COVID-19 severity and cardiovascular outcomes in SARS-CoV-2-infected patients with cancer and cardiovascular disease.

Background: Data regarding outcomes among patients with cancer and co-morbid cardiovascular disease (CVD)/cardiovascular risk factors (CVRF) after SARS-CoV-2 infection are limited. Objectives: To compare Coronavirus disease 2019 (COVID-19) related complications among cancer patients with and without co-morbid CVD/CVRF. Methods: Retrospective cohort study of patients with cancer and laboratory-confirmed SARS-CoV-2, reported to the COVID-19 and Cancer Consortium (CCC19) registry from 03/17/2020 to 12/31/2021. CVD/CVRF was defined as established CVD or no established CVD, male ≥ 55 or female ≥ 60 years, and one additional CVRF. The primary endpoint was an ordinal COVID-19 severity outcome including need for hospitalization, supplemental oxygen, intensive care unit (ICU), mechanical ventilation, ICU or mechanical ventilation plus vasopressors, and death. Secondary endpoints included incident adverse CV events. Ordinal logistic regression models estimated associations of CVD/CVRF with COVID-19 severity. Effect modification by recent cancer therapy was evaluated. Results: Among 10,876 SARS-CoV-2 infected patients with cancer (median age 65 [IQR 54-74] years, 53% female, 52% White), 6253 patients (57%) had co-morbid CVD/CVRF. Co-morbid CVD/CVRF was associated with higher COVID-19 severity (adjusted OR: 1.25 [95% CI 1.11-1.40]). Adverse CV events were significantly higher in patients with CVD/CVRF (all p<0.001). CVD/CVRF was associated with worse COVID-19 severity in patients who had not received recent cancer therapy, but not in those undergoing active cancer therapy (OR 1.51 [95% CI 1.31-1.74] vs. OR 1.04 [95% CI 0.90-1.20], pinteraction <0.001). Conclusions: Co-morbid CVD/CVRF is associated with higher COVID-19 severity among patients with cancer, particularly those not receiving active cancer therapy. While infrequent, COVID-19 related CV complications were higher in patients with comorbid CVD/CVRF. (COVID-19 and Cancer Consortium Registry [CCC19]; NCT04354701).

Leveraging corona virus disease 2019 vaccination to promote hepatitis C screening.

Health care initiatives, such as hepatitis C virus (HCV) screening, have been greatly overshadowed by the corona virus disease 2019 (COVID-19) pandemic. However, COVID-19 vaccination programs also provide an opportunity to engage with a high volume of people in a health care setting. We collaborated with a large COVID vaccination center to offer HCV point-of-care testing followed by dried blood spot collection for HCV RNA. Additionally, this opportunity was used to evaluate the practical significance of a 5-minute version of the OraQuick HCV antibody test in lieu of the standard 20-minute test. We tested 2317 individuals; 31 were HCV antibody positive and six were RNA positive of which four were treated and reached sustained virological response. Over a third of those surveyed said they would not have participated had the test required 20 minutes. Conclusion: Colocalizing HCV testing and linkage to care at a COVID vaccination clinic was found to be highly feasible; furthermore, a shortened antibody test greatly improves the acceptance of testing.

The impact of COVID-19 safety interventions on creating a controlled environment on campus.

Objectives: During COVID-19 the re-opening of educational institutes was frequently debated, however with the decline in the number of COVID-19 cases, The Aga Khan University (AKU) in Karachi, Pakistan opened its campus for medical and nursing students after more than 6 months of closure. To ensure gradual resumption of activities on-campus, a combination of interventions was diligently deployed to minimize student infection rates. Scarce literature exists on students' perceptions regarding decisions implemented by university leadership. The aim of the study was to determine the efficacy of these interventions. Methods: We conducted a convergent, parallel, mixed-methods observational study targeting medical and nursing students. An online questionnaire was disseminated to elicit students' degree of (dis)agreement on a four-point Likert scale. Focused group discussions (FGDs) were conducted to comprehend reasons for (dis)agreement. Results: Total of 183 students responded to questionnaire (59.0% nursing, 67.8% female), 11 FGDs were conducted with 85 students. Interventions with highest agreement were mandatory face masks policy (94.54%), weekly mandated COVID-testing (92.35%) and students' Academic Bubble (91.26%); highest disagreement was for Sehat Check application (41.53%); and stay strong campaign (40.44%). Four themes emerged from FGDs: Effective safety interventions, Safety interventions with limited effectiveness, Utility of Sehat Check Application and Future recommendations for informing policy. Conclusion: It is paramount to seek student-feedback at forefront of university re-opening strategy. Clear communication channels are as important as an administrative response system's robustness. Bidirectional communication channels are fundamental and requisite during ever-changing policies and regulations. Engaging student representatives in decision making or implementation processes (such as "pilot" before "roll-out") would allow any potential issues to be managed early on. Gather real-time anonymous feedback and identify key areas that need further promulgation and those that need to be replaced with more effective ones.

