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1.
New Armenian Medical Journal ; 16(2):25-32, 2022.
Article in English | EMBASE | ID: covidwho-2067787

ABSTRACT

Objectives: to assess the effect-related inflammatory and coagulation biomarkers in pregnancy and their connection with the coronavirus disease of 2019 (COVID-19). Method(s): A prospective case-control study was carried out among normal third-trimester pregnant women admitted to the labor room of Dr. Soetomo General Academic Hospital between January until June 2021. Two classified groups of patients were established in accordance with the result of the RT-PCR test. Demographic, clinical and laboratory results data of the two groups were collected and compared. Result(s): Platelet-to-lymphocyte ratio (PLR) was shown to be the only significant biomarkers found in the expectant with COVID-19, which was 35.8% higher compared to the ones free of COVID-19 [212.25 (157.57-269.37) vs 156.29 (128.55-195.3), p=0.048]. Logistic regression analysis of PLR between groups showed that the level of PLR was an independent factor in pregnant women with COVID-19 (OR 4.483, 95%CI 1.262-15.926). The ROC analysis showed that the PLR cut-off among the expectant was 171.335, with both sensitivity and specificity were 66.7% (p=0.021). The result shows no significant differences in leukocyte count, absolute neutrophils - lymphocyte count and percentage, neutrophil-to-lymphocyte ratio (NLR) and D-Dimer level between pregnant women infected with COVID-19 and free of the virus (p>0.05). Conclusion(s): Intriguingly, physiological adaptation during the course of the third trimester of pregnancy found no difference in most inflammation and coagulation markers, both in the condition of infected COVID-19 or not. The evidence from this single-centre study supports the viewpoint that elevated PLR was associated with independent biomarkers and thereby might be helpful to detect expectant with COVID-19. Copyright © 2022, Yerevan State Medical University. All rights reserved.

2.
Pakistan Journal of Medical and Health Sciences ; 16(8):24-26, 2022.
Article in English | EMBASE | ID: covidwho-2067738

ABSTRACT

Aim: To evaluate the potential use of ivermectin with standard therapy among mild to moderate covid-19 illness. Methods: This is a single-centered, prospective observational, randomized, parallel group (1:1 ratio), standard versus controlled ivermectin study recruited 210 confirmed COVID-19 positive patients who were admitted in COVID treatment center of Dr Ruth Kum Pafu Civil hospital Karachi, Pakistan from 1st November 2020 to 30th May 2021. Data were analyzed using SPSS version Results: Total of 210 patients were enrolled in the study and aged matched patients were divided in two groups 105 patients received ivermectin 6 mg twice a day for five days along with standard therapy while remaining 105 patients received standard therapy as per local and international guidelines. Male were 140(66.7%) and female 70(33.3%);age ranges between 26 to 77 years and majority 140( 66.7%) were more than 50 years of age. Fever, dry cough and dyspnea were the major symptoms seen;112(53.3%) patients had DM as a comorbid illness . Total of 21(20%) of 105 patients of ivermectin group had negative PCR for COVID 19 on day seven while the other group had positive covid test in all of 105 patients . On day 10 total of 49 more patients from ivermectin group found COVID negative along with 21 previously negative had second PCR was found negative in this way total of 70( 66.7%) of ivermectin group had negative PCR for COVID 19 while 21(20%) patients from non ivermectin got negative PCR for COVID 19 on day 10 . Conclusion: Use of ivermectin with standard therapy clear the virus earlier than standard therapy in mild to moderate COVID-19 infected patients admitted in COVID treatment center of Dr Ruth Kum Pafu Civil Hospital Karachi.

3.
Acta Phlebologica ; 23(2):59-62, 2022.
Article in English | EMBASE | ID: covidwho-2067521

ABSTRACT

BACKGROUND: Venous insufficiency has well-defined symptoms with repercussions at the socioeconomic level. The covid pandemic decreed in March 2020 the confinement of the population, leading society to a sedentary lifestyle and weight gain, with aggravation of venous symptoms. Objective(s): To treat patients who did not respond to medical treatment in times of covid, with echo-guided foam ablation of the lesser saphenous vein. METHOD(S): It is an observational, prospective and intervention study. Patients were studied from June to September 2020. Inclusion criteria: all patients who presented symptoms and who presented reflux in the small saphenous vein during the venous Doppler study, greater than 0.5 s and a diameter greater than 4 mm and less than 7 mm. Exclusion criteria: patients who refused to participate in the study, presence of insufficiency of the great saphenous vein with transfer of reflux to the system of the small saphenous vein and those who had an ABI<0.8. RESULT(S): Four hundred patients were studied, 74% were women, with an average age of 57.6. The insufficiency of the lesser saphenous vein was found in 122 (29%), 68% were female;14.7% of the patients did not respond to treatment, and ultrasound-guided sclerosis was performed with foam. At seven days control, 83.3% of patients had the lesser saphenous vein occluded;at fourteen days, 93% of patients had the vein occluded;and 73.3% had the vein with total occlusion at one-year ultrasound control. CONCLUSION(S): Athermal ablation has been found to be a good method for treating small saphenous vein insufficiency, it can be performed in the office without complications. Copyright © 2022 EDIZIONI MINERVA MEDICA.

