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Introduction This study aimed to determine the prevalence of multidrug-resistant Gram-negative bacteria (GNB) from blood cultures in a tertiary-care hospital and the multiplex PCR assay's ability to detect resistance genes. Methods A total of 388 GNB isolates obtained from hospitalized patients between November 2019 and November 2021 were included in the study. Antimicrobial susceptibility testing was done by VITEK 2 system and broth microdilution method. Beta-lactamase-encoding genes were detected by multiplex PCR assays, BioFire-Blood Culture Identification 2 (BCID2) panel (bioMerieux, France). Extended-spectrum beta-lactamases (ESBLs) were detected phenotypically with VITEK AST-GN71 card (bioMerieux, France). The isolates of GNB were classified into multidrug-resistant, extensively-drug-resistant, and pandrug-resistant categories, and their prevalence and distribution in different wards, including coronavirus diseases 2019 (COVID-19) intensive care units (ICU), were calculated. Results Results revealed that all isolates of Acinetobacter baumannii and Pseudomonas aeruginosa were multidrug-resistant as well as 91.6% of Enterobacter cloacae, 80.6% of Proteus mirabilis, and 76.1% of Klebsiella pneumoniae, respectively. In fermentative bacteria, blaOXA-48-like (58.1%), blaNDM (16.1%), blaKPC (9.7%) and blaVIM (6.5%) genes were detected. More than half of Enterobacter cloacae (58.3%) and Klebsiella pneumoniae (53.7%) produced ESBLs. Among non-fermenters, the blaNDM gene was carried by 55% of Pseudomonas aeruginosa and 19.5% of Acinetobacter baumannii. In the COVID-19 ICU, Acinetobacter baumannii was the most common isolate (86.1%). Conclusions This study revealed high proportions of multidrug-resistant blood isolates and various underlying resistance genes in Gram-negative strains. The BCID2 panel seems to be helpful for the detection of the most prevalent resistance genes of fermentative bacteria.Copyright © GERMS 2022.
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Aim: Although most patients with COVID-19 experience respiratory tract infections, severe reactions to the virus may cause coagulation abnormalities that mimic other systemic coagulopathies associated with severe infections, such as disseminated intravascular coagulation and thrombotic microangiopathy. Fluctuations in platelet markers, which are an indicator of the acute phase response for COVID-19, are of clinical importance. The aim of this study is to evaluate the relationship between disease severity and Platelet Mass Index (MPI) parameters in COVID-19 patients. Material(s) and Method(s): This retrospective observational study was conducted with patients who were diagnosed with COVID-19 in a tertiary hospital. The study was continued with the remaining 280 patients. All laboratory data were scanned retrospectively from patient files and hospital information system. Result(s): A very high positive correlation was found between PMI and PLT. The PMI value in women was significantly higher than in men. It was observed that PMI did not differ significantly in terms of mortality, intubation, CPAP and comorbidity. PMI vs. Pneumonia Ct Severity Score, biochemistry parameters (AST, CRP), hemogram parameters (WBC, HGB, HCT, MCV, LYM, MPV EO) and coagulation factors (aPTT and FIB) at various levels of positive/negative, weak and strong, and significant relationship was found. There was no significant relationship between hormone and D-dimer when compared with PMI. Discussion(s): Although platelet count alone does not provide information about the prognosis of the disease, PMI may guide the clinician as an indicator of lung damage in seriously ill patients.Copyright © 2022, Derman Medical Publishing. All rights reserved.
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Development of the Student Wellbeing Connect (SWBC) service was a response to increased student support needs in the initial stages of the COVID-19 pandemic in 2020. Due to the government-imposed restrictions during the COVID-19 pandemic, students often faced complex psychosocial and wellbeing issues (Dodd et al., 2021). Two years on from its inception, the case management service has become a core component of La Trobe University's Student Health, Wellbeing and Inclusion services responding to the complex and compounding factors that can impact the wellbeing and success of university students. Varying psychosocial needs can underly a student's presentation to a counselling service;thus, the case management service complements the counsellor's role by providing practical-based interventions. The focus of the service on practical issues has provided an alternative support model for students who do not identify as primarily requiring mental health or counselling support. This has opened service provision to a broader cohort of students. Using a multi-disciplinary, strength-based, and person-centred case management approach, students work collaboratively with Wellbeing Coordinators to identify internal and external supports to address their needs through psychosocial assessments and implementation of goal-focused planning. SWBC acts as a safety net within the university setting if/when psychosocial difficulties are impacting the student's experience, academic performance, and wellbeing. This paper will outline the operational and service provision framework for providing case management to tertiary students. © 2023, Australian and New Zealand Student Services Association. All rights reserved.
