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1.
Journal of Managed Care and Specialty Pharmacy ; JOUR:936-947, 28(9).
Article in English | EMBASE | ID: covidwho-2083547

ABSTRACT

BACKGROUND: Data on the real-world health care burden of COVID-19 in the United States are limited. OBJECTIVE(S): To compare health care resource use (HRU), direct health care costs, and long-term COVID-19-related complications between patients with vs patients without COVID-19 diagnoses. METHOD(S): Using IBM MarketScan Commercial Claims and Encounters and Medicare Supplemental and Coordination of Benefits administrative claims databases (January 1, 2018, to March 1, 2021), this retrospective, matched cohort study compared patients with a recorded COVID-19 diagnosis to control subjects with no recorded diagnosis for COVID-19, personal history of COVID-19, or pneumonia due to COVID-19. To capture typical health care utilization, the control group was analyzed in 2019 (prepandemic);their index date was assigned as 1 year before the index date (first observed COVID-19 diagnosis) of their matched COVID-19 patient. All patients had continuous health plan coverage for at least 6 months pre-index (baseline) and at least 6 months post-index (allowing censoring during month 6). Separately for commercial and Medicare cohorts, COVID-19 and control patients were matched 1:1 using propensity scores, number of followup months, and indicator of age 18 years or older. During each month of the 6-month follow-up, all-cause HRU, health care costs, and COVID-19-related complications were compared between patients with COVID-19 and controls. RESULT(S): After matching COVID-19 and control patients 1:1, a total of 150,731 commercial matched pairs and 1,862 Medicare matched pairs were retained;baseline characteristics were similar between patients with COVID-19 and controls. Patients with COVID-19 and controls had mean ages of 38.9 and 39.7 years in the commercial cohort and 74.3 and 75.3 years in the Medicare cohort, respectively. In month 1 of follow-up, patients with COVID-19 relative to controls were significantly more likely to have at least 1 inpatient admission (commercial: 6.9% vs 0.5%;Medicare: 29.1% vs 1.3%;both P<0.001) and at least 1 emergency department visit (commercial: 37.3% vs 3.4%;Medicare: 26.2% vs 4.1%;both P<0.001). Total health care costs in month 1 were significantly higher among patients with COVID-19 than controls (mean differences: $3,706 for commercial;$10,595 for Medicare;both P<0.001), driven by inpatient costs. Though the incremental HRU and cost burden of COVID-19 decreased over time, patients with COVID-19 continued to have significantly higher total costs through month 5 (all P<0.001 for both commercial and Medicare). During follow-up, patients with COVID-19 had significantly higher rates of complications than controls (commercial: 52.8% vs 29.0% with any;Medicare: 74.5% vs 47.9% with any;both P<0.001), most commonly cough, dyspnea, and fatigue. CONCLUSION(S): COVID-19 was associated with significant economic and clinical burden, both in the short-term and over 6 months following diagnosis. Copyright © 2022, Academy of Managed Care Pharmacy. All rights reserved.

2.
Chinese Journal of Evidence-Based Medicine ; 20(3):359-364, 2020.
Article in Chinese | EMBASE | ID: covidwho-2067155

ABSTRACT

Objectives To estimate the basic reproduction number of the novel coronavirus (2019-nCoV) and to provide support to epidemic preparedness and response. Methods Based on the susceptible-exposed-infected-removed (SEIR) compartment model and the assumption that the infection cases with symptoms occurred before January 26, 2020 were resulted from free propagation without intervention, we estimated the basic reproduction number of 2019-nCoV according to the reported confirmed cases and suspected cases, as well as theoretical estimated number of infected cases by other research teams, together with some epidemiological determinants learned from the severe acute respiratory syndrome. Results The basic reproduction number fall between 2.8 to 3.3 by using the real-time reports on the number of 2019-nCoV infected cases from People's Daily in China, and fall between 3.2 and 3.9 on the basis of the predicted number of infected cases from international colleagues. Conclusions The early transmission capability of 2019-nCoV is close to or slightly higher than SARS. It is a controllable disease with moderate-high transmissibility. Timely and effective control measures are capable to quickly reduce further transmission. Copyright © 2020 West China University of Medical Science. All rights reserved.

