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2.
Digital Biomarkers ; 6(1):19-30, 2022.
Article in English | ProQuest Central | ID: covidwho-1824097

ABSTRACT

Introduction: Clinical research and treatment of childhood obesity is challenging, and objective biomarkers obtained in a home-setting are needed. The aim of this study was to determine the potential of novel digital endpoints gathered by a home-monitoring platform in pediatric obesity. Methods: In this prospective observational study, 28 children with obesity aged 6–16 years were included and monitored for 28 days. Patients wore a smartwatch, which measured physical activity (PA), heart rate (HR), and sleep. Furthermore, daily blood pressure (BP) measurements were performed. Data from 128 healthy children were utilized for comparison. Differences between patients and controls were assessed via linear mixed effect models. Results: Data from 28 patients (average age 11.6 years, 46% male, average body mass index 30.9) and 128 controls (average age 11.1 years, 46% male, average body mass index 18.0) were analyzed. Patients were recruited between November 2018 and February 2020. For patients, the median compliance for the measurements ranged from 55% to 100% and the highest median compliance was observed for the smartwatch-related measurements (81–100%). Patients had a lower daily PA level (4,597 steps vs. 6,081 steps, 95% confidence interval [CI] 862–2,108) and peak PA level (1,115 steps vs. 1,392 steps, 95% CI 136–417), a higher nighttime HR (81 bpm vs. 71 bpm, 95% CI 6.3–12.3) and daytime HR (98 bpm vs. 88 bpm, 95% CI 7.6–12.6), a higher systolic BP (115 mm Hg vs. 104 mm Hg, 95% CI 8.1–14.5) and diastolic BP (76 mm Hg vs. 65 mm Hg, 95% CI 8.7–12.7), and a shorter sleep duration (difference 0.5 h, 95% CI 0.2–0.7) compared to controls. Conclusion: Remote monitoring via wearables in pediatric obesity has the potential to objectively measure the disease burden in the home-setting. The novel endpoints demonstrate significant differences in PA level, HR, BP, and sleep duration between patients and controls. Future studies are needed to determine the capacity of the novel digital endpoints to detect effect of interventions.

3.
Siberian Journal of Oncology ; 21(1):99-106, 2022.
Article in Russian | EMBASE | ID: covidwho-1822671

ABSTRACT

The aim of the study was to analyze the most significant studies representing the basic principles of diagnosis and treatment of patients with breast cancer (BC) during the CO VID -19 pandemic. Material and Methods. The search for relevant sources was carried out in PubMed, Cochrane Library, Web of Science systems, publications for 2019-2020 were studied, 48 of which were used to write this review. Results. During the CO VID -19 pandemic, it is necessary to suspend screening examinations for a certain period of time;patients with early and metastatic breast cancer should be transferred to outpatient treatment in the LU s located in their place of residence. Examinations and consultations of patients undergoing hormone therapy should be postponed or carried out using telemedicine technologies. Treatment of breast cancer patients during a pandemic should be carried out according to clinical guidelines and protocols, but minimizing the number of visits to the hospitals. Conclusion. The pandemic of the novel coronavirus infection (CO VID -19) is a serious problem for healthcare and professionals around the world. All treatment decisions must be based on risks and benefits in the context of each stage of the pandemic, on an individual basis and taking into account the preferences of patients.

