The first year of the COVID-19 pandemic and health among cancer survivors in the United States.

BACKGROUND: Cancer survivors represent a population with high health care needs. If and how cancer survivors were affected by the first year of the coronavirus disease 2019 (COVID-19) pandemic are largely unknown. METHODS: Using data from the nationwide, population-based Behavioral Risk Factor Surveillance System (2017-2020), the authors investigated changes in health-related measures during the COVID-19 pandemic among cancer survivors and compared them with changes among adults without a cancer history in the United States. Sociodemographic and health-related measures such as insurance coverage, employment status, health behaviors, and health status were self-reported. Adjusted prevalence ratios of health-related measures in 2020 versus 2017-2019 were calculated with multivariable logistic regressions and stratified by age group (18-64 vs. ≥65 years). RESULTS: Among adults aged 18-64 years, the uninsured rate did not change significantly in 2020 despite increases in unemployment. The prevalence of unhealthy behaviors, such as insufficient sleep and smoking, decreased in 2020, and self-rated health improved, regardless of cancer history. Notably, declines in smoking were larger among cancer survivors than nonelderly adults without a cancer history. Few changes were observed for adults aged ≥65 years. CONCLUSIONS: Further research is needed to confirm the observed positive health behavior and health changes and to investigate the role of potential mechanisms, such as the national and regional policy responses to the pandemic regarding insurance coverage, unemployment benefits, and financial assistance. As polices related to the public health emergency expire, ongoing monitoring of longer term effects of the pandemic on cancer survivorship is warranted.

A national quality improvement study identifying and addressing cancer screening deficits due to the COVID-19 pandemic.

BACKGROUND: Cancer-related deaths over the next decade are expected to increase due to cancer screening deficits associated with the coronavirus disease 2019 (COVID-19) pandemic. Although national deficits have been quantified, a structured response to identifying and addressing local deficits has not been widely available. The objectives of this report are to share preliminary data on monthly screening deficits in breast, colorectal, lung, and cervical cancers across diverse settings and to provide online materials from a national quality improvement (QI) study to help other institutions to address local screening deficits. METHODS: This prospective, national QI study on Return-to-Screening enrolled 748 accredited cancer programs in the United States from April through June 2021. Local prepandemic and pandemic monthly screening test volumes (MTVs) were used to calculate the relative percent change in MTV to describe the monthly screening gap. RESULTS: The majority of facilities reported monthly screening deficits (colorectal cancer, 80.6% [n = 104/129]; cervical cancer, 69.0% [n = 20/29]; breast cancer, 55.3% [n = 241/436]; lung cancer, 44.6% [n = 98/220]). Overall, the median relative percent change in MTV ranged from -17.7% for colorectal cancer (interquartile range [IQR], -33.6% to -2.8%), -6.8% for cervical cancer (IQR, -29.4% to 1.7%), -1.6% for breast cancer (IQR, -9.6% to 7.0%), and 1.2% for lung cancer (IQR, -16.9% to 19.0%). Geographic differences were not observed. There were statistically significant differences in the percent change in MTV between institution types for colorectal cancer screening (P = .02). CONCLUSION: Cancer screening is still in need of urgent attention, and the screening resources made available online may help facilities to close critical gaps and address screenings missed in 2020. LAY SUMMARY: Question: How can the effects of the coronavirus disease 2019 pandemic on cancer screening be mitigated? FINDINGS: When national resources were provided, including methods to calculate local screening deficits, 748 cancer programs promptly enrolled in a national Return-to-Screening study, and the majority identified local screening deficits, most notably in colorectal cancer. Using these results, 814 quality improvement projects were initiated with the potential to add 70,000 screening tests in 2021. Meaning: Cancer screening is still in need of urgent attention, and the online resources that we provide may help to close critical screening deficits.

Optimization of loop-mediated isothermal amplification (LAMP) assay for robust visualization in SARS-CoV-2 and emerging variants diagnosis.

