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2.
Przegl Epidemiol ; 75(2): 151-158, 2021.
Article in English | MEDLINE | ID: covidwho-1485744

ABSTRACT

INTRODUCTION: COVID-19 pandemic had a big impact on the health services organisation, including that of sexually transmitted infections (STIs). AIM: To analyse and evaluate the influence of COVID-19 epidemic on the detection of STIs and healthcare services in a group of these patients on the base of the experience of the Department of Dermatology and Venereology and University Outpatient Clinic in Bialystok, Poland. MATERIAL AND METHODS: Analysis of the number of consultations for suspicion of STIs, number of newly diagnosed cases of syphilis, gonorrhoea, Chlamydia trachomatis infections and genital herpes in two periods: January 2019 - February 2020 (before the epidemic state was introduced) and March 2020 - April 2021 (during pandemic). STIs cases hospitalised in the same periods were also analysed. RESULTS: The number of hospitalisations and outpatient consultations decreased during pandemic as compared to the period before it (by 83.3% and 41.9%, respectively). Patients with syphilis constituted the majority in both periods, remaining STIs were few. During pandemic, the proportion of detected cases of syphilis was higher as compared to the time before it, despite the diminished number of consultations (39.4% and 28%, respectively). Majority of patients with syphilis were men (92.3% and 93.3%), among them men-who-have-sex-with-men constituted at least 50%. Early syphilis was diagnosed more frequently during pandemic than before it (92.3% and 78.6%, respectively), early symptomatic syphilis in particular (46.2% and 35.7%, respectively). HIV coinfection in syphilis patients was more frequent during pandemic (15.8% and 7.1%, respectively). More than half of these patients (53.8%) did not come for follow-up visits after treatment during pandemic. CONCLUSIONS: The pandemic caused the decrease in number of outpatient STIs consultations and hospitalisations. The proportion of newly diagnosed cases of syphilis per number of consultations increased. The percentage of early syphilis cases, especially early symptomatic syphilis increased. Adherence to after treatment follow up was suboptimal.


Subject(s)
COVID-19 , Gonorrhea , HIV Infections , Sexual and Gender Minorities , Sexually Transmitted Diseases , Syphilis , Female , Gonorrhea/diagnosis , Gonorrhea/epidemiology , HIV Infections/epidemiology , Homosexuality, Male , Humans , Male , Pandemics , Poland/epidemiology , SARS-CoV-2 , Sexually Transmitted Diseases/diagnosis , Sexually Transmitted Diseases/epidemiology , Syphilis/diagnosis , Syphilis/epidemiology
6.
Ann Fam Med ; 19(4): 365-367, 2021.
Article in English | MEDLINE | ID: covidwho-1311276

ABSTRACT

When the immediate threat of COVID-19 subsides, the future of health care will involve more virtual care. Before the pandemic, patient choice rather than clinician guidance determined which medium (telephone visits, video visits, electronic messaging) was used to receive care. Two media synchronicity theory principles-conveyance and convergence-can create a framework for determining how to choose the right medium of care for the patient. The author describes how it changed their practice and decision making with a patient story that required the use of multiple virtual care options.


Subject(s)
COVID-19/prevention & control , Communication , Telemedicine/methods , COVID-19/diagnosis , Child, Preschool , Cough/etiology , Dyspnea/etiology , Humans , Male , Middle Aged , Office Visits , Patient Care Planning , Patient Preference , SARS-CoV-2 , Syphilis/diagnosis , Telephone , Text Messaging , Videoconferencing
7.
J Infect Dis ; 224(5): 798-803, 2021 09 01.
Article in English | MEDLINE | ID: covidwho-1270740

ABSTRACT

Early in the coronavirus disease 2019 (COVID-19) crisis, a statewide executive order (PAUSE) severely restricted the movement of New Yorkers from 23 March to 7 June 2020. We used New York City surveillance data for human immunodeficiency virus (HIV), chlamydia, gonorrhea, and syphilis to describe trends in diagnosis and reporting surrounding PAUSE. During PAUSE, the volume of positive HIV/sexually transmitted infection tests, and diagnoses of HIV, chlamydia, gonorrhea, and syphilis declined substantially, reaching a nadir in April before rebounding. Some shifts in characteristics of reported cases were identified.


