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1.
BMJ Open ; 11(8), 2021.
Article in English | ProQuest Central | ID: covidwho-1843117

ABSTRACT

ObjectivesWhile COVID-19 has a relatively small direct impact on infant mortality, the pandemic is expected to indirectly increase mortality of this vulnerable group in low-income and middle-income countries through its effects on the economy and health system performance. Previous studies projected indirect mortality by modelling how hypothesised disruptions in health services will affect health outcomes. We provide alternative projections, relying on modelling the relationship between aggregate income shocks and mortality.DesignWe construct a sample of 5.2 million births by pooling retrospective birth histories reported by women in Demographic and Health Surveys conducted in 83 low-income and middle-income countries between 1985 and 2018. We employ regression models with country-specific fixed-effects and flexible time trends to estimate the impact of gross domestic product per capita on infant mortality rate. We then use growth projections by the International Monetary Fund to predict the effect of the economic downturn in 2020 on infant mortality.ResultsWe estimate 267 208 (95% CI 112 000 to 422 415) excess infant deaths in 128 countries, corresponding to a 6.8% (95% CI 2.8% to 10.7%) increase in the total number of infant deaths expected in 2020.ConclusionsThe findings underscore the vulnerability of infants to the negative income shocks such as those imposed by the COVID-19 pandemic. While efforts towards prevention and treatment of COVID-19 remain paramount, the global community should also strengthen social safety nets and assure continuity of essential health services.

2.
Embase; 2022.
Preprint in English | EMBASE | ID: ppcovidwho-335803

ABSTRACT

The CDC recommended a booster dose of the Pfizer-BioNTech Comirnaty (BNT162b2) COVID-19 mRNA vaccine in September 2021 for high-risk individuals. Pregnant and high-risk lactating women were encouraged to receive the booster to obtain potential prolonged protection for themselves and their infants. This study investigated the ability of the booster vaccine to increase IgA and IgG antibodies specific to the receptor binding domain (RBD) of the SARS-CoV-2 spike protein in human milk compared to levels pre-booster. We found a significant increase in both anti-RBD-specific IgA and IgG antibodies in human milk 1-2 weeks after the Pfizer-BioNTech booster and at the study endpoint (60 days post-booster). These results suggest the booster vaccination enhances SARS-CoV-2 specific immunity in human breast milk, which may be protective for infants.

3.
Embase; 2021.
Preprint in English | EMBASE | ID: ppcovidwho-335562

ABSTRACT

Little is known about the genetics of norm violation and aggression (ASB) in relation to coronavirus disease 2019 (COVID-19). To investigate this, we used summary statistics from genome-wide association studies and linkage disequilibrium score regression to calculate a matrix of genetic correlations (rgs) for ASB, COVID-19, and various health and behavioral traits. After false-discovery rate correction, ASB was genetically correlated with COVID-19 (rg= 0.51;P = 1.54E-02) and 19 other traits. ASB and COVID-19 were both positively genetically correlated with having a noisy workplace, doing heavy manual labor, chronic obstructive pulmonary disease, and genitourinary diseases. ASB and COVID-19 were both inversely genetically correlated with average income, education years, healthspan, verbal reasoning, lifespan, cheese intake, and being breastfed as a baby. But keep in mind that rgs are not necessarily causal. And, if causal, their prevailing directions of effect (which causes which) are indiscernible from rgs alone. Moreover, the SNP-heritability (h2y) estimates for both measures of COVID-19 were very low, restricting the overlap of genetic variance in absolute terms between the two traits. Nonetheless, our findings suggest that those with antisocial tendencies possibly have a higher risk of exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) than those without antisocial tendencies. This may have been especially true early in the pandemic before vaccines against SARS-CoV-2 were available and before the emergence of the highly transmissible Omicron variant.

