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1.
PLoS One ; 17(10): e0273900, 2022.
Article in English | MEDLINE | ID: covidwho-2098738

ABSTRACT

BACKGROUND: After the COVID-19 pandemic, anxiety and depression have reached high levels, especially after the last wave, Omicron. Healthcare workers in contact with COVID-19 patients or those who come in contact with them may exhibit high levels of anxiety and depression. Therefore, we aimed to assess anxiety and depression symptoms among ICU companions of COVID-19 patients. METHODS: From 30 November 2021 to 1 March 2022, sixth-year medical students at Aleppo University Hospital conducted interviews with the companions of COVID-19 patients who they brought their patient to the ICU centre as part of a cross-sectional quantitative study using the PHQ-9 and GAD-7 tools to gauge their level of anxiety and depression among companions of COVID-19 patients. The data were analyzed using the SPSS program. In addition, logistic regression models were used to study possible factors of anxiety and depression symptoms during COVID-19. RESULTS: The total number was 997 participants in contact with COVID-19 patients. The mean score of the depression assessment tool (PHQ-9) in our questionnaire was 9.5 with a range of 0 to 27. At the same time, the anxiety assessment tool (GAD-7) had a mean score of 9.1, ranging from 0 to 21. A binary logistic regression was used to predict the relationship between depression and anxiety and various factors. We found that the companions with medical specialties were substantially less likely to develop anxiety than other companions [AOR = 0.459; 95%CI (0.23-0.9)], in addition females were substantially higher likely to develop depression than males [AOR = 1.322; 95%CI (0.992-1.762)]. 45.4% of companions had moderate to severe anxiety, in additon 50.8% of companions had moderate to severe depression. CONCLUSION: Our research reveals that moderate to severe anxiety and sadness are present in roughly half of the COVID19 patients' companions. Females, people with children, and hard workers were more inclined to feel anxious than others, and those who are not in the medical field were more likely to suffer from depression than others, thus it is critical to assist these groups during the present outbreaks (Omicron and Monkeybox).


Subject(s)
COVID-19 , Male , Female , Child , Humans , COVID-19/epidemiology , Cross-Sectional Studies , Pandemics , Depression/epidemiology , Depression/diagnosis , Anxiety/epidemiology , Anxiety/diagnosis , Hospitals, University , Intensive Care Units
2.
Scand J Trauma Resusc Emerg Med ; 28(1): 107, 2020 Oct 28.
Article in English | MEDLINE | ID: covidwho-2098376

ABSTRACT

OBJECTIVES: COVID-19 presents challenges to the emergency care system that could lead to emergency department (ED) crowding. The Huddinge site at the Karolinska university hospital (KH) responded through a rapid transformation of inpatient care capacity together with changing working methods in the ED. The aim is to describe the KH response to the COVID-19 crisis, and how ED crowding, and important input, throughput and output factors for ED crowding developed at KH during a 30-day baseline period followed by the first 60 days of the COVID-19 outbreak in Stockholm Region. METHODS: Different phases in the development of the crisis were described and identified retrospectively based on major events that changed the conditions for the ED. Results were presented for each phase separately. The outcome ED length of stay (ED LOS) was calculated with mean and 95% confidence intervals. Input, throughput, output and demographic factors were described using distributions, proportions and means. Pearson correlation between ED LOS and emergency ward occupancy by phase was estimated with 95% confidence interval. RESULTS: As new working methods were introduced between phase 2 and 3, ED LOS declined from mean (95% CI) 386 (373-399) minutes to 307 (297-317). Imaging proportion was reduced from 29 to 18% and admission rate increased from 34 to 43%. Correlation (95% CI) between emergency ward occupancy and ED LOS by phase was 0.94 (0.55-0.99). CONCLUSIONS: It is possible to avoid ED crowding, even during extreme and quickly changing conditions by leveraging previously known input, throughput and output factors. One key factor was the change in working methods in the ED with higher competence, less diagnostics and increased focus on rapid clinical admission decisions. Another important factor was the reduction in bed occupancy in emergency wards that enabled a timely admission to inpatient care. A key limitation was the retrospective study design.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Crowding , Emergency Service, Hospital , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy , Adult , Aged , Aged, 80 and over , Bed Occupancy , COVID-19 , Female , Hospitalization , Hospitals, University , Humans , Male , Middle Aged , Pandemics , Retrospective Studies , SARS-CoV-2 , Sweden
3.
Infect Control Hosp Epidemiol ; 42(6): 653-658, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-2096425

