Antibiotic Use Among Hospitalized Patients With COVID-19 in the United States, March 2020-June 2022.

We conducted a retrospective study to describe antibiotic use among US adults hospitalized with a COVID-19 diagnosis. Despite a decrease in overall antibiotic use, most patients hospitalized with COVID-19 received antibiotics on admission (88.1%) regardless of critical care status, highlighting that more efforts are needed to optimize antibiotic therapy.

Colorectal travelling fellowships: Exploring current perspective and future direction.

Travelling Surgical fellowships (TSF) have a longstanding tradition in promoting out-of-programme surgical training, fostering collegiality and collaboration among surgeons. In this retrospective review we explore its historical context and examine existing practices and likely future trends. More specifically, we focus on colorectal travelling fellowships (CTF) and provide additional quantitative and qualitative analyses, highlighting the most valued theme-based surgical experiences and examine their merits and impacts. The TSF time-series analysis was based on a total of 350 awarded fellowships from 2000 to 2019. CTF analysis was based on 98 fellowships. The accelerated utilization of internet-based virtual interaction during the COVID-19 Pandemic has offered an opportunity to examine its possible intermediate and long-term disruptive effects.

The Influence of Racism in Healthcare: COVID-19 Vaccine Hesitancy Among Black Mothers in Chicago.

Black mothers and children experience significant health disparities in the USA. These health disparities have been attributed, in part, to experiencing racism in healthcare. This study aimed to explore how experiences of healthcare discrimination and mistreatment experienced by Black mothers may influence COVID-19 vaccine beliefs and decision-making for themselves and their families. From April 2021 to November 2021, we conducted 50 semi-structured interviews among Chicago residents. Ten participants self-identified as female and with reported children; these data were extracted from the larger sample for data analysis. Interview content included perceptions and experiences with the COVID-19 vaccine and experiences with healthcare discrimination, mistreatment, and medical mistrust. Interview transcripts were transcribed verbatim and coded using the MAXQDA 2022 qualitative software. Themes were identified using a team-based thematic analysis to understand how experiences of racism in healthcare may influence COVID-19 vaccine decision-making. Four themes were generated from the data: (1) experiences of healthcare discrimination and mistreatment, (2) distrust and fears of experimentation, (3) the influence of discrimination and distrust on COVID-19 vaccine decision-making, and (4) overcoming vaccine hesitancy. The results of this study highlight the current literature; Black mothers experience racism and discrimination in healthcare when seeking care for themselves and their children. It is evident in their stories that medical racism and historical medical abuse influence vaccine decision-making. Therefore, healthcare and public health initiatives should be intentional in addressing past and present racism in healthcare to improve vaccine distrust.

Qualidade de vida no trabalho de profissionais que atuaram na atenção primária à saúde durante a pandemia da Covid-19 / Quality of working life of professionals who worked in primary health care during the Covid-19 pandemic

A qualidade de vida no trabalho está relacionada aos aspectos físicos, ambientais e psicológicos. Objetivo: avaliar a influência da pandemia da COVID-19 na qualidade de vida no trabalho de profissionais da saúde. Método: Pesquisa realizada com 26 profissionais, entre eles, enfermeiros, médicos e técnicos em enfermagem, que trabalharam na atenção primária à saúde, e atuaram na pandemia da COVID-19. Estudo transversal, de abordagem quantitativa, realizado entre junho e julho de 2022, com aprovação no Comitê de Ética em Pesquisa em Seres Humanos. Utilizou-se uma ficha de dados sociodemográficos e o Questionário de Qualidade de Vida no Trabalho (QWLQ-78) que abrange 4 domínios: físico/saúde, psicológico, pessoal e profissional. Resultados: Os profissionais de saúde apresentaram, por domínio, e no geral, qualidade de vida considerada satisfatória no trabalho. Conclusão: o estudo permitiu identificar que, mesmo no período pandêmico, os profissionais de saúde do município de Giruá apresentaram QVT satisfatória.

The quality of life at work is related to physical, environmental, and psychological aspects. Objective: to evaluate the influence of the COVID-19 pandemic on the quality of life at work of health professionals. Method: Research carried out with 26 professionals, including nurses, physicians, and nursing technicians, who worked in primary health care and worked in the COVID-19 pandemic. Cross-sectional quantitative study, carried out between June and July 2022, with approval by the Human Research Ethics Committee. A sociodemographic data form and the Quality of Life at Work Questionnaire (QWLQ-78) were used, including 4 domains: physical/health, psychological, personal, and professional. Results: Health professionals presented, by domain, and in general, satisfactory quality of life at work. Conclusion: The study identified that even during the pandemic period, health professionals in the municipality of Giruá had a satisfactory QWL.

