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1.
Clinical Nephrology ; 15:15, 2022.
Article in English | MEDLINE | ID: covidwho-2164097

ABSTRACT

INTRODUCTION: Patients with end-stage renal disease (ESRD) on dialysis and COVID-19 infection have an increased risk of in-hospital mortality, but whether these patients have a higher long-term mortality risk is unknown.

2.
Ahm Conference 2022: Witnessing, Memory, and Crisis, Vol 1 ; : 87-93, 2022.
Article in English | Web of Science | ID: covidwho-2083249

ABSTRACT

Colombia has suffered from a complex internal armed conflict for over fifty years. The war has left millions of victims of crimes against humanity and a deeply wounded society. Most of the victims belong to marginal groups such as peasant and ethnic minority communities and have been systematically unrecognized in the public sphere. This paper will focus on two photographs of the exhibition El Testigo, first opened in 2018 but closed in 2020 due to the Covid-19 pandemic and now reopened again to become part of the permanent collection of the museum Claustro San Agustin. The exhibition displays a comprehensive collection of photographs taken by the photojournalist Jesus Abad Colorado between 1992-2018 and show the horrors of the violence that the victims of the conflict had to endure. The main goal of this paper is to compare the images of this exhibition with previous images circulating in the mass media to reflect on the framing of representations of violence and on how different framings of war can serve different purposes. I will argue that the photographs of El Testigo contribute to imagining the unimaginable nature of violence by bringing to the present fragments of the past that need recognition, especially today when Colombia is facing a stage of transition towards the maintenance of peace since a peace treaty was signed between the FARC guerrilla and the Colombian Government in 2016. The photographs therefore elicit an ethical treatment of violence and contribute to the configuration of a collective memory that strives for the victim's recognition and justice.

3.
Hormone Research in Paediatrics ; 95(SUPPL 2):436-436, 2022.
Article in English | Web of Science | ID: covidwho-2068402
4.
Gastroenterology ; 162(7):S-684, 2022.
Article in English | EMBASE | ID: covidwho-1967363

ABSTRACT

Introduction: The coronavirus-2019 (COVID-19) pandemic has led to the suspension of elective outpatient procedures. Clinical educators have raised concerns that gastroenterology fellows have gotten reduced endoscopy exposure with possible decrease in quality metrics. We investigated whether quality parameters such as adenoma detection rate (ADR) and withdrawal times in index screening colonoscopies where fellows were involved have been affected now that elective procedures have resumed in greater numbers. Methods: This is a single-center observational study comparing patients who underwent index screening colonoscopies since our outpatient facilities reopened (7/1/2021 through 9/30/2021) with a pre-pandemic cohort (7/1/2018 through 9/30/2018). We collected demographic information and we tabulated the number of polyps detected, the number of tubular adenomas, and the withdrawal times. We used Chi-square testing to determine significance among our categorical variables and used t-tests to compare means for our numerical variables, particularly between procedures with and without fellow involvement, and between cohorts. All statistical analysis was done in R (R Core Team, 2020). Results: We identified 121 patients in the 2018 cohort without trainee involvement and 38 patients in the same cohort wherein fellows did the procedure. We also identified 186 patients in the 2021 cohort without fellow involvement and 58 patients in the same cohort wherein a trainee did the procedure (Table 1). The 2018 group had an overall ADR of 32.2% (25.0% for women, 39.3% for men) without fellows, and an overall ADR of 21.1% (5.6% for women, 35.0% for men) with trainees. The ADR for women was significantly lower for trainees (p=0.01), but otherwise ADR and withdrawal times were not significantly different. The 2021 cohort, however, showed improvement in all ADRs for fellows compared to 2018, and the ADR for women was equivalent to that of the attendings. Moreover, the withdrawal times were significantly longer for trainees in 2021 (18.9 vs. 15.3 minutes;p=0.01). When comparing fellows' metrics from 2018 and 2021, there was no statistically significant difference in overall ADR, ADR for men, or withdrawal times, though ADR for women had improved (p=0.02). Conclusion: When compared to a similar pre-pandemic cohort, the quality metrics for index colonoscopies have improved for our fellows, particularly with regard to female patients. We are undertaking further data collection to ensure that our findings are stable over a longer time period.(Table Presented) (Table Presented)

