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1.
World Allergy Organ J ; 15(9): 100686, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-2031741

ABSTRACT

An outbreak of coronavirus disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) started in Wuhan, Hubei Province, China and quickly spread around the world. Current evidence is contradictory on the association of asthma with COVID-19 and associated severe outcomes. Type 2 inflammation may reduce the risk for severe COVID-19. Whether asthma diagnosis may be a risk factor for severe COVID-19, especially for those with severe disease or non-allergic phenotypes, deserves further attention and clarification. In addition, COVID-19 does not appear to provoke asthma exacerbations, and asthma therapeutics should be continued for patients with exposure to COVID-19. Changes in the intensity of pollinization, an earlier start and extension of the pollinating season, and the increase in production and allergenicity of pollen are known direct effects that air pollution has on physical, chemical, and biological properties of the pollen grains. They are influenced and triggered by meteorological variables that could partially explain the effect on COVID-19. SARS-CoV-2 is capable of persisting in the environment and can be transported by bioaerosols which can further influence its transmission rate and seasonality. The COVID-19 pandemic has changed the behavior of adults and children globally. A general trend during the pandemic has been human isolation indoors due to school lockdowns and loss of job or implementation of virtual work at home. A consequence of this behavior change would presumably be changes in indoor allergen exposures and reduction of inhaled outdoor allergens. Therefore, lockdowns during the pandemic might have improved some specific allergies, while worsening others, depending on the housing conditions.

2.
Journal of Cystic Fibrosis ; 21:S48, 2022.
Article in English | EMBASE | ID: covidwho-1996760

ABSTRACT

Background: CFTR modulators have led to improvements in CF outcomes, including FEV1, exacerbation frequency and body mass index (BMI). Despite positive outcomes, modulators have brought new challenges – particularly elevated BMI. For many, weight gain has been due to increased fat rather than muscle mass, making exercise a high priority. Exercise has always been an integral part of CF management. However, the COVID-19 pandemic has made it harder for patients to access exercise. This presented a service need to set up a platform where patients could safely exercise at home with support from a known physiotherapist. Objectives: To assess the feasibility and acceptability of a physiotherapyled online group exercise class for CF patients. Methods: In this pilot study, high and low intensity virtual exercise classes were delivered twice weekly over four weeks. Eight participants were recruited;five completed the study. The primary outcomes were (1) feasibility, assessed by means, resources and time needed to deliver the intervention and (2) acceptability, assessed by qualitative interviews with participants. FEV1, BMI, 60STS and psychosocial outcomes were also monitored. Results: Time, resources and equipment were all adequate to deliver the intervention within the service. Positive themes from interviews included: (1) Impact on health: improved fitness, (2) Motivation to exercise: feeling encouraged, supported and accountable, and (3) Convenience: saved time, money and ease of exercising at home. Some challenges patients reported were space, technical issues with equipment and missing face-to-face interaction. Conclusion: Virtual exercise classes for patients with CF are both feasible and acceptable, with patients reporting a positive impact on their fitness levels as well as reduced travel burden. Patients also stated that classes delivered by a familiar physiotherapist motivated them to exercise and instilled confidence that the exercises were safe and effective.Background: CFTR modulators have led to improvements in CF outcomes, including FEV1, exacerbation frequency and body mass index (BMI). Despite positive outcomes, modulators have brought new challenges – particularly elevated BMI. For many, weight gain has been due to increased fat rather than muscle mass, making exercise a high priority. Exercise has always been an integral part of CF management. However, the COVID-19 pandemic has made it harder for patients to access exercise. This presented a service need to set up a platform where patients could safely exercise at home with support from a known physiotherapist. Objectives: To assess the feasibility and acceptability of a physiotherapyled online group exercise class for CF patients. Methods: In this pilot study, high and low intensity virtual exercise classes were delivered twice weekly over four weeks. Eight participants were recruited;five completed the study. The primary outcomes were (1) feasibility, assessed by means, resources and time needed to deliver the intervention and (2) acceptability, assessed by qualitative interviews with participants. FEV1, BMI, 60STS and psychosocial outcomes were also monitored. Results: Time, resources and equipment were all adequate to deliver the intervention within the service. Positive themes from interviews included: (1) Impact on health: improved fitness, (2) Motivation to exercise: feeling encouraged, supported and accountable, and (3) Convenience: saved time, money and ease of exercising at home. Some challenges patients reported were space, technical issues with equipment and missing face-to-face interaction. Conclusion: Virtual exercise classes for patients with CF are both feasible and acceptable, with patients reporting a positive impact on their fitness levels as well as reduced travel burden. Patients also stated that classes delivered by a familiar physiotherapist motivated them to exercise and instilled confidence that the exercises were safe and effective.