Psychological Distress and Negative Emotions in Post-COVID Infection: A Comparative Study of the COVID and NO-COVID Young Patients.

According to the literature, mental health assumed urgent relevance, and several scholars are debating on the enduring of the neurological and psychiatric symptoms in post COVID patients. Our study aimed to investigate the emotional dimensions in young population to the COVID exposition: primary endpoint was to detect the psychological distress up to 3 months in post-COVID-19. A comparative study was conducted among young adults in Italy. We also assessed dysphoria, depression, anxiety, stress symptoms, pessimism, and positive personality traits. The participants were 140 Italian young aged 18-30 years (mean = 22.1, SD ± 2.65; 65.0% female). The sample was distinguished in two groups: COVID and NO-COVID groups. The results revealed that young who have been exposed to COVID-19 infection evidenced emotional vulnerability by higher psychological distress (depression, anxiety, stress), dysphoria signs (irritability, discontent, interpersonal resentment, and feelings of renunciation/surrender) then No COVID-19 infection young. Furthermore, COVID patients showed higher negative emotions about the expected life, uncertain for future, and loss of motivation (characterized no desires) than NO-COVID infection. In conclusion, the vulnerability of young exposed to COVID infection even in mild severity should be considered as emerging unmet need of mental health recovering: urgent health policy actions to boost the psychological, biological and social strategic pillar for young generation.

Immune response to mRNA-based COVID-19 booster vaccination in people living with HIV.

OBJECTIVES: Our objective was to assess immune responses and their influencing factors in people living with HIV after messenger RNA (mRNA)-based COVID-19 booster vaccination (third dose). METHODS: This was a retrospective cohort study of people living with HIV who received booster vaccination with BNT-162b2 or mRNA-1273 between October 2021 and January 2022. We assessed anti-spike receptor-binding domain (RBD) immunoglobulin G (IgG), virus neutralizing activity (VNA) titres reported as 100% inhibitory dilution (ID100 ), and T-cell response (using interferon-gamma-release-assay [IGRA]) at baseline and quarterly follow-up visits. Patients with reported COVID-19 during follow-up were excluded. Predictors of serological immune response were analyzed using multivariate regression models. RESULTS: Of 84 people living with HIV who received an mRNA-based booster vaccination, 76 were eligible for analysis. Participants were on effective antiretroviral therapy (ART) and had a median of 670 CD4+ cells/µL (interquartile range [IQR] 540-850). Following booster vaccination, median anti-spike RBD IgG increased by 705.2 binding antibody units per millilitre (BAU/mL) and median VNA titres increased by 1000 ID100 at the follow-up assessment (median 13 weeks later). Multivariate regression revealed that time since second vaccination was a predictor of stronger serological responses (p < 0.0001). No association was found for other factors, including CD4+ status, choice of mRNA vaccine, or concomitant influenza vaccination. In total, 45 patients (59%) had a reactive baseline IGRA, of whom two lost reactivity during follow-up. Of 31 patients (41%) with non-reactive baseline IGRA, 17 (55%) converted to reactive and seven (23%) remained unchanged following booster vaccination. CONCLUSIONS: People living with HIV with ≥500 CD4+ cells/µL showed favourable immune responses to mRNA-based COVID-19 booster vaccination. A longer time (up to 29 weeks) since second vaccination was associated with higher serological responses, whereas choice of mRNA vaccine or concomitant influenza vaccination had no impact.

Data quality considerations for evaluating COVID-19 treatments using real world data: learnings from the National COVID Cohort Collaborative (N3C).

