Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 74
Filter
1.
Future Oncol ; 18(4): 437-443, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1690507

ABSTRACT

Background: This study aimed to explore the hypothesis that the stage of breast cancer at initial diagnosis in 2020 is more advanced compared with 2019. Methods: Tumor, node, metastasis and Union for International Cancer Control (UICC) stages of new breast cancer diagnoses at the Bucks Breast Unit from May 2019 to October 2020 were reviewed. A p < 0.05 was considered significant. Results: Average UICC stage increased from 1a in 2019 to 2a in 2020 (p < 0.01). Excluding cancers detected through screening, UICC stage still increased from 1b in 2019 to 2a in 2020 (p = 0.0184). There was a significant increase in the percentage of node-positive patients (p = 0.0063) and patients with metastatic disease (p = 0.0295) on initial presentation. Conclusion: Overall, patients presented with higher UICC stages and more node-positive and metastatic disease on initial diagnosis in 2020 compared with 2019.


Plain language summary During the coronavirus disease 2019 pandemic, breast cancer screening services were halted across the UK. Patients were also encouraged to stay home and to seek medical attention only in an emergency. The authors hypothesized that this might have led to delays in presentation to breast cancer clinics or missed cancer diagnoses. While patients are at home with undiagnosed breast cancer, the cancer can grow and spread. The authors evaluated whether these delays in presentation led to patients presenting with more advanced breast cancers when they finally presented to a breast cancer clinic. The authors collected data on breast cancer stages for a patient group in 2020 (during the height of the pandemic) and compared them with a patient group in 2019. The authors' results did indeed show that patients presented, on average, with more advanced breast cancers in 2020 compared with 2019.


Subject(s)
Breast Neoplasms/diagnosis , Breast Neoplasms/pathology , Delayed Diagnosis/statistics & numerical data , Mass Screening/statistics & numerical data , Missed Diagnosis/statistics & numerical data , Aged , Breast Neoplasms/epidemiology , COVID-19/epidemiology , Female , Humans , Mammography/statistics & numerical data , Middle Aged , Neoplasm Metastasis/pathology , Neoplasm Staging , Pandemics/statistics & numerical data , Retrospective Studies , SARS-CoV-2 , United Kingdom/epidemiology
2.
Infect Genet Evol ; 98: 105228, 2022 03.
Article in English | MEDLINE | ID: covidwho-1654924

ABSTRACT

The investigation of conventional complete blood-count (CBC) data for classifying the SARS-CoV-2 infection status became a topic of interest, particularly as a complementary laboratory tool in developing and third-world countries that financially struggled to test their population. Although hematological parameters in COVID-19-affected individuals from Asian and USA populations are available, there are no descriptions of comparative analyses of CBC findings between COVID-19 positive and negative cases from Latin American countries. In this sense, machine learning techniques have been employed to examine CBC data and aid in screening patients suspected of SARS-CoV-2 infection. In this work, we used machine learning to compare CBC data between two highly genetically distinguished Latin American countries: Brazil and Ecuador. We notice a clear distribution pattern of positive and negative cases between the two countries. Interestingly, almost all red blood cell count parameters were divergent. For males, neutrophils and lymphocytes are distinct between Brazil and Ecuador, while eosinophils are distinguished for females. Finally, neutrophils, lymphocytes, and monocytes displayed a particular distribution for both genders. Therefore, our findings demonstrate that the same set of CBC features relevant to one population is unlikely to apply to another. This is the first study to compare CBC data from two genetically distinct Latin American countries.


Subject(s)
COVID-19/blood , COVID-19/physiopathology , Hematologic Tests/methods , Hematologic Tests/statistics & numerical data , Mass Screening/methods , Mass Screening/statistics & numerical data , SARS-CoV-2/pathogenicity , Adult , Aged , Aged, 80 and over , Brazil/epidemiology , Ecuador/epidemiology , Female , Humans , Male , Middle Aged
3.
Med Oncol ; 39(1): 5, 2021 Nov 05.
Article in English | MEDLINE | ID: covidwho-1504271

