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1.
Frontiers in Endocrinology ; 13, 2022.
Article in English | EMBASE | ID: covidwho-1817935

ABSTRACT

Prader–Willi syndrome (PWS) is a genetic disorder caused by the lack of expression of genes on the paternally inherited chromosome region 15q11.2-q13. It is a multisystem disorder that is characterized by severe hypotonia with poor suck and feeding difficulties in early infancy, followed in early childhood by excessive eating and gradual development of morbid obesity. The incidence of type 2 diabetes mellitus is high, particularly in obese patients. Non-alcoholic fatty liver disease has also been reported in some patients with PWS. Liver adenomatosis is a benign vascular lesion of the liver, defined by the presence of >10 adenomas, in the otherwise healthy liver parenchyma. We report the first case of a patient with PWS with severe obesity, type 2 diabetes mellitus, and non-alcoholic fatty liver who also developed liver adenomatosis, review the pediatric literature on liver adenomatosis, and discuss the potential underlying mechanisms.

2.
Front Pediatr ; 10:787947, 2022.
Article in English | PubMed | ID: covidwho-1809481

ABSTRACT

OBJECTIVE: The COVID-19 lockdown extended premature rupture of membranes (PROM) expectant time among nulliparas and increased the risk of term neonatal complications. This study investigated the impact of term nulliparas with PROM delays at home on neonatal outcomes during the COVID-19 lockdown period, considering the clinical diagnostic application of maternal C-reactive protein (CRP). METHODS: This study collected 505 term nulliparous women who underwent PROM at home from five provinces in a non-designated hospital of China in 2020. We analyzed PROM maternal information at home and neonatal complications in the COVID-19 regional lockdown and compared related information in the national lockdown. Poisson regression models estimated the correlation of PROM management at home, maternal CRP, and neonatal morbidity. We constructed two diagnostic models: the CRP univariate model, and an assessed cut-off value of CRP in the combined model (CRP with PROM waiting time at home). RESULTS: In the regional lockdown, PROM latency at home and the severity of neonatal complications were extended and increased lower than in the nationwide lockdown, but term neonatal morbidity was not reduced in the COVID-19 localized lockdown. Prolonged waiting time at home (≥8.17 h) was associated with increasing maternal CRP values and neonatal morbidity (adjusted risk ratio 2.53, 95% CI, 1.43 to 4.50, p for trend <0.001) in the regional lockdown period. In the combined model, CRP ≥7 mg/L with PROM latency ≥8.17 h at home showed higher diagnostic sensitivity and AUC than only CRP for initial assessing the risk of adverse neonatal complications in COVID-19 regional lockdowns (AUC, 0.714 vs. 0.534;sensitivity, 0.631 vs. 0.156). CONCLUSION: The impact of the acute COVID-19 national blockade on the PROM newborns' health could continue to the COVID-19 easing period. Maternal CRP reference interval (≥7 mg/L) would effectively assess the risk of term neonatal morbidity when nulliparas underwent prolonged PROM expectant at home (≥8.17 h) during the second COVID-19 lockdown.

3.
Journal of Neonatal Nursing ; 2022.
Article in English | ScienceDirect | ID: covidwho-1799819

ABSTRACT

Background Neonatal intensive care unit (NICUs) nurses could suffer from job stress and burnout, which could cause increased turnover rates and decreased Quality of Life (QoL) among nurses. Purpose To determine the association between burnout and nurses’ QoL in NICUs. Study design This correlational study was performed in 2020 on 140 nurses working in NICUs. The Maslach burnout and WHO Quality of Life-BREF was used to collect data. Results There is a positive association between personal accomplishment and all dimensions of QoL (r = 0.40 to 0.56) and a negative association between emotional exhaustion, depersonalization of burnout and all dimensions of QoL (r = −0.47 to −0.79). Conclusion It is suggested that several interventions must be taken to prevent burnout and increased QoL in NICU nurses. The findings could provide scientific evidence for managers and encourage evidence-based decision-making to reduce burnout and improve the QoL of nurses especially during the Covid-19 pandemic.