ABSTRACT

BACKGROUND: The pressures exerted by the coronavirus disease 2019 (COVID-19) pandemic pose an unprecedented demand on healthcare services. Hospitals become rapidly overwhelmed when patients requiring life-saving support outpace available capacities. OBJECTIVE: We describe methods used by a university hospital to forecast case loads and time to peak incidence. METHODS: We developed a set of models to forecast incidence among the hospital catchment population and to describe the COVID-19 patient hospital-care pathway. The first forecast utilized data from antecedent allopatric epidemics and parameterized the care-pathway model according to expert opinion (ie, the static model). Once sufficient local data were available, trends for the time-dependent effective reproduction number were fitted, and the care pathway was reparameterized using hazards for real patient admission, referrals, and discharge (ie, the dynamic model). RESULTS: The static model, deployed before the epidemic, exaggerated the bed occupancy for general wards (116 forecasted vs 66 observed), ICUs (47 forecasted vs 34 observed), and predicted the peak too late: general ward forecast April 9 and observed April 8 and ICU forecast April 19 and observed April 8. After April 5, the dynamic model could be run daily, and its precision improved with increasing availability of empirical local data. CONCLUSIONS: The models provided data-based guidance for the preparation and allocation of critical resources of a university hospital well in advance of the epidemic surge, despite overestimating the service demand. Overestimates should resolve when the population contact pattern before and during restrictions can be taken into account, but for now they may provide an acceptable safety margin for preparing during times of uncertainty.


Subject(s)
COVID-19/epidemiology , Hospital Bed Capacity , Hospitals, University/organization & administration , COVID-19/prevention & control , Cross Infection/prevention & control , Forecasting , Germany/epidemiology , Hospitals, University/statistics & numerical data , Humans , Incidence , Models, Statistical , Patient Safety
5.
Pol Arch Intern Med ; 132(10)2022 10 21.
Article in English | MEDLINE | ID: covidwho-2091285

ABSTRACT

INTRODUCTION: The course of consecutive COVID­19 waves was influenced by medical and organizational factors. OBJECTIVES: We aimed to assess the outcomes of patients hospitalized for COVID­19 during the first 3 waves of the pandemic. PATIENTS AND METHODS: We performed a retrospective analysis of medical records of all COVID­19 patients admitted to the University Hospital in Kraków, Poland, a designated COVID­19 hospital in Malopolska province, between March 1, 2020 and May 31, 2021. The waves were defined as 1, 2, and 3, and covered the periods of March 2020 to July 2020, August 2020 to January 2021, and February 2021 to May 2021, respectively. Patients' characteristics and outcomes for waves 1 through 3 were compared. RESULTS: Data analyses included 5191 patients with COVID­19. We found differences in age (mean [SD], 60.2 [17.3] years vs 62.4 [16.8] years vs 61.9 [16.1] years, respectively, for waves 1, 2, and 3; P = 0.003), sex distribution (proportion of women, 51.4% vs 44.2% vs 43.6%; P = 0.003), as well as concentrations of inflammatory markers and oxygen saturation (the lowest and the highest for wave 1, respectively; P <0.001). Hospital death rates in subsequent waves were 10.4%, 19.8%, and 20.3% (P <0.001). Despite similarities in patients' characteristics, the length of hospital and intensive care unit stay was shorter for wave 3 than for wave 2. The risk factors for in­hospital death were: advanced age, male sex, cardiovascular or chronic kidney disease, higher C­reactive protein level, and hospitalization during the second or third wave. CONCLUSIONS: We identified differences in patients' clinical characteristics and outcomes between consecutive pandemic waves, which probably reflect changes in terms of COVID­19 isolation policy, hospitalization and treatment indications, and treatment strategies.


Subject(s)
COVID-19 , Pandemics , Female , Humans , Male , C-Reactive Protein , COVID-19/epidemiology , Hospital Mortality , Hospitals, University , Pandemics/statistics & numerical data , Retrospective Studies , Poland/epidemiology , Adult , Middle Aged , Aged
6.
Br J Nurs ; 31(18): 967, 2022 Oct 13.
Article in English | MEDLINE | ID: covidwho-2090930

ABSTRACT

Chief Nurse, Oxford University Hospitals, describes ongoing research into how the redeployment of staff can be improved both for those being redeployed and those making the redeployment decisions.


