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1.
Diabetes research and clinical practice ; 186:109359-109359, 2022.
Article in English | EuropePMC | ID: covidwho-1877157
2.
Adverse Drug Reactions Journal ; 24(4):169-174, 2022.
Article in Chinese | Scopus | ID: covidwho-1875842

ABSTRACT

Objective To explore the occurrence and influencing factors of serum uric acid elevation in patients with coronavirus disease 2019 (COVID⁃19) treated with favipiravir. Methods Medical records of patients with COVID⁃19 who were hospitalized in Beijing Ditan Hospital between June 1, 2020 and June 30, 2021 and treated with the 5- or 10-day regimen of favipiravir were collected and retrospectively analyzed. After favipiravir withdrawal, if the elevation in serum uric acid was ≥30% of baseline level, it was defined as serum uric acid elevation. Then patients were divided into serum uric acid elevation group and non-serum uric acid elevation group. The clinical characteristics such as gender, age, body mass index, comorbidities, smoking and drinking behavior, COVID⁃19 grade, favipiravir regimen, and serum uric acid level and renal function before treatment in patients between the 2 groups were compared. Influencing factors of favipiravir⁃associated serum uric acid elevation was analyzed using multivariate logistic regression method. Results A total of 179 patients were included in the analysis, including 104 (58.1%) males and 75 (41.9%) females, aged from 19 to 70 years with a median age of 43 years. The level of serum uric acid in 179 patients after favipiravir treatment was significantly higher than before [(451±119) μmol/L vs. (332±94) μmol/L, P<0.001]. The change rate of serum uric acid from baseline level ranged from -57.1% to 157.8% with the median of 38.6%. The elevation in serum uric acid of ≥ 30% of baseline level occurred in 108 (60.3%) patients. The incidences of serum uric acid elevation in patients treated with 5-day and 10-day regi⁃ mens of favipiravir were 46.8% (36/77) and 70.6% (72/102), respectively, and the difference between them was significant (P=0.001). Multivariate logistic regression analysis showed that body mass index 24.0 to <28.0 kg/m2 (OR=3.109, 95%CI: 1.209-7.994, P=0.019) and 10-day regimen of favipiravir (OR=3.017, 95%CI: 1.526-5.964, P=0.001) were independent risk factors for favipiravir⁃associated serum uric acid elevation. Conclusions More than half of COVID⁃19 patients treated with favipiravir can develop serum uric acid elevation. Overweight and 10-day regimen of favipiravir are independent risk factors for serum uric acid elevation in patients. © 2022 Adverse Drug Reactions Journal.

3.
Clinical Neurosurgery ; 67(SUPPL 1):131, 2020.
Article in English | EMBASE | ID: covidwho-1816190

ABSTRACT

INTRODUCTION: Covid 19 infections has been shown to be associated with a range of thromboembolic disease that has implications for the neuro-endovascular management of large vessel occlusions. METHODS: Five consecutive Covid-19 positive patients presented with large vessel occlusions to our institution. Covid-19 testing was performed using nasal swab. All thrombectomy cases was performed under general endotracheal anesthesia using a stent-aspiration combination as primary thrombectomy technique. The technical details of each case and the angiographic outcome are described. Routine labs including D-dimer, platelet count, coagulation panel (aPTT, INR), Interleukin 6 (IL-6), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) were evaluated in all patients. Rotational thrombelastography (ROTEM) was performed on the patients' blood samples to assess real-time clot formation/dissolution properties. RESULTS: Four patients had anterior circulation large vessel occlusions and one patient had both anterior and posterior circulation occlusions. Mean age was 52.8 years and 80% were males. TICI 3 revascularization was achieved in one patient, TICI 2B achieved in two patients and TICI 2A in two patients. In our cohort, patients were on average 52.8 years old and presented with a median NIHSS of 27. All our patients had very proximal occlusions. Three patients presented with intra-cranial ICA occlusions. Two patients presented with a tandem carotid bulb thrombus in conjunction with an intracranial vessel occlusion. One patient had an ICA terminus occlusion with a concomitant basilar occlusion. Second, the intravascular clots in all our patients were prone to fragment and migrate into both new vascular territories and into distal downstream vasculature. Distal emboli into a different territory (anterior cerebral artery occlusion) was seen in two two of our five patients (40%) and distal emboli into a downstream territory was seen in all five patients (100%). An average of 2.7 pstent-retriever passes was needed to achieve a final TICI revascularization of IIb or better. CONCLUSION: Covid-19 patients are predisposed to a hypercoagulable state. When presenting with large vessel occlusions, these patients present unique challenges that make successful revascularization difficult.

