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1.
Virtual Management and the New Normal: New Perspectives on HRM and Leadership since the COVID-19 Pandemic ; : 203-221, 2023.
Article Dans Anglais | Scopus | ID: covidwho-20242225

Résumé

Onboarding, the process through which newcomers become organization's insiders, has gained increasing attention in recent years. Such attention is justified by the considerable costs that companies have to face when onboarding is not properly managed. The challenges to manage this process effectively have increased during the COVID-19 pandemic that forced many organizations to onboard newcomers remotely, while fully working from home. The purpose of this chapter is (1) to explore the main goals associated with the onboarding process, (2) analyse the challenges that the COVID-19 pandemic has generated on the onboarding of employees fully working remotely and (3) present some viable solutions to address these challenges. To do this, we developed a conceptual analysis that builds on literature resources and provides empirical illustrations. The chapter is structured as follows. We first summarize the general objectives of the onboarding process for newcomers and organizations. We then discuss the challenges and sustainable solutions for managing the onboarding remotely and help newcomers and organizations get attain their respective objectives. We conclude by reflecting on the post-pandemic scenario, highlighting opportunities for future research focused on the interplay between remote and in presence working domains. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2023.

2.
Neuromodulation ; 26(4 Supplement):S51-S52, 2023.
Article Dans Anglais | EMBASE | ID: covidwho-20241429

Résumé

Introduction: There is a distinct unmet need in structured, curriculum based, unbiased education in neuromodulation. Current teaching is through sporadic industry workshops, cadaver courses and peer proctorship. The COVID pandemic has created a unique opportunity where online platforms have enabled education to be delivered remotely in both synchronous and asynchronously. The William Harvey Research Institute, Queen Mary University, London, UK have initiated University based accreditation- Post Graduate Certificate in neuromodulation (PGCert) that provides candidate a qualification in one academic year through part-time study. Method(s): The program underwent rigorous staged university approval process (figure 1). To ensure market feasibility, two short proof of concept CPD programs "Executive Education in Neuromodulation (EEPIN)" were delivered in 2021. These courses attracted 87 candidates across Australia, Singapore, India, Germany, Poland, Czech Republic, Ireland, and UK. The faculty includes key opinion leaders that will deliver the program ensuring the candidates gain academic background and specialist skills to understand safe practice of neuromodulation. The PGCert advisory board has been established to ensure strict governance in terms of content and unbiased delivery confirming ACCME guidance. In order to obtain PGCert, candidates are required to complete 4 x 15 credit modules (60 credits). The four modules include Anatomy & Neurophysiology;Patient care and Procedurals skills;Devices and available technology;Intrathecal drug delivery for cancer and non-cancer pain. The