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1.
12th Nordic Conference on Human-Computer Interaction: Participative Computing for Sustainable Futures, NordiCHI 2022 ; 2022.
Article in English | Scopus | ID: covidwho-2108350

ABSTRACT

A crucial issue in Participatory Design is to bring together and ensure knowledge dissemination among large groups of diverse stakeholders. This can be especially hard to accomplish if co-located activities are not feasible. Digital services could potentially remedy this. Although Participatory Design as a methodology for systems development has resulted in numerous systems to support collaborative work, we lack systems that directly support Participatory Design processes in their own right. In order to examine the potentials and limitations of how digital systems can better support Participatory Design, we present and analyze a case-study of Ideate, a participatory online platform for communities to develop, discuss and present best-practice examples of solutions for how to rethink and reopen society in the aftermath of COVID-19. We analyse core insights from the design process and the use of the system in three different cases. On this basis, we present and critically discuss four challenges for designing digital systems to support Participatory Design: I) lowering the barrier for participation is necessary but not enough, II) urgency and relevance is not enough, participation requires alignment with the stakeholders' immediate tasks, III) participation requires negotiation of time and place, IV) digitally mediated participatory design processes require lead figures. © 2022 ACM.

2.
Environ Sci Pollut Res Int ; 2022 Nov 08.
Article in English | MEDLINE | ID: covidwho-2104051

ABSTRACT

Businesses are becoming more conscious of operational risk management practices due to the COVID-19 pandemic. However, some firms practice risk management without fully comprehending how it might help them and their needs. As a result, companies that practice risk management without realizing it are being controlled by the discipline itself. The goal of this study is to look into the epistemic process of risk management practice in the workplace. This phenomenological study interviewed 39 risk management officers, executives, and employees. Data are thematically analyzed. This study discovered five epistemic processes of risk mapping using Foucault's governmentality paradigm. This phenomenological study, interestingly, revealed the black box of risk management practices, as well as the behavior of risk management officers, executives, and risk owners who preferred to monitor the compliance aspects of risk management practices rather than comprehend the capabilities of risk management that could be used within their strategic planning process. Unaware of this black box, organizational actors were blanketed by the organization's culture of fear, which created the impression that the authority was always watching every word said and every action taken. Practically, this study contributes an improved understanding of the real function of risk management that helps them justify the practice and reduce unnecessary fear. The paper concludes with limitations and research recommendations.

3.
J Res Med Sci ; 27: 73, 2022.
Article in English | MEDLINE | ID: covidwho-2090581

ABSTRACT

Background: Cancer patients, as a highly vulnerable population, are receiving a great deal of attention in the current crisis of coronavirus 2019 (COVID-19). To date, shreds of evidence are not sufficient to the description of COVID-19 outcomes in patients with cancer. This study was performed to evaluate the demographic and clinical characteristics and subsequent outcomes of COVID-19 in cancer patients. Materials and Methods: A hospital-based study was conducted involving 66 cancer patients with a confirmed diagnosis of COVID-19 from January 15, 2020, to December 21, 2020, in Isfahan, Iran. The clinical information was collected by interview and medical records. The statistical analyses were performed to describe categorical variables as well as mean, standard deviation, median, and the interquartile range for quantitative variables. Results: In our study, 66 cancer patients with confirmed COVID-19 (age: 17-97 years; 50% female) were included. Leukemia and bone marrow cancer with a frequency of 25.7% were the most common types of cancer among them. Cancer patients mostly complained of fever, cough and fatigue, and shortness of breath. Among 76.9% of patients discharged from the hospital with relative recovery, 23% died; the most common cause of death was acute respiratory distress syndrome. Age, gender, and type of cancer did not affect cancer mortality. COVID-19 had no potential effect to increase the risk of side effects of anticancer therapies. Conclusion: The results of our studies revealed that cancer is an important risk factor for the higher rate of mortality in patients with COVID-19. These findings could help physicians for the management, treatment, and supportive care of COVID-19 cancer patients.