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Purpose: The aim of this study was to evaluate how prevalent asymptomatic SARS-CoV-2 virus infection (COVID-19) is among patients undergoing ophthalmic surgery at two tertiary referral hospitals. Material(s) and Method(s): This retrospective study included patients without COVID-19 symptoms who underwent preoperative screening using reverse transcription-polymerase chain reaction (RT-PCR) before ophthalmic surgery at the Kocaeli University and Gaziantep University departments of ophthalmology [between September 1, 2020, and December 15, 2020 (group 1);between March 1, 2021, and May 30, 2021 (group 2)]. Patients scheduled for surgery and followed up in the retina, glaucoma, pediatric ophthalmology and strabismus, cataract and refractive surgery, and cornea departments were examined. Result(s): RT-PCR was positive for SARS-CoV-2 in 12 (1.4%) of 840 patients in group 1 and 7 (1.1%) out of 600 patients in group 2. None of the patients were symptomatic of COVID-19. The majority of the patients were scheduled for retina or cataract and refractive surgery in both groups (group 1;retina: 29.2%, cataract and refractive: 57.0%, group-2;retina: 31.3%, cataract and refractive: 54.5%). SARS-CoV-2 RT-PCR testing was positive for seven patients in group 1 (7/245, 2.9%) and five patients in group 2 (5/188, 2.6%) who were scheduled for retinal surgery. Conclusion(s): The necessity, availability, and practicality of COVID-19 RT-PCR testing prior to ophthalmic surgeries varies depending on the protocols of each institution. COVID-19 RT-PCR testing is suggested especially before vitreoretinal surgeries and general anesthesia procedures, because of the difficulty in managing postoperative complications.Copyright © 2023 Gazi Eye Foundation. All rights reserved.
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Background: The 2019 coronavirus disease (COVID-19) outbreak, which was brought on by the SARS-CoV-2 novel coronavirus, has had a significant negative influence on our environment and exposed health-care personnel to a new level of risk. Very few studies have addressed the disturbances in the sleep quality of healthcare workers during COVID-19 pandemic. Aim and Objectives: The primary objective of the study was to examine the sleep quality of frontline healthcare workers during COVID-19 pandemic in a tertiary care center in northern Kerala. Material(s) and Method(s): Healthcare workers belonging to a tertiary care center were invited to participate in the study. An online questionnaire including sociodemographics, Pittsburgh sleep quality index, and Insomnia severity index was used to evaluate sleep disturbances in healthcare workers. Univariate and bivariate analysis of the results were done to identify the predictors of poor sleep quality. Result(s): A total of 250 frontline healthcare workers were enrolled in the study, out of which 243 participants provided usable responses. About 27.6% of health workers showed features of poor sleep quality. The prevalence rate of poor sleep quality was highest among nurses, 55.2% followed by doctors and ambulance drivers, 22.4% and 11.9%, respectively. About 17.7% of the study population had subthreshold insomnia and 1.2% had clinical insomnia of moderate intensity. Conclusion(s): The prevalence of poor sleep quality is high among healthcare workers confronting COVID pandemic. This study emphasizes the need to implement specific protective measures for maintaining the sleep quality and decreasing stress among frontline health care workers during pandemics.Copyright © 2023, Mr Bhawani Singh. All rights reserved.
