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During the initial surge of the COVID-19 pandemic in the spring and summer of 2020, pediatric heart centers were forced to rapidly alter the way patient care was provided to minimize interruption to patient care as well as exposure to the virus. In this survey based descriptive study we characterize changes that occurred within pediatric cardiology practices across the United States and describe provider experience and attitudes towards these changes during the pandemic. Common changes that were implemented included decreased numbers of procedures, limiting visitors, and shifting towards telemedicine encounters. The information obtained from this survey may be useful in guiding and standardizing responses to future public health crises.
We report a case of thyroid storm precipitated by SARS-CoV-2 infection in an adolescent girl with history of Graves disease and dilated cardiomyopathy. This case highlights that SARS-CoV-2 infection can potentially trigger a thyrotoxicosis crisis and acute decompensated heart failure in a patient with underlying thyroid disease and myocardial dysfunction even in the absence of multisystem inflammatory syndrome in children. We systematically reviewed the thyrotoxicosis cases with SARS-CoV-2 infection and described its impact on pre-existing dilated cardiomyopathy.
The present study aims to explore if a relationship exists between the immediate sharp increase in Intensive Care Unit (ICU) admissions and the mortality rates in Italy.
Official epidemiological data on COVID-19 were employed. The forward lagged (0, 3, 7, 14 days) daily variations in the number of deaths according to the number of days after the outbreak started and the daily increases in ICU admissions were estimated.
A direct relationship between the sharp increase of ICU admissions and mortality rates has been shown. Furthermore, the analysis of the forward lagged daily variations in the number of deaths showed that an increase in the daily number of ICU admissions resulted in significantly higher mortality after 3, 7, and 14 days. The most pronounced effect was detected after 7 days, with 250 deaths (95% C.I. 108.1-392.8) for the highest increase in the ICU admissions -from 100 to 200-
These results would serve as a warning for the scientific community and the health care decision-makers to prevent a quick and out-of-control saturation of the ICU beds in case of a relapse of the COVID-19 outbreak.
Mass vaccination campaigns have been used effectively to limit the impact of communicable disease on public health. However, the scale of the COVID19 vaccination campaign is unprecedented. Mass vaccination sites consolidate resources and experience into a single entity and are essential to achieving community (“herd”) immunity rapidly, efficiently, and equitably. Healthcare systems, local and regional public health entities, emergency medical services, and private organizations can rapidly come together to solve problems and achieve success. As medical directors at several mass vaccination site across the United States, we describe key mass vaccination site concepts including site selection, operational models, patient flow, inventory management, staffing, technology, reporting, medical oversight, communication, and equity. Lessons learned from experience operating a diverse group of mass vaccination sites will help to inform not only sites operating during the current pandemic but may serve as a blueprint for future outbreaks of highly infectious communicable disease.
To examine how sociodemographic variables and frequency of media consumption affect hoarding behaviour and food insecurity concerns during the COVID-19 pandemic.
A quantitative, non-experimental, correlational online survey was administered using a convenience sample of 203 participants from the United Kingdom with no medical issues that affected buying behaviour during the pandemic to examine perceptions related to food insecurity, and self-reported food hoarding behaviour
Younger adults and lower income groups reported higher food insecurity perceptions and hoarding behaviours. Consuming COVID-19 information from websites was significantly associated with food insecurity perceptions, while information from social media was significantly associated with more food hoarding behaviours.
Younger adults and lower income groups are vulnerable populations from the perspective of food insecurity and hoarding behaviour in times of health disasters like pandemics. While social media can play a positively catalytic role during crises, excessive online information and misinformation can contribute negatively to public panic and feelings of insecurity. Implications for disaster preparedness and future research are discussed.
The findings suggest that age is the main predictor of food insecurity and hoarding behaviour, with younger adults more likely to be affected. They also suggest that people are turning to NHS wesbites, which were deemed more trustworthy than social media, to avoid ‘news fatigue’ and avoiding speculation. Suggestions for future research were made, specifically to examine people’s social support during the pandemic to understand its’ potential link to stockpiling behaviour or food insecurity concerns.