Loop-mediated isothermal amplification (LAMP) is widely used in detection of pathogenic microorganisms including SARS-CoV-2. However, the performance of LAMP assay needs further exploration in the emerging SARS-CoV-2 variants test. Here, we design serials of primers and select an optimal set for LAMP-based on SARS-CoV-2 N gene for a robust and visual assay in SARS-CoV-2 diagnosis. The limit of detectable template reaches 10 copies of N gene per 25 µL reaction at isothermal 58℃ within 40 min. Importantly, the primers for LAMP assay locate at 12 to 213 nt of N gene, a highly conservative region, which serves as a compatible test in emerging SARS-CoV-2 variants. Comparison to a commercial qPCR assay, this LAMP assay exerts the high viability in diagnosis of 41 clinical samples. Our study optimizes an advantageous LAMP assay for colorimetric detection of SARS-CoV-2 and emerging variants, which is hopeful to be a promising test in COVID-19 surveillance.

Impact of the COVID-19 pandemic on symptoms of anxiety and depression and health-related quality of life in older patients with chronic kidney disease.

BACKGROUND: Older patients with advanced chronic kidney disease are at increased risk for a severe course of the coronavirus disease-2019 (COVID-19) and vulnerable to mental health problems. We aimed to investigate prevalence and associated patient (demographic and clinical) characteristics of mental wellbeing (health-related quality of life [HRQoL] and symptoms of depression and anxiety) before and during the COVID-19 pandemic in older patients with advanced chronic kidney disease. METHODS: An ongoing Dutch multicentre prospective cohort study enrols patients of ≥70 years with an eGFR < 20 mL/min/1.73m2 from October 2018 onward. With additional questionnaires during the pandemic (May-June 2020), disease-related concerns about COVID-19 and general anxiety symptoms were assessed cross-sectionally, and depressive symptoms, HRQoL, and emotional symptoms longitudinally. RESULTS: The 82 included patients had a median age of 77.5 years (interquartile range 73.9-82.1), 77% were male and none had tested positive for COVID-19. Cross-sectionally, 67% of the patients reported to be more anxious about COVID-19 because of their kidney disease, and 43% of the patients stated that their quality of life was reduced due to the COVID-19 pandemic. Compared to pre-COVID-19, the presence of depressive symptoms had increased (11 to 22%; p = .022) and physical HRQoL declined (M = 40.4, SD = 10.1 to M = 36.1, SD = 10.4; p < .001), particularly in males. Mental HRQoL (M = 50.3, SD = 9.6 to M = 50.4, SD = 9.9; p = .913) and emotional symptoms remained similar. CONCLUSIONS: Older patients with advanced chronic kidney disease suffered from disease-related anxiety about COVID-19, increased depressive symptoms and reduced physical HRQoL during the COVID-19 pandemic. The impact of the pandemic on this vulnerable patient group extends beyond increased mortality risk, and awareness of mental wellbeing is important. TRIAL REGISTRATION: The study is registered at the Netherlands Trial Register (NTR), trial number NL7104. Date of registration: 06-06-2018.

Coronavirus Disease 2019 on the Heels of Ebola Virus Disease in West Africa.

This study utilized modeling and simulation to examine the effectiveness of current and potential future COVID-19 response interventions in the West African countries of Guinea, Liberia, and Sierra Leone. A comparison between simulations can highlight which interventions could have an effect on the pandemic in these countries. An extended compartmental model was used to run simulations incorporating multiple vaccination strategies and non-pharmaceutical interventions (NPIs). In addition to the customary categories of susceptible, exposed, infected, and recovered (SEIR) compartments, this COVID-19 model incorporated early and late disease states, isolation, treatment, and death. Lessons learned from the 2014-2016 Ebola virus disease outbreak-especially the optimization of each country's resource allocation-were incorporated in the presented models. For each country, models were calibrated to an estimated number of infections based on actual reported cases and deaths. Simulations were run to test the potential future effects of vaccination and NPIs. Multiple levels of vaccination were considered, based on announced vaccine allocation plans and notional scenarios. Increased vaccination combined with NPI mitigation strategies resulted in thousands of fewer COVID-19 infections in each country. This study demonstrates the importance of increased vaccinations. The levels of vaccination in this study would require substantial increases in vaccination supplies obtained through national purchases or international aid. While this study does not aim to develop a model that predicts the future, it can provide useful information for decision-makers in low- and middle-income nations. Such information can be used to prioritize and optimize limited available resources for targeted interventions that will have the greatest impact on COVID-19 pandemic response.