4.
JAMA Psychiatry ; 78(11):1285, 2021.
Article in English | APA PsycInfo | ID: covidwho-1837897

ABSTRACT

Reports an error in "Effect of online 1-day cognitive behavioral therapy-based workshops plus usual care vs usual care alone for postpartum depression: A randomized clinical trial" by Ryan J. Van Lieshout, Haley Layton, Calan D. Savoy, June S. L. Brown, Mark A. Ferro, David L. Streiner, Peter J. Bieling, Andrea Feller and Steven Hanna (JAMA Psychiatry, 2021[Nov], Vol 78[11], 1200-1207). In the originally published article, 2 pieces of data were incorrectly presented in the third paragraph of the Results section, where the denominator and percentage in the first sentence were incorrect. That sentence should have appeared as follows: "The intervention was well tolerated, with 10 of 161 participants in the experimental group (6%) expressing a preference that it be delivered differently (eg, in half-days)." This article was corrected online. (The of the original article appeared in record 2022-41504-002). Importance: Postpartum depression (PPD) affects as many as 20% of mothers, yet just 1 in 10 of these women receives evidence-based treatment. The COVID-19 pandemic has increased PPD risk, reduced treatment access, and shifted preferences toward virtual care. Objective: To determine whether an online 1-day cognitive behavioral therapy (CBT)-based workshop added to treatment as usual improves PPD, anxiety, social support, mother-infant relationship quality, and infant temperament more than treatment as usual alone. Design, setting, and participants: This randomized clinical trial included 403 women with PPD who were recruited across Ontario, Canada, during the COVID-19 pandemic (April 20 to October 4, 2020). Women with Edinburgh Postnatal Depression Scale (EPDS) scores of at least 10 who were 18 years or older and had an infant younger than 12 months were eligible. Interventions: Women were randomly assigned to receive a live, interactive online 1-day CBT-based workshop delivered by a registered psychotherapist, psychiatrist, or clinical psychology graduate student in addition to treatment as usual (n = 202) or to receive treatment as usual and wait-listed to receive the workshop 12 weeks later (n = 201). Main outcomes and measures: The primary outcome was change in PPD (EPDS scores) in experimental and wait list control groups 12 weeks after baseline. Secondary outcomes included maternal anxiety (7-item Generalized Anxiety Disorder Questionnaire [GAD-7]), social support (Social Provisions Scale), quality of the mother-infant relationship (Postpartum Bonding Questionnaire), and infant temperament (Infant Behavior Questionnaire-Revised Very Short Form). Results: Participants all identified as women with a mean (SD) age of 31.8 (4.4) years. The workshop led to significant mean (SD) reductions in EPDS scores (from 16.47 [4.41] to 11.65 [4.83];B = -4.82;P < .001) and was associated with a higher odds of exhibiting a clinically significant decrease in EPDS scores (odds ratio, 4.15;95% CI, 2.66-6.46). The mean (SD) GAD-7 scores decreased from 12.41 (5.12) to 7.97 (5.54) after the workshop (B = -4.44;95% CI, -5.47 to -3.38;P < .001) and participants were more likely to experience a clinically significant change (odds ratio, 3.09;95% CI, 1.99-4.81). Mothers also reported improvements in bonding (B = -3.22;95% CI, -4.72 to -1.71;P < .001), infant-focused anxiety (B = -1.64;95% CI, -2.25 to 1.00;P < .001), social support (B = 3.31;95% CI, 1.04 to 5.57;P < .001), and positive affectivity/surgency in infants (B = 0.31;95% CI, 0.05 to 0.56;P < .001). Conclusions and relevance: In this randomized clinical trial, an online 1-day CBT-based workshop for PPD provides an effective, brief option for mothers, reducing PPD and anxiety as well as improving social support, the mother-infant relationship, and positive affectivity/surgency in offspring. Trial registration: ClinicalTrials.gov Identifier: NCT04485000. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

5.
Applied Sciences ; 12(9):4199, 2022.
Article in English | ProQuest Central | ID: covidwho-1837783

ABSTRACT

This study aims to develop a method for multivariate spatial overdispersion count data with mixed Poisson distribution, namely the Geographically Weighted Multivariate Poisson Inverse Gaussian Regression (GWMPIGR) model. The parameters of the GWMPIGR model are estimated locally using the maximum likelihood estimation (MLE) method by considering spatial effects. Therefore, the significance of the regression parameter differs for each location. In this study, four GWMPIGR models are evaluated based on the exposure variable and the spatial weighting function. We compare the performance of those four models in real-world application using data on the number of infant, under-5 and maternal deaths in East Java in 2019 using five predictor variables. In this study, the GWMPIGR model uses one exposure variable and three exposure variables. Compared to the fixed kernel Gaussian weighting function, the GWMPIGR model with the fixed kernel bisquare weighting function and one exposure variable has a better fit based on the AICc value. Furthermore, according to the best GWMPIGR model, there are several regional groups formed based on predictors that significantly affected each event in East Java in 2019.

