary outcomes, secondary outcomes, and clinical characteristics. This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42021253879). Results: The search yielded 966 articles. 20 articles were included for analysis. The COVID-19 pandemic was associated with a 39.5% increase in pooled annual OHCA incidence (p<0.001). Pooled CFR was increased by 2.65% (p<0.001), with an odds ratio (OR) of 1.95 for mortality (95% confidence interval [95%CI] 1.51-2.51). There was increased field TOR (OR=2.46, 95%CI 1.62- 3.74). There were decreased ROSC (OR=0.65, 95%CI 0.55-0.77), survival to hospital admission (OR=0.65, 95%CI 0.48-0.89), and survival to discharge (OR=0.52, 95%CI 0.40-0.69). There was decreased shockable rhythm (OR=0.73, 95%CI 0.60-0.88) and increased asphyxial etiology of OHCA (OR=1.17, 95%CI 1.02-1.33). There was moderate-to-high statistical heterogeneity. Findings were robust to sensitivity analyses, with no publication bias detected. Conclusions: The COVID-19 pandemic was associated with significant changes in OHCA epidemiology. Compared to the pre-pandemic period, the pandemic period was associated with increased OHCA incidence and worse outcomes.

15.
Gastroenterology ; 160(6):S-90, 2021.
Article in English | EMBASE | ID: covidwho-1599376

ABSTRACT

BACKGROUND: COVID-19 patients can have persistent viral stool positivity despite negative respiratory samples, irrespective of symptoms. These patients could potentially go undetected under the current pre-endoscopy COVID-19 testing guidance recommendations. However, the clinical significance of viral RNA in the stool remains unclear. AIMS: We aimed to prospectively determine whether SARS-CoV-2 is detected via real-time reversetranscriptase polymerase chain reaction (rRT-PCR) in the GI tract of patients scheduled for endoscopy and if the virus obtained from these clinical specimens could be isolated in culture. METHODS: All patients underwent symptom screening and had negative nasopharyngeal testing for SARS-CoV-2 within 72 hours of their scheduled procedure. Study samples were collected via repeat nasopharyngeal swab, rectal swab, and fluid from the upper GI tract and/or colon based on their endoscopic procedure(s). Samples were tested for SARSCoV-2 via rRT-PCR. Clinical specimens confirmed to be positive for SARS-CoV-2 RNA were then isolated and cultured in Vero-E6 cells. RESULTS: 243 patients (mean age 63.1 years;54.3% men) were enrolled from July 15th, 2020 to September 2nd, 2020 (Table 1). Most patients (177;72.8%) were asymptomatic, with nausea/vomiting (23;9.5%) being the most commonly reported COVID-19 related symptom. SARS-CoV-2 testing was performed from 242(99.6%) nasopharyngeal, 243(100%) rectal, 183(75.3%) upper GI tract and 73(30%) colon samples. Only 1 patient (0.4%), with a history of COVID-19 infection 45 days prior to endoscopy, tested positive for SARS-CoV-2 on all the GI clinical specimens (fluid from upper GI tract, colon, and rectal swab), despite being asymptomatic and having 3 negative nasopharyngeal swabs 40, 37 and 3 days before her procedure (Figure 1). After 14-day incubation period, there was no evidence of virus growth in cells incubated with any of these specimens. CONCLUSIONS: SARS-CoV-2 is rarely detected in the GI tract of patients with negative screening nasopharyngeal COVID-19 testing prior to endoscopy. Infectious virus was not detected by culture from any of the GI specimens positive for SARS-CoV-2 RNA by rRT-PCR. Our results further highlight that presence of viral genome on its own is not sufficient proof of infectivity. Additional studies are needed to evaluate the temporal association between COVID-19 symptom onset and potential infectivity duration in the GI tract. (Table Presented)(Figure Presented)

