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1.
BMC Infect Dis ; 21(1): 1174, 2021 Nov 22.
Article in English | MEDLINE | ID: covidwho-1528679

ABSTRACT

BACKGROUND: The COVID-19 vaccines provide renewed hope in the fight against the recent pandemic. To ensure widespread vaccination, it is crucial to analyze vaccine willingness and its determinants among physicians, key health care influencers. This study aimed to assess acceptance rate and identify factors associated with vaccine hesitancy among Thai physicians. METHODS: A cross-sectional online-based questionnaire was distributed to all physicians at King Chulalongkorn Memorial Hospital during March 31, 2021 to April 30, 2021 in order to assess their attitudes toward receiving the COVID-19 vaccine. Reasons for vaccine acceptance and refusal as well as predictors of vaccine hesitancy were analyzed by bivariate and multivariable analysis. RESULTS: A total of 705 complete responses were received with 95.6% (n = 675) of physicians expressing willingness to receive a COVID-19 vaccine. Only one of the 31 physicians (4.4%) who expressed a hesitancy or unwillingness to be vaccinated was a faculty member; the others were physicians-in-training. Approximately one-fifths of physicians surveyed were also not willing to recommend the vaccine to their family members (21.4%, n = 151) or patients (18.7%, n = 132). Using multivariable logistic regression, vaccine hesitancy was independently associated with preference for particular vaccines over the government allocated option, especially for mRNA vaccine (aOR 8.86; 95% CI 1.1-71.54; p = 0.041). Vaccine literacy showed an inverse relationship (aOR 0.34; 95% CI 0.13-0.9; p = 0.029) with vaccine hesitancy. Uncertainty of the vaccine efficacy (83.9%) and fear of adverse events (48.4%) were major concerns contributing to vaccine hesitancy. CONCLUSION: This study revealed a high rate of physician willingness to take the COVID-19 vaccine especially among staffs; however, a significant proportion would not currently suggest vaccination to their families or patients. Restrictions on vaccine choice and vaccine illiteracy, together with concerns over adverse effects and uncertainty of efficacy, were associated with negative attitudes toward vaccination. To raise acceptance of the vaccination program, efforts should be made to balance individual preference for vaccine type in addition to increasing the availability of accurate data on safety and efficacy for each vaccine.


Subject(s)
COVID-19 , Physicians , Vaccines , COVID-19 Vaccines , Cross-Sectional Studies , Hospitals, Teaching , Hospitals, University , Humans , SARS-CoV-2 , Thailand , Universities , Vaccination
2.
Br J Nurs ; 30(20): 1210-1211, 2021 Nov 11.
Article in English | MEDLINE | ID: covidwho-1524633

ABSTRACT

Mark Green, Heart Failure Nurse Specialist, Portsmouth Hospitals University NHS Trust (Mark.Green@porthosp.nhs.uk) was runner up in the Cardiovascular Nurse of the Year category of the BJN Awards 2021.


Subject(s)
Awards and Prizes , Heart Failure , Nurse Clinicians , Heart Failure/epidemiology , Hospitals, University , Humans , Pandemics
3.
Acta Biomed ; 92(5): e2021266, 2021 11 03.
Article in English | MEDLINE | ID: covidwho-1504149

ABSTRACT

The outbreak of coronavirus disease 19 (COVID-19) has dramatically imposed healthcare systems to reorganize their departments, including neurological wards. We aimed to describe the rearrangements made by stroke units (SU) and neurological intensive care units (ICU) in several German community and university hospitals facing the pandemic. This cross-sectional, survey-based, nationwide study collected data of 15 university and 4 community hospitals in Germany, being part of IGNITE Study Group, from April 1 to April 6, 2020. The rearrangements and implementation of safety measures in SUs, intermediate care units (IMC), and neurological ICUs were compared. 84.2% of hospitals implemented a separated area for patients awaiting their COVID-19 test results and 94.7% had a dedicated zone for their management. Outpatient treatment was reduced in 63.2% and even suspended in 36.8% of the hospitals. A global reduction of bed capacity was observed. Hospitals reported compromised stroke treatment (52.6%) and reduction of thrombolysis and thrombectomy rates (36.8%). All hospitals proposed special training for COVID-19 management, recurrent meetings and all undertook measures improving safety for healthcare workers. In an unprecedented global healthcare crisis, knowledge of the initial reorganization and response of German hospitals to COVID-19 may help finding effective strategies to face the ongoing pandemic.


