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Objectives: This study aimed to estimate the direct medical costs of patients with post COVID-19 condition in a Colombian insurance company with more than 2.5 million affiliates. Method(s): We conducted a bottom-up cost-of-illness study of adults with persistent symptoms after at least three months of hospital discharge due to COVID-19. We surveyed patients that were hospitalized between March 2020 and August 2021. We asked about healthcare resource utilization (HCRU), which included laboratories and images, medications, consults, rehospitalizations, and others, associated with post COVID-19 condition. The answers were verified using the company's outpatient and inpatient service authorization records. Costs were estimated from the third payer perspective and expressed in American dollars using an exchange rate of 1USD$=3,743COP. Result(s): We included 202 participants, 51.5% were male, mean age of 55.6 years old, 49% had a comorbidity (41.9% hypertension), and 46 patients (22.8%) required an intensive care unit. A total of 159 (78.7%) patients reported at least one symptom after discharge. Of these, 132 (65.3%) persisted with at least one symptom during the telephone survey. Seventy-five (47.2%) of the 159 patients with persistent symptoms reported HCRU. Of these, 93.3% consulted a physician (mean consultations: 2.1 SD 1.1;mean consultations with specialists: 2.4 SD 2.0), and 9.3% were re-hospitalized. The average direct medical costs of post COVID-19 condition were US$824 (95%CI 195-1,454). Costs in outpatient were US$373 (95%CI 158-588), and in inpatient, US$3,285 (95%CI -167-6,738). Conclusion(s): It is crucial to follow up and identify patients discharged from the hospital who persist with symptoms after three months since we observed a greater HCRU, including prolonged recovery therapiesCopyright © 2023
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Background: The Early Youth Engagement (EYE) project co-developed the first engagement-focussed intervention derived from the perspectives of young people and their families in Early Intervention in Psychosis services. Patient and Public Involvement (PPI) in the EYE-2 study aimed to ensure that the voices of people experiencing first episode psychosis, and carers, were embedded in the refinement, delivery and evaluation of the Early Youth Engagement (EYE-2) approach across the UK. Method(s): The EYE-2 project used a multi-level PPI approach: Each of five sites had a PPI lead, trained and supported by senior PPI researchers. PPI leads convened local Lived Experience Advisory Panels (LEAPs), and co-delivered staff and researcher training. Practical challenges were identified and resolved. Results and Impacts: Tangible PPI impacts included: the co-produced revised booklets and EYE-2 website https://www.likemind.nhs.uk following workshops of over 40 people;the delivery of on average 52 peer-led intervention social groups at each site, allowing people to connect with peers with lived experience and build a sense of optimism, shared identity, interpersonal skills and problem-solving in a social environment, with activities driven by service users. Written outcomes included a PPI-led booklet on running peer-led social groups, a person-centred telephone interview for the HoNOS questionnaire for use during the Covid-19 pandemic, peer reviewed papers, blogs and video logs. Conclusion(s): PPI was integral to the delivery of the EYE-2 study;the multi-level approach facilitated a diversity of voices across different aspects of the study and ensured that people with lived experience shaped the intervention, research design and implementation.
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This review was carried out with the objective to study patterns of neurological, psychological and other physical consequences of COVID-19 in the long term. The guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews and Metaanalyses) had been followed;22 articles, published during January 2020 to September 2021, were selected. Original research, review articles, editorial and viewpoints were included. Google Scholar, Medline, and PubMed were searched through 2020 till 2021.Data collection in selected studies was performed mainly through the online survey, telephone survey, use of medical records, and patient interviews. This systematic review contains the studies conducted in the American, Asian and European countries. The major outcomes identified were the neurological, psychological, and other long-term chronic manifestations of COVID- 19. This review demonstrates that long-COVID has started to bring a huge wave of patients, the count of them being millions now, who can enter a phase of disability due to neurological damages if not treated during the early course of illness. Though more disabling than lethal, long-COVID patients with a neurological deficit is expected to overburden the healthcare system globally which is already been struggling to handle acute COVID-19 patients in this once-in-a-lifetime pandemic.Copyright © 2023 Lahore Medical And Dental College. All rights reserved.
