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1.
Gastroenterology ; 160(6):S-613, 2021.
Article in English | EMBASE | ID: covidwho-1599468

ABSTRACT

Introduction: The COVID-19 pandemic prompted a rapid shift to telehealth for care delivery. We aimed to assess satisfaction with and preferences for telehealth to improve care experiences for patients with irritable bowel syndrome (IBS). Methods: We conducted a prospective survey-based cross-sectional study from September 29 to November 9, 2020 in a diverse, community-based integrated healthcare system in Southern California. We included members age 18-90 with an International Classification of Diseases 9, 10 code for IBS from an office-based encounter between June 1, 2018 to June 1, 2020. A specifically developed survey (TIBS-CoV2) was emailed to patients. We collected demographic and clinical data from the electronic medical record. We assessed satisfaction via 5-point Likert scale (“strongly agree and agree” was defined as satisfied;“strongly disagree and disagree” as dissatisfied). Using Chi-square and Wilcoxon Rank Sum tests, we compared demographic and clinical characteristics of those who were satisfied and dissatisfied with telehealth in patients with ROME IV IBS. We used multivariate logistic regression to identify predictors for telehealth satisfaction. Results: Of 44,789 surveys sent, 2598 (5.8%) patients responded, 1473 (56.7%) completed the entire survey (median age 60.0 [42.4-71.2], 80.1% female;66.3% non-Hispanic white, 22.1% Hispanic, 5.0% black, 4.0% Asian) and 744 (28.6%) had ROME IV confirmed IBS. 651 (87.5%) patients with IBS used telehealth for their care: 436 (67.0%) were satisfied, 62 (9.5%) were dissatisfied and 153 (23.5%) felt neutral about their experience. No significant differences were seen in sex, race/ethnicity, BMI, marital status, income, IBS subtype or severity between satisfied and dissatisfied groups (Table 1). Telehealth satisfaction was associated with full-time employment (188, 43.1%, p>0.001), a college degree or higher (244, 56.0%, p=0.01), or daily social media use (338, 77.5%, p=0.01). Dissatisfaction was associated with older age (59.2±17, p<0.01), retirement (26, 41.9%, p=0.02) and low self-perceived health literacy (4, 6.5%, p=0.008). Satisfied patients would consider telehealth over a face-to-face visit for a travel time of 30-59 minutes (170, 39.0%, p=0.01);dissatisfied patients did not consider travel time a factor (23, 37.1%, p>0.001). Multivariate analysis confirmed age, a college degree, daily use of social media and travel time of 30-59 minutes as independent predictors of telehealth satisfaction (Table 2). Conclusions: A majority of patients with IBS are satisfied with telehealth and are more likely to use telehealth since the COVID-19 pandemic. Factors including age, available time, education level, health literacy and comfort with technology likely influence satisfaction with telehealth in IBS and may help to identify patients who would be most responsive to a focused IBS-telehealth program.(Table presented) (Table presented)

2.
Gastroenterology ; 160(6):S-188-S-189, 2021.
Article in English | EMBASE | ID: covidwho-1598773

ABSTRACT

Background and Objective: With the onset of the Coronavirus Disease 2019 (COVID-19) pandemic, various aspects of health care have been affected;however, there has been an unknown effect on hospital admissions for gastrointestinal (GI) diseases and the potential consequences on specific illnesses. Our study aims to characterize the rates of GI disease hospitalizations during the pandemic as compared to prior and any differences between specific gastrointestinal diseases throughout this period. This will be important in highlighting any gaps of care as related to gastroenterology during COVID-19.Methods: We conducted a retrospective, cross-sectional study between the months of January to May from the years 2016-2020 in a regional integrated health care system. January –May 2020 was delineated as the COVID-19 period. ICD-10 codes were used to identify principal diagnoses related to the most common GI hospitalizations in the United States (upper GI hemorrhage, pancreatitis, liver disease, diverticular disease, cholelithiasis). Rates of hospitalization were then calculated per 100,000 members for each calendar month and each respective year. Rates for the 5 most identified GI diseases were then calculated using a similar method from 2019 as compared to 2020. The rate of percent change for each month for these diseases were then analyzed during the pandemic year of 2020 versus the preceding year of 2019.Results: A total of 4589 (rate of 19.57 per 100,000) hospitalizations for GI related diseases occurred between January – May 2020 as opposed to 5328 (rate of 23.10 per 100,000) hospitalizations from January – May 2019 (p=0.03). The median age in 2020 was 59.1 (p= 0.27 compared to 2019) with a 51% female to male ratio. 38% of patients were White, 42% Hispanic, 10% Black, 8% Asian (p=0.58 compared to 2019 for all ethnicities). There was a decrease in the rate of hospitalization in each month from January – April 2020 compared to 2019 with a subsequent rise in May. There was a 2.86 increase in rate of hospitalization (p<0.01) from April to May 2020. There were only significant differences (p<0.05) in hospitalization rates between the months of March – May from 2020 versus 2019. Of the 5 most common GI diseases, upper gastrointestinal hemorrhage showed the highest average rate change of -20% from 2020 to 2019. Cholelithiasis had a change of -15%, pancreatitis with a change of -14%, diverticular disease with a change of -11%, and liver disease with a change of -9%.Conclusion: GI related hospitalizations decreased during the COVID-19 pandemic as com-pared to the previous year. Upper gastrointestinal hemorrhage showed the most average rate change of the GI diseases. Further studies highlighting the implications of these findings, such as mortality and severity of illness during the pandemic, need to be completed to assess the impact COVID-19 on GI disease.(Figure presented)(Table Presented)