Subject(s)
COVID-19 , Stroke , Critical Care , Cross-Sectional Studies , Germany/epidemiology , Hospitals, University , Humans , Intensive Care Units , Pandemics , SARS-CoV-2 , Stroke/epidemiology , Stroke/therapy
4.
Clin Infect Dis ; 73(9): e3055-e3065, 2021 11 02.
Article in English | MEDLINE | ID: covidwho-1501051

ABSTRACT

BACKGROUND: High infection rates among healthcare personnel in an uncontained pandemic can paralyze health systems due to staff shortages. Risk constellations and rates of seroconversion for healthcare workers (HCWs) during the first wave of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic are still largely unclear. METHODS: Healthcare personnel (n = 300) on different organizational units in the LMU Munich University Hospital were included and followed in this prospective longitudinal study from 24 March until 7 July 2020. Participants were monitored in intervals of 2 to 6 weeks using different antibody assays for serological testing and questionnaires to evaluate risk contacts. In a subgroup of infected participants, we obtained nasopharyngeal swabs to perform whole-genome sequencing for outbreak characterization. RESULTS: HCWs involved in patient care on dedicated coronavirus disease 2019 (COVID-19) wards or on regular non-COVID-19 wards showed a higher rate of SARS-CoV-2 seroconversion than staff in the emergency department and non-frontline personnel. The landscape of risk contacts in these units was dynamic, with a decrease in unprotected risk contacts in the emergency department and an increase on non-COVID-19 wards. Both intensity and number of risk contacts were associated with higher rates of seroconversion. On regular wards, staff infections tended to occur in clusters, while infections on COVID-19 wards were less frequent and apparently independent of each other. CONCLUSIONS: Risk of SARS-CoV-2 infection for frontline HCWs was increased during the first pandemic wave in southern Germany. Stringent measures for infection control are essential to protect all patient-facing staff during the ongoing pandemic.


Subject(s)
COVID-19 , SARS-CoV-2 , Germany/epidemiology , Health Personnel , Hospitals, University , Humans , Longitudinal Studies , Pandemics , Prospective Studies
5.
Clin Infect Dis ; 73(9): e3136-e3143, 2021 11 02.
Article in English | MEDLINE | ID: covidwho-1501035

ABSTRACT

Singapore's hospitals had prepared to receive patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), planning various scenarios and levels of surge with a policy of isolating all confirmed cases as inpatients. The National University Hospital adopted a whole of hospital approach to coronavirus disease 2019 (COVID-19) with 3 primary goals: zero hospital-acquired COVID-19, all patients receive timely necessary care, and maintenance of staff morale. These goals to date have been met. A large influx of COVID-19 cases required significant transformation of clinical and operational processes. Isolation room numbers almost tripled and dedicated COVID-19 cohort wards were established, elective care was postponed, and intensive care units were augmented with equipment and manpower. In the wake of the surge, establishing a new normal for hospital care requires maintaining vigilance to detect endemic COVID-19, establishing contingency plans to ramp up in case of another surge, while returning to business as usual.


