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1.
Preventive Medicine ; 166:107376, 2023.
Article in English | MEDLINE | ID: covidwho-2211682

ABSTRACT

Due to COVID-19, the Dutch breast cancer screening program was interrupted for three months with uncertain long-term effects. The aim of this study was to estimate the long-term impact of this interruption on delay in detection, tumour size of screen-detected breast cancers, and interval cancer rate. After validation, the micro-simulation model SiMRiSc was used to calculate the effects of interruption of the breast cancer screening program for three months and for hypothetical interruptions of six and twelve months. A scenario without interruption was used as reference. Outcomes considered were tumour size of screen-detected breast cancers and interval cancer rate. Women of 55-59 and 60-64 years old at time of interruption were considered. Uncertainties were estimated using a sensitivity analysis. The three-month interruption had no clinically relevant long-term effect on the tumour size of screen-detected breast cancers. A 19% increase in interval cancer rate was found between last screening before and first screening after interruption compared to no interruption. Hypothetical interruptions of six and twelve months resulted in larger increases in interval cancer rate of 38% and 78% between last screening before and first screening after interruption, respectively, and an increase in middle-sized tumours in first screening after interruption of 26% and 47%, respectively. In conclusion, the interruption of the Dutch screening program is not expected to result in a long-term delay in detection or clinically relevant change in tumour size of screen-detected cancers, but only affects the interval cancer rate between last screening before and first screening after interruption.

2.
Vnitrni Lekarstvi ; 68(E-8):12-17, 2022.
Article in English | MEDLINE | ID: covidwho-2206310

ABSTRACT

The available literature suggests that the most significant barriers to undergoing colonoscopy in general include "fear of pain and discomfort", "fear of bowel preparation", as well as directly unrelated influences such as "lack of support from family and friends", "busy family and work schedules", "other health problems" and the current "fear of getting COVID-19 in hospital". A marital union may play a positive role, previous cancer a negative one. Another important factor is that patients are not used to talking about their barriers spontaneously;a guided conversation is a useful tool. Respondents in this qualitative study addressed these barriers as significant in their answers.

3.
Frontiers in Public Health ; 10, 2022.
Article in English | Web of Science | ID: covidwho-2199533

ABSTRACT

This study aims to propose a pooling approach to simulate the compulsory universal RT-PCR test in Hong Kong and explore the feasibility of implementing the pooling method on a household basis. The mathematical model is initially verified, and then the simulation is performed under different prevalence rates and pooled sizes. The simulated population is based in Hong Kong. The simulation included 10,000,000 swab samples, with a representative distribution of populations in Hong Kong. The samples were grouped into a batch size of 20. If the entire batch is positive, then the group is further divided into an identical group size of 10 for re-testing. Different combinations of mini-group sizes were also investigated. The proposed pooling method was extended to a household basis. A representative from each household is required to perform the RT-PCR test. Results of the simulation replications, indicate a significant reduction (p < 0.001) of 83.62, 64.18, and 48.46% in the testing volume for prevalence rate 1, 3, and 5%, respectively. Combined with the household-based pooling approach, the total number of RT-PCR is 437,304, 956,133, and 1,375,795 for prevalence rates 1, 3, and 5%, respectively. The household-based pooling strategy showed efficiency when the prevalence rates in the population were low. This pooling strategy can rapidly screen people in high-risk groups for COVID-19 infections and quarantine those who test positive, even when time and resources for testing are limited.

