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1.
Antimicrob Resist Infect Control ; 10(1): 156, 2021 11 04.
Article in English | MEDLINE | ID: covidwho-1503693

ABSTRACT

BACKGROUND: The effect of eye protection to prevent SARS-CoV-2 infection in the real-world remains uncertain. We aimed to synthesize all available research on the potential impact of eye protection on transmission of SARS-CoV-2. METHODS: We searched PROSPERO, PubMed, Embase, The Cochrane Library for clinical trials and comparative observational studies in CENTRAL, and Europe PMC for pre-prints. We included studies that reported sufficient data to estimate the effect of any form of eye protection including face shields and variants, goggles, and glasses, on subsequent confirmed infection with SARS-CoV-2. RESULTS: We screened 898 articles and included 6 reports of 5 observational studies from 4 countries (USA, India, Columbia, and United Kingdom) that tested face shields, goggles, and wraparound eyewear on 7567 healthcare workers. The three before-and-after and one retrospective cohort studies showed statistically significant and substantial reductions in SARS-CoV-2 infections favouring eye protection with odds ratios ranging from 0.04 to 0.6, corresponding to relative risk reductions of 96% to 40%. These reductions were not explained by changes in the community rates. However, the one case-control study reported odds ratio favouring no eye protection (OR 1.7, 95% CI 0.99, 3.0). The high heterogeneity between studies precluded any meaningful meta-analysis. None of the studies adjusted for potential confounders such as other protective behaviours, thus increasing the risk of bias, and decreasing the certainty of evidence to very low. CONCLUSIONS: Current studies suggest that eye protection may play a role in prevention of SARS-CoV-2 infection in healthcare workers. However, robust comparative trials are needed to clearly determine effectiveness of eye protections and wearability issues in both healthcare and general populations.


Subject(s)
COVID-19/prevention & control , Eye Protective Devices , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Pandemics/prevention & control , COVID-19/transmission , Communicable Disease Control , Humans , SARS-CoV-2
2.
MMWR Morb Mortal Wkly Rep ; 69(35): 1221-1226, 2020 Sep 04.
Article in English | MEDLINE | ID: covidwho-1389852

ABSTRACT

Health care personnel (HCP) caring for patients with coronavirus disease 2019 (COVID-19) might be at high risk for contracting SARS-CoV-2, the virus that causes COVID-19. Understanding the prevalence of and factors associated with SARS-CoV-2 infection among frontline HCP who care for COVID-19 patients are important for protecting both HCP and their patients. During April 3-June 19, 2020, serum specimens were collected from a convenience sample of frontline HCP who worked with COVID-19 patients at 13 geographically diverse academic medical centers in the United States, and specimens were tested for antibodies to SARS-CoV-2. Participants were asked about potential symptoms of COVID-19 experienced since February 1, 2020, previous testing for acute SARS-CoV-2 infection, and their use of personal protective equipment (PPE) in the past week. Among 3,248 participants, 194 (6.0%) had positive test results for SARS-CoV-2 antibodies. Seroprevalence by hospital ranged from 0.8% to 31.2% (median = 3.6%). Among the 194 seropositive participants, 56 (29%) reported no symptoms since February 1, 2020, 86 (44%) did not believe that they previously had COVID-19, and 133 (69%) did not report a previous COVID-19 diagnosis. Seroprevalence was lower among personnel who reported always wearing a face covering (defined in this study as a surgical mask, N95 respirator, or powered air purifying respirator [PAPR]) while caring for patients (5.6%), compared with that among those who did not (9.0%) (p = 0.012). Consistent with persons in the general population with SARS-CoV-2 infection, many frontline HCP with SARS-CoV-2 infection might be asymptomatic or minimally symptomatic during infection, and infection might be unrecognized. Enhanced screening, including frequent testing of frontline HCP, and universal use of face coverings in hospitals are two strategies that could reduce SARS-CoV-2 transmission.