4.
Drug Safety ; 45(10):1122, 2022.
Article in English | EMBASE | ID: covidwho-2085670

ABSTRACT

Introduction: A method of time-to-onset (TTO) signal detection for screening unexpected temporal patterns from vaccine spontaneous report data has been published in 2012 [1]. EMA listed TTO analysis as one of the methods to be considered for signal detection [2]. Due to the large number of spontaneous reports associated to covid-19 vaccines, highly significant TTO signals could be detected whereas there are no clinically relevant unexpected temporal patterns. Objective(s): Objective was to revise the original method so that it is less sensitive to small differences and test it on two covid-19 vaccines (Pfizer/BioNTech and Moderna). Method(s): The revised method used only the most predictive measure [3] of the two Kolmogorov-Smirnov (KS) tests originally designed: the p-value of the KS test of the TTO distribution of a given event post a given vaccine against the TTO distribution of the same event post other vaccines. A threshold on the Kolmogorov-Smirnov distance, that can have values between 0 and 1-0 for no difference between time-to-onset distributions and 1 for extreme differences- was set at 0.2. A threshold on the p-value of the KS test was set at 0.05. The Vaccine Adverse Event Reporting System was prospectively frozen every week of the first quarter 2021 and the revised TTO signal detection method was prospectively applied on the two covid-19 vaccines. The performance in detecting events that were posteriori determined as causally related to the exposure of the covid-19 vaccines, namely Pericarditis and Myocarditis, was retrospectively assessed. Result(s): Pericarditis post Pfizer/BioNTech covid-19 vaccine emerged as a significant TTO signal as early as 15JAN21 (N: 4, distance: 0.80, p-value: 0.012). Myocarditis post Pfizer/BioNTech covid-19 vaccine emerged as a significant TTO signal as early as 29JAN21 (N:5, distance: 0.59, p-value: 0.031). Pericarditis post Moderna covid-19 vaccine emerged as a significant TTO signal as early as 12FEB21 (N: 13, distance: 0.55, p-value: 0.00093). Myocarditis post Moderna covid-19 vaccine emerged as a significant TTO signal as early as 05FEB2021 (N:7, distance: 0.73, p-value: 0.0014). Conclusion(s): The revised TTO method allowed early detection of unexpected TTO patterns post exposure to covid-19 vaccines by controlling both the level of significance and the magnitude of difference between the TTO distributions in a context of mass vaccination where individual case review is challenging.

5.
Revista Cubana de Informacion en Ciencias de la Salud ; 33, 2022.
Article in English | Scopus | ID: covidwho-2083542

ABSTRACT

This paper aims to report the experience of the Clinical Librarian in preparation and response to the pandemic of COVID-19, in the Hospital Library of the Study Center of Hospital “Felício Rocho”, in Belo Horizonte, Minas Gerais, Brazil. This is a qualitative and descriptive research that approaches the role of the Clinical Librarian in the context of the Hospital Library in the Brazilian scenario. For this, the Library is described, the services offered to the medical team, the opportunities and challenges of the Clinical Librarian, the need for training and the partnership with the front-line medical team of COVID-19. The Clinical Librarian played an important role in supporting decision making in facing the pandemic of COVID-19. Thus, the experience report seeks a contribution to Information Science in facing a pandemic and lessons learned from Clinical Librarian. © 2022, Centro Nacional de Informacion de Ciencias Medicas. All rights reserved.

6.
Innovar ; 32(86):75-87, 2022.
Article in Spanish | Scopus | ID: covidwho-2081093

ABSTRACT

Exporting smes are essential in economies;however, some barriers can hinder their export performance due to their particularities. The crisis caused by the covid-19 pandemic has become one of those obstacles since it has affected businesses worldwide, leading to new ways of con-ducting business, such as adopting virtual tools and using digital media as part of the business strategy. This reality shows the importance of digital marketing. Therefore, this paper seeks to evaluate the changes in smes’ strategy as a result of the pandemic and their relation to the export performance by these firms. The study employed qualitative research through a case study design, in which we conducted in-depth interviews with five Costa Rican exporting smes. The main limitations were the difficulties for contacting enterprises and their lack of marketing knowledge. The data were analyzed through the atlas.ti 9 software, finding that changes in the activities and digital marketing strategies have been essential due to the information they provided, thus allowing smes to maintain their marketing actions during the pandemic. These insights may have a bearing on export performance. © 2022, Universidad Nacional de Colombia. All rights reserved.