3.
Chinese Journal of Evidence-Based Medicine ; 22(8):932-947, 2022.
Article in Chinese | EMBASE | ID: covidwho-2006473

ABSTRACT

Objective To evaluate the evidence of the experience with medical sewage treatment procedures in medical institutions in China. Methods Databases including CNKI, WanFang Data, PubMed, Web of Science, and EBSCO were electronically searched to collect studies on the medical sewage treatment process, flow, and specifications in medical institutions in China. We used the quality evaluation system to classify and grade the experiences based on the principles and methods of evidence-based science and performed a descriptive analysis. Results After the SARS pandemic in 2003, China systematically established and standardized the technical criteria of medical sewage treatment and discharge. Moreover, a prevention system for the epidemic using medical sewage was constructed, which guaranteed that the quality of medical sewage treatment and discharge would meet the criteria and protect the citizens, and the technical specifications of medical sewage treatment would progress and increase strictly. At present, medical sewage treatment in medical institutions in China was based on mechanical and biological methods, and disinfection was mainly performed using chlorine and its compounds, ozone, and ultraviolet light. Conclusion The COVID-19 pandemic requires a higher quality of medical sewage treatment and discharge criteria for medical institutions in China. To meet these criteria, all medical institutions in China should check, replace, and update their old facilities;strengthen personnel training and effectively ensure the quality of medical sewage treatment.

4.
Frontiers in Pharmacology ; 13:926189, 2022.
Article in English | MEDLINE | ID: covidwho-1974672

ABSTRACT

Background: The coronavirus disease 2019 (COVID-19) continues to spread globally. Due to the higher risk of mortality, the treatment of severe or critical patients is a top priority. Traditional Chinese medicine (TCM) treatment has played an extremely important role in the fight against COVID-19 in China;a timely evidence summary on TCM in managing COVID-19 is crucial to update the knowledge of healthcare for better clinical management of COVID-19. This study aimed to assess the effects and safety of TCM treatments for severe/critical COVID-19 patients by systematically collecting and synthesizing evidence from randomized controlled trials (RCTs) and observational studies (e.g., cohort). Methods: We searched nine databases up to 19th March 2022 and the reference lists of relevant publications. Pairs of reviewers independently screened studies, extracted data of interest, and assessed risk of bias. We performed qualitative systematic analysis with visual presentation of results and compared the direction and distribution of effect estimates for each patient's important outcome. We performed sensitivity analyses to observe the robustness of results by restricting analysis to studies with low risk of bias.

5.
Journal of Investigative Dermatology ; 142(8, Supplement):S61, 2022.
Article in English | ScienceDirect | ID: covidwho-1936812
6.
Human Communication Research ; : 27, 2022.
Article in English | Web of Science | ID: covidwho-1868325

ABSTRACT

Social bots, or algorithmic agents that amplify certain viewpoints and interact with selected actors on social media, may influence online discussion, news attention, or even public opinion through coordinated action. Previous research has documented the presence of bot activities and developed detection algorithms. Yet, how social bots influence attention dynamics of the hybrid media system remains understudied. Leveraging a large collection of both tweets (N = 1,657,551) and news stories (N = 50,356) about the early COVID-19 pandemic, we employed bot detection techniques, structural topic modeling, and time series analysis to characterize the temporal associations between the topics Twitter bots tend to amplify and subsequent news coverage across the partisan spectrum. We found that bots represented 8.98% of total accounts, selectively promoted certain topics and predicted coverage aligned with partisan narratives. Our macro-level longitudinal description highlights the role of bots as algorithmic communicators and invites future research to explain micro-level causal mechanisms.

7.
6th Asia Conference on Environment and Sustainable Development, ACESD 2021 ; 2:339-352, 2022.
Article in English | Scopus | ID: covidwho-1826341

ABSTRACT

China’s plastic pollution has gotten worse, especially during the COVID pandemic when the city’s lockdowns boosted the food takeout business. Although the government has made efforts in curbing the use of conventional single-use plastic packaging, the problem is still looming up in the critical time of building ecological civilization. The key to resolve the overwhelming usage of disposable plastic packaging lies in reduction, along with using green alternatives: biodegradable packaging and returnable containers. The study investigated consumers’ willingness to adopt new alternatives by applying the extended classical behavioral theory: the theory of planned behavior (TPB). The measurement scale, developed upon previous literature, gains validated reliability and validity after running confirmatory factory analysis (CFA) in SmartPLS. The study distributed 536 questionnaires online, targeting consumers from Beijing and Shanghai. 430 valid samples were collected and analyzed, with results showing that consumers’ perceived behavior control has strong and positive effect on their willingness to pay more to using biodegradable packaging and willingness to participate in the returnable container programs. The environmental attitude, social norms and past green behavior show less direct relationships with people’s adopting intentions. Their effects on the intentions are mediated by perceived behavior control disproportionately. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

8.
2021 IEEE International Conference on Bioinformatics and Biomedicine, BIBM 2021 ; : 3963-3970, 2021.
Article in English | Scopus | ID: covidwho-1722891