4.
Journal of Clinical and Diagnostic Research ; 16(SUPPL 2):64, 2022.
Article in English | EMBASE | ID: covidwho-1798720

ABSTRACT

Introduction: Corona Virus Disease 2019 (COVID-19) is an infectious disease caused by SARS-COV-2. First identified in December 19 in Wuhan, China On March 12,2020, WHO announced corona virus outbreak as pandemic. Till September 14, in India >48,50,887 confirmed cases, >9,90,502 active cases, >37,79,927 recovered cases reported. In karnataka 4,59,445 confirmed, 99,203 active, 3,52,958 recovered, 7265 death reported. Aim: To study maternal and fetal outcome in COVID-19 positive pregnant patients admitted in MIMS, Mandya (from 1s t wave to 3r d wave). Materials and methods: This is a prospective study conducted in the Department of OBG, MIMS, Mandya, of a study period of 15 months from June 2020 to November 2021. All cases of confirmed COVID- 19 patients admitted in the Department of OBG are included in the study period ,using medical case records, OT registered - age ,parity ,mode of presentation, investigations, management and outcome of delivery were observed among the COVID-19 patients Results: Out of 216 admissions in 1 s t wave 139 cases delivered and in these 84 (60.4%) vaginal deliveries and 55 (39.5%) c-section ,among which 1 VBAC, 1 breech, 1 vaccum, 3 PPH, 2 IUD, 1 maternal death and 40 NICU admissions and among which 4 babies were positive and 1 neonatal death. During 2nd wave, out of 355 admissions 168 delivered and in these 98(58.3%) vaginal deliveries and 70 (41.6%) c-section, among them 8 vaccum deliveries, 4 IUD, 1 breech, 1 VBAC, 4 PPH , 1 MRP, 5 MVA and 1 ectopic pregnancy and 10 maternal death and 15 NICU admissions among them 8 COVID-19 positive babies and 1 neonatal death. In the emerge of 3r d wave 1 case we have documented and it is LSCS on 2/11/21 baby COVID-19 negative. Conclusion: Compared to 1st wave and 2nd wave there is increase in disease severity and number of cases. Burden of disease has drastically increased. Early diagnosis and prompt treatment can reduce the mortality rate in COVID-19 patients.

5.
Saúde Soc ; 31(1): e201010, 2022. tab, graf
Article in Portuguese | WHO COVID, LILACS (Americas) | ID: covidwho-1779819

ABSTRACT

Resumo As rigorosas medidas de segurança adotadas pelos hospitais, em decorrência da pandemia, estenderam-se também às Unidades de Terapia Intensiva Neonatais (UTIN). Este artigo desvela, por meio de observação sistemática, as mudanças organizacionais e estruturais ancoradas na Teoria Ambientalista de Nightingale que ocorreram na UTIN de um hospital público do interior da Bahia. Observou-se a interconexão entre os Ambientes Físico, Psicológico e Social, porém, com comprometimento na comunicação e relação entre família, neonato e equipe, apresentando um viés sensível das consequências restritivas da covid-19. Salienta-se o paradoxo entre zelar pela segurança e o impedimento das práticas informativas e facilitadoras de vínculos que envolvem o trinômio mencionado. Contudo, novas estratégias emergem desse contexto, levando os profissionais a se reinventarem e ousarem na comunicação, por meio de recursos remotos antes não utilizados, destacando as tecnologias digitais.


Abstract The strict safety measures adopted in hospital environments due to the pandemic have also been extended to Neonatal Intensive Care Units (NICU). By means of a systematic observation and based on Nightingale's Environmental Theory, this article sought to unveil the organizational and structural changes in the NICU of a public hospital in the countryside of Bahia. Results indicate an interconnection between physical, psychological, and social environments, which were committed to the communication and relationship between family, newborn, and team, thus presenting a sensitive bias of the restrictive consequences of covid-19. These findings highlight the paradox between ensuring security and preventing informational and bond-facilitator practices that involve the aforementioned triad. From this context emerge new communication strategies leading professionals to reinvent themselves, and to dare in communication by remote resources not used before, emphasizing the use of digital technologies.