Use of donor-specific red blood cell transfusions for patients undergoing liver transplantation during the COVID-19 pandemic.

BACKGROUND: Increased risks have been found for patients undergoing liver transplantation due to the blood supply shortage following the ongoing coronavirus disease 2019 (COVID-19) pandemic. Hence, exploring a method to alleviate this dilemma is urgent. This phase I, nonrandomized, prospective trial aimed to evaluate the safety and feasibility of using donor-specific red blood cell transfusion (DRBCT) as an urgent measurement to alleviate the blood supply shortage in deceased donor liver transplantation (DDLT). METHODS: The outcomes of 26 patients who received DRBCT and 37 patients in the control group who only received 3rd party packed red blood cells (pRBCs) transfusion between May 2020 and January 2021 were compared. RESULTS: Patients receiving DRBCT did not develop transfusion-related complications, and the incidence of postoperative infection was similar to that in the control group (23.1% vs. 18.9%, P=0.688). Because the patients received the red blood cells from organ donors, the median volume of intraoperative allogeneic red blood cell transfusion from blood bank was 4.0 U (IQR 1.1-8.0 U) in the DRBCT group, which is significantly lower than that (7.5 U, IQR 4.0-10.0 U) in the control group (P=0.018). The peak aspartate aminotransferase (AST) level was significantly lower in the DRBCT group than in the control group (P=0.008) and so were the AST levels in the first two days after the operation (P=0.006 and P=0.033). CONCLUSIONS: DRBCT is a safe and effective procedure to lower the need for blood supply and is associated with a reduction in AST levels after transplantation. DRBCT is beneficial to patients receiving life-saving transplantation without sufficient blood supply during the COVID-19 pandemic.

A Comparison of Diagnosed Skin Diseases between the Years with and without COVID-19 Pandemic.

Background and Objectives: The COVID-19 pandemic has a considerable influence on public health, either directly or indirectly. We investigated outpatient skin disease diagnoses at the dermatology clinic to determine the effect of the COVID-19 pandemic on these patients. Materials and Methods: We conducted a retrospective study using the International Codes of Diseases data from the outpatient department of Dermatology clinic, Vajira hospital, Navamindradhiraj University, Bangkok, Thailand from January 2019 to June 2021. Results: A total of 20,915 patients with 34,116 skin diagnoses were included in the study. The average weekly dermatologic clinic visits remained unchanged between the years with and without COVID-19 pandemic. While the percentage of xerosis cutis, other skin infections (syphilis and parasitic infections), hair and nail disorders, pigmentary disorders, benign skin tumors and drug eruptions were significantly decreased during the COVID-19 pandemic years, the percentage of other dermatitis, fungal and viral skin infections, acne, psoriasis, urticaria, vesiculobullous and autoimmune diseases were increased. Conclusion: The COVID-19 pandemic had a minimal effect on the average weekly skin clinic visits, but the diagnosed skin diseases pattern was affected. Knowing the pattern of skin diseases may help aid hospitals to better prepare for future pandemics in securing appropriate medications and supplies and training the medical teams.

The Impact of the COVID-19 Self-Isolation Policy on the Occupations of Vulnerable Groups.