4.
PubMed; 2020.
Preprint in English | PubMed | ID: ppcovidwho-333623

ABSTRACT

SARS-CoV-2 is detectable in saliva from asymptomatic individuals, suggesting a potential benefit from the use of mouth rinses to suppress viral load and reduce virus spread. Published studies on reduction of SARS-CoV-2-induced cytotoxic effects by antiseptics do not exclude antiseptic-associated cytotoxicity. Here, we determined the effect of commercially available mouth rinses and antiseptic povidone-iodine on the infectivity of SARS-CoV-2 virus and of a non-pathogenic, recombinant, SARS-CoV-2 infection vector (pseudotyped SARS-CoV-2 virus). We first determined the effect of mouth rinses on cell viability to ensure that antiviral activity was not a consequence of mouth rinse-induced cytotoxicity. Colgate Peroxyl (hydrogen peroxide) exhibited the most cytotoxicity, followed by povidone-iodine, chlorhexidine gluconate (CHG), and Listerine (essential oils and alcohol). Potent anti-viral activities of povidone iodine and Colgate peroxyl mouth rinses was the consequence of rinse-mediated cellular damage. The potency of CHG was greater when the product was not washed off after virus attachment, suggesting that the prolonged effect of mouth rinses on cells impacts anti-viral activity. To minimalize mouth rinse-associated cytotoxicity, mouth rinse was largely removed from treated-viruses by centrifugation prior to infection of cells. A 5% (v/v) dilution of Colgate Peroxyl or povidone-iodine completely blocked viral infectivity. A similar 5% (v/v) dilution of Listerine or CHG had a moderate suppressive effect on the virus, but a 50% (v/v) dilution of Listerine or CHG blocked viral infectivity completely. Prolonged incubation of virus with mouth rinses was not required for viral inactivation. Our results indicate that mouth rinses can significantly reduce virus infectivity, suggesting a potential benefit for reducing SARS-CoV-2 spread. IMPORTANCE: SARS-CoV-2 is detectable in saliva from asymptomatic individuals, suggesting the potential necessity for the use of mouth rinses to suppress viral load to reduce virus spread. Published studies on anti-SARS-CoV-2 activities of antiseptics determined by virus-induced cytotoxic effects cannot exclude antiseptic-associated cytotoxicity. We found that all mouth rinses tested inactivated SARS-CoV-2 viruses. Listerine and CHG were less cytotoxic than Colgate Peroxyl or povidone-iodine and were active against the virus. When mouth rinses were present in the cell culture during the infection, the potent anti-viral effect of mouth rinses were in part due to the mouth rinse-associated cytotoxicity. Our results suggest that assessing anti-viral candidates including mouth rinses with minimal potential disruption of cells may help identify active agents that can reduce SARS-CoV-2 spread.