Subject(s)
COVID-19 , Hospitals, University , Humans , Inpatients , Intensive Care Units , SARS-CoV-2
6.
J Intensive Care Med ; 36(12): 1507-1512, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1488354

ABSTRACT

The benefits of percutaneous dilational tracheostomy (PDT) placement have been well documented in patients requiring prolonged mechanical ventilation. However, the data regarding the benefit of PDT in coronavirus-2019 (COVID-19) patients are scarce. The objective of this study is to evaluate the outcomes of a cohort of 37 patients who underwent tracheostomy as part of their COVID-19 care. Retrospective data from a series for 37 patients undergoing tracheostomy was collected using chart review. Primary outcomes included 30 and 60 day mortality, weaning rate, and decannulation rate. Secondary outcomes collected included admission demographics, comorbidities, and procedural information. Thirty-seven (37) patients requiring prolonged mechanical ventilation due to COVID-19. Of these 37 patients, 35 were alive 60 days post-PDT placement, 33 have been weaned from mechanical ventilation and 18 have been decannulated. The low mortality and high decannulation rates in this cohort in is a promising development in the care of critically ill COVID-19 patients. Of note, all participating physicians underwent routine polymerase chain reaction (PCR) testing for infection with the severe acute respiratory syndrome coronavirus-2 virus and no physician contracted COVID-19 as a result of their involvement. Overall, this case series describes the modified PDT technique used by our team and discusses the feasibility and potential benefit to PDT placement in COVID-19 patients requiring long-term mechanical ventilation.


Subject(s)
COVID-19 , Tracheostomy , Follow-Up Studies , Hospitals, University , Humans , Respiration, Artificial , Retrospective Studies , SARS-CoV-2
7.
Rev Infirm ; 70(275): 33-34, 2021 Nov.
Article in French | MEDLINE | ID: covidwho-1479725

ABSTRACT

In a university hospital in Brittany, health monitoring of the staff was set up at the beginning of the Covid-19 pandemic. The first results of the studies carried out in this context showed that nurses showed a greater deterioration of their physical health than other professionals. However, thanks to psychological balancing measures, nurses did not appear to be more affected in terms of psychological health and well-being at work than the other hospital workers.


Subject(s)
COVID-19 , Nurses , Health Personnel , Hospitals, University , Humans , Pandemics/prevention & control , SARS-CoV-2
8.
Online braz. j. nurs. (Online) ; 19(3)set. 2020.
Article in English, Spanish, Portuguese | LILACS (Americas) | ID: covidwho-1471211

ABSTRACT

A pandemia COVID-19 vem exigindo enorme esforço dos gestores hospitalares, desafiando-os a agir e pensar fluxos de atendimento de maneira rápida, adotando estratégias seguras de cuidar. OBJETIVO: Analisar o processo de planejamento e implantação de um serviço de atenção ao paciente com COVID-19 em um hospital universitário, através da experiência cotidiana de gestão. MÉTODO: Trata-se de um relato sistemático de experiência sobre o processo de implantação de fluxo de atendimento e tratamento em um hospital universitário de pessoas acometidas pela COVID-19. Registrou-se em diário de campo a experiência, sendo as narrativas submetidas à análise de conteúdo. RESULTADOS: a análise das narrativas permitiu organizar os dados nas seguintes categorias: necessidade de segurança dos profissionais, capacitação, empatia e gestão participativa. CONCLUSÃO: É importante utilizar os processos de trabalho e a Educação Permanente em Saúde como ferramentas para a orientação do cuidado assistencial ao paciente com COVID-19. O raciocínio clínico, o trabalho interdisciplinar e a tomada de decisão de forma participativa permitiu a adequada implantação do atendimento, apesar do temor da equipe frente aos desafios da pandemia.


