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The coronavirus disease 2019 (COVID-19) pandemic had a major impact on global health and was associated with millions of deaths worldwide. During the pandemic, imaging characteristics of chest X-ray (CXR) and chest computed tomography (CT) played an important role in the screening, diagnosis and monitoring the disease progression. Various studies suggested that quantitative image analysis methods including artificial intelligence and radiomics can greatly boost the value of imaging in the management of COVID-19. However, few studies have explored the use of longitudinal multi-modal medical images with varying visit intervals for outcome prediction in COVID-19 patients. This study aims to explore the potential of longitudinal multimodal radiomics in predicting the outcome of COVID-19 patients by integrating both CXR and CT images with variable visit intervals through deep learning. 2274 patients who underwent CXR and/or CT scans during disease progression were selected for this study. Of these, 946 patients were treated at the University of Pennsylvania Health System (UPHS) and the remaining 1328 patients were acquired at Stony Brook University (SBU) and curated by the Medical Imaging and Data Resource Center (MIDRC). 532 radiomic features were extracted with the Cancer Imaging Phenomics Toolkit (CaPTk) from the lung regions in CXR and CT images at all visits. We employed two commonly used deep learning algorithms to analyze the longitudinal multimodal features, and evaluated the prediction results based on the area under the receiver operating characteristic curve (AUC). Our models achieved testing AUC scores of 0.816 and 0.836, respectively, for the prediction of mortality. © 2023 SPIE.
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Objectives: Bariatric surgery has evolved over the past two decades yet assessing trends of bariatric surgery utilization in the growing eligible population is lacking.This study aimed to update the trends in bariatric surgery utilization, changes in types of procedures performed, and the characteristics of patients who underwent bariatric surgery in the US, using real-world data. Method(s): This cross-sectional study was conducted using the TriNetX, a federated electronic medical records network from 2012 to 2021, for adult patients 18 years old or older who had bariatric surgery. Descriptive statistical analysis was conducted to assess patients' demographics and characteristics. Annual secular trend analyses were conducted for the annual rate of bariatric surgery, and the specific procedural types and proportions of laparoscopic surgeries. Result(s): A steady increase in the number of procedures performed in the US over the first six years of the study, a plateau for the following two years, and then a decline in 2020 and 2021 (during the coronavirus-19 pandemic). The annual rate of bariatric surgery was lowest in 2012 at 59.2 and highest in 2018 at 79.6 surgeries per 100,000 adults. During the study period, 96.2% to 98.8% of procedures performed annually were conducted laparoscopically as opposed to the open technique. Beginning in 2012, the Roux-en-Y (RYGB) procedure fell to represent only 17.1% of cases in 2018, along with a sharp decline in the adjustable gastric band (AGB) procedure, replaced by a sharp increase in the sleeve gastrectomy (SG) procedure to represent over 74% of cases in 2018. Conclusion(s): Bariatric surgery utilization in the US showed a moderate decline in the number of RYGB procedures, which was offset by a substantial increase in the number of SG procedures and a precipitous drop in the annual number of AGB procedures.Copyright © 2023
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OBJECTIVE: External validation of the Oldham Composite Covid-19 associated Mortality Model (OCCAM), a prognostic model for Covid-19 mortality in hospitalised patients comprised of age, history of hypertension, current or previous malignancy, admission platelet count < 150 × 103/µL, admission CRP ≥ 100 µg/mL, acute kidney injury (AKI), and radiographic evidence of > 50% total lung field infiltrates. PATIENTS AND METHODS: Retrospective study assessing discrimination (c-statistic) and calibration of OCCAM for death in hospital or within 30 days of discharge. 300 adults admitted to six district general and teaching hospitals in North West England for treatment of Covid-19 between September 2020 and February 2021 were included. RESULTS: Two hundred and ninety-seven patients were included in the validation cohort analysis, with a mortality rate of 32.8%. The c-statistic was 0.794 (95% confidence interval 0.742-0.847) vs. 0.805 (95% confidence interval 0.766 - 0.844) in the development cohort. Visual inspection of calibration plots demonstrate excellent calibration across risk groups, with a calibration slope for the external validation cohort of 0.963. CONCLUSION: The OCCAM model is an effective prognostic tool that can be utilised at the time of initial patient assessment to aid decisions around admission and discharge, use of therapeutics, and shared decision-making with patients. Clinicians should remain aware of the need for ongoing validation of all Covid-19 prognostic models in light of changes in host immunity and emerging variants.