5.
PubMed; 2020.
Preprint in English | PubMed | ID: ppcovidwho-333561

ABSTRACT

Increasing age is the strongest predictor of risk of COVID-19 severity. Unregulated cytokine storm together with impaired immunometabolic response leads to highest mortality in elderly infected with SARS-CoV-2. To investigate how aging compromises defense against COVID-19, we developed a model of natural murine beta coronavirus (mCoV) infection with mouse hepatitis virus strain MHV-A59 (mCoV-A59) that recapitulated majority of clinical hallmarks of COVID-19. Aged mCoV-A59-infected mice have increased mortality and higher systemic inflammation in the heart, adipose tissue and hypothalamus, including neutrophilia and loss of gammadelta T cells in lungs. Ketogenic diet increases beta-hydroxybutyrate, expands tissue protective gammadelta T cells, deactivates the inflammasome and decreases pathogenic monocytes in lungs of infected aged mice. These data underscore the value of mCoV-A59 model to test mechanism and establishes harnessing of the ketogenic immunometabolic checkpoint as a potential treatment against COVID-19 in the elderly. HIGHLIGHTS: - Natural MHV-A59 mouse coronavirus infection mimics COVID-19 in elderly.- Aged infected mice have systemic inflammation and inflammasome activation.- Murine beta coronavirus (mCoV) infection results in loss of pulmonary gammadelta T cells.- Ketones protect aged mice from infection by reducing inflammation. ETOC BLURB: Elderly have the greatest risk of death from COVID-19. Here, Ryu et al report an aging mouse model of coronavirus infection that recapitulates clinical hallmarks of COVID-19 seen in elderly. The increased severity of infection in aged animals involved increased inflammasome activation and loss of gammadelta T cells that was corrected by ketogenic diet.

6.
Frontiers in Education ; 7, 2022.
Article in English | Scopus | ID: covidwho-1793036

ABSTRACT

Format changes in U.S. schooling in response to the COVID-19 pandemic varied by month and by school district, ranging from exclusively home-based to full in-person learning. The impact of these changes on adolescent schooling experiences, and the factors that mitigate such impact, have been challenging to quantify. To address these challenges we employed bi-monthly repeated surveys of youths (N = 6, 546, aged 13–14 years) in a longitudinal study, starting before the pandemic peak (October 2020) and continuing through one year after the pandemic was declared (March 2021). We investigated how school format (in-person vs. remote) impacted objective time spent on academic activities and the subjective experience of school, and how these were influenced by parental engagement. Periods of exclusive at-home remote schooling were pervasive—reported by more than 60% of youths—and linked to a reduction in school enjoyment and time spent on reading, math, and science. In contrast, such periods were linked to more time with parents or guardians helping with school activities, and the frequency of such parental involvement was associated with reductions in negative feelings about school. Results point to potential pathways to mitigate the negative consequences of future school disruptions. Copyright © 2022 Guillaume, Toomarian, Van Rinsveld, Baskin-Sommers, Dick, Dowling, Gonzalez, Hasak, Lisdahl, Marshall, Nguyen, Pelham, Pillai, Sheth, Wang, Tapert and McCandliss.

7.
3rd International Conference on Video, Signal and Image Processing, VSIP 2021 ; : 8-15, 2021.
Article in English | Scopus | ID: covidwho-1784894

ABSTRACT

At present, COVID-19 cross-infection is easy to occur in dense places such as elevators. There are no epidemic prevention measures for construction site elevators on the market, and most of them require manual temperature measurement and reminders to wear masks and helmets to avoid the spread of the epidemic. This paper designs an intelligent epidemic prevention system for the elevator ride process in a modern construction site environment, which can achieve non-contact human temperature measurement, mask and helmet recognition and voice call elevator function. The system uses Arduino UNO as the control core, Kendryte K210 as machine vision processing module, non-contact infrared temperature sensor MLX90614, and voice recognition sensor LD3320. The system has the functions of non-contact temperature detection, mask/helmet recognition(YOLOv3) and voice call elevator. Experimental results showed that the recognition accuracy rate of helmet, mask, voice call elevator is 91.5%, 92.0% and 93.0% respectively. The temperature measurement accuracy rate is 0.2ĝ., which can effectively prevent the spread of the epidemic caused by contact and breathing, and has the advantages of stable, intelligent, and safe work. © 2021 ACM.