7.
Journal of Transport and Supply Chain Management ; 16, 2022.
Article in English | Scopus | ID: covidwho-2080611

ABSTRACT

Background: For the last 20 years Zimbabwe has been dependent on humanitarian aid. The country is in a desperate condition, with millions of citizens leaving to reside in neighbouring countries. These Zimbabweans are providing and sending food, necessities and cash to relatives in the country using largely informal humanitarian supply chains (HSCs). The outbreak of the coronavirus disease 2019 (COVID-19) pandemic was disastrous causing more hardship. Objective: This case study explores how informal HSCs played a significant role in the Zimbabwe humanitarian aid initiative and the impact of COVID-19 on these supply chains. Method: A mixed method design was used to collect qualitative data through personal interviews with Zimbabweans in South Africa. Additional quantitative data was obtained from humanitarian reports, Zimbabwe government reports as well as other publications. These were used to present the humanitarian crisis in Zimbabwe and specifically how support was provided through informal HSCs from outside Zimbabwe. Results: Through the case study the devastating effect COVID-19 had on a large component of the food insecure and suffering population of Zimbabwe is vividly illustrated. The closing of national borders prevented any food and other necessities, sent by diaspora from South Africa, reaching relatives. Conclusion: The results of this case study show the effect COVID-19 had on the humanitarian aid from relatives in South Africa. All the aid to Zimbabweans completely stopped for an extended period as these informal HSCs were completely broken because of the COVID-19 pandemic and 2 years later they remain disrupted. © 2022. The Authors. Licensee: AOSIS.

8.
BMC Health Serv Res ; 22(1): 1248, 2022 Oct 14.
Article in English | MEDLINE | ID: covidwho-2079417

ABSTRACT

BACKGROUND: The COVID-19 pandemic has seen unprecedented growth in the use of interactive technologies in care facilities for social contact between residents and their close contacts due to the need for social distancing. As the pandemic is transitioning into a new phase, there is a need to critically examine the new practices associated with technology usage. OBJECTIVE: Our analysis is based on a case study of how a care facility in western Norway adopted a novel technology called KOMP. We empirically investigate the stability of practices with KOMP for maintaining social communication between residents and their relatives and consider whether these practices are likely to last beyond the pandemic. We draw on normalization process theory (NPT) to interpret our findings and critically examine how stable embedding of new technologies for social communication occurs under extraordinary circumstances. METHODS: We conducted a case study based on participant observation and interviews, and the data were analyzed through inductive thematic analysis. Participants are health care professionals from a public care facility in western Norway. RESULTS: Four major themes emerged from the data. The first revolved around the pressing need for communications between residents and relatives with a suitable tool. Second, staff showed engagement through motivation to learn and adapt the technology in their practices. A third theme centered on how staff and the organization could work effectively to embed KOMP in daily practice. Our fourth theme suggested that the professionals continuously assessed their own use of the technology. CONCLUSION: From the perspective of NPT, practices with KOMP have been partially embedded by developing a shared understanding, engaging through cognitive participation, working collectively with staff and the organization, and reflexively monitoring the benefits of using KOMP. However, staff engagement with the technology was continuously threatened by factors related to diverging staff preferences, the burden of facilitating KOMP for residents with impaired cognitive and physical abilities, issues of privacy and ethics, and the technical skills of the residents' relatives. Our analysis suggests that caring practices via KOMP have become relatively stable despite barriers to engagement and are therefore likely to persist beyond the pandemic.


