ABSTRACT
BackgroundCOVID-19 infection has revealed a considerable number of extra-pulmonary manifestations, especially rheumatological. The detection of these manifestations, which herald the infection, is of great value in the early diagnosis of the disease, especially in health care workers (HCWs) who are at considerable risk of infection. Although myalgia is a common clinical feature of COVID-19, other musculoskeletal disorders (MSDs) have been rarely described.ObjectivesTo describe MSDs during SARS-COV2 infection in HCWs.MethodsProspective descriptive study conducted at the department of occupational pathology and fitness for work of Charles Nicolle Hospital in Tunis, having included the HCWs affected by COVID-19 during the period from 01 September 2020 to 28 February 2021. Data collection was carried out by regular telephone follow-up during the containment period using a pre-established form.ResultsDuring the study period, 656 HCWs were infected with SARS COV 2, of whom 134 (20.4%) had at least one musculoskeletal event. The mean age was 42±9 years with a sex ratio (M/F) of 0.2. The most represented occupational category was nurses (33.6%) followed by health technicians (23.1%). The median professional length of service was 12 [7;20] years. The presence of comorbidity was noted in 58.2% of HCWs. A pre-existing osteoarticular disease was found in 8.2% of cases. Obesity was noted in 25.4% of the population. Active smoking was reported by 14.3% of respondents. A known vitamin D deficiency was noted in 16.5% of patients. Spinal pain was the most reported MSD, present in 87.3% of cases. Low back pain was the most frequent spinal pain (56.7%) followed by back pain (37.4%) and neck pain (5.9%). MSDs of the lower limbs were found in 12.7% of patients. They were represented by gonalgia in 11.9% of cases, ankle pain in 5.2% of cases and hip pain in 4.3% of cases. MSDs of the upper limbs were described by 7.5% of the patients, 92.5% of whom presented with shoulder pain. The median duration of MSDs during COVID-19 was 5 [3;8] days. These manifestations were persistent on return to work in 21.1% of cases.ConclusionKnowledge of the frequency and consequences of musculoskeletal manifestations related to COVID-19 infection is of great importance, particularly in HCWs, in order to optimise management and ensure a rapid return to work.REFERENCES:NIL.Acknowledgements:NIL.Disclosure of InterestsNone Declared.
ABSTRACT
BackgroundIgA vasculitis (IgAV) is a rare autoimmune disease affecting small vessels. It is well established that the incidence is higher in children (3 to 26 per 100,000 children/year,) [1] than in adults (0.1 to 1.8 per 100,000 individuals/year) [1]. However others epidemiological data and impact of the COVID-19 on IgAV remain overlooked [2].ObjectivesTo collect and analyze epidemiological data on IgAV in both adults and children in France.MethodsWe conducted an observational study using a national database called "BNDMR” [3] (Banque Nationale de Données Maladies Rares) on IgA vasculitis (code ORPHA761), which gathered patients managed in the French rare disease expert network. The incidence was estimated from the date of diagnosis, and we calculated the median annual incidence over the period 2010-2022. We specifically assessed the north/south gradient (latitude of the residence higher/lower than the median of the latitudes), the seasonality, and the impact of the COVID-19 pandemic compared to other patients reported within the same period and addressed in the same expert centers used as controls.ResultsDuring this 12-year period, 1988 patients with IgAV were reported (1498 children;490 adults). The male to female ratio was 1.57 for adults and 1.05 for children. The median IgAV annual incidence was 15 cases/year [IQR 9-30] and 82 cases/year [IQR 72-86] for adult and children cases respectively. Time to diagnosis was less than 1 month for both. Compared with other patients reported in the same expert centers, IgAV was more frequently reported in the southern part of France than in the north (OR 4.88 [95% confidence intervals: 4.17 - 5.74] in adults and OR 1.51 [1.35 - 1.68] in children). IgAV was also more frequently observed in winter than during the rest of the year in both adults (OR 1.60 [1.39 - 1.82]) and children (OR 1.22 [1.01 - 1.48]). The incidence of IgAV decreased during the COVID-19 pandemic period (from March 2020 to September 2022) in children (OR 0.62 [0.47 - 0.81]) but not in the adult population (OR 0.90 [0.76 - 1.06]).ConclusionOur study confirms the winter seasonality and sex ratio in IgAV [4,5], but suggests that the incidence or the reporting of IgAV decreased in children during the COVID19 pandemia, possibly due to barrier measures [6]. The observed north/south gradient need confirmation. The main limitation of this study is a possible IgAV under-reporting as this study rely only on cases addressed in expert centers.References[1]Audemard-Verger A, Pillebout E, Guillevin L, Thervet E, Terrier B. IgA vasculitis (Henoch-Shönlein purpura) in adults: Diagnostic and therapeutic aspects. Autoimmun Rev. 2015;14(7):579-585. doi:10.1016/j.autrev.2015.02.003[2]Deshayes S, Moulis G, Pillebout E, Aouba A, Audemard-Verger A. Positive predictive value of hospital discharge diagnosis code to identify immunoglobulin A vasculitis in France: A validation study. Eur J Intern Med. 2017;43:e18-e19. doi:10.1016/j.ejim.2017.05.025[3]Jannot AS, Messiaen C, Khatim A, Pichon T, Sandrin A, BNDMR infrastructure team. The ongoing French BaMaRa-BNDMR cohort: implementation and deployment of a nationwide information system on rare disease. J Am Med Inform Assoc. 