3.
Supportive Care in Cancer ; 30:S24, 2022.
Article in English | EMBASE | ID: covidwho-1935802

ABSTRACT

Introduction Early in the pandemic, Cancer Australia developed a conceptual framework which provided guidance on approaches to optimal cancer care in the face of significant health system challenges and risk of exposure to and harm from COVID-19. Emerging evidence during the pandemic indicated that cancer patients experienced considerable psychosocial impacts, including increased distress, depression and anxiety, and unmet information needs. Methods Evidence on the impact of the COVID-19 pandemic on cancer patients, cancer care across the care continuum, and health system capacity was reviewed, to June 2021. The conceptual framework was updated based on international and national published evidence, guidance, recommendations, and position statements. Results Supportive care strategies for cancer patients during a pandemic include extra vigilance by practitioners of screening for distress;improved communication with patients and their carers of changes to cancer care plans;provision of timely information and guidance to inform shared decision making;attention to the impact of infection control measures;, and adoption of innovative models of supportive care. Conclusions Cancer Australia's updated conceptual framework, underpinned by principles defining optimal cancer care, informs optimal supportive care across the continuum during a pandemic. It provides a planning resource for cancer care clinicians and policymakers for the current and future pandemics when supportive care needs are more paramount than ever.

4.
Anaesthesia ; 77(9): 1039-1050, 2022 09.
Article in English | MEDLINE | ID: covidwho-1937910

ABSTRACT

The COVID-19 pandemic transformed everyday life, but the implications were most impactful for vulnerable populations, including patients with chronic pain. Moreover, persistent pain is increasingly recognised as a key manifestation of long COVID. This narrative review explores the consequences of the COVID-19 pandemic for chronic pain. Publications were identified related to the COVID-19 pandemic influence on the burden of chronic pain, development of new-onset pain because of long COVID with proposed mechanisms and COVID-19 vaccines and pain interventions. Broadly, mechanisms underlying pain due to SARS-CoV-2 infection could be caused by 'systemic inflammatory-immune mechanisms', 'direct neuropathic mechanisms' or 'secondary mechanisms due to the viral infection or treatment'. Existing chronic pain populations were variably impacted and social determinants of health appeared to influence the degree of effect. SARS-CoV-2 infection increased the absolute numbers of patients with pain and headache. In the acute phase, headache as a presenting symptom predicted a milder course. New-onset chronic pain was reportedly common and likely involves multiple mechanisms; however, its prevalence decreases over time and symptoms appear to fluctuate. Patients requiring intensive support were particularly susceptible to long COVID symptoms. Some evidence suggests steroid exposure (often used for pain interventions) may affect vaccine efficacy, but there is no evidence of clinical repercussions to date. Although existing chronic pain management could help with symptomatic relief, there is a need to advance research focusing on mechanism-based treatments within the domain of multidisciplinary care.


Subject(s)
COVID-19 , Chronic Pain , COVID-19/complications , COVID-19 Vaccines , Chronic Pain/etiology , Chronic Pain/therapy , Headache , Humans , Pandemics , SARS-CoV-2
5.
Palliative Medicine ; 36(1 SUPPL):62, 2022.
Article in English | EMBASE | ID: covidwho-1916791

