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1.
Front Bioeng Biotechnol ; 10:1086261, 2022.
Article in English | PubMed | ID: covidwho-2198672

ABSTRACT

Metformin is used globally to treat type II diabetes, has demonstrated anti-ageing and COVID mitigation effects and is a major anthropogenic pollutant to be bioremediated by wastewater treatment plants (WWTPs). Metformin is not adsorbed well by activated carbon and toxic N-chloro derivatives can form in chlorinated water. Most earlier studies on metformin biodegradation have used wastewater consortia and details of the genomes, relevant genes, metabolic products, and potential for horizontal gene transfer are lacking. Here, two metformin-biodegrading bacteria from a WWTP were isolated and their biodegradation characterized. Aminobacter sp. MET metabolized metformin stoichiometrically to guanylurea, an intermediate known to accumulate in some environments including WWTPs. Pseudomonas mendocina MET completely metabolized metformin and utilized all the nitrogen atoms for growth. Pseudomonas mendocina MET also metabolized metformin breakdown products sometimes observed in WWTPs: 1-N-methylbiguanide, biguanide, guanylurea, and guanidine. The genome of each bacterium was obtained. Genes involved in the transport of guanylurea in Aminobacter sp. MET were expressed heterologously and shown to serve as an antiporter to expel the toxic guanidinium compound. A novel guanylurea hydrolase enzyme was identified in Pseudomonas mendocina MET, purified, and characterized. The Aminobacter and Pseudomonas each contained one plasmid of 160 kb and 90 kb, respectively. In total, these studies are significant for the bioremediation of a major pollutant in WWTPs today.

2.
Microbiology Spectrum ; : e0378922, 2023.
Article in English | MEDLINE | ID: covidwho-2193579

ABSTRACT

Neutralization assays are important for understanding and quantifying neutralizing antibody responses toward severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The SARS-CoV-2 lentivirus surrogate neutralization assay (SCLSNA) can be used in biosafety level 2 (BSL-2) laboratories and has been shown to be a reliable alternative approach to the plaque reduction neutralization test (PRNT). In this study, we optimized and validated the SCLSNA to assess its ability as a comparator and prescreening method to support the PRNT. Comparability between the PRNT and SCLSNA was determined through clinical sensitivity and specificity evaluations. Clinical sensitivity and specificity assays produced acceptable results, with 100% (95% confidence interval [CI], 94% to 100%) specificity and 100% (95% CI, 94% to 100%) sensitivity against ancestral Wuhan spike-pseudotyped lentivirus. The sensitivity and specificity against B.1.1.7 spike-pseudotyped lentivirus were 88.3% (95% CI, 77.8% to 94.2%) and 100% (95% CI, 94% to 100%), respectively. Assay precision measuring intra-assay variability produced acceptable results for high (50% PRNT [PRNT50], 1:>=640), mid (PRNT50, 1:160), and low (PRNT50, 1:40) antibody titer concentration ranges based on the PRNT50, with coefficients of variation (CVs) of 14.21%, 12.47%, and 13.28%, respectively. Intermediate precision indicated acceptable ranges for the high and mid concentrations, with CVs of 15.52% and 16.09%, respectively. However, the low concentration did not meet the acceptance criteria, with a CV of 26.42%. Acceptable ranges were found in the robustness evaluation for both intra-assay and interassay variability. In summary, the validation parameters tested met the acceptance criteria, making the SCLSNA method fit for its intended purpose, which can be used to support the PRNT. IMPORTANCE Neutralization studies play an important role in providing guidance and justification for vaccine administration and helping prevent the spread of diseases. The neutralization data generated in our laboratory have been included in the decision-making process of the National Advisory Committee on Immunization (NACI) in Canada. During the coronavirus 2019 (COVID-19) pandemic, the plaque reduction neutralization test (PRNT) has been the gold standard for determining neutralization of SARS-CoV-2. We validated a SARS-CoV-2 lentivirus surrogate neutralization assay (SCLSNA) as an alternative method to help support the PRNT. The advantages of using the SCLSNA is that it can process more samples, is less tedious to perform, and can be used in laboratories with a lower biosafety level. The use of the SCLSNA can further expand our capabilities to help fulfill the requirements for NACI and other important collaborations.