4.
Open Forum Infectious Diseases ; 9(Supplement 2):S744, 2022.
Article in English | EMBASE | ID: covidwho-2189901

ABSTRACT

Background. SARS-CoV-2, a novel and highly pathogenic coronavirus, has caused unprecedented global disruption following its introduction into the human population. Beginning in January 2021, a NJ university invited all students to campus and initiated an asymptomatic testing protocol using weekly to twice-weekly PCR-based detection of human saliva samples. RNA extracted from PCR-positive human saliva samples was sequenced for surveillance purposes. Methods. Positive samples were submitted for RNA-Seq analysis (ARTIC amplicon sequencing protocol, Illumina MiSeq) and analyzed using Nextclade and USHER (comparison data from GISAID). Using sequencing data, the evolution, transmission, and emergence of SARS-CoV-2 variants were monitored over time in the campus community. Using sequencing data from NY, PA, and NJ in combination with University data, we performed an IQ-TREE based phylogenetic analysis. Results. Analyzing sequencing data of 1,011 University positive samples we demonstrate that SARS-CoV-2 variants Delta (B.1.617.2) and Omicron (BA.1 and BA.2) were first to emerge following widespread vaccination and, quickly, became predominant. These trends witnessed on campus preceded those same variants emerging in New Jersey, providing evidence of local campus spread distinct from the state-wide pandemic. The analysis of 2,359 total sequences from NY, PA, and NJ in combination with University data, provided evidence of the SARS-CoV-2 transmission chain on campus evolving from out-of-state (January 2021) to local (January 2022) spread over one year of the virus circulating within the community at large. Upon performing a Ct value analysis of 2,822 Princeton University sequences, no significant differences were discovered between N gene Ct values when grouped by age or vaccination status. However, there were significant differences in Ct values between strains. The Emergence of SARS-CoV-2 Variants at Princeton University This plot represents the emergence of SARS-CoV-2 clades at Princeton University, organized by Nextstrain clade and displayed as a proportion out of one. Dates of sample collection range from January 25, 2021, to March 1, 2022. X-axis represents SARS-CoV-2 sample test date (grouped by month);Y-axis represents the count per day organized by Nextstrain clade. Conclusion. Sequencing of positive SARS-CoV-2 samples from population screening of a highly vaccinated University campus community allowed the detection of emergence of new variants that became predominant on campus irrespective of the circulation of variants in the surrounding area.

5.
Open Forum Infectious Diseases ; 9(Supplement 2):S209, 2022.
Article in English | EMBASE | ID: covidwho-2189634

ABSTRACT

Background. Testing remains critical to controlling the COVID-19 pandemic. Antigen-detecting rapid diagnostic tests (Ag-RDTs), which can be used at the point of care, have the potential to increase access to COVID-19 testing, particularly in settings with limited laboratory capacity. This systematic review synthesized literature on specific use cases and performance of Ag-RDTs for detecting SARS-CoV-2, for the first comprehensive assessment of Ag-RDT use in real-world settings. Methods. We searched three databases (PubMed, EMBASE and medRxiv) up to 12 April 2021 for publications on Ag-RDT use for large-scale screening and surveillance of COVID-19, excluding studies of only presumptive COVID-19 patients. We tabulated data on the study setting, populations, type of test, diagnostic performance, and operational findings. We assessed risk of bias using QUADAS-2 and an adapted tool for prevalence studies. Results. From 4313 citations, 39 studies conducted in asymptomatic and symptomatic individuals were included. Of 39 studies, 37 (94.9%) investigated lateral flow Ag-RDTs and 2 (5.1%) investigated multiplex sandwich chemiluminescent enzyme immunoassay Ag-RDTs. Six categories of testing initiatives were identified: mass screening (n=13), targeted screening (n=11), healthcare entry testing (n=6), at-home testing (n=4), surveillance (n=4) and prevalence survey (n=1). Sensitivity and specificity values by testing category are shown in the table. Ag-RDTs were noted as convenient, easy-to-use, and low cost, with a rapid turnaround time and high user acceptability. Risk of bias was generally low or unclear across studies. Conclusion. During the first year of the COVID-19 pandemic, Ag-RDTs were used across a wide range of real-world settings for screening and surveillance of COVID-19 in both symptomatic and asymptomatic individuals. Ag-RDTs were fast and simple to run, but due to their often low sensitivity, careful consideration must be given to their implementation and interpretation. Ag-RDTs have subsequently been rolled out more broadly and recommended for COVID-19 self-testing.