Subject(s)
Humans , Male , Female , Infant, Newborn , Family , Intensive Care Units, Neonatal , Communication , Biomedical Technology
6.
Pediatria Catalana ; 81(2):102-107, 2021.
Article in Catalan | EMBASE | ID: covidwho-1766470

ABSTRACT

Background. Since the beginning of the SARS-CoV-2 pandemic, most neonatal units around the world have restricted parents’ access, aiming to protect the staff and the babies against the infection. Objective. To evaluate the side effects of the limitation of parents presence with their babies in neonatal units and those related to restrictions on maternity wards access. Method. Literature review. A search using ‘SARS-CoV-2’ and ‘COVID-19’ as keywords combined to ‘neonatal’, ‘NICU’, ‘parents’, ‘family centered care’ and ‘neurodevelopmental care’. Consultation of websites containing updated and summarized scientific literature about the pandemic and its consequences in newborns has also been performed: www.dontforgetthebubles.com and www.seneo.es. The voice of the families has been mainly obtained through the websites of their associations and the social networks. Results. The family-centered care model has shown positive effects on the health of sick newborns and on premature infants’ neurodevelopment. This model of care is under threat if parental access is limited. It has been shown that these restrictions have also adverse effects on breastfeeding and on caregivers’ psychological wellbeing. Data from different neonatal series report a benign course of COVID-19 infection in neonates and preterm babies. Conclusions. At a crucial moment for the implementation of the developmental centered care model in Catalan neonatal units, and with the available data, it is essential to redesign the policies regarding parents who accompany their babies admitted to the units.

7.
J Gynecol Obstet Hum Reprod ; 51(5): 102366, 2022 Mar 25.
Article in English | MEDLINE | ID: covidwho-1757585

ABSTRACT

OBJECTIVE: To evaluate maternal and neonatal outcomes of pregnant women who were infected by COVID-19 during pregnancy. STUDY DESIGN: A Case control retrospective study was conducted in an Obstetrical Department of a west Parisian area during the first year of COVID-19 pandemic. Maternal and neonatal outcomes were compared between a group of women infected by the SARS-CoV-2 virus during pregnancy (March 2020- February 2021) and a control group of women delivering before pandemic. They were matched according to age and parity. Subgroups of SARS-CoV-2 infection occurring before vs after 37 weeks of gestations and symptomatic vs asymptomatic patients were analyzed. The rate of preterm birth, preeclampsia, placental abruption and stillbirth were compared between the year of pandemic and the year before for all deliveries. RESULTS: Maternal and neonatal outcomes were similar. Among the 86 pregnant women with SARS-CoV-2 infection, five were admitted to Hospital (5.8%). One was transferred in intensive care unit for respiratory distress (1.2%). All patients had favorable outcomes. Patients with symptoms had more associated comorbidities (34.5%, n = 20/58, with symptoms, vs 9,1%, n = 2/22, without symptoms, p = 0.023). No differences in preeclampsia, placenta abruption and stillbirth, but less preterm births (4.9%, n = 160/3383 vs 6.2%, n = 209/3235, p = 0.04) were observed between the year of pandemic and the year before. CONCLUSION: There were few complications associated with COVID-19 infection among pregnant patients and their neonates. A low rate of associated comorbidities, a good access to healthcare services in this area and the small sample size of patients could explain these results.

8.
Trop Doct ; 52(1): 46-52, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1759598

ABSTRACT

Our study looks at the effects of burnout and stress levels of nurses, behaviour regarding medical waste, and other effective risk factors on the first time and recurrent diagnosis of nosocomial infection (NI) in neonatal intensive care units in Hargeisa, Somaliland. This multicentric follow-up study was conducted and repeated measurements were taken from 72 neonates and 45 nurses working in three hospitals for a period of five months. Nurses with high burnout levels had 3.7 times higher risk of neonates under their care being diagnosed with an NI (odds ratio: 3.743; 95% CI: 1.498-9.356). By controlling other variables, the stress level of nurses increased the incidence rate of neonates being diagnosed more than once with NI by 3.2 times. Statistically, the direction of causal association was from the high burnout among nurses to the diagnosis of NI, and high stress was associated with the recurrent diagnosis of infections in neonates.