La pandemia de COVID-19 ha exigido un enorme esfuerzo por parte de los administradores de los hospitales, desafiándolos a actuar y pensar en los flujos de atención rápidamente, adoptando estrategias de atención segura. OBJETIVO: Analizar el proceso de planificación e implementación de un servicio de atención al paciente con COVID-19 en un hospital universitario, a través de la experiencia de gestión diaria. MÉTODO: Este es un reporte sistemático de experiencia sobre el proceso de implementación de un flujo de atención y tratamiento en un hospital universitario para personas afectadas por COVID-19. La experiencia se registró en un diario de campo y las narrativas se sometieron a análisis de contenido. RESULTADOS: el análisis de las narrativas permitió organizar los datos en las siguientes categorías: necesidad de seguridad profesional, formación, empatía y gestión participativa. CONCLUSIÓN: Es importante utilizar los procesos de trabajo y la Educación Permanente en Salud como herramientas para orientar la atención brindada a los pacientes con COVID-19. El razonamiento clínico, el trabajo interdisciplinario y la toma de decisiones de manera participativa permitieron la adecuada implementación de la atención, a pesar del temor del equipo ante los desafíos de la pandemia.


The COVID-19 pandemic has demanded enormous effort from hospital managers, challenging them to act and think about care flows in a timely manner while adopting safe care strategies. OBJECTIVE: To analyze the planning and implementation process of a patient care service with COVID-19 in a university hospital, through the experience of daily management. METHOD: This is a systematic experience report on the care implementation and treatment flow process in a university hospital of people affected by COVID-19. The experience was recorded in a field diary, and the narratives were submitted to content analysis. RESULTS: the analysis of the narratives lead to the organization of data in the following categories: need for professional safety, training, empathy and participatory management. CONCLUSION: It is important to use work processes and Continuing Health Education as tools for guiding care to COVID-19 patients. Clinical reasoning, interdisciplinary work and decision-making in a participatory manner allowed the proper care implementation, despite the team's fear of the challenges caused by the pandemic.


Subject(s)
Humans , Health Services Administration , Coronavirus Infections , Pandemics , Hospitals, University , Nursing Service, Hospital/organization & administration , Occupational Health , Patient-Centered Care , Practice Management , Qualitative Research , Education, Continuing , Empathy , Health Human Resource Training , Shared Governance, Nursing
9.
Int J Environ Res Public Health ; 18(19)2021 09 26.
Article in English | MEDLINE | ID: covidwho-1463637

ABSTRACT

Nurses are vulnerable to mental health challenges, including burnout, as they are exposed to adverse job conditions such as high workload. The mental health of this population can relate not only to individual well-being but also to patient safety outcomes. Therefore, there is a need for a mental health improvement strategy that targets this population. This cross-sectional survey study investigates emotional labor, burnout, turnover intention, and medical error levels among 117 nursing staff members in a South Korean university hospital; it also analyzes correlations among outcomes and conduct correlation analysis and multiple regression analysis to determine relationships among these factors. The participants had moderate to high levels of emotional labor and burnout, and 23% had experienced medical errors within the last six months. Save for medical errors, all outcomes significantly and positively correlated with each other. These results can be used to improve the mental health outcomes of nurses working in the hospital and their consequences. Specifically, the job positions of nursing personnel may be a major consideration in such a strategy, and job-focused emotional labor and employee-focused emotional labor may be promising targets in ameliorating turnover intention and client-related burnout, respectively.


Subject(s)
Burnout, Professional , Nursing Staff, Hospital , Burnout, Professional/epidemiology , Cross-Sectional Studies , Hospitals, University , Humans , Intention , Job Satisfaction , Medical Errors , Republic of Korea , Surveys and Questionnaires , Workplace
10.
Anaesthesist ; 70(7): 573-581, 2021 07.
Article in German | MEDLINE | ID: covidwho-1453676