BACKGROUND: Multi-institution electronic health records (EHR) are a rich source of real world data (RWD) for generating real world evidence (RWE) regarding the utilization, benefits and harms of medical interventions. They provide access to clinical data from large pooled patient populations in addition to laboratory measurements unavailable in insurance claims-based data. However, secondary use of these data for research requires specialized knowledge and careful evaluation of data quality and completeness. We discuss data quality assessments undertaken during the conduct of prep-to-research, focusing on the investigation of treatment safety and effectiveness. METHODS: Using the National COVID Cohort Collaborative (N3C) enclave, we defined a patient population using criteria typical in non-interventional inpatient drug effectiveness studies. We present the challenges encountered when constructing this dataset, beginning with an examination of data quality across data partners. We then discuss the methods and best practices used to operationalize several important study elements: exposure to treatment, baseline health comorbidities, and key outcomes of interest. RESULTS: We share our experiences and lessons learned when working with heterogeneous EHR data from over 65 healthcare institutions and 4 common data models. We discuss six key areas of data variability and quality. (1) The specific EHR data elements captured from a site can vary depending on source data model and practice. (2) Data missingness remains a significant issue. (3) Drug exposures can be recorded at different levels and may not contain route of administration or dosage information. (4) Reconstruction of continuous drug exposure intervals may not always be possible. (5) EHR discontinuity is a major concern for capturing history of prior treatment and comorbidities. Lastly, (6) access to EHR data alone limits the potential outcomes which can be used in studies. CONCLUSIONS: The creation of large scale centralized multi-site EHR databases such as N3C enables a wide range of research aimed at better understanding treatments and health impacts of many conditions including COVID-19. As with all observational research, it is important that research teams engage with appropriate domain experts to understand the data in order to define research questions that are both clinically important and feasible to address using these real world data.

Impacts of the COVID-19 pandemic on life and learning experiences of indigenous and non-Indigenous university and college students in Ontario, Canada: a qualitative study.

BACKGROUND: The years people spend attending university or college are often filled with transition and life change. Younger students often move into their adult identity by working through challenges and encountering new social experiences. These transitions and stresses have been impacted significantly by the COVID-19 pandemic, which has led to dramatic change in the post-secondary experience, particularly in the pandemic's early months when colleges and universities were closed to in person teaching. The goal of this study was to identify how COVID-19 has specifically impacted the postsecondary student population in Kingston, Ontario, Canada. METHODS: The Cost of COVID is a mixed methods study exploring the social and emotional impacts of the COVID-19 pandemic, with a focus on families, youth, and urban Indigenous People. The present analysis was completed using a subset of qualitative data including Spryng.io micronarrative stories from students in college and university, as well as in-depth interviews from service providers providing services to students. A double-coded phenomenological approach was used to collect and analyze data to explore and identify themes expressed by postsecondary students and service providers who worked with postsecondary students. RESULTS: Twenty-six micronarratives and seven in-depth interviews were identified that were specifically relevant to the post-secondary student experience. From this data, five prominent themes arose. Impacts of the COVID-19 pandemic on the use of technology was important to the post secondary experience. The pandemic has substantial educational impact on students, in what they chose to learn, how it was taught, and experiences to which they were exposed. Health and wellbeing, physical, psychological and emotional, were impacted. Significant impacts were felt on family, community, and connectedness aspects. Finally, the pandemic had important financial impacts on students which affected their learning and their experience of the pandemic. Impacts did differ for Indigenous students, with many of the traditional cultural supports and benefits of spaces of higher education no longer being available. CONCLUSION: Our study highlights important impacts of the pandemic on students of higher education that may have significant individual and societal implications going forward. Both postsecondary institutions and society at large need to attend to these impacts, in order to preserve the wellbeing of graduates, the Canadian labor market, and to ensure that the pandemic does not further exacerbate existing inequalities in post-secondary education in Canada.

COVID-19 and Alzheimer's Disease: What Is the Connection?

Wang et al. found that elderly COVID-19 patients were at risk of AD. The following facts suggest a possible explanation: reactivation of herpes simplex virus type 1 (HSV1) and other herpesviruses can occur in SARS-CoV-2 patients; in cell cultures, HSV1 infection causes occurrence of many AD-like features, as does reactivation of latent HSV1 after addition of certain infectious agents; recurrent experimental reactivation of HSV1-infected mice leads to formation of the main features of AD brains, and to cognitive decline. These suggest that COVID-19 results in repeated reactivation of HSV1 in brain, with subsequent accumulation of damage and eventual development of AD.

Impacto COVID-19 en la urgencia y hospitalización de un hospital terciario. Lecciones de gestión aprendidas / COVID-19 impact on the emergency and hospitalization of a tertiary hospital. Management lessons learned

Introducción: El objetivo es analizar el impacto de la pandemia COVID-19 en las urgencias e ingresos hospitalarios pediátricos. Métodos: Estudio de cohortes retrospectivo, de los pacientes atendidos en un hospital terciario, desde el 14 de marzo hasta el 26 de abril de 2020 comparándose con el mismo periodo de los 3 años anteriores. Resultados: Se observa una notable reducción global de las visitas a urgencias e ingresos en todas las áreas pediátricas, manteniéndose la asistencia en neonatología y los ingresos programados en oncología. Discusión: La reducción de la actividad global en la urgencia pediátrica no es solo explicable por la disminución de las enfermedades transmisibles. Ha podido contribuir la disminución de la demanda inadecuada y de los ingresos inapropiados. La disponibilidad de camas pediátricas haría innecesaria la reducción de la actividad quirúrgica programada y permitiría redistribuir recursos a áreas con mayor presión asistencial.(AU)

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.(AU)

COVID-19-Related Intussusception: A Case Series and Review of the Literature.

