Coronavirus Disease Of 2019 Research Articles

Clinical profile, prognosis and post COVID-19 Illnesses among attendants to private general practitioner (GP) clinic at Urban Amman Area: a clinical case-series study

Background: The clinical manifestations of Corona Virus Disease of 2019 (COVID-19) varied from patient to patient with evidence of multi-organ involvement. Many patients continue to have a wide range of symptoms for variable periods of time. The long-term effects of COVID-19 infection (post-COVID-19 illness or syndrome) are not yet been fully explored. This study aims to highlight the clinical manifestations of the acute COVID-19 infection and the longer-term manifestations of the disease among the attendants to a private GP clinic in the Urban Amman Area, Jordan. Methods: A clinical case-series study was conducted on a sample of 300 COVID-19-positive cases among patients attending my private GP clinic in the Urban Amman Area, Jordan. We used the structured questionnaire based mainly on World Health Organization (WHO) Case Report Form (CRF) verified tool for post-COVID-19. All patients with COVID-19 were included in the study. Data collection was conducted through phone calls and analyzed using the Statistical Package for Social Sciences (SPSS) software. Results: The incidence of COVID-19 among patients attending the clinic during the period of this study was 25%. Females were 135 (45%) of the study population and males were 165 (55%). The mean (SD) of age was 34.2 (5.0) years. Most of the infected staff (90%) were symptomatic and developed acute COVID-19 symptoms. Fever, Cough, Fatigue, joint pain and loss of smell and taste were the most common symptoms. 72% of the study population had fully recovered from the infection, while 28% of them continued to suffer from many long symptoms. Fatigue (28%), shortness of breath on activity (18%), Social withdrawal (18%), anxiety (17%), forgetfulness (16%), trouble concentrating (15) and depressed mood (14%) were the most frequently reported long symptoms. Conclusion: The prevalence of Post COVID-19 illness was 28% with a high public health burden calling for the public health system to address the medical and psychological needs of affected persons. Mental health and psychosocial support are recommended elements for the management of patients.

Impact of Early COVID-19 Waves on Cardiac Rehabilitation Delivery in Australia: A National Survey.

The novel coronavirus disease of 2019 (COVID-19) pandemic significantly disrupted health care, especially outpatient services such as cardiac rehabilitation (CR). We investigated the impact of early COVID-19 waves on the delivery of Australian CR programs, comparing this time period with usual practice prior to the pandemic (2019) and current practice (2021) once the early waves had subsided. Specifically, we aimed to understand how the delivery of programs during COVID-19 compared to usual practice. An anonymous online cross-sectional survey of Australian CR program staff was conducted, comprising three sections: program and respondent characteristics, COVID-19 impact on program delivery, and barriers to, and enablers of, program delivery. Respondents were asked to consider three key timepoints: 1) Pre-COVID-19 (i.e. usual practice in 2019), 2) Early COVID-19 waves (March-December 2020), and 3) Currently, at time of survey completion post early COVID-19 waves (May-July 2021). Of the 314 Australian CR programs, 115 responses were received, of which 105 had complete data, representing a 33% response rate. All states and territories were represented. During early COVID-19 waves programs had periods of closure (40%) or reduced delivery (70%). The majority of programs reported decreased CR referrals (51.5%) and decreased participation (77.5%). The two core components of CR-exercise and education-were significantly impacted during early COVID-19 waves, affecting both the number and duration of sessions provided. Exercise session duration did not return to pre-pandemic levels (53.5 min compared to 57.7 min, p=0.02). The majority of respondents (77%) reported their CR program was inferior in quality to pre-pandemic and more organisational support was required across information technology, staffing, administration and staff emotional and social support. Australian CR programs underwent significant change during the early COVID-19 waves, consistent with international CR reports. Fewer patients were referred and attended CR and those who did attend received a lower dose of exercise and education. It will be important to continue to monitor the long-term impacts of the COVID-19 pandemic to ensure CR programs return to pre-pandemic functioning and continue to deliver services in line with best practice and evidence-based recommendations.