Subject(s)
COVID-19 , COVID-19/epidemiology , Communication , Health Personnel , Humans , Pandemics , Technology
9.
12th International Conference on Information Communication and Management, ICICM 2022 ; : 1-6, 2022.
Article in English | Scopus | ID: covidwho-2079059

ABSTRACT

Requirement engineering (RE) is crucial for any software development project. It plays a vital role in the development lifecycle, as it lays the foundation for all subsequent development steps. Ensuring proper collection of project requirements makes the subsequent process, including design, development and testing, easier. The software industry has paid great attention to RE, including tools and techniques, starting with requirement elicitation. In the last couple of years, the Covid-19 pandemic has impacted processes, as meeting clients and stakeholders face-to-face and visiting them in their workplace has been made more difficult by social distancing, changing the techniques for requirement elicitation. Most software development companies rely on distant communication and alternative approaches to collect customers' requirements to understand their needs, so they can reflect the reality in the work and try to persuade the customers that the developed solution meets their requirements. This study presents a case study of three educational projects at three different universities with different development requirements. The study compares the process before and during the pandemic to identify the challenges and features of the shift which occurred and measure its impact on number of requirements completed in both periods, as well as its impact on development project resources. This study's findings indicate increased requirements during the elicitation process and changes in human resources because of eliminating the practitioners over distance communication during the Covid-19 pandemic. © 2022 ACM.

10.
Journal of Library and Information Services in Distance Learning ; 2022.
Article in English | Scopus | ID: covidwho-2077311

ABSTRACT

Reading resources are essential for teaching and learning. Today’s students and instructors are used to the Learning Management System (LMS) for teaching and learning. Within the general LMS trend, a variety of electronic course reserves tools have emerged. One particular tool is Leganto which has been increasingly widely deployed, particularly in the wake of COVID-19. This article adopts the Educause reporting model of teaching and learning technologies best practices of “7 things You Should Know About.” The article also presents the authors’ institutional case of adoption, implementation, and data analytics results at Purdue University. © 2022 The Author(s). Published with license by Taylor & Francis Group, LLC.

11.
Chest Disease Reports ; 9(1) (no pagination), 2022.
Article in English | EMBASE | ID: covidwho-2066765

ABSTRACT

We present a case series of patients with pulmonary embolism of unknown etiology who did not have any risk factors. According to the findings, the most likely cause of the pulmonary embolism was undiagnosed, asymptomatic, or mild Corona Virus disease-2019 (COVID-19) infections in the recent past. In the current post-pandemic era, where there has been a surge of sudden unexplained deaths and pulmonary embolism cases, this case series emphasizes the importance of pulmonary embolism evaluation in patients seeking medical care for dyspnea. Physicians should be aware of the possibility of pulmonary embolism as a late complication in patients with mild, asymptomatic, or undiagnosed COVID-19 infection. Copyright © the Author(s), 2022.

12.
Open Access Macedonian Journal of Medical Sciences ; 10:1914-1921, 2022.
Article in English | EMBASE | ID: covidwho-2066688

ABSTRACT

BACKGROUND: The fluctuating COVID-19 cases among the pregnant women’s population encountered increased of cases and maternal mortality. AIM: This research aimed to describe the case of maternal deaths caused by COVID-19. CASE REPORT: We present nine serial cases of maternal death caused by COVID-19 who were admitted to Dr. Soetomo General Academic Hospital for 14 days in June. We found 32 positive COVID-19 obstetric cases and reported nine maternal deaths with a fatality rate of up to 28%. Seven of nine patients had reverse transcription-polymerase chain reaction–confirmed SARS-CoV-2 infection, while two had a positive antigen swab. Half of the patients ≥35 years old, and five of nine patients had Class I obesity as preexisting comorbidity. This study reported the death of pregnant woman at their 2nd trimester and 3rd trimester presenting infected by severe COVID-19. The usual symptoms are dyspnea, cough, fever, and decreased consciousness. The result of chest X-ray examination among eight patients showed bilateral pneumonia. Most of cases were referrals from a secondary hospital due to overload hospital capacity. Three patients were directly transferred to the tertiary hospital without receiving initial treatment. Eight of 9 patients (88.9%) were transferred to intensive care unit and intubated due to low oxygen saturation. CONCLUSION: In conclusion, the limited hospital facility and lack of intensive care capacity for obstetric cases during the second wave of the COVID-19 pandemic may enhance the probability of mortality and morbidity in pregnant women infected by COVID-19.