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Background: The COVID-19 outbreak in 2019 has presented in the form of pneumonia of unknown etiology in Wuhan. The complete clinical profile including the prevalence of different clinical symptoms of COVID-19 infection among Indian patients who develop a severe disease is largely unknown. This study is aimed to provide a detailed clinical characterization of the cohort of patients who visited our institute with signs and symptoms of COVID-19. Material(s) and Method(s): This was for inpatient hospital (inpatient) based prospective cohort study involving 520 COVID-19 patients admitted to the hospital. The adverse outcome included death and mechanical ventilation. Result(s): Total 520 participants enrolled in the study, (6.9%) participants died, (8.3%) participants required ICU and (5.5%) participants required mechanical ventilation. only signs and symptoms suggestive of severe respiratory system involvement or widespread infection were associated with adverse outcomes, T presence of dyspnoea, cyanosis and hypoxia. The most common chronic disease among patients with adverse outcomes were diabetes, hypertension and pre-existing respiratory disease, personal habit both smoking, and alcoholism was also associated with adverse clinical outcome. Conclusion(s): The adverse clinical outcome among COVID-19 patients is determined by several factors including advanced age, multi-morbidities, and the presence of severe respiratory symptoms.Copyright © 2023, Dr Yashwant Research Labs Pvt Ltd. All rights reserved.
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Introduction: The COVID-19 pandemic has imposed a large burden on our global medical systems, particularly in patients that would require emergency surgery. Method(s): This single centre study determined the perioperative outcomes of patients who underwent emergency surgery before and during the COVID-19 pandemic after using a propensity score matching analysis. Result(s): A decrease in the number of emergency surgeries performed during the pandemic was noted at 47.9%. Data showed that severe complications arose more frequently during the pandemic (pvalue<0.05). Furthermore, it arose more frequently in patients who had a concomitant COVID-19 infection. Age was directly proportional to the likelihood of developing of severe postoperative complications (pvalue<0.05). Undergoing cancer surgery and being classified as ASA IV increased the likelihood of developing severe postoperative complications (pvalue<0.05). Preoperative time was a significant factor for patients who underwent trauma and can- cer surgery during the pandemic since it was noted to be directly proportional to the likelihood of developing severe postoperative complications (pvalue<0.05). The mortality rate was significantly pronounced during the pandemic for patients who underwent benign and trauma surgeries (pvalue<0.05). Conclusion(s): Severe complications arose more frequently during the pandemic. Undergoing cancer surgery and being classified as ASA IV increased the likelihood of developing of severe postoperative complications. Age and Preoperative time were noted to be directly proportional to the development of severe postoperative complications particularly in trauma and cancer surgeries. The mortality rate was significantly more pronounced during the pandemic for patients who underwent benign and trauma surgeries especially with longer preoperative time.
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Background: Healthcare workers (HCWs) in India are facing physical and psychological pressure. The pandemic has significant psychological impacts. Hence, we wanted to assess the mental stress and social stress among HCWs during the second wave of COVID-19. Aim and Objectives: Assessment of the mental distress among HCWs of tertiary care level institution during second wave of COVID-19 with the following objectives: (1) To know the sociodemographic characteristics of the HCWs of tertiary care center and (2) to assess the psychological stress among healthcare workers of a tertiary health center. Material(s) and Method(s): It is a cross-sectional and observational study conducted in hospital setting, in a tertiary care setting. Data were collected from 196 HCWs of the institute. Institutional ethical clearance was taken before the study. Structured questionnaire included sociodemographic variables, work-related variables, and variables to assess social stress. We used hospital anxiety and depression scoring questionnaire to assess anxiety and depression. Data were collected through personal interviews and online through Google forms after taking informed consent. Descriptive statistics and Chi-square tests are used analyzed using Statistical Package for the Social Sciences Version 21 for Statistical analysis. Result(s): A total of 196 HCWs, 121 doctors, 74 nursing staff, and one ward staff participated in the study. Nursing staff were at higher risk for anxiety and depression, that is, 29% and 25% than others. Females were slightly more anxious (29%) and depressed (17%) than males. HCWs who are Muslim by religion were at more mental distress. Media exposure of more than 3 h had increased risk of mental distress. HCWs with other frontline COVID warrior as a partner were both anxious (40%) and depressed (20%). Anxiety (35%) was more among those who's family members got COVID positive. About 25% of them faced social stigma, 55% of them faced issue of isolation with in the community, and 14% of them faced acts of violence which is unacceptable. Conclusion(s): Although its second wave HCWs are still having psychological distress which needs to be addressed. Social stress that they are facing is significant and is associated with higher anxiety and depression, which has to be taken seriously.Copyright © 2023, Mr Bhawani Singh. All rights reserved.
