COVID-19 Treatment Center Research Articles

COVID-19 related knowledge sharing practice and associated factors among healthcare providers worked in COVID-19 treatment centers at teaching hospitals in Northwest Ethiopia: A cross-sectional study

BackgroundCOVID-19 is a pandemic that causes many deaths and disrupts the lives of the world population on an unprecedented scale. Healthcare providers are on the frontline in the struggle against this pandemic. In this regard, knowledge sharing is very crucial for healthcare professionals to provide safe, effective, and quality patient care during the COVID-19 pandemic. Accurate and timely COVID-19 related knowledge helps for making evidence-based decisions, during the management of the pandemic. Therefore, this study aimed to assess COVID-19 related knowledge sharing practices and associated factors among healthcare providers who worked in COVID-19 treatment centers at specialized teaching hospitals in the Amhara Regional State, Northwest Ethiopia. MethodAn institutional-based cross-sectional survey was conducted from April 1 to May 30, 2021. The study included 476 healthcare providers who worked in COVID-19 treatment centers at specialized teaching hospitals in Northwest Ethiopia. A pretested and structured self-administered questionnaire was used to collect data. EpiData 4.6 and SPSS version 23 were used for data entry and analysis respectively. Bi-variable and Multivariable logistic regression analysis was used to identify factors associated with the dependent variable. A P-value of less than 0.05 was used to declare statistical significance. ResultA total of 454 respondents, with a response rate of 95.4%, were participated in the study. About, 55.3% (95% CI: 51–60.2) of healthcare providers had a good level of COVID-19 knowledge-sharing practice. Phone type [AOR = 4.05, 95% CI (1.99–8.25)], computer access [AOR = 2.09, 95% CI (1.12–3.92)], awareness [AOR = 2.01, 95% CI (1.20–3.39)], willingness [AOR = 1.77, 95% CI (1.05–2.97)] and educational status [AOR = 2.94, 95% CI (1.92–5.71)] were significantly associated with the COVID-19 knowledge sharing practices in the multivariable logistic regression model. ConclusionThe finding implied that above half of the healthcare providers in this study setting were good at sharing their COVID-19 related knowledge. Policymakers, government, and other concerned bodies should stress to improve computer access, awareness creation, enhancing healthcare providers' willingness to share their COVID-19 related knowledge, introducing smartphone technology, and rising healthcare providers’ educational status are necessary measures to improve COVID-19 related knowledge sharing practice in this study setting.

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Background-The novel coronavirus disease emerged and rapidly spread to countries all over the world. This study aimed to assess the impact of covid 19 among COVID-19 survivors after their successful treatment at home or discharge from the COVID-19 treatment center.Methods-This was a cross-sectional, hospital-based study performed among 200 COVID-19 survivors after 3-6 months . The Hospital Anxiety and Depression Scale (HADS) was used to measure anxiety and depression. Posttraumatic Stress Disorder (PTSD)-Checklist (PCL) and Brief OC Scale were used to measure PTSD and OC symptoms. Data were analyzed by descriptive and inferential statistics using the SPSS.Results -It was seen that Older COVID-19 survivors (≥50 years) were more likely to show symptoms of depression and anxiety (P < 0.001) compared to younger ones. Furthermore, COVID-19 survivors who were ≥50 years of age had a greater level of PTSD compared to younger ones; similar trends were seen in those experiencing OC symptoms. In the present study , majority were obsessed with fears of contamination and an equal number had compulsive handwashing.conclusion-Anxiety, depression, PTSD, and OC symptoms are common among the COVID-19 survivors and that underscores the need to diagnose and manage mental health morbidities among these survivors long after their recovery from COVID-19.