ABSTRACT

BACKGROUND: In a pandemic situation the overall mortality rate is of considerable interest; however, these data must always be seen in relation to the given healthcare system and the availability of local level of care. A recently published German data evaluation of more than 10,000 COVID-19 patients treated in 920 hospitals showed a high mortality rate of 22% in hospitalized patients and of more than 50% in patients requiring invasive ventilation. Because of the high infection rates in Bavaria, a large number of COVID-19 patients with considerable severity of disease were treated at the intensive care units of the LMU hospital. The LMU hospital is a university hospital and a specialized referral center for the treatment of patients with acute respiratory distress syndrome (ARDS). OBJECTIVE: Data of LMU intensive care unit (ICU) patients were systematically evaluated and compared with the recently published German data. METHODS: Data of all COVID-19 patients with invasive and noninvasive ventilation and with completed admission at the ICU of the LMU hospital until 31 July 2020 were collected. Data were processed using descriptive statistics. RESULTS: In total 70 critically ill patients were included in the data evaluation. The median SAPS II on admission to the ICU was 62 points. The median age was 66 years and 81% of the patients were male. More than 90% were diagnosed with ARDS and received invasive ventilation. Treatment with extracorporeal membrane oxygenation (ECMO) was necessary in 10% of the patients. The median duration of ventilation was 16 days, whereby 34.3% of patients required a tracheostomy. Of the patients 27.1% were transferred to the LMU hospital from external hospitals with reference to our ARDS/ECMO program. Patients from external hospitals had ARDS of higher severity than the total study population. In total, nine different substances were used for virus-specific treatment of COVID-19. The most frequently used substances were hydroxychloroquine and azithromycin. Immunomodulatory treatment, such as Cytosorb® (18.6%) and methylprednisolone (25.7%) were also frequently used. The overall in-hospital mortality rate of ICU patients requiring ventilation was 28.6%. The mortality rates of patients from external hospitals, patients with renal replacement therapy and patients with ECMO therapy were 47.4%, 56.7% and 85.7%, respectively. CONCLUSION: The mortality rate in the ventilated COVID-19 intensive care patients was considerably different from the general rate in Germany. The data showed that treatment in an ARDS referral center could result in a lower mortality rate. Low-dose administration of steroids may be another factor to improve patient outcome in a preselected patient population. In the authors' opinion, critically ill COVID-19 patients should be treated in an ARDS center provided that sufficient resources are available.


Subject(s)
COVID-19/therapy , Respiration, Artificial/statistics & numerical data , Aged , Aged, 80 and over , Antiviral Agents/therapeutic use , COVID-19/complications , COVID-19/mortality , Critical Illness/therapy , Extracorporeal Membrane Oxygenation , Female , Germany , Hospital Mortality , Hospitals, University , Humans , Immunologic Factors/therapeutic use , Intensive Care Units/statistics & numerical data , Male , Middle Aged , Patient Transfer , Renal Replacement Therapy/statistics & numerical data , Respiratory Distress Syndrome/etiology , Respiratory Distress Syndrome/therapy , Treatment Outcome
11.
Anaesthesist ; 69(10): 717-725, 2020 10.
Article in German | MEDLINE | ID: covidwho-1453673

ABSTRACT

BACKGROUND: Following the regional outbreak in China, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread all over the world, presenting the healthcare systems with huge challenges worldwide. In Germany the coronavirus diseases 2019 (COVID-19) pandemic has resulted in a slowly growing demand for health care with a sudden occurrence of regional hotspots. This leads to an unpredictable situation for many hospitals, leaving the question of how many bed resources are needed to cope with the surge of COVID-19 patients. OBJECTIVE: In this study we created a simulation-based prognostic tool that provides the management of the University Hospital of Augsburg and the civil protection services with the necessary information to plan and guide the disaster response to the ongoing pandemic. Especially the number of beds needed on isolation wards and intensive care units (ICU) are the biggest concerns. The focus should lie not only on the confirmed cases as the patients with suspected COVID-19 are in need of the same resources. MATERIAL AND METHODS: For the input we used the latest information provided by governmental institutions about the spreading of the disease, with a special focus on the growth rate of the cumulative number of cases. Due to the dynamics of the current situation, these data can be highly variable. To minimize the influence of this variance, we designed distribution functions for the parameters growth rate, length of stay in hospital and the proportion of infected people who need to be hospitalized in our area of responsibility. Using this input, we started a Monte Carlo simulation with 10,000 runs to predict the range of the number of hospital beds needed within the coming days and compared it with the available resources. RESULTS: Since 2 February 2020 a total of 306 patients were treated with suspected or confirmed COVID-19 at this university hospital. Of these 84 needed treatment on the ICU. With the help of several simulation-based forecasts, the required ICU and normal bed capacity at Augsburg University Hospital and the Augsburg ambulance service in the period from 28 March 2020 to 8 June 2020 could be predicted with a high degree of reliability. Simulations that were run before the impact of the restrictions in daily life showed that we would have run out of ICU bed capacity within approximately 1 month. CONCLUSION: Our simulation-based prognosis of the health care capacities needed helps the management of the hospital and the civil protection service to make reasonable decisions and adapt the disaster response to the realistic needs. At the same time the forecasts create the possibility to plan the strategic response days and weeks in advance. The tool presented in this study is, as far as we know, the only one accounting not only for confirmed COVID-19 cases but also for suspected COVID-19 patients. Additionally, the few input parameters used are easy to access and can be easily adapted to other healthcare systems.