The effect of COVID-19 pandemic on depression and suicidal ideation in Korean community dwelling elderly

IntroductionThe impacts of the coronavirus disease of 2019 (COVID-19) pandemic on mental health have been relatively severe.ObjectivesThis study examined the influence of the COVID-19 especially on depression and suicidal ideation in community-dwelling elderly in Korea.MethodsData were employed from a survey on elderly mental health in Jeollanam-do (southwest province in Korea). A total of 2,423 elderlies were recruited from 22 counties in Jeollanam-do between April and October 2021. We used self-reported questionnaires, including sociodemographic factors, COVID-19 related stress, suicidal ideation, Geriatric Depression Scale-Short Form Korean Version (GDS-SF). Logistic regression was performed to examine the factors on depression and suicidal ideationResultsOf the 2423 subjects, 622 (25.7%) reported depressive symptoms and 518 (21.4%) reported suicidal ideation. The multivariate logistic regression analysis revealed that living alone, poor perceived health status, the worry of COVID-19 infection and restriction of daily activity due to COVID-19 pandemic were significantly associated with depression. Male sex, poor perceived health status, disability in house chores and depressive symptom are risk factors for suicidal ideation.Image:Image 2:Image 3:ConclusionsThese findings showed that increased risk factor for depression and suicidal ideation in community dwelling elderly during COVID-19 pandemic. We confirmed that feelings of isolation and negative perception of health were risk factors on depression in community dwelling elderly in the context of the COVID –19 pandemic. Also male, poor self-perceived health status, difficulty of independent living and worry and depression are increased the risk of suicidal ideation among the elderly.Disclosure of InterestNone Declared

Otolaryngologic Symptom Severity Post SARS-CoV-2 Infection

To assess laryngologic symptomatology following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and determine whether symptom severity correlates with disease severity. Single-institution survey study in participants with documented SARS-CoV-2 infection between March 2020 and February 2021. Data acquired included demographic, infection severity characteristics, comorbidities, and current upper aerodigestive symptoms via validated patient reported outcome measures. Primary outcomes of interest were scores of symptom severity questionnaires. Coronavirus disease of 2019 (COVID-19) severity was defined by hospitalization status. Descriptive subgroup analyses were performed to investigate differences in demographics, comorbidities, and symptom severity in hospitalized participants stratified by ICU status. Multivariate logistical regression was used to evaluate significant differences in symptom severity scores by hospitalization status. Surveys were distributed to 5300 individuals with upper respiratory infections. Ultimately, 470 participants with COVID-19 were included where 352 were hospitalized and 118 were not hospitalized. Those not hospitalized were younger (45.87 vs. 56.28 years), more likely female (74.17 vs. 58.92%), and less likely white (44.17 vs. 52.41%).Severity of dysphonia, dyspnea, cough, and dysphagia was significantly worse in hospitalized patients overall and remained worse at all time points. Cough severity paradoxically worsened in hospitalized respondents over time. Dyspnea scores remained abnormally elevated in respondents even 12 months after resolution of infection. Results indicate that laryngologic symptoms are expected to be worse in patients hospitalized with COVID-19. Dyspnea and cough symptoms can be expected to persist or even worsen by 1-year post infection in those who were hospitalized.Dysphagia and dysphonia symptoms were mild. Nonhospitalized participants tended to have minimal residual symptoms by 1 year after infection.

Characteristics of unintentional childhood injury during COVID-19: a single-center comparative study.