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Background: COVID-19 pandemic has caused limitations, in patients' accessibility in clinical and research settings. We sought whether telenutrition could be applied interchangeably with face-to-face interview for dietary intake assessment by 24-hour recall in patients with type 2 diabetes mellitus (T2DM) during the COVID-19 pandemic. Method(s): Sixty-eight females with T2DM aged 50-55 years were enrolled randomly in a descriptive-analytic cross-sectional study. The patients completed three consecutive 24-hour dietary recalls. The first one was a face-to-face interview, and the subsequent two recalls were conducted by telephone call. The total energy and 18 selected nutrients intake were calculated for the three interviews. Result(s): The mean (+/- SD) age of participants was 53.97 +/- 2.14 years. The face-to-face interview resulted in significantly higher total energy and 18 selected nutrients intake than the two telenutrition interviews (P value range: 0.031-0.001). No significant differences were found between the data provided from the two telenutrition interviews. Conclusion(s): Telenutrition underreports and underestimates the total energy and nutrient intakes compared with the face-to-face interview in the 24-hour dietary recall. Therefore, it cannot be recommended to be applied interchangeably with a face-to-face interview for dietary intake assessment during the COVID-19 pandemic, especially in patients whose nutrition assessment is of clinical importance. A combination of the two methods using new communication applications (e.g. WhatsApp) may cover the defects of telenutrition method.Copyright © 2023, Kerman University of Medical Sciences. All rights reserved.
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Objective To investigate COVID-19 vaccination status and relevant adverse reactions in patients with psoriasis treated with biological agents, and to explore the effect of COVID-19 vaccination on psoriatic lesions. Methods Clinical data were collected from 572 psoriasis patients aged 18-60 years, who were registered in the management system of psoriasis patients treated with biological agents in the University of Hong Kong-Shenzhen Hospital from May 2019 to June 2021. The COVID-19 vaccination status was investigated by telephone interviews, and the vaccination-related information was obtained by fixed healthcare workers during a fixed time period according to a predesigned questionnaire. Measurement data were compared between two groups by using t test, and enumeration data were compared by using chi- square test or Fisher's exact test. Results The COVID-19 vaccination coverage rate was 43.13%226 casesamong the 524 patients who completed the telephone interview, and was significantly lower in the biological agent treatment group30.79%, 105/341than in the traditional drug treatment group66.12%, 121/183;chi2 = 60.60, P < 0.001. The main reason for not being vaccinated was patients' fear of vaccine safety49.66%, 148/298, followed by doctors' not recommending26.51%, 79/298. In the biological agent treatment group after vaccination, the exacerbation of psoriatic lesions was more common in patients receiving prolonged-interval treatment42.86%, 6/14compared with those receiving regular treatment 4.40%, 4/91;Fisher's exact test, P < 0.001. Skin lesions were severely aggravated in two patients after COVID-19 vaccination, who ever experienced allergic reactions and whose skin lesions did not completely subside after the treatment with biological agents. Conclusions The COVID-19 vaccination coverage rate was relatively low in the psoriasis patients treated with biological agents, and no serious adverse reaction was observed after vaccination. Prolonged-interval treatment due to COVID-19 vaccination ran the risk of exacerbation of skin lesions.Copyright © The Author(s) 2023.
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Introduction: ICU-acquired weakness (ICUAW) is a long-recognised phenomenon, featuring a prevalence of 25-80%. Early mobilisation is anaccepted intervention that may attenuate ICUAW and improve outcomes [1, 2]. Method(s): Prospective observational study in polyvalent ICU analysing the effect of early rehabilitation (eRHB) on quality of life one year after discharge (D/C).Patients who required invasive mechanical ventilation > 24 h and survived SARS-CoV2 respiratory infection between 5/3/2020 and 12/01/2022 were included. Patients were classified into two groups: eRHB or not eRHB. Demographic and clinical data were collected, and a telephone survey was conducted one year after D/C. Clinical Frailty Scale at ICU admission (T1) and one year after D/C (T5);Medical Research Council (MRC) at the start of rehabilitation (T2) and hospital D/C (T4);Barthel Index at ICU D/C (T3), T4 and T5;and the SF-36 health questionnaire at T5 were also collected. Statistical analysis was performed between subgroups: Pearson's Chi-square test or Mann-Whitney U test to find significant differences. ART-ANOVA was used to analyse the survey results. Result(s): Of 99 patients, 64.6% belonged to the eRHB group. There were no statistically significant differences in the analysis of clinicdemographic variables. We observed a significant improvement of the MRC, a better Barthel Index in the eRHB group, and a statistically significant positive impact on several components of the SF-36 in the eRHB group (physical functioning, vitality, social functioning, bodily pain, general health, and self-reported health transition). Conclusion(s): Patients who received eRHB had better physical functioning and higher vitality recovery. In addition, they suffered less impact on their social life, had better pain control, and reported improved general health. All this emphasises the need for eRHB protocols in the ICU, promoting multidisciplinary care of our patients.
