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Orthopaedic Journal of Sports Medicine ; 10(5 SUPPL 2), 2022.
Article in English | EMBASE | ID: covidwho-1916579


Background: Since April 2020, some high schools were closed to in-person teaching, and interscholastic and club sports were cancelled in an attempt to slow the spread of COVID- 19. While some US adolescents participated in sports since April 2020, other US adolescents did not participate in sports during this time. It is unknown what effect sport participation has had on the health of adolescents. Hypothesis/Purpose: To identify how sport participation during the COVID-19 pandemic impacted the health of adolescents. Methods: Adolescents across the US were recruited via social media to complete an online survey in the spring of 2021. Participants were asked to report their demographics (age, gender, race), whether they participated in school club or school sports since May 2020, type of school they attended (in-person, online, hybrid), and measures of mental health (MH), physical activity (PA) and quality of life (QoL). Assessments included the: General Anxiety Disorder-7 Item (GAD-7) for anxiety, Patient Health Questionnaire-9 Item (PHQ-9) for depression, Pediatric Functional Activity Brief Scale (PFABS) for physical activity, and Pediatric Quality of Life Inventory 4.0 (PedsQL) for quality of life. Assessment scores were compared for respondents who participated in sports (PAR) with those that did not participate in sports (NoPAR). Univariable comparisons between the groups were made via ttests or chi-square tests while means for continuous outcome measures were compared between the groups by ANOVA models that controlled for age, gender, race and the type of school attendance. Results: 4,693 adolescents (52% female, Age = 16.1+1.3 yrs., grades 9-12) from 38 states participated in the study with PAR = 4,286 (91%) and NoPAR = 407 (9%). NoPAR participants reported a higher prevalence of moderate to severe levels of anxiety (29.3% vs 21.3%, p<0.001) and depression (40.7% vs 19.8%, p<0.001). NoPAR participants reported lower (worse) PFABS scores (mean 13.2 [95%CI 12.4, 13.9] vs 21.2 [20.7, 21.6] p<0.001) and lower (worse) PedsQL total scores compared to the PAR group (77.9 [76.5, 79.3] vs. 83.2 [82.3, 84.1], p<0.001). Conclusions: Adolescents who did not play a sport during the COVID-19 pandemic reported significantly higher levels of anxiety and depression, as well as lower physical activity and quality of life scores compared to adolescents who did play a school or club sport. Participation in organized sports may offer an important opportunity to improve physical activity and mental health for adolescents during and after the COVID-19 pandemic.

American Journal of Respiratory and Critical Care Medicine ; 205:2, 2022.
Article in English | English Web of Science | ID: covidwho-1880347
Open Forum Infectious Diseases ; 8(SUPPL 1):S551-S552, 2021.
Article in English | EMBASE | ID: covidwho-1746352


Background. The incidence of hepatitis A virus (HAV) infection has been rising in the US since 2016, and in New York State since 2019. New York City has also seen an increase of HAV infection among high risk populations. We present a case of acute HAV infection in an inpatient psychiatry unit which has its own unique isolation and management challenges. Methods. A patient was admitted on 3/21/21 from a group home. He developed abdominal pain, diarrhea and vomiting on 4/15, with elevated liver function tests (LFT). He was transferred to Medicine on 4/17 and HAV IgM and IgG resulted positive on 4/18. Visitation to the unit has been halted for over a year, and no outside food has been allowed. The patient has not been observed to have any sexual exposure to others. Investigation. Exposure window: 15 days prior to start of symptoms. Patients in the unit were screened for symptoms, tested for HAV IgM/IgG, LFTs. Discharged patients were contacted and referred straight for vaccination (difficult to have multiple visits). Staff members with contact to the unit were screened, via email and phone calls. If no previous vaccination and there was presence of exposure or symptoms, staff were referred to Occupational Health Services (OHS). Other Measures: The unit was terminally cleaned and daily enhanced cleaning with bleach ensued. Daily assessment of patients and staff for symptoms. Admissions were held for 2 days until all the patients were tested and given vaccine. Further admissions were screened for HAV. Results. 32 inpatients screened. One patient was positive for HAV IgM, but was asymptomatic with normal LFTs. On investigation, patient had acute hepatitis in February 2021. Patients with no immunity were vaccinated. Two immunocompromised patients were also given HAV immunoglobulin. On chart review, 6 out of 29 discharged patients had evidence of immunity. 133 staff were screened and 54 referred to OHS (see table). Conclusion. As evident with numerous COVID outbreaks in inpatient Psychiatry units, communicable diseases are difficult to control. Patients are in an interactive communal setting and participate in group sessions. For better care and safety of patients and staff, our unit will screen and offer HAV vaccine to new admissions.

Open Forum Infectious Diseases ; 7(SUPPL 1):S313-S314, 2020.
Article in English | EMBASE | ID: covidwho-1185855


Background: COVID infections in inpatient psychiatry units present unique challenges during the pandemic, including behavioral characteristics of the patients, structural aspect of the unit, type of therapy for the patients. We present COVID outbreaks in psychiatry units in two hospitals in our medical center in Bronx, NY, and describe our mitigation strategies. Methods: Hosp A: In the early period of the pandemic in NY, 2 patients in the inpatient psychiatry unit tested positive for SARS-CoV-2 PCR. The unit was temporarily closed to new admissions. Hosp B: On 4/1, one of the patients in a 22 bed Psych unit, admitted since 3/10/20, developed fever, cough and tested positive for COVID-19 PCR. Two of her close contacts tested positive for SARS-COV-2 PCR. Results: Hospital A: In total, 5 of the 29 patients (17.2%) in the unit were SARSCoV- 2 positive, all of whom were asymptomatic. Hospital B: Testing of the remaining patients showed positive PCR in 10/14. PCR tests of healthcare workers (HCW) were positive in 13/46. Except for the index patient, all the patients were asymptomatic but 32/46 HCW reported symptoms. One negative patient subsequently turned positive. Infection control and prevention strategies instituted in both hospitals were the same with subtle differences due to dissimilar burden of infection and structure of the units. Table 1 shows the timing of the outbreak and the rapid institution of preventive measures in each of the hospitals. There was still difficulty with patients regarding adherence. Some of the patients refused to stay in isolation and would roam. Compliance with masking and hand hygiene was problematic. Communication was of paramount importance. Multiple meetings were held between the Psychiatry staff, Infection Control and Prevention team, executive leadership of the hospital. Environmental Services and Engineering were also involved. Communications with the NY State Department of Health occurred frequently. Conclusion: Strategies for management of COVID-19 patients in inpatient psychiatric units depends on the density of infected patients in the hospital and in the community. The implementation of practice change may need to be rapidly adjusted depending on the situation and available resources. Contingency plans should be formulated early on.