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1.
ESMO Open ; 5(5)2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32878898

RESUMO

BACKGROUND: During the COVID-19 outbreak, healthcare professionals (HCP) are at the frontline of clinical management and at increased risk for infection. The SARS-CoV-2 seroprevalence of oncological HCP and their patients has significant implications for oncological care. METHODS: HCP and patients with cancer at the Division of Oncology, Medical University of Vienna were included between 21 March and 4 June and tested for total antibodies against SARS-CoV-2 employing the Roche Elecsys Anti-SARS-CoV-2 immunoassay. Reactive samples were confirmed or disproved by the Abbott SARS-CoV-2 IgG test. Additionally, a structured questionnaire regarding basic demographic parameters, travel history and COVID-19-associated symptoms had to be completed by HCP. RESULTS: 146 subjects (62 HCP and 84 patients with cancer) were enrolled. In the oncological HCP cohort, 20 (32.3%) subjects were medical oncologists, 28 (45.2%) nurses at our ward and 14 (22.6%) fulfil other functions such as study coordinators. In the patient cohort, most individuals are on active anticancer treatment (96.4%). 26% of the HCP and 6% of the patients had symptoms potentially associated with COVID-19 since the end of February 2020. However, only in 2 (3.2%) HCP and in 3 (3.6%) patients, anti-SARS-Cov-2 total antibodies were detected. The second assay for anti-SARS-Cov-2 IgG antibodies confirmed the positive result in all HCP and in 2 (2.4%) patients, suggesting an initial assay's unspecific reaction in one case. In individuals with a confirmed test result, an active COVID-19 infection was documented by a positive SARS-CoV-2 RNA PCR test. CONCLUSION: Specific anti-SARS-CoV-2 antibodies were found solely in persons after a documented SARS-CoV-2 viral infection, thus supporting the test methods' high sensitivity and specificity. The low prevalence of anti-SARS-CoV-2 antibodies in our cohorts indicates a lack of immunity against SARS-CoV-2. It highlights the need for continued strict safety measures to prevent uncontrolled viral spread among oncological HCPs and patients with cancer.


Assuntos
Anticorpos Antivirais/sangue , Betacoronavirus/imunologia , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Corpo Clínico Hospitalar , Serviço Hospitalar de Oncologia , Pacientes , Pneumonia Viral/diagnóstico , Testes Sorológicos , Centros de Atenção Terciária , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Áustria/epidemiologia , Betacoronavirus/patogenicidade , Biomarcadores/sangue , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Feminino , Interações Hospedeiro-Patógeno , Humanos , Masculino , Pessoa de Meia-Idade , Recursos Humanos de Enfermagem no Hospital , Oncologistas , Enfermagem Oncológica , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Valor Preditivo dos Testes , Estudos Prospectivos , Reprodutibilidade dos Testes , Estudos Retrospectivos , Estudos Soroepidemiológicos , Adulto Jovem
2.
Aust Health Rev ; 44(5): 741-747, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32862832