4.
Neurologie und Rehabilitation ; 28(1):31-42, 2022.
Article in German | EMBASE | ID: covidwho-1822628

ABSTRACT

Background: People with multiple sclerosis (pwMS) benefit from regular physical exercise. There are positive effects in physical and cognitive performance and in dealing with activities of daily living. In addition, pwMS who exercise regularly prevent themselves from comorbidities such as diabetes, osteoporosis or chronic heart diseases and create biopositive effects in the neurodegenerative disease itself. The head organizations of German health insurances authorized the German Multiple Sclerosis (MS) Society in the state of Hesse providing the ambulant rehabilitation program “DMSG-Funktionstraining” for pwMS in 2019. “DMSG-Funktionstraining” (functional training) is an exercise training program developed for people with disabilities or people at risk of disability that takes place weekly and is led by a qualified therapist. It is prescribed by a doctor (duration between 12 and 24 months) and is part of outpatient medical rehabilitation. Methods: From the 1st of October 2019 until the 13th of March 2020 training groups were started throughout the state. In April 2020, 91 participants and 53 qualified coaches were evaluated via questionnaire. Participants and coaches evaluated the value of “DMSG-Funktionstraining,” the organizational strategies, the infrastructural conditions and the framework. Results: The return rate was about 86.8 % by “DMSG-Funktionstraining” participants and 56.6 % by “DMSG-Funktionstraining” coaches. Seventy-five questionnaires by the participants and 30 questionnaires by the coaches were included in descriptive analyses. The sample participant was 56.1 ± 7.1 years old, was diagnosed before 17.7 ± 9.9 years and had 2.1 ± 1.2 therapy units in total per week. The sample coach was 42.73 ± 10.2 years old. The respondents were sport therapists, physiotherapists, ergotherapists and yoga teachers. The big challenge for “DMSG-Funktionstraining” coaches was outlined in the heterogeneity of the group in one common training session. The disabilities were very different in regard to mobility and that meant a high level of training preparation and organization. Both the participants and the coaches evaluated the dynamic and the conversation possibilities in the training group as positive. The training contents were considered to be diversified and the coaches were assessed as competent. The distance between place of living and the training location was about 8.5 ± 8.4 kilometers and seemed to be attainable by the participants. In regard to accessibility, the responses varied. Considering the infrastructure, the organization strategies and the preparation, “Funktionstraining” was described as laborious by the coaches. Discussion: In conclusion, the difficulty with group training for people with a disease that combines highly varied symptomatic outcomes presents a big challenge. The results of this accompanying research in a preliminary project period can be described as auspicious in regard to the implementation of “DMSG-Funktionstraining” in the long term. There was a high level of satisfaction among “DMSG-Funktionstraining” participants. The critical point lies especially in the infrastructural implementation and needs further development. Based on the underlying results and the new circumstances due to the corona pandemic, the “DMSG-Funktionstraining” needed a new concept to transfer group training for pwMS to a virtual training room. Furthermore, the accompanying research turns out to have a high priority in order to gain a high-quality level in health care and self-help for pwMS, prospectively.

5.
Vaccines ; 10(4), 2022.
Article in English | EMBASE | ID: covidwho-1822465

ABSTRACT

Vaccination is the most effective intervention to prevent infection and subsequent complica-tions from SARS-CoV-2. Because of their multiple comorbidities, the elderly population experienced the highest number of deaths from the COVID-19 pandemic. Although in most countries, older people have top priority for COVID-19 vaccines, their actual willingness and attitudes regarding vaccination are still unclear. Thus, we conducted a cross-sectional study to investigate their willing-ness, attitudes, awareness, and knowledge of COVID-19 through a web-based questionnaire after the first local outbreak of COVID-19 in Taiwan. A total of 957 questionnaires were completed, and 74.9% of elderly individuals were likely to receive COVID-19 vaccines. The results from a multiple logistic regression demonstrated that older people who need to visit the outpatient department and have a high level of concern about the safety of COVID-19 vaccines are prone to having a negative willingness to accept COVID-19 vaccines. The following items related to awareness of the COVID-19 pandemic were attributed to the acceptance of COVID-19 vaccines: “understanding the risk of being infected by SARS-CoV-2”, “understanding the effectiveness of COVID-19 vaccines”, “willingness to accept the COVID-19 vaccine for protecting others”, and “safety of COVID-19 vaccines is a key factor for you to accept them”. Furthermore, a positive association between COVID-19 vaccination and attitudes toward accepting booster doses of the COVID-19 vaccine was observed. Our results show that these factors could affect the willingness of older people to accept COVID-19 vaccines and that they are important for policymakers and medical staff to develop vaccination plans during the COVID-19 pandemic.