Subject(s)
Burnout, Professional , Cross Infection , Burnout, Professional/diagnosis , Burnout, Professional/epidemiology , Cross Infection/epidemiology , Follow-Up Studies , Humans , Infant, Newborn , Intensive Care Units , Intensive Care Units, Neonatal , Risk Factors
9.
Nurs Crit Care ; 2022 Mar 02.
Article in English | MEDLINE | ID: covidwho-1714281

ABSTRACT

BACKGROUND: Family-centred care (FCC) is an approach to promote family and health care provider partnership. This has been incorporated into neonatal intensive care units (NICUs) worldwide. However, FCC in low resource health settings, such as Thailand, is challenging and further impacted by coronavirus disease 2019 (COVID-19). AIMS: To evaluate FCC innovations to improve respect, collaboration and support in a Thai NICU. STUDY DESIGN: A quasi-experimental study was conducted in an NICU in southern Thailand. Pre-implementation was prior to COVID-19, and parental and staff perceptions of FCC were measured via Perceptions of Family Centred Care-Parent (PFCC-P) and -Staff (PFCC-S) survey. The FCC innovations were developed by stakeholders based on the COVID-19 restrictions, pre-survey results, parents' and clinicians' interviews and integrative review, then implemented via a flowchart. Post-implementation evaluation was via repeated surveys. Comparisons were made pre-and post-implementation, with Mann-Whitney U-test statistics for parents and Wilcoxon's Rank Sum for staff. RESULTS: A total of 185 (85 pre; 100 post) parents and 20 (pre and post; paired group) health care professionals participated. Because of COVID-19, many planned interventions were unfeasible, however, other innovations achieved (e.g., structured telephone updates, information booklet revision). There was an increase in parents' perception of respect ([median] 2.50-3.50), collaboration (2.33-3.33) and support (2.60-3.60) domains and overall (2.50-3.43; p < .001; 95% CI: 2.93-3.11). Interdisciplinary professionals' perception of FCC did not significantly change pre-and post-implementation/COVID-19 pandemic for respect (3.00-2.92), collaboration (3.22-3.33), support (3.20-3.20) and overall (3.15-3.20; 95% CI: 3.10-3.25). CONCLUSION: Despite the challenges of COVID-19 restricting NICU access, the provision of FCC was maintained and even improved. RELEVANCE TO CLINICAL PRACTICE: Further research is necessary to develop FCC practice innovations associated with communication, across diverse health care systems and resources.

10.
Romanian Journal of Legal Medicine ; 29(3):299-304, 2021.
Article in English | EMBASE | ID: covidwho-1649762

ABSTRACT

COVID-19 continues to be both a major medical problem and a real ethical and forensic issue, profoundly affecting both patients and health services around the world. This pandemic has produced major changes in the provision of healthcare, especially in patients with chronic conditions. The consequence has been the deviation in some medical situations from the medical guidelines and protocols in force with forensic risks for clinicians. When the criteria of professional competence are met, the civil liability ensures a protection of the health workers. Disputes can arise when there are doubts about how the medical activity was performed in safe conditions for patients, when local care decisions were made or when there are no nationally validated guidelines. In conclusion, clarifying legal concepts on the public health crisis, developing a legislative framework and appropriate means to combat it, are important desideratum on more judicious management of a crisis situation.

11.
Music and Medicine ; 13(2):112-123, 2021.
Article in English | APA PsycInfo | ID: covidwho-1632105

ABSTRACT

This article outlines the shifts in NICU music therapy due to the COVID-19 pandemic in Italy, Japan, and Colombia, from the beginning of the outbreak in each of the countries until September 2020. Detailed information will be provided on how the pandemic has changed hospital policies and has had an impact on the families and the music therapy services. Furthermore, the authors discuss current biosecurity protocols, parental visiting guidelines, telehealth strategies, and the financial impact of the pandemic. While the way healthcare workers and healthcare institutions cope with the current situation may be unique according to cultural and societal particularities in each country, many overlaps between the three countries were found. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