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Hematologic malignancy is a risk factor for severe coronavirus disease 2019 (COVID-19) in adults;however, data specific to children with leukemia are limited. High-quality infectious adverse event data from the ongoing Children's Oncology Group (COG) standard-risk B acute lymphoblastic leukemia/lymphoma (ALL/LLy) trial, AALL1731, were analyzed to provide a disease-specific estimate of SARS-CoV-2 infection outcomes in pediatric ALL. Of 253 patients with reported infections, the majority (77.1%) were asymptomatic or mildly symptomatic (CTCAE grade 1/2) and there was a single COVID-19-related death. These data suggest SARS-CoV-2 infection does not confer substantial morbidity among young patients with B-lymphoblastic leukemia/lymphoma (B-ALL/LLy).Copyright © 2023 The Authors. eJHaem published by British Society for Haematology and John Wiley & Sons Ltd.
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The emergence of largescale global human health events is expected to increase with evolving zoonotic and transboundary diseases, climate change, agricultural consolidation, increased globalization, and reliance on trade. The government and market response to a disease is dependent on the size of the outbreak, pathogenicity and virulence of the disease, and the perceived risks of its introduction and spread. The impact of largescale human disease events and their respective institutional response can lead to financial and market disruptions and effect nearly every industrial sector and market, including animal protein trade. The latest human disease event, the COVID-19 (SARS-CoV-2) pandemic, continues to be the largest, most expansive disease event in the last century. The COVID-19 pandemic has had sizeable implications domestically and internationally. Labor shortages and supply chain disruptions coupled with demand changes and disease eradication policies substantially impacted global markets. Despite the emergent literature on COVID-19, little has been done to collectively identify and analyze the effects of largescale human health events on animal protein trade. Using export trade data from 2010-2020 for animal protein exporters, this analysis estimates the effects human health events (i.e., MERS-Cov, COVID-19, Ebola, and Zika virus) on global animal protein trade for 23 individual commodities (6-digit HS level). Results show heterogeneity between diseases, products, and exporters. This heterogeneity indicates differences in response between events, dependent on event size, scope, and impacts. The study results can help improve preemptive business continuity planning and deepen the understanding of the implications of future emerging largescale health events on the meat industry.
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This article presents the findings of a study undertaken by a team of three film studies teacher-researchers working with undergraduate students in a course titled 'Histories of Film Theory'. In the context of the transition from face-to-face to remote learning during the COVID-19 pandemic, the authors observed that students' approaches to understanding relevant film theories became increasingly inflected by their experiences of contrasting methods of course delivery, such as that between the cinema theatre or home viewing environment. To investigate this effect, the authors conducted a study of student experience across the 2020 and 2021 cohorts;the purpose was to understand how the shift to online learning shaped students' engagement with set film texts, by analysing the behaviour exhibited when accessing film texts remotely. The study is grounded in the observation that there is an existing body of film theory on screen spectatorship that has potential significance to a scholarly understanding of the pedagogical complexity of online learning and multimodal literacies. This scholarship ranges from analyses of 'traditional' reception environments (Baudry 1974), to accounts of the differentiation in modes of attention introduced by new media (Ellis 1992, Cavell 1982), to analyses of the multiplying second screen practices of the digital era (Casetti 2011). A governing distinction highlighted in the results is between 'gazing', the mode of spectatorship associated with the traditional cinema experience, and 'glancing', the mode associated with home viewing and second screen use. Were the students in the course gazing or glancing, and how did this affect their encounters with films and characterize their remote learning experience more broadly? In asking these questions, the article demonstrates how the intellectual resources of film studies might be applied to contemporary digital pedagogy scholarship to reveal a complex scenario in which remote learning practices both hinder and enhance learning experiences, sometimes simultaneously.