3.
HeartRhythm Case Reports ; 8(12):859-860, 2022.
Article in English | EMBASE | ID: covidwho-2179087
4.
Journal of Clinical Oncology ; 40(28 Supplement):278, 2022.
Article in English | EMBASE | ID: covidwho-2098613

ABSTRACT

Background: Regular distress screening of patients with cancer is mandated by cancer care guidelines, with 25-50% of patients with cancer experiencing some level of distress. The COVID-19 pandemic amplified symptoms of distress and shifted oncologic care delivery towards telemedicine. In light of challenges faced with implementation of such screening, especially during this pandemic, we sought to assess the feasibility of implementing patient-focused distress screening at a large academic cancer center and its associated network sites. Method(s): We designed a modified distress screening tool with reflexive suicidality and mental health screening consisting of 1) Wellness Reflection, a questionnaire that incorporates questions from Patient-Reported Outcomes Measurement Information System-Global Health (PROMIS-GH) to monitor patients' physical, mental, and social health and to assess patients' needs for extra support, and 2) modified Patient Health Questionnaire 2+9 (PHQ 2+9) tool to screen for depression and suicide risk. This tool was used to triage patients in need of further assessment by the clinical team, including consideration for referrals to cancer supportive services. The two-tiered distress screening tool was delivered to patients at Stanford Cancer Center and 5 affiliate sites for inperson clinic visits starting September 2019. The Wellness Reflection was launched starting June 2020 for video visits. Result(s): From October 1, 2019 to May 14, 2021, 147,165 questionnaires representing 46,341 patients were collected. The overall Wellness Reflection questionnaire response rate was 55%;the video visit questionnaire response rate was ~70%, higher than the in-person visit response rate of ~50%. About 6% of questionnaires analyzed showed a request for more support, most commonly emotional and physical/symptom support, and this was consistent during the COVID-19 pandemic. 18.6% of questionnaire responses screened positive for further assessment, and those that triggered reflexive suicidality screening had a 17% positive PHQ 2+9 rate. Following assessment, 13,631 referrals to cancer supportive services were generated. Conclusion(s): The adoption of commonly available patient-reported outcome tools, including PROMIS-GH and PHQ 2+9, as a large-scale distress screening method for both in-person and tele-health clinic visits during the COVID-19 pandemic is feasible at a large academic cancer center and network sites. The volumes of positive screens and referrals were lower than expected despite broader implementation of distress screening and amplified symptoms of distress due to the pandemic.

5.
New Microbes New Infect ; 49: 101041, 2022.
Article in English | MEDLINE | ID: covidwho-2086595

ABSTRACT

Introduction: Coronavirus Disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has spread globally, becoming a long-lasting pandemic. Dengue is the most common arboviral disease in tropical and subtropical regions worldwide. COVID-19 and dengue coinfections have been reported, associated with worse outcomes with significant morbidity and mortality. Therefore, this study aims to determine the epidemiological situation of COVID-19 and dengue coinfection in Latin America. Methods: A systematic literature review was performed using PubMed, Scopus, Embase, Web of Science, LILACS, and BVS databases from January 1, 2020, to September 4, 2021. The key search terms used were "dengue" and "COVID-19". Results: Nineteen published articles were included. The studies were case reports with a detailed description of the coinfection's clinical, laboratory, diagnostic, and treatment features. Conclusion: Coinfection with SARS-CoV-2 and dengue virus is associated with worse outcomes with significant morbidity and mortality. The similar clinical and laboratory features of each infection are a challenge in accurately diagnosing and treating cases. Establishing an early diagnosis could be the answer to reducing the estimated significant burden of these conditions.