5.
Gastroenterology ; 162(7):S-307, 2022.
Article in English | EMBASE | ID: covidwho-1967295

ABSTRACT

Introduction: The ongoing coronavirus-2019 (COVID-19) pandemic has seen a decrease in the overall number of screening colonoscopies performed with the suspension of elective outpatient procedures. We sought to evaluate whether screening colonoscopy quality parameters such as adenoma detection rate (ADR) and withdrawal times have been affected now that such elective procedures have resumed in greater numbers. Methods: This is a singlecenter observational study comparing patients who underwent index screening colonoscopies since our outpatient facilities reopened (7/1/2021 through 9/30/2021) with a pre-pandemic cohort (7/1/2018-9/30/2018). We collected demographic information including patient age, sex, comorbidities, among others, and we tabulated the number of polyps detected, the number of tubular adenomas, and the withdrawal times. We used Chi-square testing to determine significance among our categorical variables and used t-tests to compare means for our numerical variables. All statistical analysis was done in R (R Core Team, 2020). Results: We identified and included 159 patients in the 2018 cohort and another 244 patients in the 2021 cohort (Table 1). The pre-pandemic group included 78 women (49.1%) and had an overall ADR of 29.6% (20.5% for women, 38.3% for men). The 2021 group was larger and included 133 women (54.5%) and had an overall ADR of 32.0% (27.1% for women, 37.8% for men). We found no statistically significant differences in patient characteristics, number of polyps detected, or ADR between the two groups (Tables 1 and 2). There was no significant difference in the odds of detecting an adenoma based on day of the week, morning versus afternoon session, or involvement of a fellow. We found an increase in mean withdrawal time in the 2021 cohort (16.2 minutes vs. 13.6 minutes, p= 0.005) compared to pre-pandemic. Conclusion: The pandemic has not adversely affected the quality of screening colonoscopies performed at our institution, regardless of when the procedure was done or whether a trainee was involved. We are undertaking further data collection to ensure that our findings are stable over a longer time period. (Table Presented) (Table Presented)

6.
Gastroenterology ; 162(7):S-290, 2022.
Article in English | EMBASE | ID: covidwho-1967284

ABSTRACT

Introduction: Since the start of the coronavirus-2019 (COVID-19) pandemic, there has been a decrease in the overall number of elective gastroenterology procedures. We sought to evaluate whether surveillance colonoscopy quality parameters such as polyp detection rate (PDR) and withdrawal times have been affected now that such elective procedures have resumed in greater numbers. Methods: This is a single-center observational study comparing patients who underwent surveillance colonoscopies since our outpatient facilities reopened (7/1/2021 through 9/30/2021) with a pre-pandemic cohort (7/1/2018-9/30/2018). We collected demographic information including patient age, sex, comorbidities, among others. We then tabulated the number of polyps detected, the number of tubular adenomas (TA), and the withdrawal times. We used Chi-square testing to determine significance among our categorical variables and used t-tests to compare means for our numerical variables. All statistical analysis was done in R (R Core Team, 2020). Results: Our pre-pandemic cohort included 195 patients (86 women;44.1%), of whom 81 (41.5%) had a TA on their surveillance colonoscopy. Our 2021 cohort consisted of 308 patients (140 women;45.5%), of whom 149 (48.4%) had a TA on surveillance (Tables 1 and 2). The mean PDR was significantly higher in the 2021 cohort (2.2 vs. 1.5 polyps per colonoscopy;p=0.001), and the mean withdrawal time was likewise longer compared to the pre-pandemic cohort (18.9 minutes vs. 15.8 minutes;p=0.002). While the rate of tubular adenoma detection was similar overall in both groups (41.5% vs. 48.4%;p=0.13), it was higher for male patients in the 2021 group compared to 2018 (55.4% vs. 43.1%;p=0.04). We found no difference in polyp or TA detection based on patient comorbidities, age, sex, race, day of the week, morning versus afternoon endoscopy session, or whether a fellow was involved in the procedure. Conclusion: Despite the 1.5-year hiatus in elective procedures, our quality metrics for surveillance colonoscopies have improved from before the pandemic, and this may be related to longer withdrawal times. We have been able to carry out more surveillance procedures compared to a similar pre-pandemic period irrespective of patient demographic factors, procedure timing, and trainee involvement. We are undertaking further data collection to ensure that our findings are stable over a longer time period. (Table Presented) (Table Presented)