Subject(s)
Hospitals, University , Humans
7.
Sci Rep ; 12(1): 17726, 2022 Oct 22.
Article in English | MEDLINE | ID: covidwho-2087292

ABSTRACT

Reliable forecast of COVID-19 hospital admissions in near-term horizons can help enable effective resource management which is vital in reducing pressure from healthcare services. The use of mobile network data has come to attention in response to COVID-19 pandemic leveraged on their ability in capturing people social behavior. Crucially, we show that there are latent features in irreversibly anonymized and aggregated mobile network data that carry useful information in relation to the spread of SARS-CoV-2 virus. We describe development of the forecast models using such features for prediction of COVID-19 hospital admissions in near-term horizons (21 days). In a case study, we verified the approach for two hospitals in Sweden, Sahlgrenska University Hospital and Södra Älvsborgs Hospital, working closely with the experts engaged in the hospital resource planning. Importantly, the results of the forecast models were used in year 2021 by logisticians at the hospitals as one of the main inputs for their decisions regarding resource management.


Subject(s)
COVID-19 , Models, Theoretical , Humans , COVID-19/epidemiology , Hospitalization , Hospitals, University , Pandemics , SARS-CoV-2
8.
J Prev Med Hyg ; 63(2): E325-E330, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-2081075

ABSTRACT

Introduction: This study aimed to examine the trends in patient consultations for three major diseases (cancer, heart disease, and stroke) at Showa University Hospital, Japan during the state of emergency for the Coronavirus 2019 (COVID-19) pandemic. Methods: The present study was a retrospective and descriptive study of Showa University Hospital in Tokyo, Japan. Subjects were patients who had received medical treatment at Showa University Hospital and were diagnosed from 2017 to 2020. To examine the impact of the state of emergency, the number visits to hospital by the top three causes of death or other diseases were summarised from 21 weeks of data, from week 8 to week 28, for each year. Results: Compared to the average of the previous 3 years, a comparison of the three periods before and after the state of emergency showed a V-shaped curve in 2020, with a large drop in the number of cancer patients during the state of emergency, both from within Tokyo and from outside the city. Conclusions: This study showed a long-term decrease in cancer patient visits to Showa University Hospital since the beginning of the COVID-19 pandemic compared to the previous 3 years. It is also possible that medical care that would have been available may not have been provided due to the state of emergency, so it is necessary to follow up patients while keeping a close eye on measures other than infectious diseases.


Subject(s)
COVID-19 , Pandemics , COVID-19/epidemiology , Emergency Service, Hospital , Hospitals, University , Humans , Japan/epidemiology , Retrospective Studies
9.
Medicine (Baltimore) ; 101(41): e30976, 2022 Oct 14.
Article in English | MEDLINE | ID: covidwho-2077956

ABSTRACT

AIM: Vaccination against SARS-CoV2 has been proposed as a fundamental element for the control of the pandemic. This study aimed to describe the suspected adverse reactions (ADR) reported by vaccinated hospital workers. METHODS: A descriptive study of suspected ADR was conducted between January and March 2021. The suspected ADR were identified using a specifically designed electronic form and spontaneous reporting. Data were also collected regarding the characteristics of the professionals, vaccine administered, severity, and outcome of ADR. RESULTS: 8169 professionals received 2 doses of SARS-CoV2 vaccine (6672 Comirnaty® and 1497 Spikevax®) and 894 reports of suspected ADR were reported (762 for Comirnaty® and 132 for Spikevax®), resulting in a cumulative ADR incidence of 10.94% (95%CI: 10.27-11.62). The majority of ADR were reported only after the second dose, 497 (56.2%), while 211 (23.6%) were reported only after the first dose and 186 (21%) after both doses. The symptoms were mostly mild, did not require medical assistance, and disappeared within approximately 3 days. One hundred and seventeen professionals had a history of COVID-19 infection. These studies reported, statistically significant, more suspected ADR after the first dose (42.7%) than those with no history of COVID-19 (20.7%). Among professionals, more ADR occurred after the first dose with the Spikevax® vaccine (41.6%) than with the Comirnaty® vaccine (20.5%). CONCLUSION: The majority of suspected ADR reported were described in the summary of product characteristics (SmPC). Professionals with a history of COVID-19 reported more suspected ADR after the first dose than did those without a history.