12.
Cogent Medicine ; 8, 2021.
Article in English | EMBASE | ID: covidwho-1617065

ABSTRACT

Background: The COVID-19 pandemic has changed the paradigm when it comes to infection control. However, there are still many doubts about pregnancy and the perinatal period in this context, even though many studies suggest the benignity of infection in this phase. The present study took place in a Level II Hospital with differentiated perinatal care and describes the newborns whose mothers were infected with COVID-19 during pregnancy. We aim to understand the mother-newborn pattern of transmission and clinical, analytical and serologic follow-up. Methods: Prospective observational study from 1/4/2020 to 31/5/2021, using the clinical files of every SARS-COV-2 PCR-positive mother and their newborns. Among others, we evaluated the state of infection of the newborn at 12 and 48h and after 14 days with SARS-Cov-2 PCR tests. In the first three months, serologic and clinical evaluation were performed. Results: Of the 1684 live births, 60 (3,6%) mothers were infected with SARS-COV-2 during pregnancy, 43% of which were diagnosed in the screening performed during/before labour. The median value of gestational age was 39 weeks, and the average weight was 3171g. 81,7% of the newborns remained with their mother in the hospital ward, and 85% were breastfed. 7 newborns (11,7%) needed NICU, one of which was born at 32 weeks because the mother needed ICU support due to COVID-19. Of the 26 newborns whose mothers were positive in labour, 15 were tested for SARS-Cov-2 PCR in the first 12 h, and 21 within 48h: all of them were negative.16 were tested after 14 days. Only one of them (6,2%) tested positive but remained asymptomatic. Serologic anti-spike and anti-nucleocapsid analyses were performed in 32 babies: 10 of them (31.3%) showed positive antibodies. In these cases, 80% of the mothers were positive in the 3rd trimester and 20% in the 2nd trimester. The clinical follow-up showed a positive outcome in all of them. Conclusions: This study supports others that show the benignity of perinatal SARS-COV-2 infection. There were no more significant rates of prematurity or NICU need. None of the newborns tested positive in SARS-Cov-2 PCR tests in the first 48h, supporting the rarity of the vertical infection, and only one has been affected by horizontal transmission.

13.
Hu Li Za Zhi ; 68(6): 73-82, 2021 Dec.
Article in Chinese | MEDLINE | ID: covidwho-1609205

ABSTRACT

BACKGROUND & PROBLEMS: Parent-infant attachment is affected by parent-infant interaction. The limitations on related visitations during the COVID-19 pandemic suspended the opportunity to engage in kangaroo care (skin-to-skin contact) activities. These changes impacted parent-infant attachment in the neonatal intensive care unit. After investigation, the score of premature infant-parent attachment was found to be only 64.6 points during the period in which visitation limitations were in effect. PURPOSE: To enhance maternal-premature infant attachment during the pandemic period by 10% (from an average score of 64.6 to 71.1). RESOLUTION: This project involved nurses playing audio files provided by mothers to their premature infants, and recording a video and taking pictures of the infants during this process. This project used a cloud platform as bidirectional pipelines. Furthermore, emotional support and caring information were provided to the mothers via expressive arts therapy and phone interviews. RESULTS: After the intervention, the premature infant-parent attachment score rose to 74.4 from the pre-intervention score of 64.6. CONCLUSIONS: During pandemic control periods, traditional modes of care aimed at building infant-parent attachment are not applicable. The intervention project used was found to be an effective alternative approach to increasing maternal-premature infant attachment. Breaking the restrictions of time and place, this project applies family-centered care, and may provide a reference for developing software, hardware, and communication equipment for other care units related to newborns.


Subject(s)
COVID-19 , Intensive Care Units, Neonatal , Female , Humans , Infant , Infant, Newborn , Infant, Premature , Mothers , Pandemics , SARS-CoV-2
14.
American Journal of Obstetrics and Gynecology ; 226(1):S268, 2022.
Article in English | EMBASE | ID: covidwho-1588478