7.
Neurology ; 98(18 SUPPL), 2022.
Article in English | EMBASE | ID: covidwho-1925510

ABSTRACT

Objective: We present an early systematic analysis of autonomic dysfunction following COVID19 to provide initial insights into the spectrum of this condition. Background: Post-COVID-19 syndrome is a poorly understood aspect of the current pandemic, with clinical features that overlap with symptoms of autonomic/small fiber dysfunction. Design/Methods: We conducted a retrospective review of all patients with confirmed history of COVID-19 infection referred for autonomic testing for symptoms concerning for para-/postinfectious autonomic dysfunction at Mayo Clinic Rochester or Jacksonville between March 2020 and January 2021. Results: We identified 27 patients fulfilling the search criteria. Symptoms developed between 0 and 122 days following the acute infection and included lightheadedness (93%), orthostatic headache (22%), syncope (11%), hyperhidrosis (11%), and burning pain (11%). Sudomotor function was abnormal in 36%, cardiovagal function in 27%, and cardiovascular adrenergic function in 7%. The most common clinical scenario was orthostatic symptoms without tachycardia or hypotension (41%);22% of patients fulfilled the criteria for postural tachycardia syndrome (POTS), and 11% had borderline findings to support orthostatic intolerance. One patient each was diagnosed with autoimmune autonomic ganglionopathy, inappropriate sinus tachycardia, vasodepressor syncope, cough/vasovagal syncope, exacerbation of preexisting orthostatic hypotension, exacerbation of sensory and autonomic neuropathy, and exacerbation of small fiber neuropathy. Conclusions: Abnormalities on autonomic testing were seen in the majority of patients but were mild in most cases. The most common finding was orthostatic intolerance, often without objective hemodynamic abnormalities on testing. Unmasking/exacerbation of preexisting conditions was seen. The temporal association between infection and autonomic symptoms implies a causal relationship, which however cannot be proven by this study.

8.
J Healthc Qual Res ; 37(5): 335-342, 2022.
Article in English | MEDLINE | ID: covidwho-1921080

ABSTRACT

INTRODUCTION AND OBJECTIVES: The outbreak of COVID-19 has overwhelmed healthcare systems all over the world. The aim of this article is to describe the process of transforming the Vall d'Hebron University Hospital, the second largest hospital in Spain, into a COVID-19 centre coordinating response to the pandemic in its reference area. MATERIALS AND METHODS: The study draws on the experience of the authors in transforming the hospital into a comprehensive resource in response to the COVID-19 pandemic. The strategy is based on four central strategies: early planning, coordination of all healthcare agents in its reference area, definition of clear leadership roles, and the organisation of care based on multidisciplinary teams with minimal recruitment of new staff. RESULTS: The transformation strategy enabled the hospital to cope with the surge in patients without exceeding its capacity. During the response phases, which amounted to a period of 57 days, 3106 patients consulted the ER and 2054 were admitted, 346 of whom were treated at the ICU. To accommodate the number of adult COVID-19 patients, adult ICU availability was progressive increased by 371%, and ordinary beds increased by 240. A total of 671 staff members went on sick leave after testing positive for COVID-19. CONCLUSION: The transformation experience of the hospital provides insight into how effectively adapt the structures and functioning of large hospitals. The relevance of territorial coordination during the pandemic is stressed as an effective strategy that contributed coping the pandemic.