3.
Gastroenterology ; 160(6):S-334-S-335, 2021.
Article in English | EMBASE | ID: covidwho-1598594

ABSTRACT

Background: Southern California Kaiser cares for 4.7 million patients of which thousands carry a diagnosis of Inflammatory Bowel Disease (IBD). As the SARS-COV2 Virus has rapidly become a worldwide pandemic that causes the deadly COVID-19 respiratory syndrome, particular attention has been paid to patients with chronic IBD, who often take immunosuppressive medications that pose greater infectious risk than those in the general population. Although recent international studies have not shown worsening outcomes among IBD patients with COVID 19, not much is known about the local, regional characteristics of this population. In this study, we aim to describe the characteristics of IBD patients in the Southern California Kaiser healthcare system who have been diagnosed with COVID-19. Methods: We retrospectively gathered data from the electronic medical records of adult IBD patients who carry an ICD-10 diagnosis of Ulcerative colitis (UC) or Crohns disease (CD) and who were also diagnosed with COVID-19 with a positive lab result and ICD 10 code between the dates of January 1, 2020 and October 31, 2020. We then tabulated descriptive data among non-hospitalized, hospitalized, and deceased patients of this population. This data was verified through manual chart review. Results: Among 13,262 patients with IBD, 475 cases with suspected COVID were obtained and 280 patients had a confirmed positive COVID-19 test on manual review (89 CD, 191 UC). Average age was 49 years old with a female predominance of 59%. 14%(n=39) of patients were hospitalized and 2.5% (n=7) died. The population was predominantly White (48%) and Hispanic (37.5%). 36% of patients were not on any IBD medications while 38.9% were on aminosalicylates, 21% were on biologic agents, 9.3% were on thiopurines, and 4.3% were on corticosteroids. Among the hospitalized patients, 67%(n=26) were admitted for COVID-19. Hospitalized patients had an average age of 61 years old, 51% were female, and had an average length of stay of 7.7 days. 56.4% (n=22) were not on any IBD medications, while 7.7% (n=3) were on corticosteroids, and 18% (n=7) were on biologic agents. Among patients that died, 71%(n=5) died of COVID-19 related complications and 14% (n=1) died of renal failure. None were on biologic agents and 71% (n=5) were not on any medications for IBD. Conclusion: This study did not show increased risk of mortality among patients with IBD who are on biologic therapy. Mortality rate is comparable to published data in patients without IBD. Overall, the diagnosis of COVID 19 was associated with patients that were predominantly women, White or Hispanic, and patients not on any medications for IBD. Further research will be conducted to analyze risk factors such as medical co-morbidities in this population. (Table Presented) (Table Presented) (Table Presented)