ABSTRACT

Background/aims: The COVID-19 pandemic has resulted in millions of deaths worldwide, whilst also causing severe disruption to end-of-life, grieving and coping processes. We examine bereavement experiences during the pandemic and relate our findings to the constructs of lossoriented and restoration- oriented coping, described in Stroebe and Schut's Dual Process Model (DPM). Methods: Two independent UK-wide surveys were disseminated online, including via social media and community/charitable organizations. They captured adult experiences of bereavement (to all causes of death) from March 2020 to January 2021. Free-text data were analyzed thematically. Results: Free-text comments were provided by 881 participants. Six main themes were identified: troubled and traumatic deaths;disrupted mourning, memorialization and death administration;mass bereavement, media/societal responses and the ongoing threat of the virus;grieving and coping (alone and with others);workplace and employment difficulties;and accessing support via health and social care. Examples of loss-oriented stressors included being unable to visit or say goodbye, the sudden and traumatic nature of many deaths, and restricted funeral and memorialization practices. Reactions included feelings of guilt and anger, and problems accepting the death and starting to grieve. Examples of restoration-oriented stressors and reactions comprised stressful deathrelated administration and severely curtailed social networks, support systems and social/recreational activities, which impacted peoples' ability to cope. Conclusions: These results demonstrate the exceptionally difficult sets of experiences associated with pandemic bereavement, defined by significant disruption to end of life, death and mourning practices, as well as usual coping mechanisms and formal or informal bereavement support. The DPM provides a useful framework for conceptualizing the additional challenges associated with pandemic bereavement and their impact on grieving and mental health.

6.
Palliative Medicine ; 36(1 SUPPL):25-26, 2022.
Article in English | EMBASE | ID: covidwho-1916784

ABSTRACT

Background/aims: The COVID-19 pandemic has resulted in global mass bereavement;in the UK alone there have been 140,000 deaths to date, with a disproportionate impact on Black, Asian or minoritized ethnic (BME) communities. Voluntary and community sector (VCS) bereavement services including hospices play an important role in bereavement support. We aimed to determine services' perspectives on access to their support. Methods: Cross-sectional online survey of VCS bereavement services in the UK, open March-May 2021, disseminated via national organisations, associations and networks and social media. Results: 147 organisations participated;53% served specific counties or smaller regions;16% were UK-wide. 36% were hospice or palliative care services, 15% national bereavement charities or NGOs;12% local bereavement charities. 67.3% reported there were groups with unmet needs not accessing their services before the pandemic;most frequently reported were people from BME communities (49%), sexual minority groups (26.5%), deprived communities (24.5%) and men (23.8%). 50% of services reported that, in the year before COVID-19, <5% of clients were from BME communities;25% did not collect this data and 25% reported >5% BME clients. Compared with before the pandemic, 3.4% of services were seeing more people from BME groups, 52% were seeing the same proportion, 6.1% were seeing fewer and 38% didn't know/didn't collect this data. Conclusions: For over two thirds of VCS bereavement services in the UK, there are known inequities in who accesses support, with people from BME groups most likely to be recognised as needing support but not Paediatric Palliative Care Commissioners (n=2) Gender Female:Male 2:0 accessing services. During the pandemic, the proportion of BME clients did not increase, despite these communities being disproportionately affected by COVID-19. More attention needs to be paid to assessing and meeting unmet needs for formal bereavement support among disadvantaged groups and routinely collecting client data to help determine and ensure equity. (Table Presented).

