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1.
Open Forum Infectious Diseases ; 9(Supplement 2):S898, 2022.
Article in English | EMBASE | ID: covidwho-2190029

ABSTRACT

Background. During the early Covid-19 pandemic, we observed a close-to-full disappearance of the activity of 4 respiratory viruses (RSV, hMPV, influenza, and parainfluenza), followed by an off-season sequential re-emergence in 2021. Surprisingly, a striking similarity between the dynamics of pneumococcus-associated disease (PAD;namely community-acquired alveolar pneumonia [CAAP;often considered pneumococcal] and bacteremic-pneumococcal pneumonia [IPD-Pneumonia]), was also observed. In contrast, adenovirus and rhinovirus activities did not change during COVID-19. We examined the association between PAD and RSV, hMPV, influenza, and parainfluenza (PAD-viruses). Methods. Surveillance of CAAP and IPD-Pneumonia incidences and viral activity in children < 5 years was described in detail previously [Danino D. et al. Clin Infect Dis. 2022, https://doi.org/10.1093/cid/ciab1014]. We extended the observations until December 2021, to capture the sequential re-emergence of the 4 PAD-viruses. A hierarchical linear regression model was used to quantify the association between PAD-viruses (each virus individually and combined), adenovirus and PAD. After fitting the models, the contribution of each virus was estimated. Results. The Figure shows striking similarities in the dynamics of CAAP, IPD-Pneumonia, and PAD-viruses both before and during the COVID-19 pandemic. During the expected peak season (Oct 2020 - Apr 2021) PAD episodes were extremely low. However, off-season peaks were seen during May - Dec 2021. Overall, 78% and 25% of all CAAP and IPD-Pneumonia episodes, respectively, were attributable to these viruses in children < 5 (Table). In CAAP, cases were attributable to each of the 4 PAD-viruses individually throughout the first 5 years of life: RSV and hMPV combined contributed 80%, 63%, and 42% of all CAAP episodes in children aged < 1, 1, and 2-4 years, respectively. The respective figures for influenza and parainfluenza combined were 13%, 21%, and 22%. Only RSV significantly contributed to IPD-Pneumonia (19%). Adenovirus did not contribute to PAD episodes. Conclusion. Our model suggests an important causative association between RSV, hMPV, influenza, and parainfluenza viruses and CAAP, and between RSV and IPD-Pneumonia. (Figure Presented).

2.
Open Forum Infectious Diseases ; 9(Supplement 2):S779, 2022.
Article in English | EMBASE | ID: covidwho-2189972

ABSTRACT

Background. The relative advantage of each new variant of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) depends on its inherent transmissibility and capacity to evade pre-existing immunity. Delta and Omicron are variants of concern that have immune-evasive properties and rapidly displaced variants that preceded their emergence. In the United States, SARS-CoV-2 immunity varies considerably by state, which provides a natural experiment to evaluate the effect of population-level immunity on takeover dynamics of new variants. We hypothesized that if immune evasion was a major driver of fitness compared with previously prevalent variants, Delta and Omicron would become the dominant variants faster in states with higher immunity. Methods. We evaluated changes in variant proportion per week from the first detection of Delta or Omicron in a state until they consistently represented >90% of all sequenced genomes. We used logistic growth curves to characterize the dynamics of variant takeover, evaluating three outcomes: 1) takeover rate, defined as the maximum slope of the logistic curve;2) takeover date, i.e., the estimated date at which variant proportion reached 50% in a state;and 3) time from emergence to dominance, the time taken for variant proportion to increase from 10% to 50%. Next, we estimated the relative proportion of each state that was immune from a combination of infection and full vaccination (for Delta) or boosting (for Omicron) prior to variant takeover. For each outcome, we fit linear regression models to estimate the relationship between population immunity and Delta or Omicron takeover. Results. We found no statistically significant association between takeover rate of Delta or Omicron and immunity (Fig. 1A, B). In contrast, we observed a later takeover date (p< 0.001) and slower time from emergence to dominance (p=0.046) for Omicron in more immune states (Fig. 1D, F). There was a similar but not statistically significant trend for Delta in delayed takeover date (Fig. 1C). genomes in different states with 95% confidence intervals. States are identified by standard two-letter abbreviations;states in the same census geographic region are plotted with the same color. Left panel: Delta, Right panel: Omicron. Immunity is estimated by the combined proportion of the state's population with SARS-CoV-2 infection prior to detection of the new variant in the state and either fully vaccinated (for Delta) or boosted (for Omicron) two weeks prior to takeover. Pearson correlation coefficient (R) and p-value test results are shown for each plot.