4.
Nguyen, T.; Qureshi, M.; Martins, S.; Yamagami, H.; Qiu, Z.; Mansour, O.; Czlonkowska, A.; Abdalkader, M.; Sathya, A.; de Sousa, D. A.; Demeestere, J.; Mikulik, R.; Vanacker, P.; Siegler, J.; Korv, J.; Biller, J.; Liang, C.; Sangha, N.; Zha, A.; Czap, A.; Holmstedt, C.; Turan, T.; Grant, C.; Ntaios, G.; Malhotra, K.; Tayal, A.; Loochtan, A.; Mistry, E.; Alexandrov, A.; Huang, D.; Yaghi, S.; Raz, E.; Sheth, S.; Frankel, M.; Lamou, E. G. B.; Aref, H.; Elbassiouny, A.; Hassan, F.; Mustafa, W.; Menecie, T.; Shokri, H.; Roushdy, T.; Sarfo, F. S.; Alabi, T.; Arabambi, B.; Nwazor, E.; Sunmonu, T. A.; Wahab, K. W.; Mohammed, H. H.; Adebayo, P. B.; Riahi, A.; Ben Sassi, S.; Gwaunza, L.; Rahman, A.; Ai, Z. B.; Bai, F. H.; Duan, Z. H.; Hao, Y. G.; Huang, W. G.; Li, G. W.; Li, W.; Liu, G. Z.; Luo, J.; Shang, X. J.; Sui, Y.; Tian, L.; Wen, H. B.; Wu, B.; Yan, Y. Y.; Yuan, Z. Z.; Zhang, H.; Zhang, J.; Zhao, W. L.; Zi, W. J.; Leung, T. K.; Sahakyan, D.; Chugh, C.; Huded, V.; Menon, B.; Pandian, J.; Sylaja, P. N.; Usman, F. S.; Farhoudi, M.; Sadeghi-Hokmabadi, E.; Reznik, A.; Sivan-Hoffman, R.; Horev, A.; Ohara, N.; Sakai, N.; Watanabe, D.; Yamamoto, R.; Doijiri, R.; Tokuda, N.; Yamada, T.; Terasaki, T.; Yazawa, Y.; Uwatoko, T.; Dembo, T.; Shimizu, H.; Sugiura, Y.; Miyashita, F.; Fukuda, H.; Miyake, K.; Shimbo, J.; Sugimura, Y.; Yagita, Y.; Takenobu, Y.; Matsumaru, Y.; Yamada, S.; Kono, R.; Kanamaru, T.; Yamazaki, H.; Sakaguchi, M.; Todo, K.; Yamamoto, N.; Sonodda, K.; Yoshida, T.; Hashimoto, H.; Nakahara, I.; Faizullina, K.; Kamenova, S.; Kondybayeva, A.; Zhanuzakov, M.; Baek, J. H.; Hwang, Y.; Lee, S. B.; Moon, J.; Park, H.; Seo, J. H.; Seo, K. D.; Young, C. J.; Ahdab, R.; Aziz, Z. A.; Zaidi, W. A. W.; Bin Basri, H.; Chung, L. W.; Husin, M.; Ibrahim, A. B.; Ibrahim, K. A.; Looi, I.; Tan, W. Y.; Yahya, Wnnw, Groppa, S.; Leahu, P.; Al Hashmi, A.; Imam, Y. Z.; Akhtar, N.; Oliver, C.; Kandyba, D.; Alhazzani, A.; Al-Jehani, H.; Tham, C. H.; Mamauag, M. J.; Narayanaswamy, R.; Chen, C. H.; Tang, S. C.; Churojana, A.; Aykac, O.; Ozdemir, A. O.; Hussain, S. I.; John, S.; Vu, H. L.; Tran, A. D.; Nguyen, H. H.; Thong, P. N.; Nguyen, T.; Nguyen, T.; Gattringer, T.; Enzinger, C.; Killer-Oberpfalzer, M.; Bellante, F.; De Blauwe, S.; Van Hooren, G.; De Raedt, S.; Dusart, A.; Ligot, N.; Rutgers, M.; Yperzeele, L.; Alexiev, F.; Sakelarova, T.; Bedekovic, M. R.; Budincevic, H.; Cindric, I.; Hucika, Z.; Ozretic, D.; Saric, M. S.; Pfeifer, F.; Karpowicz, I.; Cernik, D.; Sramek, M.; Skoda, M.; Hlavacova, H.; Klecka, L.; Koutny, M.; Vaclavik, D.; Skoda, O.; Fiksa, J.; Hanelova, K.; Nevsimalova, M.; Rezek, R.; Prochazka, P.; Krejstova, G.; Neumann, J.; Vachova, M.; Brzezanski, H.; Hlinovsky, D.; Tenora, D.; Jura, R.; Jurak, L.; Novak, J.; Novak, A.; Topinka, Z.; Fibrich, P.; Sobolova, H.; Volny, O.; Christensen, H. K.; Drenck, N.; Iversen, H.; Simonsen, C.; Truelsen, T.; Wienecke, T.; Vibo, R.; Gross-Paju, K.; Toomsoo, T.; Antsov, K.; Caparros, F.; Cordonnier, C.; Dan, M.; Faucheux, J. M.; Mechtouff, L.; Eker, O.; Lesaine, E.; Ondze, B.; Pico, F.; Pop, R.; Rouanet, F.; Gubeladze, T.; Khinikadze, M.; Lobjanidze, N.; Tsiskaridze, A.; Nagel, S.; Ringleb, P. A.; Rosenkranz, M.; Schmidt, H.; Sedghi, A.; Siepmann, T.; Szabo, K.; Thomalla, G.; Palaiodimou, L.; Sagris, D.; Kargiotis, O.; Kaliaev, A.; Liebeskind, D.; Hassan, A.; Ranta, A.; Devlin, T.; Zaidat, O.; Castonguay, A.; Jovin, T.; Tsivgoulis, G.; Malik, A.; Ma, A.; Campbell, B.; Kleinig, T.; Wu, T.; Gongora, F.; Lavados, P.; Olavarria, V.; Lereis, V. P.; Corredor, A.; Barbosa, D. M.; Bayona, H.; Barrientos, J. D.; Patino, M.; Thijs, V.; Pirson, A.; Kristoffersen, E. S.; Patrik, M.; Fischer, U.; Bernava, G.; Renieri, L.; Strambo, D.; Ayo-Martin, O.; Montaner, J.; Karlinski, M.; Cruz-Culebras, A.; Luchowski, P.; Krastev, G.; Arenillas, J.; Gralla, J.; Mangiafico, S.; Blasco, J.; Fonseca, L.; Silva, M. L.; Kwan, J.; Banerjee, S.; Sangalli, D.; Frisullo, G.; Yavagal, D.; Uyttenboogaart, M.; Bandini, F.; Adami, A.; de Lecina, M. A.; Arribas, M. A. T.; Ferreira, P.; Cruz, V. T.; Nunes, A. P.; Marto, J. P.; Rodrigues, M.; Melo, T.; Saposnik, G.; Scott, C. A.; Shuaib, A.; Khosravani, H.; Fields, T.; Shoamanesh, A.; Catanese, L.; Mackey, A.; Hill, M.; Etherton, M.; Rost, N.; Lutsep, H.; Lee, V.; Mehta, B.; Pikula, A.; Simmons, M.; Macdougall, L.; Silver, B.; Khandelwal, P.; Morris, J.; Novakovic-White, R.; Ramakrishnan, P.; Shah, R.; Altschul, D.; Almufti, F.; Amaya, P.; Ordonez, C. E. R.; Lara, O.; Kadota, L. R.; Rivera, L. I. P.; Novarro, N.; Escobar, L. D.; Melgarejo, D.; Cardozo, A.; Blanco, A.; Zelaya, J. A.; Luraschi, A.; Gonzalez, V. H. N.; Almeida, J.; Conforto, A.; Almeida, M. S.; Silva, L. D.; Cuervo, D. L. M.; Zetola, V. F.; Martins, R. T.; Valler, L.; Giacomini, L. V.; Cardoso, F. B.; Sahathevan, R.; Hair, C.; Hankey, G.; Salazar, D.; Lima, F. O.; Mont'Alverne, F.; Moises, D.; Iman, B.; Magalhaes, P.; Longo, A.; Rebello, L.; Falup-Pecurariu, C.; Mazya, M.; Wisniewska, A.; Fryze, W.; Kazmierski, R.; Wisniewska, M.; Horoch, E.; Sienkiewicz-Jarosz, H.; Fudala, M.; Rogoziewicz, M.; Brola, W.; Sobolewski, P.; Kaczorowski, R.; Stepien, A.; Klivenyi, P.; Szapary, L.; van den Wijngaard, I.; Demchuk, A.; Abraham, M.; Alvarado-Ortiz, T.; Kaushal, R.; Ortega-Gutierrez, S.; Farooqui, M.; Bach, I.; Badruddin, A.; Barazangi, N.; Nguyen, C.; Brereton, C.; Choi, J. H.; Dharmadhikari, S.; Desai, K.; Doss, V.; Edgell, R.; Linares, G.; Frei, D.; Chaturvedi, S.; Gandhi, D.; Chaudhry, S.; Choe, H.; Grigoryan, M.; Gupta, R.; Helenius, J.; Voetsch, B.; Khwaja, A.; Khoury, N.; Kim, B. S.; Kleindorfer, D.; McDermott, M.; Koyfman, F.; Leung, L.; Linfante, I.; Male, S.; Masoud, H.; Min, J. Y.; Mittal, M.; Multani, S.; Nahab, F.; Nalleballe, K.; Rahangdale, R.; Rafael, J.; Rothstein, A.; Ruland, S.; Sharma, M.; Singh, A.; Starosciak, A.; Strasser, S.; Szeder, V.; Teleb, M.; Tsai, J.; Mohammaden, M.; Pineda-Franks, C.; Asyraf, W.; Nguyen, T. Q.; Tarkanyi, G.; Horev, A.; Haussen, D.; Balaguera, O.; Vasquez, A. R.; Nogueira, R..
Neurology ; 96(15):42, 2021.
Article in English | Web of Science | ID: covidwho-1576349
5.
Preprint | PubMed | ID: ppcovidwho-297038

