Kawasaki Disease in the Time of COVID-19 and MIS-C - The International Kawasaki Disease Registry.

BACKGROUND: Patients with Multisystem Inflammatory Syndrome in Children (MIS-C) and Kawasaki disease (KD) have overlapping clinical features. We compared demographics/clinical presentation, management, and outcomes of patients by evidence of prior SARS-CoV-2 infection. METHODS: The International KD Registry (IKDR) enrolled KD and MIS-C patients from sites from North, Central and South America, Europe, Asia and Middle East. Evidence of prior infection was defined as: Positive (+ve household contact or positive PCR/serology), Possible (suggestive clinical features of MIS-C and/or KD with negative PCR or serology but not both), Negative (negative PCR and serology and no known exposure), and Unknown (incomplete testing and no known exposure). RESULTS: Of 2345 enrolled patients SARS-CoV-2 status was Positive for 1541 (66%) patients, Possible 89 (4%), Negative 404 (17%) and Unknown for 311 (13%) patients. Clinical outcomes varied significantly between the groups, with more patients in the Positive/Possible groups presenting with shock, having admission to Intensive Care, receiving inotropic support, and having longer hospital stays. Regarding cardiac abnormalities, patients in the Positive/Possible groups had a higher prevalence of left ventricular dysfunction, while patients in the Negative and Unknown groups had more severe coronary artery abnormalities. results CONCLUSION: : There appears to be a spectrum of clinical features from MIS-C to KD with a great deal of heterogeneity, and one primary differentiating factor is evidence for prior acute SARS CoV2 infection/exposure. SARS-CoV-2 Positive/Possible patients had more severe presentations and required more intensive management, with a greater likelihood of ventricular dysfunction but less severe coronary artery adverse outcomes, in keeping with MIS-C.

Kawasaki disease in the time of COVID-19-the international kawasaki disease registry

Background and Aim: The considerable overlap in case definition and clinical features between patients with COVID-19 associated Multisystem Inflammatory Syndrome in Children (MIS-C) and Kawasaki disease (KD) suggests shared pathogenesis. We sought to compare demographic, clinical presentation, management and outcomes of patients by COVID-19 status. Method(s): The International KD Registry (IKDR) began enrolling patients with clinical features of either acute MIS-C or KD or fever with hyperinflammation beginning in January 2020. The IKDR is unique regarding broad patient selection and includes sites from North, Central and South America, Europe, Asia and the Middle East. Patient groups stratified by COVID-19 status were compared. Result(s): As of October 6, 2021, 1330 patients were registered from 31 sites. COVID status was POSITIVE for 59% (confirmed household COVID-19 contact and/or positive SARS-CoV-2 PCR or serology), POSSIBLE for 4% (suggestive clinical features but some negative tests or absent exposure), NEGATIVE for 23%, and UNKNOWN (no known exposure and testing not com-pleted) for 14% (TABLE). Most of the UNKNOWN patients were from early in the COVID-19 pandemic before MIS-C was defined and before COVID-19 serologic testing was widely used. POSITIVE and POSSIBLE patients were older, had fewer KD clinical criteria, greater gastrointestinal symptoms, were more likely to present with shock and require ICU admission and inotropic support. POSSIBLE patients had greater days from symptom onset to first immune modulation treatment, with no differences between groups regarding days from admission to first treatment. Most patients in each group received intravenous immune globu-lin, with POSITIVE and POSSIBLE patients more likely to have received steroids and anakinra. NEGATIVE and UNKNOWN patients had higher maximal coronary artery Z scores, with a trend to having higher categories of aneurysm involvement. Conclusion(s): While there was considerable overlap in presentation, management and outcomes between COVID-19 POSITIVE/POSSIBLE (presumed MIS-C) and COVID NEGATIVE/UNKNOWN patients (presumed KD), COVID-19 POSITIVE/POSSIBLE patients had more severe presentations and required more intensive management, although coronary artery outcomes trended to be less severe. Patient recruitment con-tinues, and in-depth comparison of laboratory features and appli-cation of machine learning approaches to patient differentiation and prediction of optimal management pathways are forthcoming.

Psychosocial risks factors among victim support workers during the COVID-19 pandemic: a study with the Copenhagen Psychosocial Questionnaire.

