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Background: East during COVID-19 is a potentially serious and fatal new infection that first broke out in Italys North Eastduring Spring 2020. Among subjects considered more clinically vulnerable, patients with adrenal insufficiency (AI) have a known increased risk of infections, that could lead to poor prognosis and death due to adrenal crisis. Even the psychological and sociooccupational impact of COVID-19 could affect the health of AI patients, requiring a dynamic and continuous adaptation of the daily glucocorticoid (GC) therapy. Aim(s): To investigate if AI patients have a higher risk for COVID-19 infection than the general population, all residents in the red zone Veneto, in North-East Italy. Moreover, based on a purpose-built ADDI-COVID questionnaire, the study aimed to evaluate the subjective perception of an increased risk for COVID-19 infection and pandemic-related psycho-social impact, working life and self-adjustments of GC therapy. Method(s): Open-label, cross-sectional monocentric study on 84 (65 primary and 19 secondary) AI patients, all resident in Veneto, followed-up at the Endocrinology Unit, University-Hospital of Padua, for at least 3 years, in good and stable clinical conditions. At the end of the first COVID-19 wave (by August 2020), all patients underwent serological investigation of anti-SARS-CoV2 IgG and ADDI-COVID questionnaire. All AI patients enrolled were contacted during March-April 2021 to evaluate eventual COVID-19 infection occurrence after the second and third waves, completing a follow-up period of about 12 months. Result(s): All AI patients resulted negative to the serological test for anti-SARS-CoV2 IgG at the end of the first wave of COVID-19. After the second and third pandemic waves, COVID-19 infection occurred in 8 (10%) patients, and none needed intensive care or hospitalization. Half patients felt an increased risk of COVID-19 infection, significantly associated with an increased stress (p = 0,009) and the consequent increase of GC stress-dose (p = 0,002). Only one patient reported adrenal crisis stress correlated. The great majority of the 61 (73%) worker patients changed their working habits during the lockdown, which was inversely related with COVID-19-related stress (p = 0,0015). A significant association was found between workers and endocri- nologist contact (p= 0,046) since 18 among 20 AI patients who contacted the endocrinologist were workers. Discussion and Conclusion(s): Patients with AI residence in Veneto did not show a higher incidence of COVID19-infection compared with general population residents in Veneto after the first pandemic waves. However, the perception of increased COVID- 19 infection risk significantly impacted the psychological well-being, working habits and GC daily doses of AI patients. Especially during this pandemic period, therapeutic patient education was crucial to prevent and treat situations or conditions that could lead to an adrenal crisis. The endocrinologic consultation could help to strengthen the awareness of AI patients, especially if they were workers.
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Objectives: Interception therapy requires an individual to take a treatment today to prevent a future medical event. Patients must trade off treatment burdens incurred today against future benefits. We examined the preferences of high-risk lung cancer (LC) individuals for potential interception therapies that reduce the risk of developing lung cancer. Method(s): An online discrete-choice experiment (DCE) was developed for hypothetical LC interception treatments with four attributes: reduction in risk of LC over 3 years, injection site reaction severity, nonfatal serious infection risk, and death from serious infection risk. Respondents chose between two alternative treatments or a no-treatment option. The DCE was analyzed using random-parameters logit, and maximum acceptable risk for an LC risk reduction was calculated. Logit analysis explored characteristics of respondents who always selected no treatment. Result(s): The sample included 803 adults aged 50-80 years with at least a 20 pack-year smoking history. Respondents had an average willingness to accept interception therapy (alternative-specific constant=1.30, 95% CI: 0.91-1.69). Respondents viewed larger reductions in the risk of LC as most important. Respondents were willing to accept increases in risk of nonfatal serious infection up to 15% for a 15% improvement in relative LC risk reduction and increases in risk of death from serious infection up to 1.5% for a 23% improvement in relative LC risk reduction. However, 16% of respondents selected 'no treatment' for all DCE questions. Older respondents, current smokers who have never tried to quit, and those who did not get regular skin exams for cancer and/or COVID-19 vaccine were more likely to opt out of interception therapy. Conclusion(s): Generally, individuals at high risk of LC are willing to consider interception therapy. Study results can support benefit-risk assessments for future systemic LC interception treatments, and the results may have implications for other therapeutic areas.Copyright © 2023
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The spread of COVID-19 has increased the risk of contact transmission between people, and imposes challenges and opportunities for the prevention and control of important parasitic diseases. There may be risks of COVID-19 infection during the implementation of the virus control, including in field investigation and intervention, contacting with fecal samples, or with asymptomatic infected people. Therefore, corresponding prevention and control measures should be taken before and during field investigation, and in sample transportation and detection to prevent the risks effectively. In this paper, the risks and corresponding countermeasures in the above processes are discussed in detail, and the opportunities that COVID-19 brought to the disease control system are also analyzed.Copyright © 2021, National Institute of Parasitic Diseases. All rights reserved.