8.
Canadian Journal of Family and Youth ; 14(1):124-145, 2022.
Article in English | Web of Science | ID: covidwho-1766736

ABSTRACT

Canada has one of the largest cohorts of young carers aged 15 to 24 who provide unpaid care for a family member. Although the body of research on young carers is growing in Canada, knowledge on the experiences and needs of young carers living in remote and rural communities is almost absent. This study aimed to understand and address the needs of young carers in rural/remote communities to support our community partner's goal of expanding their resources and support of this underserved population. The study was conducted in two phases with the first phase being a needs assessment and the second phase addressed those needs. In Phase 1 (conducted pre-COVID-19), three focus groups were conducted with young carers from rural and urban communities with 20 young carers participating in total. Six themes were identified: Internet Usage in Daily Life;Finding and Filtering Information;Concerns Related to Internet Use;Social and Mental Support;What Makes Caregiving More Challenging;and Designing Something to Make Caring Easier. During Phase 2 (conducted mid-COVID-19), 2 focus groups were held via Zoom for Healthcare with a mix of rural and urban young carers in each group. One of the focus groups was held with those under 18 years old and the other included those between 18 to 25 years old. Four themes were identified: Responses to Emergencies;Awareness of Emergency Planning;Potential Impact on Planned Behaviour;and Considerations and Suggestions for Improvement.

9.
CHI Conference on Human Factors in Computing Systems ; 2021.
Article in English | Web of Science | ID: covidwho-1759470

ABSTRACT

There is an open call for technology to be more playful [5, 79] and for tech design to be more inclusive of people with disabilities [80]. In the era of COVID19, it is often unsafe for the public in general and people with disabilities, in particular, to engage in in-person design exercises using traditional methods. This presents a missed opportunity as these populations are already sharing playful content rich with tacit design knowledge that can be used to inspire the design of playful everyday technology. We present our process of scraping play potentials [4] from TikTok from content creators with disabilities to generate design concepts that may inspire future technology design. We share 7 emerging themes from the scraped content, a catalog of design concepts that may inspire designers, and discuss the relevance of the emerging themes and possible implications for the design concepts.

10.
Critical Care Medicine ; 50(1 SUPPL):780, 2022.
Article in English | EMBASE | ID: covidwho-1691794

ABSTRACT

INTRODUCTION: Opioid overdose deaths increased over two decades, with the incidence accelerated further during the COVID-19 pandemic. While opioids remain mainstay for trauma-related pain management, organizations are focused on reducing use. This study aimed to determine if a hospitalwide Alternatives to Opiates (ALTO) program reduced opioid prescribing at discharge after trauma. METHODS: A single-center, retrospective analysis of patients ≥18 years old admitted for ≥24 hours with primary diagnosis of traumatic injury between August 1, 2018 - October 31, 2019 was performed. Admissions before July 1, 2019, represent the control group, whereas admissions on/after represent the ALTO group. Patients with alcohol or polysubstance abuse, chronic opioid use, or in-hospital mortality were excluded. The primary outcome was incidence of opioid prescribing at discharge. Secondary outcomes were percent with in-hospital non-opioid and multimodal analgesia, and hospital and intensive care unit (ICU) length of stay (LOS). A sample size of 129 patients was needed to observe a 30% reduction in primary outcome and maintain 80% power to detect a statistically significant difference using alpha < 0.05. RESULTS: A total of 703 patients were included, 471 in the control and 232 in the ALTO groups. Mean age was 59±22 years and 58.7% were male. Mean initial Injury Severity Score (ISS) was 9.1±7.7 and Charlson Comorbidity Index (CCI) was 2.7±2.7. In-hospital opioid prescribing was higher (70.4% vs. 87.5%, p< 0.0001), and opioid discontinuation at hospital discharge occurred less frequently (60.5% vs. 56.2%, p=0.1237) after ALTO implementation. Surgical intervention, lack of ICU admission, ISS ≥9 and CCI ≤1 was associated with lower incidence of opioid discontinuation at discharge in both groups. Most patients received nonopioid (93.6 vs. 98.7%, p=0.0051) and multimodal analgesia (84.3% vs. 87.5%, p=0.3083) during hospitalization. Median hospital LOS [5(3-9) vs. 4(3-7), p=0.3427] and ICU LOS [2(0-4) vs. 3(2-5), p=0.3461] were similar. CONCLUSIONS: Opioids remain mainstay for traumarelated pain management. In our study, ALTO was not associated with a reduction in in-hospital opioid prescribing or at discharge. Identification and implementation of strategies to further reduce opioid prescribing at discharge in trauma patients are needed.

