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Aim of the study - to develop a scale for assessing the risk of COVID-19 disease for a differentiated approach in conducting preventive and anti-epidemic measures among military personnel. Material and methods. An array of published data was analyzed to select the risk factors for a possible COVID-19 disease. The disease risk assessment scale proposed on the basis of this analysis is implemented in the form of a table in MS Excel and a program in MS Visual Studio in C# with the inclusion of recommendations for making a management decision. Results. The risk factors for COVID-19 disease were selected and included in the questionnaire. A scale for assessing the risk of COVID-19 disease was developed: when a risk factor was identified, one point was assigned;otherwise, zero points were assigned. Then all the points are added together, and this amount is considered proportional to the risk of contracting COVID-19. The resulting total score is correlated with the recommendations for the scope of preventive and anti-epidemic measures. With the program implementation of the scale, it is possible to quickly make an adequate management decision. Conclusion. The use of such approaches can be a significant contribution to the fight against the new coronavirus infection.Copyright © 2021 Infectious Diseases: News, Opinions, Training. All rights reserved.
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Background: The use of cryopreservation for stem cell grafts for both autologous stem cell and allogeneic cord blood transplant has been utilized for years. For other allogeneic stem cell transplant sources, the use of fresh collected grafts has been preferred due to concerns that cryopreservation may result in impaired graft function. With the onset of the COVID-19 pandemic a shift was made at our institution to exclusive use of cryopreservation Methods: In this retrospective single-center analysis a total of 133 patients undergoing allogeneic stem cell transplant at the University of Minnesota between 1/2018-6/2021 for a variety of malignancies were included, with 62 patients receiving fresh stem cell product and 71 patients receiving frozen stem cell product. Univariate statistical analysis was performed. Result(s): There was no significant difference between the two groups with regards to product type, sex, age, diagnosis (acute leukemia vs other), disease risk index, conditioning regimen, Karnofsky score, co-morbidity index, or cell dose (Table 1). Donor type was notably different between the two groups (p<0.01): matched sibling grafts were more commonly used for fresh products than frozen (85% vs. 35%), while matched unrelated donors were used more frequently for frozen than for fresh products (54% vs. 6%). Use of frozen product was associated with delayed neutrophil and platelet engraftment compared to fresh (median days to engraftment 15 vs 12 for neutrophils, 23 vs 17 for platelets, p<0.01 for both). Two-year relapse rates were significantly lower for frozen products (4%) than fresh (24%) (Table 2). This may be partially attributable to differences in follow up between the groups, as fresh products had a total of 910 days of follow up vs 432 for frozen products (P<0.0001). The difference in follow up remained statistically significant if the data was censored at 730 days (P<0.0001). Of note, the use of frozen products was associated with a lower rate of chronic graft-versus-host disease at one year post-transplant (p<0.01). There was no significant difference in the rates of acute GVHD between the groups. There were significant differences in GVHD prophylaxis regimens between the fresh and frozen groups (p<0.01). (Figure Presented)Two-year overall survival did not differ between groups (p=0.96). Conclusion(s): Use of cryopreserved stem cell products is associated with similar efficacy and outcomes as those seen with the use of fresh stem cell products. Although the data presented here suggest novel finding of decreased risk of relapse and chronic GVHD with the use of frozen stem cell products, additional follow up may abrogate these differences. Regardless, the logistical benefits of cryopreservation make this an attractive option for continued use in allogeneic transplants and our data presented here suggests that cryopreserved products remain an appropriate option for allogeneic stem cell transplant.Copyright © 2023 American Society for Transplantation and Cellular Therapy
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Objective To explore the effects of perceived risk of COVID-19 of college students on their anxiety and depression, as well as the roles of attention to negative information and perceived social support, so as to provide theoretical basis for colleges and universities to formulate corresponding intervention measures. Methods By the convenience sampling method, totally 1 404 college students from Shaanxi and Henan provinces were investigated online by using General Information Questionnaire, Perceived Risk of COVID-19 Pandemic Scale, Attention to Negative Information Scale, Patient Health Questionnaire, Generalized Anxiety Disorder and Perceived Social Support Scale. SPSS 20. 0 was used for data analysis, Pearson correlation method was used to explore the correlation between variables. The mediating effect of attention to negative information and the moderating effect of perceived social support were analyzed by PROCESS. Results The scores of anxiety and depression of the 1 404 college students included in the study were 4.03 +/- 4.48 and 6.21 +/- 5.41, respectively. The detection rate of anxiety symptom was 29.9%, and that of depression symptom was 44.4%. The risk perception of COVID-19 epidemic of the college students was positively correlated with attention to negative information (r = 0.373, P<0.001), anxiety (r = 0.227, P<0.001), and depression (r = 0.226, P<0.001). Anxiety (r = 0.553, P<0.001) and depression 0 = 0.497, P<0.001) were positively correlated with attention to negative information, while perceived social support was negatively correlated with the risk perception of the COVID-19 (r = - 0.154, P<0.001), attention to negative information (r= - 0.259, P<0.001), anxiety (r = - 0.321, P<0.001) and depression (r=- 0.278, P<0.001). The risk perception of COVID-19 affected the anxiety and depression of the students mainly through the mediating effect of attention to negative information. The total effect of risk perception of COVID-19 and anxiety was 0. 227, and the mediating effect accounted for 80. 18% of the total effect. The total effect of risk perception of COVID-19 and depression was 0. 228, and the mediating effect accounted for 90. 35% of the total effect. Perceived social support played a moderating role in the last half of this mediating model. Conclusion Risk perception of COVID-19 indirectly affects the occurrence of anxiety and depression in college students through attention to negative information, and perceived social support plays a moderating role in this mediating model. The findings suggest that when a risk event occurs, colleges and universities should pay attention to guiding students to adjust their attentional bias to external information, and give students enough care and support to improve their mental health.Copyright © 2023 Xi'an Medical University. All rights reserved.