RESUMO

Objective A pilot study to: (1) describe the ability of emergency physicians to provide primary consults at an Australian, major metropolitan, adult emergency department (ED) during the COVID-19 pandemic when compared with historical performance; and (2) to identify the effect of system and process factors on productivity. Methods A retrospective cross-sectional description of shifts worked between 1 and 29 February 2020, while physicians were carrying out their usual supervision, flow and problem-solving duties, as well as undertaking additional COVID-19 preparation, was documented. Effect of supervisory load, years of Australian registration and departmental flow factors were evaluated. Descriptive statistical methods were used and regression analyses were performed. Results A total of 188 shifts were analysed. Productivity was 4.07 patients per 9.5-h shift (95% CI 3.56-4.58) or 0.43 patients per h, representing a 48.5% reduction from previously published data (P<0.0001). Working in a shift outside of the resuscitation area or working a day shift was associated with a reduction in individual patient load. There was a 2.2% (95% CI: 1.1-3.4, P<0.001) decrease in productivity with each year after obtaining Australian medical registration. There was a 10.6% (95% CI: 5.4-15.6, P<0.001) decrease in productivity for each junior physician supervised. Bed access had no statistically significant effect on productivity. Conclusions Emergency physicians undertake multiple duties. Their ability to manage their own patients varies depending on multiple ED operational factors, particularly their supervisory load. COVID-19 preparations reduced their ability to see their own patients by half. What is known about the topic? An understanding of emergency physician productivity is essential in planning clinical operations. Medical productivity, however, is challenging to define, and is controversial to measure. Although baseline data exist, few studies examine the effect of patient flow and supervision requirements on the emergency physician's ability to perform primary consults. No studies describe these metrics during COVID-19. What does this paper add? This pilot study provides a novel cross-sectional description of the effect of COVID-19 preparations on the ability of emergency physicians to provide direct patient care. It also examines the effect of selected system and process factors in a physician's ability to complete primary consults. What are the implications for practitioners? When managing an emergency medical workforce, the contribution of emergency physicians to the number of patients requiring consults should take into account the high volume of alternative duties required. Increasing alternative duties can decrease primary provider tasks that can be completed. COVID-19 pandemic preparation has significantly reduced the ability of emergency physicians to manage their own patients.


Assuntos
Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/terapia , Eficiência Organizacional/estatística & dados numéricos , Serviço Hospitalar de Emergência/organização & administração , Serviço Hospitalar de Emergência/tendências , Corpo Clínico Hospitalar/organização & administração , Assistência Centrada no Paciente/organização & administração , Pneumonia Viral/diagnóstico , Pneumonia Viral/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Agendamento de Consultas , Austrália , Betacoronavirus/patogenicidade , Estudos Transversais , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Previsões , Humanos , Masculino , Corpo Clínico Hospitalar/estatística & dados numéricos , Corpo Clínico Hospitalar/tendências , Pessoa de Meia-Idade , Pandemias/estatística & dados numéricos , Assistência Centrada no Paciente/estatística & dados numéricos , Projetos Piloto , Estudos Retrospectivos
3.
J Nepal Health Res Counc ; 18(2): 166-171, 2020 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-32969371

RESUMO

BACKGROUND: The study assesses the perspective of doctors working in government hospitals of Nepal regarding hospital preparedness for infection prevention measures, isolation services provisions, critical care service readiness, and training of staff for COVID-19 pandemic management. METHODS: This cross-sectional study was done in central, provincial, and local level health centers of the Government of Nepal to assess the perspective of medical doctors regarding COVID-19 pandemic readiness in their facility. Nonprobability sampling was used to collect 56 responses from doctors working in different hospitals of Nepal. An online survey was performed using a questionnaire tool, which was adapted from the guidelines of the World Health Organization and the Centers for Disease Control and Prevention. RESULTS: Most of the participants were medical officers with an MBBS degree (32) followed by anesthesiologists (10). Thirteen participants worked in central hospitals (23.2%), 24 in provincial hospitals (42.8%) and 19 in local health centers (33.92%). The availability of adequate facemask was 84% in central hospitals, which was higher than provincial hospitals (66.7%), and local level health centers (77.8%). There were only 53.8% trained critical care providers in central hospitals and 29.2% in provincial hospitals. Nearly 38.5% (5) of central hospitals had measures for airborne isolation in place, whereas this was only found in 8.3% (2) of provincial hospitals surveyed for critical care facilities. Overall, only 2 hospitals had the provision of a negative pressure room with air exchanges. Only 8 participants working in central hospitals (61.5%) and 14 working in provincial hospitals (58.3%) had performed hands-on training for donning and doffing personal protective equipment. CONCLUSIONS: The majority of medical doctors working in government hospitals of Nepal perceive that provision of facemask distribution, airborne isolation rooms, critical care preparedness, and hands-on training to staff were not adequate.