11.
Blood ; 138:292, 2021.
Article in English | EMBASE | ID: covidwho-1577299

ABSTRACT

VITT is an immune-based complication of adenoviral-based vaccines used to immunize against SARS_CoV2. The antibodies in VITT have been described as directed at the platelet-specific chemokine PF4 (CXCL4). While the clinical course and target chemokine in VITT has much in common with the better-known thrombocytopenic/prothrombotic disorder, heparin-induced thrombocytopenia (HIT), which involves antibodies directed against PF4 bound to the polyanion heparin, the specific loci where VITT and PF4/polyanion HIT antibodies bind appear to differ in studies using alanine-scanning mutations of PF4 (Nature, 2021. DOI: 10.1038/s41586-021-03744-4). The VITT antigenic site localizes to a heparin-binding domain. Unlike the dominant HIT locus, the VITT locus is conserved not only between human and mouse PF4, but also between PF4 and the related platelet-specific chemokine NAP2 (CXCL7). NAP2 is also expressed and stored in platelet alpha-granules and is present in equimolar concentrations to PF4. Unlike PF4, NAP2 avidly binds the chemokine receptor CXCR2 and strongly activates neutrophils. We now show that antibodies from patients who developed VITT after both AstraZeneca (AZ) or Johnson and Johnson (JJ) adenoviral vaccines, unlike HIT antibodies, recognize mouse PF4 (Figure 1A). More importantly, both AZ and JJ VITT antibodies bound NAP2, while none of the HIT antibodies tested bound PF4 or NAP2 in the absence of heparin (Figure 1A). These results are consistent with the alanine-scanning studies that distinguish the HIT and VITT binding sites. Dynamic light scattering (DLS) showed that NAP2 and PF4 bind to the adenoviral vectors, including Ad5 and the AZ vector ChAdOx5, which leads to expression of SARS_CoV2 spike protein. ChAdOx2 vaccine and CsCl 2-purified ChAdOx2 bound to both proteins, but form larger complexes with NAP2 than with PF4 even at lower concentrations of this chemokine (Figure 1C). Removal of anti-PF4 antibodies by hPF4-Sepharose abrogated PF4-dependent binding, but did not significantly reduce binding to NAP2 (not shown), indicating that VITT plasma contains discrete pools of anti-PF4 and anti-NAP2 antibodies that may have distinct functional properties. Sandwich ELISA (not shown) and Western blot analysis of purified VITT IgG demonstrates the presence of hPF4-IgG and NAP2-IgG immune complexes in purified patient's IgG (Figure 2A). Functional studies show that both PF4 and NAP2 can activate platelets in the presence of VITT antibodies. Anti-PF4-depleted VITT IgG fraction retains the ability to activate platelets in the presence of NAP2 (Figure 2B). Thus, unlike HIT, VITT appears to target a shared antigenic site on the related chemokines PF4 and NAP2. This raises the question as to whether NAP2, as one the most abundant platelet chemokines released from activated platelets, is involved in the initiation and propagation of the immunothrombotic response. Additional studies are needed to see whether NAP2, which can potently and specifically activate neutrophils via CXCLR2, contributes to the specific thromboinflammatory phenotype seen in VITT. We propose using FcgammaRIIA+ mice that concurrently express human PF4 and NAP2 and specific knockout of each chemokine, available in our group, to further understand the pathogenesis of VITT and its thrombocytopenic/ prothrombotic phenotype. [Formula presented] Disclosures: Padmanabhan: Veralox Therapeutics: Membership on an entity's Board of Directors or advisory committees. Cines: Dova: Consultancy;Rigel: Consultancy;Treeline: Consultancy;Arch Oncol: Consultancy;Jannsen: Consultancy;Taventa: Consultancy;Principia: Other: Data Safety Monitoring Board.