6.
Front Public Health ; 10: 829176, 2022.
Article in English | MEDLINE | ID: covidwho-1834645

ABSTRACT

Background: As the epidemic progresses, universal vaccination against COVID-19 has been the trend, but there are still some doubts about the efficacy and safety of COVID-19 vaccines in adolescents, children, and even infants. Purpose: To evaluate the safety, immunogenicity, and efficacy of COVID-19 vaccines in the population aged 0-17 years. Method: A comprehensive search for relevant randomized controlled trials (RCTs) was conducted in PubMed, Embase, and the Cochrane Library from inception to November 9, 2021. All data were pooled by RevMan 5.3 statistical software, with risk ratio (RR) and its 95% confidence interval as the effect measure. This study protocol was registered on PROSPERO (CRD42021290205). Results: There was a total of six randomized controlled trials included in this systematic review and meta-analysis, enrolling participants in the age range of 3-17 years, and containing three types of COVID-19 vaccines. Compared with mRNA vaccines and adenovirus vector vaccines, inactivated vaccines have a more satisfactory safety profile, both after initial (RR 1.40, 95% CI 1.04-1.90, P = 0.03) and booster (RR 1.84, 95% CI 1.20-2.81, P = 0.005) vaccination. The risk of adverse reactions was significantly increased after the first and second doses, but there was no significant difference between the first two doses (RR 1.00, 95%CI 0.99-1.02, P = 0.60). Nevertheless, the two-dose regimen is obviously superior to the single-dose schedule for immunogenicity and efficacy. After booster vaccination, both neutralizing antibodies (RR 144.80, 95%CI 44.97-466.24, P < 0.00001) and RBD-binding antibodies (RR 101.50, 95%CI 6.44-1,600.76, P = 0.001) reach optimal levels, but the cellular immune response seemed not to be further enhanced. In addition, compared with younger children, older children and adolescents were at significantly increased risk of adverse reactions after vaccination, with either mRNA or inactivated vaccines, accompanied by a stronger immune response. Conclusion: The available evidence suggests that the safety, immunogenicity and efficacy of COVID-19 vaccines are acceptable in people aged 3-17 years. However, there is an urgent need for additional multicenter, large-sample studies, especially in younger children under 3 years of age and even in infants, with long-term follow-up data. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021290205, identifier: CRD42021290205.


Subject(s)
COVID-19 , Vaccines , Adolescent , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Child , Child, Preschool , Humans , Multicenter Studies as Topic , Vaccination
7.
Health Equity ; 6(1):338-344, 2022.
Article in English | ProQuest Central | ID: covidwho-1830943

ABSTRACT

The COVID-19 pandemic has highlighted structural inequities that are barriers to thriving for children in neighborhoods with concentrated disadvantage. Health systems are increasingly addressing health-related social needs. The “Pittsburgh Study” is a longitudinal, community-partnered study focused on child and adolescent thriving and racial equity. This initiative will elucidate critical influences on childhood health and thriving, evaluate developmentally appropriate interventions to improve outcomes from birth to high school, and establish a child health data hub. Integration of community members into scientific inquiry, rapid data-to-action cycles, and workforce development are strategies health systems may consider to enhance child health equity.

8.
J Korean Med Sci ; 37(18): e147, 2022 May 09.
Article in English | MEDLINE | ID: covidwho-1834345

ABSTRACT

With the spread of coronavirus disease 2019 (COVID-19) in Korea, the number of pregnant women infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is rapidly increasing. A shortage of negative-pressure isolation rooms for newborns makes hospital assignment more difficult for late-pregnant women with COVID-19. Among 34 infants born to SARS-CoV-2-positive mothers, 5 (14.7%) presented with respiratory distress and 1 (2.9%) presented with feeding intolerance that required specialized care. Aerosol-generating procedures were performed in one infant. Overall outcomes of 34 infants were favorable, and no infant tested positive for SARS-CoV-2. Most infants born to SARS-CoV-2-positive mothers did not need to be quarantined in a negative-pressure isolation room, and 17 (50%) mother-infant dyads were eligible for rooming-in. If negative-pressure isolation rooms are selectively used for newborns requiring aerosol-generating procedures or newborns in respiratory distress, resource availability for lower-risk cases may improve.