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Introductory sentence about purpose of the study: The PRECISE study tests the effectiveness of a targeted patient navigation program for follow-up colonoscopy after abnormal fecal testing in community health centers. We present adaptations of the patient navigation program resulting from the impact of the COVID-19 pandemic. Brief description of pertinent experimental procedures: Colorectal cancer (CRC) screening by annual fecal immunochemical test (FIT) is an accessible and cost-effective strategy to lower CRC incidence and mortality. However, this mode of screening depends on follow-up colonoscopy after an abnormal FIT result to prevent CRC or find it in early, treatable forms. Unfortunately, almost half of patients with an abnormal FIT result fail to complete this essential screening component. Patient navigation can provide needed support for patients to complete a follow-up colonoscopy. PRECISE is a collaboration with a large community health center whose patient population is 37% Latino. Eligible patients were aged 50-75, had an abnormal FIT result in the past month, and were due for a follow-up colonoscopy. Patients were randomized to patient navigation or usual care. Patient navigation was delivered by a bilingual (English and Spanish) patient navigator using a six-topic phone-based protocol, adapted from the New Hampshire Colorectal Cancer Screening Program. Summary of new, unpublished data: A total of 985 patients were enrolled in the PRECISE study, 489 randomized to the intervention arm and 496 to the control arm. Due to the COVID-19 pandemic, we made adaptations to the navigator training program and navigation delivery. We converted our in-person training program to a virtual navigation training series combining pre-recorded videos and live webinars. Additionally, we strengthened relationships with GI practices to expedite referrals, improve scheduling processes, and better understand COVID-related policy changes including the conversion of some preprocedure consultations to a phone-based platform and COVID-19 testing requirements prior to the colonoscopy. Finally, we adapted patient navigator messages to address fear and anxiety about getting medical care during the peak COVID-19 pandemic. Preliminary patient navigation outcomes will be available in September 2022. Statement of conclusions: This innovative clinical trial highlights the importance of patient navigation to improve CRC screening in community health centers. Rapid response to COVID-19 provided the opportunity to adapt our navigator program for a virtual setting allowing for 1) the sustainability of patient navigation during the pandemic and 2) the broadening of training resources for patient navigators and community health workers.
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Objectives: Retractions related to COVID-19 publications has highlighted how prevalent retractions of primary research can be. Whilst there is a responsibility for authors of primary research to correct errors or remove fraudulent studies, the responsibility of correcting errors in downstream research is less clear. To further understand the situation we identifyed case studies where evidence synthesis has included retracted articles or articles with subsequently identified errors, how it has been handled and propose potential solutions. Method(s): Identified case studies from work the authors were undertaking where evidence synthesis ended up including primary studies with errors or retractions included. Result(s): Case studies with different responses to errors in primary articles were identified: A typographical error in a primary study was identified in evidence synthesis used to support a NICE health technology assessment;authors of the primary study acknowledged the error but did not correct the publication meaning the error remained in the publication and subsequent meta-analyses. Retracted COVID-19 publications were acknowledged by authors of one published meta-analysis;authors updated analysis to remove the offending research. A primary study was retracted whilst the evidence synthesis publication was under peer-review;following publication authors were notified of the retraction and opted to retract rather than revise their analysis. Conclusion(s): Prevailing errors in evidence synthesis, despite retraction or correction of a primary study, could negatively influence healthcare decision making. Living systematic reviews or meta-analyses are one solution but may not always be practicable. To minimise the risk of perpetuating errors, authors of secondary analyses could commit to ensure data included in their analyses is accurate for a defined period after the initial analysis has been conducted, e.g., 2 years, after which the analyses could be presumed to be outdated. The defined period could be influenced by several factors including rate of new studies being published in the indication. Copyright © 2022