Assessment of Surrogate Markers/Indices of Systemic Inflammation Among COVID-19 Patients with and Without Comorbid Conditions

Background: As widely reported, comorbid conditions are a significant risk for severe COVID-19 infection which is characterized by heightened adverse consequences. Since cytokine-induced inflammatory processes define COVID-19 severity, this study was aimed to evaluate the burden of COVID-19-induced inflammatory episodes, assessed using surrogate markers/indices of inflammation, among COVID-19 patients with and without comorbid conditions in Nigeria. Methods: This was a retrospective analysis of data obtained from treatment-naive real-time polymerase chain reaction (RT-PCR) confirmed COVID-19 patients at the Eleme COVID-19 treatment center in Port Harcourt within the southern region of Nigeria. All relevant data was acquired from case notes, medical review charts, nurses’ charts, and laboratory records by trained research assistants using data acquisition templates. All the data acquired were analyzed and compared between the COVID-19 patients with and without comorbid conditions using standard descriptive and comparative statistical tools. Results: Among those studied (n=604), 31.8% (n=192) had at least one pre-existing comorbid condition while 68.2% (n=412) had no comorbid conditions before COVID-19 diagnosis/subsequent presentation. The comorbid positive subgroup were mostly males and had higher mean age, BMI, body temperature, SBP, DBP, and higher proportions of elderly patients, high-risk occupational status (health workers) and social behavior (cigarette smoking), obesity, severe disease, and worse disease outcome, but lower oxygen saturation compared to the comorbid negative subjects at presentation. Additionally, the comorbid positive subjects also had higher mean levels of blood urea, creatinine, pro-calcitonin, CRP, ferritin, Glasgow prognostic scores, fibrinogen, D-Dimer, and the fibrinogen-albumin ratio, total white cell counts, isolated neutrophil counts, neutrophil-lymphocyte count ratio, and the platelet-lymphocyte count ratio but lower levels of potassium, albumin, isolated lymphocyte count and isolated platelet count compared to the comorbid negative subjects (p<0.05). The inflammatory markers/indices were significantly associated with obesity, age ≥65 years, hypertension, past/current cigarette smoking, diabetes, and cardiovascular disease. Conclusion: Comorbidities are significantly associated with amplified systemic inflammatory markers and indices among COVID-19 subjects. This may indicate the pathophysiologic link between various comorbidities and the COVID-19 severity among Nigerians. However, further studies are recommended to substantiate the findings of the current study.

Correlation of Plasma Albumin Status with Markers of Hepato-biliary Dysfunction and Systemic Inflammation Among COVID-19 Patients

<i>Background</i>: Several studies have reported profound altered serum albumin level status among patients with COVID-19 disease. Hence, the current study aimed to evaluate the plasma albumin status levels and to establish the relationship between serum albumin level status and markers of hepato-biliary dysfunction and systemic inflammation among COVID-19 patients of African origin. <i>Methods</i>: This was a retrospective study of pre-treatment data obtained from patients with confirmed real-time reverse transcription-polymerase chain reaction COVID-19 disease in Eleme COVID-19 treatment center, Port Harcourt, Southern Nigeria. Data were obtained from each patients’ case notes, medical review charts, nurses’ vital signs/medication charts, laboratory records, and archived data from the electronic medical records using trained research assistants at the treatment center. The data extraction was done using validated data collection templates. Data analysis was done using standard protocols. <i>Results</i>: Among the 473 studied cases, 112 (23.7%) had normal plasma albumin status while 361 (76.3%) had low plasma albumin status. Among the low plasma albumin status subgroups, 57.6% and 42.4% had clinically insignificant and clinically significant low plasma albumin status levels, respectively. No difference was observed in the mean plasma levels/activities of all the markers of hepato-biliary dysfunctions between the subjects with normal and low albumin status levels and also between the clinically insignificant and clinically significant low plasma albumin status subgroups (p>0.05). However, a statistically significant difference was observed in the mean plasma levels of all the systemic inflammatory markers between the subjects with normal and low albumin status levels as well as between the clinically insignificant and clinically significant low plasma albumin status subgroups (p<0.05). Furthermore, no statistically significant relationship existed between the plasma albumin status levels and all the markers of hepato-biliary dysfunctions (p>0.05). However, significant inverse relationships existed between plasma albumin status levels and all the systemic inflammatory markers/indices (p<0.05). <i>Conclusion</i>: The present study indicates that low plasma albumin level status is common among COVID-19 patients and correlates significantly with systemic inflammation. Since COVID-19 is invariably associated with systemic inflammation, albumin may have therapeutic value in COVID-19 management. However, further studies are highly recommended.

