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1.
Cities and Health ; 2022.
Article in English | Scopus | ID: covidwho-2187935

ABSTRACT

The COVID-19 pandemic has exacerbated health and socioeconomic disparities and limited access to both social services and health care. According to national public vaccination strategies, the Ministry of Health of the city of Buenos Aires has led the Butterfly Effect Project. The main objective was to implement a population-specific strategy aimed to surmount these challenges by promoting vaccination to unhoused and at-risk people in the city of Buenos Aires (Argentina). This case study presents the main findings of a survey within the Butterfly Effect Project that explored the obstacles and opportunities faced by unhoused and at-risk people in the city of Buenos Aires in terms of access to the health care system during the pandemic. The study also analyzed perceptions of both COVID-19 and the vaccination campaign. This qualitative exploratory study was conducted through semi-structured interviews carried out with unhoused and at-risk people between June and July 2021. Through this project, the city of Buenos Aires vaccinated more than 10,000 people in vulnerable social and housing situations, including unhoused people and people at risk of becoming unhoused. Peer companions, Paradores (public shelters), and homes for unhoused people were considered ‘essential' during the pandemic. © 2022 Informa UK Limited, trading as Taylor & Francis Group.

2.
Journal of Addiction Medicine ; 16(5):e302, 2022.
Article in English | EMBASE | ID: covidwho-2083662

ABSTRACT

Introduction: Methadone treatment (MT) is an established treatment for opioid use disorder, with longer treatment duration associated with decreased mortality and improved overall outcomes. Several changes to MT were instituted following Covid-19, the most significant of which was increased take home methadone doses (THM). Yet, increased THM's impact on MT retention has not been tested. We assessed whether 3-month retention rates for individuals entering MT following the onset of Covid-19 differed from those who entered one year prior. Additionally, we considered several demographic variables in the group comparisons to determine whether race, sex or age predicted treatment drop out. Method(s): De-identified chart extractions were obtained from Methasoft electronic dosing records. Data included methadone dosing, treatment intake dates and patient demographics (sex, age and race). Patients were classified into pre-Covid (intake date from from 03/16/2019-12/16/2019) or post post-Covid (03/16/2020 2020-2/16/2021) groups. We defined MT retention as at least one clinic visit for observed dosing within a two-week period. A discrete-time model was employed to assess the impact of group (pre-vs. post-Covid intake), sex, age and race on treatment drop-out. Result(s): Three months post MT intake, the pre-Covid group had an average of one THM dose/ week;the post-Covid group averaged four THM doses/week. Nonetheless, there were no differences in retention for the pre-and post-Covid groups (OR = 0.988), with ~65% retention in both groups. Sex was a moderator (OR = 2.30, P < 0.05): there was increased odds of dropout for males in Covid, yet decreased odds for females. Older patients (OR = 0.963, P < 0.001) and non-white patients (OR = 1.62, P < 0.01) were more likely to remain in treatment. Discussion(s): To our knowledge, no other studies have used computerized dosing data to evaluate treatment retention and THM status comparing preand post-COVID outcomes. Potential unmeasured confounders included type and quantity of drug use, other measures of clinical stability of enrolled patients, and the myriad social effects of life during a pandemic. The lack of differences in overall retention between the pre-Covid and post-Covid groupsdespite an increase in THM doses suggests clinicians and policymakers should consider continuing alleviated restrictions on THM dispensing, while balancing potential individual and community harms of possible worsened treatment adherence. Conclusion(s): Prior research has also pointed to lower attendance requirements supporting MT retention. Further research is needed to examine the effects of extended THM on other treatment outcomes.