Subject(s)
COVID-19/epidemiology , HIV Infections/epidemiology , Sexually Transmitted Diseases/epidemiology , Adolescent , Adult , COVID-19/diagnosis , COVID-19/virology , Chlamydia , Chlamydia Infections/diagnosis , Chlamydia Infections/epidemiology , Female , Gonorrhea/diagnosis , Gonorrhea/epidemiology , HIV Infections/diagnosis , HIV Infections/virology , Humans , Male , Middle Aged , New York City/epidemiology , Pandemics , Public Health Surveillance , SARS-CoV-2/isolation & purification , Sexually Transmitted Diseases/diagnosis , Syphilis/diagnosis , Syphilis/epidemiology , Young Adult
8.
Curr HIV/AIDS Rep ; 18(4): 280-288, 2021 08.
Article in English | MEDLINE | ID: covidwho-1258268

ABSTRACT

PURPOSE OF REVIEW: To highlight recent trends in the epidemiology of HIV and syphilis, the impact of the COVID epidemic, our approach to care of co-infected patients, and our views on important next steps in advancing the field. RECENT FINDINGS: HIV and syphilis co-infection has been on the rise in recent years although since the COVID pandemic there is a decrease in new diagnoses-it remains unclear if this represents a true decline or inadequate testing or under-reporting. Standard HIV care should include regular syphilis serology .Treatment and serological follow-up of syphilis in HIV positive and negative patients can be conducted similarly. Challenges remain in the diagnosis and management of neurosyphilis. New models for testing and prevention will be crucial next steps in controlling co-infection. The intersection of HIV and syphilis infections continues to pose new and unique challenges in diagnosis, treatment, and prevention.


Subject(s)
COVID-19 , HIV Infections , Syphilis , HIV Infections/complications , HIV Infections/diagnosis , HIV Infections/drug therapy , Humans , SARS-CoV-2 , Syphilis/diagnosis , Syphilis/drug therapy , Syphilis/epidemiology , Syphilis Serodiagnosis
10.
Sex Transm Dis ; 48(8S): S44-S49, 2021 08 01.
Article in English | MEDLINE | ID: covidwho-1221513

ABSTRACT

BACKGROUND: In response to the COVID-19 pandemic, Washington State's Stay Home, Stay Healthy (SHSH) order was implemented on March 24, 2020. We hypothesized that pandemic mitigation measures might reduce sexually transmitted infection (STI) screening and/or transmission. METHODS: We used King County, WA STI surveillance and sexual health clinic (SHC) data from January 1, 2019, to July 31, 2020. We calculated mean weekly case counts for gonorrhea, primary and secondary (P&S) syphilis, male urethral gonorrhea, and early latent (EL) syphilis for 3 periods in 2020: pre-SHSH (January 1-March 23), SHSH (March 24-June 5), and reopening (June 6-July 31). Primary and secondary syphilis and male urethral gonorrhea were used as proxies for sexual behavior, and EL syphilis was used as a proxy for STI screening. We compared SHC visits (2019 vs. 2020) and SHC gonorrhea treatment practices (across 2020 periods). RESULTS: Compared with January to July 2019, from January to July 2020, reported cases of gonorrhea, male urethral gonorrhea, P&S syphilis, and EL syphilis decreased by 9%, 5%, 16%, and 22%, respectively. Mean weekly case counts of gonorrhea, male urethral gonorrhea, and EL syphilis decreased pre-SHSH to SHSH, but all returned to pre-SHSH levels during reopening. Sexual health clinic visits during SHSH were 55% lower in 2020 than in 2019. In the SHC during SHSH, ceftriaxone treatment of gonorrhea decreased, whereas cefixime/cefpodoxime treatment and gonorrhea treatment with no testing increased. CONCLUSIONS: Decreases in reported STIs concurrent with COVID-19 SHSH may reflect a true decline in STI transmission. However, the larger decreases in asymptomatic infections indicate that much of the observed decrease was likely due to decreased screening.