ABSTRACT

Secondary bacterial infections, including ventilator-associated pneumonia (VAP), lead to worse clinical outcomes and increased mortality following viral respiratory infections. Critically ill patients with coronavirus disease 2019 (COVID-19) face an elevated risk of VAP, although susceptibility varies widely. Because mechanisms underlying VAP predisposition remained unknown, we assessed lower respiratory tract host immune responses and microbiome dynamics in 36 patients, including 28 COVID-19 patients, 15 of whom developed VAP, and eight critically ill controls. We employed a combination of tracheal aspirate bulk and single cell RNA sequencing (scRNA-seq). Two days before VAP onset, a lower respiratory transcriptional signature of bacterial infection was observed, characterized by increased expression of neutrophil degranulation, toll-like receptor and cytokine signaling pathways. When assessed at an earlier time point following endotracheal intubation, more than two weeks prior to VAP onset, we observed a striking early impairment in antibacterial innate and adaptive immune signaling that markedly differed from COVID-19 patients who did not develop VAP. scRNA-seq further demonstrated suppressed immune signaling across monocytes/macrophages, neutrophils and T cells. While viral load did not differ at an early post-intubation timepoint, impaired SARS-CoV-2 clearance and persistent interferon signaling characterized the patients who later developed VAP. Longitudinal metatranscriptomic analysis revealed disruption of lung microbiome community composition in patients who developed VAP, providing a connection between dysregulated immune signaling and outgrowth of opportunistic pathogens. Together, these findings demonstrate that COVID-19 patients who develop VAP have impaired antibacterial immune defense weeks before secondary infection onset. One sentence summary: COVID-19 patients with secondary bacterial pneumonia have impaired immune signaling and lung microbiome changes weeks before onset.

7.
Seismological Research Letters ; 92(5):3007-3023, 2021.
Article in English | Scopus | ID: covidwho-1414095

ABSTRACT

In this article, we analyze the change in anthropogenic seismic noise level within a frequency range of 4-14 Hz, through a survey of seismic stations in California, United States, New York City, United States, and Mexicali, Baja California, Mexico from early December 2019 to late April 2020. Our analysis shows that some stations recorded a drop in anthropogenic seismic noise during the COVID-19 pandemic, and the timing of the anthropogenic noise decrease typically correlates with the timing of a strict curtailment of personal and economic activity issued by the local government. In other locations, the drop in the anthropogenic seismic noise appears not to follow the lockdown timing perfectly.Duringour analysis,weobservedthatmanystations didnot recordadropduring the early stageofCOVID-19pandemic. Ofthe 19 stationsof the Southern California Seismic Network that were surveyed, we found that only five show a similar extent of drop in anthropogenic seismic noise comparable to the Christmas holiday break in 2019. This suggests that the human activity that caused seismic noise did not significantly reduce during the COVID-19 pandemic near most surveyed stations in southern California. A further analysis implies that the primary seismic noise source in southern California might be traffic, and the continuation of industrial traffic, such as cargo transportation, during the COVID-19 pandemic may be the reason why many stations did not record a noise drop. Our results show that the anthropogenic seismic noise recorded by seismic stations is capable of indicating human activity, and that thismetric is, particularly, powerful inmeasuring how localized communities initially responded to the COVID-19 pandemic. © 2021 Seismological Society of America. All rights reserved.

8.
Sensors and Actuators B: Chemical ; 348, 2021.
Article in English | Scopus | ID: covidwho-1410905

ABSTRACT

Droplet digital polymerase chain reaction (ddPCR) is a rapidly developing technology used for accurate, quantitative analysis of rare samples. However, ddPCR has only been implemented in research field but rarely in clinical trials due to its relatively high cost and negative user experiences compared with qPCR. We developed a novel programmable on-demand droplet generator based on a microfluidic adaptive printing system (MAP-ddPCR) to create a cost-effective ddPCR process. This process easily produces low-volume, spot-on-demand droplet dispensing and data analysis using simple equipment and workflow. Compared with the existing droplet generation systems that rely on surface-assistant, the proposed MAP system generates a variety of droplet arrays on regular non-surface-treated glass slides. This system directly processes PCR and performs data analysis without requiring a secondary droplets transfer. The static and independent properties of each droplet dramatically avoid cross-contamination during PCR, provide the opportunity to trace droplets in real-time and simplify the analysis. We demonstrated that the MAP-ddPCR produces reliable data using gradient concentrations of glyceraldehyde-3-phosphate dehydrogenase (GAPDH) in human genomic cDNA. These concentrations were further verified by quantitative PCR (qPCR). In addition, a very low viral load of SARS-CoV-2 was precisely detected and quantified by the MAP-ddPCR system. Finally, this system is affordable and simpler to integrate compared to other more expensive commercial digital PCR methods. Therefore, the proposed MAP-ddPCR system is expected to have a significant impact on market applications. © 2021 Elsevier B.V.