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This study was undertaken in the college of the Dentistry-University of Basra, Oral and maxillofacial surgery Department. This survey assessed protective measures regarding COVID-19 infection and aimed to evaluation the evidence on the affiliation between use of preventive measures and COVID-19 infection among dental students in Basra. The questionnaires were designed and assembled into two domains as follows: 1-Personal data including age, sex, and academic stage. 2-Analytical data including questions regarding infection rate among dental students and their commitment of COVID-19 preventive measures. An explanation for the aim of this study was coupled to the questionnaire, and the members were asked to sign an online informed permission. The questionnaires were directed toward 1000 dental students and only 875 were responding to the survey and included in the databank. The duration of study approximately takes 10 days, the questionnaire was conducted to students on February, 12th 2020 and the documents collecting were closed at (February, 22nd 2020). On the topic of preventive measures follow in order to avoid the dispersion of COVID-19 infection, an endemic feature of Corona virus disease has led to the deaths of thousands of individuals across several countries. For the prevention of the extent of the disease and its mortality, several preventive measures have been recommended. Conversely, the level of acquaintance and the implementation of such protective measures against COVID-19 among dental students in Basra which constitute vulnerable group are yet to be evaluated. Eight-hundred and seventy-fife questionnaires were analysed. Out of the 875 participants, (250) were males, and (675) were females. Two hundred and sixty-one (29.8%) participants had been infected with covid-19, and six hundred and fourteen (70%) were not being infected. Regarding the correlation between the infection with COVID-19 and the sex and college stage, consequently, no substantial statistical differences were detected between the males and females amongst COVID infected students. This survey demonstrated that the terms of self-protective means in addition to community disaffection will be considerably drops the statistics of dental student's COVID infections.Copyright © RJPT. All right reserved.
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Introduction: Despite several studies, the impact of coronavirus disease 2019 on patients with multiple myeloma remains uncertain. Material(s) and Method(s): We performed a survey that covered the period of the first and second waves of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in 23 centers inseven countries. Out of 352 patients with myeloma and SARS-CoV-2, 23% died. Results/Conclusions: Logistic regression showed a lower risk of death among patients treated with proteasome inhibitor and a higher risk of death for those who had a severe or a very severe course of disease.Copyright © 2023 Sciendo. All rights reserved.
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The need to vaccinate children under the age of 12 against COVID-19 remains an object of discussion today. The relatively low risk associated with infection in children and the ambiguous conclusions when comparing the effects of vaccination and the transferred disease are grounds to believe that the ratio of risk and benefit of vaccination in this age group is more complex. One of the key arguments in favor of vaccinating healthy children is to protect them from the long-term effects of COVID-19. In addition, socially significant factors such as a decrease in the spread of infection, the cost of vaccine supplies or damage associated with the organization of quarantine measures (including the closure of schools and the transfer of the educational process to a remote format) should be taken into account. The dynamics of the situation requires a constant reassessment of the risk and benefits of specific prevention in children. The purpose of this literature review is to systematize objective data concerning the foreign experience of vaccination of children against COVID-19;arguments for and against vaccination, which complicate the decision-making on the issue under study at one level or another.Copyright © 2023 The authors.