2022;29(3):553-558. doi:10.1093/jamia/ocab237[4]Piram M, Maldini C, Biscardi S, et al. Incidence of IgA vasculitis in children estimated by four-source capture-recapture analysis: a population-based study. Rheumatology (Oxford). 2017;56(8):1358-1366. doi:10.1093/rheumatology/kex158[5]Gardner-Medwin JMM, Dolezalova P, Cummins C, Southwood TR. Incidence of Henoch-Schönlein purpura, Kawasaki disease, and rare vasculitides in children of different ethnic origins. Lancet. 2002;360(9341):1197-1202. doi:10.1016/S0140-6736(02)11279-7[6]Kaya Akca U, Atalay E, Cuceoglu MK, et al. Impact of the COVID-19 pandemic on the frequency of the pediatric rheumatic diseases. Rheumatol Int. 2022;42(1):51-57. doi:10.1007/s00296-021-05027-7Figure.Acknowledgements:NIL.Disclosure of InterestsNone Declared.
ABSTRACT
Objectives: Clinical Practice Research Datalink (CPRD) Aurum contains primary care electronic health records, including vaccinations and nearly complete capture of SARS-CoV-2 PCR test results between August 2020-March 2022. Our objective was to build code lists to define a cohort of persons diagnosed with COVID in England using routinely collected health data. Method(s): Persons aged 1 year or older were indexed on first COVID diagnosis from August 1, 2020 - January 31, 2022. We developed SNOMED code lists to define high risk of severe disease: 1) National Health Service's (NHS) list of highest risk conditions;2) PANORAMIC trial inclusion criteria;3) UK Health Security Agency (UKHSA) clinical risk groups. COVID vaccinations were defined as of December 1, 2021 using medical and product codes. Code lists were developed using wildcard search terms which were reviewed by multiple independent reviewers, and inclusion/exclusion was determined by consensus. All lists for diagnoses were reviewed by a UK physician. Result(s): We identified 2,257,907 people diagnosed in primary care with COVID;46% were male and mean age was 34 years, comparable to governmental data for the same period reporting 47% of cases in England were male and mean age was 34 years. We identified 12% at high risk of severe disease using the NHS definition, 31% using the PANORAMIC trial criteria, and 10% using the UKHSA clinical risk groups. Among adults, 86.1% had >=1 and 80.2% had >=2 COVID vaccine doses (2% and 0.2% lower than official reports, respectively). Conclusion(s): This cohort represented the age and sex distribution of COVID cases, and the COVID vaccination coverage, in England through January 2022. Definitions were built using reproducible methods that can be leveraged for future work. The high capture of COVID vaccinations supports the use of this cohort to examine clinical and societal benefits of COVID vaccination in England.Copyright © 2023
ABSTRACT
Objective To analyze the epidemiological characteristics of COVID-19 cluster epidemic in Huizhou from January to February in 2020, and we provide experience and reference for the prevention and control of cluster epidemic. Methods Descriptive epidemiology was used to analyze the clusters of COVID-19 in Huizhou city. Results From January to February in 2020, a total of 19 COVID-19 cluster outbreaks were reported in Huizhou. The most common cluster outbreaks were in Huidong county (8 cases), Boluo county (3 cases) and Huiyang district (3 cases). There were 59 cases involved in 19 outbreaks, among which 46 were confirmed cases, and 13 were asymptomatic infected. The sex ratio of male to female was 0.84: 1, the age was 1-85 years old. The 19 cases of outbreaks were all caused by imported cases, among which 13 cases were imported from Wuhan (68.4%), 3 cases were imported from Hubei province except Wuhan (15.8%), and 3 cases were imported from other provinces and cities (15.8%). There were 13 cases (68.4%) in the first generation, and 6 cases (31.6%) in the second generation. Events exposed place were variety, including 3 (15.8%) simple family exposure, 13 (68.4%) joint exposure, exposure family, 1 (5.26%) of the joint exposure, family exposure, family dinners, 1 (5.26%) of the joint exposure, family exposure, exposure (hotel) exposed in public places, 1 (5.26%) of the collective unit (workplace) exposure. Conclusion All the COVID - 19 cluster outbreaks in Huizhou city were caused by imported cases, most of which occurred in the family and were caused by families living together and eating together. As the number of people returning to work, production and school increases, various prevention and control measures should be implemented in key areas, key populations and key places to prevent the outbreak from rebounding.Copyright © China Tropical Medicine 2021.