9.
Nguyen, T.; Qureshi, M.; Martins, S.; Yamagami, H.; Qiu, Z.; Mansour, O.; Czlonkowska, A.; Abdalkader, M.; Sathya, A.; Sousa, D. A.; Demeester, J.; Mikulik, R.; Vanacker, P.; Siegler, J.; Korv, J.; Biller, J.; Liang, C.; Sangha, N.; Zha, A.; Czap, A.; Holmstedt, C.; Turan, T.; Grant, C.; Ntaios, G.; Malhotra, K.; Tayal, A.; Loochtan, A.; Mistry, E.; Alexandrov, A.; Huang, D.; Yaghi, S.; Raz, E.; Sheth, S.; Frankel, M.; Lamou, E. G. B.; Aref, H.; Elbassiouny, A.; Hassan, F.; Mustafa, W.; Menecie, T.; Shokri, H.; Roushdy, T.; Sarfo, F. S.; Alabi, T.; Arabambi, B.; Nwazor, E.; Sunmonu, T. A.; Wahab, K. W.; Mohammed, H. H.; Adebayo, P. B.; Riahi, A.; Sassi, S. B.; Gwaunza, L.; Rahman, A.; Ai, Z.; Bai, F.; Duan, Z.; Hao, Y.; Huang, W.; Li, G.; Li, W.; Liu, G.; Luo, J.; Shang, X.; Sui, Y.; Tian, L.; Wen, H.; Wu, B.; Yan, Y.; Yuan, Z.; Zhang, H.; Zhang, J.; Zhao, W.; Zi, W.; Leung, T. K.; Sahakyan, D.; Chugh, C.; Huded, V.; Menon, B.; Pandian, J.; Sylaja, P. N.; Usman, F. S.; Farhoudi, M.; Sadeghi-Hokmabadi, E.; Reznik, A.; Sivan-Hoffman, R.; Horev, A.; Ohara, N.; Sakai, N.; Watanabe, D.; Yamamoto, R.; Doijiri, R.; Kuda, N.; Yamada, T.; Terasaki, T.; Yazawa, Y.; Uwatoko, T.; Dembo, T.; Shimizu, H.; Sugiura, Y.; Miyashita, F.; Fukuda, H.; Miyake, K.; Shimbo, J.; Sugimura, Y.; Yagita, Y.; Takenobu, Y.; Matsumaru, Y.; Yamada, S.; Kono, R.; Kanamaru, T.; Yamazaki, H.; Sakaguchi, M.; Todo, K.; Yamamoto, N.; Sonodda, K.; Yoshida, T.; Hashimoto, H.; Nakahara, I.; Faizullina, K.; Kamenova, S.; Kondybayev, A.; Zhanuzakov, M.; Baek, J. H.; Hwang, Y.; Lee, S. B.; Moon, J.; Park, H.; Seo, J. H.; Seo, K. D.; Young, C. J.; Ahdab, R.; Aziz, Z. A.; Zaidi, W. A. W.; Basr, H. B.; Chung, L. W.; Husin, M.; Ibrahim, A. B.; Ibrahim, K. A.; Looi, I.; Tan, W. Y.; Yahya, W. N. W.; Groppa, S.; Leahu, P.; Hashmi, A. A.; Imam, Y. Z.; Akhtar, N.; Oliver, C.; Kandyba, D.; Alhazzani, A.; Al-Jehani, H.; Tham, C. H.; Mamauag, M. J.; Narayanaswamy, R.; Chen, C. H.; Tang, S. C.; Churojana, A.; Aykaç, O.; Özdemir, A.; Hussain, S. I.; John, S.; Vu, H. L.; Tran, A. D.; Nguyen, H. H.; Thong, P. N.; Nguyen, T.; Nguyen, T.; Gattringer, T.; Enzinger, C.; Killer-Oberpfalzer, M.; Bellante, F.; Deblauwe, S.; Hooren, G. V.; Raedt, S. D.; Dusart, A.; Ligot, N.; Rutgers, M.; Yperzeele, L.; Alexiev, F.; Sakelarova, T.; Bedekovic, M.; Budincevic, H.; Cindric, I.; Hucika, Z.; Ozretic, D.; Saric, M. S.; Pfeifer, F.; Karpowicz, I.; Cernik, D.; Sramek, M.; Skoda, M.; Hlavacova, H.; Klecka, L.; Koutny, M.; Skoda, O.; Fiksa, J.; Hanelova, K.; Nevsimalova, M.; Rezek, R.; Prochazka, P.; Krejstova, G.; Neumann, J.; Vachova, M.; Brzezanski, H.; Hlinovsky, D.; Tenora, D.; Jura, R.; Jurak, L.; Novak, J.; Novak, A.; Topinka, Z.; Fibrich, P.; Sobolova, H.; Volny, O.; Christensen, H. K.; Drenck, N.; Iversen, H.; Simonsen, C.; Truelsen, T.; Wienecke, T.; Vibo, R.; Gross-Paju, K.; Toomsoo, T.; Antsov, K.; Caparros, F.; Cordonnier, C.; Dan, M.; Faucheux, J. M.; Mechtouff, L.; Eker, O.; Lesaine, E.; Pico, F.; Pop, R.; Rouanet, F.; Gubeladze, T.; Khinikadze, M.; Lobjanidze, N.; Tsiskaridze, A.; Nagel, S.; Arthurringleb, P.; Rosenkranz, M.; Schmidt, H.; Sedghi, A.; Siepmann, T.; Szabo, K.; Thomalla, G.; Palaiodimou, L.; Sagris, D.; Kargiotis, O.; Kaliaev, A.; Liebeskind, D.; Hassan, A.; Ranta, A.; Devlin, T.; Zaidat, O.; Castonguay, A.; Jovin, T.; Tsivgoulis, G.; Malik, A.; Ma, A.; Campbel, B.; Kleinig, T.; Wu, T.; Gongora, F.; Lavados, P.; Olavarria, V.; Lereis, V. P.; Corredor, A.; Barbosa, D. M.; Bayona, H.; Barrientos, J. D.; Patino, M.; Thijs, V.; Pirson, A.; Kristoffersen, E. S.; Patrik, M.; Fischer, U.; Bernava, G.; Renieri, L.; Strambo, D.; Ayo-Martin, O.; Montaner, J.; Karlinski, M.; Cruz-Culebras, A.; Luchowski, P.; Krastev, G.; Arenillas, J.; Gralla, J.; Mangiafico, S.; Blasco, J.; Fonseca, L.; Silva, M. L.; Kwan, J.; Banerjee, S.; Sangalli, D.; Frisullo, G.; Yavagal, D.; Uyttenboogaart, M.; Bandini, F.; Adami, A.; Lecina, M. A. D.; Arribas, M. A. T.; Ferreira, P.; Cruz, V. T.; Nunes, A. P.; Marto, J. P.; Rodrigues, M.; Melo, T.; Saposnik, G.; Scott, C. A.; Shuaib, A.; Khosravani, H.; Fields, T.; Shoamanesh, A.; Catanese, L.; MacKey, A.; Hill, M.; Etherton, M.; Rost, N.; Lutsep, H.; Lee, V.; Mehta, B.; Pikula, A.; Simmons, M.; MacDougall, L.; Silver, B.; Khandelwal, P.; Morris, J.; Novakovic-White, R.; Shah, R.; Altschul, D.; Almufti, F.; Amaya, P.; Ordonez, C. E. R.; Lara, O.; Kadota, L. R.; Rivera, L. I.; Novarro, N.; Escobar, L. D.; Melgarejo, D.; Cardozo, A.; Blanco, A.; Zelaya, J. A.; Luraschi, A.; Gonzalez, V. H.; Almeida, J.; Conforto, A.; Almeida, M. S.; Silva, L. D. D.; Cuervo, D. L. M.; Zetola, V. F.; Martins, R. T.; Valler, L.; Giacomini, L. V.; Buchdidcardoso, F.; Sahathevan, R.; Hair, C.; Hankey, G.; Salazar, D.; Lima, F. O.; Mont'alverne, F.; Iman, D. M. B.; Longo, A.; Rebello, L.; Falup-Pecurariu, C.; Mazya, M.; Wisniewska, A.; Fryze, W.; Kazmierski, R.; Wisniewska, M.; Horoch, E.; Sienkiewicz-Jarosz, H.; Fudala, M.; Goziewicz, M.; Brola, W.; Sobolewski, P.; Kaczorowski, R.; Stepien, A.; Klivenyi, P.; Szapary, L.; Wijngaard, I. V. D.; Demchuk, A.; Abraham, M.; Alvarado-Ortiz, T.; Kaushal, R.; Ortega-Gutierrez, S.; Farooqui, M.; Bach, I.; Badruddin, A.; Barazangi, N.; Nguyen, C.; Brereton, C.; Choi, J. H.; Dharmadhikari, S.; Desai, K.; Doss, V.; Edgell, R.; Linares, G.; Frei, D.; Chaturvedi, S.; Gandhi, D.; Chaudhry, S.; Choe, H.; Grigoryan, M.; Gupta, R.; Helenius, J.; Voetsch, B.; Khwaja, A.; Khoury, N.; Kim, B. S.; Kleindorfer, D.; McDermott, M.; Koyfman, F.; Leung, L.; Linfante, I.; Male, S.; Masoud, H.; Min, J.; Mittal, M.; Multani, S.; Nahab, F.; Nalleballe, K.; Rahangdale, R.; Rafael, J.; Rothstein, A.; Ruland, S.; Sharma, M.; Singh, A.; Starosciak, A.; Strasser, S.; Szeder, V.; Teleb, M.; Tsai, J.; Mohammaden, M.; Pineda-Franks, C.; Asyraf, W.; Nguyen, T. Q.; Tarkanyi, A.; Haussen, D.; Balaguera, O.; Rodriguezvasquez, A.; Nogueira, R..
Neurology ; 96(15 SUPPL 1), 2021.
Article in English | EMBASE | ID: covidwho-1407898