6.
JAMA ; 328(23):2294, 2022.
Article in English | MEDLINE | ID: covidwho-2172154
7.
Biochimica Clinica ; 46(3):S147, 2022.
Article in English | EMBASE | ID: covidwho-2169407

ABSTRACT

Introduction: SARS-CoV-2 infection has plagued the world for the past two years, during which time it has become necessary to use screening tests to prevent the spread of the virus, especially among high-risk patients. The gold standard for the detection of viral RNA is real-time PCR (RT-PCR). This technique requires special care when handling samples, as well as being time-consuming and costly. To meet the need for mass screening, antigenic tests were developed and continuously improved over the years. In our study, we examined the performance of Lumipulse G SARS-CoV-2 Ag (Fujirebio, Japan), a quantitative and automated chemiluminescence enzymeimmunoassay- based antigen test. Material(s) and Method(s): Our study includes 160 subjects (median age 38 years, interquartile range (IQR) 24-58 years;43% females) screened for SARS-COV-2 at the Service of Laboratory Medicine of Pederzoli Hospital (Peschiera del Garda, Verona, Italy), between August 16 and September 15, 2021. A nasopharyngeal swab was collected for each subject and analyzed at the same time by antigen test Fujirebio Lumipulse G SARS-CoV-2 Ag and by molecular test performed by Altona Diagnostics RealStar SARSCoV- 2 RT-PCR Kit (Altona Diagnostics GmbH, Hamburg, Germany). Result(s): A significant Spearman's correlation was found between values of Fujirebio Lumipulse G SARS-CoV-2 Ag and measurable Ct values of SARSCoV- 2 of both the S (r= -0.94;p<0.001) and E genes (r= -0.95;p<0.001). The sensitivity and specificity at 1.0 pg/ mL (cut-off already used by other authors to discriminate samples positive for SARS-CoV-2) were 0.71 and 1.00. We also used a locally calculated threshold of 0.60 pg/mL (sensitivity 0.88;specificity 0.75). The exclusion of samples tested positive at molecular testing with Ct values comprised between 25-37 enabled the attainment of better diagnostic performance on the 103 residual samples using the 0.60 pg/mL cut-off. Conclusion(s): the results of our study confirm the good performance of Fujirebio Lumipulse G SARS-CoV-2 Ag (considering cutoff 1.0 pg/mL), especially in samples with high viral load (i.e., Ct value <25), which has proved even better using our locally-calculated cut-off (i.e., 0.60 pg/mL).

8.
Mediterranean Journal of Rheumatology ; 31(3 Supplement 2):242-242, 2020.
Article in English | EMBASE | ID: covidwho-2167770
9.
Frontiers in Public Health ; 10, 2022.
Article in English | Web of Science | ID: covidwho-2163174

ABSTRACT

Fever screening is an effective method to detect infectors associated with different variants of coronavirus disease 2019 (COVID-19) based on the fact that most infectors with COVID-19 have fever symptoms. Non-contact infrared thermometers (NCITs) are widely used in fever screening. Nevertheless, authoritative data is lacking in defining "fever" at different body surface sites when using NCITs. The purpose of this study was to determine the optimal diagnostic threshold for fever screening using NICTs at different body surface sites, to improve the accuracy of fever screening and provide theoretical reference for healthcare policy. Participants (n = 1860) who were outpatients or emergency patients at Chengdu Women's and Children's Central Hospital were recruited for this prospective investigation from March 1 to June 30, 2021. NCITs and mercury axillary thermometers were used to measure neck, temple, forehead and wrist temperatures of all participants. Receiver operating characteristic curves were used to reflect the accuracy of NCITs. Linear correlation analysis was used to show the effect of age on body temperature. Multilinear regression analysis was used to explore the association between non-febrile participant's covariates and neck temperature. The mean age of participants was 3.45 +/- 2.85 years for children and 28.56 +/- 7.25 years for adults. In addition 1,304 (70.1%) participants were children (<= 12), and 683 (36.7%) were male. The neck temperature exhibited the highest accuracy among the four sites. Further the optimal fever diagnostic thresholds of NCITs at the four body surface measurement sites were neck (36.75 degrees C, sensitivity: 0.993, specificity: 0.858);temple (36.55 degrees C, sensitivity: 0.974, specificity: 0.874);forehead (36.45 degrees C, sensitivity: 0.961, specificity: 0.813);and wrist (36.15 degrees C, sensitivity: 0.951, specificity: 0.434). Based on the findings of our study, we recommend 36.15, 36.45, 36.55, and 36.75 degrees C as the diagnostic thresholds of fever at the wrist, forehead, temple and neck, respectively. Among the four surface sites, neck temperature exhibited the highest accuracy.