3.
Open Forum Infectious Diseases ; 9(Supplement 2):S691, 2022.
Article in English | EMBASE | ID: covidwho-2189872

ABSTRACT

Background. Although COVID-19 is a viral infection, it is known that antibiotics are often prescribed due to concerns about combined bacterial infection. Therefore, we aimed to analyze how many patients with COVID-19 received the antibiotic prescription as well as what kinds of factors contributed to it using the National Health Insurance database. Methods. We retrospectively reviewed claims data for adults 19 years of age and older hospitalized for COVID-19 from December 1, 2019 to December 31, 2020. According to severity classification of the National Institutes of Health guidelines, we calculated not only the proportion of patients receiving antibiotics but also days of treatment per 1000 patient days. In addition, we investigated the factors contributing to antibiotic use by linear regression analysis. Results. Of the 55,228 patients, 47% were male, 55% were older than 50 years of age, and most patients (89%) had no underlying diseases. The majority (84%, 46,576) were classified as having mild to moderate illness, with 11% (6,168) and 5% (2,484) having severe and critical, respectively. Antibiotics were prescribed in a total of 27% (15,081). While 74% of patients with severe illness and 88% of those with critical illness received antibiotic treatment, even 18% of mild to moderate cases were prescribed antibiotics. Fluoroquinolones were the most commonly prescribed antibiotics (8,348), followed by third generation cephalosporins (5,729) and beta-lactam/betalactamase inhibitors (3,822) as shown in Figure 1. Older age, severity of disease and underlying medical conditions contributed to overall prescription rates as well as days of antibiotic use significantly (Table 1). Conclusion. Although most of COVID-19 patients had mild to moderate illness, more than a quarter were prescribed antibiotics. Judicious use of broad-spectrum antibiotics is necessary for COVID-19 patients, considering the severity of disease and the risk of bacterial co-infection.

4.
Open Forum Infectious Diseases ; 9(Supplement 2):S449, 2022.
Article in English | EMBASE | ID: covidwho-2189718

ABSTRACT

Background. Predictors of SARS-CoV-2 RNA levels and changes over time during early COVID-19 are not well characterized. Methods. ACTIV-2 is a phase II/III randomized, placebo-controlled, platform trial to evaluate investigational agents for treatment of COVID-19 in non-hospitalized adults. Participants enrolled within 10 days of symptom onset. Nasopharyngeal samples were collected for SARS-CoV-2 RNA testing on Days 0, 3, 7, 14 and 28;RNA was quantified with qPCR assay. SARS-CoV-2 seropositivity was defined as detectable IgG to any of nucleocapsid, receptor binding domain, S1 and S2 antigens by Bio-Plex multiplex assay. Censored linear regression and repeated measures Poisson models evaluated predictors of RNA including age, sex, race, ethnicity, risk of severe COVID-19, diabetes, BMI, obesity (BMI > 35 kg/m2) and serostatus. Results. The study enrolled 537 participants from Aug 2020 to July 2021 at US sites. Median age was 48 years;49% were female sex, >99% cis-gender, 83% white, 29% Hispanic/Latino, and 21% had BMI > 35 kg/m2. At Day 0, median symptom duration was 6 days, 50% were seropositive (2 were vaccinated) and 17% had RNA below the lower limit of quantification (LLoQ). Higher Day 0 RNA was associated with shorter symptom duration (Spearman correlation = -0.40, p< 0.001), as well as older age, white race, lower BMI and seronegativity, even when adjusting for symptom duration (all p< 0.03). Among the 203 on placebo with Day 0 RNA >= LLoQ, female sex had larger decreases in RNA at Day 3 vs male sex (difference in mean change: -0.8 log10 copies/mL (95% CI: -1.2, -0.4), p< 0.001) when adjusted for symptom duration and Day 0 RNA;this difference was also observed when evaluating the proportion with RNA < LLoQ at Day 3 (Risk Ratio (95% CI): 2.38 (1.11, 5.09)). Seropositivity at Day 0 was associated with higher probability of RNA < LLoQ at Days 3 and 7 (p< 0.001) in adjusted models. Seropositivity at Day 0 did not differ by sex. Conclusion. In this well characterized clinical trial cohort, shorter symptom duration, older age, white race, lower BMI and seronegativity were associated with higher RNA in early infection. Female sex and seropositivity were associated with earlier viral clearance. Further research is needed to determine if viral decay differences mediated by these host factors influence clinical outcomes.