6.
American Journal of Transplantation ; 22(Supplement 3):651, 2022.
Article in English | EMBASE | ID: covidwho-2063521

ABSTRACT

Purpose: The OPTN's monitoring of equity in access to deceased donor kidney (KI) transplants (tx) among waitlisted candidates has consistently found service area (DSA) of listing as the factor most independently associated with access disparities. We extracted center-level from DSA-level effects to better characterize geographic disparities in the COVID-19 and KAS 250NM circle eras. Method(s): Poisson tx rate regression, with random DSA and center effects, was applied to 3 period-prevalent cohorts (KAS: 2018-2019;KAS COVID Onset: 1/2020-3/2021;KAS250: 4/2021-9/2021) of active KI waiting list registrations using OPTN data. Risk-adjusted, population-weighted, factor-specific disparities were quantified as the Winsorized standard deviation (SDw) of log(tx rate) among registrations, holding other factors constant. Geographic disparity was also quantified by median incidence rate ratios (MIRR), interpreted as the median increase in tx rate if a candidate switched to a random, higher tx rate center or DSA. The association between donor supply to demand ratios (S/D;# deceased kidney donors / # prevalent WL candidates) and residual (after removing center effects) DSA effects was assessed with Spearman's rho. Result(s): Pre-COVID, variation in tx rates was markedly higher for centers (MIRR 1.72) vs. DSAs (MIRR 1.32). Under COVID, center-level MIRR rose to 1.94 and has remained high. The DSA-level MIRR fell to 1.20 in the early KAS250 era (Fig 1). As measured by population-weighted SDw, tx center (0.62) is the factor most associated with unintended disparities in the KAS250 era, with residual DSA-level variation (0.25) ranked 4th (Fig 2). Residual DSA effects were positively correlated (rho=0.55, p<0.001) with local S/D. Conclusion(s): DSA-level variation declined under KAS250, but disparities remain and are associated with differential local S/D. Tx center-level variation is the top driver of access disparities and may have been exacerbated by COVID. Further reductions in geographic disparities may be possible through allocation policy changes, although other interventions - such as reducing center variation in offer acceptance decisions and maximizing the recovery of potential deceased donors - may have greater impacts.

8.
Anaesthesia ; 77:36, 2022.
Article in English | EMBASE | ID: covidwho-2032352

ABSTRACT

Pain management is a key issue during labour. Delayed analgesia causes a negative perception of labour and potentially damaging psychological effects;however, we are treating an increasingly complex and resource-intensive obstetric population as illustrated by the MBRRACE-UK report. Guidelines recommend a waiting time from epidural request until an anaesthetist attends of 30 min, only exceeding 60 min in exceptional circumstances [1]. By reviewing the waiting time from request to anaesthetist attendance and making small iterative improvements to the process, we hope to reduce the time labouring women are waiting in pain. Methods The electronic records of all women who received an epidural over a 2-week period were examined. Following this, the interventions agreed on by the maternity multidisciplinary team included: (1) placing a quick response (QR) code [2] detailing labour analgesia options in each delivery room thus facilitating informed epidural consent if requested later and (2) out-of-hours epidural requests to be screened by the midwife in charge to ensure sufficient monitoring and equipment was ready prior to an anaesthetist being called. Subsequently, a further 3 weeks of data were collected. Results In the preliminary data, 74% achieved the recommended 30-min target, 19% exceeded a 30-min wait time from epidural request to anaesthetist attendance and 7% exceeded 1 h. The highest proportion of requests and waiting times occur out of hours, coinciding with lowest anaesthetic staffing levels. The statistical process control (SPC) chart illustrates the trend of waiting times following the interventions, and that overall the average waiting time remained stable (Fig. 1). The pattern of higher epidural requests and longer waiting times at weekends (47 vs. 20 mins during the week) and overnight (39 vs. 21 mins during the day) remained. (Figure Presented) Discussion Nearly three-quarters of requests are responded to in the 30-min target. Despite our interventions, the epidural wait time remains higher out of hours. During our post-intervention data collection, there was significant disruption to midwifery staffing due to COVID-19. Thus, it is difficult to ascertain whether the interventions were used effectively with locum staffing. Continuing to record, evaluate and feedback the impact of iterative changes will allow us to make sustainable improvement.

9.
National Institute for Health and Care Research. Health and Social Care Delivery Research ; 7:7, 2022.
Article in English | MEDLINE | ID: covidwho-1974628