ABSTRACT
Background: The population of Adults with Congenital Heart Disease (ACHD) is expanding. A significant number will require Cardiac Rhythm Management (CRM) devices. In current UK practice, these patients are routinely seen in non-specialist CRM clinics and little is published regarding best-practice CRM programming and management in the ACHD population. Objective(s): Our objective was to establish a new model of patient-centred/-specific care delivered by specialist CRM physiologists, supported by an EP consultant (with a special interest in ACHD) in a dedicated clinic. We hoped to set new standards of care and patient experience, and improve efficiency and outcomes. Method(s): Data was collected from the electronic record system and CRM device database. A control group of non-ACHD patients was selected at random at our institution over the same period (2018-2022). Result(s): The clinic population n = 468 had a sex ratio of 0.92 (M:F) and mean age of 44 years (range 16 - 86). Mean time since primary implant was 9 years. All device types were represented: loop recorder (52), pacemaker (262), cardioverter defibrillator (116) and cardiac resynchronisation therapy devices (38). The underlying ACHD condition was: simple 46%, moderate 28% and complex 26%. Outcomes of appointments (n = 1,234) are shown vs controls (n = 126) (figure 1). Appointment and patient numbers rose year-on-year (100 to 226 patients, 281 to 367 appointments). There was a lower incidence of 'no review / reprogramming ' in ACHD CRM clinic appointments compared to the non-ACHD population, as well as a higher incidence of programming changes, however the trend over time within the ACHD group showed an increase in 'no review / reprogramming' and a decrease in reviews / reprogramming events. In contrast, non-ACHD patients had an increase in medical reviews and reprogramming required between 2018/19 and 2021/22. This is likely due to the COVID pandemic and deferred time to appointments and review. Conclusion(s): Our data demonstrate that the ACHD CRM population require additional input from the medical and scientist teams when compared to non-ACHD patients, however over time there has been a reduction in major programming/review and a commensurate increase in minor programming/discussion and no review. A reverse trend was observed in the non-ACHD patients pre- and post- COVID. These data support the proposal that specialised clinics provide the optimal management ACHD CRM clinics and should be delivered by dedicated practitioners. [Formula presented]Copyright © 2023
ABSTRACT
Introduction: Coronavirus infection (COVID-19), first reported at the end of 2019, which has spilled over into a worldwide pandemic and has affected all aspects of our modern lives. The aim is to study and analyze the epidemiological features of COVID-19 in the Pavlodar region. Materials and methods: Study design is a descriptive retrospective study analysis. The data were obtained from official sources of the Republican Center for e-Health of the Ministry of Health of the Republic of Kazakhstan. The study includes patients from June 30, 2020 to October 31, 2021 who received outpatient and inpatient treatment for coronavirus infection in medical institutions of the Pavlodar region. Study materials - uploading reports from the Republican Center for e-Health of the Ministry of Health of the Republic of Kazakhstan. Results: This article presents epidemiological data on the incidence of coronavirus infection in the population of Pavlodar region. The number of detected cases of COVID-19 from June 30, 2020 to October 31, 2021 was 29,443. Distribution of patients by sex predominated women - 17,831 (60.56%), than men - 11,612 (39.44%). The majority of cases were in the age group from 61 to 70 years old, with a male to female ratio of 1:1.54. Statistical significance was found between duration of stay and type of inpatient care (p < 0.001, VS-MPR*=2.135 x 10+22). Conclusion: The study showed that the number of women who fell ill prevailed over the number of men who fell ill, although the number of deaths among men prevailed over the number of deaths among women. In the study, there was no significant difference in the duration of stay for men and women in home care, compared to patients under 24-hour observation.
