Prevalence of SARS-CoV-2 infection among people experiencing homelessness in Toronto during the first wave of the COVID-19 pandemic

BackgroundPeople experiencing homelessness are at increased risk of SARS-CoV-2 infection. This study reports the point prevalence of SARS-CoV-2 infection during testing conducted at sites serving people experiencing homelessness in Toronto during the first wave of the COVID-19 pandemic. We also explored the association between site characteristics and prevalence rates. MethodsThe study included individuals who were staying at shelters, encampments, COVID-19 physical distancing sites, and drop-in and respite sites and completed outreach-based testing for SARS-CoV-2 during the period April 17 to July 31, 2020. We examined test positivity rates over time and compared them to rates in the general population of Toronto. Negative binomial regression was used to examine the relationship between each shelter-level characteristic and SARS-CoV-2 positivity rates. We also compared the rates across 3 time periods (T1: April 17-April 25; T2: April 26-May 23; T3: May 24-June 25). ResultsThe overall prevalence of SARS-CoV-2 infection was 8.5% (394/4657). Site-specific rates showed great heterogeneity with infection rates ranging from 0% to 70.6%. Compared to T1, positivity rates were 0.21 times lower (95% CI: 0.06, 0.75) during T2 and 0.14 times lower (95% CI: 0.043, 0.44) during T3. Most cases were detected during outbreak testing (384/394 [97.5%]) rather than active case finding. InterpretationDuring the first wave of the pandemic, rates of SARS-CoV-2 infection at sites for people experiencing homelessness in Toronto varied significantly over time. The observation of lower rates at certain sites may be attributable to overall time trends, expansion of outreach-based testing to include sites without known outbreaks and/or individual site characteristics.

Heterogeneity in risk, testing and outcome of COVID-19 across outbreak settings in the Greater Toronto Area, Canada: an observational study

BackgroundWe compared the risk of, testing for, and death following COVID-19 infection across three settings (long-term care homes (LTCH), shelters, the rest of the population) in the Greater Toronto Area (GTA), Canada. MethodsWe sourced person-level data from COVID-19 surveillance and reporting systems in Ontario, and examined settings with population-specific denominators (LTCH residents, shelters, and the rest of the population). We calculated cumulatively, the diagnosed cases per capita, proportion tested for COVID-19, daily and cumulative positivity, and case fatality proportion. We estimated the age- and sex-adjusted relative rate ratios for test positivity and case fatality using quasi-Poisson regression. ResultsBetween 01/23/2020-05/25/2020, we observed a shift in the proportion of cases: from travel-related and into LTCH and shelters. Cumulatively, compared to the rest of the population, the number of diagnosed cases per 100,000 was 59-fold and 18-fold higher among LTCH and shelter residents, respectively. By 05/25/2020, 77.2% of LTCH residents compared to 2.4% of the rest of the population had been tested. After adjusting for age and sex, LTCH residents were 2.5 times (95% confidence interval (CI): 2.3-2.8) more likely to test positive. Case fatality was 26.3% (915/3485), 0.7% (3/402), and 3.6% (506/14133) among LTCH residents, shelter population, and others in the GTA, respectively. After adjusting for age and sex, case fatality was 1.4-fold (95%CI: 1.1-1.9) higher among LTCH residents than the rest of the population. InterpretationHeterogeneity across micro-epidemics among specific populations in specific settings may reflect underlying heterogeneity in transmission risks, necessitating setting-specific COVID-19 prevention and mitigation strategies.

The determination of thyroid gland volume and imaging diagnosis of basedow disease by ultrasound

Background/Introduction: While manual clinical and imaging diagnosis methods expose their shortcomings such as errors, ultrasound becomes an appropriate technique for the measurement of the thyroid volume. \r\n', u'Objectives: We determine the thyroid in patient with Basedow disease by ultrasonography before radioiodine, diameter, measurement of thyroid volume, and the lesion echogenicity.\r\n', u'Subjects and method: The study groups consist of 264 patients, in which there are 53 men (20.07%) and 211 women (79.92%), in Bach Mai Hospital. The youngest is 16 years old and the oldest is 73. With a medium age of (42.97 \uf0b1 12.06) years (range from 16 to 73). The most common group ranging from 40 to 50 years of age, equivalent to a number of 80 patients (30.30%). Surveyed participants include 1845 people with normal thyroid. All of them underwent ultrasound scans with a 7.5 MHZ transducer. This is a prospective study. \r\n', u'Results/Outcomes: The average volume of thyroid is (37.03 \uf0b1 19.77) ml compared to the group with approximate thyroid volumes (p > 0.05 based on the ANOVA). Basedow patients\u2019 thyroid volumes tends to be bigger at the adult age, and were bigger than those of normal people (p = 0.0001 t test). 138 (52.27%) surveyed patients had diffuse injuries. 126 patients (47.73%) have thyroid glands which contained multiple nodules. 197 (96.57%) of them had nodules that were \r\n', u'solid echodense and echomix, and 35 (16.36%) had calcifications.\r\n', u'Conclusion: Ultrasonography (US) has become an important asset in thedetermination of thyroid volume at referred for 131I treatment and the evaluation of thyroid nodules of patients with Basedows\u2019 disease associated with nodules. These data suggest the value of surgery in Basedows\u2019 disease associated with nodules, to eliminate the risk of malignancy.\r\n', u'

Determinining the thrydoid volume of healthy aldult by Multi slice computer tomographyin comparision to ultrasound

Background: Currently there is a few research on thyroid volume determined by computer tomography scanner (CT-scanner)\r\n', u'Objectives: to add and to develop normal thyroid indicators by CT scanner method.\r\n', u'Subjects and method: Researchers determined thyroid volume in 45 normal persons (27 males, 18 females) in Bach Mai Hospital by Multi slice computer tomography (MSCT). The control ultrasound group has 1845 persons (living in Hanoi and Khanh Hoa. All of them were clinically tested with normal thyroid.\r\n', u'Results: The result of measurement by ultrasound and MSCT in the comparison (both two genders) as follow: \r\n', u'The width of the right and left lobe of thyroid measured by ultrasound were bigger than those measured by MSCT (p<0.05 as T-test). The depth of the right and the left lobe of thyroid measured by ultrasound were smaller than those measured by MSCT (p<0.05 as T-test). The length of the right and left lobe of thyroid measured by both methods gave nearly the same result (p>0.05 as T-test). In three formulas measuring thyroid volume according to ellipse, the V3=0.479 a.b.c formula shows the results which nearly same as those by MSCT directly.\r\n', u'Conclusion: Thyroid volume measured by MSCT in this study is smaller than the result of some foreign studies (p <0.05).\r\n', u'\r\n', u'\r\n', u'

Study on the thyroid of healthy adult people by computer tomography

The authors determined the length, width and depth of thyroid lobe and thyroid volume by computer tomography (CT). Results: there was no statistically significant difference in the width of right lobe with that that of left one (p>0.05), but the length and depth of right lobe is higher than those of left one (p0.05), but in general the volume of right lobe is higher than that of left one.

Assessing the change of ultrasonic image and the thyroid volume in Basedow patients

The thyroid volume and ultrasonic image of 356 healthy adults and 133 Basedow patients were assessed. The results are as follow: Thyroid gland of Basedow patients has low, diffusive echo and no steady border... These volumes are bigger than that of healthy adults (39.18ml+/-19.02ml, n=133 vs 12.06+/-4.07, n=356), p<0.0001.