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Whether at home, work, school, or traveling abroad, digital healthcare is in demand. Rapidly changing delivery models are shaping the new healthcare landscape far beyond a COVID-19 world. The papers in this minitrack present innovative digital health applications that can be administered or used in a digital health setting outside the walls of traditional healthcare facilities. These papers present apps for parolee reentry into the community, training for audiology screening, and infectious disease risk assessments. Another paper addresses optimization of at-home triage, while the final manuscript focuses on empowering patients in health consultations using an online platform. Taken together, these papers highlight the growing importance of enabling new delivery models for ubiquitous and comprehensive healthcare. © 2022 IEEE Computer Society. All rights reserved.
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Objective: To describe the burden of COVID-19 in a children's multidisciplinary hospital for two years of the pandemic, taking into account of age, severity of the disease, the spectrum of underlying conditions and the intensive care need. Method(s): An assessment of 6048 cases of COVID-19 in patients under 18 years of age hospitalized from March 26, 2020 to December 31, 2021 was carried out. The diagnosis was confirmed by PCR on an outpatient basis or after hospitalization with the help of diagnostic kits registered in the Russian Federation. The features of the work of a children's multidisciplinary hospital in new conditions, the dynamics of hospitalization, age characteristics and new coronavirus (CV) infection severity in the pandemic development process are presented. The analysis of the underlying condition's structure depending on the severity of the disease, as well as the need and volume of therapy in the intensive care unit. The frequency and main characteristics of children's multisystem inflammatory syndrome (MIS-C) in hospital conditions, long-term PCR positivity and its effect on the duration of inpatient treatment of children have been established. Result(s): The spread of SARS-COV-2 in St. Petersburg required a radical change in the work of the children's multidisciplinary hospital. During the two years of the pandemic, four waves of hospitalization of children with new CV were revealed, differing in duration, intensity, and frequency of lung damage, but having no significant differences in the proportion of severe forms of the disease (1.7-2.8% of cases). Intensive therapy was required in 3.6% of cases, of which only 1/3 was due to the severe course of COVID-19 with a lung lesion volume of up to 100%. In 1/3 of cases, patients had risks of developing severe forms and in 1/3 - other pathology. Severe course of new CV was significantly more often accompanied by the need for respiratory support, anticoagulants and anti-inflammatory therapy. Contributing factors of severe forms and unfavorable outcomes were: pathology of the central nervous system, genetic diseases and malformations, obesity, as well as chronic bronchopulmonary pathology. Mortality in the hospital was recorded only among children with severe underlying conditions (0.1% of cases). D-MVS was registered significantly more often in boys (7 out of every 10 patients), accounting for 1.2% of cases of hospitalization of children with new CV over the entire period. Convalescent PCR-positivity in the outcome of COVID-19 was detected in 1/3 of children, significantly more often during the autumn-winter waves of the pandemic and among patients of high school age. Conclusion(s): New CV is gradually strengthening its position in the structure of acute respiratory pathology in children. Some of SARS-COV-2 infection cases is accompanied by extensive lung damage, as well as severe systemic inflammation independently or in the other infectious diseases structure, induction of the debut of various somatic pathology is not excluded. The presented data confirm the need for increased attention at high risk of adverse respiratory diseases outcomes children. All severe cases of COVID-19 in children require a personalized approach, taking into account the existing background diseases and possible options for the progression of the process. MIS-C should be considered as a systemic inflammatory response syndrome within the framework of an infectious disease of various etiologies, differentiated with Kawasaki disease and the debut of systemic diseases. The long-term PCR-positivity in the outcome of COVID-19 requires further study to address the need and nature of therapy in order to prevent further spread of infection in the population.Copyright © 2022 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All rights reserved.