ABSTRACT

BACKGROUND: In England, more than 4 million hospital admissions lead to surgery each year. The perioperative encounter (from initial presentation in primary care to postoperative return to function) offers potential for substantial health gains in the wider sense and over the longer term. OBJECTIVES: The aim was to identify, examine and set in context a range of interventions applied perioperatively to facilitate physical activity in the medium to long term. DATA SOURCES: The following databases were searched - Cochrane Central Register of Controlled Trials, MEDLINE, the Cumulative Index to Nursing and Allied Health Literature, EMBASE, PsycINFO and SPORTDiscus in October 2020. Clinical trials databases were also searched, and backward and forward citation searches were conducted. REVIEW METHODS: We undertook a systematic review;ran database searches in October 2020;extracted data;conducted risk-of-bias assessments of studies;and used Grading of Recommendations Assessment, Development and Evaluation assessments. We conducted focus groups and interviews with people running services designed to promote physical activity, to understand the practical and contextual factors that make such interventions 'work'. Although the two streams of work were conducted independently, we considered overlapping themes from their findings. RESULTS: In the review, we found 51 randomised controlled trials and two quasi-randomised trials;nine non-randomised studies formed a supplementary data set. Studies included 8604 adults who had undergone (or were undergoing) surgery, and compared 67 interventions facilitating physical activity. Most interventions were started postoperatively and included multiple components, grouped as follows: education and advice, behavioural mechanisms and physical activity instruction. Outcomes were often measured using different tools;pooling of data was not always feasible. Compared with usual care, interventions may have slightly increased the amount of physical activity, engagement in physical activity and health-related quality of life at the study's end (moderate-certainty evidence). We found low-certainty evidence of an increase in physical fitness and a reduction in pain, although effects generally favoured interventions. Few studies reported adherence and adverse events;certainty of these findings was very low. Although infrequently reported, participants generally provided positive feedback. For the case studies, we conducted two online focus groups and two individual interviews between November 2020 and January 2021, with nine participants from eight services of physical activity programmes. Conceptual and practical aspects included how the promotion of physical activity can be framed around the individual to recruit and retain patients;how services benefit from committed and compassionate staff;how enthusiasts, data collection and evidence play key roles;and how digital delivery could work as part of a blended approach, but inequalities in access must be considered. LIMITATIONS: Outcome measures in the review varied and, despite a large data set, not all studies could be pooled. This also limited the exploration of differences between interventions;components of interventions often overlapped between studies, and we could not always determine what 'usual care' involved. The case study exploration was limited by COVID-19 restrictions;we were unable to visit sites and observe practice, and the range of services in the focus groups was also limited. CONCLUSIONS: Evidence from the review indicates that interventions delivered in the perioperative setting, aimed at enhancing physical activity in the longer term, may have overall benefit. The qualitative analysis complemented these findings and indicated that interventions should be focused around the individual, delivered locally and compassionately, and promoted by a patient's full clinical team. There is a need to develop a core outcome set for similar studies to allow quantitative synthesis. Future work should also investigate the experiences of patients in different contexts, such as different communities, and with different surgical indications. STUDY REGISTRATION: This study is registered as PROSPERO CRD42019139008. FUNDING: This project was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme and will be published in full in Health and Social Care Delivery Research;Vol. 10, No. 21. See the NIHR Journals Library website for further project information.

10.
Decision Sciences Journal of Innovative Education ; 2022.
Article in English | Scopus | ID: covidwho-1901649

ABSTRACT

COVID-19 pandemic policies requiring disease testing provide a rich context to build insights on true positives versus false positives. Our main contribution to the pedagogy of data analytics and statistics is to propose a method for teaching updating of probabilities using Bayes’ rule reasoning to build understanding that true positives and false positives depend on the prior probability. Our instructional approach has three parts. First, we show how to construct and interpret raw frequency data tables, instead of using probabilities. Second, we use dynamic visual displays to develop insights and help overcome calculation avoidance or errors. Third, we look at graphs of positive predictive values and negative predictive values for different priors. The learning activities we use include lectures, in-class discussions and exercises, breakout group problem solving sessions, and homework. Our research offers teaching methods to help students understand that the veracity of test results depends on the prior probability as well as helps students develop fundamental skills in understanding probabilistic uncertainty alongside higher-level analytical and evaluative skills. Beyond learning to update the probability of having the disease given a positive test result, our material covers naïve estimates of the positive predictive value, the common mistake of ignoring the disease's base rate, debating the relative harm from a false positive versus a false negative, and creating a new disease test. © 2022 Decision Sciences Institute.

