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1.
Special Interest Group on Computer Graphics and Interactive Techniques Conference - Immersive Pavilion, SIGGRAPH 2022 ; 2022.
Article in English | Scopus | ID: covidwho-2020390

ABSTRACT

While the global COVID-19 pandemic did not catalyze widespread adoption of virtual reality (VR) technologies across all industries as some had anticipated, studies like Hall et al. from 2022 have demonstrated that public valuation of VR remains strongly in gaming, entertainment, and socializing [Hall et al., 2022]. As we look towards a future in which indoor gatherings with friends and family are safe and encouraged once again, there is an opportunity to position VR gaming as a go-to add-on to social gatherings by emphasizing ease of access for players of all levels of experience, and designing gameplay that encourages engagement rather than isolation in shared space. Fruit Golf aims to use an asymmetric multiplayer format to offer an experience that spans collaborative and competitive experiences, and allows players to seamlessly interact with VR, mobile, and physical spaces in ways that most will have never seen before. © 2022 Owner/Author.

2.
Learning Health Systems ; : 1, 2022.
Article in English | Academic Search Complete | ID: covidwho-2013673

ABSTRACT

Introduction Methods Results Conclusions The learning health system (LHS) aligns science, informatics, incentives, stakeholders, and culture for continuous improvement and innovation. The Agency for Healthcare Research and Quality and the Patient‐Centered Outcomes Research Institute designed a K12 initiative to grow the number of LHS scientists. We describe approaches developed by 11 funded centers of excellence (COEs) to promote partnerships between scholars and health system leaders and to provide mentored research training.Since 2018, the COEs have enlisted faculty, secured institutional resources, partnered with health systems, developed and implemented curricula, recruited scholars, and provided mentored training. Program directors for each COE provided descriptive data on program context, scholar characteristics, stakeholder engagement, scholar experiences with health system partnerships, roles following program completion, and key training challenges.To date, the 11 COEs have partnered with health systems to train 110 scholars. Nine (82%) programs partner with a Veterans Affairs health system and 9 (82%) partner with safety net providers. Clinically trained scholars (n = 87;79%) include 70 physicians and 17 scholars in other clinical disciplines. Non‐clinicians (n = 29;26%) represent diverse fields, dominated by population health sciences. Stakeholder engagement helps scholars understand health system and patient/family needs and priorities, enabling opportunities to conduct embedded research, improve outcomes, and grow skills in translating research methods and findings into practice. Challenges include supporting scholars through roadblocks that threaten to derail projects during their limited program time, ranging from delays in access to data to COVID‐19‐related impediments and shifts in organizational priorities.Four years into this novel training program, there is evidence of scholars' accomplishments, both in traditional academic terms and in terms of moving along career trajectories that hold the potential to lead and accelerate transformational health system change. Future LHS training efforts should focus on sustainability, including organizational support for scholar activities. [ FROM AUTHOR] Copyright of Learning Health Systems is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

3.
Surg Neurol Int ; 13: 316, 2022.
Article in English | MEDLINE | ID: covidwho-1969978
4.
Gastroenterology ; 162(7):S-363, 2022.
Article in English | EMBASE | ID: covidwho-1967298