There are many articles related to child injuries during the coronavirus disease of 2019 (COVID-19) in other countries, but only few studies in this field in China. This study analyzes the clinical characteristics of unintentional childhood injury during the pandemic, to provide reference for the prevention of unintentional childhood injury in the context of pandemic. A comparative study was performed on the medical data of 2,497 children with unintentional injury who were hospitalized at Chengdu Women's and Children's Central Hospital between 1 January, 2018 and 31 May, 2021. The study period was divided into 2 periods, before the pandemic (1 January, 2018 to 31 May, 2019), during the pandemic (1 January, 2020 to 31 May, 2021). The number of unintentional childhood injuries and age distribution before and during the pandemic were compared. Group differences were examined using Mann-Whitney U for continuous variables and Chi-squared or Kruskal-Wallis tests for categorical variables. There were significant differences in age, accident location, hospitalization days, and medical expenses before and during the pandemic (P<0.05). During the pandemic, the number of children's unintentional injuries increased by 34.24% (1,066 vs. 1,431, P=0.000), and the significantly increased types of unintentional injuries included foreign bodies, falls, crush injuries, and sharp injuries. During the pandemic, the highest proportion of unintentional injury to children was foreign bodies, whereas the proportion of falls was the highest before the pandemic. During the pandemic, the number of foreign body injuries in toddler was significantly higher than before the pandemic (P=0.001), but the number of falls, crush injuries, and sharp injuries in preschooler was significantly higher (P<0.05). In the circumstance of the COVID-19, the number of foreign bodies, falls, crush injuries, and sharp injuries, in children increased significantly. It is necessary to strengthen the prevention of foreign bodies in toddler, and falls, crush injuries, and sharp injuries in preschooler.

Rationalizing the Use of COVID-19 Questionable Efficacy Drugs in a Low Middle-income Country: A Hospital Tocilizumab Committee Experience.

Only corticosteroids have confirmed mortality benefits in coronavirus disease of 2019 (COVID-19). Rational use of costlier drugs with questionable benefits poses a great concern to hospital pharmacies in low middle-income countriesAim: The present study aimed to assess the rational utilization of hospital supply tocilizumab and understand its clinical benefits in hospitalized COVID-19 pneumonia patientsMethods: The Hospital Tocilizumab Committee (HTC) decision support system framework was developed to make patients eligible or ineligible for tocilizumab procurement from the hospital pharmacy. A total of 33 consecutive patients receiving tocilizumab were analyzed retrospectively in the 3-month study period. The records of the inpatient stay of the patients were observed for pulse, blood pressure, respiratory rate (RR), oxygen saturation (SpO2), fraction of inspired oxygen (FiO2) laboratory work-up, hospital stay duration, and mortality benefit, if any. Patients were analyzed as "died," "survived," and "composite" subgroupsResults: The study observed death as a final outcome in 48% of patients. The study observed a significant effect of tocilizumab on C-reactive protein (CRP) (p = 0.02) and ferritin (p = 0.018) levels on a 10-day follow-up when all patients were analyzed together. Rising and declining trends of RR and FiO2 were observed among the "died" (RR, p = 0.02; FiO2, p = 0.03) and survived (RR, p = 0.03; FiO2, p = 0.05) subgroups. The second dose of tocilizumab was received by 88% of survivors as against 50% of patients who died (p = 0.04)Conclusion: Hospital Tocilizumab Committee (HTC) was successfully established to continue the assessment of the costlier drug with uncertain treatment benefits. A repeat dose of tocilizumab may provide a mortality benefit in Asian Indians.

Multisystem inflammatory syndrome in children associated with Bacille Calmette-Guérin scar: a case presentation

