Case Reports of Acute Transverse Myelitis Associated With mRNA Vaccine for COVID-19.

Acute transverse myelitis (ATM) has been reported as rare complication of vaccination. Herein, we report 2 cases of ATM after the administration of an mRNA vaccine for coronavirus disease 2019 (COVID-19). The first one is an 81-year-old man who received the BNT162b2 vaccine. He presented with bilateral hand weakness. Spine magnetic resonance imaging (MRI) showed high signal intensity from the C1 to C3 vertebrae. The second is a 23-year-old woman who received the BNT162b2 vaccine and experienced tingling in her legs. Spine MRI showed a high signal intensity lesion at the conus medullaris. These patients were treated with intravenous methylprednisolone and their symptoms improved slightly. Careful follow-up is needed to identify adverse events after the administration of mRNA vaccines for COVID-19.

Hand Dermatitis among Nurses during the COVID-19 Pandemic: Frequency and Factors.

OBJECTIVE: To determine the frequency of hand dermatitis among nurses during the COVID-19 pandemic and factors affecting its prevalence. METHODS: The research sample consisted of 175 nurses working in state hospitals. Research data were collected via Google survey between September and October 2020. The data were collected using a sociodemographic data collection form, and a self-assessment form was used to determine dermatologic symptoms. RESULTS: The frequency of hand dermatitis among nurses was 70.9%. A statistically significant difference was found between sex, allergy history, and increased frequency of handwashing and the frequency of hand dermatitis. No significant difference in terms of the frequency of hand dermatitis was found between nurses who provided care to patients who were COVID-19 positive versus nurses who provided care to patients who were COVID-19 negative. However, the frequency of washing hands and using hand disinfectants and hand creams was found to have increased significantly during the COVID-19 pandemic compared to the prepandemic period. CONCLUSIONS: The frequency of hand dermatitis increased among nurses during the pandemic. The increased frequency of handwashing during the pandemic poses a risk for hand dermatitis among nurses, although this should not discourage nurses from appropriate hygiene.

What Is the Impact of the COVID-19 Pandemic on Quality of Life and Other Patient-reported Outcomes? An Analysis of the Hand-Wrist Study Cohort.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic, and its associated lockdowns in many parts of the world, have changed our daily lives and may have a psychological impact on around the globe. However, it is unknown how this influences the patient-reported outcome measures (PROMs) of patients involved in ongoing clinical research and medical care. For both the current and potential future lockdowns, it is important to determine if PROMs collected during such a period can be interpreted with confidence. QUESTIONS/PURPOSES: (1) Is there a difference in quality of life between patients in the COVID-19 period group (March 23, 2020 to May 4, 2020) and patients in a reference period group (from the same period in 2018 or 2019)? (2) Is there a difference in pain, hand function, anxiety, depression, and illness perception between patients in the COVID-19 period group and patients in the reference period group? METHODS: This study was part of a large cohort study with routine outcome measures of patients with hand and wrist conditions. To answer our research questions, we analyzed two samples because not all PROMs were sent to participants at the same time points after treatment. The first sample consisted of all participants who completed PROMs on quality of life (QoL), pain, and hand function at their final follow-up time point, which was either 3, 6, or 12 months post-treatment. The second sample consisted of participants who completed PROMs 3 months post-treatment on anxiety, depression, and illness perception. Each sample consisted of two groups: a COVID-19 period group and a reference period group. We included 1613 participants in the first sample (COVID-19 period group: n = 616; reference period group: n = 997) and 535 participants in the second sample (COVID-19 period group: n = 313; reference period group: n = 222). The primary outcome was QoL, expressed in the EuroQol 5-Dimensions questionnaire (EQ-5D) index score. Secondary outcomes were the other domains on the EQ-5D, as well as pain, hand function, anxiety, depression, and illness perception. RESULTS: We found no between-group differences in the EQ-5D index score (standardized mean difference 0.035; p = 0.98). Furthermore, there were no between-group differences in PROM scores for hand function, anxiety, or depression. There were, however, a few small differences in subdomain items regarding pain and illness perception, but we believe in aggregate that these are unlikely to make a clinically important difference in our main finding. CONCLUSION: The COVID-19 pandemic and its associated lockdown had no influence on QoL and had little influence on secondary outcomes in participants who were part of the Hand-Wrist Study Cohort. This finding implies that PROMs data collected during this period can be used with confidence in clinical research. Our findings indicate that when a pandemic like this occurs again, we can continue to use PROMs for analysis in clinical research or routine outcome measures. LEVEL OF EVIDENCE: Level III, therapeutic study.

Validation of the Telephone-Based Application of the ABILHAND for Assessment of Manual Ability After Stroke.

BACKGROUND AND PURPOSE: Telephone-based assessment may be a valuable and cost-effective approach to improve monitoring and follow-up assessments in patients and research participants. Telephone-based assessment may be of particular value during times when it is important to reduce in-person contract, such as during the Covid-19 pandemic. The purpose of this study was to investigate concurrent validity of the telephone-based administration of the ABILHAND for the assessment of manual ability in individuals with stroke. METHODS: Using a cross-sectional study design, participants with stroke were invited to answer the ABILHAND questionnaire on 2 randomized occasions, face to face and by telephone, 5 to 7 days apart. The mean difference (MD) between the interviews was calculated (95% confidence interval [95% CI]) to investigate the concurrent validity. Intraclass correlation (ICC) and weighted κ coefficients were used to investigate the agreement between face-to-face and telephone-based administration. RESULTS: One hundred two participants (50 men; mean age = 65 years, SD = 13 years) were included. No significant differences were observed between the mean scores obtained with face-to-face and telephone-based administration of the ABILHAND (MD = -0.06; 95% CI, -0.72 to 0.60). Very high agreement was found between face-to-face and telephone-based administration (ICC = 0.90; 95% CI, 0.85 to 0.93) on the ABILHAND total scores. Most of the individual items had moderate or substantial κ agreement. DISCUSSION AND CONCLUSIONS: Telephone-based administration of the ABILHAND is valid for the assessment of manual ability after stroke. Clinicians and researchers may use the ABILHAND for monitoring manual ability in persons with stroke and/or screening potential research participants.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A318).