Oral clinical courses of patients with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection: A clinical follow up (a prospective prevalent cohort) study

IntroductionContemporary literature has revealed that SARS-CoV-2 causes acute sialadenitis and related symptoms, such as discomfort, pain, swelling, and secretory dysfunction in salivary glands. The secretory dysfunction is due to SARS-CoV-2 infection-induced xerostomia and other associated clinical courses such as sore tongue, mucosal ulcer, and gingivitis in the oral cavity. Furthermore, it has been reported that COVID-19 causes the development of other oral manifestations.PurposeThis cohort study was initiated to identify the possible oral clinical manifestations of patients with SARS-CoV-2 infection admitted at Eka General Hospital COVID-19 treatment center in Addis Ababa, Ethiopia.Materials and MethodsA prospective clinical follow-up (a prevalent cohort) study was conducted to identify the possible oral manifestations of SARS-CoV-2 infection among patients admitted at the Eka General Hospital COVID-19 treatment center. Patients were followed for an average period of 3.5 weeks.ResultsThe findings of this cohort prevalent study were adjusted around the main objectives of the research. A total of 55 patients (36 males and 19 females) fulfilling the inclusion criteria were included in the cohort. The age of the cohorts ranged from 8 to 90 years. The overall prevalence of oral clinical courses in patients with SARS-CoV-2 was 0.18 (n=10). Oral mucosal lesions, xerostomia, thickening of saliva yielded prevalence data of 0.5 (n=6), 0.42 (n=5), and 0.08 (n=1), respectively. The oral mucosal lesions prevalence finding was further refined into aphthous lesions 0.5 (n=3), candidiasis 0.17 (n=1), geographic tongue 0.17 (n=1), and localized gingivitis 0.17 (n=1).ConclusionThe findings of the study suggest the importance of initiating oral health care for patients with COVID-19. Therefore, multidisciplinary healthcare approaches to management should be promoted to assure optimal health outcomes. Accordingly, oral health care should be a substantial part of the multidisciplinary approach.

A Preliminary Report on Herbal Medicine Use Among Patients Hospitalized at Two-Large COVID-19 Treatment Centers in Uganda.

IntroductionHerbal medication use among patients with COVID-19 imposes a significant risk of drug-herbal interactions and adverse events. This study aimed to assess the prevalence and factors associated with herbal medicine use among patients hospitalized with COVID-19 attending two large COVID-19 Treatment Units (CTU) in Uganda.MethodsA hospital-based descriptive cross-sectional study was conducted recruiting patients with COVID-19 hospitalized at the Mulago National Referral Hospital and Namboole Stadium CTUs. Chi-square or Fishers’ exact test for categorical and Mann–Whitney U-test for numerical were used to determine the association between dependent and independent variables.ResultsThe study was terminated early because of significant reduction in the number of patients hospitalized with COVID-19 and the closure of Namboole CTU. Of the anticipated 422 participants, we recruited 108 (25.6%). Of this, 58 (53.7%) were female, with a median age of 38 (range: 20–75) years. Forty-nine (45.4%) had received at least one dose of the COVID-19 vaccine. Fifty-eight (57.3%) of the participants had ever used herbal medicine and the majority had used them in the past 12 months (71.9%, n = 41) either before the diagnosis of COVID-19 (85.4%, n = 35) or after (36.6%, n = 15). Being vaccinated for COVID-19 (adjusted odds ratio (aOR): 3.1, 95% confidence interval (CI): 1.4–6.8, p = 0.005) and having attained tertiary level of education (aOR: 6.2, 95% CI: 1.7–23.1, p = 0.006), as well as the accessibility to herbalists (aOR: 31.2, 95% CI: 3.7–263.2, p = 0.002) were significantly associated with herbal medication use. The majority of participants reported some improvement after using herbal medicine (80.7%, n = 46) and their doctors or nurses asked almost half of the participants about herbal medicine use (49.5%, n = 53).ConclusionThe use of herbal medicines to treat or prevent COVID-19 among hospitalized patients is a widespread practice in Uganda amidst unpublished evidence of their safety and efficacy.