BackgroundDuring Coronavirus disease of 2019 (COVID-19) pandemic, the WHO reported a noticeable increase in Kawasaki disease prevalence in countries where Kawasaki disease is rare. This newly seen disease, unlike typical Kawasaki disease, tends to appear at a later age, has prominent gastrointestinal findings, higher rates of myocarditis and coronary artery involvement and a greater need for admission to the intensive care unit (ICU). Induration of the Bacillus Calmette-Guerin (BCG) scar is a rare finding seen in multisystem inflammatory syndrome (MIS-C). This is the second reported case of erythema and induration of the BCG scar in a 1-year-old boy with MIS-C.Case presentationThe Arabic boy presented with high resistant fever, nausea/vomiting, diarrhea, erythematous lips, and conjunctivitis. He later developed induration of his BCG scar, diffuse rash and desquamation on fingers and toes. He had a history of COVID-19 exposure as his IgG antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were positive. Based on his clinical findings and repeated lab results, he was diagnosed with MIS-C with Kawasaki features and treated with intravenous immune globulin (IVIG) followed by methylprenisolone and aspirin.ConclusionsReaction at the BCG inoculation site is not a diagnostic criteria for Kawasaki, but it is seen clinically in 30-50% of the patients. We report the case of a 1-year-old boy diagnosed with MIS-C presenting with erythema and induration of BCG scar. Further studies are needed to explore this clinical presentation, especially in the countries that have BCG vaccination programs, and to determine the mechanisms of MIS-C.

Improving wastewater-based epidemiology performance through streamlined automation

Wastewater-based epidemiology (WBE) has enabled us to describe Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infections in populations. However, implementation of wastewater monitoring of SARS-CoV-2 is limited due to the need for expert staff, expensive equipment, and prolonged processing times. As WBE increases in scope (beyond SARS-CoV-2) and scale (beyond developed regions), there is a need to make WBE processes simpler, cheaper, and faster. We developed an automated workflow based on a simplified method termed exclusion-based sample preparation (ESP). Our automated workflow takes 40 min from raw wastewater to purified RNA, which is several times faster than conventional WBE methods. The total assay cost per sample/replicate is $6.50 which includes consumables and reagents for concentration, extraction, and RT-qPCR quantification. The assay complexity is reduced significantly, as extraction and concentration steps are integrated and automated. The high recovery efficiency of the automated assay (84.5 ± 25.4%) yielded an improved Limit of Detection (LoDAutomated=40 copies/mL) compared to the manual process (LoDManual=206 copies/mL), increasing analytical sensitivity. We validated the performance of the automated workflow by comparing it with the manual method using wastewater samples from several locations. The results from the two methods correlated strongly (r = 0.953), while the automated method was shown to be more precise. In 83% of the samples, the automated method showed lower variation between replicates, which is likely due to higher technical errors in the manual process e.g., pipetting. Our automated wastewater workflow can support the expansion of WBE in the fight against Coronavirus Disease of 2019 (COVID-19) and other epidemics.

Air Quality Index (AQI) Did Not Improve during the COVID-19 Lockdown in Shanghai, China, in 2022, Based on Ground and TROPOMI Observations

The lockdowns from the coronavirus disease of 2019 (COVID-19) have led to a reduction in anthropogenic activities and have hence reduced primary air pollutant emissions, which were reported to have helped air quality improvements. However, air quality expressed by the air quality index (AQI) did not improve in Shanghai, China, during the COVID-19 outbreak in the spring of 2022. To better understand the reason, we investigated the variations of nitrogen dioxide (NO2), ozone (O3), PM2.5 (particular matter with an aerodynamic diameter of less than 2.5 μm), and PM10 (particular matter with an aerodynamic diameter of less than 10 μm) by using in situ and satellite measurements from 1 March to 31 June 2022 (pre-, full-, partial-, and post-lockdown periods). The results show that the benefit of the significantly decreased ground-level PM2.5, PM10, and NO2 was offset by amplified O3 pollution, therefore leading to the increased AQI. According to the backward trajectory analyses and multiple linear regression (MLR) model, the anthropogenic emissions dominated the observed changes in air pollutants during the full-lockdown period relative to previous years (2019–2021), whereas the long-range transport and local meteorological parameters (temperature, air pressure, wind speed, relative humidity, and precipitation) influenced little. We further identified the chemical mechanism that caused the increase in O3 concentration. The amplified O3 pollution during the full-lockdown period was caused by the reduction in anthropogenic nitrogen oxides (NOx) under a VOC-limited regime and high background O3 concentrations owing to seasonal variations. In addition, we found that in the downtown area, ground-level PM2.5, PM10, and NO2 more sensitively responded to the changes in lockdown measures than they did in the suburbs. These findings provide new insights into the impact of emission control restrictions on air quality and have implications for air pollution control in the future.