Subject(s)
Antibodies, Viral/blood , Betacoronavirus/immunology , Coronavirus Infections/epidemiology , Personnel, Hospital/statistics & numerical data , Pneumonia, Viral/epidemiology , Academic Medical Centers , Adult , Asymptomatic Diseases , COVID-19 , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Cross Infection/prevention & control , Female , Humans , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Male , Middle Aged , Pandemics/prevention & control , Personal Protective Equipment/statistics & numerical data , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , SARS-CoV-2 , Seroepidemiologic Studies , United States/epidemiology
4.
Stroke Vasc Neurol ; 5(2): 180-184, 2020 06.
Article in English | MEDLINE | ID: covidwho-1318199

ABSTRACT

BACKGROUND: The COVID-19 pandemic has already stressed the healthcare system in the world. Many hospitals have been overwhelmed by the large number of patients with COVID-19. Due to the shortage of equipment and personnel and the highly contagious nature of COVID-19, many other healthcare services are on hold. However, at Beijing Tiantan Hospital, a rapid response system has been in place so that routine care is not interrupted. We, therefore, would like to share our hospital-wide prevention and management policy during this pandemic to help other healthcare systems to function in this crisis. METHOD: Tiantan hospital is one of the leading neuroscience institutions in the world. With 1650 beds, its annual inpatient admission exceeds 30 000 patients. Its COVID-19 rapid response policy was reviewed for its functionality. RESULTS: There are nine key components of this policy: an incident management system; a comprehensive infection prevention and control, outpatient triage and flow system; a designated fever clinic; patient screening and administration; optimised surgical operations, enhanced nucleic acid testing; screening of returning employees; and a supervision and feedback system. In addition, a specific protocol was designed for treating patients with acute stroke. CONCLUSION: A comprehensive policy is helpful to protect the employee from infection and to provide quality and uninterrupted care to all who need these, including patients with acute ischaemic stroke.


Subject(s)
Betacoronavirus/pathogenicity , Brain Ischemia/therapy , Coronavirus Infections/therapy , Infection Control/methods , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Occupational Exposure/prevention & control , Pneumonia, Viral/therapy , Stroke/therapy , Beijing , Brain Ischemia/diagnosis , COVID-19 , Coronavirus Infections/diagnosis , Coronavirus Infections/transmission , Coronavirus Infections/virology , Critical Pathways , Delivery of Health Care, Integrated , Health Services Needs and Demand , Host-Pathogen Interactions , Humans , Needs Assessment , Occupational Health , Pandemics , Patient Safety , Pneumonia, Viral/diagnosis , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , SARS-CoV-2 , Stroke/diagnosis , Triage
5.
Antimicrob Resist Infect Control ; 10(1): 102, 2021 07 02.
Article in English | MEDLINE | ID: covidwho-1295486

ABSTRACT

INTRODUCTION: In late 2019, a novel coronavirus was detected in China. Supported by its respiratory transmissibility, even by people infected without symptomatic disease, this coronavirus soon began to rapidly spread worldwide. BACKGROUND: Many countries have implemented different infection control and containment strategies due to ongoing community transmission. In this context, contact tracing as well as adequate testing and consequent quarantining of high-risk contacts play leading roles in containing the virus by interrupting infection chains. This approach is especially important in the hospital setting where contacts often cannot be avoided and physical distance is usually not possible. Furthermore, health care workers (HCWs) usually have contact with a variety of vulnerable people, making it essential to identify infections among hospital employees as soon as possible to interrupt the rapid spread of SARS-CoV-2 in the facility. Several electronic tools for contact tracing, such as specific software or mobile phone apps, are available for the public health sector. In contrast, contact tracing in hospitals often has to be carried out without helpful electronic tools, and an enormous amount of human resources is typically required. AIM: For rapid contact tracing and effective infection control and management measures for HCWs in hospitals, adapted technical solutions are needed. METHODS: In this study, we report the development of our containment strategy to a web-based contact tracing and rapid point-of-care-testing workflow. RESULTS/CONCLUSION: Our workflow yielded efficient control of the rapidly evolving situation during the SARS-CoV-2 pandemic from May 2020 until January 2021 at a German University Hospital.