ABSTRACT

The purpose of this study was to investigate the impact of the coronavirus disease 2019 (COVID-19) pandemic on patients undergoing radiotherapy by comparing the patterns of unplanned radiotherapy interruption before and after the COVID-19 pandemic. We enrolled patients who received their first dose of radiotherapy for breast cancer between January 28 and July 31, 2019 and between January 28, 2020, and July 31, 2020. We compared the radiotherapy interruption patterns in 2019 with those in 2020 to analyze the impact of the COVID-19 pandemic on treatment interruption. Between January 28 and July 31, 2019, 287 patients with breast cancer received radiotherapy. Among them, 19 patients (6.6%) experienced treatment interruption; the reasons for treatment interruption were radiotherapy-related side effects (10 patients, 52.6%), other medical reasons (three patients, 15.8%), and personal reasons (six patients, 31.6%). Between January 28 and July 31, 2020, 279 patients with breast cancer received radiotherapy. Among them, 23 patients (8.2%) experienced treatment interruption; the reasons for treatment interruption were radiotherapy-related side effects (eight patients, 35%) and COVID-19 screening clinic-related reasons (six patients, 26.1%). Among the six patients with screening clinic-related causes of radiotherapy interruption, five had asymptomatic fever and one had mild cold-like symptoms. The duration of treatment interruption was longer in patients with screening clinic-related interruptions than in those with interruptions because of other causes (p = 0.019). Multivariate analysis showed that cancer stage and radiotherapy volume did not significantly affect treatment interruption. The radiotherapy of certain patients was suspended despite the lack of a confirmed COVID-19 diagnosis. Precise and systematic criteria for the management of patients with suspected COVID-19 are needed, and the opinion of radiation oncologist in charge of the patient must also be considered.


Subject(s)
Breast Neoplasms , COVID-19 , Continuity of Patient Care/statistics & numerical data , Mass Screening/statistics & numerical data , Pandemics , Adult , Breast Neoplasms/epidemiology , Breast Neoplasms/radiotherapy , COVID-19/diagnosis , COVID-19/epidemiology , Female , Humans , Middle Aged , Practice Guidelines as Topic
4.
Medicine (Baltimore) ; 100(41): e27418, 2021 Oct 15.
Article in English | MEDLINE | ID: covidwho-1501202

ABSTRACT

ABSTRACT: The occurrence of COVID-19 pandemic had a significant negative effect on health care systems over the last year. Health care providers were forced to focus mainly on COVID-19 patients, neglecting in many cases equally important diseases, both acute and chronic. Therefore, also screening and diagnostic strategies for HIV could have been significantly impaired.This retrospective, multicenter, observational study aimed at assessing the number and characteristics of new HIV/AIDS diagnoses during COVID-19 pandemic in Italy and compared characteristics of people living with HIV at diagnosis between pre- and post-COVID-19 era (2019 vs 2020).Our results showed a significant reduction of HIV diagnoses during pandemic. By contrast, people living with HIV during pandemic were older and were diagnosed in earlier stage of disease (considering CD4+ T cell count) compared to those who were diagnosed the year before. Moreover, there was a significant decrease of new HIV diagnoses among men who have sex with men, probably for the impact of social distancing and restriction applied by the Italian Government. Late presentation incidence, if numbers in 2020 were lower than those in 2019, is still an issue.Routinely performing HIV testing in patients with suspected SARS-CoV-2 infection is identifying and linking to care underdiagnosed people living with HIV earlier. Thus, combined tests (HIV and SARS-CoV-2) should be implemented in patients with SARS-CoV-2 symptoms overlapping HIV's ones. Lastly, our results lastly showed how urgent implementation of a national policy for HIV screening is necessary.


Subject(s)
Delivery of Health Care/organization & administration , HIV Infections/epidemiology , Mass Screening/statistics & numerical data , Adult , CD4 Lymphocyte Count/statistics & numerical data , COVID-19/epidemiology , Cross-Sectional Studies , Female , HIV Infections/diagnosis , Humans , Italy/epidemiology , Male , Mass Screening/organization & administration , Middle Aged , Pandemics , Retrospective Studies , Risk Factors , SARS-CoV-2
5.
J Korean Med Sci ; 36(42): e295, 2021 Nov 01.
Article in English | MEDLINE | ID: covidwho-1497009