ABSTRACT

Background: A recent study showed that CeD patients have greater hesitancy in receiving the COVID-19 vaccine, mainly due to fear of adverse events. It is unclear if the rate of adverse events post-vaccine administration is higher in CeD compared to non-celiac population. Aims: To assess the prevalence of adverse events related to COVID-19 vaccine administration in patients with CeD compared to non-CeD controls, and to explore factors that predict the risk of adverse events related to COVID-19 vaccine. Methods: This is a preliminary analysis of an ongoing study conducted at McMaster Adult Celiac Disease Clinic. We collected data prospectively in a cohort of adult patients with a diagnosis of CeD attending our clinic and compared with non-CeD controls (university personnel). CeD diagnosis was based on serology, biopsy, and HLA DQ2/DQ8 in discrepant cases. Data collected included demographics, CeD activity through serology, adherence to the gluten-free diet (GFD), prior COVID-19 infection, vaccine type and status, and any adverse events. Mild adverse events were classified as pain at the site, fatigue, fever/chills, nausea, headaches. Severe adverse events included anaphylaxis, thrombosis, myocarditis/pericarditis, and hospitalization or emergency visits due to vaccination. Data were expressed as median [IQR] for continuous variables and n/N (%) for categorical variables. Mann-Whitney U test and Fisher exact test were performed using SPSS (v26, IBM Corp) to assess differences between groups and logistic regression to assess predictors of adverse events. Results: An interim analysis was performed in 53 patients with CeD (25% male;median age of 34[25] years) and 46 controls (37% male;median age of 41[22] years). There were no differences in sex between CeD and controls, however, controls were older than CeD (p=0.04). Fifty-five % of CeD patients were strictly adherent with a GFD. There was no difference in the rate of COVID-19 infection between CeD and controls. All CeD patients and controls reported receiving two doses of COVID-19 vaccines. Eighty-three % of CeD received the same vaccine type in both doses, and 17% mixed vaccines vs 81% and 19% respectively for controls. There were no severe adverse events reported by CeD or controls. The most common mild adverse events reported in CeD and controls included pain at the injection site (27% vs 64%;p <0.001) and fatigue (11% vs 46%;p<0.001). Celiac activity, age, sex, or vaccine type did not predict adverse events in CeD patients for either dose. Conclusions: In this preliminary analysis, administration of COVID-19 vaccines did not lead to severe adverse and less mild adverse reactions in patients with CeD compared to non-CeD controls. These results should be confirmed in a larger population, and ideally, in a future multicentre study involving pediatric and adult populations from different countries.

5.
Epidemiology ; 70(SUPPL 1):S221, 2022.
Article in English | EMBASE | ID: covidwho-1854024

ABSTRACT

Background: The COVID-19 pandemic has exacerbated multiple barriers to healthcare for vulnerable seniors. They may experience more difficulties in meeting their basic needs for food, medicine, and social support. The objective of the project was to connect with seniors to show our care, to assess food security, medication possession, mental health, and to refer those needing services to appropriate providers. Methods: Using a computer-assisted telephone interview (CATI) approach, we called patients served by our primary care providers from April to December 2020. The CATI assessed their mental health by Personal Health Questionnaire-2 (PHQ2) and General Anxiety Disorder-2 (GAD2). The California Health Place Index (HPI) was used to measure social determinants of health associated with community resources. Descriptive analyses examined the proportion of patients needing follow-up services and being referred to services to address food insecurity (if had <3 days of food), medication needs (if had <30 days of medicine), and mental health services (PHQ2>2 or GAD2>2). Multivariable logistic regression analyses examined demographic and health factors associated with the odds for needing and being referred for follow-up services. Results: Of 1921 respondents, their average age was 76 years (SD11). 52% female and 48% non-female (including male, transgender, and other);74% White, 7% Asian, 7% Hispanic, 3% Black, and 8% other. Medication needs existed among 595 (31%) patients, 196 (10%) faced food insecurity, and 292 (15%) needed mental health services. Regression results suggest, Blacks (OR1.86, p<0.05) had higher odds of being at risk of medication shortage than Whites;Blacks (OR2.30, p<0.05) and Hispanics (OR 2.30, p<0.05) had significantly higher odds of food insecurity than Whites. Higher odds for food insecurity referral were found among non-females (OR7.56, p<0.05) and Blacks (OR10.33, p<0.05). Blacks (OR13.34, p<0.05) and those living in 2nd quartile of HPI (OR2.57, p<0.05) had higher odds for mental health referrals. Conclusions: Significant disparities existed across gender, race, and community resource groups in need for food, medications, and mental health services. Findings underscore the imperatives for health and social services organizations to systematize outreach and follow-up services for vulnerable seniors.

