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1.
Central European Journal of Immunology ; 47(1):73-83, 2022.
Article in English | ProQuest Central | ID: covidwho-1837159

ABSTRACT

Predicting which patients will need the intensive care unit (ICU) due to severe COVID-19 is critical in terms of disease treatment. In this study, the use of the derived isohemagglutinin (dIH) parameter calculated from isohemagglutinin (IH) values and neutrophil to lymphocyte ratios for prediction of clinical care (CLC), ICU admission and mortality status was investigated for the morbidity and mortality of COVID-19. The data of approximately 21,500 patients admitted to the hospital with the suspicion of COVID-19 were scanned retrospectively. A total of 352 patients with IH results were divided into three groups according to CLC, ICU admission and mortality. Isohemagglutinin, hemogram and biochemistry test results, demographic characteristics, chronic diseases, length of stay, treatments, ICU admission and mortality records were reviewed for all patients. The relationship between test results, demographic characteristics, clinical status and mortality was investigated using statistical methods. The dIH values of patients with ICU admission and mortality were much lower than those of CLC patients [median (min-max): 3.34 (0.14-95.8) and 0.82 (0.05-42.3) vs. 0.18 (0.01-20.6) titers, p < 0.01, respectively]. In the ROC analysis for the power of dIH to discriminate ICU admission, the cutoff was ≤ 0.68 with sensitivity 88.9%, and specificity 79.6%. It was determined that a 1-unit increase in dIH values decreased the need for ICU by 2.09 times and the mortality of those receiving ICU treatment by 2.02 times. dIH values calculated in the early stages of the disease in patients with COVID-19 can be used to estimate the clinical progression associated with ICU admission and mortality.

2.
Canadian Journal of Public Health ; 112(5):799-876, 2021.
Article in English | CAB Abstracts | ID: covidwho-1837009

ABSTRACT

This special issue contains 9 articles on COVID-19 in Canada. Topics covered include specific modelling approaches;social inequalities in protective behaviour uptake;public health preventive measures and child health;examining the associations between food worry and mental health;provincial implementation supports for socio-demographic data collection;impacts of COVID-19 and systemic inequalities on sub-Saharan African immigrants;detection of case clusters;vaccine evaluation;and tuberculosis elimination.

3.
Journal of Maternal and Child Health ; 7(1):22-33, 2022.
Article in English | CAB Abstracts | ID: covidwho-1836444

ABSTRACT

Background: Pregnancy is a state of great susceptibility to infectious diseases, and it is not surprising that viral infections can affect pregnancy outcomes. COVID-19 infection during pregnancy is considered a risk factor for adverse outcomes such as, preterm delivery. This study aimed to analyze the risk of preterm delivery in pregnant women with COVID-19. Subjects and Method: This study was conducted using a systematic review and meta-analysis. Article searches were conducted using electronic databases such as Google Scholar, PubMed, and Scopus. The articles used are articles published from 2020-2021. The keywords used to retrieve the articles were: [(COVID-19 OR 2019-nCoV OR "novel coronavirus" OR SARS-CoV-2 OR "coronavirus 2") AND ("preterm birth" OR preterm OR "preterm delivery")] . The inclusion criteria used were full paper with observational studies (retrospective or prospective cohorts), multivariate analysis with Adjusted Odd Ratios (aOR), study subjects were pregnant women who were confirmed to be infected with COVID-19, comparison were pregnant women who were negative for COVID-19, outcome study was preterm birth (<37 weeks). The article search results are listed in the PRISMA diagram and analyzed using the Review Manager 5.3 . application.

4.
Review of Agrarian Studies ; 11(1):95-106, 2021.
Article in English | CAB Abstracts | ID: covidwho-1836384

ABSTRACT

This note analyses the impact of the Covid-19 pandemic on the production and cost of cultivation of crops grown in the monsoon (kharif) season. The note is based on a survey of 164 informants from 26 villages across 13 States of India. Moreover, this study sought primarily to understand the effects of the pandemic on agricultural production, employment, income, and food security in rural India. There are three main findings of the survey. First, there was an increase in the acreage and output under kharif crops in 2020 to 21. This increase was, first, because of good and timely rainfall, and secondly, many households, including those with migrant worker earnings in a normal year, returned to farming during the pandemic year, leasing in small plots of land. Thus, in some areas, the increase in acreage and output in kharif production was driven by the loss of work for migrant labour. Secondly, increases in costs of inputs, diesel, and hired labour significantly increased the aggregate cost of cultivation of kharif crops. Lastly, the increase in MSP between 2019 to 2020 and 2020 to 2021 for kharif crops (for instance, 3 per cent for rice, 5 per cent for cotton, 2 to 4 per cent for different pulses, and 5 per cent for oilseeds) did not compensate for the increase in the cost of cultivation of kharif crops. As a consequence of increased costs and a less than adequate increase in output prices, farm households will not reap the full benefits of increased production this kharif season. In fact, incomes may actually be less than in the previous year. A heavily indebted class of poor peasants who are primarily dependent on informal credit is also under severe income distress.