ABSTRACT

BACKGROUND: To minimize nosocomial infection against coronavirus disease 2019 (COVID-19), most hospitals conduct a prescreening process to evaluate the patient or guardian of any symptoms suggestive of COVID-19 or exposure to a COVID-19 patient at entrances of hospital buildings. In our hospital, we have implemented a two-level prescreening process in the outpatient clinic: an initial prescreening process at the entrance of the outpatient clinic (PPEO) and a second prescreening process is repeated in each department. If any symptoms or epidemiological history are identified at the second level, an emergency code is announced through the hospital's address system. The patient is then guided outside through a designated aisle. In this study, we analyze the cases missed in the PPEO that caused the emergency code to be applied. METHODS: All cases reported from March 2020 to April 2021 were analyzed retrospectively. We calculated the incidence of cases missed by the PPEO per 1,000 outpatients and compared the incidence between first-time hospital visitors and those visiting for the second time or more; morning and afternoon office hours; and days of the week. RESULTS: During the study period, the emergency code was applied to 449 cases missed by the PPEO. Among those cases, 20.7% were reported in otorhinolaryngology, followed by 11.6% in gastroenterology, 5.8% in urology, and 5.8% in dermatology. Fever was the most common symptom (59.9%), followed by cough (19.8%). The incidence of cases per 1,000 outpatients was significantly higher among first-time visitors than among those visiting for the second time or more (1.77 [confidence interval (CI), 1.44-2.10] vs. 0.59 [CI, 0.52-0.65], respectively) (P < 0.001). CONCLUSION: Fever was the most common symptom missed by the PPEO, and otorhinolaryngology and gastroenterology most frequently reported missed cases. Cases missed by the PPEO were more likely to occur among first-time visitors than returning visitors. The results obtained from this study can provide insights or recommendations to other healthcare facilities in operating prescreening processes during the COVID-19 pandemic.


Subject(s)
Ambulatory Care Facilities/statistics & numerical data , COVID-19/diagnosis , COVID-19/prevention & control , Cough/etiology , Fever/etiology , Mass Screening/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , Ambulatory Care , COVID-19/epidemiology , Child , Female , Humans , Incidence , Infection Control , Male , Mass Screening/organization & administration , Middle Aged , Pandemics , Young Adult
7.
J Med Virol ; 93(10): 6050-6053, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1432433

ABSTRACT

During the "first wave" of the coronavirus disease 2019 (COVID-19) pandemic in the United Kingdom (March-June 2020), the city of Leicester was particularly hard hit, resulting in reimposed lockdown measures. Although initial polymerase chain reaction testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was attempted within the community, testing was soon abandoned due to an inability to keep up with demand by local laboratories. It is therefore feasible that undiagnosed transmission of COVID-19 in the community by asymptomatic individuals was a real possibility. Therefore, retrospective SARS-CoV-2 immunoglobulin G (IgG) testing of archived sera from out-patients visiting University Hospitals of Leicester NHS Trust service was performed to investigate the transmission of SARS-CoV-2 in the community. A total of 1779 sera samples were tested from samples collected between 16th March and 3rd June 2020, of which 202 (11.35%) were SARS-CoV-2 IgG positive. Positivity was lowest in March (2.54%) at the beginning of the pandemic before peaking in April (17.16%) before a decline in May and June (11.16% and 12.68%, respectively). This retrospective screening offers some insight into the early patterns of SARS-CoV-2 transmission within a sampled community population during the first wave of the COVID-19 pandemic; supporting the argument for more community screening during high incidences of pandemics.


Subject(s)
Antibodies, Viral/blood , COVID-19/diagnosis , COVID-19/epidemiology , Immunoglobulin G/blood , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Immunologic Tests , Infant , Infant, Newborn , Male , Mass Screening/statistics & numerical data , Middle Aged , Pandemics , Retrospective Studies , United Kingdom/epidemiology , Young Adult
8.
PLoS Comput Biol ; 17(9): e1009374, 2021 09.
Article in English | MEDLINE | ID: covidwho-1398922