ABSTRACT

Biomedical named entity recognition from clinical texts is a fundamental task for clinical data analysis due to the availability of large volume of electronic medical record data, which are mostly in free text format, in real-world clinical settings. Clinical text data incorporates significant phenotypic medical entities, which could be used for profiling the clinical characteristics of patients in specific disease conditions. However, general approaches mostly rely on the coarse-grained annotations (e.g. mentions of symptom terms) of phenotypic entities in benchmark text dataset. Owing to the numerous negation expressions of phenotypic entities (e.g. 'no fever', 'no cough' and 'no hypertension') in clinical texts, this could not feed the subsequent data analysis process with well-prepared structured clinical data. Thus, we constructed a fine-grained Chinese clinical corpus. Thereafter, we proposed a phenotypic named entity recognizer (Phenonizer). The results on the test set show that Phenonizer outperform those methods based on Word2Vec with Fl-score of 0.896. By comparing character embeddings from different data, it is found that character embeddings trained by clinical corpora can improve F-score by 0.0103. Furthermore, the fine-grained dataset enables methods to distinguish between negated symptoms and presented symptoms, and avoids the interference of negated symptoms. Finally, we tested the generalization performance of Phenonier, achieving a superior F1-score of 0.8389. In summary, together with fine-grained annotated benchmark dataset, Phenonier proposes a feasible approach to effectively extract symptom information from Chinese clinical texts with acceptable performance. © 2021 IEEE.

9.
Embase;
Preprint in English | EMBASE | ID: ppcovidwho-326884

ABSTRACT

Boceprevir is an HCV NSP3 inhibitor that has been explored as a repurposed drug for COVID-19. It inhibits the SARS-CoV-2 main protease (MPro) and contains an α-ketoamide warhead, a P1 β-cyclobutylalanyl moiety, a P2 dimethylcyclopropylproline, a P3 tert-butylglycine, and a P4 N-terminal tert-butylcarbamide. By introducing modifications at all four positions, we synthesized 20 boceprevir-based MProinhibitors including PF-07321332 and characterized their MProinhibition potency in test tubes (in vitro) and human host cells (in cellulo). Crystal structures of MProbound with 10 inhibitors and antiviral potency of 4 inhibitors were characterized as well. Replacing the P1 site with a β-(S-2-oxopyrrolidin-3-yl)-alanyl (opal) residue and the warhead with an aldehyde leads to high in vitro potency. The original moieties at P2, P3 and the P4 N-terminal cap positions in boceprevir are better than other tested chemical moieties for high in vitro potency. In crystal structures, all inhibitors form a covalent adduct with the MProactive site cysteine. The P1 opal residue, P2 dimethylcyclopropylproline and P4 N-terminal tert-butylcarbamide make strong hydrophobic interactions with MPro, explaining high in vitro potency of inhibitors that contain these moieties. A unique observation was made with an inhibitor that contains an P4 N-terminal isovaleramide. In its MProcomplex structure, the P4 N-terminal isovaleramide is tucked deep in a small pocket of MProthat originally recognizes a P4 alanine side chain in a substrate. Although all inhibitors show high in vitro potency, they have drastically different in cellulo potency in inhibiting ectopically expressed MProin human 293T cells. All inhibitors including PF-07321332 with a P4 N-terminal carbamide or amide have low in cellulo potency. This trend is reversed when the P4 N-terminal cap is changed to a carbamate. The installation of a P3 O-tert-butyl-threonine iMProves in cellulo potency. Three molecules that contain a P4 N-terminal carbamate were advanced to antiviral tests on three SARSCoV-2 variants. They all have high potency with EC50 values around 1 μM. A control compound with a nitrile warhead and a P4 N-terminal amide has undetectable antiviral potency. Based on all observations, we conclude that a P4 N-terminal carbamate in a boceprevir derivative is key for high antiviral potency against SARS-CoV-2.

10.
Embase;
Preprint in English | EMBASE | ID: ppcovidwho-326883

ABSTRACT

As an essential enzyme to SARS-CoV-2, main protease (MPro) is a viable target to develop antivirals for the treatment of COVID-19. By varying chemical compositions at both P2 and P3 sites and the N-terminal protection group, we synthesized a series of MProinhibitors that contain β-(S-2-oxopyrrolidin-3-yl)-alaninal at the P1 site. These inhibitors have a large variation of determined IC50values that range from 4.8 to 650 nM. The determined IC50values reveal that relatively small side chains at both P2 and P3 sites are favorable for achieving high in vitro MProinhibition potency, the P3 site is tolerable toward unnatural amino acids with two alkyl substituents on the α-carbon, and the inhibition potency is sensitive toward the N-terminal protection group. X-ray crystal structures of MProbound with 16 inhibitors were determined. All structures show similar binding patterns of inhibitors at the MProactive site. A covalent interaction between the active site cysteine and a bound inhibitor was observed in all structures. In MPro, large structural variations were observed on residues N142 and Q189. All inhibitors were also characterized on their inhibition of MProin 293T cells, which revealed their in cellulo potency that is drastically different from their in vitro enzyme inhibition potency. Inhibitors that showed high in cellulo potency all contain O-tert-butyl-threonine at the P3 site. Based on the current and a previous study, we conclude that O-tert-butyl-threonine at the P3 site is a key component to achieve high cellular and antiviral potency for peptidyl aldehyde inhibitors of MPro. This finding will be critical to the development of novel antivirals to address the current global emergency of concerning the COVID-19 pandemic.