Subject(s)
COVID-19 , Adult , COVID-19/epidemiology , Hospitals, University , Humans , Pandemics , SARS-CoV-2 , Spain/epidemiology
9.
Revista de la Academia Colombiana de Ciencias Exactas, Fisicas y Naturales ; 46(178):27-35, 2022.
Article in English | Scopus | ID: covidwho-1836121

ABSTRACT

Most community-specific serological surveys for SARS-CoV-2 antibodies have been performed in healthcare workers and institutions. In this study, IgG antibodies specific to the virus were evaluated in individuals working at a university campus in Bogotá, Colombia. Our aim was to determine previous exposure to SARS-CoV-2 in those attending the campus during city lockdown. A total of 237 individuals including 93 women and 144 men were evaluated using chemiluminescent detection of IgG anti-N-viral protein between November and December 2020. There were 32 positive individuals, i.e., a seroprevalence of 13.5% (10 women and 22 men) mostly asymptomatic (68.75%);we identified three clusters of seropositive individuals. Only 13 of the seropositive individuals had previous positive detection of SARS-CoV-2 RNA by RT-qPCR performed on average 91 days before the serological test. Seropositive individuals did not come from the boroughs with higher percentages of SARS-CoV-2 cases in the city. The survey was carried out after the first peak of SARS-CoV-2 transmission in the city and before the preparedness to reopen the campus for students in 2021, which demonstrates a low seroprevalence in a high percentage of asymptomatic individuals. These results will help to evaluate some of the strategies stablished to control virus spread on the campus or other similar communities. © 2022 Colombian Academy of Exact, Physical and Natural Sciences. All rights reserved.

10.
29th International Conference on Computers in Education Conference, ICCE 2021 ; 1:362-371, 2021.
Article in English | Scopus | ID: covidwho-1762235

ABSTRACT

Mobile Learning is crucial to the continuity of healthcare education during COVID-19. Despite its penchant for the traditional delivery of course content through classroom and clinical settings, M-Learning proved to be a viable solution in a pandemic due to social isolation, community restrictions, and safety concerns. We invited 219 frontline learners from 3 universities, active healthcare professionals who are currently enrolled, to test a structural model based on the Theory of Reason Action. We positioned the human factors of cognitive, social, and affective needs as determinants of attitude in the behavioral intention to adopt M-Learning. We further hypothesize that social norms positively influence the behavioral intention to adopt M-Learning among healthcare frontliners. We applied PLS-SEM to analyze the survey data and revealed that human factors positively influence attitude, leading to the behavioral intention to adopt M-Learning. Social norms and their influence on the behavioral intention to adopt this technology are not supported. We discuss the implications of our study, acknowledge its limitations while mapping out directions for future works to understand M-Learning adoption further. © 2021 29th International Conference on Computers in Education Conference, ICCE 2021 - Proceedings. All rights reserved

11.
National Technical Information Service; 2021.
Non-conventional in English | National Technical Information Service | ID: grc-753697

ABSTRACT

We use a machine learning algorithm combining information from the NASA GEOS composition forecast (GEOS-CF) model and surface observations of nitrogen dioxide (NO2) and ozone (O3) at more than 5,000 observation sites to assess the impact of COVID-19 restrictions on surface air quality in 46 countries. Our methodology removes the compounding impacts of meteorology, seasonality and atmospheric chemistry on air pollution, thus allowing for a quantitative estimate of the change in surface air quality following COVID-19 containment measures. Compared to GEOS-CF model predictions that do not include emission reductions related to COVID-19 restrictions, surface observations show a drop in surface NO2 of up to 60% after the implementation of lockdowns. Average NO2 concentrations between February 2020 to June 2020 were 18% lower than business as usual. The earliest and strongest declines are observed over China, followed by Europe and the US. While NO2 concentrations over China recovered within 2 months, the recovery has been slower over Europe and the US. The impact of COVID-19 restrictions on O3 is complicated by non-linear atmospheric chemistry. Locally, O3 can show a short-term increase of up to 50% as a result of the decrease in NO2, which leads to a reduction in night time titration. However, this effect is offset by a decrease in photochemical production during the day. Our results indicate that these two competing processes resulted in a net zero change in average surface ozone during the first 5 months of the pandemic. The results also indicate that the reduced photochemical production becomes increasingly important over time. Our analysis is based on surface observations and model simulations available in near real-time, and we will present an up-to-date view of the short and medium-term impacts of COVID-19 restrictions on air quality around the world.