modular nature of the program is designed to provide cumulative knowledge, from basic science to clinical application in line with the best available evidence. The modules comprise nine lectures, spreading over three consecutive days, followed by a written assignment with 40 direct contact hours in each module. The webpage can be accessed at Results: The anonymous data from EEPIN reported on Likert scale 1-5: Objectives defined 30.6% - 4 and 69.4% -5;Relevance of topics 10.2%- 4 and 89.8% -5;Content of presentations 22.4%- 4 and 77.6% -5;Organization 24.5% -4 and 69.4% -5;Candidate faculty interaction 14.3% -4 and 81.6% -5. 97% of the EEPIN candidates recommended the program to others whilst 81.8% expressed their strong interest to enroll for university-based post graduate qualification if offered. Conclusion(s): This PGcert Neuromodulation is a unique, university accredited program that provides qualification in neuromodulation with access to a flexible online e-learning platform to discuss and exchange ideas, share knowledge in candidate's own time. This will support the ongoing need for formal curriculum-based education in neuromodulation. Disclosure: Kavita Poply, PHD: None, Phillippe Rigoard: None, Jan Kallewaard, MD/PhD: None, FRANK J.P.M. HUYGEN, MD PhD: ABBOTT: Speakers Bureau:, Saluda: Consulting Fee:, Boston Scientific: Consulting Fee:, Grunenthal: Speakers Bureau:, Pfizer: Speakers Bureau:, Ashish Gulve, FRCA, FFPMRCA, FFPMCAI, DPMed, FCARCSI, MD, MBBS: None, Ganesan Baranidharan, FRCA: None, Sam ELDABE, MD, FRCA, FFPMRCA: Medtronic: Consulting Fee:, Medtronic: Contracted Research:, Mainstay Medical: Consulting Fee:, Saluda Medical: Consulting Fee:, Boston Scientific: Contracted Research:, Saluda Medical: Contracted Research:, James Fitzgerald, MA,PhD: St Jude Medical: Consultant: Self, Medtronic: Consulting Fee:, UCB: Contracted Research:, Merck: Contracted Research:, Serge Nikolic, MD: None, Stana Bojanic, BSc MBBS FRCS (SN): Abbott: Contracted Research:, Habib Ellamushi: None, Paresh Doshi, MS MCh: None, Preeti Doshi, MBBS, MD, FRCA: None, Babita Ghai, MBBS, MD, DNB: None, Marc Russo, MD: Presidio Medical: Ownership Interest:, Saluda Medical: Ownership Interest:, Boston Scientific: Contracted Research: Self, Mainstay Medical: Contracted Research: Self, Medtronic: Contracted Research: Self, Nevro: Contracted Research: Self, Saluda Medical: Contracted Research: Self, Presidio Medical: Contracted Research: Self, Freedom Ne ro: Ownership Interest - Own Stocks: Self, Lungpacer: Ownership Interest - Own Stocks: Self, SPR Therapeutics: Ownership Interest - Own Stocks: Self, Lawrence Poree, MD,MPH,PHD: Medtronic: Consulting Fee: Self, Saluda Medical: Contracted Research: Family, Nalu Medical: Contracted Research: Family, Gimer Medical: Consulting Fee: Self, Nalu Medical: Consulting Fee: Self, Saluda Medical: Consulting Fee: Self, Nalu: Ownership Interest:, Saluda Inc: Ownership Interest:, Alia Ahmad: None, Alaa Abd Sayed, MD: Medtronic, Abbott, SPR and StimWave: Consulting Fee:, Salim Hayek, MD,PhD: None, CHRISTOPHER GILLIGAN, MD MBA: Persica: Consulting Fee: Self, Saluda: Consulting Fee: Self, Mainstay Medical: Contracted Research: Self, Sollis Therapeutics: Contracted Research: Self, Iliad Lifesciences, LLC: Owner: individuals with legal ownership in a company:, Vivek Mehta: NoneCopyright © 2023