6.
Frontiers in Pharmacology ; 13, 2022.
Article in English | EMBASE | ID: covidwho-1822398

ABSTRACT

Background: The appropriateness of antibiotic prescriptions in primary care has not been well evaluated in China in recent years. Furthermore, the impact of coronavirus disease 2019 (COVID-19) on antibiotic prescriptions has not yet been investigated in China. We aimed to assess the appropriateness of antibiotic prescriptions and to evaluate the potential association between the COVID-19 pandemic and antibiotic prescriptions in primary care settings of Yinchuan, a city in China. Methods: This study included 155 primary care institutions and 10,192,713 outpatient visits. Outpatient prescriptions were classified as appropriate, potentially appropriate, inappropriate, or not linked to any diagnosis for antibiotic use following a validated evaluation scheme. Interrupted time-series analyses were performed to assess the effects of the COVID-19 pandemic on antibiotic prescriptions in Chinese primary care facilities. Results: During the study period, 1,287,678 (12.6%, 95% confidence interval [12.6–12.7]) of 10,192,713 outpatient visits in primary care resulted in antibiotic prescriptions. Among 1,287,678 antibiotic prescriptions, 653,335 (50.7% [50.6–50.9]) were inappropriate, 463,081 (36.0% [35.8–36.1]) were potentially appropriate, 171,056 (13.3% [13.1–13.5]) were appropriate, and 206 could not be linked to any diagnosis. Furthermore, patient, physician, and institutional factors were associated with inappropriate antibiotic prescriptions;there was an overall decreasing trend in the proportions of inappropriate antibiotic prescriptions, with the highest level in 2017 (67.1% [66.8–67.5]) and the lowest in 2021 (40.8% [40.3–41.3]). A total of 1,416,120 individual antibiotics were prescribed, of which 1,087,630 (76.8%) were broad-spectrum and 777,672 (54.9%) were classified in the World Health Organization’s “Watch” category. In addition, the COVID-19 pandemic was associated with changes of −2.8% (−4.4 to −1.3) in the level and 0.3% (0.2–0.3) in the monthly trend of antibiotic prescription rates, as well as changes of −5.9% (−10.2 to −1.5) in the level and 1.3% (1.0–1.6) in the monthly trend of the proportions of inappropriate antibiotic prescriptions. Conclusion: More than half of the antibiotic prescriptions were inappropriate during the study period in primary care in Yinchuan. The COVID-19 pandemic may be associated with a decrease in the overall and inappropriate use of antibiotics in primary care settings in China.

7.
Frontiers in Pharmacology ; 13, 2022.
Article in English | EMBASE | ID: covidwho-1822397

ABSTRACT

At the beginning of the pandemic, we observed that lithium carbonate had a positive effect on the recovery of severely ill patients with COVID-19. Lithium is able to inhibit the replication of several types of viruses, some of which are similar to the SARS-CoV-2 virus, increase the immune response and reduce inflammation by preventing or reducing the cytokine storm. Previously, we published an article with data from six patients with severe COVID-19 infection, where we proposed that lithium carbonate could be used as a potential treatment for COVID-19. Now, we set out to conduct a randomized clinical trial number EudraCT 2020–002008–37 to evaluate the efficacy and safety of lithium treatment in patients infected with severe SARS-CoV-2. We showed that lithium was able to reduce the number of days of hospital and intensive care unit admission as well as the risk of death, reduces inflammatory cytokine levels by preventing cytokine storms, and also reduced the long COVID syndromes. We propose that lithium carbonate can be used to reduce the severity of COVID-19.

8.
Frontiers in Pediatrics ; 10, 2022.
Article in English | EMBASE | ID: covidwho-1822392

ABSTRACT

Background: Limited data is available from low-middle and upper-middle income countries of the factors associated with hospitalization or admission to pediatric intensive care unit (PICU) for children with COVID-19. Objective: To describe the factors associated with hospitalization or PICU admission of children with COVID-19 in Latin America. Method: Multicenter, analytical, retrospective study of children reported from 10 different Latin American countries to the Latin-American Society of Pediatric Infectious Diseases (SLIPE-COVID) research network from June 1, 2020, and February 28, 2021. Outpatient or hospitalized children <18 years of age with COVID-19 confirmed by polymerase chain reaction or antigen detection from the nasopharynx were included. Children with multisystem inflammatory syndrome in children (MIS-C) were excluded. Associations were assessed using univariate and multivariable logistic regression models. Results: A total of 1063 children with COVID-19 were included;500 (47%) hospitalized, with 419 (84%) to the pediatric wards and 81 (16%) to the ICU. In multivariable analyses, age <1 year (Odds Ratio [OR] 1.78;95% CI 1.08–2.94), native race (OR 5.40;95% CI 2.13–13.69) and having a co-morbid condition (OR 5.3;95% CI 3.10–9.15), were associated with hospitalization. Children with metabolic or endocrine disorders (OR 4.22;95% CI 1.76–10.11), immune deficiency (1.91;95% CI 1.05–3.49), preterm birth (OR 2.52;95% CI 1.41–4.49), anemia at presentation (OR 2.34;95% CI 1.28–4.27), radiological peribronchial wall thickening (OR 2.59;95% CI 1.15–5.84) and hypoxia, altered mental status, seizures, or shock were more likely to require PICU admission. The presence of pharyngitis (OR 0.34;95% CI 0.25–0.48);myalgia (OR 0.47;95% CI 0.28–0.79) or diarrhea (OR 0.38;95% CI 0.21–0.67) were inversely associated with hospital admission. Conclusions: In this data analysis reported to the SLIPE research network in Latin America, infants, social inequalities, comorbidities, anemia, bronchial wall thickening and specific clinical findings on presentation were associated with higher rates of hospitalization or PICU admission. This evidence provides data for prioritization prevention and treatment strategies for children suffering from COVID-19.