BACKGROUND: Being a victim support worker (VSW) involves exposure to victims' suffering, pain, and traumatic events, which may trigger the risk of VSWs developing mental health problems. Psychosocial risks (PSR) and work-related stress are considered the most challenging issues in occupational safety and health, considering they impact individuals, organizations, and economies. METHODS: The purpose of the present study was to identify the PSR in a sample of 196 Portuguese victim support workers (VSW) (Mean age = 36.49; SD = 10.52). A questionnaire with socio-demographic characteristics, variables related to VSW's job, and the Portuguese medium version of the Copenhagen Psychosocial Questionnaire II (COPSOQ II) were used to assess these professionals' perception of PSR factors. RESULTS: The results reveal that although VSW recognizes some psychosocial factors favourable to their health and well-being, they also identify some PSR that place them at intermediate and severe risk, i.e., emotional and cognitive demands, which are the main areas of risk to the VSW. VSW over 38 years old scored higher in job insecurity, burnout, and offensive behaviours. CONCLUSIONS: These findings give important insights into the areas that must be enhanced in this context involving VSW. Additionally, the results highlight the relevance of encouraging a healthy and supportive work environment, preventing and promoting the health and well-being of VSW, particularly when considering the coronavirus disease (COVID-19) pandemic.

ONLINE EDUCATION OF REMOTE SENSING IN CHINA DURING THE COVID-19 PANDEMIC: A CASE OF STUDY IN JIANGSU NORMAL UNIVERSITY

Affected by the Coronavirus Disease (COVID-19) pandemic, almost all students in China have to study online at home from February to June, 2020. In this paper, we discussed the forms of online courses and took Jiangsu Normal University as an example to introduce the online courses of remote sensing in China. The results of the satisfaction survey show that more than 90% of the respondents agree with online courses and believe that online courses can at least meet basic learning needs in the age of COVID-19, and more than 60% of respondents claimed that they had met or exceeded their learning expectations. The major advantages of online course include reducing the gathering of people and thus the risk of infection. However, there are still some problems with online courses, and we hope that these problems can be solved well in the future. © 2021 IEEE

COVID-19 impact on teleactivities: Role of built environment and implications for mobility.

This paper presents new evidence on changes in a broad range of teleactivities due to the Coronavirus disease (COVID-19) pandemic and investigates how the built environment relates to these changes. The paper relies on survey and geospatial data from Oslo and its surrounding Viken region in Norway. Findings suggest that most teleactivities increased due to COVID-19. Telework, teleconferencing, online learning, telehealth, and virtual meetings with friends and family all increased during COVID-19 compared to the pre-COVID-19 period. The next step in the analysis examined relationships between built environment characteristics and teleactivities before and during COVID-19. Telework and virtual meetings increased to a greater extent in denser neighborhoods than in lower-density neighborhoods. A larger increase in online learning was associated with lower neighborhood density, lower accessibility to public transport, and more local facilities. Numerous local facilities were associated with more frequent telework and virtual meetings both before and during COVID-19. The substantial COVID-19-induced increase in teleactivities found in the study highlights the potential of information and communications technology (ICT) for replacing travel for various activities.

Psychosocial assessment among ophthalmic patients attending tertiary eye care centre during the lockdown in times of COVID-19 pandemic.

Purpose: The coronavirus disease (COVID-19) pandemic continues to play havoc in our lives. During the first " lockdown" in 2020, we were keen on assessing the anxiety levels of patients who sought ophthalmic care despite the lockdown. Public health actions, such as social distancing, were necessary to reduce the spread of COVID-19. As a result, most people felt isolated and lonely, thereby causing increased levels of stress and anxiety in them. We aimed to assess the anxiety levels using the Hamilton Anxiety Scale and personality assessment using the 57-point Eysenck's Personality Inventory (EPI) questionnaire among patients visiting a tertiary eye care hospital during the lockdown period. Methods: Consecutive patients attending an ophthalmic tertiary care hospital during the COVID-19 pandemic and lockdown were approached to be a part of this prospective cross-sectional survey. Results: In total, 1,088 responses were analyzed during the 2-month study period with the mean age being 45.7 + 16.9 years. The majority had completed graduation (78%) with 15 years or more of formal education. The purpose of the visit was an emergency consultation in 42% (n = 455), a review appointment in 42% (n = 457), and the remaining (16%, n = 176) came for a routine consultation. The majority of the patients (>90%) did not report experiencing any of the 14 sets of symptoms. A mild level of anxiety was noted in 1,086 (>99%) respondents, whereas only 2 (<1%) respondents showed mild-moderate levels of anxiety. Financial concerns such as affordability of medications (6% vs. 3%, P = 0.05) and fear of losing their job (16% vs. 11%, P = 0.02) were significantly more in those experiencing any anxiety compared to those with no anxiety. Conclusion: Our study revealed that patients visiting a tertiary ophthalmic center during lockdown were graduates, sought eye consultation primarily for emergency or a review, and had no major anxiety symptoms. In those with anxiety, the affordability of medicines and loss of jobs were the main concerns.