13.
Open Access Macedonian Journal of Medical Sciences ; 10(C):246-251, 2022.
Article in English | EMBASE | ID: covidwho-2066676

ABSTRACT

BACKGROUND: Pregnancy state affects the immune regulation including physical barrier, innate, and adaptive immunity-related to susceptibility of infections and increasing risk for severe to critical case of COVID-19. Further, high risk of thrombosis becomes a challenge in the management of COVID19 in pregnancy due to the strong association with worse outcome. CASE REPORT: Here, we present three cases of pregnant women infected with COVID-19 pneumonia with different outcomes in maternal and fetal condition related to high-risk thrombosis. Serial inflammatory markers were needed to the early detect the disease progressivity in pregnant women with COVID-19. Further, complete assessment of fetus including reverse transcriptase-polymerase chain reaction and chest X-ray must be performed to the early diagnosis of COVID-19 in neonatal whose mother was infected by SARS-CoV-2. CONCLUSION: Pregnancy state affects the immune regulation including physical barrier, innate, and adaptive immunity-related to susceptibility of infections and increasing risk for severe to critical case of COVID-19. Further, high risk of thrombosis becomes a challenge in the management of COVID19 in pregnancy due to the strong association with worse outcome. Although fetal transmission of COVID-19 to fetus remains unclear, complete assessment of fetus including RT-PCR, and chest X-ray must be performed to the early diagnosis of COVID-19 in neonatal whose mother was infected by SARS-CoV-2.

14.
Sustainability ; 14(19):12708, 2022.
Article in English | ProQuest Central | ID: covidwho-2066452

ABSTRACT

The switch from working in-office to working from home in the context of the COVID-19 pandemic had a significant impact on people’s mobility behavior. In view of the need for action arising from the ongoing challenge of climate change, these changes should be seen as an opportunity to reduce emissions in the traffic sector. The aim of this study was to analyze changes in work-related mobility that occurred during the COVID-19 pandemic using the case of a multinational medium-sized retail chain situated in semi-rural Germany. The case study allowed us to examine those changes in connection with individual attitudes and perspectives of the company and its employees. Thus, we quantitatively recorded the mobility behavior of the company’s employees, followed by an expert interview to ascertain the company’s perspective. We found a reduction in the frequency of commuting and business trips made by employees, which seemed to continue beyond the COVID-19 crisis. However, according to our findings these changes were not based on individual motivation to act in a climate-aware manner but are subject to the framework conditions created by employers for the adoption of climate-friendly behavior. The results of this work could be used by companies and policymakers to create such favorable framework conditions.

15.
Sustainability (Switzerland) ; 14(18), 2022.
Article in English | Scopus | ID: covidwho-2066369

ABSTRACT

As a critical pattern to promote industrial growth and recover the economy, China has widely applied an electricity price-cutting policy, especially after the global spread of COVID-19. However, the current insufficient research indicates a noticeable knowledge gap around the actual outcome of this policy measure. This paper, therefore, aimed at filling this gap by focusing on the case of Zhejiang province. Recently, there have been three main kinds of price-cutting policies employed in Zhejiang, decreasing the general industrial electricity price, temporary electricity price-cutting, and targeted price reduction for large industries. Using a computable general equilibrium model that incorporates the Zhejiang electricity system’s operating characteristics, we simulated the economic impact of these electricity price adjustment policies. The results indicate that it was practical to promote the economy by reducing electricity prices, but the specific arrangements of policy have led to differences in economic stimulus consequences. This paper further obtained the multiplier effect in each industry. If electricity price adjustment policies were introduced only for industries with a higher comprehensive multiplier effect, the policy effectiveness would be further optimized. © 2022 by the authors.