10.
Epidemiol Infect ; 150: e193, 2022 Nov 15.
Article in English | MEDLINE | ID: covidwho-2133097

ABSTRACT

During 6 weeks in February-March 2021, the Dutch municipal health service Utrecht studied the epidemiological effects on test incidence and the detection of acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with mass testing (MT). During MT, inhabitants of Bunschoten could repeatedly test regardless of symptoms and as often as desired at the close-by test facilities in the municipality. Data from the regular COVID-19 registration was used for analysis. In Bunschoten, MT caused a significant increase in test incidence and an immediate increase in the number of detected active infections, in contrast to a stabilisation in the rest of the province of Utrecht. Age distribution of test incidence shifted to the older population in Bunschoten during MT. During MT, there was a 6.8 percentage point increase in detected asymptomatic cases, a 0.4 percentage point increase in pre-symptomatic cases and a decrease of 0.5 days between onset of symptoms and test date. This study has shown that MT increases test incidence and helps to obtain a more complete view of the presence of SARS-CoV-2 in a community, which can be useful in specific situations with a defined target group or goal. However, the question remains open whether the use of MT is proportionate to the overall gain.


Subject(s)
COVID-19 , SARS-CoV-2 , Humans , Netherlands/epidemiology , COVID-19/epidemiology
11.
J Anus Rectum Colon ; 6(4): 231-238, 2022.
Article in English | MEDLINE | ID: covidwho-2111369

ABSTRACT

Colorectal cancer (CRC) is the fourth most common malignancy in Korea and has been ranked as the third leading cause of cancer deaths in 2020. Although the incidence and mortality rates of CRC have decreased in recent years in Korea, it is still a significant public health burden. From the early 1990s until the mid-2000s, the 5-year relative survival of patients with CRC in Korea continuously increased. This finding appears to be a consequence of the successful introduction of a government-led screening program; the development of improved surgical techniques, anticancer drugs, and adjuvant treatment; and the advancement of medical resources and infrastructure along with economic growth. However, the improvement in survival has stagnated since the late 2000s. The recent coronavirus disease 2019 outbreak led to a reduction in hospital visits and screenings, which is expected to cause a stage shift to advanced disease stages and a worse prognosis for patients with CRC. Exploring modifiable environmental risk factors and appropriate screening test methods in Korea is necessary to overcome these challenges. Primary prevention through risk factor mediation and secondary prevention using suitable screening programs can help reduce the incidence and mortality rates of CRC.

12.
Journal of Environmental Health and Sustainable Development ; 7(3):1727-1732, 2022.
Article in English | Scopus | ID: covidwho-2091178

ABSTRACT

Introduction: Although various liquid, solid, and gaseous streams of wastewater treatment plants (WWTPs) have been analyzed in many studies for the presence of SARS-CoV-2 RNA, no study was found to sample and detect SARS-CoV-2 RNA in screenings and grit samples separated from primary treatment units of WWTP. Hence, this study aims to provide an experimental protocol for sampling and extracting SARS-CoV-2 RNA from screenings and grits separated from WWTPs. Materials and Methods: First, sampling was conducted to extract SARS-CoV-2 RNA from screenings and grit samples. After sample processing and viral RNA extraction, SARS-CoV-2 RNA detection was performed by one-step reverse transcription quantitative polymerase chain reaction (RT-qPCR). Results: Based on the results, SARS-CoV-2 RNA was successfully extracted from screenings and grit samples of the studied WWTP with concentrations of (1.54 –3.9 × 104) and (0.8 – 2.3 × 104) genomic copies/L, respectively. Conclusion: Considering the successfully isolation and detection of SARSCoV-2 viral RNA in solid phase samples of WWTP, this method can be applied for extracting SARS-CoV-2 RNA and maybe other viruses from the screenings and grit samples of WWTPs in related studies © 2022, Journal of Environmental Health and Sustainable Development.All Rights Reserved.