ABSTRACT

Accurate estimates of infection prevalence and seroprevalence are essential for evaluating and informing public health responses and vaccination coverage needed to address the ongoing spread of COVID-19 in each United States (U.S.) state. However, reliable, timely data based on representative population sampling are unavailable, and reported case and test positivity rates are highly biased. A simple data-driven Bayesian semi-empirical modeling framework was developed and used to evaluate state-level prevalence and seroprevalence of COVID-19 using daily reported cases and test positivity ratios. The model was calibrated to and validated using published state-wide seroprevalence data, and further compared against two independent data-driven mathematical models. The prevalence of undiagnosed COVID-19 infections is found to be well-approximated by a geometrically weighted average of the positivity rate and the reported case rate. Our model accurately fits state-level seroprevalence data from across the U.S. Prevalence estimates of our semi-empirical model compare favorably to those from two data-driven epidemiological models. As of December 31, 2020, we estimate nation-wide a prevalence of 1.4% [Credible Interval (CrI): 1.0%-1.9%] and a seroprevalence of 13.2% [CrI: 12.3%-14.2%], with state-level prevalence ranging from 0.2% [CrI: 0.1%-0.3%] in Hawaii to 2.8% [CrI: 1.8%-4.1%] in Tennessee, and seroprevalence from 1.5% [CrI: 1.2%-2.0%] in Vermont to 23% [CrI: 20%-28%] in New York. Cumulatively, reported cases correspond to only one third of actual infections. The use of this simple and easy-to-communicate approach to estimating COVID-19 prevalence and seroprevalence will improve the ability to make public health decisions that effectively respond to the ongoing COVID-19 pandemic.


Subject(s)
COVID-19 Testing/statistics & numerical data , COVID-19 , Models, Statistical , Antibodies, Viral/blood , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/immunology , Computational Biology , Humans , Mass Screening/statistics & numerical data , Prevalence , Seroepidemiologic Studies , United States/epidemiology
11.
Cancer ; 127(23): 4512-4515, 2021 12 01.
Article in English | MEDLINE | ID: covidwho-1372707

ABSTRACT

BACKGROUND: Breast cancer screening utilization steeply dropped at the start of the coronavirus disease 2019 (COVID-19) pandemic. However, the effects on breast cancer screening in lower income populations are unknown. This study examined changes in breast cancer screening rates (BCSRs) during the pandemic among 32 community health centers (CHCs) that provided health care to lower income populations. METHODS: Secondary data from 32 CHCs participating in an American Cancer Society grant program to increase breast cancer screening services were used. BCSRs were defined as the percentage of women aged 50 to 74 years who had a medical visit in the past 12 months (142,207 in 2018, 142,003 in 2019, and 150,630 in 2020) and received a screening mammogram within the last 27 months. BCSRs in July 2020, July 2019, and June 2018 were compared with screening rate ratios (SRRs) and corresponding 95% confidence intervals (CIs). RESULTS: BCSRs significantly rose by 18% between 2018 and 2019 (from 45.8% to 53.9%; SRR, 1.18; 95% CI, 1.17-1.18) and then declined by 8% between 2019 and 2020 (from 53.9% to 49.6%; SRR, 0.92; 95% CI, 0.92-0.93). If the 2018-2019 BCSR trends had continued through 2020, 63.3% of women would have been screened in 2020 in contrast to the 49.6% who were; this potentially translated into 47,517 fewer mammograms and 242 missed breast cancer diagnoses in this population. CONCLUSIONS: In this study of 32 CHCs, BCSRs declined by 8% from July 2019 to 2020, and this reversed an 18% improvement between July 2018 and 2019. Declining BCSRs among CHCs during the COVID-19 pandemic call for policies to support and resources to identify women in need of screening.


Subject(s)
Breast Neoplasms , COVID-19 , Early Detection of Cancer/statistics & numerical data , Breast Neoplasms/diagnosis , Breast Neoplasms/epidemiology , Community Health Centers , Female , Humans , Mammography , Mass Screening/statistics & numerical data , Pandemics , United States/epidemiology
12.
Pan Afr Med J ; 39: 149, 2021.
Article in English | MEDLINE | ID: covidwho-1359430

ABSTRACT

Cervical cancer is the leading gynaecological malignancy in Zimbabwe, constituting 33% of all female cancers in 2016. Primary prevention through vaccination and secondary prevention through screening are important public health interventions to reduce the cervical cancer burden. Unfortunately, the ongoing COVID-19 pandemic has brought unprecedented challenges to healthcare delivery, posing threats to prevention efforts at a time when the public health sector is extremely fragile. The fragility of the sector has complicated treatment for cervical cancer before and during the COVID-19 pandemic, and is expected to worsen beyond the pandemic. A multi-sectoral intersection between public health experts, clinicians and communities is urgently required to restore preventive and treatment services for cervical cancer and reduce the increased burden, morbidity and mortality stemming indirectly from the pandemic.