ABSTRACT
Purpose of Study: Sickle cell disease (SCD) is a hemoglobinopathy that disproportionately affects the indigenous Tharu population of Nepal, a marginalized ethnic group concentrated in the Dang district. There are significant global disparities in the prognosis of SCD;in low-income countries, which lack screening and management infrastructure, up to 80% of those born with SCD are undiagnosed and less than half survive beyond 5 years of age. Since 2015, University of British Columbia medical student teams have collaborated with a local community partner, Creating Possibilities (CP), to improve SCD awareness, screening, diagnosis, and management for the Tharu population in and around Dang. Community members with SCD have previously expressed numerous challenges in obtaining treatment once diagnosed. This study aims to better understand difficulties in accessing SCD care for this community. Methods Used: The Access to SCD Care Questionnaire was developed from items in existing scales, deductive and inductive item generation, and feedback from expert local partners to ensure it is culturally appropriate, needs-specific, and easily understandable. The questionnaire includes closed-ended questions using a Likert scale and open-ended interview prompts. It centers around five core themes: personal beliefs, community attitudes, finances, transportation, and medical infrastructure. Interviews were conducted in Tharu (local dialect) by CP staff members in January to March 2022. Themes and sub-themes were qualitatively analyzed. Summary of Results: Participants aged from 14 to 42 with an equal sex ratio, a total of 12 interviews were conducted before study saturation was reached. All participants reported at least one minor or major problem with access to SCD care in each of the five core themes of the questionnaire. Inadequate healthcare infrastructure was the most frequently reported barrier, with participants reporting lack of local medication accessibility and low supplies at further district hospitals. Additionally, despite government funding for treatment coverage, participants reported difficulties obtaining the necessary legal documents to prove eligibility. The second largest perceived barrier to care was transportation, which was reported to be costly, time-consuming, and not readily available. Regardless of sub-theme, participants reported that system-wide effects from COVID-19 perpetuated these issues. Conclusion(s): Results from the Access to SCD Care Questionnaire demonstrate that availability and accessibility to medications and transportation services are the primary challenges to receiving SCD care in this indigenous community. Therefore, future interventions for this community should focus on these findings. In contrast with previous literature, community stigma and personal beliefs were not often reported as hindering SCD treatment. This may be attributed to successful education campaigns within this specific community or due to participation bias.
ABSTRACT
OBJECTIVES: Globally, the case fatality ratio is more in males versus females. Some studies have suggested estrogen hormone decreases susceptibility to SARS CoV-2. We have analyzed the observed sex differences in COVID-19 behavior in males and females and the clinical profiles of females of different age groups of COVID-19 patients and discussed their symptoms, laboratory evaluations, and associated comorbidities. MATERIAL AND METHODS: The patients were tested for COVID-19 through real-time RT-PCR (Reverse Transcription Polymerase Chain Reaction) assay. The data obtained were studied for the epidemiological, clinical, and laboratory characteristics from their medical records. RESULTS: The mortality rate in females was 12.33% (36/292) whereas mortality in males was 19.63% (84/428). In between group analysis, 8.7% (14/161) of females died in the <40 years age group versus 16.8% (22/131) in more than 40 years age group whereas in males, the mortality was 13.7% (21/153) in <40 years versus 22.9%(63/275). The mortality rate in women older than 40 years was greater than mortality in younger females emphasizing the protection provided by estrogen hormone in them. The proportion of patients who expired due to COVID-19 significantly differs by age cutoff of 40 years, X2 (1, n=428). The difference is statistically significant at P < 0.05. Males more than 40 years are more likely to expire. CONCLUSION: Sex-related differences in coronavirus pandemic have been found pointing toward the protective role of estrogen hormone and other differences in immunological behavior in males and females. Downregulation of ACE2 expression, thereby reducing viral entry, might also be contributory to decreasing mortality in females.