ABSTRACT

Objective: During the early months of the pandemic, policies were implemented that sought to reduce in-person office visits. We sought to evaluate the neonatal outcomes associated with those policy changes across two disparate clinical sites. Study Design: We performed a cohort study of patients obtaining prenatal care at two clinics that were disparate in patient population and resources during two different 6 month intervals (Time I: July 1, 2019 - December 31, 2019 and Time II: March 23, 2020 - September 23, 2020). Both sites shared identical policies and leadership. Patients with known SARS-CoV-2 infection were excluded from the analysis. Medical records were reviewed for clinical and demographic characteristics. Neonatal morbidity was defined as any of the following: stillbirth, neonatal death, preterm birth, NICU admission, low birthweight. Data was analyzed using chi square and Cochran Q test where appropriate. P< 0.05 was significant. Results: Site A’s prenatal visits decreased (Time I= 9,782 and Time II= 8,694) while Site B’s prenatal visits increased (Time I= 4,144 and Time II= 6,644). At baseline, Site A compared to Site B was more likely to have patients with commercial insurance (88.7 vs 12.9%, p< 0.001) and who self-identified as White race (66.6 vs 29.9%, p< 0.001). Patients from Site A were less likely to be Hispanic (18 vs 39.1%, p< 0.001) and had a lower neonatal morbidity rate (19 vs 26%, p< 0.001). In Time I, neither site was using telehealth. In Time II, Site A conducted 21.5% of prenatal visits by telehealth. Site B conducted 1.8% of visits by telehealth but experienced net transfer of patients whose physician offices were closed. In Time II, the neonatal morbidity disparity between the two sites persisted (18.7 vs 28%, p< 0.001), with Site B experiencing a slight increase in neonatal morbidity. Cochran's Q test indicates a statistically significant difference in the proportion of perinatal morbidity over time, χ2 (2) = 740.7, p< 0.001. Conclusion: Policies to reduce in-person visits are associated with an increased neonatal morbidity in lower resourced settings and higher risk populations.

15.
American Journal of Obstetrics and Gynecology ; 226(1):S534-S535, 2022.
Article in English | EMBASE | ID: covidwho-1588445

ABSTRACT

Objective: Parents of neonates in the Neonatal Intensive Care Unit (NICU) experience many mental health stressors. The COVID-19 pandemic exacerbated these stressors, as pandemic-related restrictions created barriers to resources and newborn bonding. Modern technology offers tools that can help NICU parents maintain their mental and social health remotely. Study Design: We conducted a cross-sectional study to assess self-reported mental health and technology use among parents of infants hospitalized in the NICU at a single institution during the COVID-19 pandemic. We also studied the prevalence of specific COVID-19-related stressors among participants. Participants were asked to rank a series of statements on a Likert scale to describe their mental health, technology use, and COVID-19-related stress. Spearman rank coefficients were calculated to measure strength and direction of associations. Results: A sample of 47 participants completed the voluntary assessment. Mental health was negatively associated with higher COVID-19-related stress (rs-0.40, p=.015). The most prevalent COVID-19-related stressor was hospital visitation restriction, which 31.9% of participants assigned the highest severity stress score. Higher COVID-19-related stress was associated with the use of text and video chat for social support [(rs 0.35, p.016)and ( rs 0.33 p=.025) respectively]. Further, we found that greater enjoyment of technology use and greater access to technology were both positively associated with higher mental health scores [(rs 0.42, p=.003) and (rs 0.38, p=.009), respectively]. Conclusion: Our findings support the value of technology for individuals impacted by the stress of having a newborn who is hospitalized during a global health crisis. Evidence showing clinical benefits of technology supports the expansion of patient access and incentivizing funding for hospital programs, especially as we continue to navigate the COVID-19 pandemic. [Formula presented] [Formula presented]

16.
BMC Pediatr ; 21(1): 558, 2021 12 09.
Article in English | MEDLINE | ID: covidwho-1566512

ABSTRACT

BACKGROUND: Prior to the COVID-19 pandemic, parents of infants in the Neonatal Intensive Care Unit (NICU) frequently reported high levels of stress, uncertainty, and decreased parenting confidence. Early research has demonstrated that parents have had less access to their infants in the hospital due to restrictions on parental presence secondary to the pandemic. It is unknown how parents have perceived their experiences in the NICU since the beginning of the COVID-19 pandemic. The purpose of this study was to describe the lived experience of parents who had an infant in the NICU in the context of the COVID-19 pandemic to inform healthcare providers and policy makers for future development of policies and care planning. METHODS: The study design was a qualitative description of the impact of the COVID-19 pandemic on parents' experiences of having an infant in the NICU. Free-text responses to open-ended questions were collected as part of a multi-method study of parents' experiences of the NICU during the first six months of the pandemic. Participants from the United States were recruited using social media platforms between the months of May and July of 2020. Data were analyzed using a reflexive thematic approach. FINDINGS: Free-text responses came from 169 parents from 38 different states in the United States. Three broad themes emerged from the analysis: (1) parents' NICU experiences during the COVID-19 pandemic were emotionally isolating and overwhelming, (2) policy changes restricting parental presence created disruptions to the family unit and limited family-centered care, and (3) interactions with NICU providers intensified or alleviated emotional distress felt by parents. A unifying theme of experiences of emotional distress attributed to COVID-19 circumstances ran through all three themes. CONCLUSIONS: Parents of infants in the NICU during the first six months of the COVID-19 pandemic experienced emotional struggles, feelings of isolation, lack of family-centered care, and deep disappointment with system-level decisions. Moving forward, parents need to be considered essential partners in the development of policies concerning care of and access to their infants.


