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1.
PLoS One ; 17(11): e0277875, 2022.
Статья в английский | MEDLINE | ID: covidwho-2140667

Реферат

INTRODUCTION: During the COVID-19 pandemic, healthcare workers had a high workload and were exposed to multiple psychosocial stressors. However, a knowledge gap exists about the levels of burnout among Bangladeshi frontline doctors during this COVID-19 pandemic. The study investigated burnout syndrome (BOS) among frontline doctors in two public secondary and tertiary care hospitals in Chattogram, Bangladesh. MATERIALS & METHODS: This cross-sectional study involved frontline doctors working at two hospitals treating COVID-19 and non-COVID patients from June to August 2020. A self-administered questionnaire that included Maslach Burnout Inventory for Human Services Survey (MBI-HSS) was used to capture demographic and workplace environment information. ANOVA and t-test were used to determine the statistical differences in the mean values of the three dimensions of MBI-HSS. Scores for three domains of burnout: emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA) were calculated. Post-hoc analysis was done to identify the significant pair-wise differences when the ANOVA test result was significant. Multiple logistic regression was performed to determine the influence of factors associated with BOS. RESULTS: A total of 185 frontline doctors were invited to participate by convenience sampling, and 168 responded. The response rate was 90.81%. The overall prevalence of BOS was 55.4% (93/168) (95% CI: 47.5% to 63.0%). Moderate to high levels of EE was found in 95.8% of the participants. High DP and reduced PA were observed in 98.2% and 97% of participants. Younger age (25-29 years), being female, and working as a medical officer were independently associated with high levels of burnout in all three domains. EE was significantly higher in females (P = 0.011). DP was significantly higher in medical officers, those at earlier job periods, and those working more than 8 hours per day. CONCLUSION: During the COVID-19 outbreak, BOS was common among Bangladeshi frontline doctors. Females, medical officers, and younger doctors tended to be more susceptible to BOS. Less BOS was experienced when working in the non-COVID ward than in the mixed ward.


Тема - темы
Burnout, Professional , COVID-19 , Humans , Female , Adult , Male , COVID-19/epidemiology , Cross-Sectional Studies , Tertiary Care Centers , Bangladesh/epidemiology , Pandemics , Burnout, Professional/epidemiology , Burnout, Professional/psychology
2.
BMC Med Educ ; 22(1): 726, 2022 Oct 17.
Статья в английский | MEDLINE | ID: covidwho-2139256

Реферат

BACKGROUNDS: On March 11, 2020, the World Health Organization (WHO) declared the novel coronavirus (COVID-19) outbreak a global pandemic, which changed the residents' teaching and learning process. The purpose of this study was to determine residents' satisfaction and impressions on their training during the pandemic in a tertiary pediatric hospital. METHODS: This was a descriptive cross-sectional study. An online survey was designed to determine residents' demographic and personal characteristics, as well as their perception about the theoretical and practical training, as well as about their emotional situation. The analysis separated medical students from surgical students in order to identify any differences existing between these groups, for which χ2 was calculated. RESULTS: Overall, 148 of 171 residents (86.5%) responded to the questionnaire; 75% belonged to the medical specialty and 25% to the surgical specialty. Statistically significant differences were found in terms of those training aspects they were concerned about during the pandemic (p < 0.001) and about the difficulties associated with online learning (p = 0.001). Differences were also found regarding their satisfaction toward the time needed to complete their thesis (p = 0.059) and activities outside the hospital (p = 0.029). Regarding their degree of satisfaction in general, most medical specialty students felt slightly satisfied (43.2%) and surgical specialty students felt mostly neutral (37.8%). Regarding their feelings about their mental health, statistically significant differences were found between both groups (p = 0.038) although both groups reported the same percentage of overall dissatisfaction (2.7%) in this area. CONCLUSION: The COVID-19 pandemic has brought significant challenges to medical education systems. Lack of practice in decision-making and maneuver execution are concerns for residents and may affect their future professional performance.


Тема - темы
COVID-19 , Internship and Residency , COVID-19/epidemiology , Child , Cross-Sectional Studies , Humans , Mexico/epidemiology , Pandemics , Perception , Surveys and Questionnaires , Tertiary Care Centers
3.
Enferm Infecc Microbiol Clin (Engl Ed) ; 40(9): 503-506, 2022 11.
Статья в английский | MEDLINE | ID: covidwho-2130676

Реферат

INTRODUCTION: The objective is to analyze the impact of the COVID-19 pandemic on the pediatric emergencies and hospital admissions. METHODS: Retrospective cohort study of patients treated in a tertiary hospital, from March 14 to April 26, 2020, compared to the same period of the previous 3 years. RESULTS: A notable overall reduction in emergency room visits and admissions is observed in all pediatric areas, maintaining care in neonatology and scheduled admissions in oncology. DISCUSSION: The reduction in global activity in pediatric emergencies is not only explained by the decrease in contagious diseases. The decrease in inadequate demand and inappropriate income may have contributed. The availability of pediatric beds would make the reduction of programmed surgical activity unnecessary and would allow the redistribution of resources to areas with greater healthcare pressure.