Assuntos
Infecções por Coronavirus/epidemiologia , Planejamento Hospitalar , Hospitais Públicos/organização & administração , Controle de Infecções/organização & administração , Capacitação em Serviço , Corpo Clínico Hospitalar/psicologia , Pneumonia Viral/epidemiologia , Adulto , Betacoronavirus , Estudos Transversais , Humanos , Nepal/epidemiologia , Pandemias , Equipamento de Proteção Individual , Inquéritos e Questionários
4.
Acta Dermatovenerol Alp Pannonica Adriat ; 29(3): 115-122, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32975297

RESUMO

INTRODUCTION: This questionnaire study evaluates dermatological complaints that may arise due to hygiene measures and anxiety among healthcare professionals (HCPs) during the COVID-19 outbreak. METHODS: A total of 526 volunteers, consisting of doctors and nurses, participated. Demographic features, personal hygiene behavior, personal protective equipment (PPE) use, Hospital Anxiety and Depression Scale-Anxiety (HADS-A) parameters, and symptoms of various dermatological diseases (xerosis, eczema, acne, hair loss, palmar hyperhidrosis, xeromycteria, urticaria, aphthous stomatitis, and seborrheic dermatitis) were investigated. RESULTS: Although the frequency and severity of many dermatological complaints increased during the pandemic period, the most frequent increase was observed in the frequency of complaints suggesting xerosis and eczema. We found that complaints suggesting xerosis and eczema were seen on the hands 2.44 and 3.57 times, respectively, as a result of washing hands 10 times/day, and that handwashing times of 10 seconds or more significantly increased the risk of eczema (5.44 times). Another remarkable result was a fivefold increase in acne complaints among those using any mask. The severity of all complaints except hair loss and seborrheic dermatitis correlated significantly with HADS-A. CONCLUSIONS: Our study showed that the frequency and severity of some dermatological complaints increased in HCPs.


Assuntos
Infecções por Coronavirus/epidemiologia , Eczema/epidemiologia , Dermatoses da Mão/epidemiologia , Pessoal de Saúde/estatística & dados numéricos , Corpo Clínico Hospitalar/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Adulto , Betacoronavirus , Feminino , Luvas Protetoras/estatística & dados numéricos , Humanos , Higiene , Masculino , Exposição Ocupacional/efeitos adversos , Pandemias , Inquéritos e Questionários , Turquia
8.
Medicine (Baltimore) ; 99(32): e21548, 2020 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-32769893

RESUMO

Novel coronavirus disease (COVID-19) emerged in Wuhan in December 2019, has spread in many countries affected people globally. In response to the economic requirement of the nation and meet the need of patient's, a momentous event was going back to work step by step as fighting against COVID-19. Safety in clinical work is of priority as elective surgery in the department of surgery progressing. We used checklists based on our experiences on COVID-19 control and reality of clinical work from February to March in the West China Hospital, involving events of screening patient, chaperonage, and healthcare workers. Checklist summarized the actual clinical nursing work and management practices, hope to provide a reference for the order of surgery during the epidemic prevention and control, and standardize the clinical nursing work of surgery during pandemic.


Assuntos
Lista de Checagem/métodos , Infecções por Coronavirus/prevenção & controle , Procedimentos Cirúrgicos Eletivos/métodos , Controle de Infecções/organização & administração , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Procedimentos Cirúrgicos Vasculares/organização & administração , Distribuição de Qui-Quadrado , China , Infecções por Coronavirus/epidemiologia , Feminino , Humanos , Masculino , Corpo Clínico Hospitalar , Saúde do Trabalhador , Avaliação de Resultados em Cuidados de Saúde , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Centro Cirúrgico Hospitalar/organização & administração
9.
PLoS One ; 15(8): e0237303, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32764825

RESUMO

The coronavirus disease (COVID-19) outbreak in December has seen more than 76,000 cases in China, causing more than 3,000 medical staff infections. As the disease is highly contagious, can be fatal in severe cases, and there are no specific medicines, it poses a huge threat to the life and health of nurses, leading to a severe impact on their emotional responses and coping strategies. Therefore, this study will investigate nurses' emotional responses and coping styles, and conduct a comparative study with nursing college students. This study was conducted through the online survey 'questionnaire star' from February 1st to February 20th, 2020 in Anhui Province, using the snowball sampling method to invite subjects. The results found that women showed more severe anxiety and fear than men. Participants from cities exhibited these symptoms more than participants from rural areas, however rural participants experienced more sadness than urban participants. The nearer a COVID-19 zone is to the participants, the stronger the anxiety and anger. The COVID-19 outbreak has placed immense pressure on hospitals and those nurses at the frontline are more seriously affected. Hospitals should focus on providing psychological support to nurses and training in coping strategies.


