Use of technology to facilitate recovery in young adults with first-episode psychosis

Aims: Accessibility and engagement to high quality non pharmacological interventions for First-Episode Psychosis individuals (FEP) is hindered by different factors such as patients motivation, clinical time, lack of adaptation to patient needs. Taking into account patients' preference in the design in an individualized treatment plan as well as challenges faced by this particular patient, and his specific context/ environment can possibly enhance patient satisfaction and engagement. Technology can help to both standardized and individualize intervention to maximize the proposed services impacts. Method(s): This symposium explore how different technological tools can assist both clinicians and patients in enhancing patient experience of care First, the technokinpep, an innovative telekinesiology project offered by a peer support worker in multiple early psychosis services simultaneously, maximized accessibility of physical activity during the COVID-19 pandemic, social distanciation requirements. Second, Ocean empire, a mobile app aimed at improving physical activity motivation and affect in early psychosis. With this study, this presentation will shed light on the development and implementation of this mobile app. Third, exercise your wau used a mobile app to tailor the physical activity intervention program to the patients preferences and needs. Finally, the Freedom app gives the duo patient-clinicians a tool to facilitate shared decision making to enhance the therapeutic relation. Result(s): These different technologies can enhance patient and clinicians experience of collaborative and tailored adapted treatment. Conclusion(s): The development of new technology can help improving care by adapting it to better individual's needs.

Clinical Efficacy of Early Administration of Convalescent Plasma among COVID-19 Cases in Egypt

BACKGROUND: The rapid worldwide spread of the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) or COVID-19 pandemic from its epicenter;Wuhan was first reported in December 2019. Egypt reported its first COVID-19 case on February 14, 2020. Thereafter, Egypt scaled-up preventive measures, with a partial lockdown starting on March 25. Several therapeutic agents along with convalescent plasma transfusion (CPT) are under investigation and data from CPTs have been receiving a lot of attention, after Emergency approvals from the Food and Drug Administration suggesting that it may provide a clinical effect in the treatment of SARS-COV-2. IMPORTANCE: Early and effective treatment of COVID-19 is vital for control of SARS-CoV-2 infection. METHODS: Designs: An interventional, single-arm, and non-randomized clinical trial conducted in Egypt from April 15 to July 21, 2020. Settings: This was a multi-center study conducted in three hospitals in Egypt. Participants: A total of 94 COVID-19 laboratory-confirmed patients using quantitative real-time polymerase chain reaction were enrolled in the study. Intervention: All patients were administered with two plasma units (each unit is 200 cc). The volume of donated plasma was 800 cc. Main Outcome and measures: Primary measure was the degree of clinical improvement among the COVID-19 patients who received CPT within 7 days. RESULTS: A total of 94 patients were enrolled who received CPT either within 7 days or after 7 days of hospitalization. 82 were severely ill and 12 were critically ill. The average age remained 58 years (±standard deviation 15.1 years). Male were 69% and 49% patients got cured while 51% died with case fatality rate 51%. Seventy-five percent deaths were above 45 years of age. The symptoms were dyspnea (55%), fever (52%), cough (46%), and loss of taste and smell (21%), and cyanosis (15%). The most common co-morbidities among the <40 years remained diabetes mellitus (21%) and asthma (14%). Among 40–60 years hypertension (56%), diabetes mellitus (39%) and among >60 years age group hypertension (57%), and chronic heart disease (24%) were reported. CPT within 7 days remained significant as compared with the CPT after 7 days with the number of days to cure (p=0.007) and ICU stay (p = 0.008) among severely ill cured cases. CONCLUSIONS: Among patients with COVID-19 and severe or critical illness, the use of CPT along with routine standard therapy resulted in a statistically significant improvement when administered within seven days of hospital admission. However, plasma transfusion, irrespective of days to transfusion may not help treat critically ill patients. The overall mean time to cure in severely ill patients was 15 days if CPT provided within 7 days with 65% cure rate. TRIAL REGISTRATION: Clinical Intervention identifier: MOHP_COVID-19_Ver1.1 registered April 2020.

Evaluation of nasal function in patients with COVID-19: nasal secretion, nasal clearance, and SNOT-22 score

Objective: This study aimed to investigate the nasal findings in patients who tested positive for the coronavirus disease 2019 (COVID-19) and objectively evaluate the amount of nasal secretion and nasal clearance. Methods: The study included 40 patients who tested positive and 40 volunteers who tested negative for COVID-19 infection. The self-administered Turkish version of the sinonasal outcome test -22 (SNOT-22) questionnaire was used to evaluate the sinonasal findings, the nasal Schirmer test was used to evaluate the amount of nasal secretion, and the saccharin test was used to evaluate nasal clearance. The results of both groups were compared. Results: The SNOT-22 score averages were 23.3±14.5 and 11.2±11.7 for the COVID-19-positive group and COVID-19-negative controls, respectively. In the COVID-19 positive group, SNOT-22 results were statistically significantly higher than those of the controls (p≤0.001). The nasal Schirmer and nasal saccharin test results in the COVID-19-positive group were statistically significantly higher than those of the controls (p≤0.002 and p≤0.001). Conclusion: In patients who tested positive for COVID-19 infection, increased amounts of nasal secretion and prolonged nasal clearance time were observed. They also had higher SNOT-22 scores than those of the negative controls. Although these findings demonstrate that there may be changes in nasal functions in patients positive for COVID-19 infection, new studies are needed to elucidate the nasal effects in detail.