Тема - темы
COVID-19 , Humans , Child , Pandemics , Tertiary Care Centers , SARS-CoV-2 , Emergencies , Retrospective Studies , Emergency Service, Hospital , Hospitalization
4.
Indian J Pediatr ; 89(12): 1222-1228, 2022 12.
Статья в английский | MEDLINE | ID: covidwho-2129321

Реферат

OBJECTIVE: To describe COVID-19 in children and the differences between the two waves. METHODS: The electronic medical records of children younger than 16 y of age with laboratory-confirmed COVID-19 infection between June 1st 2020 and May 31st 2021 at Christian Medical College, Vellore were retrospectively reviewed. Demographic, clinical, and laboratory data were collected on a predesigned case record form and analyzed. RESULTS: A total of 988 children were diagnosed with confirmed COVID-19 during the study period. Of these, there were 585 children diagnosed during the 1st wave (June 2020-Feb 2021) and 403 children during the 2nd wave (March 2021-May 2021). It was found that loose stools and rash were significantly more frequent during the 1st wave and fever, cough, coryza, heart rate and temperature were significantly more during the 2nd wave. There was no significant difference between the two groups in terms of requirement of oxygen therapy, need for ICU admission, duration of ICU stay or hospital stay, or severity of illness. Mortality was significantly higher during the 2nd wave (0.3% vs. 2%). CONCLUSION: The COVID-19 pandemic among children during the 1st and 2nd waves were similar in severity, though there was a higher mortality during the 2nd wave.


Тема - темы
COVID-19 , Child , Humans , COVID-19/epidemiology , Pandemics , SARS-CoV-2 , Retrospective Studies , Tertiary Care Centers , India/epidemiology
5.
J Prev Med Hyg ; 63(3): E375-E382, 2022.
Статья в английский | MEDLINE | ID: covidwho-2145533

Реферат

Introduction: The COVID-19 pandemic was declared on March 11th, 2020. By the end of January, the first imported cases were detected in Spain and, by March, the number of cases was growing exponentially, causing the implementation of a national lockdown. Madrid has been one of the most affected regions in terms of both cases and deaths. The aim of this study is to describe the epidemic curve and the epidemiological features and outcomes of COVID-19 patients hospitalized in La Paz University Hospital, a tertiary hospital located in Madrid. Methods: We included confirmed and probable COVID-19 cases admitted to our centre from February 26th to June 1st, 2020. We studied trends in hospitalization and ICU admissions using joinpoint regression analysis. Results: A sample of 2970 patients was obtained. Median age was 70 years old (IQR 55-82) and 54.8% of them were male. ICU admission rate was 8.7% with a mortality rate of 45.7%. Global CFR was 21.8%. Median time from symptom onset to death was 14 days (IQR 9-22). Conclusions: We detected an admissions peak on March 21st followed by a descending trend, matching national and regional data. Age and sex distribution were comparable to further series nationally and in western countries.


Тема - темы
COVID-19 , Humans , Male , Aged , Female , Tertiary Care Centers , COVID-19/epidemiology , Pandemics , Communicable Disease Control , Spain/epidemiology
6.
Arq Bras Oftalmol ; 85(6): 614-619, 2022.
Статья в английский | MEDLINE | ID: covidwho-2144889

Реферат

PURPOSE: This study evaluated the frequency of the most common ophthalmological, neurological, and systemic findings in symptomatic patients seen at a COVID-19 screening service at Hospital das Clínicas - Universidade Federal de Pernambuco. METHODS: A total of 104 patients under clinical suspicion of SARS-CoV-2 infection underwent medical evaluation through an ophthalmological and systemic symptoms survey. All participants selected for the study underwent COVID-19 RT-PCR testing. RESULTS: The mean age was 38.8 years, with 44.23% between 31 and 40 years old, 68.27% female, and 31.73% male. The most common symptoms in patients with a positive RT-PCR test were cough (69.23%), fever (42.3%), hyposmia (38.46%), myalgia (38.46%), and ageusia (30.77%). In the positive group, 34.61% presented with ophthalmological symptoms: burning (19.23%), eye pain (11.54%), foreign body sensation (7.7%), hyperemia (7.7%), and tearing (3.84%). CONCLUSIONS: Systemic clinical features were characteristic of upper respiratory infection, but neurological findings of hyposmia and anosmia proved to be important markers for suspicion of SARS-CoV-2 infection. Ophthalmic symptoms in patients with COVID-19 were similar to those observed in other viral conditions and may precede systemic conditions. A high rate of self-medication was observed for general symptoms compared with ophthalmological conditions.