4.
Pediatricheskaya Farmakologiya ; 19(2):196-200, 2022.
Article in Russian | EMBASE | ID: covidwho-2067387

ABSTRACT

Background. Students, as the most active and mobile part of population, often unite into educational and informal groups, move to other regions or countries, and present a specific risk group for the spread of new coronavirus infection. Thus, they require preventive vaccination. objective. the aim of the study is to study the immunological potency, tolerance, and efficacy of GamCOVID-Vac vaccine among students of Krasnodar. methods. 119 seronegative students (18–30 years old) were examined. SARSCoV-2 IgG (ELISA method) was determined 1, 3, and 6 months after two completed rounds of vaccination. Post-vaccination adverse events and COVID-19 cases were evaluated in the study. results. SARS-CoV-2 IgG level 1 month after vaccination ranged from 6.15 to 19.38 and was to 16.39 (AU/mL) ± 1,12. Immunological potency values ranged from 4.407 to 21.5 (AU/mL) (14.74 ± 2.93) 3 months after. IgG titers were in the range of 4.14 to 17.71 (AU/mL) (10.97 ± 4.69) 6 months after. Adverse events after vaccination were revealed in 34 respondents (28.6%). Among them, local (hyperemia, pain, edema) — 21 (17.6%): slight — 90.4%, major — 9.6%;general (fever, weakness, algor, headache, arthralgia, myalgia) — 13 (10.9%): slight — 69.2%, major — 30.8%. The increase in vaccination coverage in students from 30.3 to 79.1% reduced the COVID-19 morbidity from 3.81 to 1.57%. conclusion. Gam-COVID-Vac vaccine induced stable humoral response, demonstrated sufficient safety, and reduced morbidity 2.4-fold.

5.
NeuroQuantology ; 20(10):9468-9476, 2022.
Article in English | EMBASE | ID: covidwho-2067327

ABSTRACT

Objectives: Some of the problems during the COVID-19 pandemic identified include delay in the distribution of contraception to the clients, and poor monitoring and evaluation of activities for the family planning program. These problems which occurred from task conflict would need to be managed so that the objectives of the family planning program could be achieved. The purpose of this study was to analyze the influence of conflict management on performance of family planning program Lamongan Indonesia. Methods: This was an observation study with a longitudinal prospective time series design. Thirty randomly selected teams from a total of 33 family planning program teams from both studied organizations in Lamongan were interviewed and observed. Structured questionnaires had been used while some data were obtained from the management. Data were then analyzed using liner regression. Results: There were few issues identified that had led to conflicts among the family planning program teams. The scored conflicts are in the unfavorable category with an average of 12.70 (t1), 13.13 (t2) and 13.73 (t3). Levene’s test showed that the data variants of conflict management for three periods were homogeneous (Sig. > 0.05). The beta coefficient value indicates that conflict management has a strong influence on inter-team family planning program performance of 0.581( p= 0.001). Conclusions: Conflicts between two organizations with the same goal should be managed as it can help to achieve the required performance. Policy on conflict identification and management should be developed in any health program.

6.
Journal of Clinical and Diagnostic Research ; 16(9):DC12-DC17, 2022.
Article in English | EMBASE | ID: covidwho-2067199