3.
SpringerBriefs in Applied Sciences and Technology ; : 117-123, 2023.
Article Dans Anglais | Scopus | ID: covidwho-2324745

Résumé

The chapter presents and discusses the results of two surveys addressed to coworking spaces managers in Italy, during the COVID-19 pandemic, in 2020 and 2021, respectively. The strategies coworking spaces have adopted to cope with the pandemic are described, and the determinants of the coworking resilience level (e.g., size, ownership, sector specialisation, hybridization) are presented. It is explored how the coworking spaces managers have kept the community alive and the perception of the interviewees about the future in the two years. The results of the survey in 2021 show that the average level of profitability and confidence in coworking performance returned to the pre-pandemic level. The pandemic has underlined a potential key role of CSs in enhancing work-life balance and promoting the socio-economic development of peripheral and rural areas. Besides, during the pandemic, Southern Italy has attracted remote workers (e.g., "southworkers”), and promoted the so-called ‘community garrisons', willing to host them and ‘retain' young people. © 2023, The Author(s).

4.
Vaccine ; 41(28): 4114-4120, 2023 06 23.
Article Dans Anglais | MEDLINE | ID: covidwho-2323138

Résumé

People with cystic fibrosis (pwCF) were considered to be clinically vulnerable to COVID-19 and were therefore given priority in the vaccination campaign. Vaccines induced a humoral response in these patients that was comparable to the response observed among the general population. However, the role of the cell-mediated immune response in providing long-term protection against SARS-CoV-2 in pwCF has not yet been defined. In this study, humoral (antibody titre) and cell-mediated immune responses (interferon-γ release) to the BNT162b2 vaccine were measured at different time points, from around 6-8 months after the 2nd dose and up to 8 months after the 3rd dose, in 118 CF patients and 26 non-CF subjects. Subjects were sampled between November 2021 and September 2022 and followed-up for breakthrough infection through October 2022. pwCF mounted a cell-mediated response that was similar to that observed in non-CF subjects. Low antibody titres (<1st quartile) were associated with a higher risk of breakthrough infection (HR: 2.39, 95 % CI: 1.17-4.88), while there was no significant association with low INF-γ levels (<0.3 IU/mL) (HR: 1.38, 95 % CI: 0.64-2.99). Further studies are needed in subgroup of pwCF receiving immunosuppressive therapy, such as organ transplant recipients. This data is important for tailoring vaccination strategies for this clinically vulnerable population.


Sujets)
COVID-19 , Mucoviscidose , Vaccins , Humains , SARS-CoV-2 , Vaccin BNT162 , COVID-19/prévention et contrôle , Vaccins contre la COVID-19 , Mucoviscidose/complications , Vaccination , , Immunité , Anticorps antiviraux
5.
European Journal of Public Health ; 32, 2022.
Article Dans Anglais | Web of Science | ID: covidwho-2308209
6.
2nd International Symposium on Biomedical and Computational Biology, BECB 2022 ; 13637 LNBI:365-374, 2023.
Article Dans Anglais | Scopus | ID: covidwho-2263910

Résumé

Lean Six Sigma (LSS) is a methodological approach that originated in industry and has, over time, become increasingly popular in healthcare. Its tool-to, the DMAIC cycle, consisting of 5 main steps, offers methodological rigor that helps improve processes by comparing results quantitatively. In this study, the LSS and in particular the DMAIC cycle was used to investigate the impact of COVID-19 on patients' length of stay in the Emergency Department (ED-LOS) of the Evangelical Hospital "Betania” of Naples (Italy). The study revealed a general increase in ED-LOS due mainly to the new steps that the hospital added to the standard flow, such as those for performing screening swabs, and the reduction of treatment stations, with the exception of patients discharged home for whom there was a statistically significant reduction. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

7.
Journal of the American Academy of Dermatology ; 87(3):AB164-AB164, 2022.
Article Dans Anglais | Web of Science | ID: covidwho-2234077
8.
Eur J Pediatr ; 2022 Dec 02.
Article Dans Anglais | MEDLINE | ID: covidwho-2236443

Résumé

During the COVID-19 pandemic, children and adolescents with psychiatric disorders experienced an exacerbation of their symptoms with more access to the emergency department (ED). However, little is known about the experience of somatic symptom disorders (SSDs) during the COVID-19 pandemic in children. Therefore, we aimed to compare the rates of pediatric ED admissions for SSDs before and during the COVID-19 pandemic and to understand whether the relative risk of ED admissions for SSDs changed between the two periods. We retrospectively enrolled all children between 4 and 14 years admitted for SSDs in the pediatric ED of Santobono-Pausilipon Hospital, Naples, Italy, from March 11th, 2020, to March 11th, 2021 (pandemic period), and in the same time period of the previous year (pre-pandemic period). We identified 205/95,743 (0,21%) children with SSDs presenting in ED in the pre-pandemic year and 160/40,165 (0,39%) in the pandemic year (p < 0.05). Considering the accesses for age, we observed a relative decrease of the accesses for SSDs over 12 years old (IRR 0,59; CI 0,39-0,88), while we found no differences under 12 years old (IRR 0,87; CI 0,68-1,10).   Conclusion: In this study, we found that despite the massive decrease in pediatric admissions due to the COVID-19 pandemic, somatic symptom disorders' admissions to the pediatric ED increased, suggesting an impact of the pandemic also on pediatric psychiatric disorders. What is Known: • During the COVID -19 pandemic, children and adolescents with a psychiatric disorder experienced exacerbation of their symptoms with more accesses in Emergency Department. What is New: • We found that despite the massive decrease of the pediatric admissions due to the COVID-19 pandemic, somatic symptom disorders admissions in healthy children to the pediatric Emergency Department increased ,suggesting an impact of the pandemic also on the pediatric psychiatric disorders.