5.
Open Forum Infectious Diseases ; 9(Supplement 2):S446-S447, 2022.
Article in English | EMBASE | ID: covidwho-2189711

ABSTRACT

Background. Omicron SARS-CoV-2 infections are associated with less frequent olfactory sensory loss and a predominance of pharyngitis symptoms compared to prior variants, with proposed diagnostic implications. We examined whether such symptomology predicts a higher RNA abundance in the oropharynx. We further investigated how age, symptom-day, vaccination history and clinical severity correlate with viral load to inform clinical prognostication and transmission modeling. Methods. The EPICC study is a longitudinal cohort of COVID-19 cases enrolled through U.S military medical treatment facilities. Demographic and clinical characteristics were measured with interviews and surveys. Nasopharyngeal (NP), oropharyngeal (OP) and nasal swabs (NS) were collected for SARS-CoV-2 qPCR and sequence genotyping. Multivariable linear regression models were fit to estimate the effect of anatomical site on SARS-CoV-2 RNA abundance (a proxy for viral load), adjusting for sampling time, vaccine history and host age. Results. We analyzed 77 sequence-confirmed Omicron cases;no BA.2 cases were detected. The median age was 38.8 years. 81.8% were vaccinated and 15.6% cases were hospitalized. 80.0%, 21.8%, and 65.5% reported nasal congestion, loss of smell or taste, and sore throat, respectively. The median RNA abundance was lowest in OP swabs (p < 0.001) (Fig 1). Linear regression confirmed that OP sampling was associated with lower viral load (p < 0.001). We further noted that greater age and symptom-day were independent correlates of viral load (Table 1). By bivariate analysis there was a trend toward lower RNA abundance in vaccinated subjects (p = 0.35). RNA abundance (at any site) was substantially higher in hospitalized (10634 N2 genome equivalents [GE]/reaction) versus outpatient cases (1419 N1 GE/reaction) but this was not statistically significant (p = 0.26). Conclusion. We noted prevalent sore throat symptoms and infrequent sensory loss in Omicron cases. Despite this, viral load was highest in NP/NS collected swabs as has been noted in prior variants. We note an age correlation with RNA abundance, and provide a viral load decay rate which may be useful for transmission modeling. Vaccination and clinical severity may also correlate with Omicron viral load, as noted with prior SARS-CoV-2 variants.

6.
Open Forum Infectious Diseases ; 9(Supplement 2):S65-S66, 2022.
Article in English | EMBASE | ID: covidwho-2189528

ABSTRACT

Background. Respiratory virus infections (RVIs) in adult hematopoietic cell transplant (HCT) candidates have been shown to impact posttransplant outcomes;however, there are few studies in pediatric patients. We sought to evaluate the role of specific viruses and the location of viral infection on post HCT outcomes. Methods. We evaluated allogeneic pediatric HCT recipients receiving myeloablative conditioning from 3/2010-3/2018. All patients had a multiplex PCR for RVIs prior to HCT, regardless of symptoms. Delaying HCT was recommended when feasible for RSV, parainfluenza, metapneumovirus, adenovirus, and influenza, but not routinely for human rhinovirus (HRV) and endemic coronaviruses. We utilized Cox proportional hazards models to evaluate progression to lower respiratory disease (LRD) post HCT and linear regression models to evaluated days alive and out of hospital (DAOH) by 100 days post HCT. Results. Of 310 allogeneic HCT recipients receiving myeloablative conditioning, 133 (43%) were positive for a RVI before HCT. Baseline characteristics were notable for differences for age, recipient CMV serostatus, and delayed HCT (Table 1). The most common RVI was HRV (97, 73%) and 81 (61%) patients were symptomatic at the time of detection. Most patients had a URI (92%) and 11 patients had LRD (3 proven, 8 possible). In univariate analysis, HRV as virus type was associated with fewer DAOH and preHCT URI as location of viral infection (with and without symptoms) trended towards fewer DAOH (Figure 1a). When adjusted for age, preHCT lymphocyte count, cell source, and conditioning regimen, both HRV and preHCT URI showed a trend towards fewer DAOH, but no significant association was found (Figure 1b,c). Twenty patients progressed to LRD after HCT with the same preHCT RVI;no factors, including delay of transplant, were associated with reduced progression to LRD. Conclusion. In this single center study, HRV as virus type and URI as location of viral infection before myeloablative allogeneic HCT were associated with increased hospitalization after HCT, but not inmultivariatemodels. Larger multicenter studies are needed to provide timely evaluation and adequate statistical power to definitivelydetermine role of URI versus LRD and the impact of transplant delay and treatment strategies. (Table Presented).