Subject(s)
COVID-19 , Vaccines , COVID-19/epidemiology , COVID-19/prevention & control , Hospitals, University , Humans , Immunization , RNA, Viral , SARS-CoV-2 , Vaccination
10.
Int J Environ Res Public Health ; 19(19)2022 Oct 03.
Article in English | MEDLINE | ID: covidwho-2066028

ABSTRACT

The aim of this study was to assess prevalence and associated risk factors of burnout syndrome among healthcare workers (HCWs), especially among nurses during the pandemic of COVID-19. The sample of the cross-sectional study consists of 201 employees of University Hospital. The Maslach Burnout Inventory-Human Services Survey for Medical Personnel (MBI-HSS MP) was used. An anonymous questionnaire was administered between 15 January and 1 February 2022. The majority of HCWs were female (79.4%). Overall, 69.2% displayed high levels of emotional exhaustion (EE), 35.3% high levels of depersonalization (DP), and 35.5% low levels of personal accomplishment (PA). Burnout was frequent among staff working in COVID units (EE 76.1%; DP 47.8%; and PA 46.7%). Burnout in EE and DP (70.7% and 36.6%, respectively) significantly prevailed in nurses working in COVID-19 units compared to non-frontline nurses (59.6 and 21.1%, respectively). Prevalence of burnout in PA was significantly higher in nurses working in non-COVID-19 units (47.4% vs. 29.3%). It is crucial to pay attention to the high prevalence of burnout syndrome in HCWs, especially in nurses, and not only in the frontline.


Subject(s)
Burnout, Professional , COVID-19 , Burnout, Professional/epidemiology , Burnout, Professional/psychology , COVID-19/epidemiology , Cross-Sectional Studies , Female , Hospitals, University , Humans , Male , Prevalence , Surveys and Questionnaires
11.
Sci Rep ; 12(1): 15606, 2022 10 07.
Article in English | MEDLINE | ID: covidwho-2062249

ABSTRACT

Scarce data have been reported about cellular immunity and longevity for different COVID-19 vaccination schedules. We carried out a prospective study enrolling 709 healthcare workers receiving two doses of mRNA-1273, BNT162b2, ChAdOx1, ChAdOx1/BNT162b2 or ChAdOx1 single dose to compare humoral and cellular immunogenicity across 9 months. Higher SARS-CoV-2 spike antibody levels were observed among individuals with hybrid immunity with one dose of any vaccine in comparison to uninfected individuals receiving two doses (mRNA-1273: 20,145 vs 4295 U/mL; BNT162b2: 15,659 vs 1959 U/mL; ChAdOx1: 5344 vs 2230 U/mL), except for ChAdOx1/BNT162b2 heterologous schedule (12,380 U/mL). Naturally infected individuals did not increase substantially the titers after the second dose and showed higher levels throughout the 9 months follow-up. The mean elimination half-life of antibodies among COVID-19 naïve participants was 98, 111, 60 and 36 days, for mRNA-1273, BNT162b2, ChAdOx1/ChAdOx1 and ChAdOx1/BNT162b2, respectively. Cellular immunity was preserved in 96%, 98%, 88% and 92% of uninfected individuals who received mRNA-1273, BNT162b2, ChAdOx1/ChAdOx1 and ChAdOx1/BNT162b2 after 6/9 months. Individuals with specific T cells showed robust long lasting protection, especially when m-RNA based vaccines are inoculated. These data may influence the validity of the vaccination passport and the need for booster vaccinations.


Subject(s)
COVID-19 Vaccines , COVID-19 , 2019-nCoV Vaccine mRNA-1273 , Antibodies, Viral , BNT162 Vaccine , COVID-19/prevention & control , Hospitals, University , Humans , Immunity, Cellular , Prospective Studies , RNA , SARS-CoV-2 , Spain , Vaccination
12.
Tunis Med ; 100(5): 374-383, 2022.
Article in English | MEDLINE | ID: covidwho-2058487

