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1.
Perfusion ; 38(1 Supplement):140, 2023.
Article in English | EMBASE | ID: covidwho-20241718

ABSTRACT

Objectives: Patients with severe COVID-19 infections have been shown to have prolonged periods of coma followed by meaningful neurological recovery. Therefore, neurological prognostication is challenging, particularly in those who require veno-venous extracorporeal membrane oxygenation (VV-ECMO) support. We hoped to evaluate which variables can be considered when trying to predict neurological recovery. Method(s): We conducted a case-control retrospective chart review of patients on VV-ECMO from March 2020 to January 2022. This time-frame was selected to limit the effect of post-pandemic changes in sedation practices. Our outcome was duration of unconsciousness, defined as days with GCS motor score <6. We first conducted a matched cohort analysis, comparing COVID and non-COVID patients. We then performed a Classification and Regression Tree (CART) analysis to determine the Relative Variable Importance (RVI) of clinical variables associated with duration of unconsciousness. Result(s): Our matched analysis included 52 patients, 27 (52%) of whom had COVID-19. There were no significant differences in the baseline characteristics of the groups (Table 1). Patients with COVID-19 had a significantly longer median duration on ECMO (p<0.001) and hospital length of stay (p=0.003). The median duration of unconsciousness was similar between COVID-19 and non-COVID patients (p=0.58). The CART analysis results (Figure 1) showed that the most important variables to predict duration of unconsciousness were successive variations in GCS (RVI 100%) and GCS standard deviation (RVI 99%). COVID positivity only had a weak predictability (RVI 4%). Conclusion(s): Our analysis has shown that in patients on VV-ECMO, those with COVID-19 spent a longer time on ECMO and in the hospital. While there was no significant difference in the duration of unconsciousness, we found that patients who had high fluctuations of GCS during ECMO had a shorter duration of coma. (Figure Presented).

2.
9th International Forum on Digital Multimedia Communication, IFTC 2022 ; 1766 CCIS:465-477, 2023.
Article in English | Scopus | ID: covidwho-2281133

ABSTRACT

The COVID-19 epidemic continues to have a negative impact on the economy and public health. There is a correlation between certain limits (meteorological factors and air pollution statistics) and verified fatal instances of Corona Virus Disease 2019 (COVID-19), according to several researchers. It has not yet been determined how these elements affect COVID-19. Using air pollution data and meteorological data from 15 cities in India from 2020 to 2022, Convergent Cross Mapping (CCM) is utilized to set up the causal link with new confirmed and fatal cases of COVID-19 in this study. Our experimental results show that the causal order of the factors influencing the diagnosis of COVID-19 is: humidity, PM25, temperature, CO, NO2, O3, PM10. In contrast to other parameters, temperature, PM25, and humidity are more causally associated with COVID-19, while data on air pollution are less causally related to the number of new COVID-19 cases. The causal order of the factors affecting the new death toll is as follows: temperature, PM25, humidity, O3, CO, PM10, NO2. The causality of temperature with new COVID-19 fatalities in India was higher than the causation of humidity with new COVID-19 deaths, and O3 also showed higher causality with it. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

3.
Journal of Contingencies and Crisis Management ; 2023.
Article in English | Scopus | ID: covidwho-2263226

ABSTRACT

The COVID-19 pandemic has been the world's greatest challenge since World War II. As an unprecedented global public health crisis, crisis management teams (CMTs) in the infected countries need to rethink to cope with the similar uncertainty and urgency of the ongoing COVID-19 pandemic. The shared context of COVID-19 allows us to explore a cross-nation study of different constructs and CMT to communicate information about crises with the public effectively. Since the pandemic affected all countries, the comparison is warranted. Can CMTs mitigate the effects of COVID-19? Based on the analysis of China and the US cases, our study explores how shared and common knowledge cognition among crisis responders plays a pivotal role in effective CMTs' communication while technological failures and inadequate information disrupt the system, worsening pandemics like COVID-19. Furthermore, organizational dysfunction, such as institutional fragmentation, regulatory hurdles and bureaucratic arrogance, impede effective communication between CMTs. However, effective coordination and decisive leadership could improve coordination effectiveness and reduce crisis costs. © 2023 John Wiley & Sons Ltd.