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Introduction : Coronavirus disease 2019 (COVID-19) saw an overhaul in the biomedical waste management (BMWM) practices. Waste handlers were at the brunt of these changes. If the challenges pertaining to BMWM at the ground level are better understood, more effective measures to overcome them can be formulated. Objectives: 1. To identify myths and concerns regarding BMWM in the context of COVID-19 pandemic. 2. To explore the challenges faced in BMWM amidst the COVID-19 pandemic. 3.To explore opportunities and future perspectives of BMWM. Method: In-depth interviews were conducted among 17 purposively selected Class IV health care workers during August to November 2021 in a tertiary care institute in Mumbai. Data was reported using thematic analysis. Results: Three major themes - challenges and concerns faced by BMW handlers, enablers/motivators, opportunities and future practices were generated from the transcripts. Various challenges faced by waste handlers were- difficulties in segregation and transport of BMW, exhaustion from PPE usage and fear of acquiring and spreading COVID-19 from work, stigma faced from public, and handling COVID-19 deaths. Support from family and colleagues, incentives and a positive change in public perception enabled them to work. Forming redressal committees, addressing job security concerns and timely provision of good quality equipment can improve hospital waste management measures in the future. Conclusion: It is of utmost importance to address challenges faced by waste handlers in BMWM. Onus should also be on periodic training in BMWM.
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Background: Managing patients with cancer during the coronavirus disease 2019 (COVID-19) pandemic has been challenging. Disruptions in cancer management have been observed due to cancellation of treatment, issues related to commuting, and dearth of health-care workers. Objective(s): This study was conducted during the first wave of the COVID-19 pandemic and was aimed at evaluating the 30-day all-cause mortality among patients with cancer and COVID-19 infection and the factors affecting it. Material(s) and Method(s): In this retrospective study, we collected secondary data from nine tertiary care centers in South India over a period of 10 months from March to Dec 2020. Patients across all age groups with histopathologically confirmed diagnosis of cancer who were affected by COVID-19 during their evaluation or treatment were included in the study. The primary outcome variables of the present study were 30-day all-cause mortality, cancer outcomes, and COVID-19 outcomes. Result(s): A total of 206 patients were included. Median age of the cohort was 55.5 years, and the male-To-female ratio was 1:1.03. The 30-day mortality rate was 12.6%. Twenty-Two patients (10.7%) had severe COVID-19 infection at the initial presentation. Predictors for severe pneumonia at the initial presentation were incomplete remission at the time of COVID-19 diagnosis and palliative intent of treatment. Severe pneumonia at the initial presentation, diagnosis of COVID-19 on or before August 2020, and need for ventilator support were associated with increased mortality. Conclusion(s): Severity of infection at the initial presentation, cancer status, and the intent of cancer treatment impact COVID-19 outcomes in patients with cancer.Copyright © 2022 Iranian Society of Ophthalmology. All rights reserved.
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Introduction and Aim: Previously tension-type headache (TTH) was found to be highly prevalent among the general population worldwide, but the current data available were limited. Due to the COVID-19 pandemic, many life changes occurred to adapt to the situation, students started e-learning from home and their sleep quality (SQ) might be influenced. Physiotherapy and nursing students were studied as they are rarely being studied by researchers, information about them was very limited. This study aimed to determine the prevalence of TTH, SQ and the type of correlation between the two during the COVID-19 pandemic. Method(s): A cross-sectional study was conducted by sharing the online questionnaires composed of 2 main components: (i) Questionnaire formulated from diagnosing criteria for TTH of ICHD-3 (ii) Pittsburgh Sleep Quality Index (PSQI), to PS and NS students from higher education institutions in Klang Valley, Malaysia. Result(s): A total of 259 respondents were recruited in the study. The prevalence of TTH was 76.8% and SQ had a mean score of 5.12, which indicated poor SQ among PS and NS students, during the COVID-19 pandemic. Correlation between TTH and SQ was proved to be significant in this study (p=0.032, rs =0.133). Conclusion(s): High prevalence of TTH and poor SQ among PS and NS students during the COVID-19 pandemic was determined. There is a weak positive correlation between TTH and SQ during COVID-19 pandemic.Copyright © 2023, Indian Association of Biomedical Scientists. All rights reserved.