9.
Medicine & Science in Sports & Exercise ; 54(9):256-256, 2022.
Article Dans Anglais | Web of Science | ID: covidwho-2157147
10.
Happiness and Domestic Life: The Influence of the Home on Subjective and Social Well-Being ; : 1-4, 2022.
Article Dans Anglais | Scopus | ID: covidwho-2164004

Résumé

Recently, the literature on happiness has taken the role of social interaction and place attachment seriously. Even in the economic sphere, the importance of relational goods in achieving subjective and social well-being is increasingly emphasized. The home is the privileged place where it is possible to enjoy relational goods, in particular those deriving from family ties. The authors of the book, from different perspectives, explore the contribution of the home to the well-being, content and happiness of individuals and by implication and evidence to wider society. They ask to what extent do the quality of domestic life and the home environment (family relationships, environment, technical tools, housing style) influence individual and social happiness, particularly in the context of current changes, such as those produced by the recent COVID-19 pandemic. © 2023 selection and editorial matter, Maria Teresa Russo, Antonio Argandoña and Richard Peatfield;individual chapters, the contributors.

11.
Happiness and Domestic Life: The Influence of the Home on Subjective and Social Well-Being ; : 1-243, 2022.
Article Dans Anglais | Scopus | ID: covidwho-2164003

Résumé

This book uses a multidisciplinary approach to examine the relationship between the quality of domestic life and the home environment, in its material and relational dimension, with individual and social happiness, in the context of current changes. The theme of happiness and well-being is framed within two significant changes, themselves affected by the recent COVID-19 pandemic: the relationship between the individual's quality of life and engagement within the community, and the role of new technologies in everyday life. The authors highlight the relational nature of happiness and the centrality of the home environment in its promotion. Three dimensions of psychosocial well-being in the home are analysed: the personal one, consisting of a sense of stability, intimacy and sharing;the social one, which considers the domestic environment as a place for civic education and, in times of pandemic, the site of professional activity and the physical one, consisting of spaces, services and architectural styles. This book is ideal for readers who wish to cross disciplinary boundaries and explore the topic of domestic happiness in its different facets. The target audience is both professional researchers and advanced graduate and undergraduate students. © 2023 selection and editorial matter, Maria Teresa Russo, Antonio Argandoña and Richard Peatfield;individual chapters, the contributors.

12.
Atmos Pollut Res ; 14(1): 101637, 2023 Jan.
Article Dans Anglais | MEDLINE | ID: covidwho-2158445

Résumé

Carbon neutrality, sustainable development and reducing our impact on the environment is the top priority in future measures. The COVID-19 pandemic brought challenges to every sector at a global scale but can provide valuable insight to reach these goals. The main objective of this work is to provide an integrated analysis of the impact of the COVID-19 pandemic, focused on energy and its related aspects, i.e., environment and costs. Mainland Portugal was used as a case study and two years were analysed, one pre pandemic (2019) and another post pandemic (2020). In 2020, the majority of sectors - Transport, Services, Industry and Agriculture & Fisheries - show a reduction of energy consumption, atmospheric emissions, carbon footprint and related monetary and social costs. In contrast, the Domestic sector presents an overall increase, with maximums of 25.4% in electricity consumption (during Spring), 0.72% in the PM10 (particulate matter) and NOx (nitrogen dioxides) emissions (in Summer), and 2.9% in carbon footprint (in Spring). The integrated analysis proposed in this work was crucial to identify the paths to a post pandemic world focused on the different aspects of sustainability - new concepts of mobility and workplace, as well as increased investment in energy performance and renewable energy sources. This study showed that changing our energy consumption patterns could significantly affect future greenhouse gas emissions, and contribute to the sustainable growth of the economy, while maintaining good progress towards climate-neutral goals.