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The novel COVID-19 virus caused a global pandemic disrupting lives, industries, and economies. The resulting financial strain impacted prices due to challenges with production and supply chain distribution. This study investigates the financial strain COVID-19 had on equine owners and leasers, what the market for equine care would bear if costs for care were to increase, and what factors contribute to willingness-to-pay (WTP) for increasing cost of equine care. An online survey was distributed for 4 weeks to adult US residents, where respondents reported their involvement in the equine industry, financial response to COVID-19, and responses to a double-bound dichotomous choice question pertaining to their WTP for care given a randomized increase (1–20%) in their current cost (n = 506). Data were analyzed using interval regression models where a = 0.05 (Stata15). Respondents were separated into 3 groups (owner keeping their horse at their residence, owner boarding their equids, and leaser) based on their equine ownership status and where their equine were kept. Boarders reported mean monthly payments of 23.33 ± 90.37 USD (n = 15) for free board, 236.47 ± 151.92 USD, (n = 75) for partial board, and 514.75 ± 291.71 USD (n = 181) for full board. Results show all owners, leaser, and boarders have different WTP values which range from 18.5% to 26.2% increase in current care costs which extends beyond the presented range due to many respondents responding "yes” to both WTP questions (71% of owners, 6% of boarders, 65% of leasers) and the use of mean values across the entire sample in predicting the WTP. Equine owners, with on farm equids from the southern US were WTP 11% less than from other regions (P = 0.015). The current boarding fees from owners that board their equids lowered their WTP by 0.01% (P = 0.029) for each additional dollar paid, whereas current care costs were not a significant factor for other owners (P = 0.370) or leasers (P = 0.395). Those that had a full lease for their equids, whether housed on farm or at a facility, were WTP 15% higher (P = 0.036) than those that had a partial or no lease. In comparison, boarding status (full, partial, or no boarding) did not significantly (P = 0.51) impact boarder's WTP. Age of respondent and annual household income heterogeneously affected WTP across all groups. These results indicate the market for equine care can bear the increases in cost associated with financial distress related to COVID-19. Results from this study should be taken in context of the global pandemic and the restrictions in place, or lack thereof, at the time the survey was administered.
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The COVID-19 pandemic has influenced travel, social interaction, and supply and demand shifts of goods and services. Pandemic restrictions caused difficulties across the equine industry, including ability to provide care and access to riding or training opportunities at boarding and show facilities. To determine how the pandemic affected essential and non-essential care access and financial stability for equine owners/leasers (OL) and equine boarding facility operators (FO), a survey was administered for 4 weeks (July–August 2020) to adult United States residents (n = 767, 39 states represented). The majority of respondents were Tennessee residents (n = 368). Data were analyzed using Chi-squared analyses in the frequency procedure (SAS v 9.4), where a = 0.05. Due to COVID-19 restrictions, moderate (FO: 28%, n = 31, OL: 21%, n = 114, easily manageable changes to daily activity) and major (FO: 25%, n = 28, OL: 14%, n = 80, daily activity completely disrupted) impacts on ability to provide non-essential care were reported, whereas OL (58%, n = 321) and FO (46%, n = 51) were more likely to report that their ability to provide essential care was unchanged (X2 = 13.8, P = 0.0079). Current financial ability to pay for essential care differed between OL compared with FO, where 44% (n = 50) of FO reported less financial stability compared with 31% (n = 177) of OL (X2 = 19.47, P = 0.0001). Future financial ability to pay for essential care was viewed similarly by FO and OL (X2 = 0.78, P = 0.68) and along with the ability to afford basic needs, including preventative health (X2 = 1.44, P = 0.23). More OL who maintained horses on their own property were concerned for their ability to pay for basic care over the next 6 mo (36%, n = 103) compared with OL who kept horses on someone else's property (28%, n = 80, X2 = 3.8, P = 0.05). The majority of horse owners indicated they had no plans to sell their animals before COVID-19 and currently do not plan to sell due to COVID-19 effects (78%, n = 499, P = 0.0001). A similar trend was identified for owners who lease horses, with 80% (n = 64) having no previous or current plans to end their lease, and 4% (n = 3) that now plan to end to their lease but did not before COVID-19 restrictions (P = 0.02). The COVID-19 pandemic has affected boarding facility owners and equine owners/leasers differently despite their similar optimism regarding future financial stability. Outlook on future financial stability, and ownership or lease status may have been affected by the improving COVID-19 climate during data collection, and warrants consideration when determining overall industry impact.