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BACKGROUND: There are few data on the outcome of COVID-19 in patients with IBD, none in the Chilean population. The aim of the study was to describe the demographic and clinical characteristics of patients with IBD who developed COVID-19, the evolution and clinical course of IBD at 1 month follow-up after SARS-CoV-2 infection. METHOD(S): This was an observational, cross-sectional, and analytical study. Patients with positive RT-PCR SARS-Cov-2 who were followed in the IBD Program of Clinica las Condes tertiary referral center (n = 1,493), were studied by spontaneous patient consultation and/or email survey. The clinical IBD data and COVID-19 related symptoms were obtained from the medical record and follow-up telephone interviews. Statistical significance was determined (Fisher's test P < 0.05). RESULT(S): From March 1 to August 31, 2020, 32 patients were reported positive RT-PCR SARSCov- 2, 18 (56%) ulcerative colitis and 14 (44%) Crohn's disease. The median age was 32 years (range 18 - 69), 56% women. Seven patients had an additional comorbidities. At the time of infection, 9 patients and their co-habitants maintained quarantine, isolation and social distancing recommendations. Only 1 patient was clinically active at the time of infection. Ten patients (31%) were on immunomodulator/biologic maintenance treatment, of which 4 were on combination therapy. Sixty percent of patients contacted the IBD clinical team when RT-PCR SARS-Cov-2 resulted positive. The most frequent COVID-19 onset symptoms were headache (66%), myalgia (63%), and fever (50%). Four patients required hospitalization (no 1 in Critical Care Unit), none of them were on immunomodulator nor biologic treatment. Two patients received Azithromycin and 1 received steroids as treatment for COVID-19. In univariate analysis, there were no significant differences in age, diagnosis or IBD treatment in patients who required hospitalization for COVID-19 infection. Seven patients discontinued their IBD treatment during the infection (6 at the direction of the IBD Program and 1 self-discontinued therapy). Two patients had a flare of their IBD during 1 month post-COVID-19 follow-up. CONCLUSION(S): In this cohort of patients, IBD medications, including immunomodulators and biologic therapy, were not associated with a greater severity of COVID-19 infection.
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INTRODUCTION AND OBJECTIVE: The Certified Curriculum of ERUS (CC-ERUS) fellowship on robot-assisted radical prostatectomy (RARP) is almost 10 years old. To complete the CCERUS outcome-based fellowship, a video of a full RARP performed by the fellow must be assessed by an expert. The aim of the current study was to 1) understand and report the completion rate of the fellowship (i.e. achievement of the Certificate of Excellence award) and 2) identify reasons for non-completion. METHOD(S): The CC-ERUS is a 6 months structured training program that includes an eLearning part, followed by one-week robotic skills course;then, trainees have 6 months of modular training at a host center. At the end of the fellowship, trainees are requested to submit a video of a full RARP performed by themselves. The video is objectively assessed by experts and, in case of positive assessment, the fellowship is completed and the fellow can receive the Certificate of Excellence. We analysed our prospectively collected data on all CC-ERUS fellows. We then conducted a telephone survey on 2018-2021 CC-ERUS fellows to investigate the reasons for noncompletion. Standardized interview format questions were used to conduct the survey. RESULT(S): Data on 87 subjects enrolled in the fellowship between were collated. While all subjects successfully completed the 1-wk robotic skills course, only 26 (30%) fellows achieved the certificate of excellence. The completion rate by year was 20% in 2018, 29% in 2019, 36.4% in 2020, and 31.4% in 2021. Therefore, the COVID-19 pandemic had only a modest impact on completion rate. The response rate to the telephone interview survey was 77%. The following reasons for non-completion emerged: insufficient console exposure (49%), insufficient fellowship duration (20%), COVID-19 pandemic (11%), logistic difficulties in submitting the video (20%). CONCLUSION(S): The CC-ERUS for RARP was the first validated robotic curriculum in the world, and still one of the very few outcome-based fellowships. Nonetheless, we observed a low completion rate that needs to be addressed with appropriate actions. To increase the fellowship completion rate, three solutions should be considered by the ERUS board: 1. Review of the Host Centers, to exclude those which do not meet the certification criteria (e.g. insufficient console time for fellows) 2. Periodical Train-The-Trainers courses for the mentors at host centers 3. Follow-up procedural diary: the fellows will be requested to submit videos of each phase while progressing in their modular training and self-assess their performance using validated RARP metrics.