5.
Turk Hijyen ve Deneysel Biyoloji Dergisi ; 79(1):13-24, 2022.
Article in English | GIM | ID: covidwho-1835512

ABSTRACT

INTRODUCTION: During the coronavirus infectious disease-2019 (COVID-19) pandemic, healthcare workers are the occupational group most affected by SARS-CoV-2. Infection of healthcare workers with SARS-CoV-2 poses a potential risk of infection for other healthcare workers, patients and their families. The viral load measure in the sample is determined as the cycle threshold (Ct) with the RT-qPCR method. It has been reported that the RT-qPCR Ct value may be related to the severity and potential contagiousness of the infection. In this study, it was aimed to evaluate the relationships between socio-demographic factors, COVID-19 symptoms and Ct value in SARS-CoV-2 RT-qPCR positive healthcare workers. METHODS: In this study, 300 healthcare workers with positive SARS-CoV-2 RT-qPCR test were included. SARS-CoV-2 RT-qPCR test was performed from nasopharyngeal and oropharyngeal swab samples with Bio-speedy SARS-CoV-2 RT-qPCR (Bioeksen, Turkey) kit. The RT-qPCR Ct value results of healthcare staff patients were classified as low, medium and high, socio-demographic characteristics and the risk of viral spread was evaluated. RESULTS: The rate of those who showed at least one symptom among the 300 health personnel included in the study was 88.3% (n=265) and the most common symptoms were muscle-joint pain 39.7%, fatigue 33% and sore throat 30.7%. The median RT-qPCR Ct value was determined as 23.17(19.3-29.4) and Ct value was found to be low (<24.0) in 59% of healthcare personnel. In addition, the Ct value of the personnel working in the administrative units was found to be lower than those working in the COVID-19 polyclinic, service and intensive care unit (p=0.020). Those who had fever and at least one of the COVID-19 symptom (fever, cough, respiratory distress) group had a lower Ct value than those who did not (p=0.008, p=0.019, respectively). When the possible source of transmission was evaluated, it was determined that 22% of the health personnel were infected during patient care, 21% from other health personnel and 23.3% from non-hospital sources. DISCUSSION AND CONCLUSION: Our results have shown that most of the SARS-CoV-2 transmission seen in healthcare workers occurs within the hospital, but more viral load is exposed in out-of-hospital contacts. In addition, it has been observed that administrative personnel who do not have contact with patients can be a potential source of transmission. This situation has reaffirmed that PPE usage rules should be followed in order to reduce the risk of transmission in healthcare personnel and that personnel working outside the clinic should follow the mask and distance rules during their contact with their colleagues. It was determined that the Ct value was lower (higher viral load) in the presence of any of the symptoms of fever, cough, respiratory distress and fatigue in healthcare workers. In the presence of these symptoms, PCR testing of healthcare workers and taking necessary isolation measures until the test result is obtained will reduce the possibility of transmission.

6.
Textual Analisis del Medio Rural Latinoamericano ; 77(24), 2021.
Article in English, Spanish | CAB Abstracts | ID: covidwho-1835444

ABSTRACT

The pandemic caused by COVID-19 has unleashed an economic crisis that mainly affects people with less income. The mortality of COVID-19 depends on various social, cultural and physical factors of individuals;studies have shown that large-scale disasters such as the pandemic affect the health of marginalized communities. Rural communities in Mexico are vulnerable and need to be studied to reduce COVID-19 mortality. Therefore, the objective of this research is to analyze some health and poverty factors influencing an increase in COVID-19 mortality in Mexican rural communities. The research is quantitative, data from January 1 to October 2, 2020 from the Direccion Nacional de Epidemiologia were used to carry out this analysis;a total of 188 municipalities in Mexico were analyzed that are considered rural according to INEGI, with these data a predictive mortality model was elaborated. The most important results show that the coefficients of the log-linear regression models of some health and poverty factors that influence COVID-19 mortality are: Intubated (4.03 for men over 80), Diabetes (3.19 for men under 60), Other Complications (3.36 and 4.75 for men over 80 and under 60 respectively), Another case (0.57, 0.73 and 0.65 for women per age group), similarly the coefficients of poverty are: Lack of Health Services (0.72 and 0.41 for men and women over 80, respectively). It is concluded that in rural communities age is the most important factor for the increase in mortality, although it is higher in men over 80;it becomes evident that diabetes influences mortality in all age groups.