Background: Ileocolic intussusception is a common gastrointestinal emergency that occurs in infancy. Many cases are caused by anatomic lead points, such as hypertrophied Peyer's patches. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, which causes coronavirus disease 2019 (COVID-19), commonly presents with respiratory symptoms, however, its relation to intussusception remains unknown. Methods: Two cases are reported as well as a review of pertinent English-language literature on the topic. Results: We present two cases of intussusception in COVID-19-positive patients, including the first known case of a lead point with tissue polymerase chain reaction (PCR) confirming COVID-19 positivity, and compare these findings to a review of the recent literature. Intussusception in COVID-19-positive patients is becoming more prevalent and more often requires operative treatment. Discussion: We offer evidence that intussusception can be the presenting symptom in the absence of COVID-19-related respiratory symptoms. There also seems to be a trend toward the need for operative intervention compared with COVID-19-negative intussusception. The presence of SARS-CoV-2 can be confirmed via PCR in specific lead points (lymph nodes), directly causing the intussusception. Conclusions: Providers should have a low threshold to suspect and diagnose intussusception as operative treatment is more readily used in COVID-19-positive pediatric patients with gastrointestinal symptoms.

COVID-19 impact on the emergency and hospitalization of a tertiary hospital. Management lessons learned.

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.

Experiencia del personal sanitario durante la primera ola de Covid-19 en España: un estudio cualitativo con grupos focales / Experience of health workers during the first wave of Covid-19 in Spain: a qualitative study with focus groups

Objetivo: Analizar la experiencia de los profesionales que atendieron en primera línea a los pacientes infectados durante la primera ola de la pandemia de COVID-19. Material y Métodos: Los participantes fueron reclutados entre médicos y enfermeras de varios hospitales y centros de salud en España. Sus narrativas se obtuvieron a través de tres grupos focales. Se empleó la metodología cualitativa, de acuerdo con sus principios exploratorios, inductivos y etnográficos. Resultados: La experiencia del personal sanitario se clasificó en seis categorías: La reacción y organización de los sanitarios, el material y las pruebas, los aspectos emocionales en relación con la asistencia, los conflictos éticos, la gestión sanitaria de la pandemia y el papel social de los sanitarios. Conclusiones: Los sanitarios adoptaron un rol proactivo durante la pandemia. Se señalan las vulnerabilidades y las fortalezas de la asistencia. Los aspectos que tiene que ver con la regulación emocional de los sanitarios resultan claves para el funcionamiento asistencial. (AU)

Objectives: to analyze the experience of health professionals who provided first-line care to infected patients during the COVID-19 pandemic during the first wave. Material and Methods: Participants were recruited from among physicians and nurses in several hospitals and health centers in Spain. Narratives were obtained through three focus groups. Qualitative methodology was used according to exploratory, inductive, and ethnographic principles. Results: The experience of the health personnel was classified into six categories: The reaction and organization of health workers, materials and tests, emotional aspects of care, ethical conflicts, health management of the pandemic, and the social role of health workers. Conclusions: Healthcare workers took a proactive approach during the pandemic. Weaknesses and strengths in the provision of health care were. The capacity of emotional self-regulation of the health care workers is shown to be key to the ability of the health care system to continue operating. (AU)

The genes road: impact of migration on newborn screening and health amid the COVID-19 pandemic in the Eastern Mediterranean region.

Nearly two-thirds of migrants residing in camps in Europe are women and children. Many of these children, being born on the way without essential newborns screening, are at some point admitted to pediatric wards in asylum countries. With hospitals overwhelmed with COVID-19 cases, taking appropriate care of newborns becomes a considerable burden. In this frame, prevention, in the form of adequate newborn screening, emerges as a better and more feasible strategy than healing.

COVID-19 impact on the emergency and hospitalization of a tertiary hospital. Management lessons learned. / Impacto COVID-19 en la urgencia y hospitalización de un hospital terciario. Lecciones de gestión aprendidas.

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.