Тема - темы
COVID-19 , Humans , Male , Female , Adult , COVID-19/diagnosis , COVID-19/epidemiology , SARS-CoV-2 , Anosmia , Tertiary Care Centers , Brazil/epidemiology
7.
West J Emerg Med ; 23(6): 907-912, 2022 Nov 01.
Статья в английский | MEDLINE | ID: covidwho-2144843

Реферат

INTRODUCTION: Coronavirus 2019 (COVID-19) illness continues to affect national and global hospital systems, with a particularly high burden to intensive care unit (ICU) beds and resources. It is critical to identify patients who initially do not require ICU resources but subsequently rapidly deteriorate. We investigated patient populations during COVID-19 at times of full or near-full (surge) and non-full (non-surge) hospital capacity to determine the effect on those who may need a higher level of care or deteriorate quickly, defined as requiring a transfer to ICU within 24 hours of admission to a non-ICU level of care, and to provide further knowledge on this high-risk group of patients. METHODS: This was a retrospective cohort study of a single health system comprising four emergency departments and three tertiary hospitals in New York, NY, across two different time periods (during surge and non-surge inpatient volume times during the COVID-19 pandemic). We queried the electronic health record for all patients admitted to a non-ICU setting with unexpected ICU transfer (UIT) within 24 hours of admission. We then made a comparison between adult patients with confirmed coronavirus 2019 and without during surge and non-surge time periods. RESULTS: During the surge period, there was a total of 86 UITs in a one-month period. Of those, 60 were COVID-19 positive patients who had a mortality rate of 63.3%, and 26 were COVID-19 negative with a 30.8 % mortality rate. During the non-surge period, there was a total of 112 UITs; of those, 24 were COVID-19 positive with a 37.5% mortality rate, and 90 were COVID-19 negative with a 11.1% mortality rate. CONCLUSION: During the surge, the mortality rate for both COVID-19 positive and COVID-19 negative patients experiencing an unexpected ICU transfer was significantly higher.


Тема - темы
COVID-19 , Pandemics , Adult , Humans , Retrospective Studies , Hospitalization , Tertiary Care Centers
8.
JMIR Public Health Surveill ; 7(1): e21327, 2021 01 08.
Статья в английский | MEDLINE | ID: covidwho-2141283

Реферат

BACKGROUND: The COVID-19 pandemic, caused by SARS-CoV-2, has forced the health care delivery structure to change rapidly. The pandemic has further widened the disparities in health care and exposed vulnerable populations. Health care services caring for such populations must not only continue to operate but create innovative methods of care delivery without compromising safety. We present our experience of incorporating telemedicine in our university hospital-based outpatient clinic in one of the worst-hit areas in the world. OBJECTIVE: Our goal is to assess the adoption of a telemedicine service in the first month of its implementation in outpatient practice during the COVID-19 pandemic. We also want to assess the need for transitioning to telemedicine, the benefits and challenges in doing so, and ongoing solutions during the initial phase of the implementation of telemedicine services for our patients. METHODS: We conducted a prospective review of clinic operations data from the first month of a telemedicine rollout in the outpatient adult ambulatory clinic from April 1, 2020, to April 30, 2020. A telemedicine visit was defined as synchronous audio-video communication between the provider and patient for clinical care longer than 5 minutes or if the video visit converted to a telephone visit after 5 minutes due to technical problems. We recorded the number of telemedicine visits scheduled, visits completed, and the time for each visit. We also noted the most frequent billing codes used based on the time spent in the patient care and the number of clinical tasks (eg, activity suggested through diagnosis or procedural code) that were addressed remotely by the physicians. RESULTS: During the study period, we had 110 telemedicine visits scheduled, of which 94 (85.4%) visits were completed. The average duration of the video visit was 35 minutes, with the most prolonged visit lasting 120 minutes. Of 94 patients, 24 (25.54%) patients were recently discharged from the hospital, and 70 (74.46%) patients were seen for urgent care needs. There was a 50% increase from the baseline in the number of clinical tasks that were addressed by the physicians during the pandemic. CONCLUSIONS: There was a high acceptance of telemedicine services by the patients, which was evident by a high show rate during the COVID-19 pandemic in Detroit. With limited staffing, restricted outpatient work hours, a shortage of providers, and increased outpatient needs, telemedicine was successfully implemented in our practice.