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Aim and Objectives: 1. Knowledge of the COVID 19 vaccine among medical students in a tertiary care hospital. 2. Attitude towards the COVID 19 vaccine among medical students in a tertiary care hospital. Methodology: Study Location: Tertiary care hospital facility in Visakhapatnam. Study Period: From August to September 2022 will be the study period. Study Sample Size: 316. Statistics: Data are gathered using google forms, and the spread document is error-checked. Calculations are made for descriptive numbers like frequency and percentage. Result(s): Sociodemographic details about the participants-There were 316 competitors in total. Men make up about 34.5% (n=109) of the members. Approximately 65.5% of the members (n=207) are female. About 40.5% (n=128) of the participants are first-year students, 39.25% (n=124) are second-year students, 14.5% (n=46) are third-year students, and 5.7% (n=18) are fourth-year students. Conclusion(s): The majority of medical students' responses to this research show moderate knowledge of and a favorable outlook towards the COVID 19 vaccine. It also demonstrates that medical students are more knowledgeable and have more optimistic dispositions. Our findings can be applied to interventions that promote public health, particularly for medical students. To dispel the medical students' fears and misunderstandings regarding the COVID 19 vaccine, there should be seminars, lectures, and instructional videos that are specifically aimed at them.Copyright © 2023, Dr. Yashwant Research Labs Pvt. Ltd. All rights reserved.
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Background: Mucormycosis is a serious life-threatening fungal infection that recently made severe sudden and devastating surge during the second wave of the COVID-19 epidemic with a mortality rate of up to 50%. Although the causality link between COVID-19 and rhino-orbito-cerebral mucormycosis (ROCM) remains unclear, many factors including poor diabetes control, high doses of steroids, viral-induced lymphopenia, and cytokine storm have been attributed to ROCM in patients with COVID-19. Orienting to risk factors and early recognition of this potentially fatal opportunistic infection is the key to optimal management and improved outcomes. In these contexts, we conducted a prospective study for 33 patients admitted to our tertiary hospital to determine the risk factors for ROCM in patients with COVID-19 and the cumulative mortality rates. Result(s): This study found a statistically significant relation between the fate of death in COVID-MUCOR patients who had presented fever, ophthalmoplegia, facial skin necrosis, and visual loss with those who received dose of steroid to control their respiratory symptoms P < 0.001. Death from COVID-MUCOR was statistically significant related to the prolonged interval from the onset of the symptoms to start of treatment and intervention. Also, it was found that there was a significant decrease in duration between COVID-19 infection and the start of mucormycosis (days) with incidence of DKA on admission. Nineteen (57.6%) of the patients had uncontrolled diabetes mellitus (hemoglobin A1C (HbA1c) of > 7.0%). Conclusion(s): Mucormycosis epidemic was precipitated by a unique confluence of risk factors: diabetes mellitus, widespread use of steroids, and perhaps SARS-CoV-2 infection itself. Restricting steroid use in patients with severe COVID-19 requiring oxygen therapy, and screening for and optimally controlling hyperglycemia, can prevent COVID-MUCOR in a large majority.Copyright © 2023, The Author(s).