7.
Neuropsychopharmacology ; 47(Supplement 1):400, 2022.
Article in English | EMBASE | ID: covidwho-2185754

ABSTRACT

Background: The importance of sleep amongst health care workers is undeniable, as good health and alertness are essential for the delivery of care to patients. The COVID-19 pandemic has had detrimental effects on sleep quality among health care workers, prompting the need to explore new interventions. The present study evaluated the effect of Bose Noise-Masking Sleepbuds(TM) in health care workers with reported sleep difficulties using both objective and subjective measures. Method(s): Seventy-seven (n = 46 females, n = 31 males) hospital-based health care workers, aged 20-50, completed this pre-post efficacy study. Participants had to self-identify as light or moderate sleeps with self-reported difficulty falling or staying asleep, and score at least an 8 ("subthreshold insomnia") on the Insomnia Severity Index. Objective sleep architecture data was obtained using the DREEM headband in-home sleep monitoring device, which records EEG signals, heart rate, movement and sound. Subjective measurements included perceptions of sleep onset latency, wake after sleep onset, total sleep time and scores on the Insomnia Severity Index. Participants first completed a 3-night baseline assessment wearing just the DREEM headband, followed by a 4-night adjustment period of wearing only the Sleepbuds(TM), and then a final 3-night intervention assessment wearing both the Sleepbuds(TM) and the Dreem headband. Primary outcomes were analyzed for statistical significance using mixed-effect linear regression and random intercept for each participant to model repeated measures over time. Result(s): Use of the Sleepbuds(TM) was associated with a significant decrease in perceived sleep onset latency compared to baseline, with a 6 minute decrease from the baseline mean to intervention mean (21% faster, 95% CI: 8%-35%, p = 0.003, Cohen's d= -0.38). There was also a significant decrease in Insomnia Severity Index scores from baseline (p < 0.001) with a mean change score of -7.7 (4.4) points. There were no significant changes in objective sleep measures, including objective sleep onset latency, wake after sleep onset, number of awakenings or % time in various sleep stages (all p's > 0.05). Conclusion(s): Compared to baseline assessments, the use of noise masking Sleepbuds(TM) in health care workers improved subjective sleep quality as indicated by a decrease in perceived sleep onset latency and decreases in Insomnia Severity Index scores. Lack of changes in objective sleep measures are likely due to the healthy sample population with lack of overt sleep pathology. Overall, the results suggest that noise masking ear bud technology holds promise as a non-pharmacological intervention to improve sleep in health care workers.

8.
Neuropsychopharmacology ; 47(Supplement 1):12-13, 2022.
Article in English | EMBASE | ID: covidwho-2185740

ABSTRACT

Background: The COVID-19 pandemic has disrupted the lives of billions, raising concerns about overall mental health. Further, data from the Centers for Disease Control demonstrate significant racial disparities in COVID-19 outcomes for African Americans. The current study examined the predictive association between baseline symptoms of depression and inflammation on COVID-19 related stress outcomes (as measured by the Pandemic Stress Index [PSI];Harkness, 2020). African American (n = 66) and non-Hispanic White participants (n = 50) aged 30-60 (Mage = 45.4;SD = 9.0) were recruited from a larger study on racial disparities in cognitive outcomes. Method(s): African American (n = 66) and non-Hispanic White participants (n = 50) aged 30-60 (Mage = 45.4;SD = 9.0) were recruited from a larger study on racial disparities in cognitive outcomes. For circulating (plasma) levels of inflammation-related biomarkers, we will assess both pro-and anti-inflammatory cytokines using a multiplex assay (IL-6, IL-10, TNF-a) (R and D Systems Luminex Performance Human High Sensitivity Cytokine Panel). Additional biomarkers (sCD14, CRP, MCP-1/CCL2) will be determined by ELISA (R and D Systems Human Quantikine ELISAs), as they cannot be multiplexed with the cytokines or with each other due to differences in circulating concentrations and assay requirements. Result(s): Higher PSI scores were reported among African Americans in comparison to non-Hispanic Whites. African Americans demonstrated higher levels of CRP in comparison to non-Hispanic Whites, F (2, 113) = 7.66, p = .02. Linear regression was used to examine predictive associations baseline depression, race, CRP as well as interactions on PSI scores. As expected, the overall model predicted PSI scores, (r2 = .18, p < .0001). Independent associations were found between depression (b = .57, p < .001), CRP (b = .32, p < .02), race (b = -.27, p = .03) and the CRP X depression interaction (b = .22, p = .04) on PSI outcomes. The association between depressive symptoms and CRP on PSI scores were in the expected direction. The relationship between depression and PSI scores were strongest among those with high levels of CRP. Conclusion(s): Study results provide preliminary evidence for the role of inflammation in the relationship between depression and COVID-19 pandemic stress scores.