7.
BMC Infectious Diseases ; 22(319), 2022.
Article in English | CAB Abstracts | ID: covidwho-1833284

ABSTRACT

Background: Since the first official report of SARS-CoV-2 infection in Iran on 19 February 2020, our country has been one of the worst affected countries by the COVID-19 epidemic in the Middle East. In addition to demographic and clinical characteristics, the number of hospitalized cases and deaths is an important factor for evidence-based decision-making and disease control and preparing the healthcare system to face the future challenges of COVID-19. Therefore, this cohort study was conducted to determine the demographics, clinical characteristics, and outcomes of hospitalized COVID-19 patients in Kermanshah Province, west of Iran.

8.
International Journal of Sociology and Social Policy ; 42(5/6):543-563, 2021.
Article in English | ProQuest Central | ID: covidwho-1831648

ABSTRACT

Purpose>The sudden onset of COVID-19 has brought about a watershed moment in the current research across all disciplines. As it has impacted almost all aspects of human existence, academicians are aggressively trying to understand the phenomenon from multidisciplinary perspectives. In this regard, the present study attempts to provide an in-depth understanding of academia's response pattern in the field of social sciences using a grounded theory literature review and bibliometric analysis.Design/methodology/approach>The present study analyzed 395 research articles on the pandemic phenomenon, yielding five main themes and 11 sub-themes.Findings>The emergent research themes are global impact on public health, the influence of COVID-19 on workplace functioning, global governance in COVID-19, research ethics in scholarly works and the influence of COVID-19 on demography.Originality/value>Drawing from these themes, the authors provide propositions, policy implications and future research directions.

9.
Access Microbiology ; 4(3), 2022.
Article in English | CAB Abstracts | ID: covidwho-1831588

ABSTRACT

Introduction: The coronavirus disease 2019 (COVID-19) pandemic emerged as a global health crisis in 2020. The first case in India was reported on 30 January 2020 and the disease spread throughout the country within months. Old persons, immunocompromised patients and persons with co-morbidities, especially of the respiratory system, have a more severe and often fatal outcome to the disease. In this study we have analysed the socio-demographic trend of the COVID-19 outbreak in Nagpur and adjoining districts.

10.
Embase; 2022.
Preprint in English | EMBASE | ID: ppcovidwho-335102

ABSTRACT

Objective: To examine the relationship between young adults’ labor force participation and depression in the context of the COVID-19 pandemic. Design, Setting, Participants: Data come from the nationally-representative EPICOV cohort study set up in France, and were collected in 2020 and 2021 (3 waves of online or telephone interviews) among 2217 participants aged 18-30 years. Participants with prior mental health disorder (n=50) were excluded from the statistical analyses. Results: Using Generalized Estimating Equation (GEE) models controlled for participants’ socio-demographic and health characteristics and weighted to be nationally-representative, we found that compared to young adults who were employed, those who were studying or unemployed were significantly more likely to experience depression assessed using the PHQ-9 (multivariate ORs respectively: OR: 1.29, 95% CI 1.05-1.60 and OR: 1.50, 1.13-1.99). Stratifying the analyses by age, we observed than unemployment was more strongly associated with depression among participants 25-30 years than among those who were 18-24 years (multivariate ORs respectively 1.78, 95% CI 1.17-2.71 and 1.41, 95% CI 0.96-2.09). Being out of the labor force was, to the contrary, more significantly associated with depression among participants 18-24 years (multivariate OR: 1.71, 95% CI 1.04-2.82, vs. 1.00, 95% CI 0.53-1.87 among participants 25-30 years). Stratifying the analyses by sex, we found no significant differences in the relationships between labor market characteristics and depression (compared to participants who were employed, multivariate ORs associated with being a student: men: 1.33, 95% CI 1.01-1.76;women: 1.19, 95% CI 0.85-1.67, multivariate ORs associated with being unemployed: men: 1.60, 95% CI 1.04-2.45;women: 1.47, 95% CI 1.01-2.15). Conclusions and relevance: Our study shows that in addition to students, young adults who are unemployed also experience elevated levels of depression in the context of the COVID-19 pandemic. These two groups should be the focus of specific attention in terms of prevention and mental health treatment. Supporting employment could also be a propitious way of reducing the burden of the Covid-19 pandemic on the mental health of young adults.