13.
JMIR Public Health Surveill ; 8(11): e40175, 2022 Nov 09.
Article in English | MEDLINE | ID: covidwho-2079993

ABSTRACT

BACKGROUND: The COVID-19 Omicron BA.2 epidemic wave in Hong Kong peaked in the first quarter of 2022. Following the implementation of stringent public health measures, the daily number of reported cases fell from over 50,000 to below 2000. Although outbreaks steadily receded, the government rolled out a 3-day "voluntary universal rapid testing" campaign to invite all citizens to self-perform a rapid antigen test (RAT) daily to identify undetected prevalent infections. OBJECTIVE: This study aimed to evaluate the uptake and results of RAT mass screening to estimate the population's residual epidemic burden and assess the risk of further transmission. METHODS: A cross-sectional study comprising an open web-based population-based survey was conducted a week after the RAT campaign. Participants were asked to report their COVID-19 vaccination and infection history and the RAT performance and test result during the period. They were also invited to report their coliving individuals' test performance and results. Reasons for nonuptake were enquired. Testing and positive rates were age-adjusted. Determinants of undergoing RAT were identified using univariable and multivariable logistic regression models. RESULTS: In total, particulars from 21,769 individuals were reported by 8338 participants. The overall age-adjusted testing rate was 74.94% (95% CI 73.71%-76.18%), with over 80% of participants in the age groups between 45-84 years having self-performed RAT during the campaign period. After age-adjustment, 1.03% (95% CI 0.86%-1.21%) of participants tested positive. The positive rates in the age groups between 20-29 years and >84 years exceeded 2%. Taking into account the positive rate and 5819 reported cases during the period, the cases identified in the campaign might account for 7.65% (95% CI 6.47%-9.14%) of all infections. Testers were more likely to be female, older, not previously diagnosed with COVID-19, and have received COVID-19 vaccination. Adjusting for the number of household members, those living with a child aged <12 years and whose household members were also tested were more likely to have self-performed an RAT. Main reasons for not performing an RAT included the absence of symptoms (598/1108, 53.97%), disbelief of the appropriateness of the campaign as an antiepidemic measure (355/1108, 32.04%), and a recent COVID-19 diagnosis (332/1108, 29.96%). CONCLUSIONS: The residual population burden remained substantial in spite of the clear evidence of a receding epidemic wave. Despite caution in generalization to the Hong Kong population, the high participation rate in mass screening indicated that the voluntary RAT was well accepted, making it a feasible option for implementation as a complementary means of public health surveillance.


Subject(s)
COVID-19 , SARS-CoV-2 , Female , Humans , Male , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19 Testing , Cross-Sectional Studies , COVID-19 Vaccines , Mass Screening
14.
Australian Journal of Primary Health ; 28(4):xli, 2022.
Article in English | EMBASE | ID: covidwho-2057759

ABSTRACT

Background: Primary maternity care in Indonesia faces significant challenges during the COVID-19 pandemic. The pandemic has exposed the fragility of primary care practice. The setting is pushed to help prevent the spread of the infection while maintaining care for pregnant women, however, with limited available guidance and support in practice. Aim/Objectives: To seek consensus on key recommendations and design a model for improving primary maternity care in Indonesia under the Covid-19 pandemic. Method(s): Four online co-design workshops and interviews were conducted with general practitioners (GPs), midwives, nurses, obstetricians, and patients. The first workshop discussed the way current maternity care was provided and the participants' expectations for improving the service in primary care. The second workshop discussed potential improvements for maternity care identified from a review of international recommendations, as well as discussing opportunities and potential challenges for implementing the recommendations in practice. The third and fourth workshops designed and finalised the maternity care model under the Covid-19 pandemic. Individual substitute interviews were also available for participants who could not attend the workshops. The participants' responses and suggestions were analysed using thematic analysis. Finding(s): Twenty-three participants were recruited, and 23, 20, 17, and 18 participants participated in the first-fourth workshops or substitute interviews. Key recommendations identified from the review and agreed upon in the workshops were health screening, maintaining antenatal-postnatal breastfeeding care, limiting visitors, and using telemedicine. A model of care for improving primary maternity care, covering arrangements for patients' encounters and referral plans, was also agreed and received suggestions from the participants. Potential challenges to the recommendation implementation include the available clinical resources and negotiating providers' authority. Implications: Recommendations and models of care would benefit for improving primary maternity care in Indonesia under the Covid-19 pandemic. Further research includes exploring the acceptability of the recommendations' implementation in practice.