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The outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has caused an unparalleled disruption to daily life. Given that COVID-19 primarily spreads in densely populated indoor areas, urban public transport (UPT) systems pose significant risks. This study presents an analysis of the air change rate in buses, subways, and high speed trains based on measured CO2 concentrations and passenger behaviors. The resulting values were used as inputs for an infection risk assessment model, which was used to quantitatively evaluate the effects of various factors, including ventilation rates, respiratory activities, and viral variants, on the infection risk. The findings demonstrate that ventilation has a negligible impact on reducing average risks (less than 10.0%) for short-range scales, but can result in a reduction of average risks by 32.1%-57.4% for room scales. When all passengers wear masks, the average risk reduction ranges from 4.5-folds to 7.5-folds. Based on our analysis, the average total reproduction numbers (R) of subways are 1.4-folds higher than buses, and 2-folds higher than high speed trains. Additionally, it is important to note that the Omicron variant may result in a much higher R value, estimated to be approximately 4.9-folds higher than the Delta variant. To reduce disease transmission, it is important to keep the R value below 1. Thus, two indices have been proposed: time-scale based exposure thresholds and spatial-scale based upper limit warnings. Mask wearing provides the greatest protection against infection in the face of long exposure duration to the omicron epidemic.
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The study presents the results of a numerical analysis of the effectiveness of the use of personal protective equipment of various designs on the spread of pollutants marked with CO2 emitted during human breathing. In the study of 3D geometry the upper part of the human torso and head was developed. The simulated person was supplied with different personal protective equipment covering the human face (PPE). Two types of face shields worn at a different distance from the face and one fabric face mask was analysed. The reference geometry with no personal protective equipment was also analysed. Transient calculation with full breathing model including breath-in and breath-out and species transport were simulated. The results showed that different PPE generates different airflow patterns in the vicinity of the human face. The most efficient in reducing infection risk is by wearing a face mask or face shields at a small distance from the face, as they most effectively reduce CO2 concentration in the surrounding air. However, they also increase the re-inhalation risk of high CO2 concentration which affects human well-being.
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Risk assessment models typically assume ideal mixing, in which the pathogen-laden aerosol particles emitted by a person are evenly distributed in the room. This study points out the local deviation from this idealized assumption and a correlation between the level of pathogen concentration and the distance from the emitter. For this purpose, several numerical studies (CFD) were analyzed, and a validation experiment was performed. Statistical evaluation of the spatial pathogen distribution was used to determine the potential exposure to elevated pathogen concentrations. Compared to an ideally mixed room, at a distance of 1.5 m, the mixing ventilation cases show a 25% risk of being exposed to twice the amount of pathogens and a 5% risk to more than 5 times the assumed value. For displacement ventilation there is a 75% chance of being exposed to less pathogens than in complete mixing at a distance of 1 m. The measurement values agree with the simulation results. © 2022 17th International Conference on Indoor Air Quality and Climate, INDOOR AIR 2022. All rights reserved.
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COVID-hospital healthcare workers belong to a high-risk SARS-CoV-2 infection. The aminodihydrophthalazinedione sodium (Galavit) belongs to the group of immunomodulatory and anti-inflammatory drugs. It has been shown that aminodihydrophthalazinedione sodium is effective in the prevention of acute respiratory infections, respiratory tract diseases and ENT-organs of bacterial and viral etiology. The purpose of the study. To evaluate the effectiveness and safety of immunoprophylaxis of new coronavirus infection (COVID-19) with aminodihydrophthalazinedione sodium in healthcare workers providing medical care in the "red zone". Material and methods. A multicenter prospective-retrospective observational comparative non-randomized study in healthcare workers providing medical care in the "red zone" was conducted. 428 participants were included in the study: the observation group - healthcare workers who administered aminodihydrophthalazinedione sodium (Galavit) for prophylactic purposes (n=214), and control group (n=214). The observation period of the participants or the period of collecting retrospective data in the study was 30 days. The results of PCR tests and tests for antibodies to the SARS-CoV-2 were analyzed, clinical status (COVID-19 in any form) was assessed. Descriptive statistic methods and Pearson chi2 test were used. The risk ratios, odds ratios and 95% confidence intervals were calculated with them. The influence of potential confounding factors (age, gender, work place in clinical site, the presence or absence of concomitant disease) on the clinical status were analyzed using logistic regression. The analysis of propensity score matching was carried out. The Stata/IC 14.2 for Windows software used for statistical analysis. Results and discussion. Observational study results describe the risk ratios and odds ratios of infection with a new coronavirus (COVID-19) in healthcare workers providing medical care in the "red zone" considering prophylactic administration of aminodihydrophthalazinedione sodium (Galavit). 205 (95.8%) participants in the group of healthcare workers who took aminodihydrophthalazinedione sodium (Galavit) for prophylactic purposes and 194 (90.7%) participants in control group had a negative PCR test during the observation period, chi2=4.48, p=0.034. The risk of a positive status according to the PCR test for 30 days in the preventive group was 0,04, and in the control group 0.09. The risk difference was -0.05 [95% confidence interval (CI) -0.099;-0.004]. The adjusted odds ratio using multiple logistic regression was - 0.41 (95% CI 0.18-0.93). No adverse events were observed during the prophylactic administration of aminodihydrophthalazinedione sodium over 30 days. Conclusion. Galavit preventive administration in a tablet form at a dose of 50-100 mg per day by employees of medical institutions providing medical care to patients with CIVID-19 significantly reduces the risk of SARS-CoV-2 infection and more than 2 times increases the chances not ill of new coronavirus infection. Galavit administration up to 30 days at a dose of 50-100 mg was well tolerated, no adverse events were registered.Copyright © 2022 by the authors.