9.
Epidemiology and Infection. ; 2023.
Article in English | EMBASE | ID: covidwho-2185380

ABSTRACT

The impact of individual symptoms reported post-COVID-19 on subjective well-being (SWB) is unknown. We described associations between SWB and selected reported symptoms following SARS-CoV-2 infection. We analysed reported symptoms and subjective well being from 2295 participants (of which 576 reporting previous infection) in an ongoing longitudinal cohort study taking place in Israel. We estimated changes in SWB associated with reported selected symptoms at three follow-up time points (3-6, 6-12, and 12-18 months post infection) among participants reporting previous SARS-CoV-2 infection, adjusted for key demographic variables, using linear regression. Our results suggest that the biggest and most sustained changes in SWB stems from non-specific symptoms (fatigue -7.7 percentage points (pp), confusion/ lack of concentration -10.7 pp, and sleep disorders -11.5pp, p<0.005), whereas the effect of system-specific symptoms, such as musculoskeletal symptoms (weakness in muscles and muscle pain) on SWB, are less profound and more transient. Taking a similar approach for other symptoms and following individuals over time to describe trends in SWB changes attributable to specific symptoms will help understand the post-acute phase of COVID-19 and how it should be defined and better managed. Copyright © 2023 Cambridge University Press. All rights reserved.

10.
Value in Health ; 25(12 Supplement):S291-S292, 2022.
Article in English | EMBASE | ID: covidwho-2181152

ABSTRACT

Objectives: Crowding at the emergency department (ED) is a problem in many countries. Crowding research often fails to consider external influences. In this study, we aimed to evaluate the effects of various process changes on ED crowding while taking into account changing external circumstances, such as the Covid-19 pandemic and centralization of acute care. Method(s): During a six-year period, we assessed the effects of several interventions to improve patient flow, using an interrupted time-series approach. Main outcome measures were crowding measured with the National ED Overcrowding Score, length of stay (LOS) and number of exit blocks. We determined time points of the various interventions and external circumstances and built an interrupted time-series model per outcome measure. We analysed changes in level and trend before and after the selected time points using linear regression, with baseline slope variables included to control for secular trend. Result(s): Crowding decreased when medical staffing increased during peak hours, and when next-day appointments at the ED were shifted to the policlinics. However, the closure of a neighbouring ED and further expansion of beds at the remaining ED coincided with increased crowding. During the Covid-19 surge, LOS increased but we observed no changes in crowding and number of exit blocks. Some of the interventions showed paradoxical effects, such as increased crowding after installing a psychiatric team during peak hours, but decreased LOS and number of exit blocks. Conclusion(s): Our findings reflect the importance of progressive interventions in response to changing external circumstances, in the ongoing battle against ED crowding. Timely feedback on new interventions is vital to increase the success and sustainability of projects, and long-term effects corrected for changing circumstances are pivotal to decide which interventions to prioritize. Our results show that it is possible to improve ED processes, even during changing conditions in challenging times. Copyright © 2022

11.
Journal of the American Academy of Child and Adolescent Psychiatry ; 61(10 Supplement):S168, 2022.
Article in English | EMBASE | ID: covidwho-2179858

ABSTRACT

Objectives: Early childhood education (ECE) has been shown to increase cognitive-academic functioning, developmental outcomes, and social performance at the time of entering school with benefits persisting into adulthood. Turnover has been a longstanding issue in childcare, with estimates of 15%-25% of providers exiting the field each year. The COVID-19 pandemic has increased ECE workforce exit, leading to a crisis in childcare demand. Burnout contributes to turnover and negatively impacts the relationship between providers and children. In this study, we examined factors contributing to and protective against burnout for ECE providers. Method(s): Paper questionnaires were administered at 5 childcare centers in Indianapolis, Indiana, with responses from 47 ECE providers. A single-item burnout measure was used. Stress and distress were measured using the Perceived Stress Scale (PSS-10) and the Kessler-6 Psychological Distress Scale (K6). Additional single-item questions were utilized. The null hypothesis was that there would be no differences in the relationships between burnout with stress and distress and how those variables related to feelings toward childcare and sources of support. Analyses included descriptive statistics and correlations. Significant associations were entered into bivariate linear regression. Result(s): Stress (PSS-10, beta =.471) and distress (K6, beta =.489) were significantly (p <.001) associated with burnout. Feeling like quitting (beta =.696;p <.001), feeling stuck in childcare due to few other employment opportunities (beta =.494;p <.001), and liking providing childcare but finding it difficult to make a living (beta =.438;p <.01) were significantly related to burnout. Higher supervisor support (beta = -.743) and adequate breaks (beta = -.516) were significantly (p <.001) related to less burnout. Conclusion(s): Stress and distress for ECE providers were equally related to burnout. Burnout was related to feeling like quitting, feeling stuck, and finding it difficult to make a living in childcare. Only support from supervisors and adequate breaks were related to lower burnout scores. Our study supports the idea that a better understanding of perceived stress, adequate breaktimes, and support from supervisors may be important for addressing burnout and retention of quality ECE providers. EDUC, DEV, PSC Copyright © 2022