ABSTRACT

Introduction: Bharat Biotech International Ltd in partnership with National Institute of Virology (NIV), has developed an indigenous whole virion inactivated Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) viral vaccine BBV-152 (Covaxin), formulated with Toll Like Receptors 7/8 agonist Imidazoquinoline (IMDG) molecule adsorbed to alum (Algel). Variety of factors other than environmental ones can affect vaccines efficiency outside the strict setting of clinical trials, like how the vaccine is stored or transported, and even how patients are vaccinated. In addition, the intrinsic capacity of the recipient to respond to a vaccine which is determined by sex, genetic factors, age, psychological stress, nutrition and other diseases are also likely to have an impact. Aim(s): To determine the safety, reactogenicity and immunogenicity of the inactivated whole virus vaccine (Covaxin) amongst hospital-based population groups. Material(s) and Method(s): The prospective analytical study was conducted in the Department of Microbiology, Sawai Man Singh Medical College, Jaipur, Rajasthan, India, from January 2021 to March 2021.The study primarily included Healthcare Workers (HCWs) employed at SMS Medical college and attached hospitals. In-vitro quantitative IgG antibodies against SARS-CoV-2 spike Receptor Binding Domain (RBD) were measured using Chemiluminescence Immunoassay (CLIA) based Advia centaur SARS-CoV-2 IgG, manufactured by Siemens Pvt Ltd, Munich, Germany, as per manufacture's instructions. Result(s): Out of total 223 individuals, 61.88 % (138/223) showed neutralising antibody titre of >1 index value by CLIA, rest 38.12% (85/223) were non reactive i.e., titre <1 index value, after four weeks of receiving first dose of Covaxin. After 2 to 4 weeks of receiving second dose 84.30% (188/223) showed neutralising antibody titre of >1 index value by CLIA, rest 15.70% (35/223) were non reactive i.e., titre <1 index value. After receiving first dose, 100% (223/223) of the participants developed localised pain and bodyache 33.63% (75/223). None of the participants showed any anaphylactic reaction or any emergency condition just after vaccination. Conclusion(s): Covaxin is a well-tolerated vaccine, and induces good humoral response against SARS-CoV-2 with a significant rise in the neutralising antibody titres. Copyright © 2022 Journal of Clinical and Diagnostic Research. All rights reserved.

7.
Journal of Clinical and Diagnostic Research ; 16(9):OC21-OC24, 2022.
Article in English | EMBASE | ID: covidwho-2067195

ABSTRACT

Introduction: The clinical diagnosis of COVID-19 is supplemented by clinical severity indices. These indices are the National Early Warning Score (NEWS, which aids in risk stratification), CT severity score (radiological severity score), and Reverse Transcription-Polymerase Chain Reaction (RT-PCR) cycle threshold (Ct value, which provides a semi-quantitative measure of viral load). Aim(s): To assess the correlation between NEWS at admission, RT-PCR Ct value and CT severity score in mild and moderate COVID-19 patients. Methods and Materials: This prospective cohort study was conducted in Maulana Azad Medical College and Lok Nayak hospital, New Delhi, from January to June 2021. The study included 50 subjects (25 with mild COVID-19 and 25 with moderate COVID-19). NEWS was calculated at admission and Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Ct value was estimated using real-time RT-PCR. CT severity score was calculated based on High Resolution Computed Tomography (HRCT) chest findings. The correlation among the parameters was determined using Pearson correlation formula. Result(s): The mean age of subjects in the mild and moderate COVID-19 groups were 49.52 years and 51.84 years, respectively. The mean RT-PCR Ct value of E gene was 24.48 and Rdrp gene was 24.56 in the mild COVID-19 group;while in the moderate group it was 23.72 for both E gene and Rdrp genes. The correlation between NEWS and Ct value of E gene (r-value=-0.06, p-value=0.68), Ct value of Rdrp gene (r-value=-0.03, p-value=0.79) and the correlation between CT severity score and Ct value of E gene (r-value=-0.05, p-value=0.73), Ct value of Rdrp gene (r-value=-0.06, p-value=0.68) was negative and insignificant. The mean CT severity score in mild COVID-19 group was 3.92, and in moderate COVID-19 group was 9.88. A significant positive correlation was found between the CT severity score and NEWS at admission. Conclusion(s): The clinical severity of COVID-19 as estimated by NEWS corroborates with CT severity score while the relationship between RT-PCR Ct value and clinicoradiological severity needs to be ascertained by further research. Copyright © 2022 Journal of Clinical and Diagnostic Research. All rights reserved.