7.
Palliative Medicine ; 36(1 SUPPL):23-24, 2022.
Article in English | EMBASE | ID: covidwho-1916783

ABSTRACT

Background/aims: During the COVID-19 pandemic, voluntary and community sector (VCS) bereavement services including hospices have played a central role in supporting the bereaved. We aimed to describe the impact of the pandemic on these services to inform service development and policy. Methods: Cross-sectional online survey of VCS bereavement services in the UK, open March-May 2021, disseminated via national organisations, associations and networks, and social media. Results: 147 organisations participated;53% were regional, 16% UK-wide. 36% were hospice or palliative care services, 15% national bereavement charities or NGOs;12% local bereavement charities. During the pandemic referrals increased for 46% of organisations and decreased for 35%. 40.3% reported a current waiting list >3 weeks. 78.2% had changed services due to Covid;51.7% introduced new services. There had been a significant reduction in provision of all face-toface support including peer group meetings (50% to 4.1%, OR 0.04), facilitated group meetings (78% to 11%, OR 0.04), 1:1 support (87% to 27%, OR 0.06) and specialist intervention (44% to 16%, OR 0.25). Online and telephone provision saw major increases, particularly online 1:1 support (8.8% to 83%, OR 50.3), facilitated group meetings (4.1% to 56%, OR 30.48) and specialist intervention (3.4% to 36%, OR 16.01). Challenges included staff/volunteers providing support from home (69/64%), emotional impact on staff/volunteers (67/41%), increased pressure on staff due to client volume (41%) and complexity of needs (44%), implementing staff training (60%) and financial challenges (53%). 93% reported positive changes/opportunities during the pandemic, e.g., new coordination initiatives (47%). Conclusions: UK bereavement services rapidly transformed during the pandemic, despite significant challenges. To ensure positive changes and innovations are retained, the experiences and acceptability of new and adapted services among clients and staff require further investigation.

8.
Palliative Medicine ; 36(1 SUPPL):105, 2022.
Article in English | EMBASE | ID: covidwho-1916756

ABSTRACT

Background/aims: During the COVID-19 pandemic, many children and young people have experienced the death of close family members, whilst also facing unprecedented disruption to their lives. This study aimed to investigate the bereavement experiences and support needs from the perspective of their parents or guardians. Methods: We analysed cross-sectional free-text data from a survey of adults bereaved in the UK during the pandemic. Participants were recruited via media, social media, national associations and community/ charitable organisations. Thematic analysis was conducted on parent/ guardian responses to a question on the bereavement experiences and support needs of their children. Results: Free-text responses from 106 participants were included. Three main themes were identified: the pandemic-related challenges and struggles experienced by children and young people;family support and coping;and support from schools and services. Pandemic specific challenges include the impacts of being separated from the relative prior to their death, isolation from peers and other family members and disruption to daily routines and wider support networks. Examples were given of effective family coping and communication, but also difficulties relating to parental grief and children's existing mental health problems. The important role of schools and bereavement organisations in providing specialist support was demonstrated, but there was evidence of unmet need and lack of access to specialist grief or mental health support. Conclusions: Children and young people have faced additional strains and challenges associated with pandemic bereavement. We recommend initiatives that facilitate open and supportive communication within family and school settings, adequate resourcing of school and community- based specialist services and increased information and signposting to the support that is available.

9.
Journal of Neurology, Neurosurgery and Psychiatry ; 93(6):140, 2022.
Article in English | EMBASE | ID: covidwho-1916451

ABSTRACT

Introduction Sarcoidosis is a granulomatous disease with protean manifestations. The aetiology is not fully understood. Infectious agents are considered to potentially contribute to its pathogenesis. This case report highlights the emergence of neurosarcoidosis after COVID-19 infection. Case: A 48 year old female developed cough, myalgia and fatigue and was diagnosed with COVID-19 based on serological testing in April 2020. Post-infection, she developed a reactive arthritis, then presented in June with left facial lower motor neuron weakness, initially treated as a Bell's palsy with a significant neuralgic component. This pain resolved with steroid treatment. One month later she developed multiple cranial neuropathies and bilateral leg weakness. MRI brain showed bilateral enhancement of the trigeminal and facial nerves. CSF was abnormal (CSF protein 0.95g/L, WCC 9/uL). Leg power rapidly improved with intravenous immunoglobulins, and FDG-PET identified mediastinal and axillary hilar lymphadenopathy. A neck node showed non-necrotising granulomatous inflammation. CSF angiotensin converting enzyme was elevated (2.07umol/min/L). She has since commenced high dose steroids for probable neurosarcoidosis. Discussion This case suggests a possible association between COVID-19 and the emergence of sarcoidosis. At present the strength of any association is uncertain and putative mechanisms remain to be determined.