Subject(s)
Coronavirus Infections/therapy , Critical Care/organization & administration , Hospital Bed Capacity , Hospitals, University/organization & administration , Intensive Care Units/organization & administration , Pneumonia, Viral/therapy , Betacoronavirus/isolation & purification , COVID-19 , Coronavirus Infections/epidemiology , Critical Care/statistics & numerical data , Germany , Hospitals, University/statistics & numerical data , Humans , Intensive Care Units/statistics & numerical data , Pandemics , Pneumonia, Viral/epidemiology , Prognosis , SARS-CoV-2
12.
Br J Nurs ; 30(17): 1047, 2021 Sep 23.
Article in English | MEDLINE | ID: covidwho-1450993

ABSTRACT

The outcome of a consultation on mandatory COVID-19 vaccination for health and social care staff must result in a standard approach being taken nationwide, argues Sam Foster, Chief Nurse, Oxford University Hospitals.


Subject(s)
COVID-19 Vaccines , COVID-19 , Hospitals, University , Humans , SARS-CoV-2 , State Medicine , United Kingdom , Vaccination
15.
Am J Infect Control ; 49(10): 1215-1220, 2021 10.
Article in English | MEDLINE | ID: covidwho-1437379

ABSTRACT

INTRODUCTION: The COVID-19 pandemic placed unprecedented strain on the medical supply chain. Early in the pandemic, uncertainty regarding personal protective equipment (PPE) was high. Protecting health care workers from contracting illness is critical to preserve trust and workforce capacity. METHODS: We describe an initiative to design and manufacture a novel, re-usable, half-face respirator in case conventional medical supply chain failed to meet demand. It required new collaboration between the hospital, physicians, the medical school, and the school of engineering. We describe organizational priorities, constraints, and process of design, testing and approval as the health system engaged for the first time directly with the design and manufacturing process for PPE. RESULTS: An original mask design was developed, and the University Hospital had an initial batch of this novel mask manufactured during the first wave of the SARS-COV-2 pandemic. These masks, and the die necessary to produce more, are in reserve in case of depletion of stores of conventionally sourced PPE. CONCLUSIONS: The COVID-19 pandemic demonstrated fragility of medical supply chain. Organizations considering similar efforts should anticipate constraints on raw material supply chain and be flexible, adaptive, and fast. The incident command structure was vital to identifying priority areas needing alternative approaches, creating connections, and providing rapid approvals. We found organizational value in demonstrating commitment to assuring PPE supplies for health care worker safety.