8.
Journal of Clinical and Diagnostic Research ; 16(8):44-47, 2022.
Article in English | EMBASE | ID: covidwho-2067192

ABSTRACT

Introduction: The emergence of Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) as a pandemic has put the global population at risk for its infection. It has also led to an accelerated effort to develop vaccines that can mitigate progression to severe infections at a minimum. The ambiguity about existence of antibodies in the human serum poses problem in formulating public health policies like suitable interval between doses of vaccines, appropriate time for vaccinating population, post natural infection, necessity of booster doses along with single dose. Aim: To estimate neutralising antibody level following vaccination of Healthcare Workers (HCWs) after three months and six months respectively. Materials and Methods: This was a prospective observational study performed in Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India after Institutional Ethics Committee (IEC) approval from January 2021 to February 2022. The study was conducted in 304 HCWs in the institute who had received two doses of Recombinant ChAdOx1 nCoV- 19 Corona Virus Vaccine (Covishield). 41 HCWs who were naturally infected with SARS-CoV-2 either before or after vaccination were also included. These participants were then subjected to IgG neutralising antibody titer estimation at three months and six months, postvaccination. Results: The study included 304 eligible HCWs. Majority of the participants belonged to the age group of 31-40 years (35.9%). Majority of the study participants were females (51%). Of the 304 participants, 263 were uninfected and 41 participants had been infected before and after vaccination. At the six month follow-up, it was observed that all but one HCW had seroconverted with majority of the participants showing more than 60% antibody level. Participants in the age group of 31-40 years showed the highest level and this observation was found to be statistically significant. Conclusion: Neutralising antibody response in HCWs is a key indicator of the efficacy of the vaccination program for Coronavirus Disease-2019 (COVID-19) in India.

9.
Haseki Tip Bulteni ; 60(4):318-324, 2022.
Article in English | EMBASE | ID: covidwho-2066931

ABSTRACT

Aim: We think that the nasopharyngeal swab sample should be taken bilaterally to improve the sensitivity of the real-time-reverse transcriptase-polymerase chain reaction (RT-PCR) test since there may be pathologies that cause nasal obstruction, such as nasal septum deviation (NSD). In this context, we investigated the effect of the nasopharyngeal swab sampling method and the presence of nasal obstruction on the detection of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). Method(s): This prospective clinical study was conducted from March 2021 to January 2022. Forty-four hospitalized patients with NSD were included in the study group, and 44 hospitalized patients without NSD were included in the control group. The results of the RT-PCR test studied with a unilateral nasopharyngeal swab sample taken during hospitalization and the RT-PCR test studied with a bilateral nasopharyngeal swab sample taken on the 2nd day of hospitalization and the visual analog scale (VAS) scores showing the patients' pain during the first sampling were determined. Result(s): In the first test, 23 (52.3%) patients in the study group and 32 (72.7%) patients in the control group were evaluated as SARS-CoV-2 positive. The first test sensitivity was significantly higher in the control group (p=0.048). The VAS score was significantly higher in the study group (p=0.00008). In the second test, 35 (79.5%) patients in the study group and 37 (84.1%) patients in the control group were evaluated as SARS-CoV-2 positive. The sensitivity increases in the study group and in the population were statistically significant (p=0.007 and p=0.004, respectively). The consistency of the first and second test results increased in patients without NSD and in patients with low VAS scores [odds ratio (OR)=3.779;p=0.001, OR=2.572;p=0.005, respectively]. Conclusion(s): Nasopharyngeal swab sampling may be affected by nasal congestion and the sampling method. To avoid this, it may be more appropriate to take a nasopharyngeal swab sample through the bilateral nasal cavity. Copyright © 2022 by The Medical Bulletin of Istanbul Haseki Training and Research Hospital The Medical Bulletin of Haseki published by Galenos Yayinevi.

10.
Sri Lankan Journal of Anaesthesiology ; 30(2):118-123, 2022.
Article in English | EMBASE | ID: covidwho-2066752

ABSTRACT

Background and aims:The ongoing Covid pandemic has burdened the medical system, more so due to the limited availability of ventilators. Our study aims at identifying the role of hematological markers in the risk stratification and the need for ventilator support among ICU admitted COVID-19 patients. Method(s): A single centre prospective study was conducted on 100 Covid positive patients admitted in the ICU to determine association between the haematological markers such as Hb, Platelet count, Total and Differential leukocyte count, CRP, AST, ALT, LDH, Ferritin and D-Dimer with the need for oxygen therapy with or without invasive ventilatory support. Comparative analysis was performed between the 2 groups. Result(s): Neutrophilia, a mean of 76.7% among those ventilated and 71.6% among those non ventilated (p value 0.002;highly significant) and Lymphocytopenia (p value 0.004) with a mean of 14% and 18.6% respectively was noted. Hemoglobin levels were lower in ventilated (mean 11.6g/dl) as against those non ventilated (mean 12.58%) p value 0.046 which was significant. D-dimer was increased in COVID-19 patients;mean 5380 ng/ml in ventilated patients and mean 949ng/ml in those non ventilated (P < 0.001 highly significant). Elevated D-dimer and presence of diabetes correlated with increased chances of mechanical ventilation, while higher hemoglobin levels and associated COPD have a negative association with the need of mechanical ventilation. Conclusion(s): Hypercoagulability along with neutrophilia and lymphocytopenia can be used as positive associations for the need for invasive mechanical ventilation. Copyright © 2022, College of Anaesthesiologists of Sri Lanka. All rights reserved.