12.
Palgrave Studies of Cross-Disciplinary Business Research, in Association with EuroMed Academy of Business ; : 157-179, 2022.
Article in English | Scopus | ID: covidwho-1680568

ABSTRACT

Tourism is one of the industries most affected by the coronavirus-19 (COVID-19) crisis worldwide. Because tourism makes the largest contribution of any industry to Spain and Portugal’s gross domestic product, the crisis’s impact on local communities needs to be analysed in greater depth. This chapter details on how these communities have been affected by the pandemic and identifies which positive and negative factors influence residents’ wellbeing. The state-of-the-art of research on smart and sustainable tourism is examined, as well as on local communities’ resilience. Secondary data were gathered on Spain and Portugal to develop a fuller understanding of the phenomena under study, and the ways the COVID-19 crisis has affected these two countries’ vision of tourism. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

13.
Cancer Epidemiology Biomarkers and Prevention ; 31(1 SUPPL), 2022.
Article in English | EMBASE | ID: covidwho-1677446

ABSTRACT

The purpose of this presentation is to report accomplishments of a 3-year [5/1/2018-4/30/2021] Bristol-Meyers Squibb Foundation-funded collaboration between UC Davis and the Health and Life Organization (HALO), a Federally Qualified Health Center Look-Alike in increasing cancer screenings and cancer prevention/control behaviors among Asian Americans. HALO was selected for this study becuase it is the largest health system serving Asian Americans in Sacramento Co., CA. About one-third of their patients (9000) are Asian [primarily Hmong and other SE Asains). The hypothesis we tested was based on UC Davis's prior completed research that bilingual/bicultural Hmong lay health workers significantly increased screenings for HBV and colorectal cancer screening in randomized controlled community trials among Asians who largely had limited English proficiency. Our premise was to apply this concept to a clinical setting through HALO's bilingual/bicultural medical assistants (MAs). By comparing baseline (prior to the initiation of our funding) to 3 years of collaboration, we observed an overall 13.3% increase (surpassing our 10% goal) in cancer screenings & prevention/control behaviors. The largest percentage increases were in mammography (20.3%), colorectal cancer screening (11.6%), and Pap tests (7.9%).vaccination (2.8%). Since this was our first collaboration, much was shared through our monthly UCD-HALO leadership meetings where adjustments were made. A major adjustment was to learn that the electronic health systems used by community health centers such as HALO were not intended for reseearch purposes. While primary care provider time was less flexible, we found that MAs who reflect the HALO patient population were very receptive to training. We provided training through 10 Saturday academies, in-person and later delivered virtually during the COVID-19 pandemic. All of the topics related to the above metrics as well as other topics such as cultural competence, resources for patients, and optimizing patient workflows. Effectiveness of these academies were documented through gains in average scores from pre-tests [58%] to post-tests [84%] and qualitative feedback. Fifity-eight participants attended. More rigorous evaluation approaches to link our efforts to the impact of our work would have been preferred, but would have needed to be more resource-intensive. However, we anticipate that the equipping of MAs in new competencies and tools we provided for patients in various languages as infographics will be the bases for sustained effectiveness. Another measure of success was that this collaborative contributed to the receipt of a major Federal grant to eliminate perinatal HBV transmission through HALO. A UC Davis You-Tube style interactive modules as refresher materials and for new MAs will be another means of sustaining impact.