Impact of COVID-19 and mitigation plans on essential health services: institutional experience of a hospital in Ethiopia

BackgroundHealth systems around the world are being challenged by an on-going COVID-19 pandemic. The COVID-19 pandemic and associated response can have a significant downstream effect on access to routine health care services, and indirectly cause morbidity and mortality from causes other than the disease itself, especially in resource-poor countries such as Ethiopia. This study aimed to explore the impact of the pandemic on these services and measures taken to combat the effect.MethodsThe study was conducted at St. Paul’s hospital millennium medical college (SPHMMC) from December 15, 2020 to January 15, 2021 using a comparative cross-sectional study design. We collected data on the number of clients getting different essential health care services from May to October 2019 (Pre COVID) and the same period in 2020 (during a COVID-19 pandemic) from the patient registry book. The analysis was done with SPSS version 24 software.ResultOverall, the essential services of SPHMMC were affected by the COVID-19 pandemic. The most affected service is inpatient admission, which showed a 73.3% (2044 to 682) reduction from the pre-COVID period and the least affected is maternal service, which only decreased by 13% (3671 to 3177). During the 6 months after the COVID-19 pandemic, there was a progressive increment in the number of clients getting essential health services.Conclusion and recommendationThe establishment of a triple setup for fighting against COVID-19, which encompasses non-COVID services, an isolation center and a COVID-19 treatment center, played a vital role in preserving essential health services.

A Pharmacological Review of Siddha Classical Preparations for the Management of COVID-19 at TPEC COVID Care Centre, Vellore

Despite the threat of coronavirus infection, the Siddha system of medicine, India's traditional medicine, plays an important role in southern India, particularly in Tamilnadu. It contributed considerably not only in the first wave of Covid-19, but also in the second wave. The Government of Tamilnadu developed Siddha COVID-19 treatment centers for asymptomatic, mild, and moderate COVID-19 positive patients in 2020. The TPEC COVID Care Centre initiated at Vellore also one of the Centers that can be managed by Siddha medicines and Siddhar’s Yogam. As of July 14, 2021, about 4525 COVID positive patients had been treated with Siddha integrated treatment at Vellore alone in the first and second waves. Kaba Sura Kudineer, Thalisathy Vadagam, Amukkara Chooranam Mathirai, Bramanandha Bairavam Mathirai, and Adathodai Manapagu are indeed the five Siddha classical preparations used to manage the symptoms of COVID-19 positive patients at TPEC COVID Care Centre in Vellore. This Siddha medical practice is effective in conditions of symptoms and helps in the reduction of clinical outcomes. A pilot study at the same site confirmed the Siddha classical preparation's safety and effectiveness. A feedback analysis study performed at the same center also revealed that the above-mentioned Siddha classical preparations are beneficial in symptomatic treatment without causing any side effects. The medicines utilized in this study are typically proposed in other COVID care centers also in Tamilnadu. This review attempted to analyze the preclinical and clinical efficacy of Siddha Classical medicines used at that Centre for the management of COVID-19.