11.
Pediatric Rheumatology ; 20(SUPPL 1), 2022.
Article in English | EMBASE | ID: covidwho-1677515

ABSTRACT

Introduction: Because of the epidemic, countries have begun to administer the COVID-19 vaccine. The adverse reactions (ADRs) following the vaccine can be divided into three categories. Categories are allergic reactions including anaphylaxis, vasovagal reaction including vasovagal syncope and vaccine side effects including local and systemic. Allergic reactions occurring within 5-30 minutes are considered as autoimmune problems, and the problems caused are usually unpredictable and may be serious. Objectives: For further analysis of the types of allergic reactions, medical professionals could remind the patient, prepare the responder as soon as possible, and as a reference for diagnosis and related treatment. Methods: This study is a cross-sectional study that analyzes the notification data of adverse drug reaction cases in a regional hospital from March 30 to July 31, 2021, including the AstraZeneca® (AZ) brand and the Moderna® brand. And analyze whether the discomfort immediately after vaccination is Allergic reactions, vasovagal reaction or vaccine side effects. Results: The total number of COVID-19 vaccines administered under the AZ® brand was 27,131, and Moderna® had a total of 9,203 people. A total of 80 adverse events were received. The AZ ® brand had 75 and the Moderna® brand had 5 ADRs. Among the ADRs of AZ®, there are 17 allergic reactions (22.67%), 1 vasovagal reaction reaction, and 57 vaccine side effects. Among the ADRs of Moderna®, there are 3 allergic reactions (60.00%), 0 vasovagal reaction reactions, and 2 vaccine side effects. Out of a total of 20 Allergic reactions, 20 cases require additional processing to deal with side effects. These side effects include problems related to the injection site (redness at the injection site∗2, itching at the injection site∗5, rash at the injection site∗3, soreness at the injection site, pain at the injection site, swollen left upper arm∗2, red upper left arm, lower arm Itchy rash on the other side of the armpit∗2), skin-related problems (red rash on the chest with oxygen, hives∗2, itchy rash on the face and neck∗2, skin rash∗4), other problems (wheezing, vomiting∗3, red and swollen eyes, chest tightness, dizziness). Among them, one case was reported as a 'serious adverse event', who died eight hours after vaccination. Conclusion: In the ADR of AZ®, 22.67% of allergic reactions is allergic reactions, which is 0.63 of the number of people who were administered. Although the proportion is not high, the adverse reactions caused by autoimmunity are likely to become very serious. Medical professionals should pay more attention to these information before administering the vaccine.

12.
Data Intelligence ; 4(1):134-148, 2022.
Article in English | Web of Science | ID: covidwho-1677465

ABSTRACT

Due to the large-scale spread of COVID-19, which has a significant impact on human health and social economy, developing effective antiviral drugs for COVID-19 is vital to saving human lives. Various biomedical associations, e.g., drug-virus and viral protein-host protein interactions, can be used for building biomedical knowledge graphs. Based on these sources, large-scale knowledge reasoning algorithms can be used to predict new links between antiviral drugs and viruses. To utilize the various heterogeneous biomedical associations, we proposed a fusion strategy to integrate the results of two tensor decomposition-based models (i.e., CP-N3 and ComplEx-N3). Sufficient experiments indicated that our method obtained high performance (MRR=0.2328). Compared with CP-N3, the mean reciprocal rank (MRR) is increased by 3.3% and compared with ComplEx-N3, the MRR is increased by 3.5%. Meanwhile, we explored the relationship between the performance and relationship types, which indicated that there is a negative correlation (PCC=0.446, P-value=2.26e-194) between the performance of triples predicted by our method and edge betweenness.

13.
Intelligent Systems Reference Library ; 216:109-125, 2022.
Article in English | Scopus | ID: covidwho-1669742

ABSTRACT

Digital reality technologies and their applications have become a truly global phenomenon, attracting enormous interest among museum researchers and professionals. The COVID-19 pandemic in 2020 has drastically changed contemporary human behaviors by forcing people to “shelter in place.” To deter the spread of the COVID-19 virus from adjacent human contacts and indoor congregations has prompted over 90% museums around the world to close their doors to the public. As a result, the COVID-19 also expedites the adoption of a variety of technologies by offering their services virtually. The objectives of this study are to investigate the impacts of digital reality technologies on museums around the world at this critical historical juncture. We employed a global text mining research to examine the current integration of digital reality technologies among museums and to examine how the affordances of these technologies have impacted on the museum sector as described by these media. This text mining study provides empirical data and best practice examples how museums around the world have integrated digital reality technologies in response to the challenges and opportunities due to COVID-19. Results find that virtual reality is still the most commonly used digital reality technology by museums for online viewing and exhibitions. In spite of the hype about extended reality technology, augmented and mixed reality technologies fall behind the popularity of VR. Additionally, the use of these reality-creating technologies among museums in different countries often echoes their economy and technology status. Discussion and implications are provided. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