10.
PLoS One ; 17(3): e0262423, 2022.
Article in English | MEDLINE | ID: covidwho-1910489

ABSTRACT

BACKGROUND: Multiple studies have attempted to elucidate the relationship between chronic hypoxia and SARS-CoV-2 infection. It seems that high-altitude is associated with lower COVID-19 related mortality and incidence rates; nevertheless, all the data came from observational studies, being this the first one looking into prospectively collected clinical data from severely ill patients residing at two significantly different altitudes. METHODS: A prospective cohort, a two-center study among COVID-19 confirmed adult patients admitted to a low (sea level) and high-altitude (2,850 m) ICU unit in Ecuador was conducted. Two hundred and thirty confirmed patients were enrolled from March 15th to July 15th, 2020. RESULTS: From 230 patients, 149 were men (64.8%) and 81 women (35.2%). The median age of all the patients was 60 years, and at least 105 (45.7%) of patients had at least one underlying comorbidity, including hypertension (33.5%), diabetes (16.5%), and chronic kidney failure (5.7%). The APACHE II scale (Score that estimates ICU mortality) at 72 hours was especially higher in the low altitude group with a median of 18 points (IQR: 9.5-24.0), compared to 9 points (IQR: 5.0-22.0) obtained in the high-altitude group. There is evidence of a difference in survival in favor of the high-altitude group (p = 0.006), the median survival being 39 days, compared to 21 days in the low altitude group. CONCLUSION: There has been a substantial improvement in survival amongst people admitted to the high-altitude ICU. Residing at high-altitudes was associated with improved survival, especially among patients with no comorbidities. COVID-19 patients admitted to the high-altitude ICU unit have improved severity-of-disease classification system scores at 72 hours.


Subject(s)
COVID-19 , Adult , Altitude , Critical Illness , Female , Humans , Intensive Care Units , Male , Middle Aged , Prospective Studies , SARS-CoV-2
11.
Diabetic Medicine ; 39(SUPPL 1):82, 2022.
Article in English | EMBASE | ID: covidwho-1868626

ABSTRACT

Aims: High-dose corticosteroids reduce mortality in covid- 19 patients requiring oxygen therapy. Dexamethasone-induced hyperglycaemia is a known complication and linked to increased morbidity and mortality. The National Inpatient Diabetes Covid-19 Response Group produced guidance on corticosteroid therapy in covid-19 patients (June 2020). We assessed using the MicroGuide app® to help implement this guidance. Methods: We audited patients that received Dexamethasone and supplemental oxygen for covid-19 during two admission peaks -Oct/ Nov 2020 and Jan/ Feb 2021 (sample n = 30). Along with education and diabetes team ward-rounds, between peaks our trust introduced a guideline summary using the Microguide® smartphone-app. Results: In Oct/Nov20, 15 had known diabetes vs. 15 patients not known to have diabetes;11 and 19 respectively in Jan/Feb21. Capillary blood glucose (CBG) checks carried out as per guidelines in 27% of patients Oct/Nov20 vs. 64% of patients in Jan/Feb21. 60% experienced CBG >12mmol/l at least once in Oct/Nov20, compared with 70% in Jan/Feb21. Diabetic emergencies (DKA/HHS) were ruled out by ketone/pH testing in 57% in Oct/Nov20, improving to 76% in Jan/Feb21 (all had U+E checked). Of the insulin naïve population who experienced hyperglycaemia (n = 15 both), 27% were commenced on intermediate acting insulin Oct/Nov20 compared to 60% in Jan/ Feb21. Conclusion: Most patients experienced hyperglycaemia during admission. CBG monitoring by nursing staff improved between peaks, as did ruling out emergencies. Commencing intermediate-acting insulin if hyperglycaemic, as recommended, improved too. We believe the MicroGuide® app improved these outcomes as training and education of staff was limited during this time period, and this offered remote digital and easy accessible guidance.

12.
Physics of Fluids ; 34(3), 2022.
Article in English | Scopus | ID: covidwho-1784071

ABSTRACT

Foods can serve as a universal route for the understanding and appreciation of rheologically complex materials. The Soft Matter Kitchen is an educational outreach project started during the COVID-19 pandemic that leverages food recipes and experiments that can be carried out at home to discuss concepts in soft matter and rheology. This educational article showcases two representative outreach demonstrations developed by The Soft Matter Kitchen with detailed instructions for reproduction by a presenter. The first demonstration introduces the concept of complex materials to clarify the definition of rheology by comparing the flow behavior of whipped cream and honey. The second demonstration introduces the concept of material microstructure affecting material properties and macroscale behavior using a simple experiment with cheesecake. By grounding the presentation of this knowledge in food materials with which the audience likely already has experience, the goals of this project are to accelerate the understanding of rheological concepts, increase awareness of rheology in everyday life, and promote the development of intuition for rheologically complex materials. © 2022 Author(s).