12.
European Geriatric Medicine ; 13(Supplement 1):S48, 2022.
Article in English | EMBASE | ID: covidwho-2175521

ABSTRACT

Introduction: Epigenetic ageing clocks, calculated from DNA methylation, correlate with chronological age, predict mortality, but are influenced by environmental factors, potentially including infections. We assessed if COVID-19 infection affected epigenetic ageing. Method(s): TwinsUK participants who could be visited in Spring 2020 and Spring 2021 were included. SARS-CoV-2 infection was confirmed by IgG Spike and Nucleocapsid antibody testing. Using Illumina HumanMethylation EPIC Chips, we calculated epigenetic age acceleration (EAA) using Horvath DNAmAge (EAA-H) and GrimAge (EAA-Grim). EAA compared using mixed-effects linear regression, adjusted for age, sex, BMI, smoking and cell counts. Result(s): 134 participants (mean age 51 years (sd 15.9 years), 87% female) had paired samples in Spring 2020 and Spring 2021. 35% had COVID-19 at first sample, 23% between sampling, and 42% never acquired COVID-19. 60% were vaccinated at second sample. In Spring 2020, those with past COVID-19 infection had higher EAAGrim (beta = 0.325, p<0.001) after covariate adjustment, but not EAA-H (beta = 0.449 p = 0.37). However, the association did not persist by Spring 2021, either with (beta = -0.330, p = 0.84) or without (beta = 0.038, p = 1.00) adjustment for baseline EAA. Those with interval COVID-19 were no more aged by Spring 2021 than those never acquiring infection (beta = -0.562, p = 0.478). From Spring 2020 to 2021 EAA-Grim increased in all categories (P<0.05). Conclusion(s): Those infected with COVID-19 early in the pandemic were more aged at that time, close to their infection, but not on later sampling, suggesting COVID-19 only has a short-term effect on EAA-Grim. However, the whole cohort increased in EAA-Grim, suggesting a pandemic effect on all participants.

13.
European Geriatric Medicine ; 13(Supplement 1):S102-S103, 2022.
Article in English | EMBASE | ID: covidwho-2175455

ABSTRACT

Introduction: Older Nursing Home Residents (NHRs) are at greatest risk of morbidity and mortality from SARS-CoV-2, particularly in the context of both waning vaccine efficacy and the emergence of Variants- of-Concern (VOCs). There is no data to date on long-term protective antibody responses in older NHRsMethods: Blood samples were obtained pre-vaccination, 6-weeks and 6-months following primary vaccination and 6-months following booster vaccination from older NHRs. Antibody titres and avidity for Wuhan strain/major VOC antigens were measured using an electrochemiluminescence assay and a custom bead-based assay. Stepwise adjusted linear regression assessed determinants of vaccine-induced antibody responses. Result(s): Of 86 participants (81.1 +/- 10.8 years;65% female), just under half (45.4%) had evidence of previous SARS-CoV-2 infection. Previous SARS-CoV-2 infection was the strongest predictor of antibody responses at all timepoints (beta: 3.59;2.89, 4.28;P<0.001 for 6-months). Age (beta: - 0.05;- 0.08, - 0.02;p<0.001) and frailty (beta: - 0.22;- 0.33, - 0.11;p<0.001) were both associated with faster waning. Cross-reactivity and avidity were significantly lower for Beta (B.1.351) and Gamma (P.1) VOC strains (all p<0.001), with faster antibody waning and reduced avidity to Beta and Gamma VOC antigens in SARS-CoV-2 naive NHRs. Conclusion(s): Responses were more durable, with a greater cross-reactivity to and avidity for VOCs in those with previous SARS-CoV-2 infection. Increasing age and greater frailty in NHRs was associated with faster antibody waning. Our findings support ongoing serological surveillance and use of additional vaccine doses in older NHRs, particularly in SARS-CoV-2 naive NHRs, to afford protection from emerging VOCs.

