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1.
American Journal of Respiratory and Critical Care Medicine ; 205(1), 2022.
Article in English | EMBASE | ID: covidwho-1927893

ABSTRACT

Rationale: Over 350,000,000 people have had SARS-CoV-2 infection worldwide. COVID-19 poses many challenges in the management of patients causing a long-term and significant burden on the healthcare system. Understanding the long-term complications is a challenge that the healthcare community and patients will face. To our knowledge, this is one of the largest retrospective analyses with the aim to understand the functional lung sequelae of the disease. Methods: We retrospectively reviewed 782 survivors who had COVID-19 diagnosed by RT-PCR and followed up at an outpatient pulmonary clinic in Hartford, Connecticut, USA, from March 2020 to June 2021. Data included patient's age, sex, comorbidities, pulmonary function tests (PFT), the maximal requirement of low-flow oxygen (LF), high-flow nasal cannula (HFNC), non-invasive ventilation (NIV) and mechanical ventilation (MV). We performed an adjusted logistic regression model to evaluate if severity of disease according to maximal oxygen support is associated with DLCO<80% in follow-up. SPSS IBM was used for the statistical modeling. Results: Of the 782 patients evaluated, 314 patients had PFT results available post COVID-19 for analysis. The mean age was 58.9±14.5 years, and of the total number of patients, 200 were female (63.7%). Other demographics are as follows: 156 (49.7%) were obese, 129 (41.2%) had asthma, 48 (15.3%) had COPD, 5 (1.6%) had Interstitial Lung Disease, 35 (11.1%) had anemia, 70 (22.3%) had diabetes mellitus, 164 (52.2%) had hypertension, 26 (8.3%) had heart failure. Only 14 (4.4%) required MV, 14 (4.5%) NIV, 29 (9.2%) HFNC, 94 (29.9%) LF and 153 (51.9%) remained on room air. Altered DLCO was seen in 107 patients (34.1%), 189 (60.1%) had normal DLCO, and 18 (5.7%) did not have DLCO, of which the latter were excluded from the analysis. Maximal oxygen support was associated with DLCO<80% on unadjusted analysis (p=0.003). However, it was not associated with DLCO<80% (p=0.2) when adjusted. Other variables associated with a higher risk of DLCO<80% were age (p<0.001) and COPD (p<0.028). Asthma was associated with lower risk of developing DLCO<80% (p<0.001). Conclusion: Patients with post-acute sequelae of SARS-CoV-2 infection can develop DLCO<80%, which may contribute to long-term symptoms. Altered DLCO was not associated with maximal oxygen support in the adjusted logistic regression analysis. However, this may be due to the low number of cases requiring MV or NIV, resulting in selection bias, given there was a higher mortality rate in patients requiring positive pressure ventilation. Additionally, age and COPD were correlated with DLCO<80%.

2.
Developmental Medicine and Child Neurology ; 64(SUPPL 1):25, 2022.
Article in English | EMBASE | ID: covidwho-1723128

ABSTRACT

Objective: To report a 6 year old male who presented with recurrent cerebral infarctions and vertebral artery dissection in the setting of SARS-CoV-2 infection. Method: Case report. Results: A previously well 6 year old male presented with a 2 week history of headache, neck pain and ataxia. SARS-CoV-2 was detected on surveillance nasopharyngeal PCR. Neuroimaging revealed a right inferior parietal cortical infarct with absence of flow in the distal right posterior cerebral artery. CT angiography showed no evidence of vertebral artery dissection or cerebral vasculopathy. He was anti-coagulated initially, and post investigations, discharged home on anti-platelet therapy. He represented 4 weeks later with symptom recurrence. MRI brain on admission displayed a left thalamic infarct. Cerebral angiography showed right vertebral artery dissection with new distal thrombus and bilateral cerebellar infarcts. He was treated with 6 months of LMWH and then changed to antiplatelet therapy. He has had no further events. Thrombophilia, autoimmune and metabolic investigations have been negative. The patient has made a great recovery with minimal circumduction on walking and mild intention tremor. Conclusions: The risk of stroke in young people has been highlighted in the setting of SARS-CoV-2 infection. The reported incidence of cerebrovascular disease in patients testing positive for SARS-CoV-2 ranges from 1% to 6% in the adult population. In the paediatric population, stroke has been reported in children with PIMS-TS also. The proposed mechanism for such events is a hypercoagulable state caused by viral endothelitis, a post infectious immune mediated response or systemic inflammation. Here, we present an unusual case of multiple remote ischaemic strokes in a child who had concurrent asymptomatic SARS-CoV-2 infection without evidence of further organ dysfunction or acute inflammation.

3.
2021 International Conference on ENTERprise Information Systems, CENTERIS 2021 / ProjMAN 2021 - International Conference on Project MANagement / HCist 2021 and International Conference on Health and Social Care Information Systems and Technologies 2021 ; 196:724-731, 2021.
Article in English | Scopus | ID: covidwho-1641589

ABSTRACT

University-industry R&D collaborations (UICs) are becoming more critical for discovering innovations that can lead to the development of new products, services, and processes and, more broadly, social impact in terms of employment, economic development, and public health. The Covid-19 pandemic, for example, has seen an unprecedented rise in UICs and illustrates how vital their success can be for positively impacting the collaborators involved and society at large. Several challenges face the successful execution of UICs, not the least of which is the cultural difference between the collaborators. Overcoming these challenges is the subject of several research initiatives that seek to identify the critical success factors (CSFs) that UIC consortiums can use to develop their internal capabilities and project management maturity. The challenges facing one large UIC have been studied in Portugal. Practitioners and researchers were involved in generating insights into how the UIC could be more effective. This paper presents some of these challenges facing the UIC and how they were addressed. It also offers early results into the CSFs deemed essential by researchers and practitioners based on their experience together over seven years. Top CSFs include senior management commitment, effective communication, stakeholder engagement, good leadership, clear and realistic goals, mutual trust and respect, interpersonal teamwork, and clear roles and responsibilities. © 2021 Elsevier B.V. All rights reserved.

