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1.
Sexually Transmitted Diseases ; 49(10 Supplement 1):S45, 2022.
Article in English | EMBASE | ID: covidwho-2092966

ABSTRACT

BACKGROUND: Neonatal gonococcal conjunctivitis is usually transmitted perinatally;however, in adults, gonococcal conjunctivitis occurs primarily via autoinoculation from a preexisting gonorrhea infection at another mucosal site. As the incidence of gonorrhea in California (CA) continues to increase, gonococcal conjunctivitis morbidity may also rise. There are limited data describing the incidence of this extragenital manifestation of gonorrhea. We sought to describe gonococcal conjunctivitis in CA. METHOD(S): All gonorrhea cases reported to the CA Department of Public Health (CDPH) from January 2018 through December 2021 were flagged if the specimen source reported for gonorrhea was suspicious of gonococcal conjunctivitis. A clinician reviewed these cases to determine likelihood of gonococcal conjunctivitis;confirmed cases were summarized and a bivariate negative binomial model was used to evaluate temporal trends. RESULT(S): During the study period, there were 71 gonococcal conjunctivitis cases reported in CA, representing a cumulative incidence of 0.05 cases per 100,000 people. There were 22 (31.0%) cases in 2018, 18 (25.3%) in 2019, 9 (12.7%) in 2020, and 22 (31.0%) in 2021;there was no significant trend in the number of cases reported from 2018- 2021 (p>0.05), but the number of gonococcal conjunctivitis cases reported in 2020 was significantly fewer than other years (p<0.05). There were 12 (16.9%) infants (<1 year old), including 7 (9.8%) neonates (<28 days old). There were 4 (5.6%) cases who were <18 years old and 55 (77.4%) at least 18 years old. The majority (42, 60%) of cases were males. CONCLUSION(S): Though gonorrhea rates continue to increase in CA, gonococcal conjunctivitis rates remained steady, other than both decreasing in 2020 (likely due to COVID-19-related decreases in STI testing and diagnosis). We hypothesize this may be an underestimation of the true incidence of gonococcal conjunctivitis in CA due to the nature of passive surveillance for this infection.

2.
Chest ; 162(4):A1821, 2022.
Article in English | EMBASE | ID: covidwho-2060870

ABSTRACT

SESSION TITLE: Outcomes Across COVID-19 SESSION TYPE: Rapid Fire Original Inv PRESENTED ON: 10/19/2022 11:15 am - 12:15 pm PURPOSE: Coronavirus disease 2019 (COVID-19) and influenza infections are associated with systemic inflammatory reactions that predispose to Takotsubo cardiomyopathy (TTS). Studies have investigated the epidemiology and clinical features of TTS in COVID-19 and influenza infection, however, there are limited data comparing TTS between patients with COVID-19 and influenza. METHODS: We searched PubMed/Medline, Web of Science, SCOPUS, EMBASE, and Google Scholar until November 1st, 2021, for case reports, case series, and observational cohort studies using these keywords: takotsubo syndrome/takotsubo cardiomyopathy, stress-induced cardiomyopathy, and broken heart syndrome combined with the terms COVID-19 and/or SARS-CoV-2, flu and/or influenza. All the published case reports included in the final analysis were in English and were categorized into patients with ‘COVID-19 + TTS’ and ‘Flu + TTS’. RESULTS: We identified 37 studies describing 64 patients with COVID-19+TTS and 10 case reports describing 10 patients with Flu + TTS. The mean age of patients in the COVID-19 + TTS was similar to the influenza group (69 years). Although women were more disproportionately affected by TTS in both groups, COVID-19 + TTS patients had a higher proportion of men than the Flu + TTS group (44% vs 30%) and previously reported incidence of TTS in men in the general population. Compared to patients with Flu + TTS, COVID-19 + TTS had a longer mean time from testing positive to developing TTS (7.3 days vs. 3.1 days), higher incidence rates of acute respiratory distress syndrome (77% vs. 40%), hypoxemic respiratory failure (86% vs. 60%), more likely to require invasive mechanical ventilation (63% vs. 40%) and higher in-hospital mortality rates (36%, n=23 vs 10%, n=1) CONCLUSIONS: Our systematic review highlights some important differences in the presentation and outcomes of TTS in patients with COVID-19 compared to seasonal influenza. Patients with COVID-19 + TTS had higher rates of respiratory complications and excess all-cause mortality compared to Flu + TTS. In contrast to the general population and patients infected with influenza, TTS tends to affect more men with COVID-19 infection. CLINICAL IMPLICATIONS: Hospitalized patients with COVID-19 who develop TTS appear to have a more severe disease course and poorer outcome compared to hospitalized patients with Flu+TTS. The study findings provide additional knowledge comparing complications between COVID-19 and influenza infections and may contribute to the continued efforts to manage the COVID-19 pandemic. DISCLOSURES: no disclosure on file for Temidayo Abe;No relevant relationships by Thomas Allingham No relevant relationships by Omovefe Edika No relevant relationships by Hammad Khalid No relevant relationships by Ifeoma Ogbuka No relevant relationships by Titilope Olanipekun No relevant relationships by Richard Snyder No relevant relationships by Abhinav Vedire No relevant relationships by Nicholas Wilson

