Omicron driven ECMO in a vaccinated critically ill patient

Objectives: Reporting a case of a COVID-19 vaccinated patient admitted to our intensive care unit with severe acute respiratory failure due to SARSCoV2 - Omicron variant, rapidly deteriorating requiring intubation, prone ventilation, and ECMO support. Method(s): A 62 years old Caucasian male was admitted in ICU for rapidly deranging respiratory failure and fever which occurred over the previous 24h. The patient received two doses of SARS-CoV2 vaccine (Oxford, AstraZeneca), the last one over five months before onset of symptoms. The patient was admitted to the intensive care unit (ICU) with tachypnea, low peripheral saturation (80%), elevated serum creatinine (2.4 mg/dl), and mild obesity (BMI 34,6). Pressure support ventilation trial (2 hours) failed carryng out to orotracheal intubation and protective ventilation. Worsening of respiratory exchanges (5 th day from the admission) required a rescue prone ventilation cycle, in the meantime an indication was given to the placement of veno-venous ECMO. The cannulation site was femoro-femoral and the configuration used was Vivc25- Va21, according to the current ELSO nomenclature;ECMO flow was progressively increased until a peripheral saturation of 95% was obtained. Result(s): The patient passed out after 2 month of extracorporeal support with no sign of recovery of pulmonary and renal function. Conclusion(s): Unlike evidences showing a lower symptomatic engagement of the Omicron variant SARSCoV2 positive patients, we have witnessed a rapid and massive pulmonary involvement. The short time that passed from the onset of symptoms and the rapid decay of respiratory function required rapid escalation of the intensity of care up to extracorporeal support. The patient showed previous pathologies that can lead to suspicion of a loss of immune coverage given by the vaccine, in addition to the long time elapsed since the last dose. (Figure Presented).

Impact of the COVID 19 pandemic on smoking behavior and beliefs among the American University of Beirut community

INTRODUCTION The current COVID-19 outbreak has led to sudden changes in routine and modifications in health behaviors. The study presented here investigates the changes in smoking behavior and beliefs due to the pandemic among a sample of individuals at the American University of Beirut (AUB) in Lebanon, between August and September 2020. METHODS This is a cross-sectional exploratory study based on data collected through an anonymous, web-based questionnaire. We performed descriptive and univariate analysis on sociodemographic factors, smoking practices, smoking behavior changes, and smoking beliefs. RESULTS In all, 197 participants (65.5% never smokers, 8.1% former smokers, and 26.4% current smokers) completed the online survey. Of these, 19.3% reported a change in their smoking behavior in the last four months, with an equal number of participants increasing and decreasing smoking. Univariate analysis showed that fear of contracting coronavirus and personal health concerns were significantly associated with a decrease in smoking. In contrast, the stress associated with the COVID-19 crisis and the economic crisis was associated with an increase in smoking. CONCLUSIONS The current COVID-19 outbreak has resulted in unexpected alterations in routine and changes in health behaviors. A quarter of all participants said they had changed their smoking habits, with an equal percentage saying they had increased or decreased their smoking. Future research is needed to look into changes in smoking behavior in a more representative group.

Wellbeing and stress management during the covid-19 pandemic

On February 21, 2020 Lebanon reported its first case of COVID-19.1 The World Health Organization2 declared COVID-19 a pandemic on March 11.2 As the coronavirus disease 2019 pandemic evolved, Healthcare Workers (HCW) started facing challenges they had never encountered before, in their professional and personal lives.3. © 2020, American University of Beirut. All rights reserved.