11.
Open Access Macedonian Journal of Medical Sciences ; 10(E):1374-1379, 2022.
Article in English | EMBASE | ID: covidwho-2066700

ABSTRACT

BACKGROUND: The health care workers are considered as vulnerable people who had higher infecting dose of SARS-CoV-2 infection compared to other society. Among more than 500 deaths of Indonesians physicians, obstetrics and gynecologist (OBGYN) has become the most specialists who died in this pandemic. AIM: The objective of our study is to evaluate the antibodies of SARS-CoV-2 in serum OBGYN residents post-vaccination as well as the presence of infection 3 months after the vaccination. METHODS: A prospective cohort study was conducted in OBGYN residents Universitas Indonesia. Serum antibodies SARS-CoV-2 spike (S) protein receptor-binding domain (RBD) was measured using electrochemiluminescence immunoassay, 21 days after Sinovac vaccination, with basic characteristics being recorded. Within 3 months follow-up, the participants were monthly checked related to post-vaccination infection. RESULTS: The median antibodies SARS-CoV-2 for all participants were 50.72 (19.09–98.57) U/mL. There were 20 residents (24.1%) who had post-vaccination infection within 3 months and dominated by asymptomatic to mild symptoms. Body mass index (r = –0.221, p = 0.044) and sleep hours (r = –0.225, p = 0.041) were found to be inversely correlated with antibodies SARS-CoV-2 S RBD. CONCLUSION: Antibodies SARS-CoV-2 S RBD found to be correlated with BMI and sleep hours. The 3-month post-vaccine infection among OBGYN residents was almost similar to Jakarta’s positivity rate and the efficacy rate was higher than expected by National Agency of Drug and Food Control.

12.
Anti-Infective Agents ; 20(4):24-35, 2022.
Article in English | EMBASE | ID: covidwho-2065293

ABSTRACT

Background: Coronavirus disease 2019 (Covid-19) is caused by a novel coronavirus (SARS-CoV-2) infection, while influenza viruses cause the flu. SARS-CoV-2 and influenza virus co-infection seems to be a real and serious concern. Objective(s): This study aims to evaluate the clinical features, laboratory investigations, computed tomography scans, and interventions of Covid-19 patients during seasonal influenza. Method(s): This was a multi-center prospective cohort study that collected data from hospitals, clinics, and laboratories on measurements, treatments, and outcomes from Covid-19 patients admitted to temporary Covid-19 care centers. Result(s): A total of 480 individuals (female, 231 [48.12%];male, 249 [51.88%]) were recruited from March 31st to May 14th, 2021 at five hospitals/clinics in Uttar Pradesh, North India. The patients were divided into six groups based on their age (65+ years [25.41% of cases] being the most affected age) and five groups based on their conditions (asymptomatic 65 [13.54%], mild 94 [19.58%], moderate 206 [42.91%], severe 84 [17.50%] and critical 31 [6.45%]). Patients' outcomes were documented as death (19 [3.95%]), recovery (421 [87.71%]) and under-treatment (40 [8.34%]). Conclusion(s): The most common clinical symptoms reported were fever, sore throat, and dyspnea. The severity was linked to hypoxemia, lymphocytopenia, thrombocytopenia, elevated erythrocyte sedimentation rate (ESR), and high blood urea nitrogen (BUN). The vast majority of patients were given symptomatic treatment. Any onset of fever should be suspected and examined for the viral strain to distinguish between Covid-19 and the seasonal flu. Copyright © 2022 Bentham Science Publishers.

13.
J Clin Med ; 11(19)2022 Oct 06.
Article in English | MEDLINE | ID: covidwho-2066196

ABSTRACT

This study aimed to explore the impact of the pandemic on medical students' mental health in Italy using a repeated cross-sectional survey with a nested longitudinal subsample (first timepoint: 2018; second: 2020/2021). Three research questions (RQs) were investigated. Study 1 (longitudinal sub-sample) explored whether medical students had higher levels of depressive symptoms and stress during the pandemic compared with a pre-pandemic period (RQ1) and what variables were associated with these conditions during the pandemic adjusting for baseline levels (RQ2). Study 2 (repeated cross-sectional data) aimed to examine whether medical students had higher levels of these conditions during the pandemic compared with their same-year peers during a pre-pandemic period (RQ3). In Study 1, higher levels of depressive symptoms and stress were shown during the pandemic (RQ1). Multivariable models highlighted associations between poor mental health and worsening of the judgment of medical school choice, worsened psychological condition due to the pandemic, economic repercussions due to the pandemic, and baseline levels of symptoms (RQ2). In Study 2, our findings reported higher levels of depressive symptoms and stress during the pandemic, also adjusting for other variables (RQ3). In conclusion, depressive symptoms and stress were greater during the pandemic. The most relevant variables were pandemic-related items and medical school choice judgment.