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This article presents findings from a recent study of academic perspectives towards employability in architecture. The aim of the study was to gauge the perceived impact of COVID-19 on employer values, and the degree to which these perceived changes were impacting teaching practices. Thematic analysis of data from semi-structured interviews with eight members of a postgraduate architecture community in Australia—including educators, practitioners, and students—revealed strong consensus. The relative value of skills such as teamwork and autonomy were deemed increasingly important following the widespread uptake of remote work. On the other hand, the value of competencies associated with the design process itself, as reflected in professional accreditation criteria, were perceived as stable. Most enlightening were participants' views on how they believe employability skills are encouraged, observed and judged in academic contexts. By reinforcing how employability skill development tends to rely on the discipline's tacit enculturation practices, this study raises critical questions about quality assurance and assessment practices within the architectural community. Embedded in these questions is the understanding that the challenge of employability skills assessment is entangled within the discipline's failure to address its ongoing challenges around diversity, equity and inclusion. © 2022 Deakin University. All rights reserved.
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Background: Recent research suggests that COVID-19 is associated with acute kidney dysfunction. Effect of COVID-19 infection on downstream kidney function is unknown. We investigated this using the BC Interdisciplinary COVID-19 Care Network data. Method(s): This retrospective cohort study analyzed a 2,212 COVID-19 patient cohort, aged >=18 years, referred to the Post COVID Recovery Clinic (PCRC) in BC, Canada between July 9, 2020 & April 21, 2022. COVID-19 diagnosis date was the index date. Patients with history of kidney transplantation or dialysis before index date were excluded. Patients who deceased within 3 months of cohort entry were excluded. eGFR values were retrieved from the Provincial Laboratory Information System. We examined change in eGFR at 3-, 6-, 12-months after COVID-19 infection among the same study individuals using linear mixed model. Subgroup analysis included comparison between hospitalized vs. non-hospitalized, & diabetics vs. non-diabetics. Result(s): Analytic cohort included 457 patients (median age 59 years, 50% male) for whom eGFR was recorded at 3-, 6-, 12-months from index date. Prevalence of reduced eGFR (<=59ml/min/1.73m2) was 16%, 16%, 17% at 3-, 6-and 12-months post-index date, respectively. Median (IQR) eGFR at baseline was 90 (73, 102) that was reduced to 85 (70, 101) at 6-months & remained stable or <previous value at 12 months postindex date, 86 (69, 101). Results from linear mixed model indicated a 0.23 ml/min decrease in eGFR in each month after COVID-19 infection (intercept 85.51, slope -0.23, p-value=0.0003). In subgroup analyses, similar trends of decreasing eGFR over time were observed among diabetic (n=188, intercept 83.08, slope -0.42, p-value=0.0001) & nondiabetic patients (n=269, intercept 87.33, slope -0.12, p-value=0.13). Interestingly, eGFR appeared to improve over time in non-hospitalized patients (n=133, intercept 88.34, slope 0.24, p-value=0.03) compared to a decreasing trend among hospitalized patients (n=324, intercept 83.94, slope -0.41, p-value=<0.001). Conclusion(s): One in 6 COVID-19 patients who were referred to PCRC had reduced eGFR. COVID-19 was associated with a statistically significant decrease in eGFR, particularly in diabetic & hospitalized patients that warrants ongoing monitoring following COVID-19 infection.
