Omicron COVID-19 variant outcomes and vaccination in non-severe and non-critical patients at admission.

The clinical data of patients infected with the Omicron variant virus in Zhejiang Province from January to 14 May 2022 were collected retrospectively. We analyzed the differences in symptoms, clinical categories of COVID-19, length of hospital stay, and time for clearance of Omicron variant viral RNA in the sputum among the groups receiving a different number of vaccine doses. The analysis showed that as the number of vaccine doses increased, the frequency of clinical symptoms, such as fever and fatigue, decreased and the frequency of patients with moderate infections gradually decreased. At the same time, the length of hospital stay was significantly shortened. Based on the multivariate analysis, one vaccine dose [odds ratio (OR): 0.21, 95% confidence interval (CI): 0.08-0.56, p = 0.002], two vaccine doses (OR: 0.54, 95% CI: 0.33-0.88, p = 0.013), and three vaccine doses (OR: 0.40, 95% CI: 0.24-0.64, p < 0.001) shortened the length of hospitalization than those with no vaccination. The persistence of the virus in the sputum was significantly shortened with one vaccine dose (OR: 0.36, 95% CI: 0.15-0.89, p = 0.027), two vaccine doses (OR: 0.46, 95% CI: 0.27-0.78, p = 0.004), and three vaccine doses (OR: 0.38, 95% CI: 0.22-0.64, p < 0.001) than those with no vaccination. Therefore, we concluded that vaccination was an effective way to protect people against infection with the Omicron variant. Indeed, on the premise of the current routine recommendation of vaccination, three vaccines were necessary for people to be protected against the Omicron variant.

Clinical risk score for early prediction of recurring SARS-CoV-2 positivity in non-critical patients.

Introduction: Recurrent positive results in quantitative reverse transcriptase-PCR (qRT-PCR) tests have been commonly observed in COVID-19 patients. We aimed to construct and validate a reliable risk stratification tool for early predictions of non-critical COVID-19 survivors' risk of getting tested re-positive within 30 days. Methods: We enrolled and retrospectively analyzed the demographic data and clinical characters of 23,145 laboratory-confirmed cases with non-critical COVID-19. Participants were followed for 30 days and randomly allocated to either a training (60%) or a validation (40%) cohort. Multivariate logistic regression models were employed to identify possible risk factors with the SARS-CoV-2 recurrent positivity and then incorporated into the nomogram. Results: The study showed that the overall proportion of re-positive cases within 30 days of the last negative test was 24.1%. In the training cohort, significantly contributing variables associated with the 30-day re-positivity were clinical type, COVID-19 vaccination status, myalgia, headache, admission time, and first negative conversion, which were integrated to build a nomogram and subsequently translate these scores into an online publicly available risk calculator (https://anananan1.shinyapps.io/DynNomapp2/). The AUC in the training cohort was 0.719 [95% confidence interval (CI), 0.712-0.727] with a sensitivity of 66.52% (95% CI, 65.73-67.30) and a specificity of 67.74% (95% CI, 66.97-68.52). A significant AUC of 0.716 (95% CI, 0.706-0.725) was obtained for the validation cohort with a sensitivity of 62.29% (95% CI, 61.30-63.28) and a specificity of 71.26% (95% CI, 70.34-72.18). The calibration curve exhibited a good coherence between the actual observation and predicted outcomes. Conclusion: The risk model can help identify and take proper management in high-risk individuals toward the containment of the pandemic in the community.

Unusual pattern of thrombotic events in young adult non-critically ill patients with COVID-19 may result from an undiagnosed inherited and acquired form of thrombophilia.