14.
J Eur Acad Dermatol Venereol ; 36(5): e332-e334, 2022 05.
Article in English | MEDLINE | ID: covidwho-1624575
15.
Public Integrity ; 23(6):636-638, 2021.
Article in English | Web of Science | ID: covidwho-1585448
16.
Blood ; 138:5013, 2021.
Article in English | EMBASE | ID: covidwho-1582344

ABSTRACT

Introduction: Clinical availability of highly effective novel agents (including Bruton tyrosine kinase [BTK] and B-cell lymphoma 2 [BCL-2] inhibitors) is rapidly altering the therapeutic landscape of chronic lymphocytic leukemia (CLL) necessitating a review of treatment guidelines. However, there is limited real-world data to validate if the availability of these novel agents has translated to a true shift in treatment paradigm for patients treated in the community. As the majority of CLL patients are treated in non-academic community-based settings, we investigated the clinical adoption trends of commercially available FDA approved novel agents for treatment of CLL patients. In addition, given that the COVID-19 pandemic led to major alteration in clinical oncology practices, we further studied if this contributed to an alteration in the selection of therapeutic agents resulting in changes of CLL treatment patterns and the utilization of novel agents in the real-world setting. Thus, the objectives of this study were to examine the utilization pattern of various CLL therapies, as well as evaluate the pattern of adoption of novel agents for treatment and the impact of COVID. Methods: A retrospective observational study was conducted using the Flatiron Health database that comprised EHR-derived de-identified data. Adult patients (≥18 years) with newly diagnosed CLL from January 2014 to May 2021, with no prior treatment and who were continuously enrolled for at least 6 months before and 3 months after the index date, defined as the first date of CLL/SLL diagnosis were included. Treatment regimens were classified into seven mutually exclusive categories: bendamustine-based chemotherapy, other chemotherapy, anti-CD20-based therapy, ibrutinib, idelalisib, acalabrutinib and venetoclax. Further treatment categorization included chemotherapy vs. targeted therapy, and traditional IV vs. novel oral agents. The impact of the pandemic was examined by comparing the pre- and post-COVID cohorts (defined as 15 months pre- and post- of March 1, 2021). Descriptive analyses were conducted to examine the frequency of use of treatment regimens by quarter in each year, line of therapy and between different age, gender, US geographical region, insurance status, and race/ethnicity subgroups. Multivariable regression was conducted to examine factors associated with the likelihood of adoption of novel and oral agents. Statistical significance was determined at a p-value of less than 0.05. Results: A total of 3,037 newly diagnosed CLL patients (median age =73) were included in the study. Over half were male (62.3%), white (74.6%) and commercially-insured (54.1%). Patients were primarily treated in community practices (92%). Overall, a significant trend in adoption of novel agents was observed throughout the years following their approval (Figure 1A). Across the evaluation period, a significant decrease in chemotherapy use was observed from 61.3% (quarter 1, 2014) to 20% (quarter 2, 2021) in favor of targeted therapy as first-line therapy (Figure 1B). In contrast, the utilization of novel oral agents (vs. traditional IV agents) for first-line therapy increased from 9.5% to 70.9% for the same period (Figure 1C). Similar trends were observed for second-line and third-line therapies. Encouragingly, this change in treatment patterns was adopted comparably in all sociodemographic subgroups with no evidence of disparity. While there was no statistically significant difference between the pre- and post-COVID treatment landscape, the adoption of target and novel oral agents has been more pronounced with the COVID pandemic. Conclusions: Results from real-world data suggest that there is a clear shift towards the adoption of novel therapies with preference given to targeted agents and oral therapies in the US since 2014. Further research examining real-world outcomes associated with treatment regimens are needed to inform decision makers. [Formula presented] Disclosures: Chanan-Khan: Cellectar: Current equity holder in publicly-traded company;Alpha2 P armaceuticals, NonoDev, Starton: Current holder of stock options in a privately-held company;Ascentage: Research Funding;Alpha2 Pharmaceuticals: Patents & Royalties: Tabi;Ascentage, Starton, Cellectar, NonoDev, Alpha2 Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees;BeiGene, Jansen, Ascentage: Honoraria;BieGene, Jansen, Ascentage: Consultancy. Yang: BeiGene, Ltd.: Current Employment. Liu: BeiGene, Ltd.: Current Employment. Zimmerman: BeiGene, Ltd.: Current Employment. Tang: BeiGene, Ltd.: Current Employment. Ailawadhi: Karyopharm: Consultancy;AbbVie: Consultancy;Genentech: Consultancy;Takeda: Consultancy;GSK: Consultancy, Research Funding;Xencor: Research Funding;Cellectar: Research Funding;Medimmune: Research Funding;Ascentage: Research Funding;Pharmacyclics: Consultancy, Research Funding;Amgen: Consultancy, Research Funding;Janssen: Consultancy, Research Funding;Bristol Myers Squibb: Consultancy, Research Funding;BeiGene, Ltd.: Consultancy;Sanofi: Consultancy;Oncopeptides: Consultancy.