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S44 Table 1Summary of significant medical events, thoracic computed tomography (CT) and pulmonary function tests (PFTs) in ORBCEL-C and placebo groups at 1 year follow upORBCEL-C Placebo Number of patients followed up 20 21 Significant medical events Number of patients with SMEs 6/20 9/21 Total SME events 7 11 Classification Respiratory,thoracic and mediastinal disorders 4 6 Neoplasm - benign, malignant, unspecified 1 0 Infections and infestations 1 1 Cardiac disorders 1 0 Metabolism and nutrition disorders 0 1 Injury, poisoning and procedural complications 0 1 Renal and urinary disorders 0 1 Gastrointestinal disorders 0 1 Thoracic CT Number of CTs available 5 8 Time to CT (Median, IQR) 181 (157–198) 203 (95–233) Evidence of ILD on CT 4 6 PFTs Number of PFTs available 10 8 Time to PFTs (Median, IQR) 184.5 (117.5–292.75) 203.5 (118.25–242.5) FEV1 (Mean, SD) 84.9 (13.6) 80.5 (13.3) FEV1 <80% predicted (n,%) 4/10 (44%) 4/8 (50%) FVC (Mean, SD) 78.4 (13.2) 79.3 (16.5) FVC <80% predicted (n,%) 5/10 (55%) 5/8 (62.5%) FEV1/FVC ratio (Mean, SD, n) 0.88 (0.12) N=8 0.76 (0.05) N=5 FEV1/FVC <0.7 (n,%) 0 (0%) 0 (0%) TLCO (Mean, SD, n) 78.9 (14.8) N=9 61.9 (13.4) N=7 TLCO <80% (n,%) 6/9 (66.7%) 7/7 (100%) ConclusionsOne year follow up supports the safety of ORBCEL-C MSCs in patients with moderate to severe ARDS due to COVID-19. A similar incidence of pulmonary dysfunction is reported in both groups at long term follow up.Please refer to page A?? for declarations of interest related to this .
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SESSION TITLE: Late Breaking Pulmonary and Education Topics Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/18/2022 01:30 pm - 02:30 pm PURPOSE: Healthcare professionals working in intensive care units (ICU) report high burnout levels, especially during the COVID-19 pandemic. Residents are particularly at risk for burnout and sleep deprivation, associated with increased medical errors. However, the relationship between sleep, burnout, and psychomotor vigilance has not been extensively studied in residents working in the medical ICU. METHODS: Fifty residents rotating in the ICU at an academic, tertiary care center were recruited for a prospective controlled trial during a consecutive four-week period from August 2021 – May 2022. Study parameters for two weeks in non-ICU rotations were compared with two week during ICU rotation. Residents wore a wearable sleep tracker for two weeks before and during their ICU rotation. ICU rotation dates were randomized based on a fixed annual schedule. Residents ranged in post-graduate training years one through four. Specialties included internal medicine, transitional year, emergency medicine, anesthesia, and medicine/pediatrics combined residency. Data collected included the Oldenburg burnout inventory score, Epworth Sleepiness Scale (ESS), a computer-based psychomotor vigilance test, American Academy of Sleep Medicine sleep diary, and wearable sleep tracker data. Statistical analysis was performed in Excel and R statistical software. RESULTS: Total sleep minutes detected by the wearable sleep-tracker decreased from 402 minutes (95% CI: 377-427) before ICU to 389 minutes (95%CI: 360-418) during ICU (p<0.05). Residents overestimated the amount of sleep they obtained via their validated daily log at 464 (95% CI: 452-476) minutes before ICU and 442 (95% CI: 430-454) minutes during ICU, which reflected a decrease in sleep of 22 minutes (p<0.02). ESS increased significantly from 5.93 (95% CI: 4.89, 7.07) before to 8.33 (95% CI: 7.09,9.58) during ICU (p<0.01). Oldenburg burnout inventory scores significantly increased during ICU by 8.30 (p<0.001). The total score before ICU was 34.50 (95% CI: 32.87-36.15) and after was 42.82 (95% CI: 40.65-44.98). Exhaustion and disengagement sub-scores significantly increased during ICU (3.94, 4.64, respectively;p<0.001). Interestingly, psychomotor