13.
Diabetes Research and Clinical Practice ; 186, 2022.
Article Dans Anglais | Web of Science | ID: covidwho-2104739
14.
European journal of public health ; 32(Suppl 3), 2022.
Article Dans Anglais | EuropePMC | ID: covidwho-2101820

Résumé

Background Personal protection equipment (PPE) use in hospitals has consistently increased due to the Sars-Cov-2 outbreak, in wards repurposed for Covid-19 patients and wards that kept their usual activity. This increase influenced an environmental emergency in terms of health waste (HW) disposal. This study aims to assess the economic and environmental impact of the increase in HW generated before and during the pandemic in an Italian Hospital. Methods Data from 2016 to 2019 and 2020 to 2021 was retrieved from Risk Management department. Per capita and per days-of-stay waste quantity were calculated for the hospital inpatient wards and medical service areas (anatomical pathology, laboratories, radiology, nuclear medicine). Linear regression models assessed the epidemiological impact of COVID, and LOESS analysis modeled the relationship between infectious HW generation and the percentage of COVID-related inpatient days. Average weight of HW per patient was used to estimate the monetary value of CO2 produced. Results Preliminary results show that the inpatient days related to COVID nonlinearly influenced the infectious HW generated by wards. PPE usage increased in every context, and the proportion of COVID-related bed-days ranged from 2% to 12% in low-incidence months to 17% to 31% during acute phases. Pre-COVID CO2 production weighted 487 kg per patient and cost 1705€ per-capita, whereas during the pandemic it amounted to 768 kg per patient and cost 2688€ per capita which resulted in a significant increase of 983€ per patient. Conclusions In light of the results, HW disposal is an urgent issue that should be addressed by policy makers when implementing new monitoring systems for hospitals. A more adequate disposal of HW could substantially contribute in reducing air pollution and concurrently reduce the economic impact health systems due to the coronavirus pandemic. Key messages The COVID-19 pandemic has brought an increase in hospital waste generation. The improvement of HW disposal monitoring system should be considered to avoid reaching critical levels in the near future.

16.
Eur Psychiatry ; 65(1): e56, 2022 08 26.
Article Dans Anglais | MEDLINE | ID: covidwho-2054015

Résumé

BACKGROUND: DIALOG+ is a digital psychosocial intervention aimed at making routine meetings between patients and clinicians therapeutically effective. This study aimed to evaluate the cost-effectiveness of implementing DIALOG+ treatment for patients with psychotic disorders in five low- and middle-income countries in Southeast Europe alongside a cluster randomised trial. METHODS: Resource use and quality of life data were collected alongside the multi-country cluster randomised trial of 468 participants with psychotic disorders. Due to COVID-19 interruptions of the trial's original 12-month intervention period, adjusted costs and quality-adjusted life years (QALYs) were estimated at the participant level using a mixed-effects model over the first 6 months only. We estimated the incremental cost-effectiveness ratio (ICER) with uncertainty presented using a cost-effectiveness plane and a cost-effectiveness acceptability curve. Seven sensitivity analyses were conducted to check the robustness of the findings. RESULTS: The average cost of delivering DIALOG+ was €91.11 per participant. DIALOG+ was associated with an incremental health gain of 0.0032 QALYs (95% CI -0.0015, 0.0079), incremental costs of €84.17 (95% CI -8.18, 176.52), and an estimated ICER of €26,347.61. The probability of DIALOG+ being cost-effective against three times the weighted gross domestic product (GDP) per capita for the five participating countries was 18.9%. CONCLUSION: Evidence from the cost-effectiveness analyses in this study suggested that DIALOG+ involved relatively low costs. However, it is not likely to be cost-effective in the five participating countries compared with standard care against a willingness-to-pay threshold of three times the weighted GDP per capita per QALY gained.


Sujets)
COVID-19 , Troubles psychotiques , Analyse coût-bénéfice , Pays en voie de développement , Europe , Humains , Intervention psychosociale , Troubles psychotiques/thérapie , Qualité de vie
17.
Cancer Research ; 82(12), 2022.
Article Dans Anglais | EMBASE | ID: covidwho-1986498