Assuntos
Adaptação Psicológica , Betacoronavirus , Infecções por Coronavirus/enfermagem , Infecções por Coronavirus/psicologia , Emoções , Corpo Clínico Hospitalar/psicologia , Enfermeiras e Enfermeiros/psicologia , Pneumonia Viral/enfermagem , Pneumonia Viral/psicologia , Estudantes de Enfermagem/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções por Coronavirus/virologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/virologia , Fatores Sexuais , Estresse Psicológico , Inquéritos e Questionários , Adulto Jovem
12.
BMJ Open ; 10(8): e039851, 2020 08 11.
Artigo em Inglês | MEDLINE | ID: mdl-32788191

RESUMO

INTRODUCTION: The COVID-19 pandemic is putting an unprecedented strain on healthcare systems globally. The psychological impact on frontline doctors of dealing with the COVID-19 pandemic is currently unknown. This longitudinal professional survey aims to understand the evolving and cumulative effects of working during the COVID-19 outbreak on the psychological well-being of doctors working in emergency departments (ED), intensive care units (ICU) and anaesthetics during the pandemic. METHODS AND ANALYSIS: This study is a longitudinal questionnaire-based study with three predefined time points spanning the acceleration, peak and deceleration phases of the COVID-19 pandemic.The primary outcomes are psychological distress and post-trauma stress as measured by the General Health Questionnaire-12 (GHQ-12) and Impact of Events Scale-Revised (IES-R). Data related to personal and professional characteristics will also be collected. Questionnaires will be administered prospectively to all doctors working in ED, ICU and anaesthetics in the UK and Ireland via existing research networks during the sampling period. Data from the questionnaires will be analysed to assess the prevalence and degree of psychological distress and trauma, and the nature of the relationship between personal and professional characteristics and the primary outcomes. Data will be described, analysed and disseminated at each time point; however, the primary endpoint will be psychological distress and trauma at the final time point. ETHICS AND DISSEMINATION: Ethical approval was obtained from the University of Bath, UK (ref: 4421), and Children's Health Ireland at Crumlin, Ethics Committee. Regulatory approval from the Health Regulation Authority (UK), Health and Care Research Wales (IRAS: 281944).This study is limited by the fact that it focuses on doctors only and is survey based without further qualitative interviews of participants. It is expected this study will provide clear evidence of the psychological impact of COVID-19 on doctors and will allow present and future planning to mitigate against any psychological impact. TRIAL REGISTRATION NUMBER: ISRCTN10666798.


Assuntos
Infecções por Coronavirus/terapia , Corpo Clínico Hospitalar/psicologia , Pneumonia Viral/terapia , Estresse Psicológico/epidemiologia , Serviço Hospitalar de Anestesia/organização & administração , Betacoronavirus , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/transmissão , Serviço Hospitalar de Emergência/organização & administração , Humanos , Transmissão de Doença Infecciosa do Profissional para o Paciente/estatística & dados numéricos , Unidades de Terapia Intensiva/organização & administração , Irlanda/epidemiologia , Estudos Longitudinais , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/transmissão , Prevalência , Projetos de Pesquisa , Autorrelato , Inquéritos e Questionários , Reino Unido/epidemiologia
13.
Neurology ; 95(13): 583-592, 2020 09 29.
Artigo em Inglês | MEDLINE | ID: mdl-32732292