vigilance testing scores showed no significant difference during ICU. CONCLUSIONS: ICU rotations are associated with significantly reduced sleep as objectively measured by sleep wearable and decreased self-reported sleep minutes. Residents overestimate the amount of sleep they obtain. Significant worsening of ESS was noted along with increased burnout in residents working in the ICU. Interestingly, the psychomotor testing remains unchanged. Further research is needed in this area to better understand this phenomenon. CLINICAL IMPLICATIONS: Residents may benefit from increased mandatory wellness events or days off to combat burnout and fatigue while in the ICU. DISCLOSURES: No relevant relationships by Varun Badami No relevant relationships by Danielle DeCicco No relevant relationships by Abhinav Mittal No relevant relationships by Christopher Pham No relevant relationships by Steven Sagun No relevant relationships by Sunil Sharma No relevant relationships by Robert Stansbury No relevant relationships by Jesse Thompson
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SESSION TITLE: What Lessons Will We Take From the Pandemic? SESSION TYPE: Rapid Fire Original Inv PRESENTED ON: 10/19/2022 11:15 am - 12:15 pm PURPOSE: Post-intensive care syndrome (PICS) affects 50% of ICU survivors leading to significant healthcare utilization. COVID-19 survivors are at higher risk for developing PICS given the prolonged duration of critical illness. The aim of this study was to determine the feasibility and acceptability of using telemedicine (TM) for the transitional care (TC) of post ICU COVID-19 survivors. METHODS: This prospective randomized un-blinded controlled study was conducted from July 2021 to January 2022. Adults admitted to the ICU with a diagnosis of acute respiratory distress syndrome secondary to COVID-19 infection and discharged home were included. Those who lacked communication and internet services, and had pre-morbid conditions preventing independent self-care were excluded. 40 patients were recruited with 20 patients in each arm. The study group (SG) underwent a telemedicine (TM) visit within 2 weeks of discharge, where vital signs logs (VSL), virtual six-minute walk test (v6MWT), and EuroQoL 5-Dimension (EQ-5D) questionnaire were reviewed. The control group (CG) received a TM visit within 6 weeks of discharge and completed the EQ-5D questionnaire. This study was approved by the WVU IRB (#2104284924). RESULTS: Both groups had similar baseline characteristics. Completion rate of the VSL and v6MWT was 50% in the SG. 39% of SG came off oxygen supplementation compared to 33% in the CG. There was less anxiety/depression, increased request, and compliance to follow-up in pulmonary clinic noted in SG compared to CG, however this difference was not statistically significant. All readmissions were non- preventable (n=3;2 CG, 1 SG). 100% survival rate was noted in both groups at 30-days. 5% of patients were lost to follow up in both groups due to non-working communication devices and lack of response despite multiple attempts made for the TM visit. 67% (2/3) of primary care physicians (PCP) felt that this intervention helped establish continuity of care. 83% (5/6) of participants felt that an intensivist led TC visit provided closure for their ICU hospitalization. CONCLUSIONS: There was no significant difference noted in outcomes between the 2 groups, however, this is likely due to underpowered sample sizes. This form of TC is well received by both PCP and patients in screening and mitigation of PICS. CLINICAL IMPLICATIONS: This pilot study is the first in the region to show the acceptability and feasibility of using TM for the TC of ICU COVID survivors. It is vital to ensure ICU survivors receive targeted multidisciplinary management to prevent PICS. TM can be utilized in the future for the TC of all ICU survivors. DISCLOSURES: No relevant relationships by Ariful Alam No relevant relationships by Bathmapriya Balakrishnan No relevant relationships by Lucas Hamrick No relevant relationships by Sunil Sharma Consultant relationship with Res Med Please note: 7/2021-Present Added 03/31/2022 by Robert Stansbury, value=Consulting fee No relevant relationships by Jesse Thompson