Subject(s)
COVID-19 , Pregnancy Complications, Infectious , Respiratory Distress Syndrome , Female , Humans , Infant, Newborn , Infectious Disease Transmission, Vertical/prevention & control , Mothers , Pregnancy , SARS-CoV-2
10.
Osteopathic Family Physician ; 13(3):35-39, 2021.
Article in English | EMBASE | ID: covidwho-1822742

ABSTRACT

Since the declaration of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in March 2020 by the World Health Organization (WHO), there has been an emergence of a new syndrome termed multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19. MIS-C is defined by the presence of fever, systemic inflammation and multiorgan dysfunction in association with SARS-CoV-2 infection or COVID-19 exposure. Knowledge of this syndrome’s presentation and pathophysiology is constantly evolving as more cases are reported in the literature. This case identifies a 3-month-old patient who tested negative for SARS-CoV-2 antigen, reverse transcriptase polymerase chain reaction (RT-PCR) and antibodies but qualified for MIS-C diagnosis. To the best of our knowledge and through extensive research at the time of diagnosing and reporting this condition to the healthcare authorities, we report the youngest pediatric patient with MIS-C diagnosis. We document this case to contribute to further understanding the variable manifestations of MIS-C and the importance of early diagnosis and treatment with intravenous immunoglobulin (IVIG).

11.
Cureus ; 14(4): e23734, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1822583

ABSTRACT

Background The coronavirus disease (COVID-19) pandemic has resulted in a significant increase in the number of people seeking online support and information, particularly on social media. Nevertheless, the nature and trend of internet information, as well as its accuracy, are questionable. This study aimed to assess and compare the content, type/form, and degree of accuracy of breastfeeding information on Facebook before and during the COVID-19 pandemic (n = 288/phase). Methodology The data were gathered from Malaysian public and group/page Facebook posts (n = 456). Keyword searches were conducted using Malay and English breastfeeding terms. The dataset was screened and entered into a structured codebook. The Delphi approach was used to assess the accuracy of posts' content performed by breastfeeding experts. Results Sharing personal experience (53.2%) was the most common topic in breastfeeding-related posts, followed by seeking questions (39.3%) and knowledge (8.0%). Sharing personal stories and knowledge posts were higher during COVID-19 than before (p = 0.001), although the seeking questions category was higher before the pandemic (p = 0.001). Most information posted was in text form (94.5%). About half of the posts (46.5%) were misleading, while (43.7%) were accurate. There was a significant difference in the accuracy of online posts before and during the COVID-19 pandemic (p = 0.001). Conclusions Compared to the pre-pandemic phase, forms/types of information on Facebook remained consistent, whereas the breastfeeding information content and its degree of accuracy differed during the pandemic.We need to explore other aspects of breastfeeding online content as well as its engagement, especially during a pandemic. Knowing the infant feeding-related topics that have been discussed and questioned on social media, as well as the accuracy of the data, allows policymakers and scientific communities to plan strategies for spreading credible breastfeeding information online. This includes creating interactive online media types of visual guidelines, web resources, and breastfeeding apps.

12.
European Journal of Molecular and Clinical Medicine ; 9(3):2673-2681, 2022.
Article in English | EMBASE | ID: covidwho-1820578

ABSTRACT

Background- For successful management of Covid-19 pregnancy, adequate information and understanding of its clinical presentation and impact of the disease on pregnant mothers and their newborns is required. Aim- To describe the clinical manifestations of COVID -19 infection in pregnant women during peripartum period and to study the clinical outcomes of neonates born to these mothers. Methods- This prospective study was conducted at a COVID-19 Hospital of North India, from May 2021 to July 2021.All Covid-19 positive pregnant women who presented at the time of labor (symptomatic or asymptomatic) were included in the study. Follow up of these women and their newborns was done till discharge and neonates were further followed up till 28 days of life. Results-Total 70 patients were included in the study (24.2% symptomatic and 75.7% asymptomatic). Eighteen (25.7%) were NVD and 52(74.2%) were LSCS. LSCS was done more in symptomatic subjects (p<0.05). Frequency of AFD is higher in symptomatic subjects(p value< 0.05).Co morbidities noted were PIH, GDM, hypothyroidism and anemia in 15(21.4%), 2(2.8%), 11(15.7%) and 22(31.4%) respectively. All study women were successfully discharged. There were 69 live births(53(76.8%) term and 16(23.1%) preterms)and 1 IUD. Two (2.8%) babies were tested positive for COVID19. Both remained asymptomatic and discharged. Total 11 neonates required NICU admission due to non covid reasons. Number of deaths among neonates were 2 (2.8%). During followup visits 5(9.09%) neonates required readmission in NICU. Inadequate weight gain was seen in 3(5.4%) babies. None developed COVID related symptoms. Conclusion- COVID 19 infection during pregnancy is not associated with severe clinical presentation, high mortality and morbidity. There may be an association between symptomatic COVID19 pregnant women and AFD. There is high incidence of prematurity and LBW in neonates born to COVID positive mothers.