11.
Journal of Clinical and Translational Science ; 6(s1):3-4, 2022.
Article in English | ProQuest Central | ID: covidwho-1829851

ABSTRACT

OBJECTIVES/GOALS: Suicide is a growing public health problem with the rate of suicide increasing 33% since 1999. Physicians are not immune to this growing problem. Physicians represent a unique population that has been understudied with respect to suicide. The aim of the study is to investigate risk factors unique to physicians compared to the general population. METHODS/STUDY POPULATION: Using data from the National Violent Death Reporting System, a nationwide CDC database which aggregates information on violent deaths, we extracted demographic and circumstantial data on 172,135 suicide decedents ≥ 25 years old in participating states from 2003-2017. Of these, we found complete information regarding demographics, occupation, and circumstance for 160,159 suicide decedents. We separated suicide decedents by physician-status and compared 795 physicians to 159,364 non-physician decedents using chi-squared test. We then used multivariate logistic regression to examine differences in suicide method and circumstance by physician-status status, controlling for age, sex, and race. RESULTS/ANTICIPATED RESULTS: Compared to non-physicians, physicians were more likely to be male (84.5% vs 77.3%, p<0.001) and older (45.1% ≥65 vs. 17.8%, p<0.001). Controlling for demographics, physicians were less likely to complete suicide by firearm (aOR=0.60, 95%CI=0.51-0.71) but were more likely to suicide by overdose (aOR=1.41, 95%CI=1.13-1.77) or cutting (aOR=2.81, 95%CI=2.03-3.88). Physicians were more likely to have job related stressors (aOR=2.24, 95%Cl=1.83-2.74) and legal problems (aOR=2.34, 95%Cl=1.70-3.21). Physicians were also more likely to leave a suicide note (aOR=1.48, 95%Cl=1.26-1.73) but were less likely to be intoxicated on alcohol at time of death (aOR=0.76, 95%Cl=0.62-0.93). Physicians were no different than non-physicians in terms of financial or relational stressors. DISCUSSION/SIGNIFICANCE: Physicians are more likely to be male and older. Given their medical training, overdose and cutting may be more accessible and lethal methods for physicians. Physicians are more likely to leave a suicide note and less likely to be intoxicated, which may imply less impulsivity. Job stressors and legal problems may also contribute to physician suicide.

12.
Journal of Infection and Public Health ; 15(4):400-405, 2022.
Article in English | GIM | ID: covidwho-1828916

ABSTRACT

Background: Healthcare workers are considered to be at a higher risk of acquiring tuberculosis (TB) infection than the general population. Clinical medical students are part of the healthcare team and clinical practice are done during their clinical rotation. They could be exposed to similar occupational risks as the healthcare workers. Most students who become infected have latent tuberculosis infection (LTBI) and may not exhibit any clinical symptoms. Some students with LTBI can progress to TB disease during clinical rotations in the hospitals. Therefore, screening for LTBI in this population represents hospital aspect of public health strategy and infection control in medical school in high TB burden countries.

13.
Agbiol ; 2021.
Article in English | GIM | ID: covidwho-1823726

ABSTRACT

During the pandemic, stress is caused by the imbalance between the individual's perception and external environmental demands. Studies have shown that psychological stress is closely related to anxiety, depression, and physical conditions such as cardiovascular diseases and cancer. Students at universities face many stressors, including the volatile environment, lifestyle changes, academic burdens and interpersonal relationships, all of which can lead to significant psychological dysfunction. In particular, they are vulnerable to the stress that most university students in developing countries have to cope with, for themselves and their families, to fight the Covid-19 infection. The sample of this descriptive cross-sectional study consisted of 141 undergraduate health science students from Trakya University in the north west region of Turkey. The study was conducted April 2021 to July 2021. The sociodemographic characteristics of the university students were evaluated. Health sciences students, from the perspective of the Turkish cultural context;we identified the stress levels that have been elevated due to Covid-19. In addition, from the high perceived stress levels due to Covid-19, which is associated with anxiety and depression;We have seen that school success is negatively affected in university students. Many issues related to health science students have been discussed many times in the literature. However, our current research in a goal-oriented context;"students who will work with infections and may even encounter new pandemics";self-regulation and an approach that jointly develops the solution.