14.
Open Forum Infectious Diseases ; 8(SUPPL 1):S103-S104, 2021.
Article in English | EMBASE | ID: covidwho-1746766

ABSTRACT

Background. The COVID-19 pandemic had a considerable impact on US healthcare systems, straining hospital resources, staff, and operations. Our objective was to evaluate the impact of COVID-19 pandemic on incidence and trends of healthcare-associated infections (HAIs) in a network of hospitals. Methods. This was a retrospective review of central-line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), C. difficile infections (CDI), and ventilator-associated events (VAE) in 51 hospitals from 2018 to 2021. Descriptive statistics were reported as mean hospital-level monthly incidence rates (IR) and compared using Poisson regression GEE models with period as the only covariate. Segmented regression (SR) analysis was performed to estimate changes in monthly IR of CAUTIs, CLABSIs and CDI in the baseline period (01/2018 - 02/2020) and the Pandemic period (03/2020 -03/2021). SR model was not appropriate for VAE based on the plot. All models were constructed using SAS v.9.4 (SAS Institute, Cary NC). Results. Compared to the baseline period, CLABSIs increased significantly by 50% from 0.6 to 0.9/ 1000 catheter days (P< 0. 001). In contrast, no significant changes were identified for CAUTI (P=0.87). Similar trends were seen in SR models for CLABSI and CAUTI (Figures 1, 2 and Table 1). While overall CDIs decreased significantly from 3.5 to 2.5/10,000 patient days in the pandemic period (P< 0.001), SR model showed increasing pandemic trend change (Figure 3). VAEs increased > 700% from 6.9 to 59.7/1000 ventilator days (P=0.15), but displayed considerable variation during the pandemic period (Figure 4). Compared to baseline period, there was a significant increase in central line days (647 vs 677, P=0.02), ventilator days (156 vs 215, P< 0.001), but no change in urinary catheter days (675 vs 686, P=0.32) during the pandemic period. Conclusion. The COVID-19 pandemic was associated with substantial increases in CLABSIs and VAEs, no change in CAUTIs, and an increasing trend in CDI incidence. These variations in trends of different HAIs are likely due, in part, to unique characteristics of the underlying infection, resource shortages, staffing concerns, increased device use, changes in testing practices, and the limitations of surveillance definitions.

15.
Open Forum Infectious Diseases ; 8(SUPPL 1):S167-S168, 2021.
Article in English | EMBASE | ID: covidwho-1746741

ABSTRACT

Background. The COVID-19 pandemic placed a strain on inpatient clinical and hospital programs due to increased patient volume and rapidly evolving data on best COVID-19 management strategies. However, the impact of the pandemic on ASPs has not been well described. Methods. We performed a cross-sectional electronic survey of stewardship pharmacy and physician leaders in 37 hospitals within the Duke Antimicrobial Stewardship Outreach Network (DASON) (community) and Duke/UNC Health systems (academic) in April-May 2021. The survey included 60 questions related to staffing changes, use of COVID-targeted therapies, related restrictions, and medication shortages. Results. Twenty-seven facilities responded (response rate of 73%). Pharmacy personnel was reduced in 17 (63%) facilities by an average of 16%. Impacted pharmacy personnel included the stewardship lead in 15/17 (88.2%) hospitals. Converting to remote work was rare and only reported in academic institutions (n=2, 7.4%). ASP personnel were reassigned to non-stewardship duties in 12 (44%) hospitals with only half returning to routine ASP work as of May 2021. Respondents estimated that 62% of routine ASP activities were diverted during the time of the pandemic. Non-traditional, pandemic-related ASP activities included managing multiple drug shortages, of which ventilator support medications (91%) were most common affecting patient care at 52% of facilities. Steroid and hydroxychloroquine shortages were less frequent (44% and 22%, respectively). Despite staff reductions, pharmacists often served as primary contact for remdesivir approvals either using a criteria-based checklist at dispensing or as part of a dedicated phone approval team (Figure). Most (77%) hospitals used a criteria-based pharmacist review strategy after remdesivir FDA approval. Restriction processes for other COVID-19 therapies such as tocilizumab, hydroxychloroquine, and ivermectin were reported in 64% of hospitals. Proportion of facilities implementing specific remdesivir allocation strategies from the time of the first US Food and Drug Administration (FDA) Emergency Use Authorization (EUA) through FDA approval Conclusion. Pandemic response diverted routine ASP work and has not yet returned to baseline. Despite the reduction in pharmacy personnel due to the pandemic, the ASP pharmacy lead took on a novel and critical stewardship role throughout the pandemic exemplified by their involvement in novel treatment allocation for COVID patients.