A comparative systematic scan of COVID-19 health literacy information sources for Canadian university students. / Analyse comparative systématique des sources d'information sur la littératie en matière de santé liée à la COVID-19 des étudiants universitaires au Canada.

INTRODUCTION: With the rapid spread of online coronavirus-related health information, it is important to ensure that this information is reliable and effectively communicated. This study observes the dissemination of COVID-19 health literacy information by Canadian postsecondary institutions aimed at university students as compared to provincial and federal government COVID-19 guidelines. METHODS: We conducted a systematic scan of web pages from Canadian provincial and federal governments and from selected Canadian universities to identify how health information is presented to university students. We used our previously implemented health literacy survey with Canadian postsecondary students as a sampling frame to determine which academic institutions to include. We then used specific search terms to identify relevant web pages using Google and integrated search functions on government websites, and compared the information available on pandemic measures categorized by university response strategies, sources of expertise and branding approaches. RESULTS: Our scan of Canadian government and university web pages found that universities similarly created one main page for COVID-19 updates and information and linked to public sector agencies as a main resource, and mainly differed in their provincial and local sources for obtaining information. They also differed in their strategies for communicating and displaying this information to their respective students. CONCLUSION: The universities in our sample outlined similar policies for their students, aligning with Canadian government public health recommendations and their respective provincial or regional health authorities. Maintaining the accuracy of these information sources is important to ensure student health literacy and counter misinformation about COVID-19.

Can Sound Public Health Policies Stem the Tide of Burgeoning Epidemic of Cardiovascular Disease in South Asians?

PURPOSE OF REVIEW: To revisit the importance of prevention strategies and policies in reducing the burden of ischemic heart disease in South Asian countries. RECENT FINDINGS: South Asia has seen rapid growth in its population with variable improvement in health indicators such as life expectancy at birth over the last three decades. Parallel to these improvements, there has been a stark rise in noncommunicable diseases (NCDs) but without a commensurate improvement in infrastructure/policies and health system interventions to address NCDs. South Asia is the epicenter of the cardiovascular disease (CVD) epidemic in Asia. It has a population that manifests accelerated atherosclerosis at a younger age. Poverty, lower health literacy, lack of health-promoting behaviors, poor urban design, rising air pollution, weak health systems, and lack and poor implementation of existing policies contribute to the continued rise in the incidence of CVD and the associated case fatality rates. A relatively young population presents an opportunity for implementation of prevention measures now which if not adequately utilized will result in an exponential rise in the CVD burden. There is a large gap between policymaking and implementation in this part of the world. Economic realities further constrain coverage of prevention policies; and therefore, stronger collaboration between governments, stakeholders, civil society, and regional and international funding agencies is needed to universally implement prevention strategies in South Asia.

Using Social Media as a Survey Recruitment Strategy for Post-Secondary Students During the COVID-19 Pandemic.

The COVID-19 pandemic rapidly forced Canadian post-secondary students into remote learning methods, with potential implications on their academic success and health. In recent years, the use of social media to promote research participation and as a strategy for communicating health messages has become increasingly popular. To better understand how the pandemic has impacted this population, we used social media platforms to recruit students to participate in a national bilingual COVID-19 Health Literacy Survey. The purpose of the survey was to assess the health literacy levels and online information-seeking behaviors of post-secondary students in relation to the coronavirus. This paper outlines the social media recruitment strategies used for promoting participation in the survey among Canadian post-secondary students during the pandemic. Facebook, Twitter, and Instagram accounts were created to promote the online survey. The objective of this paper is to examine the use of Instagram, Facebook, and Twitter as survey recruitment strategies tailored to students. Data analytics from these platforms were analyzed using descriptive statistics. We found that the most commonly used platform for survey dissemination was Twitter, with 64800 total impressions recorded over 3 months. The use of social media as a survey recruitment strategy showed promise in the current context of COVID-19 where many students are participating in online learning and for a study population that actively uses these platforms to seek out information.