14.
Economic and Political Weekly ; 56(44), 2021.
Article in English | CAB Abstracts | ID: covidwho-1824226

ABSTRACT

Through a series of data visualisations, the article attempts to illustrate the economic repercussions of the COVID-19-induced lockdown of 2020 on rural households. It focuses on how consumption, labour and income, healthcare, access to relief programmes and migration were effected by the lockdown in six major states.

15.
Pakistan Journal of Medical and Health Sciences ; 16(3):560-563, 2022.
Article in English | EMBASE | ID: covidwho-1822797

ABSTRACT

Objectives: The study aimed to examine COVID-19 knowledge among the general public in Pakistan, to review their attitudes and views regarding the fast epidemic. Study Design: Descriptive cross-sectional study. Duration of Study: June-July 2020. Methodology: A total of 679 respondents included. The questionnaires comprised of the following basic themes: basic demography, general & basic clinical/medical knowledge, attitudes, awareness, perceptions as well as a sense of prevention regarding COVID-19. Results: The majority (75.5%) of the respondents were from Punjab province. Around half (54.5%) of the respondents had heard about the COVID-19 infection through different social media. The majority were 28.4% medical students. The majority of the respondents (80-95%) selected correct answers from the given choices for the questions related to some clinical knowledge. More than half of people (59-64%) think positively that COVID-19 will successfully be controlled and Pakistan will be successful in winning this battle of the pandemic. 61% were afraid of COVID-19 as it is highly contagious disease (37.7%). Around 60% always covered their noses and mouths while sneezing and coughing. Conclusion: The people must have a thorough understanding of COVID-19 to successfully execute COVID-19 prevention strategies. Although we found enough knowledge, favorable perspectives, and readiness to follow SOPs, we believe that additional preventative and cautious attitudes, as well as awareness, are needed.

16.
Journal of Critical and Intensive Care ; 13(1):12-17, 2022.
Article in English | EMBASE | ID: covidwho-1822779

ABSTRACT

Objective: Coronavirus Disease-2019 (COVID-2019), which originated in Wuhan, China in December 2019 and became a global pandemic in March 2020, is a viral infectious condition. This study was planned due to the novel character of the virus, unexpected clinical course of the disease as well as due to the relative lack of data on determinants of severe disease. Methods: This retrospective study was carried out with the inclusion of 80 patients admitted to the Intensive Care Unit (ICU), Medical Faculty of Erzincan Binali Yildirim University between 1st April 2020 and 1st October 2020 due to the diagnosis of COVID-19 pneumonia. Demographic, clinical, and laboratory data, as well as treatments complications, length of ICU stay and mortality rate were compared between patients who had survive or not. Results: Of the 80 patients, 18 were died, and 62 were discharged. The mean age was 69.7 ± 14.7 years, with a female to male ratio of approximately 1:2. Systolic blood pressure and mean arterial pressure on admission were significantly lower in non-survivors (p=0.002, and p=0.026, respectively). Also, non-survivors had significantly higher levels of CRP, procalcitonin, D-dimer, urea, LDH, INR, lactate, and neutrophil count and significantly lower lymphocyte counts as compared to survivors. The predictors of mortality were determined as the need for mechanical ventilation, presence of complications, higher CRP and urea levels in a multivariate regression analysis. Conclusion: Early estimation of patients with a high likelihood of severe illness, assessment of the intensive care unit admission, and convenient treatment strategies are important. This is a precious study that detects an early need for ICU admission and close follow-up of patients.