17.
Blood ; 138:3887, 2021.
Article in English | EMBASE | ID: covidwho-1582301

ABSTRACT

Introduction: World Marrow Donor Association (WMDA) promotes global collaboration for the benefit of stem cell donors and transplant patients. WMDA activities include recording the number of unrelated hematopoietic stem cell (HSC) donations globally. Because the COVID-19 pandemic also has an impact on the treatment of patients with other diseases, we hypothesise that it also impacted the practice of unrelated hematopoietic stem cell transplantation (HSCT). We used the 2020 WMDA data to examine the trends in unrelated HSC donations during the COVID-19 pandemic globally, per continent and per country/region. Methods: Donor registries (DRs) and cord blood banks (CBBs) from 61 countries participated in the 2020 survey, compared to 59 countries in the 2019. Slight differences in participation between the data sets of 2019 and 2020 do not explain the trends we observe in HSC donations. Country/region-specific COVID-19 data on cases and deaths were obtained from the data repository operated by the Johns Hopkins University Center for Systems Science and Engineering(https://github.com/CSSEGISandData/COVID-19, accessed July 12, 2021);and population data were retrieved from the Worldometer website(https://www.worldometers.info/, accessed July 12, 2021). Results: HSC donations from unrelated donors (peripheral blood stem cells (PBSC) and bone marrow (BM)) decreased from 20,330 in 2019 to 19,623 in 2020 (-3.5%), compared to an average annual growth rate of 3.9% from 2015 to 2019 (figure 1). The 3.5% decrease is composed of a 29.0% decrease for BM and a 2.6% increase for PBSC, resulting in a drop in the BM share of unrelated HSC donations from 19.3% in 2019 to 14.2% in 2020. The number of cord blood unit (CBU) shipments globally decreased with 3.5% from 2,851 to 2,750. The percentage of national use of HSC products (PBSC and BM) increased from 51.2% to 53.5%. When considering the continent on which the patient is transplanted (table 1), the change rate of use of HSC donated products in 2020 vs. 2019 ranged from -28.0% in South America to +18.2% in Africa. In absolute numbers, the largest decrease of HSC donations occurred for patients in Asia (n=-485) followed by Europe (n=-205), and the largest increase occurred in North America (n=+88) followed by Oceania (n=+25). The share of HSC donations requiring intercontinental transport decreased from 24.6% in 2019 to 21.9% in 2020. In terms of the country/region of transplant (table 2), the largest percentage decrease occurred in Colombia (-90,5%) followed by Russia (-55,5%). In absolute numbers, the largest decrease occurred in Turkey (-147), with Japan following (-128, although Japan saw an increase of CBU use of +106). The highest growth rate was observed in Iran (+28,7%), followed by South Africa (+28,2%). In absolute figures, the greatest increase occurred in Italy (+67). The two countries receiving the largest HSC donation numbers showed no major changes versus the previous year: USA: +0.6% (although a decrease for CBU of -21,0% was observed) and Germany: -2.4%. We did not find any significant correlation between the numbers of COVID-19 cases or COVID-19-related deaths per 1 million inhabitants with the HSC donation numbers (Spearman's r=0.05 for cases and =0.08 for deaths). Discussion: The decline in the number of unrelated HSC donations in 2020 suggests an impact of the COVID-19 pandemic on HSC donation and unrelated HSCT. The significant decrease in BM collections and intercontinental/cross-border shipments can be explained by logistically complex processes, as well the increased risk to the donor of being exposed to an operative procedure. CBU as a stem cell source potentially circumvents these logistical complications. However, on a global scale our data does not show increased use of CBU suggesting that decisions to use CBU as a stem cell source did not change in the pandemic. We were unable to demonstrate a correlation between country/region-specific severity of the pandemic and HSC donation numbers. We suspect this is due to the data quality of reported number of COVID-1 cases and COVID-19-related deaths. Also, we did not gather monthly data and therefore could not specify pandemic waves. In conclusion, we would like to point out the fact that global exchanges of HSC products continued and only decreased slightly is an extraordinary achievement of DRs, CBBs and their donors and is a testament to the importance of international collaborations in the WMDA. [Formula presented] Disclosures: Devine: Orca Bio: Consultancy, Research Funding;Johnsonand Johnson: Consultancy, Research Funding;Sanofi: Consultancy, Research Funding;Magenta Therapeutics: Current Employment, Research Funding;Tmunity: Current Employment, Research Funding;Vor Bio: Research Funding;Kiadis: Consultancy, Research Funding;Be the Match: Current Employment. Shaw: Orca bio: Consultancy;mallinkrodt: Other: payments. Forman: Mustang Bio: Consultancy, Current holder of individual stocks in a privately-held company;Lixte Biotechnology: Consultancy, Current holder of individual stocks in a privately-held company;Allogene: Consultancy.