Subject(s)
COVID-19 Nucleic Acid Testing/methods , COVID-19/transmission , Computer Communication Networks , Contact Tracing/methods , Infectious Disease Transmission, Patient-to-Professional , Pandemics , Point-of-Care Testing , SARS-CoV-2 , COVID-19/epidemiology , Germany/epidemiology , Hospitals, University , Humans , Infection Control/methods , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Mobile Applications , Personnel, Hospital , Real-Time Polymerase Chain Reaction , Retrospective Studies , Seasons , Software , Workflow
6.
World Neurosurg ; 153: e187-e194, 2021 09.
Article in English | MEDLINE | ID: covidwho-1275762

ABSTRACT

OBJECTIVE: To assess organizational and technical difficulties of neurosurgical procedures during the coronavirus disease 2019 (COVID-19) pandemic and their possible impact on survival and functional outcome and to evaluate virological exposure risk of medical personnel. METHODS: Data for all urgent surgical procedures performed in the COVID-19 operating room were prospectively collected. Preoperative and postoperative variables included demographics, pathology, Karnofsky performance status (KPS) and neurological status at admission, type and duration of surgical procedures, length of stay, postoperative KPS and functional outcome comparison, and destination at discharge. We defined 5 classes of pathologies (traumatic, oncological, vascular, infection, hydrocephalus) and 4 surgical categories (burr hole, craniotomy, cerebrospinal fluid shunting, spine surgery). Postoperative SARS-CoV-2 infection was checked in all the operators. RESULTS: We identified 11 traumatic cases (44%), 4 infections (16%), 6 vascular events (24%), 2 hydrocephalus conditions (8%), and 2 oncological cases (8%). Surgical procedures included 11 burr holes (44%), 7 craniotomies (28%), 6 cerebrospinal fluid shunts (24%), and 1 spine surgery (4%). Mean patient age was 57.8 years. The most frequent clinical presentation was coma (44 cases). Mean KPS score at admission was 20 ± 10, mean surgery duration was 85 ± 63 minutes, and mean length of stay was 27 ± 12 days. Mean KPS score at discharge was 35 ± 25. Outcome comparison showed improvement in 16 patients. Four patients died. Mean follow-up was 6 ± 3 months. None of the operators developed postoperative SARS-CoV-2 infection. CONCLUSIONS: Standardized protocols are mandatory to guarantee a high standard of care for emergency and urgent surgeries during the COVID-19 pandemic. Personal protective equipment affects maneuverability, dexterity, and duration of interventions without affecting survival and functional outcome.


Subject(s)
COVID-19/prevention & control , COVID-19/transmission , Infection Control , Neurosurgical Procedures/mortality , Aged , Aged, 80 and over , COVID-19/epidemiology , COVID-19 Testing , Emergencies , Female , Humans , Infant , Infection Control/instrumentation , Infection Control/methods , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Italy/epidemiology , Length of Stay/statistics & numerical data , Male , Middle Aged , Operating Rooms/organization & administration , Pandemics , Perioperative Care , Personal Protective Equipment/adverse effects , Personal Protective Equipment/virology , Prospective Studies , SARS-CoV-2 , Survival Analysis , Treatment Outcome
7.
J Health Care Poor Underserved ; 32(2): 591-597, 2021.
Article in English | MEDLINE | ID: covidwho-1268209

ABSTRACT

Most people think that origami has little practical utility, but it has many applications, and this paper highlights particularly its usefulness in making face shields for the containment of COVID-19. The article presents an origami-based, do-it-yourself face shield that the end-user can make for personal use rather than commercial production.


Subject(s)
Masks , COVID-19/prevention & control , COVID-19/transmission , Equipment Design , Humans , Infectious Disease Transmission, Professional-to-Patient/prevention & control
9.
Asia Pac J Ophthalmol (Phila) ; 10(2): 142-145, 2021 Mar 23.
Article in English | MEDLINE | ID: covidwho-1165516

ABSTRACT

ABSTRACT: Ophthalmologists and patients have an inherent increased risk for transmission of SARS-CoV-2. The human ocular surface expresses receptors and enzymes facilitating transmission of SARS-CoV-2. Personal protective equipment alone provides incomplete protection. Adjunctive topical ocular, nasal, and oral antisepsis with povidone iodine bolsters personal protective equipment in prevention of provider-patient transmission of SARS-CoV-2 in ophthalmology.