3.
Journal of Food Safety and Food Quality ; 73(2):48-57, 2022.
Article in German | CAB Abstracts | ID: covidwho-1933504

ABSTRACT

Due to the SARS-CoV-2 pandemic, many areas of public life had to respond. That also included the university teaching. The veterinary universities / faculties of Germany, Austria and Switzerland have a common catalogue of teaching objectives, which was created and established by the working group: "Teaching in the food hygiene subjects of the German-speaking countries". This allowed the authors to guarantee uniform and efficient teaching. After the first SARS-CoV-2 wave in spring 2020, a summary of the first semester within the pandemic is summarized within this work from the lecturers' point of view. It showed that e-learning elements in the form of videos, pictures, case reports etc. have great potential to embrace teaching. Due to the outbreak of the SARS-CoV-2 pandemic, it became necessary to switch to complete distance learning. The available resources (Blackboard, Webex etc.) can be used specifically to convey the necessary learning objectives. At the same time, however, the strong limitations of this type of teaching were recognized. The physical presence at the educational establishment is and remains indispensable to prepare students for their future work as a veterinarian in the field of food safety and food hygiene.

4.
Wiener Klinisches Magazin ; 23(3):92-115, 2020.
Article in German | MEDLINE | ID: covidwho-1906083

ABSTRACT

The COVID-19 pandemic is currently a challenge worldwide. In Austria, a crisis within the health care system has so far been avoided. The treatment of patients with community-acquired pneumonia (CAP), including SARS-CoV-2 infections, should continue to be based on evidence-based CAP guidelines during the pandemic. However, COVID-19-specific adjustments are useful. The treatment of patients with chronic lung diseases must be adapted during the pandemic, but must still be guaranteed.

8.
United European Gastroenterology Journal ; 9(SUPPL 8):891, 2021.
Article in English | EMBASE | ID: covidwho-1490973

ABSTRACT

Introduction: Viral infections may trigger diabetes. Clinical data suggest infection with the pandemic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causing coronavirus disease 2019 (COVID-19), may impact glucose homeostasis in patients. Notably, cases of new-onset diabetes upon SARS-CoV-2 infection have been reported. However, experimental evidence of pancreatic infection is still controversial. Aims & Methods: Here, we employ cadaveric human pancreatic islets, as well as pancreatic tissue from deceased COVID-19 patients to investigate the impact of SARS-CoV-2 on the pancreas. Results: We show that human β-cells express viral entry proteins ACE2 and TMPRSS2, making them susceptible to SARS-CoV-2 infection and replication. Our data further demonstrates that SARS-CoV-2 infects and replicates in ex vivo cultured human islets and infection. This infection is associated with morphological, transcriptional and functional changes, such as reduction of insulin-secretory granules in β-cells and impaired glucose-stimulated insulin secretion. In COVID-19 post-mortem examinations, we detected SARS-CoV-2 nucleocapsid protein in pancreatic exocrine cells, and in cells that stain positive for the β-cell marker NKX6.1 in all patients investigated. Conclusion: Taken together, our data define the human pancreas as a target of SARS-CoV-2 infection and suggest that β-cell infection might contribute to the metabolic dysregulation observed in patients with COVID- 19.

9.
Wellcome Open Research ; 5:1-14, 2021.
Article in English | Scopus | ID: covidwho-1485509

ABSTRACT

Background: Across the African continent, other than South Africa, COVID-19 cases have remained relatively low. Nevertheless, in Kenya, despite early implementation of containment measures and restrictions, cases have consistently been increasing. Contact tracing forms one of the key strategies in Kenya, but may become infeasible as the caseload grows. Here we explore different contact tracing strategies by distinguishing between household and non-household contacts and how these may be combined with other nonpharmaceutical interventions. Methods: We extend a previously developed branching process model for contact tracing to include realistic contact data from Kenya. Using the contact data, we generate a synthetic population of individuals and their contacts categorised by age and household membership. We simulate the initial spread of SARS-CoV-2 through this population and look at the effectiveness of a number of nonpharmaceutical interventions with a particular focus on different contact tracing strategies and the potential effort involved in these. Results: General physical distancing and avoiding large group gatherings combined with contact tracing, where all contacts are isolated immediately, can be effective in slowing down the outbreak, but were, under our base assumptions, not enough to control it without implementing extreme stay at home policies. Under optimistic assumptions with a highly overdispersed R0 and a short delay from symptom onset to isolation, control was possible with less stringent physical distancing and by isolating household contacts only. Conclusions: Without strong physical distancing measures, controlling the spread of SARS-CoV-2 is difficult. With limited resources, physical distancing combined with the isolation of households of detected cases can form a moderately effective strategy, and control is possible under optimistic assumptions. More data are needed to understand transmission in Kenya, in particular by studying the settings that lead to larger transmission events, which may allow for more targeted responses, and collection of representative age-related contact data. © 2020. Wagner M et al.