4.
Critical Care Medicine ; 51(1 Supplement):271, 2023.
Article in English | EMBASE | ID: covidwho-2190572

ABSTRACT

INTRODUCTION: Medical complications among pregnant peripartum patients are not common. However, certain disease such as obstetric hemorrhage or respiratory failure could be associated with poor outcome among obstetric patients whose biological systems are already stretched. When a peripartum patients encounter a severe medical condition, they are frequently transferred to a tertiary center for management of these patients' complex conditions. Our study investigated the outcomes of the peripartum patients who were transferred from other hospitals (Interhospital transfer [IHT]) to the Intensive Care Unit at an academic quaternary center. METHOD(S): We retrospectively analyzed all adult IHT peripartum patients to our institution's ICU between Jan. 2017 to Dec. 2021. We presented descriptive analysis for our patients and used multivariable ordinal regressions for association between demographic, clinical factors, and patients' length of stay (LOS) in the ICU (ICULOS), hospital (HLOS). RESULT(S): Among 1794 IHT peripartum patients, 59 patients were transferred directly to an ICU, 8 (13.6%) to Medical ICU, 2 (3.4%) Neuro ICU, 2 (3.4%) Surgical ICU and 47 (79.7%) to our Critical Care Resuscitation Unit. Patients' mean (Standard Deviation) age was 32 (6) years, SOFA score 3 (3), APACHE II 8 (4), median Respiratory Oxygenation (ROx) index was 13 [Interquartile Range 4-22], and serum lactate 11 [9-15] mmol/L. Respiratory failure occurred in 19 (32%), postpartum hemorrhage 9 (15%), sepsis 8 (14%) patients. 16 (27%) patients were infected with COVID-19. 24 (41%) needed intubation, 13 (22%) vasopressor, 4 (7%) Extracorporeal Membrane Oxygenation. Median ICULOS and HLOS was 5 [2-12], 8 [5-17] days. Only 1 (1.7%) died, while 45 (76.3%) were discharged home directly. Having COVID-19 infection was associated with both ICULOS (Correlation Coefficient -2,23, OR 0.06, 95%CI 0.02-0.65, P = 0.016) and HLOS (Corr. Coeff. -2.75, OR 0.06, 95%CI 0.01-0.37, P = 0.002). CONCLUSION(S): Although severe medical conditions were uncommon among interhospital transferred peripartum patients, they could be severe, especially during the COVID-19 pandemic. Fortunately, the mortality rate for peripartum patients in our study was very low. Further studies with larger sample sizes are needed to confirm our observation.

5.
Critical Care Medicine ; 51(1 Supplement):232, 2023.
Article in English | EMBASE | ID: covidwho-2190565

ABSTRACT

INTRODUCTION: Neurological prognostication is an important part of caring for critically ill patients and can help guide goals of care. This has become a challenge when caring for patients with severe COVID-19 pneumonia, as they have been shown to often have prolonged periods of coma followed by meaningful neurological recovery. However, this has not been studied in patients who require venovenous extracorporeal membrane oxygenation (VV-ECMO) support. We hypothesize that patients with COVID-19 pneumonia on VV-ECMO will have a more prolonged period of unconsciousness when compared to their COVID-negative counterparts. METHOD(S): We conducted a retrospective chart review of all patients who received VV-ECMO support at our institution from March 2020 to January 2022. This timeframe was selected to limit the effect of any changes in sedation practices that were brought about by the COVID-19 pandemic. We compared the daily Glascow Coma Scale (GCS) of patients with COVID-19 pneumonia to those who were cannulated for other etiologies. Our outcomes were duration of unconsciousness, which was defined as time from intubation to GCS motor score=6 for 48 hours, as well as changes in GCS over time. RESULT(S): Our preliminary analysis included 84 patients, 57 (68%) of whom were COVID-19 positive. There were no significant differences in the baseline characteristics of the groups, including initial Sequential Organ Failure Assessment score and need for renal replacement therapy. Patients with COVID-19 pneumonia had a significantly longer duration on ECMO in hours (952 vs 312, p< 0.001) and hospital length of stay in days (42 vs 30, p=0.01). There was no significant difference in the duration of unconsciousness (days) between the two groups (11 vs 9, p=0.21). However, the trend in GCS over time was notable as we found that patients with COVID-19 spent more days unresponsive, defined as a GCS=3 (8 vs 5, p=0.04). CONCLUSION(S): Our preliminary analysis found that in patients on VV-ECMO, those with COVID-19 pneumonia spent a longer time on ECMO and in the hospital. While there was no difference in the duration of unconsciousness, patients with COVID-19 spent more of that period unresponsive prior to recovery. While additional analysis is needed, this finding may assist providers when prognosticating neurological recovery.