3.
American Journal of Respiratory and Critical Care Medicine ; 205:2, 2022.
Article in English | English Web of Science | ID: covidwho-1880666
5.
Circulation ; 144(SUPPL 1), 2021.
Article in English | EMBASE | ID: covidwho-1639303

ABSTRACT

Introduction: There have been over 13 million cases of COVID-19 cases with a 2% mortality rate [1]. Over the past year there has been a significant progress in the understanding and management of COVID-19 infections. There are still many factors and complications of COVID-19 that have yet to be elucidated. There have been multiple studies looking at the possible link between ABO group type and increased risk of mortality. Many studies from China, Europe and Canada indicate that blood group “O” had lower risk of susceptibility and severe infection[2-4]. We wanted to identify weather this trend was applicable within our hospital network in Eastern Pennsylvania. We wanted to identify through retrospective analysis if there is an association between ABO type, Race, Gender, and mortality at 30-day or 90 days. Methods: We identified n=568 patients between February 2020 to June 2020 that were admitted to the hospital for treatment of COVID-19 that also had historical data regarding ABO grouping. Demographics, length of stay, intubations, and smoking history. Once data was collected, statistical analysis was conducted with SPSS for means, standard deviations, and Chi-squared test for nonparametric testing. Results: The breakdown of blood groups in our populations was [ A: 35.1%, B: 11.6%, AB: 7.9%, O:45.3% ]. The average age of patients by blood group was [A:70.9±6 , B: 68.6±15, AB:66.3±12, O: 65±17], The percentage of females in each group is [A:45%, B: 35%, AB:67%, O:50%]. The mean BMI for all groups were 31±7 (p>0.05) and there was no significant difference between blood groups with length of stay [A:8±6.1 , B: 10.5±9.6, AB:8.3±6.7, O: 9±8 (p>0.05)] There was no significant difference in mortality rate among the blood groups during admission [ A: 26%, B: 16%, AB: 13%, O:24% (p=0.17)] or the rate of intubation [ A: 10%, B: 15%, AB: 11%, O:12% (p=0.72)]. Conclusion: Our findings indicate there is no significant difference between mortality, inpatient length of stay, or proportion of intubations between different blood groups. Our population of blood groups was distributed close to distribution of blood group in the general population. While there have been studies that indicate there is a protective nature of type O blood group, we did not see this in our cohort.

6.
American Journal of Respiratory and Critical Care Medicine ; 203(9):1, 2021.
Article in English | Web of Science | ID: covidwho-1407371
7.
Journal of Clinical Oncology ; 39(15 SUPPL), 2021.
Article in English | EMBASE | ID: covidwho-1339259