Subject(s)
Anti-Infective Agents, Local/therapeutic use , COVID-19/transmission , Disinfection/methods , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Povidone-Iodine/therapeutic use , SARS-CoV-2 , Administration, Ophthalmic , Humans , Ophthalmic Solutions , Personal Protective Equipment , Physical Examination
10.
J Hosp Infect ; 111: 6-26, 2021 May.
Article in English | MEDLINE | ID: covidwho-1141983

ABSTRACT

BACKGROUND: There is general consensus that hand hygiene is the most effective way to prevent healthcare-associated infections. However, low rates of compliance amongst healthcare workers have been reported globally. The coronavirus disease 2019 pandemic has further emphasized the need for global improvement in hand hygiene compliance by healthcare workers. AIM: This comprehensive systematic review provides an up-to-date compilation of clinical trials, reported between 2014 and 2020, assessing hand hygiene interventions in order to inform healthcare leaders and practitioners regarding approaches to reduce healthcare-associated infections using hand hygiene. METHODS: CINAHL, Cochrane, EMbase, Medline, PubMed and Web of Science databases were searched for clinical trials published between March 2014 and December 2020 on the topic of hand hygiene compliance among healthcare workers. In total, 332 papers were identified from these searches, of which 57 studies met the inclusion criteria. FINDINGS: Forty-five of the 57 studies (79%) included in this review were conducted in Asia, Europe and the USA. The large majority of these clinical trials were conducted in acute care facilities, including hospital wards and intensive care facilities. Nurses represented the largest group of healthcare workers studied (44 studies, 77%), followed by physicians (41 studies, 72%). Thirty-six studies (63%) adopted the World Health Organization's multi-modal framework or a variation of this framework, and many of them recorded hand hygiene opportunities at each of the 'Five Moments'. However, recording of hand hygiene technique was not common. CONCLUSION: Both single intervention and multi-modal hand hygiene strategies can achieve modest-to-moderate improvements in hand hygiene compliance among healthcare workers.


Subject(s)
COVID-19/prevention & control , Cross Infection/prevention & control , Guideline Adherence/trends , Hand Hygiene/standards , Hand Hygiene/trends , Health Personnel/psychology , Health Personnel/statistics & numerical data , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Adult , Female , Forecasting , Guideline Adherence/statistics & numerical data , Hand Hygiene/statistics & numerical data , Humans , Male , Middle Aged , SARS-CoV-2
11.
J Healthc Qual Res ; 36(3): 136-141, 2021.
Article in Spanish | MEDLINE | ID: covidwho-1137459

ABSTRACT

INTRODUCTION: During the SARS-CoV-2 pandemic, elective surgical activity was reduced to a minimum. As both the number of cases and the hospitalization needs for this pathology decreased, we thought it appropriate to progressively recover scheduled surgical activity. This work describes how, even with the current alarm state, we were able to practically normalize this activity in a few weeks. METHODS: Two weeks before the intervention, the patients included in the waiting lists were contacted by telephone. After checking their health status and expressing their desire to undergo surgery, they were provided with recommendations to decrease the risk of coronavirus infection. Likewise, an exclusive circuit was established to carry out, 48 hours before the intervention, the detection of SARS-CoV-2 by means of exudates nasopharyngeal PCR. The results were evaluated by each surgical service and the anesthesiology service. In addition, asymptomatic Surgical Area professionals could undergo weekly screening for the early detection of coronavirus according to the recommendations of Occupational Health. RESULTS: In the midst of a pandemic, scheduled surgical activity was reduced by 85%. From the week of April 13, the operating rooms available were recovered, which allowed practically all surgical activity to be recovered the week of May 25. CONCLUSIONS: The creation of circuits and procedures to streamline surgical activity, still in full force of the state of alarm, has allowed us, in a few weeks, to recover almost all of it.