17.
Journal of Clinical Neonatology ; 11(2):65-70, 2022.
Article in English | EMBASE | ID: covidwho-1822508

ABSTRACT

Background: Multisystem inflammatory syndrome in children (MIS-C) is a well-known entity that occurs 3-4 weeks after COVID-19. A similar entity in newborns, known as Multisystem Inflammatory Syndrome in Newborns (MIS-N), is also described. However, the epidemiology, case definition, clinical presentations, and outcomes of MIS-N are still being updated. The presence of SARS CoV 2 antibodies in both the mother and the neonate suggests transplacental transfer of IgG antibodies causing cytokine storm and multisystem inflammatory syndrome in newborns (MIS-N). Aims and Objectives: To investigate the clinical characteristics, laboratory parameters, outcomes, and treatment modalities of neonates with multisystem inflammatory syndrome due to transplacental transfer of SARS CoV 2 antibodies. Materials and Methods: The study included eighteen consecutive neonates who met the MIS-C criteria. Following prior ethical clearance and consent from parents or guardians, socio-demographic data, lab parameters, clinical parameters, and treatment given were documented, tabulated, and analysed. Results: All of the 18 neonates had fever. The most common system involved was the respiratory system (15/18), followed by the cardiovascular system with coronary artery dilatations (10/18) and persistent pulmonary hypertension (4/18). All 17 cases (17/18) responded favourably to intravenous immunoglobulins (2 gm/kg) and intravenous dexamethasone (0.15 mg/kg). D-Dimers decreased significantly after treatment, with a p value of 0.01. One case with more than three systems involved (respiratory, CVS, CNS, and renal involvement) (1/18) resulted in death. Conclusion: A high index of suspicion is warranted in critically ill neonates, especially with fever, multisystem involvement and positive SARS CoV 2 antibodies. Fever may be a soft pointer to the diagnosis as fever is rare in neonates with other illnesses. Followup antibody titres are needed to document if there is any relationship between level of antibodies and disease. Safety of vaccination also needs to be addressed as antibodies are implicated in the etiopathogenesis of MIS-N.

18.
Neurological Sciences ; 2022.
Article in English | EMBASE | ID: covidwho-1820939

ABSTRACT

Objectives: To investigate the safety and tolerability of COVID-19 vaccines in people with epilepsy (PwE). Methods: In this multicentric observational cohort study, we recruited adult patients (age > 18 years old) with epilepsy who attended the Outpatient Epilepsy Clinic from 1st July to 30th October 2021. We administered to the patients a structured questionnaire and interview on demographic and epilepsy characteristics, current treatment, previous SARS-CoV-2 infection, vaccine characteristics, post-vaccine seizure relapse, other side effect, variation of sleep habits, caffeine, or alcohol intake. Seizure frequency worsening was defined as a ratio between mean monthly frequency post-vaccination and mean monthly frequency pre-vaccination superior to 1. Patients were categorized in two groups: patients with seizure frequency worsening (WORSE) and patients with seizure stability (STABLE). Results: A total of 358 people participated with a mean age of 47.46 ± 19.04. Focal seizure (79.1%), generalized epilepsy (20.4%), and unknown types of epilepsy (0.5%) were detected among participants. In total, 31 (8.7%) people expressed that they were not willing to receive a COVID-19 vaccine;302 patients (92.35%) did not experience an increase in the seizure frequency (STABLE-group) whereas 25 patients (7.65%) had a seizure worsening (WORSE-group). Post-vaccine seizures occurred mainly in the 7 days following the administration of the vaccine. Patients in the WORSE-group were treated with a mean higher number of anti-seizure medication (ASMs) (p = 0.003) and had a higher pre-vaccine seizure frequency (p = 0.009) compared with patients in the STABLE-group. Drug-resistant epilepsy was also associated with seizure worsening (p = 0.01). One-year pre-vaccination seizure frequency pattern demonstrated that patients in the WORSE-group had a higher frequency pattern (p < 0.001). Multivariate analysis of the vaccinated group showed that only the seizure frequency pattern (confidence interval [CI] = 1.257–2.028;p < 0.001) was significantly associated with seizure worsening. Conclusion: In our cohort of vaccinated PwE, only a little percentage had a transient short-term increase of seizure frequency. The present study demonstrates that COVID-19 vaccines have a good safety and tolerability profile in the short term in PwE.

19.
European Journal of Molecular and Clinical Medicine ; 9(3):2809-2818, 2022.
Article in English | EMBASE | ID: covidwho-1820648