9.
Frontiers in Cellular and Infection Microbiology ; 12, 2022.
Article in English | EMBASE | ID: covidwho-1822356

ABSTRACT

Objective: The longitudinal effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on the liver are unknown. This study aimed to characterize dynamic changes in liver function test abnormalities in patients with COVID-19 at the acute phase and recovery phase. Methods: A prospective cohort study involved patients with COVID-19 who were admitted to Shenzhen Third People’s Hospital between January 11, 2020, and April 27, 2020. Patients underwent liver function tests at hospitalization and at the outpatient visit at the 1-month, 3-month, 6-month, and 12-month follow-ups. Results: Among 461 patients, 28.4% of patients had any kind of liver function tests abnormality at admission, manifested as elevated ALT (13.0%), AST (17.6%), and GGT (15.8%) levels. The trajectory analysis indicated a marked improvement in liver function after discharge, with any kind of liver function test abnormalities of 25.1% at 1 month, 13.2% at 3 months, 16.7% at 6 months, and 13.2% at 12 months after discharge. Persistent liver function abnormalities were observed in patients with pre-existing conditions during follow-up. A significantly higher prevalence of ultrasound determined fatty liver disease was found in those patients with more frequent LFT abnormalities at follow-up. Conclusion: In this study of patients with COVID-19, liver damage in COVID-19 was usually temporary and could return to normal at the end of the 12-month follow-up.

10.
Influenza and other Respiratory Viruses ; 2022.
Article in English | EMBASE | ID: covidwho-1822050

ABSTRACT

Based on our national outpatient sentinel surveillance, we have developed a novel approach to determine respiratory syncytial virus (RSV) epidemic seasons in Germany by using RSV positivity rate and its lower limit of 95% confidence interval. This method was evaluated retrospectively on nine RSV seasons, and it is also well-suited to describe off-season circulation of RSV in near real time as observed for seasons 2020/21 and 2021/22 during the COVID-19 pandemic. Prospective application is of crucial importance to enable timely actions for health service delivery and prevention.

11.
Clinical and Experimental Dermatology ; 47(5):982-983, 2022.
Article in English | EMBASE | ID: covidwho-1822048
12.
Neurological Sciences ; 2022.
Article in English | EMBASE | ID: covidwho-1820939

ABSTRACT

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

13.
Revue Medicale Suisse ; 17(758):1915-1921, 2021.
Article in French | EMBASE | ID: covidwho-1819198

ABSTRACT

The SARS-CoV-2 pandemic has caused an unprecedented global public health crisis. The term long Covid is used to describe diverse and heterogeneous symptoms that persist more than 4 weeks after infection with an estimated incidence of 10-40%, which varies between studies. The principal characteristics of long Covid are fluctuating symptoms of prolonged duration affecting multiple organs, such as fatigue, dyspnea, cough, anosmia, dysgeusia, chest pain, palpitations, headache, myalgia, cognitive and gastrointestinal disorders. Contributing factors, possible pathophysiological explanations and international recommendations can help in the management of the disease in the outpatient setting. Biopsychosocial and multidisciplinary management in primary care medicine is essential.