1615P Impact of the COVID-19 pandemic on diagnosing and treatment referrals of lung cancer patients: A single-centre experience

Due to the global pandemic of COVID-19 in 2020, a substantial drop in the rate of cancer diagnosis, treatment and prognosis is anticipated owing to limited health resources dealing with cancer. Here, we present single-centre data of University Clinic Golnik, which addresses more than 40% of all cases of diagnosis and treatment of lung cancer in Slovenia, but was also one of the main COVID-19 treatment centres in the country during the last year. Data for lung cancer diagnosis and treatment referrals through multidisciplinary tumour board (MDT) were prospectively collected through the clinical hospital registry and analysed in comparison with the year before. Descriptive statistical analysis was performed. There were 583 patients diagnosed with lung cancer in year 2019 and 614 in 2020. There was no major difference in symptom duration prior to diagnosis: no symptoms in 17% vs 22%, symptoms lasting less than 1 month in 12% vs 5%, 1-3 months in 43% vs 39% and more than 3 months in 25% vs 24% for years 2019 and 2020, respectively. Also, at the time of diagnosis patients did not present in worse ECOG performance status (PS): 90% vs. 89% had PS 0-2 and 10% vs. 8% had PS 3-4 in 2019 and 2020, respectively. Limited stage of disease was diagnosed in 31% and 37% of patients, loco-regionally advanced in 10% and 8% of patients and metastatic disease in 57% and 53% comparing the years 2019 and 2020. Referrals to the first oncological treatment by the MDT in years 2019 and 2020 were as follows: 31% and 37% proceeded to surgery, 9% and 9% to chemo-radiotherapy, 15% and 16% to palliative radiotherapy, 33% and 28% to systemic therapy and 11% and 10% to best supportive care alone. No major differences in any of these parameters was found comparing the two years. In our small single-centre experience, there seems to be no decline in newly diagnosed lung cancer cases, neither increase in later-stage diagnosis. Later analysis will show if this might be attributable to increased radiological investigations performed due to respiratory symptoms and fear of COVID-19 and surely due to timely performed diagnostic procedures and excellent organisation despite the pandemic.

Mental Health Outcomes among Frontline Health-Care Workers at Eka Kotebe National COVID-19 Treatment Center, Addis Ababa, Ethiopia, 2020: A Cross-Sectional Study.

BackgroundThe COVID-19 pandemic has resulted in many frontline health-care workers vulnerable to developing various mental health conditions. This study aimed to determine prevalence and associated factors of such conditions among frontline workers at Eka Kotebe National COVID-19 Treatment Center in Addis Ababa, Ethiopia.MethodsThis institution-based cross-sectional study was conducted between May and June 2020 on 280 frontline workers. Mental health outcomes (depression, anxiety, insomnia, and posttraumatic stress disorder) were assessed using the Patient Health Questionnaire9, Generalized Anxiety Disorder 7 questionnaire, PTSD Checklist — civilian version, and Pittsburgh Sleep Quality Index. Responses were coded, entered into EpiData 3.1 and analyzed using SPSS 20. Associations between outcomes and independent variables were identified using bivariate and multivariate logistic regressions, statistical significance set at p<0.05.ResultsA total of 238 subjects participated in the study, with a response rate of 85%. Estimated prevalence was 31.1% (95% CI 24.8%–37%) for anxiety, 27.3% (95% CI 21.8%–32.4%) for depression, 16% (95% CI 11.3%–21%) for PTSD, and 40.8% (95% CI 33.6%–47.5%) for insomnia. Female sex (AOR 2.99, 95% CI 1.49–5.97), being married, (AOR 13.2, 95% CI 3.42–50.7), being single (AOR 11.5, 95% CI 3.38–39.8), duration of exposure 1–2 hours (AOR 0.29, 95% CI 0.14–0.64), and assigned place of work (critical ward —AOR 2.26, 95% CI 1.03–4.97; ICU — AOR 4.44, 95% CI 1.51–13.05) were found to be significant predictors of depression.ConclusionWe found a high estimated prevalence of mental health outcomes. Sex, marital status, duration of exposure, and assigned place of work were found to be associated with depression.

Assessment of SARS-CoV-2 Infection among Healthcare Workers of a German COVID-19 Treatment Center.