6.
Ieee Transactions on Instrumentation and Measurement ; 71:15, 2022.
Article in English | Web of Science | ID: covidwho-1794799

ABSTRACT

With the rapid development of industrialization, the environmental pollution issue is becoming increasingly serious, especially the air pollution problem. As the core of the prevention and control of air pollution, air pollution prediction plays a very significant role in human survival and development. Therefore, it is highly essential to develop an accurate air pollution prediction model for mass rallies (e.g., playground and bazaar). Recent studies have suggested that multiple air contaminants, e.g., PM2.5 and PM10, which belong to a kind of aerosol, can carry the Covid-19 virus and spread it rapidly through the atmosphere, and this dramatically increases the risk of Covid-19 infection, particularly in the crowded and enclosed environment. Nevertheless, most existing air pollution prediction methods, which rely on large amounts of historical data for modeling and assume that the crowd flows relatively slow, are difficult to apply well to predict air pollution in mass rallies. To solve the aforementioned problem and better assist the decision-makers in managing environmental risk to human beings, in this article, we come up with a novel air pollution prediction model for mass rallies. More specifically, we first propose a temporally weighting matrix to differentiate the significance of training samples in the time domain. Then, we construct a temporal support vector regressor (TSVR), which puts more emphasis on the adjacent samples by considering the fact that the crowd usually flows promptly and disorderly in mass rallies. Finally, based on the extended TSVR, we develop a multitask TSVR (MTSVR) that simultaneously considers the related tasks. Since different air contaminants are correlated with each other, all the tasks can benefit by sharing information. The results of comparison experiments demonstrate that our presented MTSVR outperforms state-of-the-art single-task learners, multitask learners, and air pollution predictors when applied for air pollution prediction in mass rallies. Particularly, when under the six-task condition, the error values of the prediction of PM2.5, PM10, and O-3 obtained by our proposed method are relatively lower, outperforming the most advanced method tested by 15.2%, 6.1%, and 4.3%, and the precision values of the predicted values outperform the advanced method tested by 28.3%, 25.1%, and 24.8%.

7.
AMIA ... Annual Symposium Proceedings/AMIA Symposium ; 2021:1198-1207, 2021.
Article in English | MEDLINE | ID: covidwho-1749821

ABSTRACT

COVID-19 is a disease with vast impact, yet much remains unclear about patient outcomes. Most approaches to risk prediction of COVID-19 focus on binary or tertiary severity outcomes, despite the heterogeneity of the disease. In this work, we identify heterogeneous subtypes of COVID-19 outcomes by considering 'axes' of prognosis. We propose two innovative clustering approaches - 'Layered Axes' and 'Prognosis Space' - to apply on patients' outcome data. We then show how these clusters can help predict a patient's deterioration pathway on their hospital admission, using random forest classification. We illustrate this methodology on a cohort from Wuhan in early 2020. We discover interesting subgroups of poor prognosis, particularly within respiratory patients, and predict respiratory subgroup membership with high accuracy. This work could assist clinicians in identifying appropriate treatments at patients' hospital admission. Moreover, our method could be used to explore subtypes of 'long COVID' and other diseases with heterogeneous outcomes.

8.
Public Health ; 203: 110-115, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1630605

ABSTRACT

OBJECTIVES: At the end of 2020, many countries commenced a vaccination programme against SARS-CoV-2. Public health authorities aim to prevent and interrupt outbreaks of infectious disease in social care settings. We aimed to investigate the association between the introduction of the vaccination programme and the frequency and duration of COVID-19 outbreaks in Northern Ireland (NI). STUDY DESIGN: We undertook an ecological study using routinely available national data. METHODS: We used Poisson regression to measure the relationship between the number of RT-PCR confirmed COVID-19 outbreaks in care homes, and as a measure of community COVID-19 prevalence, the Office for National Statistics COVID-19 Infection Survey estimated the number of people testing positive for COVID-19 in NI. We estimated the change in this relationship and estimated the expected number of care home outbreaks in the absence of the vaccination programme. A Cox proportional hazards model estimated the hazard ratio of a confirmed COVID-19 care home outbreak closure. RESULTS: Care home outbreaks reduced by two-thirds compared to expected following the introduction of the vaccination programme, from a projected 1625 COVID-19 outbreaks (95% prediction interval 1553-1694) between 7 December 2020 and 28 October 2021 to an observed 501. We estimated an adjusted hazard ratio of 2.53 of the outbreak closure assuming a 21-day lag for immunity. CONCLUSIONS: These findings describe the association of the vaccination with a reduction in outbreak frequency and duration across NI care homes. This indicates probable reduced harm and disruption from COVID-19 in social care settings following vaccination. Future research using individual level data from care home residents will be needed to investigate the effectiveness of the vaccines and the duration of their effects.