14.
An Sist Sanit Navar ; 44(3): 445-456, 2021 Dec 27.
Article in Spanish | MEDLINE | ID: covidwho-1609080

ABSTRACT

The SARS-CoV-2 infection has become as a worldwide public health emergency. It exhibits a variety of clinical presentations, ranging from benign to acute respiratory distress syndrome, systemic involvement, and multiorganic failure. The severity of the clinical picture depends on host and virus biological features and the presence of comorbidities such as chronic kidney disease. In addition, the interaction between the virus, angiotensin-converting enzyme 2, and the exacerbated immune response could lead to the development of acute kidney injury. However, the implications of SARS-CoV-2 infection on renal cells, the prognosis of patients with chronic kidney disease, and the long-term behavior of renal function are not entirely understood. This review aims to explore the role of SARS-CoV-2 in acute and chronic kidney disease and the possible pathogenic mechanisms of renal involvement.


Subject(s)
Acute Kidney Injury , COVID-19 , Renal Insufficiency, Chronic , Acute Kidney Injury/etiology , Humans , SARS-CoV-2
15.
European Heart Journal ; 42(SUPPL 1):2670, 2021.
Article in English | EMBASE | ID: covidwho-1554204

ABSTRACT

Background: The COVID-19 pandemic is associated with more than 127 million of infected people and 2.7 million deaths in the world. However, cardiovascular diseases are still a worldwide main health problem. Patients are afraid to go to the hospital because of the risk of being infected with SARS-COV2. In particular, exercise testing (ET) has been underused, due to the fear of the airborne aerosol generation. There are cardiology centers performing ET that ask patient to wear a mask, although its consequences are not yet well known and there is only preliminary information of its use in patients with heart disease. Purpose: Our objective was to evaluate the ergometric behavior of patients that performed an ET wearing a mask during the COVID-19 pandemic (COVID-G) and compare them with patients in the pre-pandemic period. Methods: A cohort of patients who underwent an ET from march to december 2020 was compared with patients that performed an ET between march and december 2019. Because of COVID-19 preventive restrictions, we used a larger and highly ventilated room to perform ET. The antisepsis protocol was performed (room and equipment) and healthcare crew always wore high efficiency masks and ocular protection. All patients studied in 2020, must had succeeded a biological triage, and wore a mask throughout the ET. Variables are presented as frequency (percentage), mean (standard deviation) or median (interquartile interval) according to variable-type and distribution. Chi-square test, Student's t test or the Wilcoxon rank test were used as appropriate. All p values less than 0.05 were considered stochastically significant. Results: A total of 361 stress tests were studied, where 209 (58%) belonged to pre-pandemic group and 152 (42%) to COVID-G. Eighty-one percent were male, the mean age was 46±20 years and the most prevalent diagnosis was coronary heart disease (61%). There were no statistically diferences between groups according to demographic variables. No mayor adverse outcome occurred during ET. The most common reason of exercise suspension in COVID-G was dyspnea compared to prepandemic studies: 117 (77%) vs 8 (4%), OR= 6.3 (95% CI, 4.6 to 8.6, p<0.001). Heart rate behavior along ET did not show significant differences between groups. Nevertheless, blood pressure levels were significantly higher in COVID-G patients than those in pre-pandemic group. Exertional blood pressure index was higher in the COVID-G (1.31±0.24 vs 1.26±0.2, p<0.05) than the pre-pandemic group. On the other side, maximal exercise tolerance (METs) did not show significant differences between groups (p=ns). Conclusions: Exercise testing can be safely performed in patients with cardiovascular disease while wearing masks. In the COVID period, a significantly lower number of ET was performed. In addition, ET performance with mask was associated with higher values of systolic blood pressure and an increased number of tests suspended due to dyspnea. (Figure Presented).