ABSTRACT

Objective: The objectives of this study were to measure the global impact of the pandemic on the volumes for intravenous thrombolysis (IVT), IVT transfers, and stroke hospitalizations over 4 months at the height of the pandemic (March 1 to June 30, 2020) compared with two control 4-month periods. Background: The COVID-19 pandemic led to widespread repercussions on the delivery of health care worldwide. Design/Methods: We conducted a cross-sectional, observational, retrospective study across 6 continents, 70 countries, and 457 stroke centers. Diagnoses were identified by ICD-10 codes and/or classifications in stroke center databases. Results: There were 91,373 stroke admissions in the 4 months immediately before compared to 80,894 admissions during the pandemic months, representing an 11.5% (95%CI,-11.7 to-11.3, p<0.0001) decline. There were 13,334 IVT therapies in the 4 months preceding compared to 11,570 procedures during the pandemic, representing a 13.2% (95%CI,-13.8 to-12.7, p<0.0001) drop. Interfacility IVT transfers decreased from 1,337 to 1,178, or an 11.9% decrease (95%CI,-13.7 to-10.3, p=0.001). There were greater declines in primary compared to comprehensive stroke centers (CSC) for stroke hospitalizations (-17.3% vs-10.3%, p<0.0001) and IVT (-15.5% vs-12.6%, p=0.0001). Recovery of stroke hospitalization volume (9.5%, 95%CI 9.2-9.8, p<0.0001) was noted over the two later (May, June) versus the two earlier (March, April) months of the pandemic, with greater recovery in hospitals with lower COVID-19 hospitalization volume, high volume stroke center, and CSC. There was a 1.48% stroke rate across 119,967 COVID-19 hospitalizations. SARS-CoV-2 infection was noted in 3.3% (1,722/52,026) of all stroke admissions. Conclusions: The COVID-19 pandemic was associated with a global decline in the volume of stroke hospitalizations, IVT, and interfacility IVT transfers. Primary stroke centers and centers with higher COVID19 inpatient volumes experienced steeper declines. Recovery of stroke hospitalization was noted in the later pandemic months, with greater recovery in hospitals with lower COVID-19 hospitalizations, high volume stroke centers, and CSCs.