16.
Open Forum Infectious Diseases ; 8(SUPPL 1):S317, 2021.
Article in English | EMBASE | ID: covidwho-1746564

ABSTRACT

Background. The correlation between SARS-CoV-2 RNA and infectious viral contamination of the hospital environment is poorly understood. Methods. housed in a dedicated COVID-19 unit at an academic medical center. Environmental samples were taken within 24 hours of the first positive SARS-CoV-2 test (day 1) and again on days 3, 6, 10 and 14. Patients were excluded if samples were not obtained on days 1 and 3. Surface samples were obtained with flocked swabs pre-moistened with viral transport media from seven locations inside (bedrail, sink, medical prep area, room computer, exit door handle) and outside the room (nursing station computer). RNA extractions and RT-PCR were completed on all samples. RT-PCR positive samples were used to inoculate Vero E6 cells for 7 days and monitored for cytopathic effect (CPE). If CPE was observed, RT-PCR was used to confirm the presence of SARS-CoV-2. Results. We enrolled 14 patients (Table 1, Patient Characteristics) between October 2020 and May 2021. A total of 243 individual samples were obtained - 97 on day 1, 98 on day 3, 34 on day 6, and 14 on day 10. Overall, 18 (7.4%) samples were positive via RT-PCR - 9 from bedrails (12.9%), 4 from sinks (11.4%), 4 from room computers (11.4%) and 1 from the exit door handle (2.9%). Notably, all medical prep and nursing station computer samples were negative (Figure 1). Of the 18 positive samples, 5 were from day 1, 10 on day 3, 1 on day 6 and 2 on day 10. Only one sample, obtained from the bedrails of a symptomatic patient with diarrhea and a fever on day 3, was culture-positive (Figure 2). Conclusion. Overall, the amount of environmental contamination of viable SARS-CoV-2 virus in rooms housing COVID-19 infected patients was low. As expected, more samples were considered contaminated via RT-PCR compared to cell culture, supporting the conclusion that the discovery of genetic material in the environment is not an indicator of contamination with live infectious virus. More studies including RT-PCR and viral cell culture assays are needed to determine the significance of discovering SARS-CoV-2 RNA versus infectious virus in the clinical environment.

17.
13th Annual First Year Engineering Experience, FYEE 2020 ; 2021.
Article in English | Scopus | ID: covidwho-1716588

ABSTRACT

This full paper describes the transition of a makerspace peer mentoring program into a student engagement liaison program in an effort to support student connection and community building during the pandemic. Creating community for first year students is an essential component to developing a strong sense of belonging. Whether or not students feel as though they belong is closely linked to their likelihood of success. Remote learning and social distancing have made it more challenging for students to develop connections with one another which has led to challenges fostering belonging. The pandemic has required educators to come up with new strategies to cultivate student connections and enhance student engagement. With a focus on connecting students across engineering disciplines and academic levels, the Engineering and Design Department at Western Washington University adapted an existing peer mentoring program to enhance student engagement and build social networks for first year engineering students. This paper includes a discussion of the evolution from an on-campus, makerspace centered, peer mentoring program to an online, student engagement liaison program. Of particular interest is how the remote version of the program has provided new ways for students to connect virtually and has allowed first year students to develop relationships with upper-division students despite the physical disconnection that has occurred as a result of the pandemic. The authors share their insights and reflections on the process of adapting to online mentoring and summarize the challenges and opportunities of exploring new ways of connecting students. The new program will continue to be developed and modified as the department begins to resume in-person operations and adapts to the changing needs and expectations of incoming students. © American Society for Engineering Education, 2021