10.
Journal of Clinical Oncology ; 39(15 SUPPL), 2021.
Article in English | EMBASE | ID: covidwho-1339220

ABSTRACT

Background: Sarcoma pts often receive aggressive, highly immunosuppressive therapy and may be at high risk for severe COVID-19. Demographics, outcomes and risk factors for pts with sarcoma and COVID-19 are unknown. We aimed to describe the course of COVID-19 in sarcoma pts and to identify factors associated with adverse outcomes. Methods: The COVID-19 and Cancer Consortium (NCT04354701) is an international registry of pts with cancer and COVID-19. Adult pts (≥18 years old) with a diagnosis of sarcoma and laboratory confirmed SARS-CoV-2 were included from 50 participating institutions. Data including demographics, sarcoma diagnosis and treatment, and course of COVID-19 infection were analyzed. Primary outcome was the composite rate of hospitalization or death at 30 days from COVID-19 diagnosis. Secondary outcomes were 30 day all-cause mortality, rate of hospitalization, O2 need, and ICU admission. Descriptive statistics and univariate Fisher tests are reported. Results: From March 17, 2020 to February 6, 2021, N=204 pts were included. Median follow up was 42 days. Median age was 58 years (IQR 43-67). 97 (48%) were male. 30 (15%) had ECOG performance status ≥2. 104 (51%) received cancer treatment, including surgery or radiation, within 3 months of COVID-19 diagnosis. 153 (75%) had active cancer, of whom 34 (22%) had lung metastases. 100 (49%) pts met the composite primary endpoint;96 (47%) were hospitalized and 18 (9%) died within 30 days from COVID-19 diagnosis. 64 (31%) required oxygen, and 16 (8%) required ICU admission. Primary endpoint rates were similar for pts who received cytotoxic chemotherapy (38/58, 66%) or targeted therapy (16/28, 57%). Pts with higher rates of the primary endpoint included patients ≥60 years old (59% vs 40%, OR 2.04, 95% CI 1.12-3.74, p=0.016), pts with ECOG PS ≥2 vs 0-1 (90% vs 41%, OR 12.2, 95% CI 3.44-66.8, p<0.001), pts receiving any systemic therapy within 3 months of COVID-19 diagnosis (62% vs 39%, OR 2.65, 95% CI 1.43-4.97, p=0.001), and pts with lung metastases (68% vs 42%, OR 2.77, 95% CI 1.19- 6.79, p=0.013). Primary endpoint rates were similar across sarcoma subtypes (Table). Conclusions: This is the largest cohort study of pts with sarcoma and COVID-19 to date. Sarcoma pts have high rates of complications from COVID-19. Older patients, those with poor performance status, those recently receiving systemic cancer therapy, and those with lung metastases appear to have worse outcomes.

11.
Geburtshilfe Und Frauenheilkunde ; 81(06):E14-E15, 2021.
Article in English | Web of Science | ID: covidwho-1269403
12.
Topics in Antiviral Medicine ; 29(1):70, 2021.
Article in English | EMBASE | ID: covidwho-1250516