6.
Surg Neurol Int ; 13: 167, 2022.
Article in English | MEDLINE | ID: covidwho-1836387
7.
PubMed; 2020.
Preprint in English | PubMed | ID: ppcovidwho-333594

ABSTRACT

BACKGROUND: Health conditions and immune dysfunction associated with trisomy 21 (Down syndrome, DS) may impact the clinical course of COVID-19 once infected by SARS-CoV-2. METHODS: The T21RS COVID-19 Initiative launched an international survey for clinicians or caregivers/family members on patients with COVID-19 and DS (N=1046). De-identified survey data collected between April and October 2020 were analysed and compared with the UK ISARIC4C survey of hospitalized COVID-19 patients with and without DS. COVID-19 patients with DS from the ISARIC4C survey (ISARIC4C DS cases=100) were matched to a random set of patients without DS (ISARIC4C controls=400) and hospitalized DS cases in the T21RS survey (T21RS DS cases=100) based on age, gender, and ethnicity. FINDING: The mean age in the T21RS survey was 29 years (SD=18), 73% lived with their family. Similar to the general population, the most frequent signs and symptoms of COVID-19 were fever, cough, and shortness of breath. Pain and nausea were reported less frequently (p<0.01), whereas altered consciousness/confusion were reported more frequently (p<0.01). Risk factors for hospitalization and mortality were similar to the general population (age, male gender, diabetes, obesity, dementia) with the addition of congenital heart defects as a risk factor for hospitalization. Mortality rates showed a rapid increase from age 40 and were higher than for controls (T21RS DS versus controls: risk ratio (RR)=3.5 (95%-CI=2.6;4.4), ISARIC4C DS versus controls: RR=2.9 (95%-CI=2.1;3.8)) even after adjusting for known risk factors for COVID-19 mortality. INTERPRETATION: Leading signs/symptoms of COVID-19 and risk factors for severe disease course are similar to the general population. However, individuals with DS present significantly higher rates of mortality, especially from age 40. FUNDING: Down Syndrome Affiliates in Action, Down Syndrome Medical Interest Group-USA, GiGi's Playhouse, Jerome Lejeune Foundation, LuMind IDSC Foundation, Matthews Foundation, National Down Syndrome Society, National Task Group on Intellectual Disabilities and Dementia Practices.

8.
Patient Educ Couns ; 105(8): 2771-2777, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1763929

ABSTRACT

OBJECTIVE: Examine factors impacting U.S. parents' intention to vaccinate their children against COVID-19. METHODS: Data were collected February-May 2021 from parents living in six geographically diverse locations. The COVID-19 Exposure and Family Impact Survey assessed perceived susceptibility and severity to adverse outcomes from the pandemic. Semi-structured interviews assessed perceptions about benefits and risks of vaccinating children. RESULTS: Fifty parents of 106 children (newborn-17 years) were included; half were Spanish-speaking and half English-speaking. 62% were hesitant about vaccinating their children against COVID-19. Efficacy and safety were the main themes that emerged: some parents perceived them as benefits while others perceived them as risks to vaccination. Parent hesitancy often relied on social media, and was influenced by narrative accounts of vaccination experiences. Many cited the lower risk of negative outcomes from COVID-19 among children, when compared with adults. Some also cited inaccurate and constantly changing information about COVID-19 vaccines. CONCLUSION: Main drivers of parent hesitancy regarding child COVID-19 vaccination include perceived safety and efficacy of the vaccines and lower severity of illness in children. PRACTICE IMPLICATIONS: Many vaccine-hesitant parents may be open to vaccination in the future and welcome additional discussion and data.