11.
Age and Ageing ; 50:1, 2021.
Article in English | Web of Science | ID: covidwho-1852913
12.
Age and Ageing ; 51, 2022.
Article in English | ProQuest Central | ID: covidwho-1740779

ABSTRACT

Introduction COVID-19 is associated with an increased risk of venous thromboembolism (VTE). We compared the incidence of VTE on a busy hip fracture unit during 2020 with previous years to identify factors that may have played a role in its development. Methods Data were retrospectively obtained by notes review for patients admitted with neck or shaft of femur fracture. This included baseline characteristics, comorbidities and operative risk factors for VTE. Results 11 of 420 patients (2.6%) were diagnosed with VTE in 2020, compared with 25 of 2,115 patients (1.2%) between January 2015 and December 2019 (RR 2.2 [95% CI 1.1 to 4.5, p < 0.05]). Only one patient in 2020 had confirmed COVID-19. Retrospective data between 2015–2019 were incomplete, and so statistical analysis of demographic and operative risk factors was not conducted. Descriptive statistics show there were comparable proportions of smokers and malignancy in both groups, and the majority of patients in both groups received either mechanical or pharmacological VTE prophylaxis. A higher proportion of patients were independently mobile prior to admission in 2020 (72.7% vs 28%). There was a shorter interval to development of VTE in 2020 (mean 12 days in 2020 vs 25 days in 2015–2019). Conclusion Following hip fracture surgery patients were twice as likely to develop venous thromboembolism in 2020 than in the previous five years. There was also a shorter time to development of VTE. This was despite a higher reported level of premorbid mobility in 2020 in otherwise similar patient groups. We hypothesise that isolation due to the COVID-19 lockdown contributed to this result. This suggests a need for enhanced vigilance and prompt VTE prophylaxis in this vulnerable population in the event of further pandemic waves and lockdowns.

13.
1st Indian International Conference on Industrial Engineering and Operations Management, IEOM 2021 ; : 236-245, 2021.
Article in English | Scopus | ID: covidwho-1738066

ABSTRACT

The goal of this research is to explore solutions to recent shortages in the computer chip supply chain. The COVID-19 pandemic revealed weakness in the supply chain for computer chips. With more industries needing computer chips for their products, particularly the automotive industry, a shortage caused by shutdowns in China after the pandemic led to a rise in prices of consumer goods. In this research, we focus on the technicalities of the computer chip supply chain to find methods of preventing shortages and improving the overall supply chain to avoid future shortages. This is particularly important with the increased dependence on computer chips in products. India has shown success with its government incentives to encourage reshoring of computer chip manufacturing, so there is less dependence on other countries to obtain chips. It is recommended that the US follow India’s lead and encourage reshoring of computer chip manufacturing to reduce the likelihood of shortages in the future. © IEOM Society International.

14.
Am J Transplant ; 22 Suppl 2: 21-136, 2022 03.
Article in English | MEDLINE | ID: covidwho-1735851

ABSTRACT

The year 2020 presented significant challenges to the field of kidney transplantation. After increasing each year since 2015 and reaching the highest annual count to date in 2019, the total number of kidney trans- plants decreased slightly, to 23642, in 2020. The decrease in total kidney transplants was due to a decrease in living donor transplants; the number of deceased donor transplants rose in 2020. The number of patients waiting for a kidney transplant in the United States declined slightly in 2020, driven by a slight drop in the number of new candidates added in 2020 and an increase in patients removed from the waiting list owing to death-important patterns that correlated with the COVID-19 pandemic. The complexities of the pandemic were accompanied by other ongoing challenges. Nationwide, only about a quarter of waitlisted patients receive a deceased donor kidney transplant within 5 years, a proportion that varies dramatically by donation service area, from 14.8% to 73.0%. The nonutilization (discard) rate of recovered organs rose to its highest value, at 21.3%, despite a dramatic decline in the discard of organs from hepatitis C-positive donors. Nonutilization rates remain particularly high for Kidney Donor Profile Index ≥85% kidneys and kidneys from which a biopsy specimen was obtained. Due to pandemic-related disruption of living donation in spring 2020, the number of living donor transplants in 2020 declined below annual counts over the last decade. In this context, only a small proportion of the waiting list receives living donor transplants each year, and racial disparities in living donor transplant access persist. As both graft and patient survival continue to improve incrementally, the total number of living kidney transplant recipients with a functioning graft exceeded 250,000 in 2020. Pediatric transplant numbers seem to have been impacted by the COVID-19 pandemic. The total number of pediatric kidney transplants performed decreased to 715 in 2020, from a peak of 872 in 2009. Despite numerous efforts, living donor kidney transplant remains low among pediatric recipients, with continued racial disparities among recipients. Of concern, the rate of deceased donor transplant among pediatric waitlisted candidates continued to decrease, reaching its lowest point in 2020. While this may be partly explained by the COVID-19 pandemic, close attention to this trend is critically important. Congenital anomalies of the kidney and urinary tract remain the leading cause of kidney disease in the pediatric population. While most pediatric de- ceased donor recipients receive a kidney from a donor with KDPI less than 35%, most pediatric deceased donor recipients had four or more HLA mis- matches. Graft survival continues to improve, with superior survival for living donor recipients versus deceased donor recipients.