Time-Series Trends of Depressive Levels of Korean Adults During the 2020 COVID-19 Pandemic in South Korea.

This study aimed to observe the changes in people's depressive levels over 9 months since the coronavirus disease of 2019 (COVID-19) outbreak as well as to identify the predictors of people's depressive levels including COVID-19 infection fear in the context of South Korea in 2020. For these purposes, four cross-sectional surveys were periodically implemented from March to December 2020. We randomly recruited 6,142 Korean adults (aged 19 to 70) by using a quota survey. Along with descriptive analysis, which included a one-way analysis of variance and correlations, multiple regression models were built to identify the predictors of people's depressive levels during the pandemic. Overall, people's depressive levels and fear of COVID-19 infection gradually increased since the COVID-19 outbreak. In addition to demographic variables (i.e., being a female, young age, unemployed, and living alone) and the duration of the pandemic, people's COVID-19 infection fear was associated with their depressive levels. To ameliorate these rising mental health issues, access to mental health services should be secured and expanded, particularly for individuals who present greater vulnerabilities due to socioeconomic characteristics that may affect their mental health.

Effect of COVID-19 on Glycemic Control, Insulin Resistance, and pH in Elderly Patients With Type 2 Diabetes.

Background The coronavirus disease of 2019 (COVID-19) was spread all over the world, while diabetes mellitus (DM) remains the most prevalent chronic disease worldwide. Aims This study aims to investigate the effect of COVID-19 on glycemic control, insulin resistance (IR), and pH in elderly patients with type 2 diabetes. Methods A retrospective study was conducted on patients with type 2 DM who were diagnosed with COVID-19 infection in the central hospitals of the Tabuk region. Patient data were collected from September 2021 to August 2022. Four non-insulin-based insulin resistance indexes were calculated for patients: the triglyceride-glucose (TyG) index, the triglyceride glucose-body mass index (TyG-BMI) index, the triglyceride to high-density lipoprotein cholesterol (TG/HDL) ratio, and the metabolic score for insulin resistance (METS-IR). Results Patients showed increased serum fasting glucose and blood HbA1c associated with a high TyG index, TyG-BMI index, TG/HDL ratio, and METS-IR as compared with results before COVID-19. Moreover, during COVID-19, patients revealed a reduction in pH, associated with a reduction in cBase and bicarbonate, and an elevation in PaCO2 as compared with their results before COVID-19. After complete remission, all patients' results turn back to their level before COVID-19. Conclusions Patients with type 2 DM who catch the COVID-19 infection suffer from dysregulation of glycemic control and elevated insulin resistance associated with a significant reduction in their pH.

Causes of death of forensic autopsy cases tested positive for COVID-19 in Tokyo Metropolis, Japan

BackgroundThe profile of deaths related to coronavirus disease of 2019 (COVID-19) that occurred outside the hospital in Japan remains unclear because of cautious stance on performing autopsies of COVID-19 positive cases. MethodsAutopsy cases that tested positive for COVID-19 in the Tokyo Metropolis from April 2020 to July 2022 were handled by medical examiners (n = 41). Age, sex, medical history, autopsy findings, cause of death, postmortem computed tomography (PMCT) findings, and the causal relationship between death and COVID-19 were examined. ResultsThe mean age of the deceased was 58.0 years (range: 28–96 years), and the study sample consisted of 33 males (80.5%) and 8 females (19.5%). The most frequent medical histories were hypertension (n = 7) and diabetes (n = 7), followed by mental disorders (n = 5). Nineteen cases showed a body mass index ≧25.0 (46.3%). The leading cause of death was pneumonia (n = 17), in which diffuse ground-glass opacification and/or consolidation was noted on PMCT. There were 26 deaths directly related to COVID-19 (63.4%), including pneumonia, myocarditis, laryngotracheobronchitis, and emaciation. The proportion of deaths directly related to COVID-19 was lower after 2022 (42.1%) than prior to 2022 (81.8%). ConclusionPneumonia was the leading cause of death in this study sample; however, the causes of death in COVID-19 positive cases varied, especially after 2022, when the omicron variant was dominant. Mortality statistics may be affected by viral mutations, and the results of this study further emphasize the need for autopsy because more differential diagnoses should be considered in the phase of the omicron variant.