Subject(s)
COVID-19 Vaccines , COVID-19 , Adult , COVID-19/prevention & control , Child , Health Knowledge, Attitudes, Practice , Humans , Infant, Newborn , Parents , Vaccination
9.
Transl Behav Med ; 12(3): 466-479, 2022 03 17.
Article in English | MEDLINE | ID: covidwho-1705832

ABSTRACT

To describe how social disruptions caused by the COVID-19 pandemic impacted child access to healthcare and child health behaviors in 2020. We used mixed-methods to conduct surveys and in-depth interviews with English- and Spanish-speaking parents of young children from five geographic regions in the USA. Participants completed the COVID-19 Exposure and Family Impact Survey (CEFIS). Semistructured telephone interviews were conducted between August and October 2020. Of the 72 parents interviewed, 45.8% of participants were Hispanic, 20.8% Black (non-Hispanic), and 19.4% White (non-Hispanic). On the CEFIS, the average (SD) number of social/family disruptions reported was 10.5 (3.8) out of 25. Qualitative analysis revealed multiple levels of themes that influenced accessing healthcare during the pandemic, including two broad contextual themes: (a) lack of trustworthiness of medical system/governmental organizations, and (b) uncertainty due to lack of consistency across multiple sources of information. This context influenced two themes that shaped the social and emotional environments in which participants accessed healthcare: (a) fear and anxiety and (b) social isolation. However, the pandemic also had some positive impacts on families: over 80% indicated that the pandemic made it "a lot" or "a little" better to care for their new infants. Social and family disruptions due to COVID-19 were common. These disruptions contributed to social isolation and fear, and adversely impacted multiple aspects of child and family health and access to healthcare. Some parents of infants reported improvements in specific health domains such as parenting, possibly due to spending more time together.


Subject(s)
COVID-19 , Child , Child, Preschool , Delivery of Health Care , Family Health , Humans , Infant , Pandemics , SARS-CoV-2
10.
Surg Neurol Int ; 12: 591, 2021.
Article in English | MEDLINE | ID: covidwho-1566962

ABSTRACT

The ongoing "pandemic" involving the severe acute respiratory syndrome coronavirus 2 virus (SARS-CoV-2) has several characteristics that make it unique in the history of pandemics. This entails not only the draconian measures that some countries and individual states within the United States and initiated and made policy, most of which are without precedent or scientific support, but also the completely unscientific way the infection has been handled. For the 1st time in medical history, major experts in virology, epidemiology, infectious diseases, and vaccinology have not only been ignored, but are also demonized, marginalized and in some instances, become the victim of legal measures that can only be characterized as totalitarian. Discussions involving various scientific opinions have been eliminated, top scientists have been frightened into silence by threats to their careers, physicians have lost their licenses, and the concept of early treatment has been virtually eliminated. Hundreds of thousands of people have died needlessly as a result of, in my opinion and the opinion of others, poorly designed treatment protocols, mostly stemming from the Center for Disease Control and Prevention, which have been rigidly enforced among all hospitals. The economic, psychological, and institutional damage caused by these unscientific policies is virtually unmeasurable. Whole generations of young people will suffer irreparable damage, both physical and psychological, possibly forever. The truth must be told.

11.
Clin Infect Dis ; 73(9): e3113-e3115, 2021 11 02.
Article in English | MEDLINE | ID: covidwho-1500993

ABSTRACT

We describe the impact of universal masking and universal testing at admission on high-risk exposures to severe acute respiratory syndrome coronavirus 2 for healthcare workers. Universal masking decreased the rate of high-risk exposures per patient-day by 68%, and universal testing further decreased those exposures by 77%.