Тема - темы
Pandemics/prevention & control , Telemedicine/methods , Ambulatory Care/methods , COVID-19/complications , COVID-19/transmission , Humans , Michigan , Pandemics/statistics & numerical data , Patient Satisfaction , Prospective Studies , Retrospective Studies , Telemedicine/trends , Tertiary Care Centers/organization & administration , Tertiary Care Centers/trends
9.
Sao Paulo Med J ; 138(4): 305-309, 2020.
Статья в английский | MEDLINE | ID: covidwho-2140943

Реферат

BACKGROUND: The COVID-19 pandemic is threatening healthcare systems and hospital operations on a global scale. Treatment algorithms have changed in general surgery clinics, as in other medical disciplines providing emergency services, with greater changes seen especially in pandemic hospitals. OBJECTIVES: To evaluate the follow-up of patients undergoing emergency surgery in our hospital during the COVID-19 pandemic. DESIGN AND SETTING: Cross-sectional study conducted in a tertiary-level public hospital. METHODS: The emergency surgeries carried out between March 11 and April 2, 2020, in the general surgery clinic of a tertiary-care hospital that has also taken on the functions of a pandemic hospital, were retrospectively examined. RESULTS: A total of 25 patients were included, among whom 20 were discharged without event, one remained in the surgical intensive care unit, two are under follow-up by the surgery service and two died. Upon developing postoperative fever and shortness of breath, two patients underwent thoracic computed tomography (CT), although no characteristics indicating COVID-19 were found. The discharged patients had no COVID-19 positivity at follow-up. CONCLUSION: The data that we obtained were not surgical results from patients with COVID-19 infection. They were the results from emergency surgeries on patients who were not infected with COVID-19 but were in a hospital largely dealing with the pandemic. Analysis on the cases in this study showed that both the patients with emergency surgery and the patients with COVID infection were successfully treated, without influencing each other, through appropriate isolation measures, although managed in the same hospital. In addition, these successful results were supported by 14-day follow-up after discharge.


Тема - темы
Coronavirus Infections , Emergency Medical Services , Pandemics , Pneumonia, Viral , Surgical Procedures, Operative , Betacoronavirus , COVID-19 , Cross-Sectional Studies , Hospitals, Public , Humans , Retrospective Studies , SARS-CoV-2 , Tertiary Care Centers , Turkey
10.
BMC Infect Dis ; 22(1): 836, 2022 Nov 11.
Статья в английский | MEDLINE | ID: covidwho-2119375

Реферат

BACKGROUND: The COVID-19 pandemic has raised awareness of infection prevention and control. We found that the incidence of nosocomial infection in neurosurgery has changed. This study aimed to evaluate the impact of "coronavirus disease 2019 (COVID-19) prevention and control measures" on nosocomial infections in neurosurgery. METHODS: To explore changes in nosocomial infections in neurosurgery during the COVID-19 pandemic, the clinical data of inpatients undergoing neurosurgery at Taizhou Hospital of Zhejiang Province between January 1 and April 30, 2020 (COVID-19 era) were first analyzed and then compared with those from same period in 2019 (first pre-COVID-19 era). We also analyzed data between May 1 and December 31, 2020 (post-COVID-19 era) at the same time in 2019 (second pre-COVID-19 era). RESULTS: The nosocomial infection rate was 7.85% (54/688) in the first pre-COVID-19 era and 4.30% (26/605) in the COVID-19 era (P = 0.01). The respiratory system infection rate between the first pre-COVID-19 and COVID-19 eras was 6.1% vs. 2.0% (P < 0.01), while the urinary system infection rate was 1.7% vs. 2.0% (P = 0.84). Between the first pre-COVID-19 and COVID-19 eras, respiratory system and urinary infections accounted for 77.78% (42/54) vs. 46.15% (12/26) and 22.22% (12/54) vs. 46.15% (12/26) of the total nosocomial infections, respectively (P < 0.01). Between the second pre-COVID-19 and post-COVID-19 eras, respiratory system and urinary accounted for 53.66% (44/82) vs. 40.63% (39/96) and 24.39% (20/82) vs. 40.63% (39/96) of the total nosocomial infections, respectively (P = 0.02). CONCLUSIONS: The incidence of nosocomial infections in neurosurgery reduced during the COVID-19 pandemic. The reduction was primarily observed in respiratory infections, while the proportion of urinary infections increased significantly.