Subject(s)
COVID-19 , Elective Surgical Procedures , Hospitals, University/organization & administration , Pandemics , SARS-CoV-2 , Surgery Department, Hospital/organization & administration , Tertiary Care Centers/organization & administration , Anesthesiology/organization & administration , COVID-19/diagnosis , COVID-19/prevention & control , COVID-19/transmission , COVID-19 Nucleic Acid Testing , Cross Infection/prevention & control , Elective Surgical Procedures/statistics & numerical data , Hospitals, Urban/organization & administration , Humans , Infection Control/methods , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Mass Screening , Nasopharynx/virology , Operating Rooms/statistics & numerical data , Personnel, Hospital , SARS-CoV-2/isolation & purification , Spain , Time-to-Treatment , Waiting Lists
12.
Cir Cir ; 89(1): 4-11, 2021.
Article in English | MEDLINE | ID: covidwho-1077009

ABSTRACT

Background: The coronavirus disease 2019 (COVID-19) outbreak have major implications in conventional surgical practice. As the number of patients with this diagnosis is rising, the infection risk for the surgical staff will be higher. Few publications have addressed the surgical management of patients diagnosed with COVID-19. Objective: To assess recommendations for care of patients and surgical team during the COVID-19 pandemic. Method: MEDLINE, Embase and the Cochrane Database of Systematic Reviews (April 2020) were searched the key words "COVID-19", "PROTOCOL" and "SURGERY". Relevant recommendations, guidelines and cases series were checked for the most accurate information for apply to our center. Results: We found 379 papers that included the key words. A total of 25 papers were included in the manuscript based in the pertinence of the recommendations. Three major topics were selected: perioperative, intraoperative and postoperative. Conclusion: As an attempt to regulate the surgical team approach, we present recommendations to preserve patients and surgical staff safety with high quality standards of care through reproducible strategies applicable in most hospital centers.


Subject(s)
COVID-19/prevention & control , Cross Infection/prevention & control , Infection Control/methods , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Pandemics , SARS-CoV-2 , Aerosols , Air Pollution, Indoor , Appointments and Schedules , COVID-19/transmission , Disinfection/methods , Equipment Contamination/prevention & control , Humans , Mexico , Occupational Exposure , Operating Rooms , Patient Isolation , Perioperative Care , Personal Protective Equipment , Personnel, Hospital , Recovery Room , Sterilization/methods , Surgical Equipment
13.
Saudi Med J ; 42(2): 166-169, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1076930

ABSTRACT

OBJECTIVES: To avoid hospital spread of Coronavirus-2019 (COVID-19) and to analyze out of hospital outcomes after amputation. METHODS: Prospective analysis of data obtained from 60 diabetic patients in 2020 was performed at Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina. Personal protection equipment included double surgical mask, glasses, disposable surgical coats, and surgical masks for patients. Swabs were used to take samples from wounds. We randomly divided patients in 2 groups of 30 patients each. In pre-operative treatment, we used local anesthesia lidocaine hydrochloride 2% (Belupo, Koprivnica, Croatia) in group A and systemic analgesia intravenous tramadol chloride 100 mg intravenous (Krka, Novo Mesto, Slovenia) in group B. Wounds were surgically treated each day and heal spontaneously. Periodical control exams were performed. RESULTS: Wound healing did not present any statistically significant differences between groups (group A: 69±21.97 and B: 61±22.13 days, t=-1.22; p=0.11). No statistically significant differences (p<0.05) between groups A and B in wound healing regarding to gender or cigarette use was noted. CONCLUSION: No significant differences in amputation treatment between the 2 comparative groups were noted. No confirmed COVID-19 infections in medical staff who performed surgical interventions or in treated patients were detected.


Subject(s)
Amputation , COVID-19/prevention & control , Diabetic Foot/surgery , Infection Control/methods , Perioperative Care/methods , Bosnia and Herzegovina/epidemiology , COVID-19/complications , COVID-19/epidemiology , COVID-19/transmission , Diabetic Foot/complications , Female , Humans , Infection Control/instrumentation , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Male , Pandemics , Personal Protective Equipment , Prospective Studies , Treatment Outcome , Wound Healing
14.
Ann Ig ; 33(5): 410-425, 2021.
Article in English | MEDLINE | ID: covidwho-1076850

ABSTRACT

Methods: We hereby provide a systematic description of the response actions in which the public health residents' workforce was pivotal, in a large tertiary hospital. Background: The Coronavirus Disease 2019 pandemic has posed incredible challenges to healthcare workers worldwide. The residents have been affected by an almost complete upheaval of the previous setting of activities, with a near total focus on service during the peak of the emergency. In our Institution, residents in public health were extensively involved in leading activities in the management of Coronavirus Disease 2019 pandemic. Results: The key role played by residents in the response to Coronavirus Disease 2019 pandemic is highlighted by the diversity of contributions provided, from cooperation in the rearrangement of hospital paths for continuity of care, to establishing and running new services to support healthcare professionals. Overall, they constituted a workforce that turned essential in governing efficiently such a complex scenario. Conclusions: Despite the difficulties posed by the contingency and the sacrifice of many training activities, Coronavirus Disease 2019 pandemic turned out to be a unique opportunity of learning and measuring one's capabilities and limits in a context of absolute novelty and uncertainty.