Subject(s)
COVID-19 , SARS-CoV-2 , COVID-19 Testing , Health Personnel , Humans , Tertiary Healthcare
12.
Preprint in English | medRxiv | ID: ppmedrxiv-21262275

ABSTRACT

ObjectiveTo determine whether hydroxychloroquine (HCQ) is safe and effective at preventing COVID-19 infections among health care workers (HCW). DesignMulticenter, 1:1 randomized, placebo-controlled, double-blind, parallel-group, superiority trial. Setting34 clinical centers in the United States. Participants1360 HCW at risk for COVID-19 infection enrolled between April and November 2020. InterventionsA loading dose of HCQ 600 mg twice on Day 1 followed by 400 mg daily for 29 days or matching placebo taken orally. Main Outcome MeasureComposite of confirmed or suspected COVID-19 clinical infection by Day 30 defined as new onset fever, cough, or dyspnea and either a positive SARS-CoV-2 PCR test (confirmed) or a lack of confirmatory testing due to local restrictions (suspected). ResultsEnrollment for the study was closed before full accrual due to difficulties recruiting additional participants. The primary composite endpoint occurred in 41 (6.0%) participants receiving HCQ and 53 (7.8%) participants receiving placebo. No statistically significant difference in the proportion of participants experiencing clinical infection (estimated difference of -1.8%, 95% confidence interval -4.6% to 0.9%, p=0.20). We identified no significant safety issues. ConclusionOral HCQ taken as prescribed appeared to be safe in a group of HCW. No significant clinical benefits were observed. The study was underpowered to rule out a small but potentially important reduction in COVID-19 infections. Trial RegistrationNCT04334148

13.
Contemp Clin Trials ; 109: 106525, 2021 10.
Article in English | MEDLINE | ID: covidwho-1347516

ABSTRACT

BACKGROUND: The SARS CoV-2 virus has caused one of the deadliest pandemics in recent history, resulting in over 170 million deaths and global economic disruption. There remains an urgent need for clinical trials to test therapies for treatment and prevention. DESIGN: An online research platform was created to support a registry community of healthcare workers (HCWs) to understand their experiences and conduct clinical studies to address their concerns. The first study, HERO-HCQ, was a double-blind, multicenter, randomized, pragmatic trial to evaluate the superiority of hydroxychloroquine (HCQ) vs placebo for pre-exposure prophylaxis (PrEP) of COVID-19 clinical infection in HCWs. Secondary objectives were to assess the efficacy of HCQ in preventing viral shedding of COVID-19 among HCWs and to assess the safety and tolerability of HCQ. METHODS: HCWs joined the Registry and were pre-screened for trial interest and eligibility. Trial participants were randomized 1:1 to receive HCQ or placebo. On-site baseline assessment included a COVID-19 nasopharyngeal PCR and blood serology test. Weekly follow-up was done via an online portal and included screening for symptoms of COVID-19, self-reported testing, adverse events, and quality of life assessments. The on-site visit was repeated at Day 30. DISCUSSION: The HERO research platform offers an approach to rapidly engage, screen, invite and enroll into clinical studies using a novel participant-facing online portal interface and remote data collection, enabling limited onsite procedures for conduct of a pragmatic clinical trial. This platform may be an example for future clinical trials of common conditions to enable more rapid evidence generation.


Subject(s)
COVID-19 , Quality of Life , Health Personnel , Humans , SARS-CoV-2 , Treatment Outcome
15.
European Journal of Neurology ; 28(SUPPL 1):157, 2021.
Article in English | EMBASE | ID: covidwho-1307711