16.
Blood ; 138:1390, 2021.
Article in English | EMBASE | ID: covidwho-1582265

ABSTRACT

Background Current NCCN guidelines recommend 1 of 3 first-line (1L) regimens for stage III or IV classical Hodgkin lymphoma (cHL): ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine), A+AVD (brentuximab vedotin, doxorubicin, vinblastine, dacarbazine), or escalated BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, prednisone);preferred regimens vary by region (e.g., North America vs Europe). The NCCN recommends positron emission tomography/computerized tomography (PET/CT) imaging after cycle 2 (interim PET2) to guide ABVD escalation or de-escalation. We surveyed physicians on their cHL treatment decision-making process and how PET/CT scan access, reimbursement, and comprehension influence their choices as part of CONNECT, the first real-world survey of physicians, patients, and caregivers in cHL. Methods Medical oncologists, hematologist/oncologists, or hematologists who treat cHL were invited to participate in an Institutional Review Board-approved, 30-minute online anonymous survey. Eligible participants had ≥2 years of practice experience in the United States (US) and treated ≥1 adult (aged ≥18 years) with stage III or IV cHL and ≥1 adult with cHL in the 1L setting within the prior 12 months. Surveys were completed from October 19, 2020-November 16, 2020. Results Of 301 participating physicians, 80% were hematologist/oncologists with a median practice duration of 15 years;62% practiced in community and 38% in academic settings. Participants were located in the US (South, 34%;Northeast, 26%;West, 21%;Midwest, 20%) and spent 90% of their professional time in direct patient care. In the preceding 12 months, participants treated a median (interquartile range) of 16 (7-40) patients with active cHL (stage III [median], 4;stage IV, 5) and 15 (8-40) cHL survivors. When treating cHL, 88% of participants reported giving NCCN guidelines somewhat/significant consideration. Overall, 94% of participants (n=284) reported using a PET/CT combined scan to diagnose/stage cHL, in line with current guideline recommendations. Of these participants, 97% reported typically getting an interim PET/CT scan for stage III or IV cHL with 65% typically getting the scan after cycle 2 (Figure A). Participants reported both escalating and de-escalating treatment based on interim PET/CT results (Figure B) with 61% making decisions after cycle 2. Of participants using a PET/CT scan, 42% reported receiving both a Deauville score and a standardized uptake value (SUV;Figure C) with 62% of participants noting that the Deauville score was the primary system used for reviewing PET/CT results (Figure D). However, 19% of participants reported challenges interpreting PET/CT results. Among participants using a Deauville score (n=209), consensus was limited on what defined a positive scan (≥3, 44%;≥4, 37%). Challenges obtaining PET/CT scans were reported by 16% of participants using PET/CT scans. However, despite not reporting challenges 55% of participants on average were unable to obtain a PET/CT scan 20% of the time. Of participants using PET/CT scans, 86% reported typically receiving results within 2 business days and 14% within 3-5 business days. Twenty-one percent of participants reported that delays in PET/CT results affected their ability to use a PET-adaptive approach. Forty-nine percent of those using PET/CT scans reported increased difficulty in PET/CT access for stage III or IV cHL due to lack of insurance coverage. In absence of a PET/CT scan, 36% of participants reported using an interim biopsy and 63% an interim CT scan to inform treatment choices. Among all participants, 36% reported increased difficulty in getting patients with cHL access to PET/CT scans due to COVID-19. Conclusions Although participants consider NCCN guidelines when treating cHL, interim PET scans are not universally obtained after cycle 2 for stage III or IV cHL, with 65% of participants who use PET/CT scans obtaining an interim PET scan after cycle 2 for stage III or IV cHL. When PET/CT scans are obtained, Deau ille scores are commonly provided;however, there is variability in what is termed a positive or negative Deauville score. Challenges in obtaining PET/CT scans, with increased difficulty during COVID-19, were reported. Also, there are other barriers, such as lack of insurance, that may prohibit the optimal adherence to guidelines on interim PET/CT utilization. [Formula presented] Disclosures: Parsons: SeaGen: Consultancy. Yu: Seagen, Inc: Current Employment, Current equity holder in publicly-traded company. Liu: Seagen, Inc: Current Employment, Current equity holder in publicly-traded company. Kumar: Seagen, Inc: Consultancy. Fanale: Seagen, Inc: Current Employment, Current equity holder in publicly-traded company. Flora: Seagen, Inc: Research Funding.