Subject(s)
COVID-19 , Pandemics , Health Personnel , Hospitals, University , Humans , Masks , Personal Protective Equipment , SARS-CoV-2
17.
PLoS One ; 16(9): e0256763, 2021.
Article in English | MEDLINE | ID: covidwho-1416875

ABSTRACT

BACKGROUND: The COVID-19 pandemic has had a devastating impact in the United States, particularly for Black populations, and has heavily burdened the healthcare system. Hospitals have created protocols to allocate limited resources, but there is concern that these protocols will exacerbate disparities. The sequential organ failure assessment (SOFA) score is a tool often used in triage protocols. In these protocols, patients with higher SOFA scores are denied resources based on the assumption that they have worse clinical outcomes. The purpose of this study was to assess whether using SOFA score as a triage tool among COVID-positive patients would exacerbate racial disparities in clinical outcomes. METHODS: We analyzed data from a retrospective cohort of hospitalized COVID-positive patients in the Yale-New Haven Health System. We examined associations between race/ethnicity and peak overall/24-hour SOFA score, in-hospital mortality, and ICU admission. Other predictors of interest were age, sex, primary language, and insurance status. We used one-way ANOVA and chi-square tests to assess differences in SOFA score across racial/ethnic groups and linear and logistic regression to assess differences in clinical outcomes by sociodemographic characteristics. RESULTS: Our final sample included 2,554 patients. Black patients had higher SOFA scores compared to patients of other races. However, Black patients did not have significantly greater in-hospital mortality or ICU admission compared to patients of other races. CONCLUSION: While Black patients in this sample of hospitalized COVID-positive patients had higher SOFA scores compared to patients of other races, this did not translate to higher in-hospital mortality or ICU admission. Results demonstrate that if SOFA score had been used to allocate care, Black COVID patients would have been denied care despite having similar clinical outcomes to white patients. Therefore, using SOFA score to allocate resources has the potential to exacerbate racial inequities by disproportionately denying care to Black patients and should not be used to determine access to care. Healthcare systems must develop and use COVID-19 triage protocols that prioritize equity.


Subject(s)
COVID-19/prevention & control , Delivery of Health Care/statistics & numerical data , Healthcare Disparities/statistics & numerical data , Hospitals, University , Organ Dysfunction Scores , Triage/statistics & numerical data , Adolescent , Adult , African Americans/statistics & numerical data , Aged , Aged, 80 and over , COVID-19/epidemiology , COVID-19/virology , Connecticut , European Continental Ancestry Group/statistics & numerical data , Female , Healthcare Disparities/ethnology , Hispanic Americans/statistics & numerical data , Hospital Mortality/ethnology , Humans , Male , Middle Aged , Pandemics , Retrospective Studies , SARS-CoV-2/physiology , Triage/methods , Young Adult
18.
Sci Rep ; 11(1): 18456, 2021 09 16.
Article in English | MEDLINE | ID: covidwho-1415951

ABSTRACT

The variant 20I/501Y.V1, associated to a higher risk of transmissibility, emerged in Nice city (Southeast of France, French Riviera) during January 2021. The pandemic has resumed late December 2020 in this area. A high incidence rate together with a fast turn-over of the main circulating variants, provided us the opportunity to analyze modifications in clinical profile and outcome traits. We performed an observational study in the University hospital of Nice from December 2020 to February 2021. We analyzed data of sequencing of SARS-CoV-2 from the sewage collector and PCR screening from all positive samples at the hospital. Then, we described the characteristics of all COVID-19 patients admitted in the emergency department (ED) (n = 1247) and those hospitalized in the infectious diseases ward or ICU (n = 232). The UK-variant was absent in this area in December, then increasingly spread in January representing 59% of the PCR screening performed mid-February. The rate of patients over 65 years admitted to the ED decreased from 63 to 50% (p = 0.001). The mean age of hospitalized patients in the infectious diseases ward decreased from 70.7 to 59.2 (p < 0.001) while the proportion of patients without comorbidity increased from 16 to 42% (p = 0.007). Spread of the UK-variant in the Southeast of France affects younger and healthier patients.