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Introduction: The negative impact of Post-Intensive Care Syndrome on the quality of life of critical illness survivors has previously been well characterised.1 Survivors of Covid-19 critical illness are a relatively new cohort in terms of younger age and less prior comorbidity.2 The healthrelated quality of life, psychological problems, resilience, or wellbeing of survivors of Covid-19 critical illness have not been fully explored. Objectives: To characterise the resilience, wellbeing, selfefficacy, and quality of life of ICU-survivors, who were admitted with Covid-19, 6-9 months post-hospital discharge. To explore any potential associations with baseline characteristics. Methods: This was a prospective follow-up study of ICUsurvivor patients who were admitted with Covid-19 and discharged alive from the Royal Infirmary Edinburgh or St John's Hospital, Scotland. Eligible patients were identified by 2 specialist research nurses from the medical records and were contacted via telephone for consent. Paper copies of the questionnaire pack were posted to patients who consented. Demographic characteristics were captured from WardWatcher IT system (age, sex, length of ICU stay). 2 investigators telephoned participants to complete the questionnaires. Outcomes measured were: resilience, using the 10-item Connor-Davidson Resilience Scale (CDRISC), self-efficacy, using the General Self-Efficacy (GSE) Scale, overall health state, using The EuroQol EQ5D-5L Health Questionnaire, and Wellbeing, using 6 10-point visual analogue scales. Statistical analysis was conducted using R-Studio. Associations were tested with Fisher's exact test for categorical variables, and Kruskal-Wallis for continuous variables. Statistical significance was accepted at p<=0.05. Results: Of the 52 eligible patients consented to be contacted, 40 (76.9%) completed the questionnaires. 59.6% (31/52) were male;median age was 59.0 (IQR:53.0-66.2), and participants spent median 6.3 (IQR: 4.1-11.0;) days in ICU. Questionnaires were completed median 202 days (IQR:187.5-224.0) from hospital discharge. The median total CDRISC score was 34.5 (IQR: 30.8-38.0), which has previously been defined as normal resilience (27-37/40)3. 12.5% (5/40) and 32.5% (13/40) reported low (<27/40) and high (>=38/40) resilience respectively.3 The median total GSE score was 34.0 (IQR: 30.0-38.0) (international mean: 29.554). For overall health state (EQ5D-5L), the median overall health score was 80.0% (IQR:75.0-81.2), with the results in each domain as follows: Mobility: 27% (11/40) reported moderate or worse problems (with the remainder reporting no problems);Self-care: 10% (4/40) reported moderate or worse problems;Usual activities: 17% (7/40) reported moderate or worse problems;Pain: 17.5% (7/40) reported moderate or worse problems;Anxiety or depression: 17.5% (7/40) reported moderate or worse problems. For the wellbeing measures, participants rated 'Overall satisfaction with life as a whole' median 8/10 (IQR: 7-9), and 'I have a sense of direction and purpose in life' median 8/10 (IQR:7-9.5). Resilience, self-efficacy, health-related quality of life, and wellbeing were not significantly associated with age, length of ICU-stay, or time between discharge and questionnaire completion. Conclusion: Overall, ICU-survivors of Covid-19 critical illness reported normal resilience, and high levels of selfefficacy and wellbeing at 6-9 months post-hospital discharge. Many ICU-survivors experienced problems affecting their overall health state, such as with mobility and pain. Future studies are indicated to investigate how to best support ICU-survivors in their recovery.