Subject(s)
COVID-19 , Chlamydia Infections , Gonorrhea , HIV Infections , Sexually Transmitted Diseases , Syphilis , Chlamydia Infections/diagnosis , Chlamydia Infections/drug therapy , Chlamydia Infections/epidemiology , Gonorrhea/diagnosis , Gonorrhea/drug therapy , Gonorrhea/epidemiology , HIV Infections/epidemiology , Humans , Male , Pandemics , SARS-CoV-2 , Sexually Transmitted Diseases/diagnosis , Sexually Transmitted Diseases/drug therapy , Sexually Transmitted Diseases/epidemiology , Syphilis/diagnosis , Syphilis/drug therapy , Syphilis/epidemiology , Washington/epidemiology
11.
Sex Transm Dis ; 48(6): e81-e83, 2021 06 01.
Article in English | MEDLINE | ID: covidwho-1158050

ABSTRACT

ABSTRACT: The impact of the COVID-19 pandemic on syphilis rates is unknown. A retrospective chart review was performed of all patients screened for syphilis through universal screening in a large, urban emergency department from June 2019 to June 2020. During the early pandemic (April through June 2020), screening rates remained similar, but the rate of presumed active infection increased from 1.2% to 1.8% (prevalence ratio, 1.54; 95% confidence interval, 1.17-2.00; P < 0.01), with significant increases among adolescents and women. Only 19.2% of patients with presumed active infection presented for STI-related complaints. Universal screening represents a valuable tool for achieving syphilis control within high-prevalence communities.


Subject(s)
COVID-19 , Syphilis , Adolescent , Female , Humans , Pandemics , Prevalence , Retrospective Studies , SARS-CoV-2 , Syphilis/diagnosis , Syphilis/epidemiology , Syphilis/prevention & control
12.
BMJ Case Rep ; 14(3)2021 Mar 17.
Article in English | MEDLINE | ID: covidwho-1140317

ABSTRACT

A 31-year-old immunocompetent, heterosexual man with no relevant medical history presented with 1 week of jaundice, abdominal pain, cough and headache. Examination revealed scleral icterus, right upper quadrant tenderness and hepatomegaly. Initial investigations revealed hyperbilirubinaemia and elevated transaminases. Serum studies were positive for antinuclear antibodies, antimitochondrial antibodies, and herpes simplex virus IgM. Despite being started on intravenous acyclovir, his bilirubin and transaminase levels continued to rise. He was subsequently tested for syphilis given his maculopapular rash on the soles of his feet and it returned positive. He improved clinically with the initiation of penicillin. In this case, we will discuss the presentation, diagnosis and treatment of syphilitic hepatitis.


Subject(s)
Hepatitis A , Hepatitis , Jaundice , Syphilis , Adult , Hepatitis/diagnosis , Hepatitis/drug therapy , Hepatomegaly , Humans , Male , Syphilis/diagnosis , Syphilis/drug therapy
13.
Clin Dermatol ; 39(4): 710-713, 2021.
Article in English | MEDLINE | ID: covidwho-1038069

ABSTRACT

Restrictive measures to contain the coronavirus disease 2019 (COVID-19) pandemic might produce different effects on other infective diseases, especially those affecting the most intimate sphere of sexuality. The epidemiology of syphilis could reflect the consequences of whether people are avoiding or not risky behaviors. To understand the course of syphilis during the COVID-19 outbreak, we performed a retrospective observational study of all new diagnoses observed at the STDs Service of the Dermatology Clinic at Cagliari, part of the Italian sentinel surveillance system. All incident cases diagnosed during the first 6 months of each year, from 2016 to 2020, thus including the recent lockdown period, were retrieved from the database. Of the 87 cases studied, 18 occurred during the first 6 months of 2020, almost all patients (88%) presenting with early phases of the disease and reporting unprotected sexual intercourses in spite of community containment and social distancing. Comparison with the previous 4 years found no significant statistical differences that hospital access and management limitations had not impaired the management of patients with syphilis. We alert the medical community of the possible increase of sexually transmitted diseases, as society returns to normal.


