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Gastroenterology ; 160(6):S-215, 2021.
Article in English | EMBASE | ID: covidwho-1599091


Background: The coronavirus disease 19 (COVID-19) pandemic has disrupted healthcare delivery including cancellation of elective endoscopy. Despite the implementation of safety protocols to limit COVID-19 spread in endoscopy units, significant fear of infection remains among patients. We aimed to determine the prevalence of endoscopy cancellations in the COVID-19 era and identify patient characteristics associated with cancellation due to the pandemic. Methods: Medical charts were reviewed for adults who cancelled a scheduled endoscopic procedure from 5/2020-8/2020 at a tertiary care academic center. Inpatient endoscopies were excluded. Reasons for cancellation were categorized as COVID-19 related, non-COVID-19 related, or unclear. COVID-19 related cancellations were further categorized as COVID-19 testing logistics related, COVID-19 fear related, or other. The association of patient characteristics with cancellation of endoscopy due to COVID-19 were assessed using logistic regression. Results: 652 patient charts were reviewed. Median age was 58, with55% female, 61% non-Hispanic white, 11% had IBD, and 16% were immunosuppressed.Procedure types included 120 (18%) upper endoscopies (EGD), 362 (56%) colonoscopies, 93 (14%) EGD/colonoscopies, 20 (3%) sigmoidoscopies, and 57 (9%) advanced endoscopic procedures. 211 (32%) cancellations were due to COVID-19, 384 (59%) were due to non-COVID-19 reasons, and 57 (9%) were undetermined. Among COVID-19 related cancellations, 75 (36%) were COVID-19 testing logistics related, 121 (57%) were COVID-19 fear related, and 15 (7%) were other. On multivariate analysis, the odds of cancellation due to COVID-19 was significantly higher for black patients (OR 2.01, 95% CI 1.05-3.86, p=0.04), while patients undergoing EGD (OR 0.50, 95% CI 0.28-0.89, p=0.02) or advanced endoscopy (OR 0.18, 95% CI 0.07-0.49, p=0.001) had lower odds of cancellation [Table 1]. The odds of cancelling due to COVID-19 testing was significantly higher among black patients (OR 3.12, 95% CI 1.03-9.46, p=0.05), patients with Medi-Cal insurance (OR 2.89, 95% CI 1.21-6.89, p=0.02), and patients undergoing sigmoidoscopy (OR 11.6, 95% CI 1.23-108.5, p=0.03) and diagnostic indications (OR 2.96, 95% CI 1.22-7.21, p=0.02). Patients with older age (≥65) had higher odds of COVID-19 fear related cancellation (OR 0.29, 95% CI 0.10-0.81, p=0.02) [Table 2]. Conclusion: COVID-19 has negatively impacted endoscopy scheduling. Diagnostic or therapeutic procedures are associated with a lower risk of cancellation related to COVID-19. Black race is associated with an increased risk of COVID-19 related cancellation. Specifically, black patients and those with Medi-Cal are at increased risk of cancellation related to COVID-19 testing logistics. Racial and socioeconomic disparities in access to endoscopy may be further amplified by the COVID-19 pandemic and warrant further study.(Table Presented)(Table Presented)

AIMS Biophysics ; 8(3):248-263, 2021.
Article in English | Scopus | ID: covidwho-1367953


The initial step of interaction of some pathogens with the host is driven by the interaction of glycoproteins of either side via endcaps of their glycans. These end caps consist of sialic acids or sugar molecules. Coronaviruses (CoVs), including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), are found to use this route of interaction. The strength and spatial interactions on the single molecule level of sialic acids with either the spike (S) protein of SARS coronaviruses, or human angiotensin-converting enzyme 2 (ACE2) and furin are probed and compared to the binding modes of those sugar molecules which are present in glycans of glycoproteins. The protocol of using single molecules is seen as a simplified but effective mimic of the complex mode of interaction of the glycans. Averaged estimated binding energies from a docking approach result in preferential binding of the sialic acids to a specific binding site of the S protein of human coronavirus OC43 (HCoV-OC43). Furin is proposed to provide better binding sites for sialic acids than ACE2, albeit outweighed by sites for other sugar molecules. Absolute minimal estimated binding energies indicate weak binding affinities and are indifferent to the type of sugar molecules and the proteins. Neither the proposed best binding sites of the sialic acids nor those of the sugar molecules overlap with any of the cleavage sites at the S protein and the active sites of the human proteins. © 2021, AIMS Biophysics. All rights reserved.

Gastroenterology ; 160(6):S215-S215, 2021.
Article in English | Web of Science | ID: covidwho-1250854
Journal of Integrative Agriculture ; 19(12):2866-2876, 2020.
Article in English | Web of Science | ID: covidwho-1003174


In the face of the corona virus disease 2019 (COVID-19) pandemic, it is essential to stabilize the security of urban "shopping baskets". Through a survey and interviews with 46 agricultural cooperatives in Shanghai, this paper analyzes the impact of the pandemic on vegetable production and offers suggestions on agricultural insurance. The research results show that: (1) the pandemic has impacted almost all stages of the vegetable supply chain but has had a greater impact on the sales stage;(2) the market risks of vegetable production have increased significantly, and the gap between the field price and the market price has widened. The sales price difference between traditional channels and e-commerce is notable;(3) farmers' incomes have generally declined due to the COVID-19 pandemic, and traditional small-scale farmers have suffered more losses;and (4) agricultural insurance plays an important role in stabilizing the supply of vegetables to the city. To minimize the impact of the pandemic on vegetable production and to stabilize both urban "shopping baskets" and farmers' incomes, it is necessary to further improve agricultural insurance, especially to provide insurance against market risks.