15.
Vertex: Revista Argentina de Psiquiatria ; XXXII(153):53-69, 2021.
Article in Spanish | MEDLINE | ID: covidwho-1516048

ABSTRACT

BACKGROUND: Evidence about the impact of the COVID-19 pandemic on the mental health of specific subpopulations- such as university students-is needed as communities prepare for future waves. AIMS: To study the association of proximity of COVID-19 with symptoms of anxiety and depression in university students. METHODS: This trend study analyzed weekly cross-sectional surveys of probabilistic samples of students from the University of British Columbia for 13 weeks through the first wave of COVID-19. The main variable assessed was propinquity of COVID-19, defined as "knowing someone who tested positive for COVID-19", which was specified at different levels: knowing someone anywhere globally, in Canada, in Vancouver, in their course, or at home. Proximity was included in multivariable linear regressions to assess its association with primary outcomes, including 30-day symptoms of anxiety and/or depression. RESULTS: Of 1,388 respondents (adjusted response rate=50%), 5.6% knew someone with COVID-19 in Vancouver, 0.8% in their course, and 0.3% at home. Ten percent were overwhelmed and unable to access help. Knowing someone in Vancouver was associated with an 11 percentage-point increase in the probability of 30-day anxiety symptoms (SE=0,05;p<=0,05), moderated by gender, with a significant interaction of the exposure and being female (coefficient= 20(SE=0,09), p<=0,05). No association was found with depressive symptoms. CONCLUSION: Propinquity of COVID-19 cases may increase the likelihood of anxiety symptoms in students, particularly amongst men. Most students report coping well, but additional supports are needed for an emotionally overwhelmed minority who report being unable to access help.

16.
Psychosomatic Medicine ; 83(7):A16-A16, 2021.
Article in English | Web of Science | ID: covidwho-1405805
17.
2021 IEEE Systems and Information Engineering Design Symposium, SIEDS 2021 ; 2021.
Article in English | Scopus | ID: covidwho-1402845

ABSTRACT

This project seeks to investigate the under addressed issue of indoor environmental quality (IEQ) and the impacts these factors can have on human health. The recent COVID-19 pandemic has once again brought to the forefront the importance of maintaining a healthy indoor environment. Specifically, the improvement of indoor air flow has shown to reduce the risk of airborne virus exposure. This is extremely important in the context of hospitals, which contain high concentrations of atrisk individuals. Thus, the need to create a healthy indoor space is critical to improve public health and COVID-19 mitigation efforts. To create knowledge and provide insight on environmental qualities in the hospital setting, the authors have designed and built an interface to deploy in the University of Virginia Hospital Emergency Department (ED). The interface will display room-specific light, noise, temperature, CO2, humidity, VOC, and PM2.5 levels measured by the low-cost Awair Omni sensor. These insights will assist ED clinicians in mitigating disease-spread and improving patient health and satisfaction while reducing caregiver burden. The team addressed the problem through agile development involving localized sensor deployment and analysis, discovery interviews with hospital clinicians and data scientists throughout, and the implementation of a human-design centered Django interface application. Furthermore, a literature survey was conducted to ascertain appropriate thresholds for the different environmental factors. Together, this work demonstrates opportunities to assist and improve patient care with environmental data. © 2021 IEEE.

18.
2020 5th International Conference on Mechanical, Control and Computer Engineering ; : 906-911, 2020.
Article in English | Web of Science | ID: covidwho-1372639