4.
Irish Journal of Medical Science ; 190(SUPPL 5):207-208, 2021.
Article in English | Web of Science | ID: covidwho-1576331
8.
Journal of Rehabilitation ; 87(1):17-24, 2021.
Article in English | Scopus | ID: covidwho-1308743

ABSTRACT

The COVID-19 pandemic has greatly influenced all aspects of daily life. Especially hard hit during the pandemic are typically marginalized individuals, including individuals with chronic illnesses and disabilities. Vocational rehabilitation counselors are uniquely positioned to support these individuals both during and after the pandemic. The Illinois Work and Well-Being Model can be utilized by researchers and counselors supporting marginalized individuals as an effective theoretical framework to address anticipated COVID-19-related challenges. In this article we also provide insights into three potential issues that may be more likely to occur as a result of the pandemic. These issues are a delay in career development, an extended absence from work, and experiences of both primary and secondary trauma. We conclude by providing future directions for research that could impact the lives of individuals directly impacted by the COVID-19 pandemic. © 2021 National Rehabilitation Association. All rights reserved.

9.
Endoscopy ; 53(SUPPL 1):S13-S14, 2021.
Article in English | EMBASE | ID: covidwho-1254043

ABSTRACT

Aims To determine the incidence of COVID-19 transmission following outpatient gastrointestinal (GI) endoscopy duringrising community incidence of COVID-19. Methods This prospective study was conducted in a single tertiary referral centre in Dublin. Consecutive patients whoattended the endoscopy unit for a procedure at time points in June, September, and October 2020 were included. Patientsreceived a COVID-19 triage phone call 48 hours before their procedure. COVID-19 testing was not performed beforeoutpatient endoscopy. Inpatients and any outpatient that failed telephone triage were excluded. Standard surgical masks,FFPs and PPE were used by endoscopy staff for all procedures. Patients were contacted 14 days after the procedure toenquire if they had developed symptoms suggestive of COVID-19. Results 522 patients who had GI endoscopy were enrolled, and 506(96.9 %) were contacted for follow up. 163, 157, and186 patients were included in June, September, and October respectively. The mean age was 55.6(range 16-92). Nationallythere were 558, 7430, and 25476 new cases of COVID-19 in June, September, and October respectively. In the two weeks post endoscopy, 7/506(1.3 %) patients required testing for symptoms suggestive of COVID-19. Allpatients had negative results. No member of our endoscopy personnel contracted COVID-19 during the study period. Conclusions This study highlights that the risk of COVID-19 transmission related to GI endoscopy is negligible despitedramatic escalation in community infection.

10.
J Hosp Infect ; 114: 117-125, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1210061

ABSTRACT

BACKGROUND: Healthcare workers (HCWs) are at the front line of the ongoing coronavirus 2019 (COVID-19) pandemic. Comprehensive evaluation of the seroprevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) among HCWs in a large healthcare system could help to identify the impact of epidemiological factors and the presence of symptoms on the immune response to the infection over time. AIM: To determine the seroprevalence of SARS-CoV-2-specific antibodies among HCWs, identify associated epidemiological factors and study antibody kinetics. METHODS: A longitudinal evaluation of the seroprevalence and epidemiology of SARS-CoV-2-specific antibodies was undertaken in approximately 30,000 HCWs in the largest healthcare system in Connecticut, USA. FINDINGS: At baseline, the prevalence of SARS-CoV-2 antibody among 6863 HCWs was 6.3% [95% confidence interval (CI) 5.7-6.9%], and was highest among patient care support (16.7%), medical assistants (9.1%) and nurses (8.2%), and lower for physicians (3.8%) and advanced practice providers (4.5%). Seroprevalence was significantly higher among African Americans [odds ratio (OR) 3.26 compared with Caucasians, 95% CI 1.77-5.99], in participants with at least one symptom of COVID-19 (OR 3.00, 95% CI 1.92-4.68), and in those reporting prior quarantine (OR 3.83, 95% CI 2.57-5.70). No symptoms were reported in 24% of seropositive participants. Among the 47% of participants who returned for a follow-up serological test, the seroreversion rate was 39.5% and the seroconversion rate was 2.2%. The incidence of re-infection in the seropositive group was zero. CONCLUSION: Although there is a decline in the immunoglobulin G antibody signal over time, 60.5% of seropositive HCWs had maintained their seroconversion status after a median of 5.5 months.


Subject(s)
Antibodies, Viral/blood , COVID-19 , SARS-CoV-2 , Adult , COVID-19/immunology , Connecticut/epidemiology , Female , Health Personnel , Humans , Kinetics , Male , Middle Aged , SARS-CoV-2/immunology , Seroepidemiologic Studies
11.
Irish Medical Journal ; 114(2), 2021.
Article in English | Scopus | ID: covidwho-1172210
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