Today, the spread of the Coronavirus 2019 (COVID-19) pandemic continues to impact on world public health and bring about considerable human suffering partly due to government policies on reducing the spread. COVID-19 has significantly affected human health and it has impacted on the occupation of vulnerable groups such as tour guides, drivers and shop assistants. Of these, the present study aims to investigate the impact of the COVID-19 self-isolation policy on the occupation of vulnerable groups in Semarang City, Indonesia. To achieve this objective, this study uses a qualitative method with an ethnography approach considering a rational or non-rational thinking model. The binary opposition thinking pattern pioneered by Lévi-Strauss was used in the interview process with 25 informants in Semarang City, Indonesia. The data analyzed the response pattern of informants through the taxonomy analysis. Three levels of vulnerability among groups relating to occupation were identified; jobs lost, income decreased, and delayed salary. The result of the analysis found that the group who obeyed self-isolation was categorized as a rational thinking; these groups stay at home, do not go to work, and have no income. Besides that, the group who ignored self-isolation is categorized as non-rational thinking; they work, as usual, get their salary, and believe that the COVID-19 pandemic is a disaster and they pray for their safety to God. In conclusion, COVID-19 brings a significant impact on occupation in the forms of postponing, declining, and missing income besides the health effects among vulnerable groups in Semarang city, Indonesia. In avoiding COVID-19 infection, the circumstances of vulnerable groups are worse when self-isolation is required. Thus, this study suggests that the government needs to assist vulnerable groups by focusing on strategic policies, such as strategies for survival, providing access to basic needs, including health, and offering livelihood plans by providing access to medical services and other source of income.

The impact of the COVID-19 pandemic on positive airway pressure usage in children with sleep-disordered breathing.

PURPOSE: To evaluate the impact of the COVID-19 pandemic on non-invasive positive airway pressure (PAP) usage among children with sleep-disordered breathing (SDB). METHODS: PAP usage data in children with SDB aged 1 to 18 years old at The Hospital for Sick Children, Canada, were analyzed. The PAP usage data were recorded for 3 months prior to and 3 months following the COVID-19 lockdown in Ontario, Canada. The primary outcomes of interest were (i) percentage of days that PAP was used for ≥ 4 h and (ii) average daily usage of PAP based on days when PAP was used. RESULTS: A total of 151 children were included. The mean (± SD) age and BMI were 12.6 ± 4.1 years and 28.7 ± 12.4 kg/m2, respectively. The median (IQR) percentage of days of PAP usage for ≥ 4 h and average nightly PAP usage was significantly higher during compared with prior to the pandemic (76.7 [19.0-94.0] vs 62.0 [15.5-89.0]%, p = 0.02, and 406.0 [244.0-525.0] vs 367.0 [218.0-496.0] min, p = 0.006, respectively). Within this cohort, 95/151 (63%) children with SDB showed increased PAP usage and 56/151 (37%) either decreased the amount of time they used PAP or stopped PAP use altogether. CONCLUSIONS: COVID-19 pandemic has provided opportunities for increased PAP usage in a significant number of children with SDB. A subset of children with prior evidence for suboptimal PAP usage showed further decreases in PAP usage during the pandemic. This information is critical for clinicians to provide anticipatory guidance to encourage PAP usage both during the pandemic and beyond.

Mental Health and Physical Activity among Children and Adolescents during the COVID-19 Pandemic.

Coronavirus disease 2019 (COVID-19) is causing disruptions in the global social system. Japanese children and adolescents have had their schools closed, government-mandated activity restrictions imposed, and interactions outside the home reduced. These restrictions can have a considerable psychological impact on children and adolescents. This review aims to describe the impacts of COVID-19 pandemic on physical activity and psychological status of this population. The review was conducted by searching PubMed for information on the impact of COVID-19-related activity restrictions on children and adolescents. The search identified 11 articles, three of which contained data on anxiety and psychological problems due to physical inactivity. Next, a PubMed search was conducted about physical activity and psychological status in children and adolescents under psychological stress. The search identified 368 articles, 28 of which were included in the review. For children, data that revealed a correlation between physical activity and psychological health and sedentary time leading to mood disorders were included. For adolescents, there were nine studies that reported a correlation between physical activity and psychological health and four studies that reported no correlation between physical activity and psychological health. Of the studies that reported a correlation, seven reported that physical activity improves psychological health. The impact of psychologically stressful situations such as COVID-19 on children and adolescents has been experienced worldwide. Physical activity has been correlated with psychological health, and it may improve psychological status; physical activity should be recommended to better support the psychological health of children and adolescents under the influence of COVID-19.