ABSTRACT

BACKGROUND: The analysis of the clinical and radiological characteristics of COVID-19 patients around the world observed a rich semiology, different from one country to another, and within the same country. AIM: To analyze the clinical, computed tomography (CT) features, and the outcome of patients suspected of COVID-19 hospitalized in a COVID-19 unit of Oran university hospital (Algeria). METHODS: We collected retrospectively the files of patients suspected of COVID-19 admitted in a COVID-19 unit during July 2020. Data were collected on standardized questionnaire with prior coding of parameters. Patients were admitted according to a triage based on their clinical situation and the chest CT aspects suggestive of COVID-19. Two physicians reviewed the high-resolution CT (HR-CT) images independently, and discrepancies were resolved by consensus with the input of two others experimented physicians. RESULTS: 112 patients (64% males, median age: 68 (18-88) years) were included. The main symptoms were dyspnea (51.7%), cough (34%), fatigue (14%). Almost the half (49.1%) of patients had hypoxemia. The HR-CT findings were typical of COVID-19 in 96% of patients. Although 61% of patients had favorable prognosis, mortality rate was 30%. Mutlivariate analysis of risk factors for death showed that patients aged > 60 years had a 4-fold risk of death (95% confidence interval: [1.27-12.58], p=0.018). CONCLUSION: Dyspnea, cough and fatigue were predominant symptoms, moderate and severe COVID-19 characterized our patients. Age > 60 years was a major risk factor for the deaths of our patients.


Subject(s)
COVID-19 , Aged , Algeria/epidemiology , COVID-19/diagnostic imaging , COVID-19/epidemiology , Cough , Dyspnea , Fatigue , Female , Hospitals, University , Humans , Male , Retrospective Studies , SARS-CoV-2 , Tomography, X-Ray Computed/methods
13.
PLoS One ; 17(8): e0269562, 2022.
Article in English | MEDLINE | ID: covidwho-2054308

ABSTRACT

PURPOSE: The COVID-19 pandemic has imposed severe challenges on medical education at German university hospitals. In this first German nationwide expert survey, we addressed the responsible university teaching coordinators in obstetrics and gynecology departments and investigated their experiences during the pandemic as well as their opinions on future developments, especially with regard to the broader implementation of e-learning in the standard curriculum. METHODS: The questionnaire included 42 items and was disseminated among teaching coordinators at all 41 departments of obstetrics and gynecology at German university hospitals via an email that included a weblink to the online survey provider. Responses were collected between 19 April and 7 June 2021. RESULTS: In total, 30 responses were collected from 41 departments across Germany and their respective teaching coordinators in obstetrics and gynecology. The general opinion of the medical teaching provided during the pandemic was positive, whereas the teaching quality in practical skills was considered inferior and not equivalent to the standard face-to-face curriculum. Lectures and seminars had to be substituted by remote-learning alternatives, while clinical clerkships were reduced in length and provided less patient contact. Students in their final year experienced only a few differences in the clinical and teaching routine. Teaching coordinators in obstetrics and gynecology stated that they intend to incorporate more e-learning into the curriculum in the future. CONCLUSION: The medical educators' views presented here may help to complement the already-thoroughly investigated experiences of students under the restrictions of the COVID-19 pandemic. Medical educators in obstetrics and gynecology at German university hospitals have successfully established online and hybrid teaching alternatives to their standard face-to-face courses. Building on recent experiences, digitalization could help to improve future medical education.


Subject(s)
COVID-19 , Education, Medical, Undergraduate , Education, Medical , Gynecology , Obstetrics , Students, Medical , COVID-19/epidemiology , Female , Gynecology/education , Hospitals, University , Humans , Obstetrics/education , Pandemics , Pregnancy , Surveys and Questionnaires , Teaching
14.
Medicine (Baltimore) ; 101(38): e30837, 2022 Sep 23.
Article in English | MEDLINE | ID: covidwho-2042664