Subject(s)
COVID-19/epidemiology , Internship and Residency , Pandemics , Public Health Administration , Public Health/education , SARS-CoV-2 , Asymptomatic Infections , COVID-19/diagnosis , COVID-19/prevention & control , COVID-19/therapy , COVID-19 Testing , Case Management/organization & administration , Emergency Medical Services/organization & administration , Emergency Medical Services/supply & distribution , Health Personnel , Health Services Needs and Demand , Humans , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Italy , Mass Screening , Outpatient Clinics, Hospital/organization & administration , Population Surveillance , Preoperative Care , Quarantine , Role , Self-Assessment , Software Design , Tertiary Care Centers/organization & administration , Workforce
15.
Arq. neuropsiquiatr ; 78(7): 430-439, July 2020. tab
Article in English | WHO COVID, LILACS (Americas) | ID: covidwho-1076298

ABSTRACT

ABSTRACT Background: The novel coronavirus disease 2019 (COVID-19) pandemic poses a potential threat to patients with autoimmune disorders, including multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD). Such patients are usually treated with immunomodulatory or immunosuppressive agents, which may tamper with the organism's normal response to infections. Currently, no consensus has been reached on how to manage MS and NMOSD patients during the pandemic. Objective: To discuss strategies to manage those patients. Methods: We focus on how to 1) reduce COVID-19 infection risk, such as social distancing, telemedicine, and wider interval between laboratory testing/imaging; 2) manage relapses, such as avoiding treatment of mild relapse and using oral steroids; 3) manage disease-modifying therapies, such as preference for drugs associated with lower infection risk (interferons, glatiramer, teriflunomide, and natalizumab) and extended-interval dosing of natalizumab, when safe; 4) individualize the chosen MS induction-therapy (anti-CD20 monoclonal antibodies, alemtuzumab, and cladribine); 5) manage NMOSD preventive therapies, including initial therapy selection and current treatment maintenance; 6) manage MS/NMOSD patients infected with COVID-19. Conclusions: In the future, real-world case series of MS/NMOSD patients infected with COVID-19 will help us define the best management strategies. For the time being, we rely on expert experience and guidance.


RESUMO Introdução: A mais recente pandemia causada pelo coronavírus SARS-CoV-2 (COVID-19, do inglês coronavirus disease 2019) representa uma ameaça potencial para pacientes com doenças autoimunes, incluindo esclerose múltipla (EM) e transtorno do espectro de neuromielite óptica (NMOSD, do inglês neuromyelitis optica spectrum disorders). Esses pacientes são geralmente tratados com medicamentos imunomoduladores ou imunossupressores que podem alterar a resposta normal do organismo a infecções. Até o momento, não há consenso sobre como o manejo dos pacientes com EM e NMOSD deve ser realizado durante a pandemia. Objetivo: Discutir estratégias para manejar esses pacientes. Métodos: Focamos em como 1) reduzir o risco de infecção por COVID-19, como distanciamento social, telemedicina e exames laboratoriais e de imagem em intervalos mais amplos; 2) manejo de surtos, incluindo evitar tratamento de surto leve e uso de corticoide oral; 3) gerenciar terapias modificadoras de doença, como a preferência por medicamentos associados a menor risco de infecção (interferons, glatirâmer, teriflunomida e natalizumabe) e infusão em intervalo estendido de natalizumabe, quando seguro; 4) individualizar a escolha da terapia de indução para EM (anticorpos monoclonais anti-CD20, alentuzumabe e cladribina); 5) manejar terapias preventivas de NMOSD, incluindo seleção inicial de terapia e manutenção do tratamento atual; 6) manejar pacientes com EM/NMOSD que foram infectados por COVID-19. Conclusão: No futuro, séries de casos de pacientes com MS/NMOSD infectados com COVID-19 nos ajudará a definir as melhores estratégias de manejo. Por enquanto, contamos com a experiência e orientação especializadas.