16.
American Journal of Gastroenterology ; 116(SUPPL):S993-S994, 2021.
Article in English | EMBASE | ID: covidwho-1534797

ABSTRACT

Introduction: Little is known about the extent of GI tract involvement in acute COVID-19 infection. GI bleed (GIB) has been reported in COVID patients;the etiology is difficult to determine given that of confirmed COVID infection where patients, without prior medical history, presumably developed COVID induced HC, and it was their only presenting symptom. Case Description/Methods: Case 1 A 44 year old male presented with hematochezia, abdominal pain, and syncope and a drop in hemoglobin (Hb) from 15.3 to 12.6g/dL. COVID PCR was positive. Fecal calprotectin (FCP) elevated at 169ug/g (n, 49ug/g), with negative stool cultures (SCx). CT showed a long segment of circumferential wall thickening of the mid-distal descending colon with haustral thickening of the transverse colon. Patient declined treatment with remdesivir and dexamethasone Case 2 A 65 year old female presented with hematochezia and confirmed COVID infection. CBC revealed a drop in Hb 13.5 to 11.8g/dL, platelets 237 to 184K/uL. Negative SCx, elevated FCP 88ug/g, procalcitonin 0.31ng/nL, CRP 7.1mg/dL, and D-Dimer 740ng/mL. CT showed severe wall thickening of the transverse, descending and rectosigmoid colon with fat stranding. Given negative SCx, patient was started on methylprednisolone Case 3 A 38 year old male presented with painless hematochezia. Negative SCx, O&P, C. diff. Elevated FCP, ESR and CRP (ESR 80mmh/CRP 12.1mg/dL). COVID PCR positive. CT showed extensive colonic wall thickening in the rectum, sigmoid, descending colon and splenic flexure, increased vascularity around the inflamed colon and fat stranding. Given lack of clinical improvement with antibiotics and conservative management, patient was started on methylprednisolone with improvement Discussion: GI symptoms due to COVID occur from the expression of ACE2 receptors on intestinal epithelial cells that allow for binding and replication. This leads to a direct inflammatory state accounting for enteritis and HC. All patients presented had hematochezia without bleeding history, AC use or a source of bleeding, except for the colitis seen on CT. Confirmed HC in the setting of COVID infection has been documented twice;one case with a similar presentation who had colonoscopy with biopsy proven HC, another case with diffuse HC on endoscopic evaluation. Nonetheless, more research is needed to explore the effects of COVID on the GI tract. (Figure Presented).

17.
Journal of the American Society of Nephrology ; 32:105, 2021.
Article in English | EMBASE | ID: covidwho-1489906

ABSTRACT

Introduction: Since the rapid spread of the COVID 19 pandemic, it is crucial to identify possible sources of transmission of the SARS-COV-2 virus in order to perform procedures safely. There has been interest to identify the presence of SARS-CoV-2 in different compartments including peritoneal compartment. SARS-CoV-2 was detected by reverse transcriptase-polymerase chain reaction (RT-PCR) in dialysis effluent on a few single cases while other authors have reported negative results. Peritoneal membrane pores have a diameter of 20-40 nm while the SARS-CoV-2 virion diameter is between 60 to 140 nm, theoretically the virion could reach the peritoneal cavity by hematogenous diffusion or through the dialysis catheter after contact contamination. Case Description: We report dialysis effluent findings of four patients, two women and two men, with an age range of 35 to 64 years and different comorbidities including: diabetes mellitus, hypertension and obesity. They were diagnosed with COVID-19 using RT-PCR assay on nasopharyngeal samples or by tomography findings. RT-PCR samples of peritoneal effluent were obtained with a length of stay on peritoneal cavity of 6 hours, without centrifugation of the sample. Three patients were positive for presence of SARSCoV-2 on nasopharyngeal sample and dialysis effluent, while the fourth patient was negative in both samples despite having tomography findings suggestive of COVID-19 infection. It should be noted that in the 3 patients that had a positive RT-PCR on both nasopharyngeal and peritoneal effluent, samples were obtained within the first 7 days following the onset of symptoms associated with COVID-19 and on the fourth patient the peritoneal effluent sample was obtained 12 days after initial symptoms. All patients presented with acellular peritoneal fluid. No abdominal symptoms were reported. Discussion: Presence of SARS-CoV-2 on peritoneal fluid continues to be a subject of debate. Peritoneal effluent sample-drawing procedure has not been standardized, which may explain the inconsistent results noted by different authors. The positive results of the RT-PCR for SARS-CoV2 on peritoneal effluent must be confirmed on a larger sample. Although based on a small group, these findings should prompt to consider these fluids as potentially infective.