14.
International Journal of Stroke ; 17(2 Supplement):11, 2022.
Article in English | EMBASE | ID: covidwho-2064674

ABSTRACT

Background: Cardiac Rehabilitation (CR) is a multidisciplinary approach involving exercise training and health-related education routinely available to cardiac patients, but rarely offered to people with stroke. We have shown people with stroke can be integrated into centre-based CR, but due to access difficulties, opportunities for people with stroke to participate in centre-based CR are limited. Home-based CR is well-established for people with heart disease and offers an alternative for people with stroke who are unable to access centre-based rehabilitation. Aim(s): Investigate the safety and feasibility of home-based, telehealthdelivered, stroke-adapted CR. Method(s): A single-site, prospective-cohort safety and feasibility trial. People with ischaemic stroke were screened for eligibility and invited to participate in a six-week program of exercise and education delivered via telehealth to the participant in their own home following discharge from inpatient rehabilitation (i.e. <6-weeks post-stroke). Safety and feasibility were assessed by incidence of adverse events and measures of participant recruitment, retention, and adherence. Result(s): Ninety-five people with stroke were screened, 67 (70%) were eligible to participate, and 19 (28%) consented. Of the 28 that were ineligible to participate, the main reasons for exclusion were haemorrhagic stroke (53%), nil medical clearance (18%), and nil acute stroke (14%). Of the 48 eligible participants that did not consent, 45% were not included due to the impact of COVID-19, 20% were discharged prior to being approached to participate, and 12% did not consent due to a lack of time. Three participants dropped out of the study prior to commencing the outpatient intervention. The remaining 16 participants completed the six-week intervention. Positive written and verbal feedback was received from participants on the appropriateness of the intervention. Conclusion(s): COVID-19 significantly impacted our capacity to recruit participants to this trial. Preliminary data suggests home-based, telehealthdelivered, stroke-adapted CR is safe and potentially feasible in early subacute stroke.

15.
International Journal of Stroke ; 17(1):15-16, 2022.
Article in English | EMBASE | ID: covidwho-2064666

ABSTRACT

Background: A growing body of international research suggests the prevalence of upper limb weakness early after stroke is currently lower (40-57%) than widely cited values of 70-80% from two decades ago. Recent work also indicates the distribution of upper limb weakness may be bimodal, with a higher proportion of people with severe or little/no weakness as compared to mild/moderate weakness. Aim: To describe the prevalence and distribution of upper limb weakness early post-stroke. Methods: Patients admitted to a tertiary acute stroke unit with a suspected stroke were screened between November 2018 to February 2020 (interrupted by COVID-19) and April to November 2021. Upper limb weakness was captured via Shoulder Abduction and Finger Extension (SAFE) score (0-10), which was prospectively assessed at first contact by the unit therapist. Data on stroke type, acute medical intervention received, and National Institute of Health Stroke Scale (NIHSS) were also extracted. Results: A total of 662 individuals with confirmed stroke (median NIHSS score 6, IQR 2-13) were administered SAFE a median 1 (IQR 1,2) day after unit admission. Only 46.2% had upper limb weakness (SAFE score ≤9). Three most common SAFE scores were 10 (53.8%), 8 (11.5%) and 0 (9.4%). The subgroup severity distribution was 59.2% little to no impairment (SAFE 9-10), 24.1% mild to moderate impairment (SAFE 5-8), and 16.7% severe impairment (SAFE 0-4). Approximately one third (29.8%) received ≥1 acute interventions (e.g., thrombolysis, thrombectomy). Data collection remains ongoing, and a larger total sample will be presented. Conclusion: The prevalence of upper limb weakness at this single tertiary centre aligns with recent international data. A better understanding of the upper limb weakness profile will help inform service delivery e.g., shifting resources to subgroups which are more common. Furthermore, it can guide researchers in target population selection in trials, which can enhance generalisability of findings.