In 145 previously healthy non-critically ill young adults, coronavirus disease 2019 (COVID-19)-related symptoms, risk factors for thrombosis, coagulation and inflammatory parameters were compared, with 29 patients reporting unusual thrombotic events (UTEs) and 116 not having thrombotic events. The inflammatory indices, coagulation and prothrombotic platelet phenotype (PTPP) were significantly higher in patients with UTEs versus those without. Patients with UTEs were categorised according to detection of thrombophilic genes (TGs), coagulation and inflammatory markers to the non-TG and TG subcohort. A total of 38 UTEs were identified, which included splanchnic vein thrombosis (SVT; 11), stroke (six), cerebral vein thrombosis (five), thrombotic microangiopathy (four), limb ischaemia and inferior vena cava thrombosis (three each), ST-segment elevation myocardial infarction (two), superior vena cava thrombosis (two), upper limb deep venous thrombosis and retinal vein thrombosis, one each. We found a 55% prevalence of TGs mainly heterozygous coagulation factor II, thrombin (FII)-G20210A, Janus kinase 2 (JAK2)-V617F, protein-S, and antithrombin III deficiency with a high (76·9%) prevalence of venous UTEs, multiple vessels thrombosis, and recurrence rate among the TG versus non-TG subcohort. The presence of JAK2-V617F, and FII-G20210A mutations was linked with SVT. Thrombosis in the non-TG subcohort was associated with more haemorrhagic problems, thrombosis progression and a significantly higher level of inflammatory markers, PTPP, mean platelet volume, von Willebrand factor, and factor VIII, which remained high for up to 6 months, as well as elevated D-dimer. Acquired and inherited thrombophilia with endotheliopathy appeared to be a relevant mechanism to explain the occurrence of UTEs that are not correlated to COVID-19 severity.

Nurses' cleaning practice of non-critical medical equipment in the era of COVID 19: A cross-sectional study in Debre-Tabor comprehensive specialized hospital.

OBJECTIVES: This study was aimed at assessing the cleaning practice of non-critical medical equipment (NCME) in the era of corona virus disease-2019 of nurses working in Debre-Tabor comprehensive specialized hospital (DTCSH), north-central Ethiopia. DESIGN: Facility based cross-sectional study was conducted in DTCSH, Ethiopia, from July 05 to August 05, 2020. SETTING: The study was conducted in inpatient and outpatient units of the hospital. PARTICIPANTS: A total of 76 randomly selected staff nurses and 6 head nurses were included for observational study and interview respectively. RESULTS: Only 1.3%-5.3% of nurses cleaned stethoscopes, thermometers, pulse oximeters, and glucometers right after using these devices for patients. None of them cleaned the blood pressure apparatus before or after checking a patient's blood pressure and glucometer before determining blood glucose levels. Lack of disinfecting materials and lack of training on infection prevention were perceived by head nurses as major barriers for proper cleaning practices. CONCLUSION: Nurses' cleaning practice of NCME was very low. Therefore, proper supply of materials needed to clean these devices need to be secured. Besides, nurses need to get training on infection prevention.

Identification, Monitoring, and Prediction of Disease Severity in Patients with COVID-19 Pneumonia Based on Chest Computed Tomography Scans: A Retrospective Study.

Background and Aims Non-contrast chest computed tomography (CT) scans can accurately evaluate the type and extent of lung lesions. The aim of this study was to investigate the chest CT features associated with critical and non-critical patients with coronavirus disease 2019 (COVID-19). Methods A total of 1078 patients with COVID-19 pneumonia who underwent chest CT scans, including 169 critical cases and 909 non-critical cases, were enrolled in this retrospective study. The scans of all participants were reviewed and compared in two groups of study. In addition, the risk factors associated with disease in critical and non-critical patients were analyzed. Results Chest CT scans showed bilateral and multifocal involvement in most (86.4%) of the participants, with 97.6 and 84.3% reported in critical and non-critical patients, respectively. The incidences of pure consolidation (p = 0.019), mixed ground-glass opacities (GGOs) and consolidation (p < 0.001), pleural effusion (p < 0.001), and intralesional traction bronchiectasis (p = 0.007) were significantly higher in critical compared to non-critical patients. However, non-critical patients showed higher incidence of pure GGOs than the critical patients (p < 0.001). Finally, the total opacity scores of the critical patients were significantly higher than those of non-critical patients (13.71 ± 6.26 versus 4.86 ± 3.52, p < 0.001), with an area under the curve of 0.91 (0.88-0.94) for COVID-19 detection. Conclusions Our results revealed that the chest CT examination was an effective means of detecting pulmonary parenchymal abnormalities in the natural course of COVID-19. It can distinguish the critical patients from the non-critical patients (AUC = 0.91), which is helpful for the judgment of clinical condition and has important clinical value for the diagnosis and follow-up of COVID-19 pneumonia.