12.
4th International Symposium on Image Computing and Digital Medicine, ISICDM 2020 ; : 86-90, 2020.
Article in English | Scopus | ID: covidwho-1403110

ABSTRACT

The novel corona-virus disease (COVID-19) pandemic has caused a major outbreak in more than 200 countries around the world, leading to a severe impact on the health and life of many people globally. Accurate and rapid diagnosis of COVID-19 suspected cases plays a crucial role in timely quarantine and medical treatment. In this work, we present a deep learning based framework for automatic segmentation of pathologic COVID-19 associated tissue areas from clinical CT images available from a dataset with 108 cases in China. More specifically, we present an effective multi-scale feature fusion U-Net equipped with ResNet architecture and a deep supervision mechanism to increase the network's capacity for learning richer representations of infected tissue. Our experiments demonstrate that our model achieves an average dice score (0.674), sensitivity (0.733) and Precision (0.714) on the dataset. The experimental results have indicated the effectiveness of the proposed improvements and the potential of our proposed method for real clinical practice. © 2020 ACM.

13.
Chinese Journal of Microbiology and Immunology (China) ; 41(6):417-422, 2021.
Article in Chinese | EMBASE | ID: covidwho-1325819

ABSTRACT

Objective: To monitor the changes in specific IgM and IgG antibodies in patients diagnosed with COVID-19 after SARS-CoV-2 infection, and analyze their clinical significance. Methods: A total of 168 serum samples were collected from 56 COVID-19 patients with different disease courses who were positive for nucleic acid test at Henan Center for Disease Control and Prevention on January 8, 2020 and February 21, 2020. Serum samples from 25 healthy people excluded from COVID-19 were used as control group. IgM and IgG antibodies against SARS-CoV-2 were detected by chemiluminescence method. Results: IgM antibody increased sharply in 1-3 weeks after onset, and reached the peak value (21.78 AU/ml) in the 3rd week after onset. IgG antibody increased the most in 3-6 weeks after onset, and reached the peak value (81.58 AU/ml) in the 9th week after onset. The levels of IgM and IgG antibodies were closely correlated with age and disease course (P<0.05). The antibody level of 30-60 years old group was the highest, the IgM antibody positive rate and antibody level of acute stage and previous infection were lower than that of recovery stage, and the IgG antibody positive rate and antibody level of acute stage were lower than that of recovery stage and previous infection. During the whole course of the disease, the levels of IgM and IgG antibodies increased gradually in the acute stage, reached the peak in the recovery stage, and decreased and maintained at a certain level in the past infection. Conclusions: Serum SARS-CoV-2 IgM and IgG antibody detection can be used as auxiliary diagnostic indicators for COVID-19, and its continuous observation is helpful for epidemiological investigation, serological diagnosis and disease course monitoring.

14.
Medical Journal of Wuhan University ; 42(4):517-519, 2021.
Article in Chinese | Scopus | ID: covidwho-1299718

ABSTRACT

Lung transplantation is the only effective method for the treatment of end-stage lung diseases. Lung transplantation has achieved rapid development in the world. At present, about 4 000 cases are carried out every year, and the long-term survival rate has gradually improved. With a high incidence of lung disease in China, at least ten thousand patients with respiratory failure need lung transplantation every year. In 2020, 29 lung transplantation centers in China has carried out more than 500 cases of lung transplantation. Idiopathic pulmonary interstitial fibrosis, chronic obstructive pulmonary disease, secondary pulmonary interstitial fibrosis and pneumoconiosis were the main primary diseases in lung transplantation recipients in China. Single-lung transplantation accounted for 57.6% and double-lung transplantation accounted for 42.4%, respectively. Peri-operation (<30 days), one-year, and three-year survival rates were 78.5%, 64.5% and 48.9%, respectively for double-lung transplant. The corresponding survival rates for single-lung transplant recipients were 83.0%, 69.9% and 46.8%, respectively. The Renmin Hospital of Wuhan University completed the first case of COVID-19 lung transplantation operation in Hubei Province in 2020, and the patients recovered and discharged successfully after the operation. Although China has made great progress in lung transplantation, it is still necessary to realize that the multi-disciplinary team cooperation mode and data registration management still need to be further strengthened, in order to provide more clinical guidelines and expert consensus and make the steady development and improvement of each lung transplantation center. The lung transplantation in China will be gradually promoted to the center of the organ transplantation stage in the world. © 2021, Editorial Board of Medical Journal of Wuhan University. All right reserved.