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There is a description of two clinical cases of a new coronavirus infection COVID-19 in patients with a history of heart transplantation. Patients who receive immunosuppressants for life are at risk of developing infectious diseases. This requires the vigilance of doctors, especially in the face of a pandemic of a new coronavirus infection. Adequate and timely started therapy increases the effectiveness of treatment and reduces the risk of complications. The complex participation of different specialists is necessary to determine the tactics of treatment, correct pathogenetic and suppressive therapy.Copyright © 2021 Sovero Press Publishing House. All rights reserved.
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The ongoing COVID-19 pandemic has caused millions of deaths worldwide along with detrimental socioeconomic consequences. Existing evidence suggests that the rate of indoor transmission is directly linked with the Indoor Air Quality (IAQ) conditions. Most of the existing methodologies for virus transmissibility risk estimation are based on the well-known Wells-Riley equation and assume well-mixed, uniform conditions;so spatiotemporal variations within the indoor space are not captured. In this work, a novel fine-grained methodology for real-time virus transmission risk estimation is developed using a 3D model of a real office room with 31 occupants. CONTAM-CFD0 software is used to compute the airflow vectors and the resulting 3D CO2 concentration map (attributed to the exhalations from the occupants). Simulation results are also provided that demonstrate the efficacy of using CO2 sensors for estimating the infection risk in real-time in the 3D office environment. © 2022 17th International Conference on Indoor Air Quality and Climate, INDOOR AIR 2022. All rights reserved.
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Patient suffering from autoimmune diseases (AID) typically have an increased risk of infection, which is attributed to the disease itself, but also to immunosuppressive drugs (IS) and comorbidities. During the current COVID-19 outbreak, the way to manage these diseases remains elusive. Limited data is currently available on AID and IS in the context of this new coronavirus infection. To date, there is no evidence to support an increase in complications of COVID-19 in these patients. In addition, certain drugs that are commonly used to treat AID could be part of the therapeutic arsenal used in COVID-19. The purpose of this article is to review the unique aspects of patients with AID during the COVID-19 outbreak.Copyright © 2020 Editions Medecine et Hygiene. All rights reserved.
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A widely used analytical model to quantitatively assess airborne infection risk is the Wells-Riley model based on the assumption of complete air mixing in a single zone. This study aimed to extend the Wells-Riley model so that the infection risk can be calculated in spaces where complete mixing is not present. This is done by evaluating the time-dependent distribution of infectious quanta in each zone and by solving the coupled system of differential equations based on the zonal quanta concentrations. In conclusion, this study shows that using the Wells-Riley model based on the assumption of completely mixing air may overestimate the long-range airborne infection risk compared to some high-efficiency ventilation systems such as displacement ventilation, but also underestimate the infection risk in a room heated with warm air supplied from the ceiling. © 2022 17th International Conference on Indoor Air Quality and Climate, INDOOR AIR 2022. All rights reserved.