ABSTRACT

Background and aims: To systematically describe CNS and PNS complications in hospitalized COVID-19 patients. Methods: We conducted a prospective, observational study of adult patients from a tertiary referral center with confirmed COVID-19. All patients were screened daily for neurological and neuropsychiatric symptoms during admission and discharge. Three-month follow-up data were collected using electronic health records. We classified complications as caused by SARS-CoV-2 neurotropism, immune-mediated or critical illness-related. Results: From April-September 2020, we enrolled 61 consecutively admitted COVID-19 patients, 35 (57%) of whom required ICU management for respiratory failure. Forty-one CNS/PNS complications were identified in 28 of 61 patients and were more frequent in ICU compared to non-ICU patients. The most common CNS complication was encephalopathy (n=19, 31.1%), which was severe in 13 patients (GCS 12), including eight with akinetic mutism. Length of ICU admission was independently associated with encephalopathy (OR=1.22). Other CNS complications included ischemic stroke, a biopsy-proven acute necrotizing encephalitis, and transverse myelitis. The most common PNS complication was critical illness polyneuromyopathy (13.1%), with prolonged ICU stay as independent predictor (OR=1.14). Treatment-related PNS complications included meralgia paresthetica. Of 41 complications in total, three were para/post-infectious, 34 were secondary to critical illness or other causes, and four remained unresolved. Cerebrospinal fluid was negative for SARS-CoV-2 RNA in all five patients investigated. Conclusion: CNS/PNS complications were common in hospitalized COVID-19 patients, particularly in the ICU, and often attributable to critical illness. When COVID-19 was the primary cause for neurological disease, no signs of viral neurotropism were detected, but laboratory changes suggested autoimmune-mediated mechanisms.

16.
Preprint in English | medRxiv | ID: ppmedrxiv-21252457

ABSTRACT

IntroductionEarly COVID-19 vaccine acceptance rates suggest that up to one-third of HCWs may be vaccine-hesitant. However, it is unclear whether hesitancy among HCWs has improved with time and if there are temporal changes whether these differ by healthcare worker role. MethodsIn October 2020, a brief survey was sent to all participants in the Healthcare Worker Exposure Response and Outcomes (HERO) Registry with a yes/no question regarding vaccination under emergency use authorization (EUA): "If an FDA emergency use-approved vaccine to prevent coronavirus/COVID-19 was available right now at no cost, would you agree to be vaccinated?" The poll was repeated in December 2020, with the same question sent to all registry participants. Willingness was defined as a "Yes" response, and hesitancy was defined as a "No" response. Participants were stratified into clinical care roles. Baseline demographics of survey respondents at each timepoint were compared using appropriate univariate statistics (chi-squared and t-tests). Analyses were descriptive, with frequencies and percentages reported for each category. ResultsOf 4882 HERO active registry participants during September 1 - October 31, 2020, 2070 (42.4%) completed the October survey, and n=1541 (31.6%) completed the December survey. 70.2% and 67.7% who were in clinical care roles, respectively. In October, 54.2% of HCWs in clinical roles said they would take an EUA-approved vaccine, which increased to 76.2% in December. The largest gain in vaccine willingness was observed among physicians, 64.0% of whom said they would take a vaccine in October, compared with 90.5% in December. Nurses were the least likely to report that they would take a vaccine in both October (46.6%) and December (66.9%). We saw no statistically significant differences in age, race/ethnicity, gender, or medical role between time points. When restricting to the 998 participants who participated at both time points, 69% were vaccine-willing at both time points; 15% were hesitant at both time points, 13% who were hesitant in October were willing in December; and 2.9% who were willing in October were hesitant in December. ConclusionsIn a set of cross-sectional surveys of vaccine acceptance among healthcare workers, willingness improved substantially over 2 calendar months during which the US had a presidential election and two vaccine manufacturers released top-line Phase 3 trial results. While improved willingness was observed in all role categories, nurses reported the most vaccine hesitancy at both time points.

18.
J Infect Dis ; 223(1): 10-14, 2021 01 04.
Article in English | MEDLINE | ID: covidwho-1066339

ABSTRACT

Estimates of seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies have been hampered by inadequate assay sensitivity and specificity. Using an enzyme-linked immunosorbent assay-based approach that combines data about immunoglobulin G responses to both the nucleocapsid and spike receptor binding domain antigens, we show that excellent sensitivity and specificity can be achieved. We used this assay to assess the frequency of virus-specific antibodies in a cohort of elective surgery patients in Australia and estimated seroprevalence in Australia to be 0.28% (95% Confidence Interval, 0-1.15%). These data confirm the low level of transmission of SARS-CoV-2 in Australia before July 2020 and validate the specificity of our assay.