Subject(s)
COVID-19 , Mass Screening/statistics & numerical data , Public Health , Uterine Cervical Neoplasms/prevention & control , Delivery of Health Care/organization & administration , Early Detection of Cancer/statistics & numerical data , Female , Humans , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/therapy , Zimbabwe
14.
PLoS One ; 16(7): e0254581, 2021.
Article in English | MEDLINE | ID: covidwho-1311287

ABSTRACT

BACKGROUND: Research has revealed that asymptomatic and pre-symptomatic infections are important contributors to the transmission of SARS-CoV-2 in populations. In Egypt, the true prevalence of infections is veiled due to the low number of screening tests. The aim of this study was to determine the SARS-CoV-2 PCR positivity rate as well the seroprevalence of the SARS-CoV-2 antibodies before the ultimate development of a second wave of the epidemic in Cairo, Egypt. METHODS: Our study was carried out between May 5 and the end of October 2020. It included all patients requiring admission to Ain Shams University hospitals. An interview questionnaire was used to collect demographic and clinical data. Laboratory tests for all participants included RT-PCR and total antibody assay for SARS-CoV-2. RESULTS: A total of 4,313 subjects were enrolled in our study, with females representing 56% of the sample. Adults and middle-aged individuals represented around 60% of the study sample. The positivity rate of SARS-CoV-2 PCR was 3.84% (95% CI 3.29-4.48), and the SARS-CoV-2 antibody seroprevalence was 29.82% (95% CI: 28.16-31.51). Males showed a higher risk for getting the COVID-19 infection, while middle-age group had significantly higher antibody seroprevalence rates. CONCLUSION: SARS-CoV-2 infection imposes a high burden on the community as detected by high seroprevalence rates.


Subject(s)
COVID-19 Nucleic Acid Testing/statistics & numerical data , COVID-19 Serological Testing/statistics & numerical data , COVID-19/epidemiology , Adolescent , Adult , COVID-19/diagnosis , Egypt , Female , Hospitals, University/statistics & numerical data , Humans , Male , Mass Screening/statistics & numerical data , Middle Aged , Seroepidemiologic Studies
16.
Pediatrics ; 148(3)2021 09.
Article in English | MEDLINE | ID: covidwho-1278233

ABSTRACT

BACKGROUND: Mental health concerns increased during the coronavirus disease 2019 pandemic, but previous studies have not examined depression screening in pediatric primary care. We aimed to describe changes in screening, depressive symptoms, and suicide risk among adolescents during the coronavirus disease 2019 pandemic. METHODS: In a repeat cross-sectional analysis of electronic health record data from a large pediatric primary care network, we compared the percentage of primary care visits where adolescents aged 12 to 21 were screened for depression, screened positive for depressive symptoms, or screened positive for suicide risk between June and December 2019 (prepandemic) and June and December 2020 (pandemic). Changes were examined overall, by month, and by sex, race and ethnicity, insurance type, and income. Modified Poisson regression was used to calculate prevalence ratios (PRs) for the prepandemic to pandemic changes. RESULTS: Depression screening at primary care visits declined from 77.6% to 75.8% during the pandemic period (PR: 0.98, 95% confidence interval [CI]: 0.90-1.06). The percentage of adolescents screening positive for depressive symptoms increased from 5.0% to 6.2% (PR: 1.24, 95% CI: 1.15-1.34), with greater increases among female, non-Hispanic Black, and non-Hispanic white adolescents. Positive suicide risk screens increased from 6.1% to 7.1% (PR: 1.16, 95% CI: 1.08-1.26), with a 34% relative increase in reporting recent suicidal thoughts among female adolescents (PR: 1.34, 95% CI: 1.18-1.52). CONCLUSIONS: Results suggest that depression and suicide concerns have increased during the pandemic, especially among female adolescents. Results underscore the importance of consistent depression and suicidality screening.