Subject(s)
COVID-19 , Intensive Care Units, Neonatal , Humans , Infant , Infant, Newborn , Pandemics , Parents , Qualitative Research , SARS-CoV-2 , United States/epidemiology
17.
Neonatology ; 119(1): 129-132, 2022.
Article in English | MEDLINE | ID: covidwho-1518192

ABSTRACT

The COVID-19 pandemic has upset habits in any workplace. In hospitals, several precautions have been taken to maintain health-care workers' safety and to avoid disease spread or the possible creation of new epidemic outbreaks. The use of medical devices makes the contamination and the nosocomial virus spread possible, causing infection in medical operators and hospitalized patients. In the neonatal intensive care unit, ultrasound has been an increasingly used tool because it is a non-invasive, repeatable method and it is side effect-free as the newborn is not exposed to radiation. It makes a fast diagnosis and then therapy possible such as in the lung diseases and other life-threatening conditions. The use of portable devices such as the wireless probe has many advantages in routine clinical practice, and during the COVID-19 pandemic, it has proved to be fundamental for the patient and the physician's safety because it reduced the risk of contamination. We report the use of the wireless ultrasound probe in 2 isolated neonates born to SARS-CoV-2-positive mothers.


Subject(s)
COVID-19 , Pregnancy Complications, Infectious , Female , Humans , Infant, Newborn , Infectious Disease Transmission, Vertical , Mothers , Pandemics , Pregnancy , Pregnancy Complications, Infectious/epidemiology , SARS-CoV-2
18.
Front Psychol ; 12: 734640, 2021.
Article in English | MEDLINE | ID: covidwho-1477870

ABSTRACT

The main aim of the present study was to investigate the effects of the COVID-19 pandemic on the mothers' postnatal depression, stress, and attachment during their stay in the Neonatal Intensive Care Unit (NICU). Twenty mothers of very premature infants born before 32weeks of gestational age were recruited at the Geneva University Hospital between January 2018 and February 2020 before the COVID-19 pandemic started. Mothers were screened for postnatal depression after their preterm infant's birth (Edinburgh Postnatal Depression Scale, EPDS), then for stress (Parental Stressor Scale: Neonatal Intensive Care Unit, PSS:NICU), and attachment (Maternal Postnatal Attachment Scale, MPAS) at infant's term-equivalent age. Data were compared with 14 mothers recruited between November 2020 and June 2021 during the COVID-19 pandemic. No significant differences were found in the scores for depression, stress, and attachment between the two groups. However, a non-statistically significant trend showed a general increase of depression symptoms in mothers during the COVID-19 pandemic, which significantly correlated to the attachment and stress scores. Moreover, the PSS:NICU Sights and Sounds score was significantly positively correlated with EPDS scores and negatively with the MPAS score only in the During-COVID group. To conclude, we discussed a possible dampened effect of the several protective family-based actions that have been adopted in the Geneva University Hospital during the health crisis, and we discussed the most appropriate interventions to support parents in this traumatic period during the COVID-19 pandemic.