18.
Blood ; 138:4307, 2021.
Article in English | EMBASE | ID: covidwho-1582266

ABSTRACT

Introduction: Paroxysmal nocturnal hemoglobinuria (PNH) is a rare, life-threatening disease affecting 1-10 per million per year, characterized by uncontrolled complement-mediated intravascular hemolysis, thrombosis, and marrow failure. PNH manifests in a wide variety of symptoms such as fatigue, dyspnea, chest pain, abdominal pain, and hemoglobinuria. Due to its nonspecific presentation, patients may experience a delay in accurate diagnosis of this rare disease, which has been shown to have a significant impact on quality of life (QoL) and survival. At any point in the patient's journey, they may experience delays or poor accessibility to care. Key challenges in PNH remain its initial identification, diagnosis, and subsequent timely treatment. Methods: The Canadian PNH Network (CPNHN) use the “CATCH criteria” to suspect diagnosis of PNH: Cytopenias, Aplastic anemia/myelodysplasia, Thrombosis, Coombs‘-negative hemolysis, and Hemoglobinuria. This screening tool has not been formally validated, however it was hypothesized to be useful for real-world practitioners. In this study, we aimed to: (1) identify opportunities and gaps during the journey of a patient with suspected or confirmed PNH, referred to a CPNHN center (Pilot sites: University Health Network (UHN) & Sunnybrook Health Sciences Centre (SHSC));(2) characterize time to diagnosis and treatment initiation, specifically considering CATCH criteria;and (3) assess the presentations with the highest frequency of being referred to a CPNHN center to create a process map. Results: A total of 19 participants were identified at UHN, 17 charts were reviewed, and 15 patients were available for 30-minute individual interviews. The timeline was based on the participants’ initial presentation to start of targeted treatment (i.e., eculizumab). Baseline demographic data are presented in Table 1. Mean age at diagnosis was 46.1 years (standard deviation [SD] 16.7), with varied symptoms at presentation (Figure 1). Median number of healthcare providers seen prior to diagnosis and/or referral was 6 (interquartile range [IQR] 4-10;Figure 2), and time from symptom onset to referral was 17 months (IQR 6-67). The most common CATCH criteria at presentation were hemoglobinuria, Coombs'-negative hemolysis, and cytopenias (i.e., anemia and thrombocytopenia) (Table 2). Flow cytometry revealed large granulocyte (85.9% ± 16.9), monocyte (84.7% ± 17.4), and type III RBC (20.8% ± 18.5) populations. From the interviews, we noted that individual participants had diverse experiences and journeys with PNH. Reflecting on the COVID-19 pandemic, participants reported no change in quality of care they had received, and some endorsed the convenience of virtual consultation without being required to travel long distances for in-person visits. Several suggestions included: improving community physician awareness and education on PNH, assistance with finances (transportation/parking), and need for ongoing patient education on available medications and clinical trials. Discussion and Conclusion: PNH is a rare disease that can manifest in many different, non-specific ways, contributing to delays in diagnosis and treatment initiation. We have characterized the patient journeys of a cohort of patients followed at our centers, and have identified gaps and potential areas for improvement. The variability and delay in assessment for PNH may be attributed to the diverse backgrounds of the participants, first presentation abroad, year of symptom presentation, and availability of high-sensitivity flow cytometry, which is the diagnostic gold standard. In addition to characterizing the initial presentations and barriers to diagnosis and treatment, we also evaluated humanistic factors such as QoL. As PNH is rare, the study was limited by the small sample size and some incomplete records, as some patients were diagnosed and managed elsewhere initially. We plan to expand our work across Canada, which will increase our cohort size and better allow an assessment of the impact of geographical differences on a cess to care. Following this, we plan to provide recommendations for diagnostic and treatment benchmarks to colleagues across the country, introduce the CATCH criteria, and subsequently evaluate the impact of these knowledge translation strategies with comparison to our initial cohort. [Formula presented] Disclosures: Chow: Alexion: Other: Site investigator for clinical trial. Patriquin: Alexion, AstraZeneca Rare Disease: Consultancy, Honoraria, Speakers Bureau;Apellis: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees;Biocryst: Honoraria;Sanofi: Honoraria.

