The potential impact of post-COVID symptoms in the healthcare sector.

BACKGROUND: The phenomenon of post-COVID syndrome (PCS) is evolving from an abstract array of non-specific symptoms to an identifiable clinical entity of variable severity. Its frequency and persistence have implications for service delivery and workforce planning. AIMS: This study was aimed to assess the prevalence of symptoms consistent with PCS and the subjective degree of recovery in a cohort of healthcare workers, focusing on those who have returned to work. METHODS: A study population of 1176 was surveyed when attending for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody testing. Two sub-groups were identified: those with known (i.e. diagnosed on PCR testing) and assumed (i.e. antibody evidence of previous infection) SARs-CoV-2 infection, at least 12 weeks prior to the study. Each group was asked about their subjective degree of recovery and the nature of their persistent symptoms. Results were analysed via excel and SPSS. RESULTS: In total, 144 employees showed PCR evidence of previous infection, with 139 of these being infected at least 12 weeks prior to the study. Of these 139, only 19% (n = 26) reported feeling 100% recovered, and 71% reported persistent symptoms. Of those with assumed SARS-CoV-2 infection (n = 78), 32 (41%) were truly asymptomatic since the commencement of the pandemic, while 46 (59%) described symptoms suggestive of possible infection at least 12 weeks prior to the study. Of this latter group, 23% (n = 18) also reported residual symptoms. CONCLUSIONS: PCS is prevalent among this group, including those not previously diagnosed with COVID-19. Its' frequency and duration present challenges to employers with regards to the management of work availability and performance.

Deprivation in cold weather increases the risk of hospital admission with hypothermia in older people.

BACKGROUND: Material deprivation in cold weather may increase the risk of hypothermia and contribute to excess winter mortality. To date, there were no local data to support the potential contribution of material deprivation to the incidence of hypothermia in Irish older people. AIM: To contribute evidence from a hospital-based perspective. METHODS: Patient series from St James's Hospital Dublin, Ireland. Of all patients aged≥65 years experiencing their last medical admission between 1 January 2002 and 31 December 2010, we selected those who presented with a body temperature of <35 °C. Their clinical characteristics were compared with those of a random sample of 200 age and gender-matched non-hypothermic patients. Multivariate logistic regression was used to identify predictors of presentation with hypothermia. The following predictors were considered: age, gender, mean air temperature on the day of admission, year of admission, comorbidity, major diagnostic categories, and material deprivation as per the Irish National Deprivation Index (NDI). RESULTS: Eighty patients presented with hypothermia over the period. They presented in colder days (mean 8.8 vs. 10.8 °C, P<0.001) were less likely to present in summer (P<0.002), more likely to present in winter (P=0.010), and their mortality was high (50 vs. 17%, P<0.001). The interaction NDI* air temperature was a significant multivariate predictor of hypothermia (OR=1.03, 95% CI 1.01-1.06, P=0.033). CONCLUSIONS: The NDI could be an adequate tool to target fuel poverty in older people.