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Objective: Government of India (GOI) has allowed vaccination for age group of 15-18 y. It is a positive step toward boosting immunization rates across the nation. As per guidelines, BBV152 vaccine, Bharat Biotech's "Covaxin" is approved for adolescents. The study was designed to evaluate adverse events following immunization (AEFI) among adolescents. Method(s): A prospective, observational survey was carried out among the first 315 beneficiaries (adolescents of age 15-18 y) for a period of 5 mo at Osmania medical college and hospitals. Within 24 h, 48-72 h, and two weeks following the first and second doses of Covaxin, active and passive surveillance using telephonic inquiry and documentation relating to adverse events was conducted. The prevalence of AEFI and its association with demographic factors have been identified. Collected data were analyzed using SPSS 25. Result(s): The first 315 beneficiaries (Adolescents between the ages of 15 and 18) who received Covaxin were identified. All AEFIs reported were within the first 24-72 h of vaccination. AEFI incidence was higher in 1st dose (16.6%) when compared to 2nd dose (3.5%). No AEFIs were noted after 2 w. We found no association of AEFI with sex, age group, and past history of Covid as this finding is not significant (p>0.05). Conclusion(s): Overall, Covaxin has a good safety profile in adolescents. Symptoms were transient and of low intensity. There were no documented severe and serious AEFI. It is obligatory for documentation as the AEFI profile will encourage vaccine adoption and lessen reluctance.Copyright © 2023 The Authors. Published by Innovare Academic Sciences Pvt Ltd.
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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.
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Background: Nurses who are occupied in emergency departments play a critical role in health services provision and patient care. Considering the importance of providing appropriate and immediate care in emergency departments, nurses need to acquire sufficient skills and up-to-date knowledge. Objective(s): This study aimed to identify the educational needs of nurses working in the emergency department and explore strategies to meet challenges against the elimination of these needs. Method(s): This qualitative study was conducted using a content analysis approach. This study selected the emergency departments of two large educational hospitals affiliated with Shiraz University of Medical Sciences, Shiraz, southern Iran. This study was conducted on 15 emergency department nurses selected via purposive sampling with maximum variation within January 2020 and March 2021.The data were collected by performing 15 in-depth, semi-structured interviews (11 face-to-face and 4 telephone interviews due to the coronavirus disease 2019 pandemic) and making field notes. Then, the recorded interviews were transcribed verbatim and analyzed using the qualitative content analysis approach proposed by Graneheim and Lundman. The consolidated criteria for reporting qualitative studies (COREQ) was used to report the findings of this study. Result(s): Three main themes, namely the need for comprehensive and continuous education, challenges of managing educational needs, and strategies to meet educational needs, were extracted following data analysis. Conclusion(s): Clarifying the educational needs of nurses and exploring strategies to solve these challenges can be effective by providing continuous practical training and adopting effective teaching-learning strategies to promote nurses' education and improve their performance in clinical skills. Accordingly, the provision of appropriate infrastructure for mobile health applications and utilization of mobile-based educational applications in emergency departments have to be taken into account by hospital managers and health policymakers.Copyright © 2023, Author(s).
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Background: Hospitals worldwide implemented visitor restrictions policies due to the SARS-CoV-2 pandemic. Aim: To investigate the impact of visitor restrictions experienced by non-Covid-19 orthopaedic patients, their relatives, and health professionals from a person-centred practice (PCP) perspective. Methods: Seventy-eight patients/relatives completed a self-reported survey. Template Analysis was conducted on twenty-five telephone interviews and one focus group interview. Findings: Despite accepting the restrictions for the country's good, we found a profound need for visits among the relatives. However, one-fifth of the patients were content, and one-third got more rest than earlier admissions. We uncovered a current readiness to develop an organisational PCP culture focused on the good of the patient. All stakeholders were attentive to the importance of the relatives' role, and the need for the involvement of relatives as team players became evident. Conclusion: The study emphasised the need for PCP strategies to involve relatives when visitor restrictions are necessary.