13.
Postgrad Med ; : 1-9, 2022 May 10.
Article in English | MEDLINE | ID: covidwho-1819649

ABSTRACT

OBJECTIVE: The maternal-child health services remain an important indicator to look at how different countries have handled the pandemic. This study aims to investigate the effect of the COVID-19 pandemic on maternal and child healthcare use and evaluate data on stillbirths and infant mortality. METHODS: In this descriptive, cross-sectional study, a retrospective analysis was performed on 293 stillbirths and 324 infant deaths, which occurred in Samsun Province of Turkey between 1 March 2018 and 1 March 2021. The study period was examined in three groups as pre-pandemic period 1 (1 March 2018-28 February 2019), pre-pandemic period 2 (1 March 2019-29 February 2020) and pandemic period (1 March 2020-28 February2021). RESULTS: The study found that the share of difficulties in delivering health-care services to the families (may be due to reasons such as difficulty in accessing health services for those living in rural areas, disruption of the referral chain) in stillbirths and infant deaths has decreased during the COVID-19 pandemic compared to previous years (p = 0.037 in stillbirths, p = 0.002 in infant deaths). The mean number of follow-up visits during pregnancy has partially reduced during the pandemic (p > 0.05). Other variables of the health-care services have remained similar to years before the pandemic (p > 0.05). The rate of families without health insurance (p = 0.001 in stillbirths, p = 0.001 in infant deaths) and unemployed persons contributing to family budget (p = 0.012 in stillbirths, p = 0.016 in infant deaths) has significantly decreased during the pandemic. CONCLUSIONS: In our study, it was determined that the variables of stillbirth and infant mortality during the COVID-19 pandemic period, and maternal and child health services in primary care and hospitals continued to provide services in a similar way to the pre-pandemic period. Compared to pre-pandemic periods during the COVID-19 pandemic, it was found that while the number of stillbirths was similar, there was a significant decrease in infant mortality.

14.
Journal of Clinical Obstetrics and Gynecology ; 32(1):7-12, 2022.
Article in English | EMBASE | ID: covidwho-1818564

ABSTRACT

Objective: As approval of one of many coronavirus disease-2019 (COVID-19) vaccines' use for pregnancy is getting closer, vaccine hesitancy may take place in pregnant individuals for this new vaccine. Our study aimed to evaluate vaccine acceptance and factors affecting vaccine acceptance in case of an approved COVID-19 vaccine for pregnant individuals. Material and Methods: Our study was designed as one group, cross-sectional, prospective study. Sample consisted of pregnant individuals who didn't have any chronic illnesses and didn't contract COVID-19 in the last 6 months. In-person style survey was used to collect data about demographics, knowledge about COVID- 19 disease and it's effects on pregnant individuals, vaccine acceptance and reasons for acceptance or refusal. Results were analyzed with descriptive statistics, chi-square test and Shapiro-Wilk test of normality using Number Cruncher Statistical System. Results: Among 250 participants, 183 (73.2%) reported they wouldn't accept COVID-19 vaccination if there was a safe and effective vaccine approved for use in pregnancy. Main reasons of refusal were the belief that vaccine hadn't been studied on humans enough or that it might have adverse effectes on baby and/or pregnant individual. Only factor associated with vaccine acceptance was found to be knowing someone who had severe COVID-19 disease (p=0.022). Conclusion: Our study shows that vaccine hesitancy rates may be high among pregnant individuals when a COVID-19 vaccine is approved for use in pregnancy. The main reason for vaccine hesitancy is safety concerns.