ABSTRACT
Objective To understand the epidemiological characteristics of COVID-19 in Shaanxi Province from December 9, 2021 to January 20, 2022, and analyze the factors influencing the interval from isolation to diagnosis. Methods We collected the data of local COVID-19 cases from December 9, 2021 to January 20, 2022 published on the official website of Health Commission of Shaanxi Province. Descriptive statistical method was used to analyze the epidemiological characteristics of COVID-19 in Shaanxi Province. Mann-Whitney U test and Kruskal-Wallis H test were used to compare the differences between groups. The unconditional Logistic regression model was applied to analyze the factors influencing the interval between isolation and diagnosis. Results The outbreak of COVID-19 in Shaanxi Province started on December 9, 2021 and ended on January 20, 2022. The overall change trend of the outbreak showed an "inverted V" shape. A total of 2,080 confirmed local cases were reported, and the main type of disease was mild, with an incidence rate of 5.26/100,000. Xi'an had the most cases, accounting for 98. 69% of the total. The reported cases were mainly concentrated in people aged 21 to 55 years old, with a male-to-female sex ratio of 1.19:1. The median interval from isolation to diagnosis was 3 days, the shortest interval being 0 day and the longest interval being 21 days. Unconditional Logistic regression model analysis showed that the way of finding cases was the factor influencing the interval from isolation to diagnosis. Compared with the way of isolation of the key population, the way of the nucleic acid screening could reduce the risk of late detection of confirmed cases by 89% (OR = 0.11, 95% CI: 0. 07 - 0.16). Conclusion The way of finding cases is the factor influencing the interval from isolation to diagnosis. In the face of the recent intensification of the spread of Omicron variant in mainland China, accurate and rapid identification and detection of confirmed cases can not only reduce the risk of the spread of the epidemic, but also endeavor more time and initiative for the treatment of patients, which is the key to curbing the spread of the epidemic.Copyright © 2023 Xi'an Medical University. All rights reserved.
ABSTRACT
Background: Acute sinusitis is not an uncommon disease that manifests with inflammation of the mucosal lining of the paranasal sinuses. It has varied etiologies including viral, bacterial, fungal, and allergic. Anatomical variations, trauma, auto-immunity, diabetes mellitus, and dental procedures are predisposing factors. With the wide variation in the etiological factors, the management could be tricky. This study is quite relevant with the advent of the relentlessly persisting COVID-19 pandemic which affects the upper respiratory tract as well. Method(s): This is a descriptive hospital-based prospective study conducted at the Khartoum ENT Teaching Hospital, Ibnsina Teaching Hospital, Omdurman Military Hospital, and Omdurman Teaching Hospital in Khartoum State in the period from March 2020 to February 2021. The study included all patients 18 years and older diagnosed with acute sinusitis. The data was collected by a well-structured questionnaire designed to meet the objectives of the study and analyzed using SPSS 20. Any COVID-19 suspect is excluded from the study. Result(s): The total number of patients was 109;of them, 59 (54.1%) were females and 50 (45.9%) were males, and the female to male ratio was 1.18:1. One hundred seven (98.2%) patients received medical treatment and two patients (1.8%) did take the medications. Eighty-one patients (74.3%) were cured with medical treatment and only 28 patients (25.7%) needed surgical intervention. The age group from 25 to 40 years old was the most affected, accounting for 68 patients (62.4%), and the above 60 years old (3.7%) was the least affected group. Conclusion(s): Acute sinusitis is not an uncommon disease, if addressed properly and timely is medically treatable in most cases apart from complicated cases. This study shows that the active working ages (25-40) were the most affected. Few patients needed surgery (FESS). Negligence could result in complications. Diseases like COVID-19 affect the upper respiratory tract, and there is a similarity in symptoms, and in the advent of the COVID-19 pandemic nowadays, differentiation is of paramount importance.Copyright © 2022, The Author(s).
ABSTRACT
Objective The objective of this study was to investigate the basic needs of medical staff during the coronavirus disease 2019 pandemic in a fever clinic, so as to provide a reference for the global epidemic medical teams. Methods A semi-structured qualitative interview outline was designed, including: (1) work level: Working hours, working intensity, and safety guarantee in a fever clinic;(2)life level: Diet, sleep, and physical comfort;(3)psychological level: Emotion, pressure, coping style, and interpersonal resources. The basic needs of the first batch of the fever clinic in Peking Union Medical College Hospital was studied by open telephone interviews. Results A total of 37 medical staff were interviewed, including 8 males (21.6%) and 29 females (78.4%). Among them, there were 16 doctors (43.2%), 19 nurses (51.4%), and 2 medical technicians (5.4%). In terms of work settings, the ideal continuous working time was 4-6 hours per shift. There should be pro re nata positions during extremely high workload, and sufficient personal protective equipment was the key to safety. In terms of living conditions, providing meals according to different shifts was important for dietary needs, and sleeping pills were temporarily needed for sleep. In terms of psychological reactions, nervousness and worrying were relatively common. Family and colleagues were important resources of support. Sport could help relieve physical and psychological stress, and psychological support from psychologists was helpful in reducing their negative emotions. Conclusions The basic needs of medical staff should be respected so as to keep the efficacy of their work. We suggest that medical staff can rest after each 4-6 h working shift. Personal protective equipment should be sufficient. Psychological support should be noted in all of them and provided when necessary.Copyright © 2021, Peking Union Medical College Hospital. All rights reserved.