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Objective To investigate COVID-19 vaccination status and relevant adverse reactions in patients with psoriasis treated with biological agents, and to explore the effect of COVID-19 vaccination on psoriatic lesions. Methods Clinical data were collected from 572 psoriasis patients aged 18-60 years, who were registered in the management system of psoriasis patients treated with biological agents in the University of Hong Kong-Shenzhen Hospital from May 2019 to June 2021. The COVID-19 vaccination status was investigated by telephone interviews, and the vaccination-related information was obtained by fixed healthcare workers during a fixed time period according to a predesigned questionnaire. Measurement data were compared between two groups by using t test, and enumeration data were compared by using chi- square test or Fisher's exact test. Results The COVID-19 vaccination coverage rate was 43.13%(226 cases)among the 524 patients who completed the telephone interview, and was significantly lower in the biological agent treatment group(30.79%, 105/341)than in the traditional drug treatment group(66.12%, 121/183;chi2 = 60.60, P < 0.001). The main reason for not being vaccinated was patients' fear of vaccine safety(49.66%, 148/298), followed by doctors' not recommending(26.51%, 79/298). In the biological agent treatment group after vaccination, the exacerbation of psoriatic lesions was more common in patients receiving prolonged-interval treatment(42.86%, 6/14)compared with those receiving regular treatment (4.40%, 4/91;Fisher's exact test, P < 0.001). Skin lesions were severely aggravated in two patients after COVID-19 vaccination, who ever experienced allergic reactions and whose skin lesions did not completely subside after the treatment with biological agents. Conclusions The COVID-19 vaccination coverage rate was relatively low in the psoriasis patients treated with biological agents, and no serious adverse reaction was observed after vaccination. Prolonged-interval treatment due to COVID-19 vaccination ran the risk of exacerbation of skin lesions.Copyright © The Author(s) 2023.
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Background: Little is known about the course of COVID-19 in patients with severe asthma/chronic spontaneous urticaria (CSU) using biological agents. To assess the incidence and course of COVID-19 in patients with severe asthma/CSU using biological agents Method: A total of 202 patients (142 with asthma, 60 with CSU) were enrolled. The subjects were questioned via face-to- face or telephone interview whether they had been diagnosed with COVID-19 and the course of the disease. Result(s): Study group consisted of 132 women, 70 men (median age: 48 years). Thirty-one (15.3%) patients were diagnosed with COVID-19, 22 (71%) of whom were receiving omalizumab and 9 (29%) were receiving mepolizumab. Diagnosed with asthma or CSU, age, sex, smoking, weight, comorbidities, atopy and receiving biological agent were not statistically different between patients with or without COVID-19. Nine COVID -19 patients were hospitalised, three of them required intensive care. Mepolizumab usage was higher in hospitalised patients (5, 55.6%), whereas omalizumab usage was higher in home-treated patients (18, 81%). The mean duration of biologicals usage in home treated patients was significantly higher than that of the hospitalised patients (35.64 months vs.22.56 months, p = 0.024). Biological treatments were interrupted in 47 (23%) patients, self-interruption due to the infection risk was the foremost reason (34%) while having COVID-19 took the next place (28%). Conclusion(s): The incidence of COVID-19 among patients with asthma and CSU on mepolizumab and omalizumab was higher compared to studies from other countries. The disease course appeared mild in patients receiving long-term biological therapy.
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Introduction: The utilization of health services is an opportunity for using health services by the needy. Since COVID-19 can have significant effects on all life dimensions, including the utilization patterns, especially in patients with non-communicable diseases (NCDs), this study aimed to determine and compare the extent of utilizing health services by individuals with and without NCDs in the Shahrekord cohort study before and during the COVID-19 pandemic. Materials and Methods: The present cross-sectional study was conducted on 760 patients of the age group of 35-70 years in the Shahrekord cohort study, which addressed the urban areas of Shahrekord and the rural regions of Ardel city during two separate periods. For all patients, the questionnaire on benefiting from health services was completed. The data was collected using the telephone interview method and then analyzed using SPSS software. Results: The mean and standard deviation of the age was 44.95±8.65 years in the patients without NCDs and 53.38±8.60 years in those with NCDs(p<0.001). The rates of medical service reception in those without common NCDs before and during the corona epidemic were 3.2% and 15.3%, respectively. In those with common NCDs, the rates were 7.1% and 27.1%, respectively (p<0.001). During the coronavirus epidemic, the average duration of receiving service, duration of service, paid fee, and the frequency of receiving service were longer in the participants with chronic NCDs (P<0.001).Conclusion: The reception of medical services and outpatient services in the two groups of patients with and without NCDs during the coronavirus pandemic increased compared to the pre-pandemic period. This point should be considered as a lesson learned from the epidemic by the health system policymakers and planners to lay the grounds for providing care services, especially for chronic patients during epidemics. © 2022, Research Institute for Endocrine Sciences. All rights reserved.