16.
Otolaryngology - Head and Neck Surgery ; 167(1 Supplement):P74-P75, 2022.
Article in English | EMBASE | ID: covidwho-2064505

ABSTRACT

Introduction: The purpose of this study is to evaluate longterm laryngotracheal outcomes in patients who required 10 or more days of invasive mechanical ventilation (IMV) for COVID-19. Method(s): This is a prospective cohort study of patients previously hospitalized for active COVID-19 infection between January 2020 and March 2021 who required intubation for 10+ days. Subjects who met criteria were enrolled at an outpatient laryngology clinic, where they underwent a clinical evaluation with head and neck exam, nasolaryngoscopy, and patient-reported outcome measures (Voice Handicap Index, EAT-10). Medical history was collected through electronic medical record review. Result(s): In total, 166 patients met criteria based on chart review. Of these patients, 31 (18.6%) were deceased since discharge. Enrolled subjects included 16 patients, 2 women and 14 men, with mean (SD) age of 57.4 (14.12) years. The mean duration (SD) of IMV was 36.8 (21.8) days. Fourteen of 16 patients underwent tracheostomy for prolonged endotracheal intubation. The mean time (SD) from hospital admission to intubation was 2.7 (3.2) days, intubation to tracheostomy or extubation was 13.9 (5.3) days, and tracheostomy to decannulation was 38.1 (22.6) days. Conclusion(s): Patients who required prolonged mechanical ventilation to treat COVID acute respiratory distress syndrome demonstrated significant laryngeal or tracheal pathology during laryngoscopy at 1-year follow-up, though subjectively, their self-reported voice and swallowing deficits were mild.

17.
Otolaryngology - Head and Neck Surgery ; 167(1 Supplement):P13, 2022.
Article in English | EMBASE | ID: covidwho-2064501

ABSTRACT

Introduction: Despite dramatic expansion of telehealth visits across health disciplines during the COVID-19 pandemic, little is known about attitudes toward telehealth offerings among patients affected by head and neck neoplasms. We investigate patient responses regarding their desire for telemedicine, personal attitudes, and barriers in availing telemedicine visits for head and neck oncology-related care. Method(s): Retrospective analyses of patient surveys prospectively administered between August and October 2021 to adult patients at a tertiary care head and neck oncology clinic. Level of interest in telemedicine appointments was the assessed primary outcome. Covariates including demographics, place of residence, primary neoplastic condition, speech/communication barriers, access to internet-enabled devices or reliable internet, personal preferences, and qualitative self-reporting of attitudes toward telemedicine were assessed for association with interest in telemedicine appointments. Result(s): Of 633 survey responses, 50.6% were male. More than 70% of surveyed patients were older than 56 years. Overall, 49.7% demonstrated interest in telehealth visits. Limitations in access to technology (17.7% [112 of 633 respondents]) and lack of reliable internet connection (13.74% [87 of 633 respondents]) were considered key barriers. Only 6% patients expressed concerns about missing key elements of care or quality of care delivered through telemedicine visits. Conclusion(s): Limited access to technology platforms and unreliable internet were key concerns for 1 in 2 patients considering telemedicine appointments for head and neck oncologic care. Understanding the needs and attitudes of specific patient populations may be important for organizations pivoting to telemedicine platforms for improving health care access. Key interventions to enhance participation in telemedicine- based care delivery could include identifying rural connectivity hubs and ensuring availability of connected devices through grant or device loan programs, and employing userfriendly technology platforms.

18.
Otolaryngology - Head and Neck Surgery ; 167(1 Supplement):P147, 2022.
Article in English | EMBASE | ID: covidwho-2064494

ABSTRACT

Introduction: Olfactory dysfunction (OD) is a prevalent and characteristic symptom among individuals with COVID-19 infection. Although most patients with COVID-19-related OD experience a significant recovery, there exists a substantial population of patients with persistent OD with limited therapeutic options. Method(s): Patients with laboratory-confirmed or clinically suspected COVID-19 infection and self-reported new onset OD from March 2020 to October 2021 were prospectively recruited for a randomized, placebo-controlled, doubleblinded clinical trial. Patients with evidence of quantitative OD, defined as a Brief Smell Identification Test (BSIT) score of 9 or less, were eligible for study inclusion. The experimental group received 2 g of omega-3 fatty acid (O3FA) supplementation, including 1366-mg eicosapentaenoic acid and 504-mg docosahexaenoic acid, while the control group received an identical placebo, each to be taken daily for 6 weeks. The primary outcome was change in BSIT score from initial test to a 6-week follow-up BSIT. Result(s): A total of 117 patients were included in analysis, including 57 patients in the O3FA group and 60 in the placebo group. The mean duration of OD prior to study enrollment was 200.1 days with no significant difference between groups (P=.685). Patients receiving O3FA supplementation demonstrated a mean BSIT improvement of 1.12+/-1.99 compared with 0.68+/-0.86 in the placebo group (P=.385). Among those with severe hyposmia, defined as a BSIT score of 7 or less, patients in the O3FA group (n=23) demonstrated a BSIT improvement of 2.30+/-0.77 compared with 1.63+/-1.82 among those in the placebo group (n=16, P=.255). Conclusion(s): Our study showed a trend toward improved olfactory recovery among COVID-19-related OD patients receiving high doses of O3FA supplementation at a 6-week follow-up time point. Future work will be needed to better define the effectiveness and durability of O3FA supplementation as a treatment for COVID-19-related OD.