Subject(s)
COVID-19 , Syphilis , Communicable Disease Control , Humans , Pandemics , SARS-CoV-2 , Sexual Behavior , Syphilis/diagnosis , Syphilis/epidemiology , Syphilis/prevention & control
14.
BMC Infect Dis ; 21(1): 33, 2021 Jan 07.
Article in English | MEDLINE | ID: covidwho-1035153

ABSTRACT

BACKGROUND: Septic cardiomyopathy has been observed in association with influenza, indicating that not only bacteria but also other infective agents can cause this condition. There has been no systematic study as to whether Treponema pallidum infection induces septic cardiomyopathy, and we are the first to report this possibility. CASE PRESENTATION: We report two cases of a 48-year-old man and a 57-year-old man who were diagnosed with syphilis-related septic cardiomyopathy. The diagnosis of cardiomyopathy was made based on elevation of cardiogenic markers and decrease in ejection fraction evaluated by echocardiography. Screen for infective pathogens was negative except for syphilis, which supported our diagnosis. The two patients recovered following effective anti-syphilis treatment and advanced life support technology. Syphilis serology became negative after treatment. CONCLUSION: Syphilis has the potential to cause septic cardiomyopathy. Clinicians should consider Treponema pallidum in cases of septic cardiomyopathy with unknown pathogens. However, the specific pathophysiological mechanism of syphilis-associated septic cardiomyopathy has not been elucidated, and more specific studies are needed.


Subject(s)
Bacteremia/etiology , Cardiomyopathies/etiology , Syphilis/complications , Anti-Bacterial Agents/therapeutic use , Bacteremia/complications , Bacteremia/drug therapy , Biomarkers/blood , Cardiomyopathies/diagnosis , Cardiomyopathies/microbiology , Echocardiography , Humans , Imipenem/therapeutic use , Male , Middle Aged , Syphilis/diagnosis , Syphilis/drug therapy , Syphilis Serodiagnosis , Treponema pallidum/immunology
15.
Matern Child Health J ; 25(2): 198-206, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1006455

ABSTRACT

INTRODUCTION: Public health responses often lack the infrastructure to capture the impact of public health emergencies on pregnant women and infants, with limited mechanisms for linking pregnant women with their infants nationally to monitor long-term effects. In 2019, the Centers for Disease Control and Prevention (CDC), in close collaboration with state, local, and territorial health departments, began a 5-year initiative to establish population-based mother-baby linked longitudinal surveillance, the Surveillance for Emerging Threats to Mothers and Babies Network (SET-NET). OBJECTIVES: The objective of this report is to describe an expanded surveillance approach that leverages and modernizes existing surveillance systems to address the impact of emerging health threats during pregnancy on pregnant women and their infants. METHODS: Mother-baby pairs are identified through prospective identification during pregnancy and/or identification of an infant with retrospective linking to maternal information. All data are obtained from existing data sources (e.g., electronic medical records, vital statistics, laboratory reports, and health department investigations and case reporting). RESULTS: Variables were selected for inclusion to address key surveillance questions proposed by CDC and health department subject matter experts. General variables include maternal demographics and health history, pregnancy and infant outcomes, maternal and infant laboratory results, and child health outcomes up to the second birthday. Exposure-specific modular variables are included for hepatitis C, syphilis, and Coronavirus Disease 2019 (COVID-19). The system is structured into four relational datasets (maternal, pregnancy outcomes and birth, infant/child follow-up, and laboratory testing). DISCUSSION: SET-NET provides a population-based mother-baby linked longitudinal surveillance approach and has already demonstrated rapid adaptation to COVID-19. This innovative approach leverages existing data sources and rapidly collects data and informs clinical guidance and practice. These data can help to reduce exposure risk and adverse outcomes among pregnant women and their infants, direct public health action, and strengthen public health systems.


Subject(s)
Civil Defense/methods , Mother-Child Relations , Population Surveillance/methods , Adult , COVID-19/complications , COVID-19/diagnosis , Civil Defense/instrumentation , Female , Hepatitis C/complications , Hepatitis C/diagnosis , Humans , Infant, Newborn , Mass Screening/methods , Pregnancy , Syphilis/complications , Syphilis/diagnosis
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