RESUMO

In response to the COVID-19 pandemic epicenter in Bronx, NY, the Montefiore Neuroscience Center required rapid and drastic changes when considering the delivery of neurologic care, health and safety of staff, and continued education and safety for house staff. Health care leaders rely on principles that can be in conflict during a disaster response such as this pandemic, with equal commitments to ensure the best care for those stricken with COVID-19, provide high-quality care and advocacy for patients and families coping with neurologic disease, and advocate for the health and safety of health care teams, particularly house staff and colleagues who are most vulnerable. In our attempt to balance these principles, over 3 weeks, we reformatted our inpatient neuroscience services by reducing from 4 wards to just 1, in the following weeks delivering care to over 600 hospitalized patients with neuro-COVID and over 1,742 total neuroscience hospital bed days. This description from members of our leadership team provides an on-the-ground account of our effort to respond nimbly to a complex and evolving surge of patients with COVID in a large urban hospital network. Our efforts were based on (1) strategies to mitigate exposure and transmission, (2) protection of the health and safety of staff, (3) alleviation of logistical delays and strains in the system, and (4) facilitating coordinated communication. Each center's experience will add to knowledge of best practices, and emerging research will help us gain insights into an evidence-based approach to neurologic care during and after the COVID-19 pandemic.


Assuntos
Infecções por Coronavirus , Departamentos Hospitalares/organização & administração , Corpo Clínico Hospitalar/organização & administração , Neurologia/organização & administração , Pandemias , Pneumonia Viral , Assistência Ambulatorial , Betacoronavirus , Comunicação , Assistência à Saúde , Unidades Hospitalares/organização & administração , Hospitalização , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Neurologia/educação , Enfermagem em Neurociência , Recursos Humanos de Enfermagem no Hospital/organização & administração , Equipamento de Proteção Individual , Admissão e Escalonamento de Pessoal , Telemedicina , Envio de Mensagens de Texto
15.
J Infect ; 81(3): 427-434, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32615198

RESUMO

BACKGROUND: Significant nosocomial transmission of SARS-CoV-2 has been demonstrated. Understanding the prevalence of SARS-CoV-2 carriage amongst HCWs at work is necessary to inform the development of HCW screening programmes to control nosocomial spread. METHODS: Cross-sectional 'snapshot' survey from April-May 2020; HCWs recruited from six UK hospitals. Participants self-completed a health questionnaire and underwent a combined viral nose and throat swab, tested by Polymerase Chain Reaction (PCR) for SARS-CoV-2 with viral culture on majority of positive samples. FINDINGS: Point prevalence of SARS-CoV-2 carriage across the sites was 2.0% (23/1152 participants), median cycle threshold value 35.70 (IQR:32.42-37.57). 17 were previously symptomatic, two currently symptomatic (isolated anosmia and sore throat); the remainder declared no prior or current symptoms. Symptoms in the past month were associated with threefold increased odds of testing positive (aOR 3.46, 95%CI 1.38-8.67; p = 0.008). SARS-CoV-2 virus was isolated from only one (5%) of nineteen cultured samples. A large proportion (39%) of participants reported symptoms in the past month. INTERPRETATION: The point-prevalence is similar to previous estimates for HCWs in April 2020, though a magnitude higher than in the general population. Based upon interpretation of symptom history and testing results including viral culture, the majority of those testing positive were unlikely to be infectious at time of sampling. Development of screening programmes must balance the potential to identify additional cases based upon likely prevalence, expanding the symptoms list to encourage HCW testing, with resource implications and risks of excluding those unlikely to be infectious with positive tests. FUNDING: Public Health England.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Transmissão de Doença Infecciosa/estatística & dados numéricos , Pessoal de Saúde/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Adulto , Idoso , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/transmissão , Estudos Transversais , Inglaterra , Feminino , Humanos , Masculino , Corpo Clínico Hospitalar/estatística & dados numéricos , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/transmissão , Estudos Prospectivos , RNA Viral , Reação em Cadeia da Polimerase em Tempo Real , Inquéritos e Questionários , Adulto Jovem
17.
Am Surg ; 86(6): 599-601, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32683962