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Background and Aims : Background Low density lipoprotein cholesterol (LDL-C) treatment goals used for cardiovascular disease (CVD) prevention. Sex differences in CVD have been reported and women are less likely to receive statin therapy for secondary prevention. Nevertheless, little is known about gender according to risk categories Aims To assess the degree of LDL-C control in men vs women by CV risk levels and to report possible associations with clinical characteristics and lipid lowering therapies (LLT) in Portugal Methods: A non-interventional, cross-sectional study of patients regularly consulted for primary/secondary CVD in Portugal (1 hospital, 14 primary care centres). Data spanned a 12-year period (01/2008-12/2020) with index date for patient identification the 31/12/2020. CVD risk assessment was done according to 2019 ESC/EAS guidelines for the management of dyslipidaemias. Result(s): In our cohort of 129 764 patients with an overall median age of 53 years, 56.9% were women. 38.9% of men and 28.9% of women were classified as high/very high risk. History of previous CV hospitalization was present in 7.3% males and 5.0% females (table 1). LDL-C targets were attained more commonly in men for high and very high risk levels, although prescription of any LLT was more frequent in women (table 2). We found similar pattern in the two years prior to the COVID-19 pandemic. [Formula presented] [Formula presented] Conclusion(s): Women fail to achieve their LDL-C goals compared to men, although they are more frequent under LLT and have lower CV risk. The reasons and clinical associations require further research. More intensive therapies should perhaps be considered in women. Copyright © 2022
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Background: Asymptomatic COVID-19 is common among the general population, but little has been reported on this phenomenon among people with HIV (PWH) globally. Here we present data on a representative subset of 2,464 REPRIEVE participants with blood collected for COVID-19 serology from May 2020 to February 2021. Methods: REPRIEVE is an international primary atherosclerotic cardiovascular disease (ASCVD) prevention RCT of pitavastatin calcium vs. placebo among 7,770 PWH ages 40-75 on antiretroviral therapy (ART). Beginning in April 2020, targeted data on COVID-19 diagnosis and symptoms were collected as part of routine trial visits every 4 months, and blood was collected annually to assess SARS-CoV-2 serology. SARS-CoV-2 infection was defined as either presence of SARS-CoV-2 IgG or IgA RBD protein (anti-spike) antibodies or reporting of confirmed COVID-19 disease prior to the date of antibody sampling in the absence of prior COVID-19 vaccine receipt. We distinguished symptomatic from asymptomatic disease based on completed COVID-19 symptom questionnaire. Demographic, cardiometabolic, and HIV-specific data are described among those with symptomatic versus asymptomatic COVID-19 disease. Results: Participant characteristics (n=2464) included median age 53 years, 35% female sex, 47% Black or African American race, median CD4 count 649 c/mm3, and 97% with HIV VL <400 cp/mL. SARS-CoV-2 infection occurred in 318 persons (13%): 58 with clinical disease diagnosis and 260 with reactive Abs but no reported clinical disease. Of these persons, 304 completed symptom questionnaires: 120 (39%) reported at least 1 symptom of COVID-19 disease, but 184 (61%) reported no symptoms. PWH with asymptomatic infection were more likely to be from non-High Income Regions, of Black or African American race, and to be non-obese (Table). Median ASCVD risk score was <5% (low risk) for the two groups. Potential differences in symptomatic disease based on ART-regimen were noted, but no clinical differences between the groups for CD4 counts or HIV viral suppression were observed. Conclusion: Asymptomatic SARS-CoV-2 infection is very common among ART-treated PWH globally. With Ab testing, we determined that 61% of COVID-19 infections were asymptomatic in the REPRIEVE cohort, similar to rates reported in the general population. HIV clinicians must remain vigilant about COVID-19 testing among PWH to assure that asymptomatic cases are identified.
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SARS-CoV-2, the cause of COVID-19, infected over 100 million people globally by February 2021. Reverse zoonotic transmission of SARS-CoV-2 from humans to other species has been documented in pet cats and dogs, big cats and gorillas in zoos, and farmed mink. As SARS-CoV-2 is closely related to known bat viruses, assessment of the potential risk of transmission of the virus from humans to bats, and its subsequent impacts on conservation and public health, is warranted. A qualitative risk assessment was conducted by a multi-disciplinary group to assess this risk in bats in the Australian context, with the aim of informing risk management strategies for human activities involving interactions with bats. The overall risk of SARS-CoV-2 establishing in an Australian bat population was assessed to be Low, however with a High level of uncertainty. The outcome of the assessment indicates that, for the Australian situation where the prevalence of COVID-19 in humans is very low, it is reasonable for research and rehabilitation of bats to continue, provided additional biosecurity measures are applied. Risk assessment is challenging for an emerging disease where information is lacking and the situation is changing rapidly; assessments should be revised if human prevalence or other important factors change significantly. The framework developed here, based on established animal disease risk assessment approaches adapted to assess reverse zoonotic transmission, has potential application to a range of wildlife species and situations.