14.
Acta Phlebologica ; 22(3):79-83, 2021.
Article in English | EMBASE | ID: covidwho-1818990

ABSTRACT

BACKGROUND: This preliminary study aimed to evaluate the safety of radiofrequency (RF) thermoablation of the great saphenous vein (GSV) with immediate foam sclerotherapy of superficial tributary veins performed in the outpatient clinic (Hospital Department). Further, we also evaluated the cost reduction compared to the same procedure performed in the operating room. METHODS: Thirty patients were evaluated for RF thermoablation of the GSV. Foam sclerotherapy was performed with 1-3%sodium-tetra-decyl-sulphatefoam (Tessari’s method). We evaluated the possible risks of the procedure and methods to resolve them. We compared the costs of both procedures performed in the operating room and in the outpatient clinic. RESULTS: We had complete occlusion of the GSV in 28/30 patients (93.3%). Periodic check-up revealed a reflux through an anterior lateral saphenous vein in one patient and a long saphenous stump in another patient. There were no severe intraoperative complications. In two cases, it was necessary to convert the radiofrequency procedure into foam sclerotherapy (using the hollow probe as a long catheter in one case and using needle injection in the second case). In another case, it was necessary to perform surgical cannulation of the GSV. There were no severe postoperative complications. Moreover, the cost of the operating room procedure was € 1226.50, while that of the outpatient clinic procedure was € 1082.65 (cost reduction, 12.5%). CONCLUSIONS: This procedure is safe and sufficiently cost-effective to perform in an outpatient clinic and the operating room can hence be reserved for patients with more serious pathologies. These results should be validated in further studies with larger sample size.

15.
Acta Scientiae Veterinariae ; 50, 2022.
Article in English | EMBASE | ID: covidwho-1818984

ABSTRACT

Background: Diarrhea induced by infectious factors may lead to significant health problems in dogs. Canine parvovirus (CPV), canine coronavirus (CCV), canine distemper virus (CDV), Giardia spp., Escherichia coli (E. coli), and Salmonella spp. are the important infectious agents that may induce diarrhea in dogs. The present study aimed to investigate the effect of CPV, CCV, CDV, Giardia spp., E. coli, and Salmonella spp. infections on the change in serum calprotectin (Calp) concentration. Materials, Methods & Results: A total of 30 dogs were enrolled in the study. The study dogs were divided into 3 groups. Healthy animals as confirmed by clinical examination and animals negative for the specified pathogens were placed in Group 1. Animals infected by one or more agents, including CPV, CCV, CDV, and Giardia spp., but negative for E. coli or Salmonella spp. were placed in Group 2. Finally, animals positive for E. coli or Salmonella spp. and infected or not infected by one or more agents, including CPV, CCV, CDV, and Giardia spp., were placed in Group 3. Stool samples and rectal and conjunctival swab samples were collected to investigate the etiologic agents that induced diarrhea. Blood samples were collected through vena cephalica antebrachii for hematological and biochemical examinations. The samples were obtained via routine clinical examinations at the Prof. Dr. Servet Sekin outpatient clinic at Dicle University Veterinary Faculty. CPV, CCV, CDV, and Giardia spp. diagnoses were made based on immunochromatographic test kits. The bacteriological analysis of stool samples was used to diagnose E. coli and Salmonella spp. infection. Serum Calp concentrations were measured by Enzyme-Linked Immunosorbent Assay (ELISA). The analysis of swab and stool samples by immunochromatographic rapid diagnosis kits and microbiological methods showed that 5 animals were infected with CPV, 10 with CCV, 6 with CDV, 3 with Giardia spp., 12 with E. coli, and 2 with none of the specified agents. Total leukocyte count (WBC), lymphocyte (Lym - %), and granulocyte (Gra - %) values were higher in the diarrheal dogs when compared with the control group. In the biochemical examination of serum samples, total bilirubin (TBIL) and phosphorus (P) levels were higher and sodium (Na) levels were lower in Group 3 when compared to the control group (P = 0.025, 0.024, and 0.018, respectively). Total protein (TP) and albumin (Alb) values were lower in Group 2 compared to Groups 1 and 3 [P = 0.001 and 0.019 for TP, P = 0.000 and 0.01 for Alb, respectively]. There was a statistically significant difference in creatine kinase (CK) levels between Group 1 and Group 2 (P = 0.013). Serum Calp level was higher in the E. coli infected group (Group 3) compared to the other groups, no significant differences were noted between the groups (P > 0.05). Discussion: In conclusion, to the best of authors knowledge, this study is the first to evaluate serum Calp levels in dogs with diarrhea induced by viral, bacterial, and protozoan infections. The Calp level was higher in the sick dogs that were infected by at least one agent, including CPV, CCV, CDV, and Giardia spp., and were at the same time E. coli positive when compared with the control group and the group without E. coli infections. It was concluded that new studies could be useful to reveal the diagnostic importance of serum Calp concentration in dogs with diarrhea and that these results may contribute to future studies in this area.