Subject(s)
Humans , Pneumonia, Viral/prevention & control , Neuromyelitis Optica/drug therapy , Coronavirus Infections/prevention & control , Coronavirus , Immunosuppressive Agents/therapeutic use , Multiple Sclerosis/drug therapy , Pneumonia, Viral/epidemiology , China/epidemiology , Risk , Neuromyelitis Optica/diagnosis , Telemedicine , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Coronavirus Infections , Coronavirus Infections/epidemiology , Disease Susceptibility , Pandemics , Betacoronavirus , Immunologic Factors/therapeutic use , Multiple Sclerosis/diagnosis
17.
J Surg Res ; 264: 30-36, 2021 08.
Article in English | MEDLINE | ID: covidwho-1065394

ABSTRACT

BACKGROUND: The onset of the COVID-19 pandemic led to the postponement of low-acuity surgical procedures in an effort to conserve resources and ensure patient safety. This study aimed to characterize patient-reported concerns about undergoing surgical procedures during the pandemic. METHODS: We administered a cross-sectional survey to patients who had their general and plastic surgical procedures postponed at the onset of the pandemic, asking about barriers to accessing surgical care. Questions addressed dependent care, transportation, employment and insurance status, as well as perceptions of and concerns about COVID-19. Mixed methods and inductive thematic analyses were conducted. RESULTS: One hundred thirty-five patients were interviewed. We identified the following patient concerns: contracting COVID-19 in the hospital (46%), being alone during hospitalization (40%), facing financial stressors (29%), organizing transportation (28%), experiencing changes to health insurance coverage (25%), and arranging care for dependents (18%). Nonwhite participants were 5 and 2.5 times more likely to have concerns about childcare and transportation, respectively. Perceptions of decreased hospital safety and the consequences of possible COVID-19 infection led to delay in rescheduling. Education about safety measures and communication about scheduling partially mitigated concerns about COVID-19. However, uncertainty about timeline for rescheduling and resolution of the pandemic contributed to ongoing concerns. CONCLUSIONS: Providing effective surgical care during this unprecedented time requires both awareness of societal shifts impacting surgical patients and system-level change to address new barriers to care. Eliciting patients' perspectives, adapting processes to address potential barriers, and effectively educating patients about institutional measures to minimize in-hospital transmission of COVID-19 should be integrated into surgical care.


Subject(s)
Appointments and Schedules , COVID-19/transmission , Elective Surgical Procedures/psychology , Fear , Health Services Accessibility/organization & administration , Adult , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/psychology , Cross-Sectional Studies , Elective Surgical Procedures/statistics & numerical data , Female , Health Services Accessibility/statistics & numerical data , Humans , Infection Control/organization & administration , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Male , Middle Aged , Pandemics/prevention & control , Pandemics/statistics & numerical data , Patient Education as Topic/organization & administration , Surgery Department, Hospital/organization & administration , Surveys and Questionnaires/statistics & numerical data , Uncertainty
18.
Transfus Clin Biol ; 28(1): 16-24, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1060273

ABSTRACT

BACKGROUND: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has spurred a global health crisis. The safety and supply of blood during this pandemic has been a concern of blood banks and transfusion services as it is expected to adversely affect blood system activities. We aim to assess the situation in the Eastern Mediterranean Region (EMR) during the first months of the pandemic. MATERIALS AND METHODS: A survey was designed to address blood supply, transfusion demand, and donor management during the coronavirus disease-19 (COVID-19) pandemic. Medical directors of different blood banks were invited to participate. RESULTS: A total of 16 centers participated with representation from 15/19 countries in the region. In total, 75% were from national blood banks. Most centres had a decrease in the blood supply, ranging from 26-50%. Representatives from 14 countries (93.3%) believed that public fear has contributed to a decrease in donations. Most centres (n=12, 75%) had a reduction in transfusion demand, while those who did not, reported heavy involvement in treating patients with underlying haemoglobinopathies and haematological malignancies. Half of the centres activated their contingency plans. Four centres had to alter the blood donor eligibility criteria to meet demands. All centres implemented donor deferral criteria in relation to SARS-CoV-2, but were variable in measures to mitigate the risk of donor and staff exposure. CONCLUSION: Blood services in the region faced variable degrees of blood shortages. We summarize lessons learnt during this pandemic for the blood banks to consider to plan, assess, and respond proportionately to future similar pandemics.