16.
Energies ; 15(19):7374, 2022.
Article in English | ProQuest Central | ID: covidwho-2065784

ABSTRACT

With rising electricity demand, heavy reliance on imports, and recent economic downturns due to the negative impact of the COVID-19 pandemic, supply chain bottlenecks, and the Russian invasion of Ukraine, Thailand is suffering severely from energy resilience risks. The government has therefore set a goal of decentralizing energy production through small-scale distributed renewable energy systems. To support their design and the planning process, we simulate multiple scenarios with wind turbines, photovoltaic systems, and battery storage for a model community in rural Nakhon Phanom, Thailand. Using the software NESSI4D, we evaluate and discuss their impact on energy resilience by considering environmental sustainability, economic attractiveness, and independence from the central power grid. To fill the gap of missing data on energy demand, we synthesize high-resolution load profiles from the Thailand Vietnam Socio-Economic Panel. We conclude that distributed photovoltaic systems with additional battery storage are only suitable to promote energy resilience if the government provides appropriate financial incentives. Considering temporal variations and local conditions, as well as a participatory decision-making process, are crucial for the long-term success of energy projects. Our advice to decision-makers is to design policies and regulatory support that are aligned with the preferences and needs of target communities.

17.
The American Biology Teacher ; 84(8):459-466, 2022.
Article in English | ProQuest Central | ID: covidwho-2065200

ABSTRACT

Assessment of student learning is crucial to capture accurately student understanding of core concepts and competencies as well as to provide relevant feedback for informing teaching and learning. Yet, many instructors in two-year and four-year undergraduate institutions rarely have pedagogical training to design fair instruction and assessments. This qualitative study describes changes occurring in the perspectives and practices of two postsecondary educators teaching introductory biology courses after participating in a one-day workshop on assessments and applying their new knowledge during course implementations. The assessment workshop emphasized the use of “backward design” for course planning and alignment. Learnings particularly focused on using Bloom’s taxonomy and best practices in assessment design. Data from educators’ interviews and samples of their course documents revealed encouraging findings. Even after a short intervention, the educators took initiatives to align course objectives, learning activities, and assessments. And notwithstanding the challenges arising from the COVID-19 pandemic, they also made some changes in formulating and communicating objectives with students, introduced relevant learning activities, and revised assessment questions to reflect best practices. The article discusses these findings and offers the next steps for research on supporting educators to design fair assessments and courses for undergraduate instruction.

18.
BMC Med Res Methodol ; 22(1): 265, 2022 10 08.
Article in English | MEDLINE | ID: covidwho-2064735

ABSTRACT

BACKGROUND: The failure of randomised controlled trials to adequately reflect areas of highest health need have been repeatedly highlighted. This has implications for the validity and generalisability of findings, for equity and efficiency, but also for research capacity-building. Rai et al. (BMC Med Res Methodol 21:80, 2021) recently argued that the poor alignment between UK clinical research activity (specifically multi-centre RCTs) and local prevalence of disease was, in part, the outcome of behaviour and decision-making by Chief Investigators involved in trial research. They argued that a shift in research culture was needed. Following our recent multi-site mixed methods evaluative study about NHS 111 online we identify some of the additional structural barriers to delivering health research "where populations with the most disease live", accounting for the Covid-19 disruption to processes and delivery. METHODS: The NHS 111 study used a mixed-method research design, including interviews with healthcare staff and stakeholders within the primary, urgent and emergency health care system, and a survey of users and potential users of the NHS 111 online service. This paper draws on data collated by the research team during site identification and selection, as we followed an action research cycle of planning, action, observation and reflection. The process results were discussed among the authors, and grouped into the two themes presented. RESULTS: We approached 22 primary and secondary care sites across England, successfully recruiting half of these. Time from initial approach to first participant recruitment in successful sites ranged from one to ten months. This paper describes frontline bureaucratic barriers to research delivery and recruitment in the local Clinical Research Network system and secondary care sites carrying large research portfolios, alongside the adaptive practices of research practitioners that mitigate these. CONCLUSIONS: This paper augments the recommendations of Rai et al., describing delays encountered during the COVID-19 pandemic, and suggesting in addition to cultural change, it may be additionally important to dismantle infrastructural barriers and improve support to research teams so they can conduct health research "where populations with the most disease live".