To date, more than 160 million people have been infected with COVID-19 worldwide. In the present study, we investigated the history of SARS-CoV-2 infection among 3067 healthcare workers (HCW) in a German COVID-19 treatment center during the early phase of the pandemic (July 2020) based on the seroprevalence of SARS-CoV-2 antibodies and self-reported previous PCR results. The results demonstrate a low prevalence of SARS-CoV-2 infection (n = 107 [3.5%]) with no increased risk for employees with a high level of patient exposure in general or working in COVID-19-confined areas in particular. This suggests that the local hygiene standards implemented in our hospital during the first wave of COVID-19 pandemic were effective in preventing patient-to-HCW transmission. No evidence for highly mobile staff serving as a vector for SARS-CoV-2 transmission could be found. In addition, impairment of smell and/or taste was strongly associated with SARS-CoV-2 history.

Feasibility of collecting and processing of COVID-19 convalescent plasma for treatment of COVID-19 in Uganda.

IntroductionEvidence that supports the use of COVID-19 convalescent plasma (CCP) for treatment of COVID-19 is increasingly emerging. However, very few African countries have undertaken the collection and processing of CCP. The aim of this study was to assess the feasibility of collecting and processing of CCP, in preparation for a randomized clinical trial of CCP for treatment of COVID-19 in Uganda.MethodsIn a cross-sectional study, persons with documented evidence of recovery from COVID-19 in Uganda were contacted and screened for blood donation via telephone calls. Those found eligible were asked to come to the blood donation centre for further screening and consent. Whole blood collection was undertaken from which plasma was processed. Plasma was tested for transfusion transmissible infections (TTIs) and anti-SARS CoV-2 antibody titers. SARS-CoV-2 testing was also done on nasopharyngeal swabs from the donors.Results192 participants were contacted of whom 179 (93.2%) were eligible to donate. Of the 179 eligible, 23 (12.8%) were not willing to donate and reasons given included: having no time 7(30.4%), fear of being retained at the COVID-19 treatment center 10 (43.5%), fear of stigma in the community 1 (4.3%), phobia for donating blood 1 (4.3%), religious issues 1 (4.4%), lack of interest 2 (8.7%) and transport challenges 1 (4.3%). The median age was 30 years and females accounted for 3.7% of the donors. A total of 30 (18.5%) donors tested positive for different TTIs. Antibody titer testing demonstrated titers of more than 1:320 for all the 72 samples tested. Age greater than 46 years and female gender were associated with higher titers though not statistically significant.ConclusionCCP collection and processing is possible in Uganda. However, concerns about stigma and lack of time, interest or transport need to be addressed in order to maximize donations.

Emotional responses and perceived stressors of frontline medical staffs in case of COVID-19 treatment centers and obstetrics emergency in Ethiopia

Backgroundthe rapid spread of COVID-19, its lethality in severe cases and the absence of specific medicine poses a huge threat to human life and health, as well as huge impact on the mental health. Facing this critical situation, health care workers on the front line who are directly involved in the diagnosis, treatment, and care of patients with COVID-19 are at risk of developing psychological distress and other mental health symptoms including emotional disturbance.Objectivethe aim of this study will be to assess the current state of emotional responses and perceived stressors of frontline medical staffs in case of Addis Ababa COVID-19 Treatment Centers and obstetrics emergency and abortion care, Ethiopia 2020.MethodsHospital based comparative cross-section study design was conducted by using self-administered questionnaire survey from June 1st to 30th of 2020 among 133 and 266 frontline medical staffs from obstetric emergency and abortion care clinic and COVID-19 treatment centers respectively. The data were collected after getting written consent from each participant and it entered into the computer using Epi-data version 7, then exported to SPSS version 20 for further analysis. Descriptive analysis was done using frequencies & percent. All independent determinants with P-value < 0.05 were used to identify important predictors of emotional responses and perceived stressors.ResultA total of 399 frontline medical staffs were included in the study. The mean age of the respondents of those who were working in obstetrics emergency and abortion care clinic was 27.47 (SD, 3.46) years and it was 28.12 (SD, 4.09) years for the other groups. This study revealed that, 72.9 and 5.6% of the study participant from obstetrics emergency and abortion clinic and COVID-19 treatment centers had a positive emotional response, respectively. Factors such as having a low level of motivational factors (AOR 2.78, 95% CI (1.13, 6.84)), being a nurse (AOR 10.53, 95% CI (1.31, 85.26)) and working at triage (AOR 8.61, 95% CI (1.15, 64.81))) had statistically significant association with negative emotional response.ConclusionThe current study revealed that a high proportion of front line a negative emotional responses had negative emotional response. Further, almost all of the medical staffs working in COVID-19 treatment centers and at obstetrics emergency and abortion care unit had perceived the outbreak related stressors. So, providing comprehensive psychological support is warranted for health care providers working in such kinds of department or units.

