Impact of COVID-19 infection among myasthenia gravis patients- a Cerner Real-World DataTM study.

BACKGROUND: Myasthenia gravis (MG) is an auto-immune disease, and the mainstay of therapy is immunomodulation. Such patients are at high risk of acquiring any infections. Hence, we sought to determine the impact of the current global pandemic COVID-19 infection in MG patients. METHODS: For our study, we used Cerner Real-World DataTM that was provided through Cerner's HealtheDataLab research tool. We ran a database query from January 2019 to July 2020 in our study and identified myasthenia patients with and without COVID-19 infection. To extract these patients' data, we used ICD 9-CM, ICD-10, and SNOMED-CT codes. We reported the data using means, range, and prevalence rates, and the p-values were calculated using the two-sample t-test and Pearson's chi-squared test. RESULTS: In the COVID-19 data set, a total of twenty-seven myasthenia patients were identified with a positive COVID-19 infection, and four were diagnosed with an exacerbation. The male to female ratio was equal and one unknown gender (3.7%) with a mean (± SD) age of 64.33 ± 18.42 years. This study group was compared with a non-COVID-19 data set in which a total of sixty-four myasthenia patients were identified, and twenty-three had an exacerbation. Among the 13 hospitalized patients in the two groups, the mean length of hospitalization for the myasthenia patients in the COVID-19 data set was 8.28 days (n = 7), and the non-COVID-19 set was 4.33 days (n = 6), and it was statistically significant (p-value= 0.007). CONCLUSIONS: The mean length of hospital stay is prolonged in myasthenia patients who tested positive for COVID-19.

Social Service Workers' Use of Social Media to Obtain Client Information: Current Practices and Perspectives on a Potential Informatics Platform.

To gain insight into current use of social-media platforms in human services delivery, we systematically surveyed 172 social-service workers from six agencies in a Midwest US city to gather data about social-media usage among social-service providers, potential challenges and benefits of using social media, and whether a social-media-based informatics platform could be valuable. Quantitative analyses showed that approximately half of participants have used social media to collect client-related information; nearly one-quarter indicated "often" or "nearly daily" use. Adjusting for the effects of worker characteristics, social-media use was associated with the type of agency involved and with increased tenure in social services. Adjusted results also showed that participants' comfort with using the potential application was greater in those agencies substantially involved with investigative/legal work. However, trust in the information collected by the potential application was a stronger, independent predictor of comfort using the tool. Qualitative analyses identified numerous challenges and ethical concerns, and positive and negative aspects of a social-media-based informatics platform. If the platform is to be created, work must be done carefully, fully considering ethical issues rightly raised by social service workers, existing agency policies, and professional standards. Future research should investigate ways to negotiate these complex challenges.