ABSTRACT
Introduction (contexte de la recherche): Although the SARS-CoV-2 vaccines have undergone preclinical tests and clinical trials evaluating their efficacy and safety, few data have been reported in the post-licensure real-world setting. Objectif: We aimed to assess the safety of COVID-19 vaccines among a Tunisian Pharmacovigilance database. Methodes: An exhaustive observational study including all adverse events following COVID-19 vaccination notified to the pharmacovigilance unit of the Monastir Hospital. Resultats: A total of 336 events were collected. The patients' sex ratio was 1.4. Elderly patients (>= 65-years-old) represented 54% of cases. The most common adverse reaction was fatigue and fever (30%, respectively), followed by headache (21%), muscle soreness (15%) and localized pain at the injection site (13%). Skin eruptions accounted for 14% of the reported events and anaphylaxis was noted in 0.6% of cases. The most reported events were mild. However, 15 patients developed serious events [anaphylaxis (seven cases), thrombotic reactions (seven cases), and thrombocytopenia (one case)]. The event was fatal in five patients. Pfizer-BioNTech vaccine was implicated in 65% of reported events, followed by AstraZeneca vaccine (11%). Pfizer-BioNTech vaccine was implicated in 9/15 serious events. Fatal events were observed with Pfizer-BioNTech vaccine in three cases, and AstraZeneca and CoronaVac vaccines in one case each. Conclusion(s): Our study implies that the COVID-19 vaccines have a favorable safety profile due to the low incidence of self-reported adverse reactions. Further large-scale studies are needed to confirm the safety of COVID-19 vaccines.Copyright © 2023
ABSTRACT
Background: Although the SARS-CoV- 2 vaccines have undergone preclinical tests and clinical trials evaluating their efficacy and safety, few data have been reported in the post-licensure real-world setting. We aimed to assess the safety of Covid-19 vaccines among a Tunisian Pharmacovigilance database. Method(s): An exhaustive observational study including all adverse events following Covid-19 vaccination notified to the pharmacovigilance unit of the Monastir Hospital from April to December 2021. Result(s): A total of 336 events were collected. The patients' sex ratio was 1.4. Elderly patients (>=65 years old) represented 54% of cases. The most common adverse reaction was fatigue and fever (30%, respectively), followed by headache (21%), muscle soreness (15%) and localized pain at the injection site (13%). Skin eruptions accounted for 14% of the reported events and anaphylaxis was noted in 0.6% of cases. The most reported events were mild. However, 15 patients developed serious events (anaphylaxis (seven cases), (thrombotic reactions (seven cases), and thrombocytopenia (one case)). The event was fatal in five patients. Pfizer-BioNTech vaccine was implicated in 65% of reported events, followed by AstraZeneca vaccine (11%). Pfizer-BioNTech vaccine was implicated in 9/15 serious events. Fatal events were observed with Pfizer-BioNTech vaccine in three cases, and AstraZeneca and CoronaVac vaccines in one case each. Conclusion(s): Our study implies that the Covid-19 vaccines have a favorable safety profile due to the low incidence of self-reported adverse reactions. Further large-scale studies are needed to confirm the safety of Covid-19 vaccines.