Résumé

Introduction: Patients with hematologic malignancies, including multiple myeloma (MM), experience worse SARS-CoV-2 infection outcomes and sub-optimal vaccine responses. Monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM) precede MM and affect ∼5% of individuals age >=50. We previously showed that individuals with MGUS and SMM exhibit immune dysregulation. Here, we investigate the immune response to SARS-CoV-2 vaccination in these asymptomatic but potentially immunocompromised individuals. Methods: The IMPACT study (IRB #20-332) is a prospective study at Dana-Farber Cancer Institute in collaboration with MMRF, which enrolled individuals nationwide with a diagnosed plasma cell dyscrasia and healthy individuals. As of October 2021, 3,005 individuals completed a questionnaire regarding prior infection or vaccination. We obtained 1,350 blood samples from 628 participants and analyzed anti-SARS-CoV-2 IgG antibody titer by ELISA. Results: 2,771 (92%) participants were fully vaccinated (2 doses BNT162b2 or mRNA-1273;1 dose Ad26.COV2.s), 269 (9%) had received a 3rd mRNA vaccine dose, and 234 (8%) were unvaccinated. 1,387 (46%) and 1,093 (36%) participants received mRNA vaccines (BNT162b2 and mRNA-1273), and 139 (5%) participants received an adenovirus vector vaccine (Ad26.COV2.S). 34 (1%) individuals reported SARS-CoV-2 infection after full vaccination. We measured antibody titers in 201 MGUS, 223 SMM, 40 smoldering Waldenstrom macroglobulinemia (SWM), 64 MM, and 100 healthy controls. Multiple linear regression model estimated the association between various clinical variables and post-vaccination antibody titers. As previously reported, having MM was associated with low antibody titer (p < 0.001). Of note, having SMM, regardless of risk stratification by 2/20/20 criteria, was also associated with low antibody titers, indicating that even low-risk SMM patients have a poor response to vaccination. MGUS and SWM diagnoses were not significantly associated with antibody titers. Additionally, male sex (p < 0.010), elapsed time after vaccination (p < 0.001), and BNT162b2 vaccine (p < 0.001) were associated with low antibody titers. SARS-CoV-2 infection prior to vaccination was associated with high antibody titers. We identified 25 patients (6 MGUS, 10 SMM, 2 SWM, 7 MM) who submitted blood samples after both the 2nd and 3rd dose. In these patients we observed a significant increase in antibody titer after a 3rd dose (p = 0.002). We also observed that antibody titers of patients after a 3rd dose (13 MGUS, 12 SMM, 2 SWM, 31 MM) were comparable to that of healthy individuals after a 2nd dose (p = 0.833). Conclusion: Our data indicates that suboptimal response to SARS-CoV-2 does not only occur with MM and cancer patients receiving therapy but also in precursor asymptomatic patients including low-risk SMM.

18.
Statistica Applicata ; 34(1):23-74, 2022.
Article Dans Anglais | Scopus | ID: covidwho-1975733

Résumé

The COVID-19 pandemic has had a dramatic impact on many dimensions of living and working conditions, and uncertainties about the developments that we shall still face in the near future. This paper analyses the implications of a forced overnight push to online teaching. Drawing upon an online survey conducted during the 2020 lockdown by the University of Modena and Reggio Emilia, this article describes students’ living and studying conditions revealed by a large set of open and closed questions. The survey provides significant information on the students’ real off-campus conditions, crucial data for the multidimensional analysis by combining non-parametric multivariate analysis of closed questions with textual analyses. It offers important indications about the most useful tools for inclusive teaching across thematic areas and highlights the main difficulties that emerged during the lockdown. Reflections on advantages and disadvantages, strengths and weaknesses in the innovative learning environment set up overnight are offered at a policy level. © 2022, ASA Associazione per la Statistica Applicata. All rights reserved.

