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Cogent Medicine ; 8, 2021.
Article in English | EMBASE | ID: covidwho-1617061


Background: Known risk factors for child maltreatment, including parental unemployment and domestic violence (1, 2), were compounded by social isolation from school closures and restriction of home visitors during the COVID-19 lockdown. Data on the incidence of child maltreatment during the pandemic is limited. Aim: Our study aimed to compare the incidence of and characterize the types of child protection concerns among inpatients during the 2020 lockdown versus the same period in 2019. Methods: We carried out a retrospective chart review of inpatients at Children's Health Ireland (CHI) at Crumlin and CHI at Tallaght assessed for child protection concerns during the lockdown from March 13 to August 31, 2020, and the same timeframe in 2019. Results: Fewer patients with child protection concern were admitted in 2020 (n=86) compared to 2019 (n=163). Total admissions were also less in 2020 (n=4609) compared to 2019 (n=7728). Patients assessed for child protection concerns accounted for a smaller percentage of inpatients in 2020 (1.8% versus 2.1% in 2019 (p=0.35)). In 2020, there was a greater percentage of physical (52.3% versus 11% in 2019 (p<.001)) and emotional (6.9% versus 1.2% in 2019 (p=0.014)) abuse concern cases. There was also a greater percentage of neglect and sexual abuse concern cases and a lower percentage of welfare concern cases in 2020, but these differences were not statistically significant. The cases in 2020 were more complex, with 48.8% involving more than one concern type per case versus 13.4% in 2019 (p<.001). Child protection concerns increased steadily during the lockdown, peaking in July. In 2020, there were more unwitnessed injuries (34.8% versus 17.7% in 2019 (p=.002)) and parental use of physical discipline (6.9% versus 0.6% in 2019 (p=.003)). No statistically significant differences in delayed presentation and domestic violence were observed. Conclusions: While fewer inpatients were assessed for child protection concerns during the 2020 lockdown versus 2019, the 2020 cases were more complex. An increase in physical and emotional abuse concerns, unwitnessed injuries and physical disciplining highlights child protection issues specific to the pandemic.

Atherosclerosis ; 331:e140, 2021.
Article in English | EMBASE | ID: covidwho-1401206


Background and Aims: Hypolipidaemia is a known consequence of sepsis, predominantly from HDL-C (HDL-cholesterol) lowering. The dynamic of lipoprotein responses is in COVID-19 is not yet elucidated. We aim to describe a lipoprotein response pattern in patients with severe COVID-19 admitted to Intensive Care Department (ICU) at TUH during the first wave of the pandemic in Ireland. Methods: A multidisciplinary team extracted the clinical data and laboratory results of all patients diagnosed with COVID-19 by RT-PCR and admitted to the ICU department in March and April 2020. Data are presented as means, apart from laboratory data where patients had more than one set of results in 24 hours, when median results were calculated for each 24-h period. Results: Twenty-five patients were admitted to ICU (table 1). Presenting comorbidities included hypertension in 10, cardiovascular disease in 5 and diabetes mellitus in 8 patients. Lipoprotein median concentrations demonstrated initial reduction at admission to ICU, followed by rise in concentration during ICU stay (table 1 and figure 1). A significant negative correlation was observed between ICU outcome and HDL-C area under the curve (AUC) (R=-0.506, p=0.004) and LDL-AUC (R=-0.575, p=0.003). Delta LDL-AUC had the strongest correlation with ICU length of stay (LOS) (R=0.455, p=0.02), hospital LOS (R=0.484, p=0.02) and ICU outcomes (R=-0.454, p=0.02). Individual lipoprotein parameters did not demonstrate significant correlation. [Formula presented] [Formula presented] Conclusions: Lipoprotein concentrations (HDL-C and LDL-C) upon ICU admission are low in severe COVID-19 pneumonia patients and subsequent changes in concentrations may be associated with patient outcomes.

Microbiology Australia ; 41(4):167, 2020.
Article in English | EMBASE | ID: covidwho-1214007