Nigerian doctors’ willingness to work at COVID-19 treatment center: How does Abraham Maslow’s motivation theory explain this finding?

Nigerian doctors’ willingness to work at COVID-19 treatment center: How does Abraham Maslow’s motivation theory explain this finding?

Psychiatric Care in a Novel Federal COVID-19 Treatment Center: Development of a Consultation-Liaison Psychiatry Service at the Javits New York Medical Station.

ABSTRACTAt the outset of the 2019 coronavirus disease (COVID-19) pandemic, New York City faced the highest burden of COVID-19 cases in the United States. In response, the U.S. Federal Government deployed medical providers from various uniformed services to treat patients with COVID-19 at the Jacob Javits Convention Center in New York City. There quickly arose a need for psychiatric services for patients with COVID-19 and psychological support for medical staff. Psychiatrists were tasked with establishing a consult-liaison psychiatry service in this unique environment. The authors detail the establishment of a novel consultation-liaison psychiatry service in a large convention center and explore lessons learned from this experience with the aim to empower uniformed psychiatrists to prepare for and deliver patient-focused care in pandemic settings.

Risk of COVID-19 Infection and Associated Factors Among Healthcare Workers: A Cross-Sectional Study at Eka Kotebe Treatment Center in Ethiopia.

BackgroundHealthcare worker-associated COVID-19 infection is a worldwide problem. The magnitude of exposure risk to COVID-19 infections in Ethiopia is rapidly increasing following its spread in the country. However, studies about the risk of COVID-19 infection among healthcare workers and factors associated with risk of COVID-19 infection are lacking in Ethiopia.ObjectiveThe study investigated level of risk of COVID-19 infection and associated factors among healthcare workers at Eka Kotebe COVID-19 treatment center.MethodsA facility-based cross-sectional study was conducted from September to October 2020 to determine risk of COVID-19 infection and associated factors at Eka Kotebe COVID-19 treatment center. In total, 318 healthcare workers participated in the study. Data was analyzed using SPSS version 25. A binary logistic regression model was used to evaluate the risk of COVID-19 infection among healthcare workers.ResultsA total of 243 (76%) healthcare workers had a high exposure risk of COVID-19 infection. Department of healthcare workers, ICU department workers [AOR: 6.545, 95% CI; (1.79–23.97)], long working hours [AOR: 9.224, 95% CI; (2.00–42.61)], inadequate supply of PPE [AOR: 0.318, 95% CI; (0.14–0.75)], lack of access to alcohol-based hand rub [AOR: 0.093, 95% CI; (0.01–0.98)], providing care within one meter of COVID-19 patients [AOR: 20.633, 95% CI; (3.88–109.76)], and direct contact with an environment in which a COVID-19 patient received care [AOR: 9.600, 95% CI; (1.05–84.50)] were found to be risk factors for COVID-19 infection.ConclusionHealthcare workers face a high risk of COVID-19 infection while providing care for COVID-19 patients. Proper use and adequate supply of PPE and the implementation of basic infection prevention and control with frequent protocol revision and strict supervision are crucial to limit exposure risk to COVID-19 among healthcare workers.

In Reply: Dismantling the Apocalypse Narrative: The Myth of the COVID-19 Stroke.

In Reply: Dismantling the Apocalypse Narrative: The Myth of the COVID-19 Stroke.

Infection prevention and control compliance among exposed healthcare workers in COVID-19 treatment centers in Ghana: A descriptive cross-sectional study.