19.
Gastroenterology ; 162(7):S-1280, 2022.
Article Dans Anglais | EMBASE | ID: covidwho-1967447

Résumé

Introduction: Solid organ transplant recipients have 2-5 times increased mortality after coronavirus disease 2019 (COVID-19) infection as compared to general population. These patients also have lower protection after vaccination against COVID-19. Therefore, the risk of breakthrough infection and hospitalization are also significantly higher in this patient population. Studies on efficacy of COVID-19 vaccination in post liver transplant (LT) patients are limited. We aimed to investigate the rate of mortality, hospitalization, and breakthrough infection and assess possible risk factors in COVID-19 infection mortality post LT. Methods: A retrospective chart review study. All post liver transplant patients at Carolinas Medical Center (CMC) who were tested positive for respiratory syndrome coronavirus 2 (SARS-CoV- 2) PCR test from Dec. 2020 (when first COVID-19 vaccine was approved in the US for emergency use authorization) until Nov. 2021 were included in this study. Breakthrough infection was defined as COVID-19 infection ≥14 days after full vaccination. Data was analyzed using Prism (GraphPad Software, San Diego, CA) and reported as mean ± SEM. T- test and chi square tests were applied for analyzing the data. Results: Thirty-six patients were identified and 66.1±9.6 months post liver transplantation (LT). Mean age was 61.2±1.6 years-old, male (72.2%) and Caucasian (91.6%). Ten patients (27.7%) expired. Chronic kidney disease (CKD) was present in 70.0% of expired patients as compared to 53.3% of recovered (p=0.0003). Type 2 diabetes (T2DM) was present in 70.0% vs. 25.0% of expired and recovered patients, respectively (p<0.0001). Hypertension (HTN) was present in 90.0% vs. 55.0% of expired and recovered patients, respectively (p<0.0001). No statistically significant difference was observed in weight of expired vs. recovered patients (50% vs. 65% obesity;p=0.4). Only 9 patients were vaccinated. Breakthrough infection rate was 25% and 2/9 (22.2%) died vs. 29.6% of non-vaccinated patients (p=0.4). COVID-19 infection occurred 4.9±0.86 months after vaccination. Hospitalization (44.4% vs. 55.5%) and ICU admission (22.2% vs. 37.0%) was not statistically different among vaccinated and non-vaccinated patients. Conclusion: T2DM and CKD were significantly higher among COVID-19 infected patients who expired, which are similar risk factors in patients who have not had a liver transplant. However, obesity was not significantly correlated with mortality as it was shown before in non-immunocompromised population. Although COVID-19 vaccine is effective in post LT patients, larger studies are warranted to evaluate its efficacy in this population. Our study also highlights that the efficacy of current COVID-19 vaccines decreases in 4-6 months after full vaccination, which warrants evaluating the efficacy of booster dose(s) in post LT patients

20.
Gastroenterology ; 162(7):S-886, 2022.
Article Dans Anglais | EMBASE | ID: covidwho-1967380

Résumé

Background: Hereditary colorectal cancer syndromes require timely endoscopic surveillance. Aims: This study evaluated the approach of Italian gastroenterologists to the management of such patients. It then assessed the impact of SARS-CoV-2 on clinical outcomes, including interval cancers (cancers diagnosed during the time between two screening exams). Materials and methods: All members affiliated with the leading gastroenterology Italian societies (AIGO, SIED, and SIGE) received an online questionnaire. Data collection occurred between March 8, 2021, and May 3, 2021. Results: One hundred and twenty-one clinicians from 96 Italian hospitals answered, not necessarily experts in the field (males: 73, 60.3%;average clinical experience: 20.13±11.69 years). Many collected family history for genetic risk assessment (74.4%), but only 14.0% used online predictive software. 65.6% discussed cases in multidisciplinary units. Genetic analysis was available to most centers, but only a few hospitals offered dedicated endoscopy (19.0%), outpatient clinics (33.9%), or surgeries (23.1%). Since the start of the SARS-CoV-2 pandemic, clinicians noticed a reduction in the number of patients with hereditary colorectal cancer seen at follow-up. The number of clinicians with a high volume of patients decreased (from 38.8% to 28.1%). Almost half of the clinicians (45.5%) reported a delay in the surveillance (median: 4-12 months). Ultimately, 30.6% detected one interval colorectal cancer or more in at least one of their patients. 8.1% reported up to five interval cancers. Conclusion: The SARS-CoV-2 pandemic directly affected the surveillance of hereditary colorectal cancer syndromes in Italy. The worst repercussion was the reported increase in interval cancers during the pandemic. This result was likely due to delays in their endoscopy surveillance. Surveillance should resume, to avoid the possible long-term consequences of its interruption, especially for hereditary colorectal cancer syndromes.(Figure Presented)(Figure Presented)

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