15.
6th International Conference on Internet of Things, Big Data and Security, IoTBDS 2021 ; 2021-April:343-353, 2021.
Article in English | Scopus | ID: covidwho-2045128

ABSTRACT

In this paper, we introduce a solution aiming to improve the accuracy of the surface temperature detection in an outdoor environment. The temperature sensing subsystem relies on Mobotix thermal camera without the black body, the automatic compensation subsystem relies on Raspberry Pi with Node-RED and TensorFlow 2.x. The final results showed that it is possible to automatically calibrate the camera using machine learning and that it is possible to use thermal imaging cameras even in critical conditions such as outdoors. Future development is to improve performance using computer vision techniques to rule out irrelevant measurements. © 2021 by SCITEPRESS - Science and Technology Publications, Lda.

16.
Future Virol ; 2022 Sep.
Article in English | MEDLINE | ID: covidwho-2043362

ABSTRACT

Aim: The Belgium's strategy against COVID-19 was partly based on mass screening. Here, we reported the results observed in a Belgian mass screening center. Materials & methods: Between October 2020 and February 2021, 32,089 samples were collected analyzed with reverse-transcription PCR (Thermo Fisher Scientific kits and apparatus). Patients were categorized according to their contagiousness (extrapolated from the cycle threshold [Ct] values and the recommendation of Sciensano). Results: We observed association between Ct values and age, with higher Ct observed in extreme age groups (<6 years and >75 years). Conclusion: The analysis of the evolution of the contagiousness of these patients tested twice within a 7-day period showed the relevancy of the recommendation edited by Sciensano.

17.
Epidemiol Health ; 44: e2022053, 2022.
Article in English | MEDLINE | ID: covidwho-2024880

ABSTRACT

OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic has affected the utilization of healthcare services, including participation in cancer screening programs. We compared cancer screening participation rates for colorectal, gastric, breast, and cervical cancers among participants in the National Cancer Screening Program (NCSP) in 2019 and 2020 to address the potential distraction effect of COVID-19 on cancer screening. METHODS: Data from the NCSP for 4 cancer types (stomach, colorectal, breast, and cervical) in 2019 and 2020 were used to calculate cancer screening participation rates by calendar month, gender, age group, and geographical region. Monthly participation rates were analyzed per 1,000 eligible individuals. RESULTS: The screening participation rate decreased in 2020 compared to 2019 for all 4 cancers: colorectal (40.5 vs. 35.3%), gastric (61.9 vs. 54.6%), breast (63.8 vs. 55.8%), and cervical (57.8 vs. 52.2%) cancers. Following 2 major COVID-19 waves in March and December 2020, the participation rates in the 4 types of cancer screening dropped compared with those in 2019. The highest decline was observed in the elderly population aged 80 years and older (percentage change: -21% for colorectal cancer; -20% for gastric cancer; -26% for breast cancer; -20% for cervical cancer). CONCLUSIONS: After the 2 major COVID-19 waves, the screening participation rate for 4 types of cancer declined compared with 2019. Further studies are needed to identify the indirect effects of the COVID-19 pandemic on cancer patients, such as delayed diagnoses of cancer or excess cancer deaths.


Subject(s)
Breast Neoplasms , COVID-19 , Colorectal Neoplasms , Uterine Cervical Neoplasms , Aged , Breast Neoplasms/diagnosis , Breast Neoplasms/epidemiology , Breast Neoplasms/prevention & control , COVID-19/diagnosis , Colorectal Neoplasms/diagnosis , Colorectal Neoplasms/epidemiology , Early Detection of Cancer , Female , Humans , Mass Screening , Pandemics , Republic of Korea/epidemiology , Stomach , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/epidemiology , Uterine Cervical Neoplasms/prevention & control
18.
Journal of the Formosan Medical Association ; 121(9):1617-1621, 2022.
Article in English | Scopus | ID: covidwho-2015654
19.
Health Education and Health Promotion ; 10(2):265-269, 2022.
Article in English | Scopus | ID: covidwho-2011330