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BACKGROUND: Coronavirus disease 2019 (COVID 19) has emerged as a rapidly spreading communicable disease affecting more than 100 countries across the globe at present and leading cause of mortality worldwide. The current research is an attempt to assess the impact of demographics on morbidity and mortality of COVID 19. METHODOLOGY: This is a Retrospective Study Design, and a survey was conducted from January to June 2021 among COVID 19 patients in and around warangal district, Telangana. RESULTS & DISCUSSION: A total of 1347 respondents were included in this study.The demographic finding that impact COVID 19 are Gender [male (64.7%) and female (35.3%)], Age [15-35years (38%), 16-55years (44.2%), above 55years (17.8%)] and Education [literates (86.9%), Illiterates (13.1%)]. CONCLUSION(S): Demographics such as gender, age, followed by social habits like smoking, alcoholism were found to be major contributing factor for in increasing severity of disease among study population.Copyright © 2022, Anka Publishers. All rights reserved.
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Background: The pandemic of Coronavirus disease 19 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV- 2), has become a global challenge in the last two years. SARS-CoV- 2 enters the cells of the infected subjects through angiotensin converting enzyme 2 (ACE-2), leading to its depletion on cell surface. ACE-2 activity is involved in the catabolism of des-Arg( 9)-bradykinin and increases the expression of angiotensin converting enzyme (ACE) in animal models. ACE in turn inactivates bradykinin. The infection has therefore the potential to cause a deregulation of the contact system and its pro-inflammatory activity, which could also contribute to the pathogenesis of COVID-19. Since bradykinin-mediated angioedema is generally thought to be the result of a poorly regulated contact system, it has been speculated that these patients are prone to severe SARS-CoV- 2 infection and that COVID-19 can in turn elicit angioedema attacks. We examined these hypotheses in a large group of bradykinin-mediated angioedema patients. Method(s): W e c onducted a m ulticenter r etrospective s tudy t argeting all the patients with hereditary angioedema (HAE) or acquired angioedema due to C1 inhibitor deficiency followed up by the centers of the Italian Network for Hereditary and Acquired Angioedema (ITACA). All accessible patients underwent a telephone interview between January 1st and March 31st 2021;we collected data about demographic and angioedema features, the occurrence of SARS-CoV- 2 positivity and COVID-19 outcomes from the beginning of the pandemic until March 31st 2021. A digital diary of attacks developed by ITACA helped us to collect attacks data. 15 centers participated in the survey. Result(s): 677 patients were included;52/677 reported SARS-CoV- 2 positivity (48 with hereditary and 4 with acquired C1 inhibitor deficiency). The incidence was 7.68% (confidence interval 5,79-9,95%), similar to the general population (6.04%). 4/52 patients (7.7%) reported severe COVID-19;the median disease duration was 15 days. One patient suffered a pulmonary thromboembolism;no deaths were reported. 27/52 patients (51,9%) had angioedema attacks during the infection, with a median of 1 attack per patient;severity of COVID-19 predicted more frequent and more severe angioedema attacks in a multivariate analysis (p < 0.001). Conclusion(s): COVID-19 does not seem more severe in bradykinin-mediated angioedema than in the general population. SARS-CoV- 2 infection can elicit angioedema attacks.