Тема - темы
COVID-19 , Cross Infection , Neurosurgery , Respiratory Tract Infections , Urinary Tract Infections , Humans , Cross Infection/prevention & control , COVID-19/epidemiology , Pandemics , Tertiary Care Centers , Urinary Tract Infections/epidemiology , Urinary Tract Infections/complications , Respiratory Tract Infections/epidemiology , China/epidemiology
11.
Surg Endosc ; 36(12): 9304-9312, 2022 Dec.
Статья в английский | MEDLINE | ID: covidwho-2119131

Реферат

BACKGROUND: The COVID-19 pandemic caused many surgical providers to conduct outpatient evaluations using remote audiovisual conferencing technology (i.e., telemedicine) for the first time in 2020. We describe our year-long institutional experience with telemedicine in several general surgery clinics at an academic tertiary care center and examine the relationship between area-based socioeconomic measures and the likelihood of telemedicine participation. METHODS: We performed a retrospective review of our outpatient telemedicine utilization among four subspecialty clinics (including two acute care and two elective surgery clinics). Geocoding was used to link patient visit data to area-based socioeconomic measures and a multivariable analysis was performed to examine the relationship between socioeconomic indicators and patient participation in telemedicine. RESULTS: While total outpatient visits per month reached a nadir in April 2020 (65% decrease in patient visits when compared to January 2020), there was a sharp increase in telemedicine utilization during the same month (38% of all visits compared to 0.8% of all visits in the month prior). Higher rates of telemedicine utilization were observed in the two elective surgery clinics (61% and 54%) compared to the two acute care surgery clinics (14% and 9%). A multivariable analysis demonstrated a borderline-significant linear trend (p = 0.07) between decreasing socioeconomic status and decreasing odds of telemedicine participation among elective surgery visits. A sensitivity analysis to examine the reliability of this trend showed similar results. CONCLUSION: Telemedicine has many patient-centered benefits, and this study demonstrates that for certain elective subspecialty clinics, telemedicine may be utilized as the preferred method for surgical consultations. However, to ensure the equitable adoption and advancement of telemedicine services, healthcare providers will need to focus on mitigating the socioeconomic barriers to telemedicine participation.


Тема - темы
COVID-19 , Telemedicine , Humans , COVID-19/epidemiology , Pandemics , Tertiary Care Centers , Reproducibility of Results , Telemedicine/methods , Social Class
12.
Neurol India ; 70(5): 1942-1946, 2022.
Статья в английский | MEDLINE | ID: covidwho-2117614

Реферат

Introduction: The unprecedented challenges during the COVID pandemic and the subsequent lockdown had resulted in a delay in treatment metrics for acute stroke. There is a rising concern that COVID-19 co-infection can adversely affect stroke outcome. We aim to investigate the impact of COVID-19 in the management of stroke patients. We also compared the differences in stroke manifestations, etiological pattern, treatment course, and outcome of acute stroke patients in COVID-19 confirmed cases. Methodology: A single-center retrospective study was done at the Stroke Unit, Government Medical College, Thiruvananthapuram. Consecutive patients of acute stroke confirmed by imaging, presenting within 24 hours of the onset of symptoms in May to July 2020 and May to July 2019, were included. The primary data variables included baseline demographics, risk factors, admission NIHSS, stroke timings, thrombolysis rate, TOAST etiology, mRS at discharge, and in-hospital mortality. Results: Strokes with higher NIHSS, arrival blood sugar and blood pressure, and delays in door-to-CT and door-to-needle time were more during the pandemic. Intravenous thrombolysis was less and mortality was higher in COVID-19 strokes during the pandemic. COVID-19-positive stroke patients had more hemorrhagic strokes, more severe strokes with low CT ASPECTS, more hemorrhagic transformation, high in-hospital mortality, and poor functional outcome at discharge and 3 months. Conclusion: Our study was a hypothesis-generating study with a limited number of patients. This study has reconfirmed the higher severity of the stroke, with a higher mRS score and mortality during the pandemic, especially among COVID-19-positive stroke patients.


Тема - темы
COVID-19 , Stroke , Humans , Tertiary Care Centers , Retrospective Studies , Time-to-Treatment , Treatment Outcome , Communicable Disease Control , Stroke/epidemiology , Stroke/etiology , Stroke/therapy , Thrombolytic Therapy/adverse effects
13.
Neurol India ; 70(5): 1901-1904, 2022.
Статья в английский | MEDLINE | ID: covidwho-2116688