ABSTRACT

Globally, healthcare workers (HCWs) have a high risk of SARS-CoV-2 infection, but less is known about healthcare workers in Thailand. We estimated the prevalence and risk factors for COVID-19 among HCWs in Bangkok, Thailand. A retrospective cohort study was conducted at a large tertiary care academic hospital in Thailand from May 2020 to May 2021. HCWs that presented with fever and/or acute respiratory tract symptoms who tested with RT-PCR were identified, and their clinical data were collected. There were 1432 HCWs with fever and/or acute respiratory tract symptoms during May 2020 and May 2021. A total of 167 patients were front-line HCWs and 1265 were non-front-line HCWs. Sixty HCWs (4.2%) developed COVID-19; 2 were front-line and 58 were non-front-line HCWs. The prevalence of COVID-19 in front-line HCWs was 1.7% (2/167), and 4.6% (58/1265) in non-front-line HCWs (P = .04). In addition, non-front-line HCWs, non-medical staffs, history of contact with a confirmed COVID-19 case at home/family, unvaccinated status, fair compliance to personal protective equipment (PPE) standard, and initial presentation with pneumonia were significantly more common in HCWs with COVID-19 than those without COVID-19 (P < .05). Front-line HCWs, history of contact with a confirmed COVID-19 case at the clinical care areas in the hospital, vaccinated status, good compliance to PPE standards, and initial presentation with upper respiratory infection were significantly more common in HCWs without COVID-19 than those with COVID-19 (P < .05). Multivariate analysis revealed history of exposure with confirmed COVID-19 case at home or in family, unvaccinated status, non-frontline-HCWs, non-medical staffs, and fair compliance to PPE standard to be independent factors associated with COVID-19 in HCWs. COVID-19 was more common in non-front-line HCWs at this tertiary hospital. Thai guidelines on infection prevention and control for COVID-19 seem to be effective in preventing SARS-CoV-2 transmission. Therefore, the adherence to these recommendations should be encouraged.


Subject(s)
COVID-19 , COVID-19/epidemiology , Health Personnel , Hospitals, University , Humans , Prevalence , Retrospective Studies , SARS-CoV-2 , Thailand/epidemiology
15.
PLoS One ; 17(9): e0274484, 2022.
Article in English | MEDLINE | ID: covidwho-2039417

ABSTRACT

This study aimed to determine the cumulative incidence, prevalence, and seroconversion of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and its associated factors among healthcare workers (HCWs) of a University Hospital in Bogotá, Colombia. An ambispective cohort was established from March 2020 to February 2021. From November 2020 to February 2021, SARS-CoV-2 antibodies were measured on two occasions 14-90 days apart to determine seroprevalence and seroconversion. We used multivariate log-binomial regression to evaluate factors associated with SARS-CoV-2 infection. Among 2,597 HCWs, the cumulative incidence of infection was 35.7%, and seroprevalence was 21.5%. A reduced risk of infection was observed among those aged 35-44 and ≥45 years (adjusted relative risks [aRRs], 0.84 and 0.83, respectively), physicians (aRR, 0.77), those wearing N95 respirators (aRR, 0.82) and working remotely (aRR, 0.74). Being overweight (aRR, 1.18) or obese (aRR, 1.24); being a nurse or nurse assistant (aRR, 1.20); working in the emergency room (aRR, 1.45), general wards (aRR, 1.45), intensive care unit (aRR, 1.34), or COVID-19 areas (aRR, 1.17); and close contact with COVID-19 cases (aRR, 1.47) increased the risk of infection. The incidence of SARS-CoV-2 infection found in this study reflects the dynamics of the first year of the pandemic in Bogotá. A high burden of infection calls for strengthening prevention and screening measures for HCWs, focusing especially on those at high risk.


Subject(s)
COVID-19 , COVID-19/epidemiology , Colombia/epidemiology , Health Personnel , Hospitals, University , Humans , Incidence , Prevalence , SARS-CoV-2 , Seroconversion , Seroepidemiologic Studies
16.
J Hosp Infect ; 128: 74-79, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2028204

ABSTRACT

BACKGROUND: Transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) can occur through direct, indirect, or close contact with infected people. However, the extent of environmental contamination is unknown. The nature of the relation between patients' symptoms and SARS-CoV-2 environmental shedding remains unclear. The aim of this study was to assess the relationship between patient coronavirus disease 2019 (COVID-19) status and environmental contamination. METHODS: Between May and November 2020, environmental swabs were taken before and after room disinfection at day 7 after symptom onset in a cohort of patients clinically or biologically diagnosed with COVID-19. Twelve surfaces per room were collected in 13 rooms. Sample analysis was performed by reverse transcription polymerase chain reaction (RT-PCR) for SARS-CoV-2 detection [SARS-CoV-2 R-Gene (biomérieux, Marcy l'Etoile, France)]. Clinical data (day of illness, symptoms, RT-PCR results) was collected from the clinical software. RESULTS: Five medical units were included in the study. Of 156 samples collected in 13 rooms, five rooms (38.5%) presented 11 SARS-CoV-2-positive samples. These positive samples were detected on eight different surfaces. There was no association between detection of SARS-CoV-2 and patient age (P=1) or patient symptoms (P=0.3). CONCLUSION: Viral shedding during COVID-19 appears to be unrelated to the presence of symptoms, patient age, and low-value cycle threshold of patient's test. This study supports the evidence for the environmental shedding of SARS-CoV-2 until at least 7 days after symptom onset. It emphasizes the need for strict compliance with contact precautions, hand hygiene, the correct use of personal protective equipment and room disinfection for the routine care of patients with COVID-19.