Short-term Cardiovascular Complications of Multi-system Inflammatory Syndrome in Children (MIS-C) in Adolescents and Children.

PURPOSE OF REVIEW: We provide the readers with a review of cardiac complications in children with multi-system inflammatory syndrome in children (MIS-C) and its short-term outcomes. RECENT FINDINGS: Recent reports described the acute cardiac manifestations of MIS-C in children and provided a glimpse of the short-term outcomes. SUMMARY: Children with MIS-C have been reported to acutely have variable degrees of cardiac findings including abnormal cardiac enzymes, abnormal electrocardiographs, decreased systolic function, coronary artery abnormalities from coronary dilation to giant aneurysms, mitral valve regurgitation, tricuspid valve regurgitation, aortic valve insufficiency, pericardial effusion, diastolic dysfunction, abnormal cardiac strain, and abnormal cardiac MRI. The majority of these abnormalities resolved during short-term follow-up. Further studies are needed to assess if transient or persistent cardiac complications are associated with long-term adverse cardiac events in children with MIS-C. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40124-021-00258-5.

Quality of life and academic resilience of Filipino nursing students during the COVID-19 pandemic: a cross-sectional study.

OBJECTIVES: Studies on quality of life (QoL) and academic resilience among nursing students during the Coronavirus disease (COVID-19) pandemic remain underreported. This study investigated the relationship between nursing students' QoL and academic resilience and their predictors during the COVID-19 pandemic. METHODS: A descriptive survey, cross-sectional study that used two self-reported questionnaire scales to evaluate the QoL and academic resilience of Filipino nursing students (n=924). Chi-squared test and multiple regression were used to analyze the data. RESULTS: There was no significant association between the QoL and academic resilience to participants' profile variables. Gender and year level of nursing students were significant predictors of QoL and academic resilience. CONCLUSIONS: Our study concludes that a better understanding of the QoL and academic resilience, which are two distinct concepts critical in developing a student's mental well-being, will help stakeholders in nursing education establish effective psychoeducation programs for nursing students.

COVID-19 and the compact city: Implications for well-being and sustainable urban planning.

This paper provides new evidence on the role of city planning, urban form, and built environment characteristics in health and well-being during the coronavirus disease (COVID-19) pandemic. Based on survey and geographic information systems (GIS) data from Oslo and Viken in Norway, the paper investigates changes in health and well-being due to COVID-19 and how the compact city and its characteristics relate to these changes. Findings indicate that self-reported measures of health and well-being worsened due to COVID-19. The most substantial changes were reported for life satisfaction, anxiety, and satisfaction with leisure, personal relationships, and vacations. General health, happiness, and satisfaction with income also declined during COVID-19 in comparison with pre-COVID-19 times. Overall, residents of compact neighborhoods reported lower well-being during COVID-19 compared to residents of lower-density neighborhoods. Important compact city characteristics - higher neighborhood density, reliance on public transport, smaller dwellings, and less green space - were negatively associated with well-being and health outcomes during COVID-19. In contrast, another compact city attribute, the presence of numerous local facilities, was positively linked to well-being and health during COVID-19. Based on these findings, the paper presents possible implications for sustainable urban planning and compact cities.

COVID-19 pandemic-related stressors and posttraumatic stress: The main, moderating, indirect, and mediating effects of social support.