Subject(s)
Antibodies, Viral/analysis , COVID-19/diagnosis , Enzyme-Linked Immunosorbent Assay , Seroepidemiologic Studies , Antigens, Viral/immunology , Australia , COVID-19/immunology , Coronavirus Nucleocapsid Proteins/immunology , Humans , Immunoglobulin G/analysis , Phosphoproteins/immunology , Sensitivity and Specificity , Spike Glycoprotein, Coronavirus/immunology
19.
Aust Health Rev ; 45(1): 74-76, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1057742

ABSTRACT

The global focus on nation states' responses to the COVID-19 pandemic has rightly highlighted the importance of science and evidence as the basis for policy action. Those with a lifelong passion for evidence-based policy (EBP) have lauded Australia's and other nations' policy responses to COVID-19 as a breakthrough moment for the cause. This article reflects on the complexity of the public policy process, the perspectives of its various actors, and draws on Alford's work on the Blue, Red and Purple zones to propose a more nuanced approach to advocacy for EBP in health. We contend that the pathway for translation of research evidence into routine clinical practice is relatively linear, in contrast to the more complex course for translation of evidence to public policy - much to the frustration of health researchers and EBP advocates. Cairney's description of the characteristics of successful policy entrepreneurs offers useful guidance to advance EBP and we conclude with proposing some practical mechanisms to support it. Finally, we recommend that researchers and policy makers spend more time in the Purple zone to enable a deeper understanding of, and mutual respect for, the unique contributions made by research, policy and political actors to sound public policy.


Subject(s)
COVID-19/therapy , Evidence-Based Practice/standards , Guidelines as Topic , Health Policy , Pandemics/prevention & control , Public Health/legislation & jurisprudence , Public Health/standards , Australia/epidemiology , COVID-19/epidemiology , Humans , SARS-CoV-2
20.
ANZ J Surg ; 91(1-2): 27-32, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-1015521

ABSTRACT

BACKGROUND: The study aimed to estimate the prevalence of active or previous SARS-CoV-2 infection in asymptomatic adults admitted for elective surgery in Australian hospitals. This surveillance activity was established as part of the National Pandemic Health Intelligence Plan. METHODS: Participants (n = 3037) were recruited from 11 public and private hospitals in four states (NSW, Vic, SA and WA) between 2 June and 17 July 2020, with an overall 66% participation rate. Presence of SARS-CoV-2 viral RNA was assessed by Reverse Transcriptase - Polymerase Chain Reaction (RT-PCR) analysis of nasopharyngeal swabs taken after induction of anaesthesia. Presence of anti-SARS-CoV-2 antibodies was assessed by analysis of serum collected at the same time using a novel dual-antigen ELISA assay. RESULTS: No patient (0/3010) returned a positive RT-PCR result. The Bayesian estimated prevalence of active infection of 0.02% (95% probability interval 0.00-0.11%), with the upper endpoint being 1 in 918. Positive serology (IgG) was observed in 15 of 2991 patients, with a strong positive in five of those individuals (Bayesian estimated seroprevalence 0.16%; 95% probability interval 0.00-0.47%). CONCLUSION: These results confirm that during periods of low community prevalence of SARS-CoV-2 elective surgery patients without fever or respiratory symptoms had a very low prevalence of active SARS-CoV-2 infection.


Subject(s)
COVID-19/epidemiology , Carrier State/epidemiology , Elective Surgical Procedures , Hospitalization , Adult , Aged , Aged, 80 and over , Australia , COVID-19/diagnosis , COVID-19 Nucleic Acid Testing , COVID-19 Serological Testing , Carrier State/diagnosis , Female , Humans , Male , Middle Aged , Prevalence , Prospective Studies , Reverse Transcriptase Polymerase Chain Reaction
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