Making Radiology Antifragile

Physicist Richard Gott correctly predicted that the pyramids of Egypt would last longer than the Berlin wall. His insight, called the Lindy effect, was that the longevity of nonperishables, such as stories, ideas, and innovations, depended on how long they have been around. Simply put, the longer something has been around, the longer it will be around. This tautology belies the fact that time filters bad ideas. Though not everything new will be discarded, as all ideas that stood the test of time were once novel, the novel is more perishable than the antediluvian [ 1 Taleb N.N. Antifragile. Random House, New York2012 Google Scholar ]. The Antifragile RadiologistJournal of the American College of RadiologyPreviewRadiologists work in an unpredictable world. Reflecting on the coronavirus disease of 2019 (COVID-19) pandemic provides a pressing example. To be resilient, we must adapt to an ever-changing health care environment. Resiliency allows one to survive challenges without failure or decline. What if it were possible to benefit from uncertainty and become stronger because of it? This is the question Nassim Taleb addresses in his book, Antifragile: Things That Gain From Disorder [1]. He defines antifragility as growth through hardship; it allows people to thrive in an uncertain world. Full-Text PDF

The Antifragile Radiologist

The Antifragile Radiologist

Commentary on glucose reduction in type 2 diabetes (GRADE).

Commentary on glucose reduction in type 2 diabetes (GRADE).

EN PRENSA. Graphical-mathematical model to estimate CO2 concentration level as an indicator of SARS-CoV-2 transmission. EN PRENSA

The first documented cases of Coronavirus disease of 2019 (COVID-19) in Wuhan city (Hubei province, China) were caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), studies mention viral transmission is more common in indoor and poorly ventilated environments compared to outdoor environments or environments with abundant airflow. In this context, this research aimed to estimate, through a mathematical model by a Box-Behnken design, the time and occupancy required in a physical space to reach CO2 levels that exceed the risk level established as a safer condition of 700 ppm for SARS-CoV-2 transmission. According to the proposed mathematical model, it is possible to predict safe conditions. With this, it was found that natural ventilation is the best option to reduce CO2 concentration, considering the occupancy/m3 and time, allowing a constant airflow; the use of air conditioners to control the temperature in rooms without natural ventilation is suggested; notwithstanding, these types of equipment are not designed to reduce CO2 concentration. Thus, their use in rooms with open windows and doors leads to a shorter equipment lifetime, for this reason, its operation in special conditions, such as in rooms without natural ventilation should be considered.

Bidirectional and persistent immunomodulation of Astragalus polysaccharide as an adjuvant of influenza and recombinant SARS-CoV-2 vaccine