ABSTRACT
Background: Coronavirus disease-2019 (COVID-19) has caused a pandemic that has recently affected every aspect of life. Fortunately, many vaccines with high safety and efficacy profiles were developed timely to face this pandemic. In a very short time, billions of people were vaccinated. In the meantime, a wide range of neurological syndromes are being reported. Guillain-Barre syndrome (GBS) which is a rare immune-mediated post-infectious peripheral neuropathy was reported after both the COVID-19 infection itself and many types of its vaccines. Method(s): We are reporting a case of post-AstraZeneca vaccine GBS and reviewing the literature of all reported post-COVID-19 vaccines GBS till July 2021. Result(s): 29 adult patients were reported. Of them 58.6% were males. Their mean age is 58.2 years. The median time to clinical onset after vaccine administration was 13.2 days. 86.2% of patients had their symptoms following immunization with the 1st dose of AstraZeneca vector-based covid vaccine. Facial palsy was the most predominant single symptom in 75.8% of patients. Conclusion(s): Guillain-Barre syndrome is a well-recognized but still rare adverse event following vaccination against COVID-19. Although preliminary data incriminates viral vector-based vaccines more than the other types, active post-vaccination surveillance and more powerful statistics are mandatory to reach a solid conclusion regarding the presence of a causal relation.Copyright © 2022
ABSTRACT
Objective: To study the clinical characteristics of diabetes mellitus with Coronavirus disease 2019 (COVID-19) and explore the possible mechanism of diabetes predisposition. Method(s): A single center, retrospective and observational study was used to collect 48 inpatients diagnosed with COVID-19 who were admitted to the first ward of the third department of infection, Raytheon hospital, Wuhan from February 23, 2020 to March 30, 2020. Demographic data, symptoms, laboratory tests, comorbidities, treatments and clinical outcomes have been collected. The patients were divided into non-diabetic group and diabetic group according to the combination of diabetes. The clinical data and laboratory test results of the two groups were observed, and the t test, non-parametric test and Chi square test were used for comparison. Result(s): All the 5 patients with COVID-19 diabetes mellitus had fever and respiratory symptoms, chest CT was consistent with typical COVID-19 imaging features, and novel coronavirus nucleic acid test results were positive. There were no statistically significant differences in age, gender composition, co-existing diseases, clinical symptoms, clinical typing, disease course and treatment plan between the diabetic group and the non-diabetic group (P>0.05).There was a statistically significant difference in fasting blood glucose between the non-diabetic group and the diabetic group (P<0.05).The difference of fasting blood glucose at discharge from the diabetes group compared with that at admission was also statistically significant (P<0.05).There was no statistically significant difference between the two groups in other laboratory examination indexes (P>0.05). Conclusion(s): COVID-19 patients with diabetes are mainly manifested by fever and respiratory symptoms.Chest CT shows typical COVID-19 imaging features.Copyright © 2020 by the Chinese Medical Association.
ABSTRACT
In the period April 24, 2020 - December 31, 2021 at Saint Andrew's County Emergency Clinical Hospital's Molecular Biology Laboratory were performed 2856 RT-PCR tests on childrens. This method consists of two steps: extraction and amplification. RT-PCR is the golden standard to diagnose infection with Covid-19. The tests were performed on patients of both genders and under 18 years old. Statistics show that both male and female patients were affected by Sars-Cov-2 in relatively equal proportions: in the first year (male 46% and female 54%), followed by the next year (male 48% and female 52%). The results concluding, that during the study, in 2020, 6.98% of the total number of tests came out positive, 92.32% came out negative, 0.70% inconclusive. In 2021, 4.21% of the total number of tests came out positive, 95.56% came out negative, 0.23% inconclusive. This study highlights the situation of Covid-19 cases encountered at childrens from the Pediatric section diagnosed in Constanta, Romania.Copyright © 2022 Ramona-Anca Sterian et al., published by Sciendo.
ABSTRACT
Background: COVID-19 is the most important health problem in the world nowadays. Since the publication of the first cases, the symptoms have become more numerous. Anosmia has been recently recognized as a frequent and relevant symptom for the detection of COVID-19, especially in pauci-symptomatic forms. Objective(s): To determine the prevalence of anosmia in health care workers affected by SARS-COV2 and to identify its associated factors. Method(s): This is a cross-sectional analytical study, carried out over a six-month period, which included all healthcare workers of Farhat Hached Academic Hospital of Sousse, Tunisia, affected by SARS-COV2 and confirmed by polymerase chain reaction or antigen rapid test. Result(s): A total of 474 healthcare workers were enrolled with a mean age of 41.02+/-10.67 years and a sex ratio of 0.2. The gynecology department was the most represented one (13.9%). Nurses were the most affected (31.4%). Hospitalization was required for 16 patients (3.4%). The average time of work was 17.04 +/- 11.6 days. Anosmia persisted for more than 90 days in 35 patients (7.4%). After multiple binary logistic regression, anosmia was statistically associated with female gender (p = 0.001;ORIC95%:2.46 [1.4-4.2]) and blue-collar occupational category (p = 0.002;ORIC95%:3.1 [1.5-6.5]). A significant association was also noted between the presence of anosmia and professional seniority (p = 0.019;OR IC95%: 0.97 [0.95-0.99]) and the duration of work (p = 0.03;OR IC95%: 0.97 [0.95-0.99]). Conclusion(s): Although anosmia seems to be frequent in COVID-19 patients, there is still not enough evidence to affirm that it is a strong predictor of the diagnosis of COVID-19.