Subject(s)
COVID-19 , Tissue and Organ Procurement , COVID-19/epidemiology , Child , Graft Survival , Humans , Kidney , Living Donors , Pandemics , Registries , SARS-CoV-2 , Tissue Donors , United States/epidemiology , Waiting Lists
15.
Journal of Research of the National Institute of Standards and Technology ; 126:19, 2022.
Article in English | Web of Science | ID: covidwho-1667644

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic led to the need for tracking of physical contacts and potential exposure to disease. Traditional contact tracing can be augmented by electronic tools called "electronic contact tracing" or "exposure notification.". Some methods were built to work with smartphones;however, smartphones are not prevalent in some high-contact areas (e.g., schools and nursing homes). We present the design and initial testing of low-cost, highly privacy preserving wearable exposure notification devices. Several devices were constructed based on existing hardware and operated independently of a smartphone. The method (devices and analyses) was not able to reliably use the received signal strength indicator (RSSI) as a proxy for distance between pairs of devices;the accuracy of RSSI as a proxy for distance decreased dramatically outside of the idealized conditions. However, even an imperfect device could be useful for research on how people use and move through spaces. With some improvement, these devices could be used to understand disease spread and human or animal interaction in indoor environments.

16.
Age and ageing ; 50(Suppl 3), 2021.
Article in English | EuropePMC | ID: covidwho-1602450

ABSTRACT

Background There are concerns that the COVID-19 pandemic could lead to a rise in mental health problems including anxiety amongst older people, especially those shielding alone during the pandemic. The aim of this study therefore is to examine the prevalence of anxiety symptoms during the COVID-19 pandemic amongst older people and clarify factors associated with higher burden of symptoms. Methods We analysed data from the COVID-19 study of The Irish Longitudinal Study on Ageing, conducted on over 3,100 community dwelling people aged ≥60 years from July–November 2020. Anxiety symptoms were measured with the Generalised Anxiety Disorder-7 Questionnaire with a score ≥ 10 indicating moderate–severe anxiety. Linear regression models were used to assess the association of variables of interest with anxiety symptoms. Results Almost 9% of participants (n = 3,128;mean age 71 years) had moderate–severe symptoms of anxiety. Factors independently associated with a higher burden of anxiety symptoms included female sex (β = 0.60 (0.33–0.87));living alone (β = 0.72 (0.41–1.02));≥2 chronic diseases (β = 0.85 (0.41–1.30);heart disease (β = 0.95 (0.45–1.46)) and reporting frequent loneliness (β = 6.59 (6.03–7.16)). Age ≥ 80 years (β = −0.77 (−1.16—0.37)) and tertiary level education (β = −0.48 (−0.86—-0.10)) were associated with lower anxiety symptom burden. Conclusion Almost 1 in 10 of this population-representative sample of older people had moderate to severe anxiety symptoms during the COVID-19 pandemic. Strategies to address loneliness, which was particularly strongly associated with anxiety symptoms during the pandemic, should be a priority.