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The restrictions imposed to limit the spread of COVID-19 resulted in the switch from in-person to online teaching, including the teaching of foreign languages in 2020-2022. This study uses the feedback of students who have studied English for Specific Purposes (ESP) in virtual and classroom settings. The aim is to investigate the benefits and limitations of each approach for language acquisition in ESP for sport and health sciences. A questionnaire to ascertain students' experiences was distributed to 60 students in sport and health sciences who studied ESP at the Latvian Academy of Sport Education. It was found that online and face-to-face studies of ESP in sport and health sciences tended to facilitate the acquisition of different language skills. In the questionnaire, students reported consistent progress in the study of vocabulary and reading the texts related to their area of study during both online and face-to-face studies, but less improvement was reported in the areas of grammar and speaking skills. Overall, synchronous online live classes would facilitate the steady and continuous development of all language skills if supplemented by continuous support from the teaching personnel, regular offline meetings or classes, and access to specially designed online resources.
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BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) and Vancomycin-resistant S. aureus (VRSA) frequently cause nosocomial infections yearly. During the COVID-19 pandemic, the potential for excessive use of antibiotics is a global threat to the increasing incidence of multiresistant bacteria. AIM: This study aimed to determine MRSA and VRSA colonization and identify factors associated with the risk of MRSA and VRSA nasal colonization in health workers at Dr. Soemarno Sosroatmodjo General Hospital, Kuala Kapuas, as one of the type C hospitals in Indonesia. METHOD(S): This cross-sectional analytic study at Dr. Soemarno Sosroatmodjo General Hospital, a tertiary hospital in Indonesia. A 128 health workers' subjects had undergone nasal swab screening for MRSA and VRSA colonization examinations. Then, they were asked to complete a questionnaire concerning the risk factors of MRSA and VRSA infections. RESULT(S): Nasal swab results obtained as many as 30 (23.5%) MRSA positive subjects and 6 (4.7%) subjects with positive VRSA. The most common risk factors that led to MRSA colonization included a history of positive MRSA in the previous hospital (60%), a history of ear, nose, and throat infection (41.7%), and did not do hand rub/handwash (36.7%). In comparison, the most risk factors for VRSA colonization were having pigs farm at home (33.3%), a history of positive MRSA in the previous hospital (20%), and a history of hospitalization in the past 6-12 months (16.7%). The results of multivariate analysis showed the most powerful and statistically significant risk factors in influencing nasal MRSA colonization were a history of positive MRSA in the previous hospital (OR 13.69, 95% confidence intervals [CI]: 1.34-140.25, p = 0.028) and did not do hand rub/handwash (OR 2.95, 95% CI: 1.167-7.49, p = 0.023). Meanwhile, marital status (OR 0.160, 95% CI: 0.02-1.06), p = 0.058) and home care service (OR 6.10, 95% CI: 0.79-46.96, p = 0.082) were the strongest risk factors for nasal colonization of VRSA but not statistically significant. CONCLUSION(S): As many as, 23.5% and 4.7% of healthcare workers' subjects were found with nasal colonization of MRSA and VRSA, respectively. Accordingly, strict policies are needed to minimize the transmission of these organisms from the hospital setting to the community.Copyright © 2023 Siti Nur Rohmah, Rizka Humardewayanti Asdie, Ida Yosopa, Daya Daryadijaya.
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Background: The abrupt change to distance learning due to the coronavirus disease 2019 (COVID-19) pandemic imposed great challenges on tertiary education. While aspects such as mental health and stress exposure have been investigated, little research has been conducted regarding the impact of distance learning on students' health behaviors. This article investigates the influence of the teaching mode (in situ vs. distance) on students' physical activity and nutrition. Methods: A retrospective questionnaire study was conducted comparing two student cohorts who had attended the same course in two subsequent years. One group had participated in situ before the pandemic, while the other one participated via distance learning during the pandemic. A total of 79 questionnaires were submitted by students belonging to the latter and 51 by students of the former group. Data were compared regarding differences in students' health behavior. Results: Findings indicate that online classes facilitated the pursuit of physical activities and healthy eating. Students with in situ teaching felt restricted in their exercise activities. Findings for healthy nutrition are similar. Conclusion: Students in distance learning found themselves in a more flexible learning environment and in a position to allocate their time resources more autonomously. Student health promotion in face-to-face teaching settings should be improved and the opportunities presented by distance learning utilized. © 2023, The Author(s), under exclusive licence to Der/die Autor(en), exklusiv lizenziert an Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature.