Subject(s)
COVID-19/psychology , Depression/diagnosis , Suicide , Adolescent , African Americans , COVID-19/epidemiology , Confidence Intervals , Cross-Sectional Studies , Depression/epidemiology , Depression/ethnology , Depression/psychology , Female , Humans , Income , Insurance Coverage , Male , Mass Screening/statistics & numerical data , Pandemics , Poisson Distribution , Prevalence , Risk , Sex Factors , Symptom Assessment , Time Factors , Young Adult
17.
PLoS One ; 16(6): e0253327, 2021.
Article in English | MEDLINE | ID: covidwho-1269922

ABSTRACT

BACKGROUND: The National Health Service (NHS) abdominal aortic aneurysm (AAA) screening programme (NAAASP) in England screens 65-year-old men. The programme monitors those with an aneurysm, and early intervention for large aneurysms reduces ruptures and AAA-related mortality. AAA screening services have been disrupted following COVID-19 but it is not known how this may impact AAA-related mortality, or where efforts should be focussed as services resume. METHODS: We repurposed a previously validated discrete event simulation model to investigate the impact of COVID-19-related service disruption on key outcomes. This model was used to explore the impact of delayed invitation and reduced attendance in men invited to screening. Additionally, we investigated the impact of temporarily suspending scans, increasing the threshold for elective surgery to 7cm and increasing drop-out in the AAA cohort under surveillance, using data from NAAASP to inform the population. FINDINGS: Delaying invitation to primary screening up to two years had little impact on key outcomes whereas a 10% reduction in attendance could lead to a 2% lifetime increase in AAA-related deaths. In surveillance patients, a 1-year suspension of surveillance or increase in the elective threshold resulted in a 0.4% increase in excess AAA-related deaths (8% in those 5-5.4cm at the start). Longer suspensions or a doubling of drop-out from surveillance would have a pronounced impact on outcomes. INTERPRETATION: Efforts should be directed towards encouraging men to attend AAA screening service appointments post-COVID-19. Those with AAAs on surveillance should be prioritised as the screening programme resumes, as changes to these services beyond one year are likely to have a larger impact on surgical burden and AAA-related mortality.


Subject(s)
Aortic Aneurysm, Abdominal/diagnosis , Aortic Rupture/prevention & control , COVID-19/prevention & control , Mass Screening/statistics & numerical data , Models, Statistical , Age Factors , Aged , Aortic Aneurysm, Abdominal/complications , Aortic Aneurysm, Abdominal/mortality , Aortic Aneurysm, Abdominal/surgery , Aortic Rupture/etiology , Aortic Rupture/mortality , COVID-19/epidemiology , COVID-19/transmission , Communicable Disease Control/standards , Computer Simulation , Cost of Illness , Elective Surgical Procedures/standards , Elective Surgical Procedures/statistics & numerical data , England/epidemiology , Health Policy , Humans , Male , Mass Screening/organization & administration , Mass Screening/standards , Pandemics/prevention & control , Patient Acceptance of Health Care/statistics & numerical data , Risk Assessment/statistics & numerical data , Risk Factors , Severity of Illness Index , State Medicine/standards , State Medicine/statistics & numerical data , Time-to-Treatment , Ultrasonography/standards , Ultrasonography/statistics & numerical data
18.
PLoS One ; 16(6): e0252886, 2021.
Article in English | MEDLINE | ID: covidwho-1269920

ABSTRACT

BACKGROUND: Subgroups of precarious populations such as homeless people are more exposed to infection and at higher risk of developing severe forms of COVID-19 compared to the general population. Many of the recommended prevention measures, such as social distancing and self-isolation, are not feasible for a population living in shelters characterised by physical proximity and a high population density. The objective of the study was to describe SARS-CoV-2 infection prevalence in homeless shelters in Brussels (Belgium), and to identify risk factors and infection control practices associated with SARS-CoV-2 positivity rates. METHODS: A total of 1994 adults were tested by quantitative PCR tests in 52 shelters in Brussels (Belgium) between April and June, 2020, in collaboration with Doctors of the World. SARS-CoV-2 prevalence is here described site by site, and we identify risk factors associated with SARS-CoV-2 positivity rates. We also investigate associations between seropositivity and reported symptoms. RESULTS: We found an overall prevalence of 4.6% for the period, and a cluster of high rates of SARS-CoV-2 positivity (20-30% in two shelters). Among homeless people, being under 40 years of age (OR (CI95%) 2.3 (1.2-4.4), p = 0.02), having access to urgent medical care (AMU) (OR(CI95%): 2.4 (1.4-4.4)], p = 0.02), and sharing a room with someone who tested positive (OR(CI95%): 5.3 (2.9-9.9), p<0.0001) were factors associated with SARS-CoV-2 positivity rates. 93% of those who tested positive were asymptomatic. CONCLUSION: This study shows high rates of SARS-COV-2 infection positive tests in some shelters, with a high proportion of asymptomatic cases. The survey reveals how important testing and isolation measures are, together with actions taken by medical and social workers during the outbreak.