ABSTRACT

In order to avoid the spread of new coronavirus, it is necessary to keep a distance, wear masks and wash hands, not close contact. When the academic research or market survey needs to fill in the questionnaire, it is a safe and necessary choice to use the network electronic form. In order to prevent the spread of virus, it is necessary to keep a safe distance between people. The demand for electronic forms is more diverse and vigorous. To prevent the spread of virus through interviews and questionnaires, we can change the way of filling in electronic forms to achieve the purpose of maintaining a safe distance. As a result, the demand for electronic forms has increased, and the electronic forms can be more convenient. At the same time, the anti-counterfeiting function of electronic signature is used. The undeniable characteristics of personal signature can be customized and diversified. At present, the system development and technology of web forms are various and mature. In order to increase the employability of college students, the implementation course of online spreadsheet is added to the professional courses of University, which has gradually become a popular option of software engineering for students' graduation design. From the system analysis and system design, JavaScript, HTML5, CSS3 and other technologies are selected. Through the programming framework on the server, through the browser, it is convenient to use the web spreadsheet. The system functions are successfully implemented, and the graduation design of university professional courses is completed, which is a reference for successful cases of course practice. This model is a successful example of system development. Combined with the theory of university courses and the practice of project design, the system development, design and system testing are completed successfully within the effective time limit.

19.
2021 Ieee Conference on Virtual Reality and 3d User Interfaces Abstracts and Workshops ; : 675-676, 2021.
Article in English | Web of Science | ID: covidwho-1365047

ABSTRACT

With AR's dynamic and immersive qualities, the Pickrick AR project aims to serve two purposes: to support the civil rights movement in remembrance of the African Americans who fought for equality and to educate students about this special moment in history via a pedagogical tool. With considerations of the Covid-19 pandemic, this tool aims to create an immersive and enlightening experience within the real physical space without the presence of a tour guide. In this paper, is an introduction to our design concepts, specifically in how to integrate multimedia information and create a user-friendly interface by using Human Computer Interaction (HCI) principles and the Sense of Place (SOP) Theory.

20.
Annals of Emergency Medicine ; 78(2):S47-S48, 2021.
Article in English | EMBASE | ID: covidwho-1351543

ABSTRACT

Study Objectives: To determine whether behavior changes made during the SARS-CoV-19 pandemic impacted the number of patients being tested and the positivity rate of sexually transmitted infections (STI) at a large, urban ED in the Bronx to identify how to improve the sexual health services available to our patients. Methods: A retrospective, cross-sectional study using data from the EMR at a public hospital in the Bronx, New York. Included patients were aged 13 and over that had STI testing from Aug. 1, 2019 to Feb. 1, 2020 (Period 1) and Aug. 1, 2020 to Feb. 1, 2021 (Period 2) in the adult or pediatric ED. Periods 1 and 2 are 6 month periods before and after the SARS-CoV-19 pandemic in NYC, respectively. Counts and percents were used to quantify STI tests (HIV point of care, HIV 4th generation serum, Gonorrhea Amplification, Chlamydia Amplification, and Treponema Pallidum Ab screen) and positive results during Period 1 vs. Period 2. A chi-squared test of independence determined significance of positivity rates in Period 1 vs Period 2 with a p-value of.05. Results: In Period 1, there were 2386 distinct patients accounting for 5445 STI tests with 54% female, 30% male and 18% unknown or other self-identified sex. The average age of all patients was 37 years (S.D. ± 15). In Period 2, 2218 distinct ED patients accounting for 5816 STI tests with 52% female, 24% male, 24% unknown or other self-identified sex. The average age for Period 2 was 37 years (S.D. ± 15). Our data (Table 1) show that more STI diagnostic tests were performed in Period 2 than Period 1 for chlamydia, gonorrhea, and syphilis in our ED. There were fewer HIV tests performed in Period 2. There were no significant differences in positivity rates between Periods 1 and 2 for HIV, chlamydia, gonorrhea, or syphilis, although there was a trend towards significance for gonorrhea and syphilis. Conclusion: A higher absolute number of chlamydia, gonorrhea, and syphilis tests were performed in our ED in the post-SARS-CoV-19 time period. This overall increase in testing may be due to an increased utilization of emergency services given oversubscribed outpatient resources. The decrease in HIV testing could be due to patients opting out of testing, or providers having a lower suspicion of HIV infection in the context of the pandemic. A stable positivity rate could imply that despite newly imposed SARS-CoV-19 guidelines on social behavior, patients in our population continued to engage in condomless sexual encounters. STI testing panels incorporated into the electronic medical record may facilitate complete STI testing that includes HIV as an opt-out reminder for providers. [Formula presented]

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