Respiratory viral infections, such as coronavirus disease of 2019 (COVID-19) and influenza, cause significant morbidity and mortality and have become a worldwide public health concern with tremendous economic and societal burdens. Vaccination is a major strategy for preventing infections. However, some new vaccines have an unmet need for impairing responses in certain individuals, especially COVID-19 vaccines, despite ongoing vaccine and adjuvant research. Here, we evaluated the effectiveness of Astragalus polysaccharide (APS), a bioactive polysaccharide extracted from the traditional Chinese herb Astragalus membranaceus as an immune adjuvant to regulate the efficacy of influenza split vaccine (ISV) and recombinant severe acute respiratory syndrome (SARS)-Cov-2 vaccine in mice. Our data indicated that APS as an adjuvant can facilitate the induction of high levels of hemagglutination inhibition (HAI) titer and specific antibody immunoglobulin G (IgG) and confer protection against the lethal challenge of influenza A viruses, including increased survival and amelioration of weight loss in mice immunized with the ISV. RNA sequencing (RNA-seq) analysis revealed that the NF-κB and Fc gamma R-mediated phagocytosis signaling pathways are essential for the immune response of mice immunized with the recombinant SARS-Cov-2 vaccine (RSV). Another important finding was that bidirectional immunomodulation of APS on cellular and humoral immunity was observed, and APS-adjuvant-induced antibodies persisted at a high level for at least 20 weeks. These findings suggest that APS is a potent adjuvant for influenza and COVID-19 vaccines, and has the advantages of bidirectional immunoregulation and persistent immunity.

The Knowledge and Perception about COVID-19 among Medical Imaging Professionals

The coronavirus invaded the world in late 2019. It includes many subtypes, majorly severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). Jordan has faced enormous hardships in dealing with the abrupt spread of the coronavirus disease of 2019 (COVID-19) pandemic. Jordan has taken severe and deterring measures to combat the disease’s spread, such as closing Jordanian schools and institutions. Medical imaging professionals (MIPs) play a vital role in corona patients’ diagnosis, management, and treatment planning, and their awareness is essential to understand. This study focuses on medical imaging professionals (MIPs) and their aid in COVID-19 planning. The knowledge and perception of the COVID-19 pandemic were assessed using a live cross-sectional survey conducted during the outbreak. Medical imaging professionals and trainees in private, military, and government hospitals provided data. Regarding the diagnosis of COVID-19, the researchers have found that molecular biology techniques are the first line of defence, whereas nasopharyngeal swabs and the polymerase chain reaction (RT-PCR) are also prevalent among medical professionals for COVID-19 testing. Overall, medical imaging experts and interns in Jordan exhibited expected levels of knowledge and perception. They advised following the CDC and WHO guidelines in their healthcare settings to offer an acceptable approach during the pandemic.

High levels of antibodies 6 months after COVID-19 vaccination in children with severe chronic diseases: A prospective longitudinal case series.

High levels of antibodies 6 months after COVID-19 vaccination in children with severe chronic diseases: A prospective longitudinal case series.

Assessment of a COVID-19 vaccination protocol for unhoused patients in the emergency department.

We aimed to evaluate the feasibility of implementing an emergency department (ED)-based Coronavirus Disease of 2019 (COVID-19) vaccination protocol in a population of unhoused patients. On June 10, 2021, a best practice alert (BPA) was implemented that fired when an ED provider opened the charts of unhoused patients and prompted the provider to order COVID-19 vaccination for eligible patients. We downloaded electronic medical record data of patients who received a COVID-19 vaccine in the ED between June 10, 2021 and August 26, 2021. The outcomes of interest were the number of unhoused, and the total number of patients vaccinated for COVID-19 during the study period. Data were described with simple descriptive statistics. There were 25,871 patient encounters in 19,992 unique patients (mean 1.3 visits/patient) in the emergency department during the study period. There were 1,474 (6% of total ED population) visits in 1,085 unique patients who were unhoused (mean 1.4 visits/patient). The BPA fired in 1,046 unhoused patient encounters (71% of PEH encounters) and was accepted in 79 (8%). Forty-three unhoused patients were vaccinated as a result of the BPA (4% of BPA fires) and 18 unhoused patients were vaccinated without BPA prompting. An additional 76 domiciled patients were vaccinated in the ED. Implementing an ED-based COVID-19 vaccination program is feasible, however, only a small number of patients underwent COVID-19 vaccination. Further studies are needed to explore the utility of using the ED as a setting for COVID-19 vaccination.