Subject(s)
COVID-19 Nucleic Acid Testing/statistics & numerical data , COVID-19/epidemiology , Homeless Persons/statistics & numerical data , Point-of-Care Testing/statistics & numerical data , SARS-CoV-2/isolation & purification , Adult , Age Factors , Asymptomatic Infections/epidemiology , Belgium/epidemiology , COVID-19/diagnosis , COVID-19/virology , Female , Health Services Accessibility/statistics & numerical data , Humans , Infection Control/organization & administration , Infection Control/standards , Infection Control/statistics & numerical data , Male , Mass Screening/statistics & numerical data , Middle Aged , Pandemics/prevention & control , Pandemics/statistics & numerical data , Prevalence , Risk Factors , SARS-CoV-2/genetics , Young Adult
19.
Womens Health (Lond) ; 17: 17455065211017070, 2021.
Article in English | MEDLINE | ID: covidwho-1242233

ABSTRACT

BACKGROUND: The Coronavirus disease 2019 (COVID-19) pandemic has led to an unprecedented upheaval within global healthcare systems and resulted in the temporary pausing of the National Health Service (NHS) Scotland Cervical Screening Programme. With several months of backlogs in appointments, there has not only been a reduction in primary samples being taken for human papilloma virus (HPV) testing but there have also been fewer women referred to colposcopy for investigation and treatment of precancerous or cancerous changes as a result. Encouraging uptake for cervical screening was always a priority before the pandemic, but it is even more important now, considering that the fears and barriers to screening that women may have are now exacerbated by COVID-19. OBJECTIVES: This article explores the impact of the pandemic on the uptake of cervical screening within NHS Ayrshire & Arran and evaluates potential strategies to improve uptake now and in future such as self-sampling and telemedicine. METHODS: This article presents evidence-based literature and local health board data relating to cervical screening during the pandemic. RESULTS: Human papilloma virus self-sampling carried out by the woman in her home has been shown to improve uptake, especially in non-attenders, whilst maintaining a high sensitivity and, crucially, reducing the need for face-to-face contact. Increased education is key to overcoming barriers women have to screening and telemedicine can strengthen engagement with women during this time. CONCLUSION: There are lessons to be learned from the pandemic, and we must use this opportunity to improve cervical screening uptake for the future.


Subject(s)
Early Detection of Cancer/methods , Mass Screening/methods , Mass Screening/statistics & numerical data , Papillomaviridae , Self Care , Uterine Cervical Neoplasms/prevention & control , Adult , Appointments and Schedules , COVID-19/epidemiology , Cervical Intraepithelial Neoplasia/prevention & control , Colposcopy , Female , Humans , Middle Aged , Papanicolaou Test , Scotland/epidemiology , Vaginal Smears
20.
Proc Natl Acad Sci U S A ; 118(21)2021 05 25.
Article in English | MEDLINE | ID: covidwho-1223146

ABSTRACT

We analyze data from the fall 2020 pandemic response efforts at the University of Colorado Boulder, where more than 72,500 saliva samples were tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) using qRT-PCR. All samples were collected from individuals who reported no symptoms associated with COVID-19 on the day of collection. From these, 1,405 positive cases were identified. The distribution of viral loads within these asymptomatic individuals was indistinguishable from what has been previously observed in symptomatic individuals. Regardless of symptomatic status, ∼50% of individuals who test positive for SARS-CoV-2 seem to be in noninfectious phases of the disease, based on having low viral loads in a range from which live virus has rarely been isolated. We find that, at any given time, just 2% of individuals carry 90% of the virions circulating within communities, serving as viral "supercarriers" and possibly also superspreaders.


Subject(s)
COVID-19/virology , Carrier State/virology , SARS-CoV-2 , Asymptomatic Infections/epidemiology , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/transmission , Carrier State/diagnosis , Carrier State/epidemiology , Carrier State/transmission , Colorado/epidemiology , Hospitalization/statistics & numerical data , Humans , Mass Screening/statistics & numerical data , SARS-CoV-2/genetics , SARS-CoV-2/isolation & purification , Saliva/virology , Universities , Viral Load , Virion
SELECTION OF CITATIONS
SEARCH DETAIL