15.
Int J Environ Res Public Health ; 19(9)2022 Apr 21.
Article in English | MEDLINE | ID: covidwho-1818133

ABSTRACT

Perinatal maternal anxiety and depression negatively affect intrauterine fetal development, birth outcome, breastfeeding initiation, duration, and milk composition. Antenatal classes potentially reduce the anxiety of pregnant women and may thus contribute to healthy infant development. The study investigates the relationship between participation in online or in-person antenatal classes and levels of anxiety and depression in Polish women during the COVID-19 pandemic. The study group included 1774 adult, non-smoking pregnant women. We compared the state anxiety (STAI-State) and depression levels (EPDS) in women who (i) attended antenatal classes in-person, (ii) attended online classes, and (iii) did not attend any of them. The statistical analyses included a GLM model and trend analysis, while controlling for maternal trait anxiety, age, pregnancy complications, trimester of pregnancy, previous pregnancies, and COVID-19 infections. We observed statistically significant differences in the level of anxiety (and depression). Women who did attend antenatal classes in person had the lowest levels of anxiety and depression. Considering the importance of maternal mental well-being on fetal development, birth outcome, and breastfeeding, in-person participation in antenatal classes should be recommended to pregnant women.


Subject(s)
COVID-19 , Pregnancy Complications , Adult , Anxiety/epidemiology , COVID-19/epidemiology , Child , Depression/epidemiology , Female , Humans , Pandemics , Parturition , Pregnancy , Pregnancy Complications/epidemiology
16.
Front Pediatr ; 10: 853389, 2022.
Article in English | MEDLINE | ID: covidwho-1818003

ABSTRACT

[This corrects the article DOI: 10.3389/fped.2021.762684.].

17.
Clinical Cancer Research ; 27(6 SUPPL 1), 2021.
Article in English | EMBASE | ID: covidwho-1816933

ABSTRACT

Importance: Given concerns that cancer patients may be at increased risk of COVID-19 and may have more severe complications if infected, there have been profound changes to routine cancer care. We aimed to identify risk factors for developing COVID-19 among cancer patients. Methods: We conducted a retrospective cohort study of cancer patients tested for SARS-CoV-2 infection between March 1, 2020 and June 6, 2020 at NewYork-Presbyterian Hospital (NYPH)/Columbia University Irving Medical Center (CUIMC) in New York City. During this time period, all hospitalized patients (starting April 4, 2020) and all symptomatic cancer patients seen in the outpatient clinics were tested for COVID-19. Our primary outcome of interest was COVID-19 test results, defined as positive (SARS-CoV-2 detected on at least one test) or negative (not detected on any COVID-19 tests). Clinical data extraction included: age, sex, race/ethnicity (non-Hispanic white, non-Hispanic black, Hispanic, Asian, other, unknown), body mass index (BMI), smoking status, time since cancer diagnosis, cancer type, current cancer status, most recent cancer treatment type within the past year, time since last cancer treatment prior to COVID-19 testing, and infusion center visit within the past year. Chi-squared tests and multivariable logistic regression were used to examine the association between demographic, clinical, tumor and treatment-related factors and COVID-19 test results while controlling for covariates. Results: A total of 1,174 cancer patients were tested for COVID-19 with 317 (27%) patients testing positive. Demographic characteristics of the study population included a median age of 67 years (range, 1-103), 55.1% female, and 35.7% non-Hispanic white, 32.5% Hispanic, 15.2% non-Hispanic black, and 4.0% Asian. About 27.2% had a recent cancer diagnosis, 56.7% had active disease, and 56.7% were on active cancer treatment within the past year. In multivariable analysis, older age and higher BMI were associated with COVID-19. Compared to non-Hispanic whites, black and Hispanic cancer patients were more likely to test positive for COVID-19 (odds ratio [OR]=2.21, 95% confidence interval [CI]=1.44-3.40 and OR=2.71, 95% CI=1.91-3.83, respectively). A recent cancer diagnosis, active disease, and active cancer treatment were not associated with COVID-19. Compared to cancer patients not on active treatment, those receiving chemotherapy were less likely to develop COVID-19 (OR=0.65, 95% CI=0.44-0.95). We observed excess deaths among cancer patients who tested positive vs. negative for COVID-19 (28.4% vs. 8.3%, p<0.001). Conclusions and Relevance: Consistent with the general population, we found that older age, minority race/ethnicity, and obesity were associated with COVID-19 among cancer patients. Surprisingly, patients on active treatment including chemotherapy were not at increased risk for COVID-19. Therefore, delays in cancer diagnosis and treatment during the COVID-19 pandemic should be minimized.