Subject(s)
COVID-19 , Pandemics , COVID-19/epidemiology , England , Health Services Research , Humans , Surveys and Questionnaires
19.
American Journal of Transplantation ; 22(Supplement 3):806, 2022.
Article in English | EMBASE | ID: covidwho-2063511

ABSTRACT

Purpose: The Coronavirus Disease 2019 (COVID-19) pandemic prompted widespread vaccination for the immunosuppressed population starting in January 2021 with minimal information on safety outcomes. The purpose of this study is to evaluate the relationship between kidney pathological changes and mRNA-based COVID-19 vaccines in three kidney transplant recipients. Method(s): We conducted a single-center retrospective case review of three kidney transplant recipients with biopsy-proven acute rejection or pathological changes after 2-dose COVID-19 mRNA vaccination. Renal function, maintenance immunosuppressant regimens, and pathology slides at baseline and post-rejection are recorded. Possible factors associated with the development of rejection were analyzed. Result(s): All participants were male, two received related-living donor transplants and one received a deceased donor transplant. The mean age was 44.3 years. Average time from 2nd COVID-19 vaccine to confirmed rejection or pathological changes was 33.7 days. Two patients received mRNA-1273 COVID-19 mRNA vaccine and one received the BNT162b2 COVID-19 mRNA vaccine. All three allograft biopsies demonstrated findings consistent with acute active antibody mediated rejection and thrombotic microangiopathy. One allograft biopsy also demonstrated findings consistent with collapsing focal segmental glomerular sclerosis. As of November 26, 2021, there have been over 26 reports of solid organ rejection or failure to the Vaccine Adverse Event Reporting System (VAERS) for the COVID-19 mRNA vaccines highlighting the need for further investigation. Conclusion(s): Immunization with COVID-19 mRNA vaccine has potential to precipitate clinically significant immune response to renal allografts leading to acute allograft rejection, thrombotic microangiopathy, and collapsing focal segmental glomerular sclerosis.

20.
American Journal of Transplantation ; 22(Supplement 3):984-985, 2022.
Article in English | EMBASE | ID: covidwho-2063500

ABSTRACT

Purpose: The COVID pandemic presents a unique set of challenges during pregnancy including thromboembolic complications, direct placental infection, transplacental transmission, and systemic hyperinflammatory state. The liver is the second most commonly affected organ in COVID infection after the lungs. Mechanisms of liver injury in COVID-19 patients include: direct viral cytopathic effect, drug-induced hepatotoxicity, worsening of underlying liver disease, cytokine storm, hypoxic ischemic injury, and cholangiopathy. Post-COVID cholangiopathy leads to marked cholestasis with ongoing jaundice that persists long after other organs have recovered from infection. Method(s): We describe three infants at Texas Children's Hospital with intrauterine or perinatal COVID exposure with persistent cholestasis and extrahepatic biliary obstruction (mimicking biliary atresia), suggesting cholangiopathy. Result(s): All three patients described in this case series developed liver failure in the setting of low GGT cholestasis with histologic evidence of extrahepatic biliary obstruction, and all three required liver transplantation within the first year of life. Conclusion(s): Though post-COVID cholangiopathy is described in adults in the literature, our series is unique in that it is the first to describe this phenomenon in infancy. Additionally none of our infants had moderate or severe COVID infection but still progressed to advanced liver disease. Though further studies are needed to determine if additional factors are at play, our case series certainly raises the question of if the timing of exposure/infection might play a role in overall prognosis.

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