19.
Annals of Oncology ; 32:S1262, 2021.
Article in English | EMBASE | ID: covidwho-1432825

ABSTRACT

Background: Malnutrition is a common issue in oncology patients, and negatively affects patients' evolution and their quality of life, increasing the incidence of infection, hospital stay, and mortality. New approaches to targeted therapy and immunotherapy represent the future in the field of oncology, making it essential to understand its effect on patients. Study endpoints were (a). To describe the percentage of nutritional counseling or nutritional support among those diagnosed as malnourished or at risk. And (b) to categorize the percentage and descriptive characteristics of cancer patients with mild, moderate, or severe malnutrition in Spain and descriptive characteristics of patients with malnutrition according to sociodemographic and clinical characteristics. Methods: From a total of 585 patients from 10 hospitals, two groups were established, group A, N: 408, patients undergoing immunotherapy, group B with patients with inmuno plus chemotherapy and/or radiotherapy (N: 204). The objective of this observational study was to determine the prevalence (or risk) of malnutrition in the Spanish population of outpatients receiving immunotherapy. To do this, it was proposed to explore the nutritional status of these patients using Nutritional risk (NutriScore), Nutritional Global Subjective Assessment, ECOG PS;type of cancer and nutritional treatment: chemo, type of chemo, and COVID-19 diagnosis. Results: In group A (Immuno only) 28.3% of the patients were at risk of malnutrition, compared to 58.5% in group B (combined Immuno plus Chem&RT) with a statistically significant difference (p<0.0001);27.4% were on nutritional therapy, 97 (42.9%) of patients who obtained a score ≥of 5 (at risk), and 63 (17.5%) %) of patients who obtained a score <5 (out of risk) in NutriScore (p<0.0001). Dietary advice was the most common type of nutritional therapy, present in 123 (76.9%) patients of 160 with nutritional therapy, followed by oral supplements (69 (43.1%)) and enteral nutrition (11 (6.9%)). Conclusions: Nutritional diagnosis is key in cancer patients. It allows determining the needs of the patient in each of the phases of the patient's evolution, improving the quality of life through different interventions, especially dietary education. Clinical trial identification: NCT04168814. Legal entity responsible for the study: Spanish Society of Oncology Nursing. Funding: Baxter Healthcare Corporation. Disclosure: All authors have declared no conflicts of interest.

20.
Antibiotics ; 10(8), 2021.
Article in English | CAB Abstracts | ID: covidwho-1408370

ABSTRACT

Pneumonia is an acute pulmonary infection whose high hospitalization and mortality rates can, on occasion, bring healthcare systems to the brink of collapse. Both viral and bacterial pneumonia are uncovering many gaps in our understanding of host-pathogen interactions, and are testing the effectiveness of the currently available antimicrobial strategies. In the case of bacterial pneumonia, the main challenge is antibiotic resistance, which is only expected to increase during the current pandemic due to the widespread use of antibiotics to prevent secondary infections in COVID-19 patients. As a result, alternative therapeutics will be necessary to keep this disease under control. This review evaluates the advantages of phage therapy to treat lung bacterial infections, in particular those caused by the Gram-positive bacteria Streptococcus pneumoniae and Staphylococcus aureus, while also highlighting the regulatory impediments that hamper its clinical use and the difficulties associated with phage research.

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