18.
Respirology ; 27(SUPPL 1):179, 2022.
Article in English | EMBASE | ID: covidwho-1816641

ABSTRACT

Introduction: COVID-19 lockdown measures implemented in March 2020 markedly reduced hospitalisations of infants with respiratory infections at Kidz First Hospital. There was no characteristic winter peak of respiratory infections with only three hospitalisations during 1 March-31 August with a positive PCR result for RSV and one for influenza. The commencement of quarantine-free travel between Australia and New Zealand started in April 2021 and within 2 weeks there was a positive PCR panel for RSV at Kidz First, the first RSV positive test for over a year with case numbers steadily increasing thereafter. Methods: To confirm the return of the winter peak we examined respiratory viral PCR test results and infant lower respiratory tract infection (LRTI) hospitalization data from 1 January 2015, through 31 July 2021. All specimens submitted by Kidz First clinicians for respiratory viral PCR testing were identified. ICD codes were used to identify infants <2 years of age hospitalized for >3 h with a LRTI. Results: During the months of March-July the number of inpatient hospitalisations at Kidz First varied from 944 in 2015 to 706 in 2018. There was a dramatic reduction to 144 hospitalisations in 2020 but this has rebounded back to 730 in 2021. The number of positive PCR panels for RSV increased to 803(52%) with a much higher percentage than any previous year. There were no PCR positive tests for influenza A or B. The percentage of positive PCR panels for adenovirus (7%), parainfluenza (4%) and rhinovirus/ enterovirus (53%) have remained similar to previous years. Clinician-directed investigation of infants with respiratory infections has increased in response to COVID-19. Conclusion: Easing of COVID-19 restrictions and commencement of quarantine-free travel with Australia has likely resulted in the return of RSV and LRTI hospitalisations rates similar to previous winter peaks.

19.
Respirology ; 27(SUPPL 1):185, 2022.
Article in English | EMBASE | ID: covidwho-1816637

ABSTRACT

Introduction: PCD is a rare, progressive disease resulting in upper and lower respiratory tract manifestations that increase the risk of sleep disordered breathing. This study is the first to characterize sleep quality in Australian children with PCD and examine it is relationship to mood and health-related quality of life (HrQOL). Methods: Clinically stable children with PCD (1-18 years of age) were recruited. Subjective sleep quality was assessed with the SDSC, PDSS and OSA-18 questionnaires. HrQOL and depressive symptoms were assessed via age-appropriate QOL-PCD and CDI questionnaires. Demographic data including passive smoke exposure was recorded. Pulmonary function testing and ENT assessments were performed. Children underwent overnight polysomnography including transcutaneous CO2 and video monitoring (50% studies complete due to Covid restrictions). Results: Twenty-two participants (10 female) aged 8.1 ± 5.1 (mean ± SD) years were recruited. Mean(±SD) FEV1 was 78.2 ± 21.2%. Ninety-two percent of children assessed were diagnosed with chronic rhinosinusitis and 35% exposed to regular passive cigarette smoke. Polysomnography identified sleep fragmentation in 90% of studies and one case of mild obstructive sleep apnoea. Subjective sleep questionnaires revealed 76% of parents and 50% of children reported clinically significant scores indicating sleep disturbance and excessive daytime somnolence respectively. Twenty-seven percent of parents reported a moderate-severe impact of sleep disturbance on QOL. Forty-six percent of children had elevated depression scores. HrQOL and mood scores were correlated with poor subjective sleep quality. Children exposed to passive cigarette smoke had poorer subjective sleep quality and lower HrQOL and mood. Conclusion: Even in periods of clinical stability, children with PCD exhibit poor sleep quality and excessive daytime sleepiness and this is associated with lower mood and HrQOL. Based on these findings, we recommend routine screening for mental health and symptoms of sleep disturbance in children and adolescents with PCD. The continued education of children and families regarding the effects of cigarette smoke is advised.

20.
J Infect Dis ; 2022 Mar 04.
Article in English | MEDLINE | ID: covidwho-1816120
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