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Background: COVID-19 pandemic is certainly the biggest health challenge in the world today. Since the beginning of this pandemic, the severity of the disease has been associated with chronic diseases such as cardiovascular disease, diabetes and hypertension. Given that asthma is one of the most common chronic diseases of childhood that affects the respiratory system which is the main and important target of COVID-19, it was necessary to study and determine the clinical course and the effect of COVID-19 on different aspects of asthmatic patients' lives. Method(s): In this study, which is a cross-sectional study, patients' information was collected by a questionnaire in the form of a telephone interview with the parents of children with asthma which registered in the database of the Asthma and Allergy Clinic. The sample size of this study included 200 patients with asthma under the age of 18 (129 boys and 71 girls). When collecting patient information, due to the fact that more than 12 months have passed since the onset of the COVID-19 pandemic in Iran, patient information was collected for the first year of the COVID-19 pandemic. Result(s): Among the 200 asthmatic patients studied, 45 patients (22.5%) suspected COVID-19. Of these, 11 patients (24.4% of suspected patients) underwent diagnostic PCR test. Among these tests, the result of 10 tests (90.9% of the total tests) was positive. Also, 101 patients (50.5%), at least one of their parents had COVID-19. 189 patients (94.5%) evaluated their asthma status better than last year and out of 200 patients, only 31 patients (15.5%) were treated for their asthma with the highest share of Salbutamol (96.8%), Montelukast (64.5%) and inhaled corticosteroids (ICS) (54.8%). 41 patients (20.5%) had referred to medical centers at least once in the first year of COVID-19 pandemic, of which 31.7% (13 patients) had an asthma attack. Among the total patients, 20 patients (10%) had received the influenza vaccine in the last year (1399). Patients' ACT score in 159 patients aged 4-11 years with a mean score of 25.55 +/- 2.27 and 40 patients aged 12-18 years with a mean score of 23.28 +/- 3.31 were calculated, which was in the range of well controlled. Average score of parental stress and anxiety (on a scale of 0 to 10), It was 5.93 +/- 2.82. Conclusion(s): The results of this study generally showed an improvement in asthma control status among children with asthma during the first year of COVID-19 pandemic. Despite the improvement in control of asthma in most of the children studied, the presence of stress and anxiety caused by COVID-19 in children and their parents was significant. To reduce it, it is necessary to plan and take preventive actions.
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Background: Cancer(ca) and old age are risk factors for developing severe COVID-19 (C19+) disease, related morbidity and mortality. These patients (pts) were excluded from clinical trials evaluating the safety and efficacy of 3 FDA approved C19 vaccines (vax). Genitourinary (GU) ca-prostate, bladder and kidney ca contribute to the majority of non-skin ca and median age of these pts range from 65-75 yrs. We aimed to study these highly vulnerable pts behavior and outcomes regarding C19 vax in comparison to non-GU ca pts (18-89 years). Method(s): A prospective and observational single center study. Adult ca pts seen in clinics from Nov 2021-Sept 2022 were randomly interviewed using telephone surveys after a verbal consent. Type of ca and therapy data were collected from pts' medical records. The survey included C19 disease status, vax status positive (+) or negative (-), reason for vax status, side effects (s.e), impact on ca Rx or ca progression. Data was entered on REDCap. The primary end point was rate of vaccination in adult ca pts. Secondary end points were to quantify C19 vax acceptance vs. hesitance, identify s.e of C19 vax and effect of C19 vax on outcomes in GU and non-GU Ca pts. Result(s): N=172;GU ca 21 (12.2%) and non-GUca 151 (87.8%). Among GU ca pts- 9 had prostate ca, 7 had bladder ca and 5 had renal ca. C19+ in 4 (19%) GU and 45 (30.2%) non-GU pts. GU pts: 90.5% received C19 vax (Pfizer 47.6%;Moderna 42.9%, J & J 0%);9.5% were not vaxed. Non-GU pts: 85.2% received C19 vax (Pfizer 39.1%;Moderna 43%, J & J 2.6%);14.8% were not vaxed. The top 3 risk factors for serious C19+ were age >65yr (76.2%), heart disease (61.9%) and BMI.30 (42.9%) in GU ca pts and age >65yr (46.4%), BMI.30 (35.1%) and smoking (19.9%) in non-GU ca pts. The top 3 reasons for C19 vax (+) in GU ca pts: protection against C19+ for self (81%), for others (47.6%) and provider recommendation (38.1%). The main reasons for vax hesitancy in C19 vax (-) GU ca pts: concern for allergy to the vax (4.8%) and prior C19 infection (4.8%). The common s.e of C19 vax reported in GU ca pts were injection site inflammation (19%), headache (4.8%), muscle/body aches (4.8%) but no lymphadenopathy. None of GU ca pts reported delay in Rx or progression of the disease due to C-19 vax. Conclusion(s): C19 vax were overall well tolerated and did not impact ca outcomes in pts with GU malignancies. Oncologists should discuss the importance of C19 vax in the context of ca.