The COVID-19 pandemic has created a variety of stressors, some of which have been linked to intense stress reactions, such as posttraumatic stress (PTS)-like symptoms. However, we have limited knowledge on cumulative effects of pandemic-related stressors on PTS or on variables that may mitigate the effects of these stressors. We aimed to address some of these knowledge gaps by testing three models to examine the interrelationships among pandemic-related stressors, perceived social support, coping flexibility, and pandemic-related PTS. The sample of this cross-sectional correlational study is comprised of 2291 adults from the United States who completed an online survey between 22 May 2020 and 15 July 2020. Results indicated that greater exposure to secondary stressors, but not COVID-19-related stressors, was associated with increased PTS. After controlling for COVID-19-related and secondary stressors, social support had negative direct and indirect (via coping flexibility) effects on PTS. In addition, social support mediated the effects of COVID-19-related and secondary stressors on PTS. Our findings highlight the complexity of the role of social support in relation to pandemic-related stressors and PTS, and suggest that early interventions that target social support and coping flexibility may help reduce pandemic-related PTS.

COVID-19 and urban planning: Built environment, health, and well-being in Greek cities before and during the pandemic.

The coronavirus disease (COVID-19) pandemic has led to dramatic changes in quality of life, bringing to the forefront of the debate the question of planning and design of pandemic-resilient cities. Using quasi-longitudinal survey data (via a social media campaign) and geospatial data from Greek cities, we evaluate changes in health and well-being during COVID-19 compared to the pre-COVID-19 period, and then explore in detail how specific built environment characteristics in Athens and Thessaloniki relate to health and well-being before and during COVID-19. Results suggest that overall health, life satisfaction, happiness, personal relationships satisfaction, leisure satisfaction, satisfaction with income, and satisfaction with vacations all decreased during COVID-19, while anxiety and back pain increased during COVID-19. The role of the urban built environment in health and well-being was found to differ considerably for the COVID-19 period compared to pre-COVID-19. Proximity to large parks, proximity to numerous local facilities, lower neighborhood density, living further from the city center, and living in a larger dwelling were associated with better health and well-being outcomes during COVID-19. Urban planning and relevant policies that cities adopt should carefully focus on mitigating implications for critical issues such as the quest for sustainable urban development and city forms.

How COVID-19 reshaped quality of life in cities: A synthesis and implications for urban planning.

This paper synthesizes knowledge on how the Coronavirus disease (COVID-19) pandemic reshaped the relationship between cities and quality of life. The possible impacts of cities on seven domains of quality of life - travel, leisure, work, social relationships, residential well-being, emotional responses, and health - during COVID-19 are reviewed. Findings indicate that the role of transport and land use, urban nature, public space, facilities and services, housing, and information and communications technology (ICT) in quality of life in cities was transformed during COVID-19. Access to healthcare facilities and services and local amenities; opportunities for walking and cycling; COVID-19-secure public transport; access to a car; urban blue or green space and access to nearby nature; easy access to open public space; living in a dwelling of sufficient size and quality; private or communal outdoor areas; and ICT infrastructure and systems possibly helped to mitigate the negative impacts of COVID-19 on quality of life in cities. Implications for urban planning and policy arise from the COVID-19 crisis, shedding light on ways to address inequities, support vulnerable groups, and improve quality of life in cities in times of pandemics but also under normal circumstances.

COVID-19, internet, and mobility: The rise of telework, telehealth, e-learning, and e-shopping.

This study provides new evidence on changes in a range of online activities due to the Coronavirus disease (COVID-19) pandemic. Online activities replaced physical participation in activities and contributed to changes in urban mobility during the pandemic. Using data from a nationwide survey in Greece, the paper examines changes in the importance and the frequency of engaging in online activities before and during COVID-19. Findings show that both the importance and the frequency of engaging in telework, teleconferencing, online learning (e-learning), telehealth, and online shopping (e-shopping) significantly increased during COVID-19 compared to pre-COVID-19. Substantial increases in importance were reported for telework (31% increase), teleconferencing (34% increase), online learning (34% increase), and telehealth (21% increase). Those who, on a daily basis, teleworked, teleconferenced, and made video calls with family or friends quadrupled during COVID-19, while daily online learners increased seven-fold. Telehealth and online shopping also increased but more modestly. Urban mobility in the post-COVID-19 era is likely to depend on the degree of prevalence and acceptance of these remote online activities, together with a set of complex and interconnected factors related to urban form, the spatial planning and decision-making system, and social awareness about the future of cities.