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This study investigated upper-room germicidal ultraviolet (UR-GUV) light application in a music rehearsal room with a high ceiling (7.5 m). The focus was on the influences of the elevation and height of UV zone on disinfection of airborne viruses. This study assumed a uniform UV fluence rate of 0.2 W/m2 in the UV irradiation zone. According to the Computational Fluid Dynamics (CFD) results, average viral concentrations (Ca), fraction remaining (FR), and equivalent air exchange rate (λe) attributed to GUV, have power relationships with UV zone height. Ca and FR decreased with UV zone height, while λe did the opposite. UV zone elevation showed little influence on UR-GUV performance, indicating well-mixed air in the rehearsal room. High ceiling makes it possible to achieve adequate UV dose by increasing both UV zone height and UV light intensity. Using open fixtures improved energy efficiency and reduced operational costs of the UR-GUV system. © 2022 17th International Conference on Indoor Air Quality and Climate, INDOOR AIR 2022. All rights reserved.
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Aim - the discutability of existing scientific publications prompted a retrospective analysis of COVID-19 risk factors among the working population using the example of Russian Railways. Material and methods. Based on the archival documentation of medical institutions of Russian Railways, an analysis of the incidence of employees of the holding was carried out. Data from 2452 cases were analysed, for which full medical documentation was available. The comparison group randomly included 2911 workers who did not have COVID-19, comparable in sex, age, and area of residence. Results. Significant factors of difference between the groups of patients and those who were not ill were: sex, the presence of influenza vaccination, smoking and established diabetes mellitus. There was a trend towards an association of COVID-19 incidence and the presence of cardiovascular disease. In the comparison group, unlike the group of COVID-19 cases, there are 23% more persons who were vaccinated against influenza. In the group of patients with diabetes mellitus was found 3 times more often than in the group of non-patients. In both groups, the incidence rates of cardiovascular disease did not differ. However, as the severity of the disease increased, there was a tendency to increase the incidence of cardiovascular diseases. Meanwhile, the presence of other cardiovascular risk factors (male sex, smoking, diabetes mellitus, obesity) was significantly associated with a higher incidence in the disease group compared to non-patients. Multifactorial analysis also revealed other significant combinations of risk factors with COVID-19 risk: lack of influenza vaccination and the presence of diabetes mellitus;lack of vaccination, smoking and the presence of diabetes mellitus. Conclusion. For the working population, male sex and diabetes may be a significant risk factor for developing COVID-19. Influenza vaccination should be considered as a factor in anti- COVID-19 protection. Cardiovascular diseas e and smoking may serve as additional risk factors.Copyright © 2021 Infectious Diseases: News, Opinions, Training. All rights reserved.
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This study contributes to a better understanding of the airborne transmission risks in multizone, mechanically ventilated buildings and how to reduce infection risk. A novel modeling approach combining the Wells-Riley and the US National Institute of Standards and Technology (NIST) CONTAM models was applied to a multizone whole building to simulate exposure and assess the effectiveness of different mitigation measures. A case study for the US Department of Energy large office prototype building was conducted to illustrate the approach. © 2022 17th International Conference on Indoor Air Quality and Climate, INDOOR AIR 2022. All rights reserved.
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The problem of COVID-19 vaccination in patients with autoimmune inflammatory rheumatic diseases is discussed. There is an increased risk of viral infections in these patients. Attending physicians should provide patients with rheumatic diseases with complete information about the risks and benefits of COVID-19 immunoprophylaxis. The use of immunosuppressive drugs, rather than the diseases themselves, can reduce the level of post-vaccination immune response. This requires choosing the optimal time for carrying out COVID-19 vaccination in this group of patients. Fragments of European and American recommendations on vaccination against COVID-19 in patients with rheumatic diseases are given.Copyright © 2022 Infectious Diseases: News, Opinions, Training.
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In light of the current pandemic, doctors need to raise the suspicion of concurrent SARS-CoV-2 infection with Neisseria meningitides infection. In this article we reported a case of invasive meningococcal infection in an adolescent with COVID-19. Severity of the disease depended on septic shock due to invasive meningococcal infection associated with sepsis and meningitis. The differential diagnosis with a multisystem inflammatory syndrome was tricky considering the fever, shock, meningeal symptoms, elevated levels of C-reactive protein and D-dimer, patient age, and a positive test for SARS-CoV-2. The disease outcome was good. Given the risk of invasive forms of meningococcal infection, the possible synergy of SARS-CoV-2 and Neisseria meningitidis, the complexity of differential diagnosis in patients in critical condition, immunization against meningococcal infection should be carried out according to epidemic indications, despite the COVID-19 pandemic.Copyright © 2022 Sorbtsionnye i Khromatograficheskie Protsessy. All rights reserved.