Реферат

Background: Coronavirus is a novel virus which has disrupted life in the past year. While it involves the lungs in the majority and this has been extensively studied, it involves other organ systems. More number of studies need to be focused on the extrapulmonary manifestations of the disease. Objective: To delineate the clinical manifestations of coronavirus disease 2019 (COVID-19) virus on the central and peripheral nervous systems and to assess the risk factors and the outcome of COVID-19 patients with neurological manifestations. Materials and Methods: All patients who were SARS-CoV-2 RNA polymerase chain reaction (PCR) positive were assessed, and detailed clinical history and laboratory findings were collected. Data was analyzed using percentage, mean, and frequency. Results: Out of 864 patients, 17 (N = 17, 1.96%) had neurological manifestations. Twelve out of 17 had comorbid conditions. Patients had diverse presentations ranging from acute cerebrovascular accident to paraplegia and encephalopathy. Ten (58.8%) patients presented with acute cerebrovascular accidents. Of the patients who developed stroke, five (50%) died. Conclusions: COVID-19 usually presents as a respiratory disease. The neurological manifestations of COVID-19 are not uncommon. One should be aware of a wide spectrum of neurological signs and symptoms of COVID-19 for early diagnosis and treatment for preventing mortality and morbidity.


Тема - темы
COVID-19 , Nervous System Diseases , Stroke , Humans , COVID-19/complications , SARS-CoV-2 , RNA, Viral , Tertiary Care Centers , Nervous System Diseases/epidemiology , Nervous System Diseases/etiology
14.
Medicine (Baltimore) ; 101(39): e30799, 2022 Sep 30.
Статья в английский | MEDLINE | ID: covidwho-2113721

Реферат

The coronavirus disease 2019 (COVID-19) has affected millions of people worldwide, of which 5% required intensive care, especially mechanical ventilation. The prognosis depends on several factors including comorbidities. This study was conducted to identify the comorbidities associated with the intensive care unit (ICU) admission in elderly with COVID-19 admitted to a tertiary academic hospital. A retrospective cross-sectional study was conducted at KSUMC including all hospitalized patients (age ≥ 65 years) with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection admitted between March 2020 and August 2021. Data collection included sociodemographic characteristics, underlying comorbidities, and the Charlson comorbidity index. Comorbidities were compared between the elderly patients with COVID-19 admitted to the ICU and those not admitted to the ICU. The odds ratios were calculated and a P value of < .05 and 95% confidence intervals were used to report the statistical significance A total of 444 patients (ICU = 147, non-ICU = 297) were included in the study. The study revealed that elderly patients with COVID-19 admitted to ICU had a higher rate of mortality (n = 64, 67.4%; P < .0001) and a higher proportion of them had shortness of breath (n = 97, 38.3%; P = .007) compared to the elderly patients not admitted to ICU. The mean length of stay (P < .0001), and weight (P = .02) among ICU patients were higher than the values for the non-ICU group, while the mean oxygen saturation (SpO2; P = .006) was lower among the ICU group. The comorbidities that demonstrated a statistically significant association with ICU admission were heart failure (P = .004, odd ratio (OR) = 2.02, 95% confidence intervals (CI) [1.263, 3540]), chronic obstructive pulmonary disease (COPD; P = .027, OR = 3.361, 95% CI [1.080, 10.464]), and chronic kidney disease (P = .021, OR = 1.807, 95% CI [1.087, 3.006]). The current study identified that the comorbidities such as COPD, heart failure, and factors like SpO2 and length of stay are associated with an increased risk of ICU admission in elderly patients with COVID-19. These findings highlight the clinical implications of comorbidity among geriatric population.


Тема - темы
COVID-19 , Heart Failure , Pulmonary Disease, Chronic Obstructive , Aged , COVID-19/epidemiology , COVID-19/therapy , Comorbidity , Cross-Sectional Studies , Heart Failure/complications , Humans , Intensive Care Units , Retrospective Studies , Saudi Arabia/epidemiology , Tertiary Care Centers
15.
Indian J Med Res ; 155(5&6): 491-495, 2022.
Статья в английский | MEDLINE | ID: covidwho-2110457

Реферат

This retrospective analysis was done to ascertain the SARS-CoV-2-positivity rate in children (0-12 yr) with severe acute respiratory infection (SARI) and compare it to those without SARI to determine the need for running a dedicated SARI isolation facility for paediatric COVID-19 care. The case records of 8780 children (0-12 yr) admitted and/or tested for SARS-CoV-2 between June 2020 and May 2021 at a tertiary care centre in north India were analyzed. The overall SARS-CoV-2 reverse transcription (RT)-PCR positivity rate was 3.0 per cent (262/8780). There were 1155 (13.15%) children with SARI. Fifty of these 1155 (4.3%) children with SARI, as against 212 of the 7625 (2.8%) children without SARI, tested positive for COVID-19. The absolute difference in the positivity rate among SARI and non-SARI groups was only 1.54 per cent which translates to cohorting and isolating 65 children with SARI to pick up one extra SARS-CoV-2-positive child (compared to those without SARI). The positive predictive value of SARI as a screening test was 4.3 per cent. Our findings suggest that isolation of children with SARI as a transmission-prevention strategy for COVID-19 may not be required. This is particularly relevant in resource-limited settings.