19.
Otolaryngology - Head and Neck Surgery ; 167(1 Supplement):P15-P16, 2022.
Article in English | EMBASE | ID: covidwho-2064492

ABSTRACT

Introduction: Anosmia has been described as one of the characteristic symptoms of COVID-19 disease. It is even considered as a key marker for COVID-19 diagnosis. The aim of the study is to evaluate anosmia as prognostic factor in moderate and severe cases of COVID-19 patients. Method(s): Our study is a multicenter prospective study;300 patients were recruited and confirmed COVID-19 infection and admitted into 3 tertiary referral quarantine hospitals to receive medical treatment in Minia, Egypt. The study was conducted between April and October 2021. The selected random sample met the following inclusion criteria: adults older than 18 years, rhinopharyngeal swab positive for SARS-CoV-2 infection, and moderate and severe cases of COVID-19. The patients were subjected to the following protocol: full clinical history, general medical examination, otorhinolaryngological evaluation, mandatory swab for COVID-19, and recording of laboratory data. Patients underwent olfactory assessment and follow-up for 3 months. Olfactory assessment was done subjectively by odor recognition thresholds using L-butanol;after evaluation, the patients were divided into anosmic and nonanosmic groups. Collected data were compared and statistically analyzed. Result(s): Olfactory impairment was seen in 35% of moderate cases and 13% in severe cases. Our study revealed that patients with anosmia were younger and mostly female. Hospitalized patients with anosmia had a better prognosis. Our results showed no significant differences between the 2 groups regarding temperature, heart rate, and respiratory rate. Of patients with anosmia, 70% were associated with dysgeusia, and 50% recovered within 13 days while 85% recovered within 28 days. There was significant relationship (parallel relationship) between progress of anosmia and level of D-dimer, C-reactive protein, and serum ferritin. This indicateds that the prognosis of anosmia is highly related to the inflammatory process of COVID-19 pathophysiology. Conclusion(s): Anosmic patients with COVID-19 have more favorable prognosis and recovery than nonanosmic patients do, and anosmia improves with treatment of the disease.

20.
Otolaryngology - Head and Neck Surgery ; 167(1 Supplement):P144-P145, 2022.
Article in English | EMBASE | ID: covidwho-2064489

ABSTRACT

Introduction: Olfactory dysfunction is a common symptom associated with COVID-19 infection. While often transient, nearly 1 in 8 patients experience persistent dysfunction after initial infection resolution. Given the known association between impaired olfaction and mild cognitive impairment (MCI), this persistent COVID-19 olfactory dysfunction may impede early detection of cognitive decline. Method(s): Patients with confirmed COVID-19-associated hyposmia (n=73), MCI (n=58), and normal controls (n=86) were prospectively enrolled. Demographic data were collected alongside formal olfactory testing via AROMA (Affordable Rapid Olfaction Measurement Assay) at time of initial enrollment. MCI was assessed via MoCA (Montreal Cognitive Assessment). Multivariate logistic regressions were utilized to evaluate for associations between variables and etiology of olfactory dysfunction. Result(s): After controlling for age and gender, when compared against normal controls, the inability to smell licorice, cinnamon, and lemon at the lowest 3 concentrations increased odds of COVID-19 hyposmia by 10.8 (95% CI, 4.6-25.6), 5.7 (95% CI, 2.7-11.7), and 5.3 (95% CI, 2.6-10.8), respectively. While the inability to smell coffee (9.9 odds ratio [OR];95% CI, 2.02-48.1), eucalyptus (6.7 OR;95% CI, 2.2-20.0), and rose (4.0 OR;95% CI, 1.7-9.7) were associated with MCI, decreased ability to smell licorice, cinnamon, and lemon were not. When combined into a composite score and compared against controls, decreased detection of licorice, cinnamon, and lemon was associated with a 16.5 OR (95% CI, 6.6-41.3) for COVID-19 hyposmia. This composite score was not significantly associated with MCI (1.2 OR;95% CI, 0.6-2.2) and, as such, performed well at discriminating between COVID-19 and MCI patients (receiver operating characteristic area under the curve=0.76). Conclusion(s): Distinct patterns of impaired olfaction were noted for COVID-19. We show that this etiology-specific phenotype has good discriminative performance when differentiating from MCI-associated hyposmia, which may allow for continued utilization of olfactory screening for MCI even among those with previous COVID-19 infection.

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