16.
Journal of Clinical and Diagnostic Research ; 16(4):IC01-IC04, 2022.
Article in English | EMBASE | ID: covidwho-1818676

ABSTRACT

Introduction: Delhi, India’s capital, witnessed the first Coronavirus Disease 2019 (COVID-19) case on February 10, 2020, and subsequently three waves of the pandemic due to which the government had to impose lockdown starting March 25. It led to a decrease in patients seeking health care services for non emergency problems. Janakpuri Super Speciality Hospital (JSSH), a three hundred bedded autonomous institute under Delhi Government, also encountered a decrease in patient footfall. Aim: To identify the changes in trend in Outpatient Department (OPD) registrations and Inpatient Department (IPD) admissions during one year (January 1, 2020 to December 31, 2020) of COVID-19 pandemic in comparison to 2019 and also to analyse the collected data with the publicly available data on daily COVID-19 incidence in Delhi. Materials and Methods: A retrospective study was done by collecting data from the Janakpuri Super Speciality Hospital, Medical Record Department from 1st January 2019 to 31s December 2020, for daily OPD visits and IPD admissions. The collected data was analysed with the publicly available data on daily COVID-19 incidence in Delhi. Statistical analysis was performed using Microsoft Excel 2017. The non parametric exponential smoothening technique (dampening factor= 0.9) was applied over the dot plot graphs. Results: In 2020, compared to 2019, the daily OPD visits decreased by 37%. After an initial fall with March lockdown, there was a gradual increase in daily load. The OPD load peaked near middle of August 2020, The second big fall in OPD footfall occurred near second wave in September 2020, After that, OPD volume remained low till the 31st December 2020. Similarly, IPD admission volume peaked near the first wave in June 2020. The 2020 IPD admission volume also witnessed a massive decrease of 40.67% compared to 2019 and was maximum in gastroenterology admissions (65.63%). Conclusion: The study’s findings suggest that temporal associations between COVID-19 pandemic and hospital OPD and IPD admissions during 2020. The possibility of increased morbidity and mortality amongst non COVID-19 patients due to the unavailability of timely health care cannot be ruled out. The government should do capacity building to guide patients to identify the best doctor, clinic and hospital nearest to them in case of future pandemics.

17.
Allergy, Asthma and Clinical Immunology ; 18(SUPPL 1), 2022.
Article in English | EMBASE | ID: covidwho-1817256

ABSTRACT

Background: COVID-19 vaccination efforts focus on adolescents and adults and are expected to include children< age 12 years shortly. We aim to assess barriers and identify solutions for vaccination, especially in parents and their children. Methods: Families seen at the outpatient allergy clinic at the Montreal Children's Hospital and at a private allergy clinic were invited to complete an anonymous online survey on COVID-19 and vaccination. Statistical results were analyzed using R (version 4.0.0). Uni and multivariate logistic regressions were compared to estimate factors associated with vaccine hesitancy. Results: Between May and June 2021, 97 parents and children responded to the survey. The majority (36.1%) of children were 6 to 10 years old (range: 0 - 17years). Most parents (56.7%) were 40-49 years (range: 20-59 years) and 41.2% had at least college level education. The most common barrier to vaccination was fear of adverse effects. (49.5%). Over half of families (56.7%) believed that a history of allergies was a contra indication for vaccination. Fifty-nine (60.8%) participants stated that dissemination of additional information would increase their willingness to be vaccinated. Educational videos (59.8%) were preferred by respondent. Health professionals i.e. (physicians, nurses and pharmacists) were the favored sources of information. Most (96.9%) parents reported that their children's vaccinations were up to date. Interestingly 76.3% of parents indicated they would vaccinate their children for while only 44.3% stated a plan to vaccinate for seasonal influenza in 2021 COVID (28.1% difference, 95%CI: 17.9%, 46.0%). Hesitant parents were less likely to have children between the ages of 11-14 and were more likely to be of Asian descent while controlling for parental sex and education level. Conclusions: Most families of children with food allergy plan to vaccinate their children for COVID-19. Videos addressing identified concerns and misinformation, especially the adverse effects of this vaccine would be reassuring.