19.
4th International Conference on Information Systems and Computer Aided Education, ICISCAE 2021 ; : 2542-2545, 2021.
Article in English | Scopus | ID: covidwho-1566400

ABSTRACT

Novel coronavirus is raging, impacting and affecting all areas of society, seriously threatening people's life safety and social stability. COVID-19 epidemic has brought various influences on Chinese college teaching, and online teaching in colleges and universities is facing various difficulties and challenges. In order to ensure the personal safety of teachers and students and solve the problem of teaching in schools, the General Office of the Ministry of Education has successively issued measures such as "postponing the start of school"and "stopping classes without stopping school". In the special period of outbreak, the advantages of online teaching are prominent, and the rapid development of network and technology provides a high-quality platform and channel for its implementation. Online teaching through computers, TV, mobile phones and other terminals makes up for the lack of face-to-face communication between teachers and students under special circumstances. This paper analyzes the application of the Internet plus online teaching platform in higher education, and explores how to integrate the network teaching resources better under the COVID-19 epidemic, and build the network learning community that all parties participate in, so as to give full play to the advantages of network teaching. © 2021 ACM.

20.
Chest ; 160(4):A273, 2021.
Article in English | EMBASE | ID: covidwho-1458220

ABSTRACT

TOPIC: Chest Infections TYPE: Fellow Case Reports INTRODUCTION: Drug induced pneumonitis is a major cause of adverse events during cancer therapy, and has become increasingly common with the use of immune-checkpoint inhibitor (ICI) therapy. Due to its rarity, ICI pneumonitis is a diagnosis of exclusion, and infection and malignancy must be ruled out. While multiple types of infection are typically assessed for, Herpes Simplex Virus (HSV) pneumonia is often not considered. We report the case of a 75 year old man with non-small cell lung cancer (NSCLC) on pembrolizumab who died despite aggressive treatment for a presumed ICI pneumonitis, and was found on autopsy to have had HSV pneumonia. CASE PRESENTATION: A 75 year old man with NSCLC presented to hospital with two days of dyspnea. The patient was being treated with a multi-drug chemotherapy regimen, including pembrolizumab. His last cycle was five days prior to admission. On admission, he was found to be hypoxic, saturating 70% on room air, with course bilateral crackles, and extensive bilateral ground glass opacities on chest CT. He did not have leukocytosis. Multiple infectious studies, including COVID-19, CMV, respiratory viral panel, legionella, mycoplasma, beta-D glucan, and galactomannan were negative. ICI pneumonitis was highest on the differential, and the patient was therefore started on solumedrol. After two days of no improvement, the solumedrol was increased and infliximab was added. The patient's respiratory status continued to worsen, and he was ultimately intubated. The patient underwent bronchoscopy once intubated, however, he expired before the studies resulted. Autopsy revealed a severe HSV pneumonia. DISCUSSION: ICI pneumonitis occurs in approximately 5% of patients treated with PD(L)-1 inhibitors, of which approximately 25% of cases are graded as severe or life-threatening. While the vast majority of patients with non-severe disease are successfully treated by withholding the ICI alone or in conjunction with glucocorticoids, those with more severe disease may require additional immunosuppression, and a small number of these patients die despite treatment. Due to its rarity, ICI pneumonitis is a diagnosis of exclusion, and diagnoses such as infection and malignancy should always be ruled out. The fact that its radiographic presentation is so heterogenous, with patterns as variable as those seen with COP, NSIP, HP, and AIP/ARDS, makes it all the more difficult to diagnose. HSV pneumonia is known to infrequently cause pneumonia in severely immunocompromised patients. A prospective observational study conducted in 2018 on immunocompromised adults with pneumonia not responding to empiric antibiotic therapy found it to be much more common than expected, with 42% of patients testing positive for HSV-1 on BAL, and 24% meeting criteria for HSV pneumonia. CONCLUSIONS: HSV pneumonia should be more frequently considered in immunocompromised patients suspected of having an ICI pneumonitis. REFERENCE #1: Nishino M, et al. Drug-related pneumonitis in the era of precision cancer therapy. JCO Precision Oncology. 2017 May 26;1: 1-12. REFERENCE #2: Naidoo J, et al. Pneumonitis in patients treated with anti-programmed death-1/programmed death ligand 1 therapy. J Clinical Oncology. 2017 Mar;35 (7): 709-717. REFERENCE #3: Luzzati R, et al. Herpex simplex virus (HSV) pneumonia in the non-ventilated immunocompromised host: burden and predictors. J Infect. 2019 Feb;78 (2): 127-133. DISCLOSURES: No relevant relationships by Jeffrey Ordner, source=Web Response No relevant relationships by Ariella Pratzer, source=Web Response No relevant relationships by Mark Sloane, source=Web Response No relevant relationships by Kristen Thomas, source=Web Response No relevant relationships by Karen Yang, source=Web Response

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