18.
PLoS One ; 17(2): e0264280, 2022.
Article in English | MEDLINE | ID: covidwho-1702557

ABSTRACT

In March 2020, residents of the Bronx, New York experienced one of the first significant community COVID-19 outbreaks in the United States. Focusing on intensive longitudinal data from 78 Bronx-based older adults, we used a multi-method approach to (1) examine 2019 to early pandemic (February-June 2020) changes in momentary psychological well-being of Einstein Aging Study (EAS) participants and (2) to contextualize these changes with community distress scores collected from public Twitter posts posted in Bronx County. We found increases in mean loneliness from 2019 to 2020; and participants that were higher in neuroticism had greater increases in thought unpleasantness and feeling depressed. Twitter-based Bronx community scores of anxiety, depressivity, and negatively-valenced affect showed elevated levels in 2020 weeks relative to 2019. Integration of EAS participant data and community data showed week-to-week fluctuations across 2019 and 2020. Results highlight how community-level data can characterize a rapidly changing environment to supplement individual-level data at no additional burden to individual participants.


Subject(s)
Anxiety/pathology , COVID-19/epidemiology , Depression/pathology , Loneliness , Social Media , Affect , Aged , Aged, 80 and over , COVID-19/virology , Female , Humans , Longitudinal Studies , Male , New York/epidemiology , Pandemics , SARS-CoV-2/isolation & purification
19.
BMC Infect Dis ; 22(1): 127, 2022 Feb 05.
Article in English | MEDLINE | ID: covidwho-1690956

ABSTRACT

BACKGROUND: The city of Manaus, north Brazil, was stricken by a second epidemic wave of SARS-CoV-2 despite high seroprevalence estimates, coinciding with the emergence of the Gamma (P.1) variant. Reinfections were postulated as a partial explanation for the second surge. However, accurate calculation of reinfection rates is difficult when stringent criteria as two time-separated RT-PCR tests and/or genome sequencing are required. To estimate the proportion of reinfections caused by Gamma during the second wave in Manaus and the protection conferred by previous infection, we identified anti-SARS-CoV-2 antibody boosting in repeat blood donors as a mean to infer reinfection. METHODS: We tested serial blood samples from unvaccinated repeat blood donors in Manaus for the presence of anti-SARS-CoV-2 IgG antibodies using two assays that display waning in early convalescence, enabling the detection of reinfection-induced boosting. Donors were required to have three or more donations, being at least one during each epidemic wave. We propose a strict serological definition of reinfection (reactivity boosting following waning like a V-shaped curve in both assays or three spaced boostings), probable (two separate boosting events) and possible (reinfection detected by only one assay) reinfections. The serial samples were used to divide donors into six groups defined based on the inferred sequence of infection and reinfection with non-Gamma and Gamma variants. RESULTS: From 3655 repeat blood donors, 238 met all inclusion criteria, and 223 had enough residual sample volume to perform both serological assays. We found 13.6% (95% CI 7.0-24.5%) of all presumed Gamma infections that were observed in 2021 were reinfections. If we also include cases of probable or possible reinfections, these percentages increase respectively to 22.7% (95% CI 14.3-34.2%) and 39.3% (95% CI 29.5-50.0%). Previous infection conferred a protection against reinfection of 85.3% (95% CI 71.3-92.7%), decreasing to respectively 72.5% (95% CI 54.7-83.6%) and 39.5% (95% CI 14.1-57.8%) if probable and possible reinfections are included. CONCLUSIONS: Reinfection by Gamma is common and may play a significant role in epidemics where Gamma is prevalent, highlighting the continued threat variants of concern pose even to settings previously hit by substantial epidemics.


Subject(s)
COVID-19 , SARS-CoV-2 , Blood Donors , Brazil/epidemiology , Humans , Reinfection , Seroepidemiologic Studies
20.
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.

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