17.
Journal of Studies on Alcohol and Drugs ; 82(6):776-781, 2021.
Article in English | Scopus | ID: covidwho-1599027

ABSTRACT

Objective: The COVID-19 pandemic has produced major life disruptions and increased stress. We explored associations between pandemic-related stress and substance use problems. Method: Adults (N = 180;65% female) with problematic substance use (CAGE-AID > 1) were recruited online June–August 2020. Measures included the 15-item Short Inventory of Problems–Alcohol and Drugs (SIP-AD), Generalized Anxiety Disorder–7 (GAD-7) seven-item anxiety measure, Patient Health Questionnaire–8 (PHQ-8) eight-item depression measure, a three-item measure of pandemic life disruptions, a six-item measure of pandemic-related mental health effects, and a five-item measure of pandemic-related personal growth. Participants reported whether they frequented bars and attended large gatherings. Participants with children (<18 years of age) in the home completed a four-item measure of pandemic-related worry about children’s well-being. Pandemic-related measures with significant bivariate associations with SIP-AD, GAD, and PHQ scores were tested in multivariable linear regression, adjusting for sex, age, and race/ethnicity. Results: Participants who struggled with responsibilities at home, had greater mental health impacts, had greater personal growth, and frequented bars or large gatherings had higher SIP-AD scores (all ps < .05). Participants who struggled with responsibilities at home, had difficulty getting necessities, had greater mental health impacts, and worried more about their children had higher GAD-7 and PHQ-8 scores (all ps < .05). Participants who lost a job or income during the pandemic had higher PHQ-8 scores (p = .015). In multivariable analyses, greater mental health impacts were associated with higher SIP-AD, PHQ-8, and GAD-7 scores (all ps < .05). Conclusions: Expe-riencing worsened mental health symptoms during COVID-19 was associated with more substance use problems and symptoms of depression and anxiety. Pandemic disruptions may exacerbate preexisting substance use problems. (J. Stud. Alcohol Drugs, 82, 776–781, 2021). © 2021, Alcohol Research Documentation Inc.. All rights reserved.

18.
Journal of Pediatric Neurology ; : 5, 2021.
Article in English | Web of Science | ID: covidwho-1550393

ABSTRACT

This report presents the case of acute disseminated encephalomyelitis in a 2-year-old patient following a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test. She presented with ataxic gait, truncal ataxia, and reduced coordination following 10 days of intermittent fever and lethargy. She did not have any respiratory symptoms. Magnetic resonance imaging of the brain and spine showed widespread T2 high signal within the gray and white matters and within the spinal cord. She was treated with intravenous methylprednisolone followed by tapering oral prednisolone;this led to resolution of her neurological symptoms. This case highlights that neurological complications can occur secondary to SARS-CoV-2 infection.

19.
Public Health ; 205: e5, 2022 04.
Article in English | MEDLINE | ID: covidwho-1514264
20.
Hepatology ; 74(SUPPL 1):327A, 2021.
Article in English | EMBASE | ID: covidwho-1508746

ABSTRACT

Background: During the Coronavirus Disease 2019 (COVID-19) pandemic, alcohol sales have increased and studies have reported an increase in binge-drinking behavior. This has led medical experts to forewarn of a rise in alcohol use disorder (AUD) and alcohol associated liver disease (ALD) as a consequence of the pandemic. We aim to observe the trends in alcohol-related hospital encounters as a result of the COVID-19 pandemic. Methods: Rates of inpatient hospital encounters from January 1, 2016 until May 1, 2021 were retrospectively evaluated in a large integrated health system in Northern California, including observation, admission and emergency department encounters. Diagnoses related to AUD and ALD, including alcohol dependence and withdrawal, alcoholic hepatitis, alcoholic cirrhosis, and alcoholic hepatic failure were included. Each encounter was categorized by admission month. Chi-squared tests were used to compare encounters from the pre-pandemic (March 2019-February 2020) era to the pandemic era (March 2020-February 2021). Results: Our study included 43,195 hospital encounters related to AUD/ALD, which represented 0.9% of all encounters during the study period. Mean age of patients was 51 (SD = 13.5), and 31% of visits were women. The race/ethnicity distribution was 62% White, 9% Black, 21% Hispanic, 3% Asian, 5% Other/Unknown. The highest rates of encounters were for alcohol dependence with withdrawal (23,725 [55%]), followed by alcoholic cirrhosis (17,671 [41%]), and alcoholic hepatitis (6,423 [15%]). When comparing pandemic to pre-pandemic era hospital encounters, rates of AUD/ALD encounters were higher in every month studied after March 2020 (Figure 1). The rate of AUD/ALD admissions was significantly higher during the pandemic (11.64 per 1000 encounters) compared to pre-pandemic (8.84, p<0.001). The sex distribution was similar during these two periods (30.9% vs. 31.1% female, p=0.809);the race/ethnicity distribution was also similar, but an increase in patients with Other/unknown race/ethnicity was observed (4.91% vs. 6.18%, p<0.001). Conclusion: We found a significant increase in the rate of hospital encounters related to AUD and ALD when comparing the pre-pandemic to the pandemic era. This may foreshadow an increased burden of AUD and ALD in the aftermath of the COVID-19 pandemic.

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