Subject(s)
COVID-19 , SARS-CoV-2 , COVID-19/diagnosis , Hospitals, University , Humans , Infection Control , Personal Protective Equipment
17.
PLoS One ; 17(7): e0271271, 2022.
Article in English | MEDLINE | ID: covidwho-2021869

ABSTRACT

BACKGROUND: In pandemic COVID-19 (coronavirus disease 2019), the prognosis of patients has been determined using clinical data and CT (computed tomography) scans, but it is still unclear whether chest CT characteristics are correlated to COVID-19 severity. AIM: To explore the potential association between clinical data and 25-point CT score and investigate their predictive significance in COVID-19-positive patients at Fayoum University Hospital in Egypt. METHODS: This study was conducted on 252 Egyptian COVID-19 patients at Fayoum University Hospital in Egypt. The patients were classified into two groups: a mild group (174 patients) and a severe group (78 patients). The results of clinical laboratory data, and CT scans of severe and mild patients, were collected, analyzed, and compared. RESULTS: The severe group show high significance levels of CRP, alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatinine, urea, ferritin, lactate dehydrogenase (LDH), neutrophil percent, and heart rate (HR) than the mild group. Lymphopenia, hypoalbuminemia, hypocalcemia, and decreased oxygen saturation (SpO2) were the most observed abnormalities in severe COVID-19 patients. Lymphopenia, low SpO2 and albumin levels, elevated serum LDH, ferritin, urea, and CRP levels were found to be significantly correlated with severity CT score (P<0.0001). CONCLUSION: The clinical severity of COVID-19 and the CT score are highly correlated. Our findings indicate that the CT scoring system can help to predict COVID-19 disease outcomes and has a strong correlation with clinical laboratory testing.


Subject(s)
COVID-19 , COVID-19/diagnostic imaging , Egypt/epidemiology , Ferritins , Hospitals, University , Humans , Lymphopenia , Retrospective Studies , SARS-CoV-2 , Tomography, X-Ray Computed , Urea
18.
PLoS One ; 17(6): e0267835, 2022.
Article in English | MEDLINE | ID: covidwho-2021713

ABSTRACT

BACKGROUND: Acute respiratory distress syndrome is a life-threatening condition that has a significant effect on the occurrence of morbidity and mortality among patients with severe Coronavirus disease 2019 (COVID-19). To the best of researchers' knowledge, there is no Study on ARDS of COVID-19 in Ethiopia. Therefore, this study aimed to identify the prevalence of ARDS and associated factors among severe COVID-19 patients at Wollega University Referral Hospital. METHODS: An institution-based retrospective cross-sectional study was conducted from September 20, 2020, to June 10, 2021. Real-Time Reverse transcription-polymerase Chain Reaction (rRT-PCR) test was used to test Patients for COVID-19. Epi-data version 3.2 was used for data entry, and the final data analysis was through STATA version 14. After checking the assumption P-value<0.25 in the bivariable analysis was used to select a candidate variable for multi-variable analysis, and a p-value of <0.05 was used to declare statistical significance. RESULTS: In this study, the prevalence of ARDS was 32%. Almost all the patients had the clinical feature of cough (93.7%), followed by shortness of breath (79.9%), fever (77.7%), and headache (67%). Age older than 65 years (AOR = 3.35, 95%CI = 1.31, 8.55), male gender (AOR = 5.63, 95%CI = 2.15, 14.77), and low oxygen saturation level (AOR = 4.60, 95%CI = 1.15, 18.35) were the independent predictors of ARDS among severe COVID-19 patients. CONCLUSION: The prevalence of ARDS among patients with severe COVID-19 was high in the study area. Therefore, elders and patients with critical conditions (low oxygen saturation) better to get special attention during COVID-19 case management to enhance good care and monitoring of the patients.