Тема - темы
COVID-19 , Child , Humans , SARS-CoV-2 , Retrospective Studies , Tertiary Care Centers , Mass Screening
16.
Indian J Med Res ; 155(5&6): 518-525, 2022.
Статья в английский | MEDLINE | ID: covidwho-2110449

Реферат

BACKGROUND & OBJECTIVES: The COVID-19 pandemic has caused significant global morbidity and mortality. As the vaccination was rolled out with prioritization on healthcare workers (HCWs), it was desirable to generate evidence on effectiveness of vaccine in prevailing real-life situation for policy planning. The objective of the study was to evaluate the safety, effectiveness and immunogenicity of COVID-19 vaccination among HCWs in a tertiary care hospital. METHODS: This prospective observational study was undertaken on the safety, immunogenicity and effectiveness of the ChAdOx1 nCoV- 19 coronavirus vaccine (Recombinant) during the national vaccine roll out in January-March 2021, in a tertiary care hospital, New Delhi, India. RESULTS: The vaccine was found to be safe, with local pain, fever and headache as the most common adverse events of milder nature which generally lasted for two days. The adverse events following vaccination were lower in the second dose as compared to the first dose. The vaccine was immunogenic, with seropositivity, which was 51 per cent before vaccination, increasing to 77 per cent after single dose and 98 per cent after two doses. Subgroup analysis indicated that those with the past history of COVID-19 attained seropositivity of 98 per cent even with single dose. The incidence of reverse transcription (RT)-PCR positive COVID-19 was significantly lower among vaccinated (11.7%) as compared to unvaccinated (22.2%). Seven cases of moderate COVID-19 needing hospitalization were seen in the unvaccinated and only one such in the vaccinated group. The difference was significant between the fully vaccinated (10.8%) and the partially vaccinated (12.7%). The hazard of COVID-19 infection was higher among male, age >50 yr and clinical role in the hospital. After adjustment for these factors, the hazard of COVID-19 infection among unvaccinated was 2.09 as compared to fully vaccinated. Vaccine effectiveness was 52.2 per cent in HCWs. INTERPRETATION & CONCLUSIONS: ChAdOx1 nCoV-19 coronavirus vaccine (Recombinant) was safe, immunogenic as well as showed effectiveness against the COVID-19 disease (CTRI/2021/01/030582).


Тема - темы
COVID-19 Vaccines , COVID-19 , Male , Humans , COVID-19 Vaccines/adverse effects , COVID-19/epidemiology , COVID-19/prevention & control , Pandemics/prevention & control , ChAdOx1 nCoV-19 , Tertiary Care Centers , Health Personnel , Vaccination/adverse effects
17.
Medicina (Kaunas) ; 58(11)2022 Nov 10.
Статья в английский | MEDLINE | ID: covidwho-2110177

Реферат

Background and Objectives: Respiratory syncytial virus (RSV) is a major cause of morbidity and hospital admission due to respiratory tract infection among infants and young children. The current study aims to describe the prevalence and the seasonal pattern of RSV during the previous seven years. Materials and Methods: Clinical data and RSV antigen and PCR test results were collected from patients' medical records at King Fahd Hospital of the University in the Eastern Province of Saudi Arabia between January 2015 and February 2022. Results: The overall percentage of RSV detection was 26.3% (336/1279) among the tested individuals. RSV infection was more common among children below five years and elderly above 60 years of age. Two-thirds of the cases required hospitalization. The average hospital stay due to RSV infection was 6.5 days (range 0-56 days). The rate of hospitalization was higher among infants and younger children and decreased with age (p-value < 0.001). RSV infection was more prevalent between August and February and decreased appreciably between March and July. The peak level of infection was during December and January. No RSV infections were reported during the COVID-19 pandemic and the following winter. The cases increased again in August 2021, with an unusual out-of-season peak. Conclusions: RSV infection is one of the important causes of morbidity and hospitalization among infants and young children in Saudi Arabia. The seasonal pattern of infection has changed after the COVID-19 pandemic, and the physicians should be aware that infection may happen currently at different times throughout the year.