RESUMO

The chief of surgery of a 264-bed acute care facility and clinic system in Topeka, KS, USA, gives a chronology that illustrates the rapid and profound clinical, economic, and emotional impact of the SARS-CoV-2 outbreak on his hospital and community. In his view, the pandemic has laid bare the weaknesses of several factors basic to the modern US health care system and the resulting economic crisis: just-in-time supply chain technology; foreign sourcing of masks, gowns, and critical equipment, all at critical shortages during the crisis; rural hospital closings; lack of excess capacity through maximization of utilization for efficiency; and an overreliance on high revenue elective procedures and tests. His team was tested by an emergency operation for bowel obstruction that put all the isolation protocols into action. Despite their readiness and the success of the operation and the potential for telemedicine as an alternative to in-person evaluations and outpatient visits, the forced cancellation of all elective operations have led to the loss of revenue for both hospital system and providers, furlough and termination of workers, and financial hardship and uncertainty.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Hospitais Comunitários/economia , Corpo Clínico Hospitalar/psicologia , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Betacoronavirus , Protocolos Clínicos , Procedimentos Cirúrgicos Eletivos/economia , Fechamento de Instituições de Saúde/economia , Humanos , Controle de Infecções/métodos , Obstrução Intestinal/cirurgia , Kansas/epidemiologia , Isolamento de Pacientes , Equipamento de Proteção Individual/provisão & distribução , Downsizing Organizacional/economia , Telemedicina
18.
Am Surg ; 86(6): 577-584, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32683966

RESUMO

Under the aegis of the American College of Surgeons (ACS), the senior author (SDW), a member of the Board of Regents of the ACS, interviewed 3 of his international colleagues in colon and rectal surgery who found themselves dealing with a flood of patients from the COVID-19 pandemic. Each was in a "hot spot" where the outbreak overwhelmed the capacities of the hospitals. Professor Antonino Spinelli of Milan dealt with the sudden increase in COVID-19 patients that threatened to push all other emergencies and urgent cancer cases aside. Providers lacked the personal protective equipment to be adequately safe in the environment. In Madrid, Dr Julio Mayol recounted how 10%-15% of the workers in his hospital were incapacitated by the virus, many of them doctors providing direct care to patients. The disease is so prevalent that all emergency patients are treated as though they have the infection. Having practices in Saudi Arabia and Spain, Dr Delia Cortés-Guiral saw how the former country controlled the epidemic through a strict lockdown of travel and closure of holy pilgrimage sites and social gatherings. In contrast, upon her return to her native country, she experienced the near-breakdown of the health care system by the suddenness of the outbreak. "There are now no specialists now, she says." All of the specialties are treating COVID-19 patients and all of us are learning at the same time how to deal with this disease."It is a nightmare now here in Spain".


Assuntos
Infecções por Coronavirus/terapia , Pandemias , Papel do Médico , Pneumonia Viral/terapia , Cirurgiões , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Serviço Hospitalar de Emergência , Humanos , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Itália/epidemiologia , Corpo Clínico Hospitalar , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Arábia Saudita/epidemiologia , Isolamento Social , Espanha/epidemiologia , Procedimentos Cirúrgicos Operatórios
19.
Crit Care Med ; 48(10): e846-e855, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32639413