Subject(s)
COVID-19 Vaccines , COVID-19 , Disease Outbreaks , Humans , SARS-CoV-2 , Vaccination
9.
6th International Technical Conference on Frontiers of Hydraulic and Civil Engineering Technology, HCET 2021 ; 19:594-601, 2021.
Article in English | Scopus | ID: covidwho-1566626

ABSTRACT

The global outbreak of COVID-19 has exposed the deficiency of urban space quality in terms of health and awareness of respiratory infectious diseases.This article analyzes the influencing factors of urban health mechanisms and simulates through infectious disease mechanisms and approaches. Finally Propose corresponding strategies and optimization methods for the optimization of urban space form and structure, and provide corresponding strategies and basis for healthy urban space planning. © 2021 The authors and IOS Press.

10.
Nat Med ; 27(7): 1290-1297, 2021 07.
Article in English | MEDLINE | ID: covidwho-1263501

ABSTRACT

Reports of ChAdOx1 vaccine-associated thrombocytopenia and vascular adverse events have led to some countries restricting its use. Using a national prospective cohort, we estimated associations between exposure to first-dose ChAdOx1 or BNT162b2 vaccination and hematological and vascular adverse events using a nested incident-matched case-control study and a confirmatory self-controlled case series (SCCS) analysis. An association was found between ChAdOx1 vaccination and idiopathic thrombocytopenic purpura (ITP) (0-27 d after vaccination; adjusted rate ratio (aRR) = 5.77, 95% confidence interval (CI), 2.41-13.83), with an estimated incidence of 1.13 (0.62-1.63) cases per 100,000 doses. An SCCS analysis confirmed that this was unlikely due to bias (RR = 1.98 (1.29-3.02)). There was also an increased risk for arterial thromboembolic events (aRR = 1.22, 1.12-1.34) 0-27 d after vaccination, with an SCCS RR of 0.97 (0.93-1.02). For hemorrhagic events 0-27 d after vaccination, the aRR was 1.48 (1.12-1.96), with an SCCS RR of 0.95 (0.82-1.11). A first dose of ChAdOx1 was found to be associated with small increased risks of ITP, with suggestive evidence of an increased risk of arterial thromboembolic and hemorrhagic events. The attenuation of effect found in the SCCS analysis means that there is the potential for overestimation of the reported results, which might indicate the presence of some residual confounding or confounding by indication. Public health authorities should inform their jurisdictions of these relatively small increased risks associated with ChAdOx1. No positive associations were seen between BNT162b2 and thrombocytopenic, thromboembolic and hemorrhagic events.


Subject(s)
COVID-19 Vaccines/therapeutic use , COVID-19/prevention & control , Hemorrhage/epidemiology , Purpura, Thrombocytopenic, Idiopathic/epidemiology , Thrombocytopenia/epidemiology , Thromboembolism/epidemiology , Venous Thromboembolism/epidemiology , Adolescent , Adult , Aged , BNT162 Vaccine , Case-Control Studies , ChAdOx1 nCoV-19 , Cohort Studies , Female , Humans , Incidence , Male , Middle Aged , Prospective Studies , SARS-CoV-2 , Scotland/epidemiology , Sinus Thrombosis, Intracranial/epidemiology , Young Adult
11.
IOP Conf. Ser. Earth Environ. Sci. ; 692, 2021.
Article in English | Scopus | ID: covidwho-1185572

ABSTRACT

At present, most disinfection methods in indoor scenes use manual spraying and sweeping. The disinfection workers hold watering cans or pesticide sprayers to spray disinfection solutions, which is very inconvenient to use. In this paper, an automatic disinfection car is designed to be used in indoor places such as hospitals, shops, banks, etc, without manual cleaning. Especially during the current COVID-19 epidemic, it effectively realizes the timely disinfection of the public indoor environment, reduces the waste of human resources, protects the cleaning and disinfection staff, and reduces further cross-infection. © 2021 Institute of Physics Publishing. All rights reserved.