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Objective To investigate the physical and mental condition and medicine consumption of medical staff of shelter hospitals in Shanghai during the fight against the epidemic of coronavirus disease 2019 (COVID-19). Methods A total of 144 frontline medical staff who fighting against the COVID-19 epidemic from a tertiary first-class hospital from Apr. 4 to May 12, 2022 were surveyed by questionnaires online. Their physical condition including body weight change before the medical work and one month later, sleep quality and the medicine consumption during the medical work were collected and analyzed. Results The mean body weight of frontline doctors before the medical work and one month later were (69.80+/-8.35) kg and (68.60+/-7.37) kg, while those of nurses were (55.36+/-8.27) kg and (53.80+/-7.38) kg, both showing a decreasing trend but without significant difference (all P0.05). A total of 63.89% (92/144) frontline medical staff suffered from insomnia, of which 27.08% (39/144) needed drug intervention. The top 5 common diseases among frontline medical staff were sleep disorder (63.89%, 92/144), skin injury (25.69%, 37/144), body pain (23.61%, 34/144), oral ulcer (13.19%, 19/144), and acute upper respiratory tract infection (9.72%, 14/144). A total of 155 medical staff used drugs, and the top 5 common drugs were skin application (16.77%, 26/155), Ganmao'an granule (12.26%, 19/155), zolpidem tartrate tablets (11.61%, 18/155), Kangfuxin liquid (11.61%, 18/155), and celecoxib capsules (8.39%, 13/155). Conclusion Frontline medical staff in shelter hospitals are prone to have body weight change, sleep disorder, skin injury, body pain, oral ulcer, acute upper respiratory tract infection and so on, which suggests that in future similar large-scale medical support, it is necessary to pay sufficient attention to the physical condition of frontline medical staff and provide them sufficient medicine.Copyright © 2022, Second Military Medical University Press. All rights reserved.
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Objectives: Obesity is a condition prone to pose difficulties to a successful extra-corporeal membrane oxygenation (ECMO) support. Not being a contraindication, it yields significant challenges to physicians and may interfere with patient;s outcome. The number of obese patients supported by ECMO has increased during COVID-19 pandemic due to severe illness in this population. We designed a retrospective study in order to identify prognostic factors for 180-day survival in critical COVID-19 obese patients in venovenous ECMO (VV-ECMO). Method(s): Single-center retrospective cohort of critical COVID-19 adult patients in VV-ECMO, obese and overweight (according to WHO classification), admitted in a tertiary hospital;s ICU from April 1st 2020 to May 31th2022. Univariate logistic regression analysis was performed to assess 180-day mortality differences. Result(s): The analysis included 41 patients. The median [interquartile range (IQR)] age was 55 (IQR 45-60) years and 70,7% were male. Median body mass index (BMI) was 36 (IQR 31-42,5) Kg/m2 ;39% of patients had a BMI >=40 kg/m2 . The sampling had 3 (IQR 1,5-4) days of invasive ventilation prior to ECMO and 63,4% were weaned from ECMO-VV support after a median of 19 (IQR 10-34) days. The median ICU length of stay was 31,9 (IQR 17,5-44,5) days. The invasive ventilation period was 30 (IQR 19-49,5) days. The 60, 90 and 180-day mortalities were 41,5%. On the univariate logistic regression analysis we found that higher BMI was associated with higher 180-day survival (odds ratio [OR] 1,157 (1,038-1,291), p 0,009). Younger age, female patients, less invasive ventilation time prior to ECMO and fewer complications at time of ECMO cannulation were associated with higher 180-day survival [respectively, OR 0,858 (0,774- 0,953), p 0,004;OR 0,074 (0,008-0,650), p 0,019;OR 0,612 (0,401-0,933), p 0.022;OR 0.13 (0,03-0,740), p 0,022)]. Conclusion(s): In this retrospective cohort of critical COVID-19 obese adult patients supported by VVECMO, a higher BMI, younger age and female patients were associated with higher 180-day survival. A shorter invasive ventilation time prior to ECMO and fewer complications at ECMO cannulation were also associated with increased survival.