Subject(s)
Blood Banks/statistics & numerical data , Blood Donors/supply & distribution , Blood Transfusion/statistics & numerical data , COVID-19 , Pandemics , SARS-CoV-2 , Africa, Northern , Blood Banks/organization & administration , Blood Donors/psychology , COVID-19/prevention & control , Donor Selection/standards , Health Care Surveys , Hematologic Neoplasms/therapy , Hemoglobinopathies/therapy , Humans , Infection Control/organization & administration , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Mediterranean Region , Middle East , Pakistan , Professional-Patient Relations
19.
Rev Assoc Med Bras (1992) ; 66(Suppl 2): 102-105, 2020. graf
Article in English | WHO COVID, LILACS (Americas) | ID: covidwho-1043192

ABSTRACT

SUMMARY INTRODUCTION What has been published so far regarding safe methods to deal with chest tube insertion during COVID-19. METHODS A descriptive study of the literature available in the Medline/PubMed, Lilacs, Scopus databases and specialized books. The search was carried out using the terms "infectious diseases"; "COVID-19"; "Chest tubes". RESULTS This paper aggregates and consolidates some old concepts to new tactics to minimize the contamination of teams who deal with chest tubes, before, during, and after the procedure. CONCLUSIONS Health officials are under increasing pressure to control the spread of COVID-19, which is a very virulent disease. Our analysis brought together old rules against contamination along with new tactics for professionals who deal with chest drains in order to minimize the contamination of teams during the Pandemic.


Subject(s)
Humans , Pneumonia, Viral/prevention & control , Chest Tubes/adverse effects , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Coronavirus Infections/prevention & control , Personal Protective Equipment , Pneumonia, Viral/epidemiology , Coronavirus Infections , Coronavirus Infections/epidemiology , Pandemics , Betacoronavirus
20.
J Healthc Qual Res ; 36(3): 160-167, 2021.
Article in Spanish | MEDLINE | ID: covidwho-1039448

ABSTRACT

BACKGROUND: The interruption of surgical care in Spain caused by the pandemic must end. Recovery from this activity must be carried out on an elective basis and in conjunction with possible cases of COVID-19. The objective of this review was to incorporate good practice criteria related to COVID-19 into the context of safe surgery, which would make it possible to develop a proposed surgical safety checklist adapted to patients with this disease. METHODS: Narrative literature review, following the PRISMA protocol, in the Medline and Cochrane directories, using the MeSH terms (coronavirus, infections, safety, surgical procedures, operative, checklist) and the Boolean operator AND. In addition, recommendations from scientific bodies and societies were reviewed (grey literature). RESULTS: Thirty-three final studies were included with recommendations for safe surgery and surgical safety checklist adapted for COVID-19, the most frequent being aspects related to treatment (41.3%) and prevention and control measures (27.6%). CONCLUSIONS: The existence of a broad consensus on good practices recommended for COVID surgical patients makes it possible to make a proposal for surgical safety checklist to these patients.


Subject(s)
COVID-19/prevention & control , Pandemics , SARS-CoV-2 , Surgical Procedures, Operative , Airway Management , Anesthesia/adverse effects , Anesthesia/methods , Antibiotic Prophylaxis , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/transmission , COVID-19 Testing , Checklist , Consensus , Cross Infection/prevention & control , Elective Surgical Procedures , Emergencies , Equipment Contamination , Humans , Hygiene , Infection Control/methods , Infection Control/standards , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Medical Waste Disposal , Operating Rooms , Patient Safety , Personal Protective Equipment , Practice Guidelines as Topic/standards , Recovery Room , SARS-CoV-2/isolation & purification , SARS-CoV-2/physiology , Spain/epidemiology , Time-to-Treatment
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