Due to the COVID-19 pandemic, there is currently a need for accurate, rapid, and easy-to-administer diagnostic tools to help communities manage local outbreaks and assess the spread of disease. The use of Artificial Intelligence within the domain of breath analysis techniques has shown to have potential in diagnosing a variety of diseases such as cancer and lung disease by analyzing volatile organic compounds (VOCs) in exhaled breath. This combined with their rapid, easy-to-use, and non-invasive nature makes them a good candidate for use in diagnosing COVID-19 in large scale public health operations. However, there remains issues with their implementation when it comes to the infrastructure currently available to support their use on a broad scale. This includes issues of standardization, and whether or not a characteristic VOC pattern can be identified for COVID-19. Despite these difficulties, breathalysers offer potential to assist in pandemic responses and their use should be investigated.
Serbia was one of the countries in Europe and the world that were most affected by the coronavirus disease (COVID-19) pandemic. City Novi Pazar was the greatest coronavirus hotspot in Europe on July 1st, 2020, due to several hundred infected people. Even though united data was published at the state level, there is no data by region or city, so the interpretation of the COVID-19 epidemic in Serbia at the regional level is difficult. Different levels of health care and health education of citizens and the degree of respect for the proposed epidemiological measures have led to significant differences in the number of tests, a large number of infected, and several deaths by regions and cities. Insufficiently precise and up-to-date keeping of records and statistical data on COVID-19 at the state and local level also complicates the pandemic’s scientific and epidemiological analysis. Novi Pazar is a city in southwestern Serbia with a population of 100 000. It is similar in population to the city of Bergamo, in northern Italy in the Lombardy region. As of 1st of July, 2020, Novi Pazar had 300% higher mortality per 100 000 population compared to the same month last year, and almost ten times higher mortality than the rest of Serbia.
Understanding factors associated with post-discharge sleep quality among COVID-19 survivors is important for intervention development.
This study investigated sleep quality and its correlates among COVID-19 patients 6 months after their most recent hospital discharge.
Healthcare providers at hospitals located in five different Chinese cities contacted adult COVID-19 patients discharged between 1 February and 30 March 2020. A total of 199 eligible patients provided verbal informed consent and completed the interview. Using score on the single-item Sleep Quality Scale as the dependent variable, multiple linear regression models were fitted.
Among all participants, 10.1% reported terrible or poor sleep quality, and 26.6% reported fair sleep quality, 26.1% reported worse sleep quality when comparing their current status with the time before COVID-19, and 33.7% were bothered by a sleeping disorder in the past 2 weeks. After adjusting for significant background characteristics, factors associated with sleep quality included witnessing the suffering (adjusted B = −1.15, 95% CI = −1.70, −0.33) or death (adjusted B = −1.55, 95% CI = −2.62, −0.49) of other COVID-19 patients during hospital stay, depressive symptoms (adjusted B = −0.26, 95% CI = −0.31, −0.20), anxiety symptoms (adjusted B = −0.25, 95% CI = −0.33, −0.17), post-traumatic stress disorders (adjusted B = −0.16, 95% CI = −0.22, −0.10) and social support (adjusted B = 0.07, 95% CI = 0.04, 0.10).
COVID-19 survivors reported poor sleep quality. Interventions and support services to improve sleep quality should be provided to COVID-19 survivors during their hospital stay and after hospital discharge.
The prevalence of serious psychological distress (SPD) was elevated during the COVID-19 pandemic in the USA, but the relationships of SPD during the pandemic with pre-pandemic SPD, pre-pandemic socioeconomic status, and pandemic-related social stressors remain unexamined.
A probability-based sample (N = 1751) of the US population age 20 and over was followed prospectively from February 2019 (T1), with subsequent interviews in May 2020 (T2) and August 2020 (T3). Multinomial logistic regression was used to assess prospective relationships between T1 SPD with experiences of disruption of employment, health care, and childcare at T2. Binary logistic regression was then used to assess relationships of T1 SPD, and socioeconomic status and T2 pandemic-related stressors with T3 SPD.