15.
American Journal of Respiratory and Critical Care Medicine ; 203(9), 2021.
Article in English | EMBASE | ID: covidwho-1277583

ABSTRACT

Rationale: Throughout recent studies, data suggests high viral load in the plasma and nasopharynx of patients with severe SARS-CoV2 infection is associated with disease severity (mortality, length of hospitalization, and risk of intubation). Here, we evaluated whether viral load in the airway is associated with poor clinical outcomes in patients with SARS-CoV2. Methods: Lower airway samples in 148 patients from an academic center that were admitted to the ICU (dates: March 10th to May 10th, 2020) with severe respiratory failure requiring mechanical ventilation and underwent bronchoscopy for airway clearance and/or tracheostomy. Clinical outcome was defined as ≤ 28 Day mechanical ventilation vs. > 28 Day mechanical ventilation vs. death. Post-admission followup time was 232 [IQR 226-237] days. RNA was isolated in parallel using zymoBIOMICS™ DNA/RNA Miniprep Kit (Cat: R2002) as per manufacturer's instructions. Viral load was measured by quantitative real-time reverse transcription polymerase chain reaction (rRT -PCR) targeting the virus nucleocapsid (N) gene and an additional primer/probe set to detect the human RNase P gene (RP). Results: Among this bronchoscopy cohort, n=58 39% of the subjects were successfully extubated within 28 days of initiation of mechanical ventilation, n=56 38% required prolonged mechanical ventilation and n=34 23% died. We evaluated the viral load by rRT-PCR for SARSCoV2 N gene adjusted by human RP gene throughout the respiratory tract using supraglottic samples and bronchoalveolar lavage (BAL) samples obtained during bronchoscopy. Paired analysis of upper and lower airway samples shows that there is a subset of subjects (n=31, 21%) where there is greater viral load in the BAL than in the supraglottic area supporting topographical differences in viral replication (Fig 1A). BAL samples from subjects that died had higher viral load in their lower airways than patients that survived, even after adjusting for confounders such as age, gender, BMI and timing of sample collection (Fig 1B magenta dots (deceased) vs. yellow/green dots (alive)). Conclusions: Using samples obtained via bronchoscopy we identified that in a subset of subjects with acute SARS-CoV2 infection, the lower airways are the predominant site for viral replication. From our study, it is unclear if the higher viral load reflects host co-morbidies (e.g., diabetes or immunosuppression) or viral factors favoring higher replication. High viral load can be used as a predictor for disease severity upon hospital admission as viral load in the lower airways correlated with poor outcomes.

16.
American Journal of Respiratory and Critical Care Medicine ; 203(9), 2021.
Article in English | EMBASE | ID: covidwho-1277050

ABSTRACT

RATIONALE:Secondary infections with bacterial pathogens are thought to be responsible for poor outcomes in the 1918 Spanish and H1N1 pandemics. We postulate that poor prognosis in patients with SARS-CoV2 may be associated with uncontrollable viral replication, co-infection with a secondary pathogen, and over exuberant host immune response. We seek to evaluate whether there is an association between distinct features of the lower airway microbiota and poor clinical outcome in patients with SARS-CoV2. METHODS:We collected lower airway samples in 148 patients from NYU admitted between 3/10/2020 and 5/10/2020 with severe respiratory failure requiring mechanical ventilation and that underwent bronchoscopy for airway clearance and/or tracheostomy. Clinical outcome was defined as dead vs alive. DNA was isolated in parallel using zymoBIOMICS™ DNA/RNA Miniprep Kit (Cat: R2002) as per manufacturer's instructions. The V4 region of the 16S rRNA gene marker was sequenced using Illumina MiSeq. Sequences were analyzed using the Quantitative Insights into Microbial Ecology (QIIME version 1.9.1) pipeline. Total bacterial load was evaluated in lower airway samples using digital droplet PCR targeting the 16S rRNA gene. RESULTS:Of the 148 patients included, 114 survived (77%) and 34 (23%) died. Among those with poor clinical outcome, there was a non-statistically significant trend towards higher age and BMI. Patients who died more commonly had chronic kidney disease and prior cerebrovascular accidents, and more often required dialysis. There was no statistically significant difference in the rate of positive bacterial respiratory or blood cultures among those that survived vs. those that died (75 vs. 73% and 43 vs 38%, respectively). Topographical analysis of the 16S RNA microbiome shows compositional differences between the upper and lower airways based on β diversity comparisons. When comparing across clinical outcomes, the α diversity was lower in the dead group but there was no statistically significant difference in overall community composition (β diversity). Taxonomic differential enrichment analysis using DESeq analysis showed that oral commensals were enriched in the group that survived. Patients that died had a higher bacterial load in their lower airways than those who survived. CONCLUSION:Using samples obtained via bronchoscopy we identified lower airway microbiota signatures associated with mortality among critical patients infected with SARS-CoV2. Taxonomic signals identified as associated with poor prognosis did not reveal bacterial taxa commonly classified as respiratory pathogens. This data is not supportive of the hypothesis that secondary untreated bacterial co-infections are responsible for increased mortality in patients with severe SARS-CoV-2.

17.
19.
Gastroenterology ; 160(6):S334-S335, 2021.
Article in English | Web of Science | ID: covidwho-1250775
20.
Preprint in English | PubMed | ID: ppcovidwho-8864

ABSTRACT

Secondary bacterial infections, including ventilator-associated pneumonia (VAP), lead to worse clinical outcomes and increased mortality following viral respiratory infections including in patients with coronavirus disease 2019 (COVID-19). Using a combination of tracheal aspirate bulk and single-cell RNA sequencing (scRNA-seq) we assessed lower respiratory tract immune responses and microbiome dynamics in 28 COVID-19 patients, 15 of whom developed VAP, and eight critically ill uninfected controls. Two days before VAP onset we observed a transcriptional signature of bacterial infection. Two weeks prior to VAP onset, following intubation, we observed a striking impairment in immune signaling in COVID-19 patients who developed VAP. Longitudinal metatranscriptomic analysis revealed disruption of lung microbiome community composition in patients with VAP, providing a connection between dysregulated immune signaling and outgrowth of opportunistic pathogens. These findings suggest that COVID-19 patients who develop VAP have impaired antibacterial immune defense detectable weeks before secondary infection onset.

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