12.
Epidemiol Infect ; 148: e218, 2020 09 21.
Article in English | MEDLINE | ID: covidwho-779905

ABSTRACT

'Recurrence' of coronavirus disease 2019 (COVID-19) has triggered numerous discussions of scholars at home and abroad. A total of 44 recurrent cases of COVID-19 and 32 control cases admitted from 11 February to 29 March 2020 to Guanggu Campus of Tongji Hospital affiliated to Tongji Medical College Huazhong University of Science and Technology were enrolled in this study. All the 44 recurrent cases were classified as mild to moderate when the patients were admitted for the second time. The gender and mean age in both cases (recurrent and control) were similar. At least one concomitant disease was observed in 52.27% recurrent cases and 34.38% control cases. The most prevalent comorbidity among them was hypertension. Fever and cough being the most prevalent clinical symptoms in both cases. On comparing both the cases, recurrent cases had markedly elevated concentrations of alanine aminotransferase (ALT) (P = 0.020) and aspartate aminotransferase (AST) (P = 0.007). Moreover, subgroup analysis showed mild to moderate abnormal concentrations of ALT and AST in recurrent cases. The elevated concentrations of ALT and AST may be recognised as predictive markers for the risk of 'recurrence' of COVID-19, which may provide insights into the prevention and control of COVID-19 in the future.


Subject(s)
Alanine Transaminase/blood , Aspartate Aminotransferases/blood , Coronavirus Infections/enzymology , Pneumonia, Viral/enzymology , COVID-19 , Case-Control Studies , Cough , Female , Fever , Humans , Male , Middle Aged , Pandemics , Recurrence , Retrospective Studies , Risk Factors
13.
Headache ; 60(5): 864-877, 2020 05.
Article in English | MEDLINE | ID: covidwho-98794

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) is an emerging infectious disease of pandemic proportions. Healthcare workers in Singapore working in high-risk areas were mandated to wear personal protective equipment (PPE) such as N95 face mask and protective eyewear while attending to patients. OBJECTIVES: We sought to determine the risk factors associated with the development of de novo PPE-associated headaches as well as the perceived impact of these headaches on their personal health and work performance. The impact of COVID-19 on pre-existing headache disorders was also investigated. METHODS: This is a cross-sectional study among healthcare workers at our tertiary institution who were working in high-risk hospital areas during COVID-19. All respondents completed a self-administered questionnaire. RESULTS: A total of 158 healthcare workers participated in the study. Majority [126/158 (77.8%)] were aged 21-35 years. Participants included nurses [102/158 (64.6%)], doctors [51/158 (32.3%)], and paramedical staff [5/158 (3.2%)]. Pre-existing primary headache diagnosis was present in about a third [46/158 (29.1%)] of respondents. Those based at the emergency department had higher average daily duration of combined PPE exposure compared to those working in isolation wards [7.0 (SD 2.2) vs 5.2 (SD 2.4) hours, P < .0001] or medical ICU [7.0 (SD 2.2) vs 2.2 (SD 0.41) hours, P < .0001]. Out of 158 respondents, 128 (81.0%) respondents developed de novo PPE-associated headaches. A pre-existing primary headache diagnosis (OR = 4.20, 95% CI 1.48-15.40; P = .030) and combined PPE usage for >4 hours per day (OR 3.91, 95% CI 1.35-11.31; P = .012) were independently associated with de novo PPE-associated headaches. Since COVID-19 outbreak, 42/46 (91.3%) of respondents with pre-existing headache diagnosis either "agreed" or "strongly agreed" that the increased PPE usage had affected the control of their background headaches, which affected their level of work performance. CONCLUSION: Most healthcare workers develop de novo PPE-associated headaches or exacerbation of their pre-existing headache disorders.


Subject(s)
Coronavirus Infections/prevention & control , Headache/epidemiology , Health Personnel/statistics & numerical data , Pandemics/prevention & control , Personal Protective Equipment/adverse effects , Pneumonia, Viral/prevention & control , Adult , COVID-19 , Coronavirus Infections/epidemiology , Cross-Sectional Studies , Female , Humans , Male , Pneumonia, Viral/epidemiology , Singapore/epidemiology , Surveys and Questionnaires , Young Adult
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