ABSTRACT

Background: The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), mainly affects the lung, but may also result in extrapulmonary manifestations such as lesions in kidneys, heart, brain, gastrointestinal and endocrine organs. Clinical data suggest that a SARS-CoV-2 infection disturbs glucose homeostasis, and cases of new-onset diabetes mellitus after SARS-CoV-2 infection have been reported. However, experimental evidence that SARS-CoV-2 can infect pancreatic tissue is lacking. We here explored whether pancreatic tissue is susceptible to SARS-CoV-2 infection. Methods: We analyzed healthy human pancreas tissue and cells for ACE2 and TMPRSS2 expression by immunohistochemistry. We exposed human Langerhans islets to SARS-CoV-2 ex vivo and determined viral infection by staining for SARS-CoV-2 spike and nucleoprotein. Viral replication was monitored by detection of released viral RNA by qPCR and infectious titers by TCID50 titration. In addition, infection and the impact of SARS-CoV-2 on cell morphology was examined by electron microscopy. Consequential changes in cell functionality were analyzed by determining insulin secretion and performing transcriptomics. Finally, we performed immunohistochemistry staining of pancreatic sections of four COVID-19 deceased individuals for the presence of SARS-CoV-2 nucleoprotein. Results: Our results show that SARS-CoV-2 infects cells of the human exocrine and endocrine pancreas ex vivo and in vivo. We demonstrate that human β-cells express ACE2 and TMPRSS2, and support SARS-CoV-2 replication. The infection was associated with morphological, transcriptional and functional changes, including reduced numbers of insulin secretory granules in β-cells, upregulation of antiviral gene expression, and impaired glucose-stimulated insulin secretion. Finally, all four analyzed full body autopsies of COVID-19 patients showed SARSCoV-2 nucleoprotein in pancreatic cells, including those that stain positive for the β-cell marker NKX6.1. Conclusion: Our data demonstrate that the human pancreas is a target of SARS-CoV-2 ex vivo and in vivo and suggest that β-cell infection may contribute to pancreatic dysregulation observed in COVID-19 patients.

13.
J Hosp Infect ; 110: 60-66, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1087052

ABSTRACT

BACKGROUND: Healthcare workers (HCWs) have been disproportionately affected by coronavirus disease 2019 (COVID-19), which may be driven, in part, by nosocomial exposure. If HCW exposure is predominantly nosocomial, HCWs in paediatric facilities, where few patients are admitted with COVID-19, may lack antibodies to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and be at increased risk during the current resurgence. AIM: To compare the seroprevalence of SARS-CoV-2 amongst HCWs in paediatric facilities in seven European countries and South Africa (N=8). METHODS: All categories of paediatric HCWs were invited to participate in the study, irrespective of previous symptoms. A single blood sample was taken and data about previous symptoms were documented. Serum was shipped to a central laboratory in London where SARS-CoV-2 immunoglobulin G was measured. FINDINGS: In total, 4114 HCWs were recruited between 1st May and mid-July 2020. The range of seroprevalence was 0-16.93%. The highest seroprevalence was found in London (16.93%), followed by Cape Town, South Africa (10.36%). There were no positive HCWs in the Austrian, Estonian and Latvian cohorts; 2/300 [0.66%, 95% confidence interval (CI) 0.18-2.4] HCWs tested positive in Lithuania; 1/124 (0.81%, 95% CI 0.14-4.3) HCWs tested positive in Romania; and 1/76 (1.3%, 95% CI 0.23-7.0) HCWs tested positive in Greece. CONCLUSION: Overall seroprevalence amongst paediatric HCWs is similar to their national populations and linked to the national COVID-19 burden. Staff working in paediatric facilities in low-burden countries have very low seroprevalence rates and thus are likely to be susceptible to COVID-19. Their susceptibility to infection may affect their ability to provide care in the face of increasing cases of COVID-19, and this highlights the need for appropriate preventative strategies in paediatric healthcare settings.


Subject(s)
Antibodies, Viral/blood , COVID-19/epidemiology , Health Personnel/statistics & numerical data , Hospitals, Pediatric/statistics & numerical data , Occupational Diseases/epidemiology , Risk Assessment/statistics & numerical data , Adult , Aged , Cross-Sectional Studies , Europe/epidemiology , Female , Humans , Male , Middle Aged , Prevalence , Seroepidemiologic Studies , South Africa/epidemiology , Young Adult
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