Asthma and clinical outcomes of COVID-19 in a community setting.

OBJECTIVES: The association between asthma and COVID-19 mortality remains inconclusive. We examined the association between asthma and clinical outcomes of patients with COVID-19. STUDY DESIGN: A case-control study based on a surveillance cohort in Harris County, Texas. METHODS: Using the data of 21,765 patients who reported having at least one chronic health condition, we investigated the association between asthma and COVID-19 severity, characterized primarily by hospitalization and death. Unconditional logistic regression models were used to estimate the multivariable odds ratio (mOR) and its 95 % confidence interval (CI) of COVID-19 severity associated with asthma and other chronic lung diseases, adjusting for demographic and other comorbidities. A P-value < 0.005 was considered statistically significant after correcting multiple testing. RESULTS: In total, 3034 patients (13.9 %) had asthma, and 774 (3.56 %) had other chronic lung diseases. The case death rate among patients with asthma and other chronic lung diseases was 0.75 % and 19.0 %, respectively. Compared to patients without the respective conditions, patients with asthma had lower odds of death (mOR = 0.44, 95 % CI: 0.27-0.69), while patients with other chronic lung diseases had higher odds of hospitalization (mOR = 2.02, 95 % CI: 1.68-2.42) and death (mOR = 1.95, 95 % CI: 1.52-2.49) (P-values < 0.005). Risk factors for COVID-19 mortality included older age, male gender, diabetes, obesity, hypertension, cardiovascular disease, active cancer, and chronic kidney disease. CONCLUSIONS: The public health surveillance data suggested that preexisting asthma was inversely associated with COVID-19 mortality.

Comparative evaluation of a novel fluorescent marker and environmental surface cultures to assess the efficacy of environmental cleaning practices at a tertiary care hospital.

BACKGROUND: Cleaning high-touch surfaces serves as a crucial step towards controlling the transmission of multidrug-resistant pathogens in hospital environments. The process can be made most effective if scientifically monitored using a simple, feasible and reliable technique, especially in resource-poor settings. AIM: To identify a novel florescent marker (FM) comparable to the already existing commercial FM systems and to assess its efficacy in evaluating cleaning of high-touch surfaces in a hospital environment. METHODS: A liquid detergent used for washing purposes was identified as a novel FM. Pre- and post-cleaning sampling were performed from 250 high-touch surfaces in different patient-care areas using this marker and aerobic colony counts. Concordance between the two methods was assessed and compared by Cohen's kappa coefficient. The sensitivity, specificity, positive predictive and negative predictive values for the new FM method were calculated against the microbiological method. FINDINGS: A good correlation (κ = 0.60) with overall concordance of 79.6% was observed between the two methods. The sensitivity, specificity, positive predictive value and negative predictive value of the FM were 79.58% (95% confidence interval (CI): 72-85.85%), 79.63% (95% CI: 70.79-86.78), 83.70% (95% CI: 76.38-89.50) and 74.78% (95% CI: 65.83-82.38), respectively. CONCLUSIONS: The FM used in the present study proved to be a simple and cost-effective alternative to commercially available FMs for assessing environmental cleaning practices on a daily basis in resource-poor settings. Additional studies making direct comparisons of the FM used here with the established FMs are warranted before it can be generalized for use.