18.
Journal of the International Association of Providers of AIDS Care ; 21:6-7, 2022.
Article in English | EMBASE | ID: covidwho-1817135

ABSTRACT

Background: SARS-CoV-2 pandemic had a negative impact not only on diagnostic and therapeutic services but also on prevention, including HIV screening. In this study we evaluated and compared the impact of the pandemic on HIV testing in healthcare and community settings in Milan. Method: We considered the HIV screening tests performed between 01/01/2019 and 10/06/2021 in two local hospitalbased STIs outpatient clinics and in a community-based HIV testing facility. We then compared the two settings in pre COVID (before Mar2020) and post COVID (Mar2020-Jun2021) period in terms of number of tests performed, test results and age, sex and nationality of the subjects tested. Results: 4106 HIV screening tests have been performed (30.8% healthcare setting, 69.2% community setting). Globally, the community setting tested younger subjects, more females, and fewer foreigners, with a lower HIV prevalence (Tab1). In the healthcare setting, in the post COVID period there has been a decrease in the number of tests performed (Tab4), with older subjects and fewer females tested (Tab2). HIV prevalence remained quite high (Tab3). In the community setting, in the post COVID period there has been also a decrease in the number of tests performed, mostly due to lockdown (Mar - Jun 2020, Fig1). Indeed, after restricting to the period of Jul 2020 - Jun 2021, the average number of HIV-test/month was similar to pre COVID era. Younger subjects, fewer females and a lower HIV prevalence have been found in post COVID period. Conclusion: Both settings have reduced their activity due to the pandemic. The prevalence of HIV was high in the healthcare setting, possibly because of subjects attending the service while symptomatic or at higher risk. The differences between the subjects tested in the two settings demonstrate the importance of an integrated approach to ensure greater coverage of HIV screening campaigns.

19.
Blood Purification ; 50(SUPPL 1):20, 2021.
Article in English | EMBASE | ID: covidwho-1816960

ABSTRACT

Background: Until the present time, the effect of hemoperfusion to mitigate inflammatory response and improve outcome in severe COVID-19 is still unknown. Therefore, we aimed to investigate the effects of early HA-330 hemoperfusion in combination with standard therapy in severe COVID-19 patients. Methods: We conducted a single center, prospective cohort study on patients who diagnosed with severe COVID-19 patients and admitted to ICU. Patients in hemoperfusion group (defined as patients who were treated with hemoperfusion therapy at least 3 sessions in combination with standard therapy) were compared with the control group (defined as patients who received standard treatment alone or received less than 3 sessions of hemoperfusion therapy). We assessed C-reactive protein, oxygenation assessment (PaO2 and ratio of PaO2/FiO2) , severity scoring of lung infiltration on the chest x-ray (CXR RALE score) and organ failure score (SOFA score) daily. Those were defined as a primary outcome. The secondary outcomes were ventilator free day, hospital mortality and 28-day mortality. All outcome was adjusted by regression analysis to reduce the confounders due to some difference in baseline characteristics. Results: Between April 7,2021 and May 31,2021, a total number of 29 severe and critical COVID-19 confirmed patients were enrolled. Fifteen patients were defined as hemoperfusion group and 14 were control group. The median of C-reactive protein and SOFA score at the baseline (the day after severe pneumonia diagnosis or before hemoperfusion) in hemoperfusion and control groups were comparable, 96.79 mg/L and 87.3 mg/L, p=0.53, 3.53 ± 0.99 VS 4.3 ±1.89, p=0.15, respectively. Clinical improvement associated with decreased SOFA score and improvement of CXR RALE score were found in hemoperfusion group compared to control group (p=0.008 and p=0.005, respectively). The 28-day mortality rate was significantly lower in hemoperfusion group compared to control group (6.67 % vs 85.71 %, p<0.001) and adjusted HR of death was 0.017 (95 % CI = 0.008-0.351, p=0.008) Conclusion: In severe COVID-19 patients, the addition of at least 3 sessions of hemoperfusion therapy to standard COVID-19 therapy seemed to improve severity of organ failure, CXR severity score, ventilator-free day and reduced the mortality rate.

20.
Clinical Cancer Research ; 27(6 SUPPL 1), 2021.
Article in English | EMBASE | ID: covidwho-1816933

ABSTRACT

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

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