Demographic and clinical features associated with in-hospital mortality in egyptian covid-19 patients: A retrospective cohort study

AIM: We evaluated in this study the demographic and clinical characteristics of COVID-19 disease in the Egyptian population with special consideration for its mortality predictors. METHODS: About 8162 participants (mean age 48.7 ± 17.3 years, 54.5% males) with RT-PCR positive COVID-19 were included. The electronic medical records were reviewed for demographic, clinical, laboratory, and radiologic features. The primary outcome was the in-hospital mortality rate. RESULTS: The in-hospital mortality was 11.2%. There was a statistically significant strong association of in-hospital mortality with age >60-years-old (OR: 4.7;95% CI 4.1–5.4;p < 0.001), diabetes mellitus (OR: 4.6;95% CI 3.99–5.32;p <0.001), hypertension (OR: 3.9;95% CI 3.4–4.5;p < 0.001), coronary artery disease (OR: 2.7;95% CI 2.2–3.2;p < 0.001), chronic obstructive pulmonary disease (OR: 2.1;95% CI 1.7–2.5;p < 0.001), chronic kidney disease (OR: 4.8;95% CI 3.9–5.9;p < 0.001), malignancy (OR: 3.7;95% CI 2.3–5.75;p < 0.001), neutrophil-lymphocyte ratio >3.1 (OR: 6.4;95% CI 4.4–9.5;p < 0.001), and ground glass opacities (GGOs) in CT chest (OR: 3.5;95% CI 2.84–4.4;p < 0.001), respectively. There was a statistically significant moderate association of in-hospital mortality with male gender (OR: 1.6;95% CI 1.38–1.83;p < 0.001) and smoking (OR: 1.6;95% CI 1.3–1.9;p < 0.001). GGOs was reported as the most common CT finding (occurred in 73.1% of the study participants). CONCLUSION: This multicenter, retrospective study ascertained the higher in-hospital mortality rate in Egyptian COVID-19 patients with different comorbidities.

COVID-19 in Egyptian Children: A Multicenter Study

Objective The novel coronavirus disease 2019 (COVID-19) has made its worldwide spread since its outbreak in December 2019. Limited information is available about the epidemiology and clinical characteristics of COVID-19, especially in Africa and Egypt. Methods We aimed to study the clinical and epidemiological characteristics of COVID-19 in Egyptian children. This is an observational retrospective cohort study performed at two specialized COVID-19 isolation hospitals in Egypt. All admitted COVID-19 pediatric patients between March 20, 2020, and May 1, 2020, were included in the study. Discussion This study included 40 COVID-19 confirmed cases (mean age, 9.4 years), 67.5% were male, 85% were asymptomatic, and 15% had mild symptoms. There were no confirmed severe or critically ill cases among the patients. Conclusion COVID-19 runs in a benign course in Egyptian children with no mortality and no significant morbidity.

Sex- and gender-based analysis of coronavirus crisis competence

The COVID-19 pandemic has dramatically changed the social and economic activities of the world. Social distancing measures put in place by public health authorities have indirectly increased the level of stress and reduced the number and quality of social interactions maintained by individuals. Because biological sex and socio-cultural gender are important determinants of health, the sexes are at risk of experiencing these COVID-19-related changes in unique ways. To our knowledge, few studies have assessed how socio-political crises like that of the COVID-19 pandemic can exacerbate the mental health disparities that exist between men, women and gender diverse people. In addition, very little is known about what factors can promote protection, coping, and resilience in the face of catastrophes faced during pandemics and how this may differ by sex and gender. Using a cross-sectional online survey composed of 9 short questionnaires, this study aims to assess the ways in which sex and gender factors relate to stress, coping, resilience, and mental health in the current COVID-19 crisis. To adequately assess sex and gender factors and maximize representation, participants (N = 3000) of different sex, gender and sexual identities from across Canada and the world will be recruited. The complete protocol as well as the statistical analyses used to assess COVID-19 stress, mental health, sociodemographic factors, sex/gender factors’ association with coping and resilience, and ‘coronavirus crisis competence’ will be presented. This ongoing study is funded in part by the Fonds de recherche du Québec – Santé (FRQS).