RESUMO

IMPORTANCE: Recent reports identify that among hospitalized coronavirus disease 2019 patients, 30% require ICU care. Understanding ICU resource needs remains an essential component of meeting current and projected needs of critically ill coronavirus disease 2019 patients. OBJECTIVES: This study queried U.S. ICU clinician perspectives on challenging aspects of care in managing coronavirus disease 2019 patients, current and anticipated resource demands, and personal stress. DESIGN, SETTING, AND PARTICIPANTS: Using a descriptive survey methodology, an anonymous web-based survey was administered from April 7, 2020, to April 22, 2020 (email and newsletter) to query members of U.S. national critical care organizations. MEASUREMENTS AND MAIN RESULTS: Through a 16-item descriptive questionnaire, ICU clinician perceptions were assessed regarding current and emerging critical ICU needs in managing the severe acute respiratory syndrome coronavirus 2 infected patients, resource levels, concerns about being exposed to severe acute respiratory syndrome coronavirus 2, and perceived level of personal stress. A total of 9,120 ICU clinicians responded to the survey, representing all 50 U.S. states, with 4,106 (56.9%) working in states with 20,000 or more coronavirus disease 2019 cases. The 7,317 respondents who indicated their profession included ICU nurses (n = 6,731, 91.3%), advanced practice providers (nurse practitioners and physician assistants; n = 334, 4.5%), physicians (n = 212, 2.9%), respiratory therapists (n = 31, 0.4%), and pharmacists (n = 30, 0.4%). A majority (n = 6,510, 88%) reported having cared for a patient with presumed or confirmed coronavirus disease 2019. The most critical ICU needs identified were personal protective equipment, specifically N95 respirator availability, and ICU staffing. Minimizing healthcare worker virus exposure during care was believed to be the most challenging aspect of coronavirus disease 2019 patient care (n = 2,323, 30.9%). Nurses report a high level of concern about exposing family members to severe acute respiratory syndrome coronavirus 2 (median score of 10 on 0-10 scale). Similarly, the level of concern reached the maximum score of 10 in ICU clinicians who had provided care to coronavirus disease 2019 patients. CONCLUSIONS: This national ICU clinician survey identifies continued concerns regarding personal protective equipment supplies with the chief issue being N95 respirator availability. As the pandemic continues, ICU clinicians anticipate a number of limited resources that may impact ICU care including personnel, capacity, and surge potential, as well as staff and subsequent family members exposure to severe acute respiratory syndrome coronavirus 2. These persistent concerns greatly magnify personal stress, offering a therapeutic target for professional organization and facility intervention efforts.


Assuntos
Infecções por Coronavirus/epidemiologia , Unidades de Terapia Intensiva/organização & administração , Corpo Clínico Hospitalar/organização & administração , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Síndrome Respiratória Aguda Grave/terapia , Infecções por Coronavirus/prevenção & controle , Estado Terminal/mortalidade , Estado Terminal/terapia , Feminino , Mortalidade Hospitalar/tendências , Humanos , Comunicação Interdisciplinar , Masculino , Avaliação de Resultados em Cuidados de Saúde , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Síndrome Respiratória Aguda Grave/diagnóstico , Síndrome Respiratória Aguda Grave/mortalidade , Inquéritos e Questionários , Estados Unidos
20.
J Infect Public Health ; 13(10): 1453-1455, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32694083

RESUMO

Since the outbreak of novel coronavirus (SARS-CoV-2)-infected pneumonia (COVID-19), numerous medical staff are fighting on the frontline. However, the possibility of occult infection in medical staff is ignored in many recent studies. Herein, we collected data in a COVID-19 designated hospital from January 22, 2020 to March 10, 2020. A total of 33 medical staff had at least one nucleic acid test of throat swab, immunoglobulin G (IgG) or IgM serum antibody test, and chest computed tomography (CT), were enrolled. Finally, we identified 25 cases (75.8%) were isolated for hospitalized treatment after positive virus detection. In addition, 4 cases who were all negative for nucleic acid test detection with no clinical symptoms, and none of their chest CT were abnormal. However, the results of serum IgG or IgM antibody test in these 4 cases were positive, suggesting the presence of occult infection. In conclusion, data from our single center indicated that SARS-CoV-2 had a high medical infection rate (29/33 = 87.9%) and might have a potential risk of occult infection.


Assuntos
Anticorpos Antivirais/sangue , Infecções Assintomáticas , Betacoronavirus/imunologia , Infecções por Coronavirus/diagnóstico , Hospitais Especializados , Corpo Clínico Hospitalar/estatística & dados numéricos , Pneumonia Viral/diagnóstico , RNA Viral/sangue , Adulto , Betacoronavirus/genética , China/epidemiologia , Infecções por Coronavirus/epidemiologia , Feminino , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Radiografia Torácica , Tomografia Computadorizada por Raios X
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