ABSTRACT

Aims: COVID-19 has affected a worldwide population, causing more than a million deaths from the end of 2019 until now;so the aim of this study was to determine the symptoms of COVID-19 in the Iranian population through a teleconsultation-based service to better deal with it. Instrument & Methods: This study was a cross-sectional study that included 12125 individuals calling for COVID-19 screening and consultation from 2 March 2020 to 19 April 2020 with the census method. A telephone number was assigned for consultation with more than 70 nurses responding to first-level questions and more than 30 medical doctors responding to second-level questions. For statistical analysis, a chi-squared test and univariate logistic regression with SPSS 25 were used. Finding: Cough was the most common complaint (41.3%), followed by shortness of breath (32.8%), and fever (31.5%). Confusion was the least common complaint (1.6%). Binary logistic regression revealed that men were at a higher risk of COVID-19 compared to women (OR:1.31, 95% CI 1.10-1.55, p=0.002). In addition, older age was a risk factor for COVID-19 (OR:1.02, 95% CI 1.02-1.03, p<0.001). Also, significant positive correlations were found between fever, chills, sore throat, shortness of breath, cough, body ache, and gastrointestinal symptoms with COVID-19 even after adjustment for gender and age. Conclusion: Fever, cough, and shortness of breath were the most common complaints in individuals calling for COVID-19 teleconsultation. It’s suggested that in times of crisis, such as the Covid-19 pandemic, remote sensing can be done to raise public awareness and break the transmission chain. © 2022, Tarbiat Modares University. All rights reserved.

20.
Journal of Clinical Oncology ; 40(16), 2022.
Article in English | EMBASE | ID: covidwho-2009653

ABSTRACT

Background: Chest X ray (CXR) has been the most common screen procedure for detection of lung cancer. We have shown that there is a profit to repeated visitors to the same facility for the lung cancer detection screening (Kimura T. Health Prim Car, 2021). Declaration of Emergency by Japan government in response to the COVID-19 pandemic and subsequent changes made to healthcare provision impacted people's abilities to effectively manage their health condition. The hypothesis was that many people would be reluctant to visit health checkup centers, and that opportunities for detection of cancers would decrease. Methods: Our clinic “MedCity21” is a university outpatient clinic to undergo a complete medical checkup in private health screening program. The visitors with abnormalities detected in CXR were announced by call request and invited to our specialty clinic for chest CT scan as further examination. Per year from 2018 to 2021, we examined the varieties of abnormal shadows by CXR and CT scans and compared the differences between the repeated and the first-time visitors using the chisquare tests and one-way ANOVA. We determined 2018 and 2019 to be before COVID-19 and 2020 and 2021 to be during COVID-19. We have been checking for previous COVID-19, and those with previous COVID-19 can be seen after 4 weeks of recovery. Results: From 2018 to 2021, in order, there were 12540,13690, 12070, and 13409 visitors of which 45.0%, 42.5%, 32.1%, and 29.2% were first-time visitors, respectively. There was a significant decrease of first-time visitors during COVID-19 compared to before COVID-19 (p = 0.0454). From 2018 to 2021, the CXR abnormalities requiring further examinations were 2.7%, 2.4%, 2.4%, and 2.3%, of which 2.1% and 3.4% were repeated and first-time visitors, 1.8% and 3.2%, 1.8% and 3.8%, and 1.5% and 4.0%, respectively. Each year, the detection rate was significantly lower for repeated comparing to first-time visitors (p < 0.01). The CT confirmation revealed that CXR abnormalities in repeated visitors were diagnosed with different variations compared to those of first-time visitors. Repeated visitors had a significantly lower proportion of old inflammatory changes than first-time visitors. This distribution is consistent with our previous report. It should be noted that there were no lung cancer patients in first-time visitors, on the contrary, there were 3 confirmed lung cancer in repeated visitors in 2021. Conclusions: There was a significant decrease of first-time visitors during COVID-19 compared to before COVID-19, but the rate of decrease was not as high as expected. The repeated visitors had significantly lower rate of CXR abnormalities detection, but higher detection of lung cancer. The number of people with previous COVID-19 will continue to increase. If the facility has adequate infection control measures in place, it is recommended that medical checkups be conducted annually.

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