19.
Cureus ; 13(10): e18455, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1471164

ABSTRACT

The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has rapidly spread across the globe. The clinical spectrum of infection with SARS-CoV-2 among the most vulnerable extremely premature patient population in the neonatal intensive care units (NICUs), particularly those with chronic lung disease (CLD), remains unclear. Additionally, post-COVID conditions have been described in children with limited published data among infants. Symptoms in children appear similar to those described in the adults. We report a case of SARS-CoV-2 infection in a 24-week preterm infant with CLD acquired via horizontal transmission while still in the NICU. We also provide follow-up data on patient until one year post-discharge. Our patient developed fever prompting testing for SARS-CoV-2. Although extremely premature infants with CLD are known to be at high risk for morbidities if they acquire respiratory viral infections, infection with SARS-CoV-2 in this case report presented with relatively mild clinical symptoms. He remained clinically stable on respiratory support (nasal cannula) with eventual weaning to room air. Our patient was followed until one year post-discharge (chronological age: 20 months) and had follow-up by various subspecialties for chronic lung disease, hypothyroidism, chronic kidney disease, and poor growth. We did not observe any specific post-COVID symptoms. This case illustrates that horizontal transmission of SARS-CoV-2 infection among extremely premature infants with CLD is possible in the NICU but likely presents with mild clinical symptoms during acute infection and less chances of post-COVID conditions. Additionally, this case highlights the need for adherence to infection prevention guidelines to prevent nosocomial transmission amid the ongoing pandemic.

20.
J Med Internet Res ; 23(10): e27261, 2021 10 20.
Article in English | MEDLINE | ID: covidwho-1463396

ABSTRACT

BACKGROUND: Health care organizations (HCOs) adopt strategies (eg. physical distancing) to protect clinicians and patients in intensive care units (ICUs) during the COVID-19 pandemic. Many care activities physically performed before the COVID-19 pandemic have transitioned to virtual systems during the pandemic. These transitions can interfere with collaboration structures in the ICU, which may impact clinical outcomes. Understanding the differences can help HCOs identify challenges when transitioning physical collaboration to the virtual setting in the post-COVID-19 era. OBJECTIVE: This study aims to leverage network analysis to determine the changes in neonatal ICU (NICU) collaboration structures from the pre- to the intra-COVID-19 era. METHODS: In this retrospective study, we applied network analysis to the utilization of electronic health records (EHRs) of 712 critically ill neonates (pre-COVID-19, n=386; intra-COVID-19, n=326, excluding those with COVID-19) admitted to the NICU of Vanderbilt University Medical Center between September 1, 2019, and June 30, 2020, to assess collaboration between clinicians. We characterized pre-COVID-19 as the period of September-December 2019 and intra-COVID-19 as the period of March-June 2020. These 2 groups were compared using patients' clinical characteristics, including age, sex, race, length of stay (LOS), and discharge dispositions. We leveraged the clinicians' actions committed to the patients' EHRs to measure clinician-clinician connections. We characterized a collaboration relationship (tie) between 2 clinicians as actioning EHRs of the same patient within the same day. On defining collaboration relationship, we built pre- and intra-COVID-19 networks. We used 3 sociometric measurements, including eigenvector centrality, eccentricity, and betweenness, to quantify a clinician's leadership, collaboration difficulty, and broad skill sets in a network, respectively. We assessed the extent to which the eigenvector centrality, eccentricity, and betweenness of clinicians in the 2 networks are statistically different, using Mann-Whitney U tests (95% CI). RESULTS: Collaboration difficulty increased from the pre- to intra-COVID-19 periods (median eccentricity: 3 vs 4; P<.001). Nurses had reduced leadership (median eigenvector centrality: 0.183 vs 0.087; P<.001), and neonatologists with broader skill sets cared for more patients in the NICU structure during the pandemic (median betweenness centrality: 0.0001 vs 0.005; P<.001). The pre- and intra-COVID-19 patient groups shared similar distributions in sex (~0 difference), race (4% difference in White, and 3% difference in African American), LOS (interquartile range difference in 1.5 days), and discharge dispositions (~0 difference in home, 2% difference in expired, and 2% difference in others). There were no significant differences in the patient demographics and outcomes between the 2 groups. CONCLUSIONS: Management of NICU-admitted patients typically requires multidisciplinary care teams. Understanding collaboration structures can provide fine-grained evidence to potentially refine or optimize existing teamwork in the NICU.


Subject(s)
COVID-19 , Intensive Care Units, Neonatal , Humans , Infant, Newborn , Intensive Care Units , Pandemics , Retrospective Studies , SARS-CoV-2
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