Subject(s)
COVID-19 , Respiratory Distress Syndrome , Aged , COVID-19/complications , COVID-19/epidemiology , Cross-Sectional Studies , Ethiopia/epidemiology , Hospitals, University , Humans , Male , Referral and Consultation , Respiratory Distress Syndrome/epidemiology , Retrospective Studies , SARS-CoV-2 , Universities
19.
Sci Rep ; 12(1): 4109, 2022 03 08.
Article in English | MEDLINE | ID: covidwho-2004793

ABSTRACT

Preeclampsia and cardiovascular disease (CVD) share multiple features and risk factors. Circulating angiotensin-converting enzyme 2 (ACE2) is increased in CVD and mediates SARS-CoV-2 entry into host cells, causing COVID-19 infection. The role of ACE2 in preeclampsia pathophysiology is unknown. We hypothesized that circulating ACE2 is increased in mid-pregnancy in women later developing preeclampsia. We included 296 women later developing preeclampsia (cases) and 333 women with a continuous healthy pregnancy (controls). Circulating ACE2 was measured with an immunoassay based on proximity extension assay technology, with levels being expressed as relative quantification on a log2 scale. Median (interquartile range) ACE2 levels were higher in cases than in controls; 3.84 (3.50-4.24) vs. 3.72 (3.45-4.04), p = 0.002. Adjusted logistic regression models showed a 60% increased risk for later development of preeclampsia with one unit elevation of ACE2 (adjusted odds ratio (aOR) 1.60, 95% confidence intervals (CI) 1.17-2.18). Preterm preeclampsia (diagnosis before 37 gestational weeks, n = 97) seemed to have a stronger ACE2 association than term preeclampsia, n = 199 (aORs, 95% Cis 2.14, 1.15-3.96 and 1.52, 1.04-2.23, respectively). Circulating ACE2 is increased at mid-pregnancy in women later developing preeclampsia, particularly preterm preeclampsia. Thus, our finding indicates a partly shared pathophysiological pathway between preeclampsia and CVD.


Subject(s)
Angiotensin-Converting Enzyme 2/blood , Pre-Eclampsia/diagnosis , Adult , Body Mass Index , Cardiovascular Diseases/complications , Cardiovascular Diseases/pathology , Case-Control Studies , Female , Gestational Age , Hospitals, University , Humans , Logistic Models , Odds Ratio , Pre-Eclampsia/pathology , Pregnancy , Risk Factors , Sweden
20.
J Stomatol Oral Maxillofac Surg ; 123(5): e229-e232, 2022 10.
Article in English | MEDLINE | ID: covidwho-2004270

ABSTRACT

PURPOSE: The aim of this retrospective case study was to evaluate the impact of the COVID-19 confinement on consultation number and nature of dental emergencies. MATERIALS AND METHODS: The investigators implemented a retrospective case-control study and enrolled a sample of patients who presented to the University Hospital of Geneva for dental emergencies during the COVID-19 confinement from March 16 to April 26, 2020. They were compared to a matched case-control group treated in 2018 and 2019. The predictor variable was the COVID-19 confinement. The outcome variables were consultation number and nature of dental emergencies. Other study variables included age, gender, socio-economic status, delay from symptoms to consultation and type of treatment. Descriptive and bivariate statistics were computed and significance level was set at ≤ 0.05. RESULTS: The study sample was composed of 1104 patients, with 386 in the case-study and 718 in the control group. No significant change in patient numbers was observed. In the case-study group patients were significantly younger (P= 0.004), had a significantly higher proportion of acute toothache and dental infections (P= 0.01), the main reason for consultation was pain or swelling (P= 0.01) and the delay from first symptoms to consultation was shorter compared to the controls (P=0.008). CONCLUSION: The COVID-19 confinement had no impact on the consultation number of dental emergencies. However, changes in emergency type were noted, with an increase in acute toothaches and infections and patients waited less time between the onset of symptoms to consultation.


Subject(s)
COVID-19 , COVID-19/epidemiology , Case-Control Studies , Communicable Disease Control , Dental Clinics , Emergencies , Hospitals, University , Humans , Retrospective Studies , Toothache/therapy
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