14.
Neurological Sciences ; 43(Supplement 1):S336, 2022.
Article in English | EMBASE | ID: covidwho-2174268

ABSTRACT

Background: SARS-CoV-2 vaccination has been associated with rare neurological syndromes. The aim of this study is to evaluate the risk of association between specific neurological symptoms and syndromes and SARS-CoV-2 vaccination. Method(s): In this prospective single center cohort study, we included all adult inpatients consecutively admitted to a tertiary Neurological Centre from January 2021 to February 2022. Vaccinated cases were subgrouped according to the onset of neurological manifestation in the first 30 days (V<30d), 30-60 days (V30-60d) and more than 60 days (V>60d) following SARS-CoV-2 vaccination. The incidence and characteristics of neurological syndromes were compared between unvaccinated and vaccinated cases (including subgroups) adjusting for the effect of age, sex and premorbid conditions in linear regression analyses. Result(s): 830 subjects entered the study, namely 398 unvaccinated (UVC) and 432 vaccinated cases;these groups were comparable for demographic characteristics and clinical diagnosis distribution and. Compared to UVC, V<30d exhibited higher prevalence of Medical unexplained symptoms (MUS, 24.5% vs 10.6%), primary headache (10.9% vs 5%) and lower number of cerebrovascular diseases (30.7% vs 41.9%). V30-60d cases exhibited higher number of primary headache (13% vs 5%) compared to UVC, whereas V>60d showed similar diagnosis distribution with UVC. Conclusion(s): Unexplained transient neurological symptoms and primary headache appeared to be the most common neurological conditions following SARS-CoV-2 vaccination. The findings confirmed the safety of SARS-CoV-2 vaccination and argued against a prominent role in the pathogenesis of either cerebrovascular or inflammatory-mediated neurological disorders, exception made for rare CVT cases.

15.
Research Journal of Pharmacy and Technology ; 15(12):5700-5706, 2022.
Article in English | EMBASE | ID: covidwho-2207048

ABSTRACT

Favipiravir is an anti-viral agent used for the treatment of a large number of RNA viruses including influenza and was considered for the treatment of COVID-19. A new stability indicating RP-HPLC has been developed for the estimation of Favipiravir and the method was validated. Hypersil BDS C18 column was used for the chromatographic study with a flow rate 1ml/min (Detection wavelength 230nm). The LOD and LOQ were found to be 0.2918mug/mL and 0.9207mug/mL respectively. Linearity was observed over the concentration 1-300mug/mL with linear regression equation, y = 28444x + 21853 (R2 = 09998) and the method is precise, accurate and robust. Stress degradation studies were performed and the method was found to be selective and specific. Copyright © RJPT All right reserved u.

16.
Anales de la Facultad de Medicina ; 83(4), 2022.
Article in Spanish | EMBASE | ID: covidwho-2155880

ABSTRACT

Introduction. The current COVID-19 pandemic has forced medical education to change to a virtual modality. This can influence the quality of teaching and the perception that students have about older adults. Objective. Our objective is to evaluate the perception of the self-report fulfillment of geriatric competencies (SRFGC) in medical students from universities in Lima-Peru, comparing face-to-face and virtual techniques. Methods. A cross-sectional study was designed including students from 3 universities in Lima, Peru who have taken the geriatrics course in person or virtually, measuring the main variables such as ACCG according to the recommendations of the pogoe web portal and ageing the UCLA-GAS scale. Averages and standard deviations were calculated for numerical variables and frequency for categorical variables. Bivariate analysis was also performed between ACCG and the rest of the variables measured. Results. Means 0.72 (SD=0.22) were found for the face-to-face modality and 0.75 (SD=0.23) for virtual teaching. We found no statistical association between the study variables (p value = 0.39), so there is no difference between the SRFGC between the virtual and face-to-face modalities. Through a linear regression model of SRFGC and ageism adjusted to statistically significant variables of the study, it was found that the greater the SRFGC, the greater the ageism. Conclusions. So far, it cannot be said that virtual education is inferior to face-to-face educationwith regard to the SRFGC. Copyright © 2022 Vittorio Klostermann. All rights reserved.

17.
European Psychiatry ; 65(Supplement 1):S498, 2022.
Article in English | EMBASE | ID: covidwho-2153992

ABSTRACT

Introduction: Both public and private sector pharmacists were instrumental in containing this health crisis in Tunisia. The high workload had a considerable impact on their mental health during the outbreak of the Corona Virus. Objective(s): This study aims to assess burnout and the psychological toll of the pandemic among pharmacists in Tunisia during covid-19. Method(s): 258 Tunisian pharmacists working in the public and private sector participated in a questionnaire. Burnout was assessed by the Maslach burnout scale. Regression analysis was used to assess the impact of the pandemic on Tunisian pharmacists. Result(s): 80% of the respondents were women. Participants ranged in age from 22 to 62, 60% were married, 57% had at least one child, and 42% had been working for less than five years. The burnout scale revealed 76% burnout among them. Univariate linear regression showed that female gender (p = 0.014 <0.05) was associated with the development of burnout. Conclusion(s): The considerable prevalence of burnout among pharmacists during the COVID-19 pandemic in Tunisia can be attributed to the enormous and overwhelming responsibilities that any health care worker endured.