ABSTRACT

Aim: To evaluate neutrophilic lymphocyte ratio and lymphocyte monocyte ratio as prognostic markers in COVID 19. Material and method: The present retrospective observational studyconducted in the department of Medicine, Government Medical College, Jammu for a period of one year. The study comprised of 100 Covid 19 RT PCR positive cases admitted patient in ICU as well as Ward, in covid care centre of Government Medical College, Jammu. Patients characteristics were obtained from the hospital covid care centre satisfying inclusion criteria from electronic medical records and demographic, clinical, laboratory data were extracted included age, sex clinical features, signs and symptoms, comorbidities, exposure history, oxygen support during hospitalization, duration of oxygen support during hospitalization,imaging features of the chest (CT scoring), laboratory findings (Hemogram, Total leucocyte count, differential counts, NLR and LMR. Complete blood count including NLR and LMR collected at day of admission and day 3 of admission and documented on a standardized proforma. Two outcomes were evaluated: “discharge” or “died.” Results:In majority (53%) of patients, ventilation given was high flow followed by bipap (21%), ventimask (19%) and ventilator (5%). Ventilation given was room air in only 2 out of 100 patients (2%). In present study, only 10 out of 100 patients (10.00%) died.Discriminatory power of neutrophil lymphocyte ratio (AUC 0.865;95% CI: 0.781 to 0.925) was excellent and discriminatory power of lymphocyte monocyte ratio (AUC 0.791;95% CI: 0.698 to 0.867) was acceptable. Among both the parameters, neutrophil lymphocyte ratio was the best predictor of CTSI severity at cut off point of >3.57 with 86.50% chances of correctly predicting CTSI severity. Conclusion: It can be concluded from the results that NLR may be a rapid, widely available, useful prognostic factor in the early screening of critical illness in patients with confirmed COVID-19.

20.
Anesthesia and Analgesia ; 134(4 SUPPL):30, 2022.
Article in English | EMBASE | ID: covidwho-1820560

ABSTRACT

Introduction: Social determinants of health (SDOH) have a significant impact on access to health. Low socioeconomic status (SES) has been associated with delayed care and missed appointments. Telehealth services provides an opportunity to deliver health care by reducing physical barriers. During the COVID-19 pandemic, telehealth services were expanded by many health systems to continue providing socially distant care. While telehealth has the potential to bridge physical gaps in care, technology can be an additional barrier to accessing care and exacerbate existing health disparities. Understanding the impact of telehealth in the context of SDOH risk factors may be an important component toward studying and achieving health equity. Unfortunately, there is a limited amount of SES factors available to study in the electronic health record (EHR). The goal of our study was to use an innovative method to better understand the SES and location risk factors that are associated with the utilization of telehealth services in a pediatric pain clinic at an academic children's hospital. Methods: Following IRB approval, we conducted a retrospective study of all pediatric pain clinic patients seen by telehealth at a freestanding academic children's hospital from 4/2020 to 5/2021. Patient demographic details and telehealth utilization data were ed from the EHR and the enterprise data lake. Administrative outcomes of interest were telehealth appointment no-show or cancellations within 24 hours. Patient EHR addresses were geocoded and geospatial analytic techniques, including spatial linkage of EHR data with US Census-American Community Survey 2019 Data (5-Year) was conducted. Analysis was at the patient-level and neighborhood block-group level for SDOH measures. Specific neighborhood level measures used included the percent of households that have no computer. Analysis was conducted utilizing SAS, R, and ArcGIS Pro. Results: Our study included 550 pediatric pain patients, and all were successfully geocoded at the street level address. There were 309 patients (56.2%) who had their initial follow-up appointment using telehealth and 241 (43.8%) who were seen as a new patient visit. Most patients had government insurance (61.6%) as compared to commercial (38.4%). Overall, 14.9% of appointments were cancelled <24 hours or did not show up for their telehealth appointment. New appointments were more likely to be cancelled <24 hours or not show up (21.2%) as compared to follow-up appointments where 10% were cancelled/no show. A large percentage of patients self-reported their race as “Other” (51.8%) or were unknown (14.2%). Patient residential addresses came from a variety of locations in the state of California with a small number of patients from Nevada and Arizona. Patients who cancelled <24 hours or did not show up were more likely to come from neighborhoods (defined as Census Block Groups) of lower socioeconomic status. In addition, census block groups that had more “households with no computers” were more likely to cancel/no show for their telehealth appointment. Digital maps demonstrating geographic variation and disparities in access to telehealth utilization were created for exploration and descriptive purposes. Discussion: We successfully identified patient level and neighborhood level socioeconomic risk factors that are associated with cancelling (<24 hours) or not showing up for their telehealth appointment. Leveraging EHR data with geospatial analytics can augment our understanding of the SDOH that may impact the delivery of telehealth services in a pediatric population. Future steps include using these spatial risk factors to risk stratify and improve care delivery pathways to reduce disparities in telehealth utilization. (Figure Presented).

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