Subject(s)
COVID-19 Nucleic Acid Testing/methods , COVID-19/epidemiology , SARS-CoV-2/genetics , Sewage/virology , Age Factors , Aged , Aged, 80 and over , COVID-19/virology , Comorbidity , Female , France/epidemiology , Hospitalization/statistics & numerical data , Hospitals, University , Humans , Incidence , Male , Middle Aged , United Kingdom/epidemiology , Wastewater-Based Epidemiological Monitoring
19.
J Infect Public Health ; 14(10): 1474-1480, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1415574

ABSTRACT

BACKGROUND: Healthcare workers (HCWs) are at a high risk for disease exposure. Given the limited availability of nucleic acid testing by PCR in low resource settings, serological assays can provide useful data on the proportion of HCWs who have recently or previously been infected. Therefore, in this study, we conducted an immunologic study to determine the seroprevalence of anti-SARS-CoV-2 antibodies in two university hospitals in Egypt. METHODS: in this cross sectional study, HCWs who were working in SARS-CoV-2 Isolation Hospitals were interviewed. Estimating specific antibodies (IgM and IgG) against SARS-CoV-2 was carried out using an enzyme-linked immunosorbent assay targeting the Spike antigen of SARS-CoV-2 virus. RESULTS: Out of 111, 82 (74%) HCWs accepted to participate with a mean age of 31.5 ± 8.5 years. Anti-SARS-COV2 antibodies were detected in 38/82 (46.3%) of cases with a mean age of 31 years and female HCWs constituted 57.6% of cases. The highest rate of seropositivity was from the nurses (60.5%), and physicians (31.6%) with only (7.9%) technicians. Only 28/82 (34.1%) HCWs reported previous history of COVID19. We reported a statistically significant difference in the timing of exposure (p = 0.010) and the frequency of contact with COVID-19 cases (p = 0.040) between previously infected and on-infected HCWs. Longer time of recovery was reported from IgG positive HCWs (p = 0.036). CONCLUSION: The high frequency of seropositive HCWs in investigated hospitals is alarming, especially among asymptomatic personnel. Confirmation of diseased HCWs (among seropositive ones) are warranted.


Subject(s)
COVID-19 , SARS-CoV-2 , Adult , Antibodies, Viral , Cross-Sectional Studies , Egypt/epidemiology , Female , Health Personnel , Hospitals, University , Humans , Prevalence , Seroepidemiologic Studies , Young Adult
20.
Am J Infect Control ; 49(12): 1464-1468, 2021 12.
Article in English | MEDLINE | ID: covidwho-1415170

ABSTRACT

OBJECTIVE: The objective of this study was to evaluate the incidence of nosocomial infection and the impact of cross-transmission of SARS-CoV-2 among inpatients at a tertiary care teaching hospital. METHODS: This was a retrospective cohort study involving inpatients admitted to a tertiary university hospital in the city of São Paulo, Brazil, between March 2020 and February 2021. Cases were identified on the basis of a positive reverse-transcription polymerase chain reaction result for SARS-CoV-2 and the review of electronic medical records. Nosocomial transmission was defined by applying the criteria established by the Brazilian National Health Regulatory Agency. RESULTS: We identified 2146 cases of SARS-CoV-2 infection, 185 (8.6%) of which were considered cases of nosocomial transmission. The mean age was 58.3 years. The incidence density was 1.78 cases per 1,000 patient-days on the general wards, being highest on the cardiac surgery ward, and only 0.16 per 1,000 patient-days on the COVID-19 wards. Of the 185 patients evaluated, 115 (62.2%) were men, 150 (81.1%) cases had at least one comorbidity, and 104 (56.2%) evolved to death. CONCLUSIONS: Despite the preventive measures taken, nosocomial transmission of SARS-CoV-2 occurred throughout our hospital. Such measures should be intensified when the incidence of community transmission peaks.


Subject(s)
COVID-19 , Cross Infection , Brazil/epidemiology , Cross Infection/epidemiology , Hospitals, University , Humans , Inpatients , Male , Middle Aged , Retrospective Studies , SARS-CoV-2
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