18.
European Psychiatry ; 65(Supplement 1):S339, 2022.
Article in English | EMBASE | ID: covidwho-2153917

ABSTRACT

Introduction: Contagious disease outbreaks can have major repercussions on medical stuff. Doctors in Tunisia were requested to act as the first-line filter in managing active cases during the beginning of COVID19 pandemic. Objective(s): This study aims to assess perceived stress in Tunisian doctors during COVID19 pandemic early stages and to identify factors associated to stress in order to guide prevention strategies. Method(s): This was a cross-sectional study conducted through an online survey, from April 18th 2020 to June 6th 2020. A 62-item semi-structured survey was created, consisting of 5 series of questions and scales. Linear regression models were performed to identify the associations between the study variables and the perceived stress score of the participants. Result(s): Weincluded 203 physicians in this study. Stress levels were high among Tunisian doctors with a mean perceived stress score (PSS) of 28.6. One hundred fifteen participants (56.3%) scored for high PSS. This study identified vulnerable subgroups too stress. The female gender, working in the capital and working in critical medicine units were risk factors for high PSS. Managing COVID19 patients was not itself correlated to stress, however social isolation, stigma and luck of access to information were correlated to high stress levels. Conclusion(s): Several stressors can affect the well-being of doctors during the COVID-19 pandemic, which can lead to adverse psychosocial outcomes. The findings of this study may guide decisionmakers to implement early mental health interventions for doctors.

19.
European Psychiatry ; 65(Supplement 1):S310, 2022.
Article in English | EMBASE | ID: covidwho-2153901

ABSTRACT

Introduction: During a public health crisis, preventive measures are essential. However, to make them effective, all citizens must be engaged. Objective(s): To analyse the differential role of individual and contextual variables in the adherence to public health recommendations. Method(s): 1376 adults (70.5% female;mean age=35.55+/-14.27) completed a survey between September/2020 and May/2021 with: Adherence Scale to the Recommendations during COVID-19 (ASR-COVID19;evaluates three dimensions of adherence), Fear of Covid-19 Scale (FC19S) and Toronto and Coimbra Prosocial Behaviour Questionnaire (ProBeQ;assesses empathy and altruism). Result(s): Adherence did not differ between individuals with or without personal or family history of COVID-19 infection. ASRCOVID19 and all dimensions were positively correlated to ProBeQ's altruism and empathy (from r=.32 to r=.54);FCV19S correlated positively to total adherence score and house sanitation (from r=.18 to r=.26;all p<.01). Linear regressions revealed that altruism and empathy (first model), as well as fear of Covid-19 (second model), were significant predictors of adherence;however, while the first model explained ffi28% of its variance, the second (FCV19S as independent variable) only explained ffi3%. Regression models performed in a subsample of participants with personal or family history of COVID-19 revealed that only empathy, but not altruism, was a significant predictor of adherence;in this subsample, fear was no longer a significant predictor of adherence, except for lockdown and use of teleservices. Conclusion(s): Based on our results, we suggest health care providers and public health campaigns should take into consideration social solidarity and altruism, as well as previous experiences, when appealing to public's engagement in health behaviour.

20.
European Psychiatry ; 65(Supplement 1):S202, 2022.
Article in English | EMBASE | ID: covidwho-2153852

ABSTRACT

Introduction: Understanding the predictors of belief in covidrelated conspiracy theories and willingness to get vaccinated against COVID-19 may aid the resolution of current and future pandemics. Objective(s): We aim to investigate how psychological and cognitive characteristics influence general conspiracy mentality and covidrelated conspiracy theories. Method(s): A cross-sectional study was conducted based on data from an online survey of a sample of Czech university students (n=866) collected in January 2021, using multivariate linear regression and mediation analysis. Result(s): Sixteen percent of respondents believed that COVID-19 is a hoax;17% believed that COVID-19 was intentionally created by humans. Seven percent of the variance of the hoax theory and 10% of the variance of the creation theory was explained by (in descending order of relevance) low cognitive reflection, low digital health literacy, high experience with dissociation and, to some extent, high bullshit receptivity. Belief in covid-related conspiracy theories depended less on psychological and cognitive variables compared to conspiracy mentality (16% of the variance explained). The effect of digital health literacy on belief in covidrelated theories was moderated by cognitive reflection. Conclusion(s): Belief in conspiracy theories related to COVID-19 was influenced by experience with dissociation, cognitive reflection, digital health literacy and bullshit receptivity.

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