ABSTRACT

Background: The surge of the SARS coronavirus-2 (COVID-19) pandemic posed great challenges in the oncology community for optimal management of cancer patients. We sought to analyze the treatment changes experienced by the prostate cancer patients in March, April and May 2020 and to compare these treatment decisions to the published guidelines. Methods: We focused on patients currently receiving androgen deprivation therapy (ADT) with leuprolide acetate, and/or oral anti-androgen agents (Androgen receptor axis targeted agent, ARAT), or chemotherapy. Electronic medical records were reviewed, and the oncologists and nurse practitioners were interviewed to understand the decision-making process. Results: Seventy-five patients were included, median age 72 years old (range 47- 95). All were taking ADT, and 21 were also taking ARAT, and 3 were also receiving chemotherapy. The incidence and indications for their ADT treatments and schedule changes are shown in the table below. Twenty-seven patients (36%) experienced delays in their ADT treatment, and the percentage of treatment change was similar in categories of metastatic hormone sensitive prostate cancer (mHSPC), metastatic castration resistant cancer (mCRPC), biochemical recurrence as well as stage IVA post surgery. Four patients were receiving neoadjuvant ADT planned prior to definitive radiation, and none had schedule change. One patient with mHSPC and 2 patients with mCRPC continued chemotherapy as planned. One patient declined recommended chemotherapy for mCRPC. Two patients were given q 3 months dose of ADT instead of q 1m, while all the rest were already receiving q3 months dosing. Among the 27 patients who had schedule change, 12 (44.4%) patients had a discussion with their providers first, and 15 patients (55.6%) did not keep their treatment appointment. Conclusions: About one third of patients changed ADT injection schedule with a similar percentage in patients with mHSPC, or mCRPC or Biochemical recurrence, or IVA after surgery. Every 3 months dosing of ADT recommended by NCCN significantly decreases exposure to COVID -19, delaying or skipping treatment was still encountered due to health concern or travel limitations. On the other hand, all patients receiving neoadjuvant ADT, or chemotherapy stayed on schedule. Although NCCN guideline recommended delaying myelosuppressive therapy, palliative chemotherapy for symptomatic, refractory patients may still be a priority.

8.
American Journal of Respiratory and Critical Care Medicine ; 203(9), 2021.
Article in English | EMBASE | ID: covidwho-1277433

ABSTRACT

Introduction The mental health impact of COVID-19 infection on its survivors have been reported. African Americans are disproportionately affected by COVID-19 and more likely to experience severe outcomes relative to other ethnicities. We evaluated the incidence and severity of depression among African American patients within 90 days of recovery from severe COVID-19 infection. Methods We identified African American patients with severe SARS-CoV-2 infection who received invasive mechanical ventilation at the intensive care unit (ICU) of Grady Memorial Hospital, Atlanta, Georgia between May 1, 2020, and June 30, 2020. The patient health questionnaire (PHQ-9), a nine-item questionnaire used to assess depression, and its severity was administered to the patients within 30 to 90 days of hospital discharge. Patients with a history of psychiatric disorders were excluded. We categorized patients into major depressive disorder (MDD) diagnosis or other depression based on their responses. To assess severity, all patients were categorized into none or minimal, mild, moderate, moderately severe, and severe based on a score range of 0-27 on the PHQ-9. We calculated the number of patients on treatment for depression as a percentage of the total eligible for treatment based on their PHQ-9 scores. Data analysis was performed using R version 3.6.3 (R Foundation). Results A total of 73 patients completed the questionnaire. The median age of the participants was 52.5 years [IQR 44-65 years] and 65% were males. 44% of the patients had a diagnosis of MDD. The incidence of MDD was higher among females (69%, n=18/26) compared to males (29%, n=14/47), patients aged 55-74 years (60%, n=18/30), > 75 years (66%, n=4/6) compared to younger patients and patients with multiple co-morbidities (45%, n=28/62) compared to patients with only one or no co-morbidity (36%, n=4/11). 27 patients in the study were eligible for treatment based on a PHQ-9 score of at least 14 (moderate and moderately severe depression). However, only 7 of them were receiving some form of depression treatment. The remaining 74% (n=20/27) had not been screened for depression since hospital discharge (Figure 1). ConclusionOur study showed that at least 4 out of 10 African Americans without prior psychiatric illness, hospitalized in the ICU for severe COVID-19 infection will develop MDD within 90 days of discharge. 74% of treatment eligible patients in our study had not been evaluated by a medical professional and were not on any form of treatment.

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