ABSTRACT
Background: Since the emergence of SARS-CoV- 2 in China, health care workers have been identified as being at risk of contracting Covid-19. Objective(s): To describe the exposure situations of healthcare workers affected by SARS-CoV- 2. Method(s): A questionnaire was established and filled in by healthcare workers practicing at the Sahloul University Hospital of Sousse-Tunisia, who were diagnosed with COVID-19 during the period from September 1, 2020 to December 31, 2020. Data were collected on activity, type of tasks performed, wearing of protective equipment, and existence of possible contacts with cases (professional or extra-professional), in the 2 weeks preceding the date of symptom onset. Result(s): A total of 188/287 infected healthcare workers responded to the questionnaire. The gender and age distribution of the respondents showed a sex ratio of 0.34 and an average age of 41 years. Paramedical staff represented 63% of the participants. Among the infected caregivers, 16 (8.5%) had not worked during the 15 days preceding the symptoms. There were 69 (36.7%) professionals who worked in the Covid sector. The rate of use of a FFP2 mask for the most risky tasks varied greatly according to the sector of practice. Concerning hydro-alcoholic solutions, 58.5% of the workers stated that they had them as often as necessary. Other exposure situations outside of direct patient care were reported by these infected workers: 20.4% reported at least one contact without a mask with one or more caregivers with a confirmed Covid-19 infection, and 32.4% reported contacts with suspected or confirmed cases of Covid-19 infection outside of their professional activity. Conclusion(s): The context of contamination of healthcare workers seems to be essentially professional. The nonuse of protective masks, particularly in non-COVID sectors, as well as the role of contamination between caregivers at their workplace seem to be important determinants of healthcare workers' contamination.
ABSTRACT
Introduction: Despite considerable developments made in the representation of women in cardiology (WIC) recently, there still remain substantial disparities in the representation of women participants in clinical trials, as well as women physicians and scientists in clinical trial leadership. Under-representation of women in Randomized Clinical Trials (RCTs) remains the bane of the modern medicine, impeding the development of sexspecific guidelines in cardiovascular diseases. Female leadership in clinical trials has been shown to enhance the inclusion of women as trial participants. Furthermore, while the COVID-19 pandemic has impacted women in academia, there is no data thus far reporting the impact of the pandemic in terms of presenters and leadership of late-breaking clinical trials (LBCT) in cardiology during this period. Purpose(s): We aimed to determine inclusion of WIC in LBCTs leadership and their correlation to inclusion of women in reported RCTs. Method(s): In our comprehensive analysis, we included all LBCTs presented at major international cardiovascular meetings reported over the period of January 2020 to February 2022. Data were derived from the original presentation at the meeting and/or simultaneous/ subsequent publication of manuscript. Sex of the presenter (woman or man), was assessed by either original videos of the presentation at the meeting, or based on pronoun use in the biographies derived from institutional profiles. The presence or absence of reporting of sex distribution of study participants were also recorded from original presentation at the meeting and/or published manuscript. Proportion of women included in each trial was sourced from either original publication or calculated from any similar data shown during the presentations. Result(s): A total of 400 of RCTs from 19 meetings were included with a total of 400 presenters/principal investigators recorded - 32 (8%) women and 368 (92%) men. There were no significant differences between 2020 and 2021 [15 (7.2%) women in 2021 vs. 17 (19.3%) in 2020 (P=0.446)]. Proportions of women included in RCTs with WIC (37.3%) vs. non-WIC (38.7%) presenters were comparable (p=0.559), while 45% of RCTs didn't report sex distribution of participants. Except for 2 meetings (CRT 2020 and 2022), all others were virtual. Conclusion(s): WIC representation as RCTs presenters was significantly low, despite the opportunity of virtual attendance afforded during the COVID-19 pandemic. Modest inclusion of women irrespective of sex of RCT leadership emphasizes multi-level problems that require more actionable solutions: I.e. implicit bias training started as early as medical school, continuing education on necessity for diversity, equity and inclusion, patient and public involvement, and comprehensive guidance on trial design, such that future RCT participants reflect the populations intended to treat. (Figure Presented).