17.
Blood ; 138:4011, 2021.
Article in English | EMBASE | ID: covidwho-1582152

ABSTRACT

Introduction: Primary care physicians are essential to cancer care. They frequently identify signs and symptoms leading to a diagnosis of cancer, and provide ongoing support and management of non-cancer health conditions during cancer treatment. Both primary care and cancer care have been greatly affected by the COVID-19 pandemic. In the United States, cancer-related patient encounters and cancer screening decreased over 40% and 80% respectively in January to April 2020 compared to 2019 (London et al. JCO Clin Cancer Inform 2020). However, the impact of the COVID-19 pandemic on primary care access for cancer patients remain unclear. Methods: We undertook a population-based, retrospective cohort study using healthcare databases held at ICES in Ontario, Canada. Patients with a new lymphoid or myeloid malignancy diagnosed within the year prior to the COVID-19 pandemic, between July 1, 2019 and September 30, 2019 (COVID-19 cohort) were compared to patients diagnosed in years unaffected by the COVID-19 pandemic, between July 1, 2018 - September 30, 2018 and July 1, 2017 - September 30, 2017 (pre-pandemic cohort). Both groups were followed for 12 months after initial cancer diagnosis. In the COVID-19 cohort, this allowed for at least 4 months of follow-up data occurring during the COVID-19 pandemic. The primary outcome was number of in-person and virtual visits with a primary care physician. Secondary outcomes of interest included number of in-person and virtual visits with a hematologist, number of visits to the emergency department (ED), and number of unplanned hospitalizations. Outcomes, reported as crude rates per 1000 person-months, were compared between the COVID-19 and pre-pandemic cohorts using Poisson regression modelling. Results: We identified 2882 individuals diagnosed with a new lymphoid or myeloid malignancy during the defined COVID-19 timeframe and compared them to 5997 individuals diagnosed during the defined pre-pandemic timeframe. The crude rate of in-person primary care visits per 1000 person-months significantly decreased from 574.4 [95% CI 568.5 - 580.4] in the pre-pandemic cohort to 402.5 [395.3 - 409.7] in the COVID-19 cohort (p < 0.0001). Telemedicine visits to primary care significantly increased from 5.3 [4.8 - 5.9] to 173.0 [168.4 - 177.8] (p < 0.0001). The rate of combined in-person and telemedicine visits to primary care did not change from 579.8 [573.8 - 585.8] in the pre-pandemic cohort to 575.5 [566.9 - 584.2] in the COVID-19 cohort (p = 0.43). In-person visits to hematologists decreased from 504.1 [498.5 - 509.7] to 432.8 [425.3 - 440.3] (p < 0.0001), and telemedicine visits to hematologists increased from 6.6 [6.0 - 7.3] to 75.9 [72.8 - 79.1] (p < 0.0001). The rate of combined visits to hematologists did not change from 510.7 [505.1 - 516.4] to 508.7 [500.6 - 516.8] (p = 0.68). The rate of ED visits significantly decreased from 95.1 [92.7 - 97.6] in the pre-pandemic cohort to 84.7 [81.4 - 88.0] in the COVID-19 cohort (p < 0.0001). The rate of unplanned hospitalizations did not change from 64.8 [62.8 - 66.8] to 65.7 [62.9 - 68.7] (p = 0.60). Conclusions: Primary care visits for patients with hematologic malignancies did not significantly change during the pandemic, but there was a sizeable shift from in-person to telemedicine visits. Similar findings were seen for visits to hematologists. While the rate of visits to the ED decreased, potentially due to concern of being exposed to the COVID-19 virus, the shift in ambulatory practices did not seem to impact the rate of unplanned hospitalizations. Disclosures: No relevant conflicts of interest to declare.

18.
IEEE Access ; 2021.
Article in English | Scopus | ID: covidwho-1574898

ABSTRACT

This paper proposes a joint model based on the generalized LASSO to smooth a time-varying graph. The model generalizes the gLASSO from a purely spatial setting to a spatial-temporal one. In the proposed model, the first term measures the fitting error, while the second term incorporates the structural information of graphs and total variations of time sequence, and hence the model can extract both temporal and spatial information. To illustrate the performance of the proposed model, we analyzed the simulated datasets for epidemic diseases and the real datasets for COVID-19 and mortality rate in mainland China. The results show that the proposed model can capture the trends/regions simultaneously in both temporal and spatial domains, being an effective model to analyze the problems that can be modelled as time-varying graphs. Author

20.
Oeconomia Copernicana ; 12(2):217-268, 2021.
Article in English | Scopus | ID: covidwho-1350626

ABSTRACT

Research background: The outbreak and spread of COVID-19 brought disastrous influences to the development of human society, especially the development of economy. Purpose of the article: Considering that knowing about the situations of the existing studies about COVID-19 and economy is not only helpful to understand the research progress and the connections between COVID-19 and economy, but also provides effective suggestions for fighting against COVID-19 and protecting economy, this paper analyzes the existing studies on COVID-19 and economy from the perspective of bibliometrics. Methods: Firstly, the discussion starts from the statistical analysis, in which the basic distributions of the studies on different countries/regions, different publication sources, different publication years, etc., are presented. Then, the paper shows the cooperation situations of the researchers from analyzing the related citation networks, co-citation networks and cooperation networks. Further, the theme analysis of the related studies is presented, in which the related co-occurrence networks are shown, and then the detailed analyses of the studies are introduced. Based on these analyses, the discussions about future research are presented, and finally we draw a conclusion. Findings & value added: The analyses not only present the basic situation on the research about COVID-19 and Economy, but also show the future research trends, which can provide meaningful research expectations. © 2021 Nicolaus Copernicus University.

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