At T1, SPD was associated with age, race/ethnicity, and household income. SPD at T1 predicted disruption of employment (OR 4.5, 95% CI 1.4–3.8) and health care (OR 3.2, 95% CI 1.4–7.1) at T2. SPD at T1 (OR 10.2, 95% CI 4.5–23.3), low household income at T1 (OR 2.6, 95% CI 1.1–6.4), disruption of employment at T2 (OR 3.2, 95% CI 1.4–7.6), and disruption of healthcare at T2 (OR 3.3, 95% CI 1.5–7.2) were all significantly associated with elevated risk for SPD at T3.
Elevated risk for SPD during the COVID-19 pandemic is related to multiple psychological and social pathways that are likely to interact over the life course. Policies and interventions that target individuals with pre-existing mental health conditions as well as those experiencing persistent unemployment should be high priorities in the mental health response to the pandemic.
To investigate the opinions of different groups of people in Iran on their willingness to receive a COVID-19 vaccine.
In this cross-sectional study, we surveyed a sample (based on consecutive referrals) of five groups of people in late 2020: a group of the general population from Shiraz (without a history of any chronic medical or psychiatric problems), patients with epilepsy, patients with diabetes mellitus (DM), patients with cardiac problems, and patients with psychiatric problems. The survey included four general questions and three COVID-19 specific questions.
582 people participated. In Total, 66 (11.3%) people expressed that they were not willing to receive a COVID-19 vaccine. Psychiatric disorders (OR: 3.15; 95% CI: 1.31-7.60; p = 0.006) and male sex (OR: 2.10; 95% CI: 1.23-3.58; p = 0.010) were significantly associated with COVID-19 vaccine hesitancy.
Vaccine hesitancy is a global issue. Patients with psychiatric disorders had the highest rate of vaccine hesitancy. Previous studies have shown that depression and anxiety are associated with a reduced adherence to the recommended medical advices. Why male sex is associated with vaccine hesitancy is not clear. Researchers should investigate the rates and the factors affecting the vaccine hesitancy in their corresponding communities.
Some studies in countries affected by the coronavirus disease of 2019 (COVID-19) pandemic have shown that the missions of Emergency Medical Service (EMS) have changed during the COVID-19 pandemic, and the rate of death and out-of-hospital cardiac arrest (OHCA) has been increased due to the direct and indirect effects of COVID-19.
The aim of this study was to determine the effect of the COVID-19 pandemic on the process of EMS missions, death, and OHCA.
This cross-sectional study was performed in Tehran, Iran. All conducted missions in the first six months of the three consecutive solar years of March 21 until September 22 of 2018-2020, which were registered in the registry bank of the Tehran EMS center, were assessed and compared. Based on the opinion of experts, the technician’s on-scene diagnoses were categorized into 14 groups, and then death and OHCA cases were compared.
In this study, the data of 1,050,376 missions performed in three study periods were analyzed. In general, the number of missions in 2020 was 17.83% fewer than that of 2019 (P < .001); however, the number of missions in 2019 was 30.33% more than that of 2018. On the other hand, the missions of respiratory problems, cardiopulmonary arrest, infectious diseases, and poisoning were increased in 2020 compared to that of 2019. The raw number of OHCA and death cases respectively in 2018, 2019, and 2020 were 25.0, 22.7, and 28.6 cases per 1,000 missions. Of all patients who died in 2020, 4.9% were probable/confirmed COVID-19 cases. The history of heart disease, hypertension, diabetes, and respiratory disease in patients in 2020 was more frequent than that of the other two years.
This study showed that the number of missions in the Tehran EMS in 2020 were decreased compared to that of 2019, however the number of missions in 2019 was more than that of 2018. Respiratory problems, infectious diseases, poisoning, death, and OHCA were increased compared to the previous two years and cardiovascular complaints, neurological problems, and motor vehicle collisions (MVCs) in 2020 were fewer than that of the other two years