Тема - темы
COVID-19 , Respiratory Syncytial Virus Infections , Respiratory Syncytial Virus, Human , Infant , Child , Humans , Child, Preschool , Aged , Respiratory Syncytial Virus Infections/epidemiology , Seasons , COVID-19/epidemiology , Tertiary Care Centers , Saudi Arabia/epidemiology , Pandemics , Hospitalization
18.
Int J Infect Dis ; 111: 333-335, 2021 Oct.
Статья в английский | MEDLINE | ID: covidwho-2113770

Реферат

This single-centre observational study demonstrated that lower cycle threshold (Ct) values (indicating higher viral loads) on admission to hospital were associated with poorer outcomes in unvaccinated, hospitalized patients with coronavirus disease 2019 (COVID-19). Demographic and outcome data were collected prospectively for all adult patients who tested positive for severe acute respiratory syndrome coronavirus-2 on admission to the University Hospitals North Midlands NHS Trust between 1 February and 1 July 2020. Nasopharyngeal swab samples were obtained, and a valid Ct value was determined for all patients using the Viasure reverse transcription polymerase chain reaction assay, validated by Public Health England, on admission to hospital. Multi-variable logistic regression results based on data from 618 individuals demonstrated a significant inverse relationship between the odds of death and Ct values (adjusted odds ratio 0.95, 95% confidence interval 0.92-0.98, P=0.001). The association remained highly significant after adjusting for known clinical risk factors for COVID-19.


Тема - темы
COVID-19 , Adult , Humans , Prospective Studies , SARS-CoV-2 , Tertiary Care Centers , United Kingdom
19.
Rev Inst Med Trop Sao Paulo ; 64: e62, 2022.
Статья в английский | MEDLINE | ID: covidwho-2109457

Реферат

This study aimed to evaluate the COVID-19 hospitalizations in a tertiary hospital by age group and month, considering the introduction and the advance of the vaccination against the disease. The laboratory-confirmed COVID-19-associated hospitalizations among people aged 20 years or older, that occurred between March 2020 and June 2021, were distributed by month of symptom onset and age group. The proportion of hospitalizations by age group was calculated for the year 2021. The proportions were compared using the chi-square test for trends. The marks of vaccination advances among different age groups were taken from the official website LocalizaSUS. In 2020, hospitalizations among people aged 60-80 years old were the most frequent (39.1%). From January-June 2021, when the vaccination commenced, while hospitalizations of patients aged 20 to < 40 and 40 to 60 years old showed an increasing trend, the older age groups and those with vaccination recommendations (from 60 to < 80 and from 80 or over) showed a downward trend. As of June 2021, with widespread vaccination, a drop in hospitalizations was observed in > 60 years old. At 20 to <40 and 40 to < 60, an increase in hospitalizations was observed. It demonstrates the important role of vaccination in combating the COVID-19 pandemic.


Тема - темы
COVID-19 , Aged , Aged, 80 and over , Brazil/epidemiology , COVID-19/epidemiology , COVID-19/prevention & control , Hospitalization , Humans , Middle Aged , Pandemics , Tertiary Care Centers , Vaccination
20.
PLoS One ; 17(11): e0275832, 2022.
Статья в английский | MEDLINE | ID: covidwho-2109322

Реферат

BACKGROUND: Studies from Asia, Europe and the USA indicate that widely available haematological parameters could be used to determine the clinical severity of Coronavirus disease 2019 (COVID-19) and predict management outcome. There is limited data from Africa on their usefulness in patients admitted to Intensive Care Units (ICUs). We performed an evaluation of baseline haematological parameters as prognostic biomarkers in ICU COVID-19 patients. METHODS: Demographic, clinical and laboratory data were collected prospectively on patients with confirmed COVID-19, admitted to the adult ICU in a tertiary hospital in Cape Town, South Africa, between March 2020 and February 2021. Robust Poisson regression methods and receiver operating characteristic (ROC) curves were used to explore the association of haematological parameters with COVID-19 severity and mortality. RESULTS: A total of 490 patients (median age 54.1 years) were included, of whom 237 (48%) were female. The median duration of ICU stay was 6 days and 309/490 (63%) patients died. Raised neutrophil count and neutrophil/lymphocyte ratio (NLR) were associated with worse outcome. Independent risk factors associated with mortality were age (ARR 1.01, 95%CI 1.0-1.02; p = 0.002); female sex (ARR 1.23, 95%CI 1.05-1.42; p = 0.008) and D-dimer levels (ARR 1.01, 95%CI 1.002-1.03; p = 0.016). CONCLUSIONS: Our study showed that raised neutrophil count, NLR and D-dimer at the time of ICU admission were associated with higher mortality. Contrary to what has previously been reported, our study revealed females admitted to the ICU had a higher risk of mortality.


Тема - темы
COVID-19 , Adult , Humans , Female , Middle Aged , Male , COVID-19/epidemiology , Tertiary Care Centers , South Africa/epidemiology , Intensive Care Units , Hospitalization , Retrospective Studies
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