Compliance with infection prevention and control (IPC) protocols is critical in minimizing the risk of coronavirus disease (COVID-19) infection among healthcare workers. However, data on IPC compliance among healthcare workers in COVID-19 treatment centers are unknown in Ghana. This study aims to assess IPC compliance among healthcare workers in Ghana's COVID-19 treatment centers. The study was a secondary analysis of data, which was initially collected to determine the level of risk of COVID-19 virus infection among healthcare workers in Ghana. Quantitative data were conveniently collected using the WHO COVID-19 risk assessment tool. We analyzed the data using descriptive statistics and logistic regression analyses. We observed that IPC compliance during healthcare interactions was 88.4% for hand hygiene and 90.6% for Personal Protective Equipment (PPE) usage; IPC compliance while performing aerosol-generating procedures (AGPs), was 97.5% for hand hygiene and 97.5% for PPE usage. For hand hygiene during healthcare interactions, lower compliance was seen among nonclinical staff [OR (odds ratio): 0.43; 95% CI (Confidence interval): 0.21-0.89], and healthcare workers with secondary level qualification (OR: 0.24; 95% CI: 0.08-0.71). Midwives (OR: 0.29; 95% CI: 0.09-0.93) and Pharmacists (OR: 0.15; 95% CI: 0.02-0.92) compliance with hand hygiene was significantly lower than registered nurses. For PPE usage during healthcare interactions, lower compliance was seen among healthcare workers who were separated/divorced/widowed (OR: 0.08; 95% CI: 0.01-0.43), those with secondary level qualifications (OR 0.08; 95% CI 0.01-0.43), non-clinical staff (OR 0.16 95% CI 0.07-0.35), cleaners (OR: 0.16; 95% CI: 0.05-0.52), pharmacists (OR: 0.07; 95% CI: 0.01-0.49) and among healthcare workers who reported of insufficiency of PPEs (OR: 0.33; 95% CI: 0.14-0.77). Generally, healthcare workers' infection prevention and control compliance were high, but this compliance differs across the different groups of health professionals in the treatment centers. Ensuring an adequate supply of IPC logistics coupled with behavior change interventions and paying particular attention to nonclinical staff is critical in minimizing the risk of COVID-19 transmission in the treatment centers.

A Robotic Health-Care Assistant for COVID-19 Emergency: A Proposed Solution for Logistics and Disinfection in a Hospital Environment

The COVID-19 pandemic and the related emergency have contributed to the push for innovative solutions applied to health care. In particular, robotics has shown huge potential for contributing to pandemic relief efforts and improving people's quality of life in several scenarios. In this article, a robotic system, characterized by interaction capabilities and autonomous navigation, is developed to be used in a COVID-19 health-care treatment center for logistics and disinfection purposes. The article describes the two-month use of the platform in the University Hospital Campus Bio-Medico (UCBM) COVID-19 treatment center in Rome, Italy, and presents experimental results for the robot's navigation capabilities in unstructured environments and collaborative activities with health-care operators in the clinical setting.

Challenges and Strategies for Conducting Clinical Research During the COVID-19 Pandemic: Experiences from Resource Limited Settings

Background: As COVID-19 disease surges across much of the world, researchers in different settings have a unique opportunity to address the various research priorities that have been identified. The challenges that containment and mitigation strategies present for research, especially in resource limited settings, could be significant and negatively impact the essential contribution of these settings to COVID-19 research.&#x0D; Objectives: To describe experiences of conducting research during this pandemic, discuss challenges faced and present strategies implemented to address these challenges&#x0D; Methods: Malaria Consortium recently initiated an observational case series study to assess the magnitude and clinical consequences of co-infection of COVID-19, malaria, and other common infections. This study is being conducted in eight COVID-19 treatment centres in Uganda. Qualitative methods including observations and interviews were utilized to document experiences and mitigating strategies for identified challenges. The main outcomes were a descriptive narrative of experiences conducting this research, discussion of challenges faced, and presentation of strategies implemented to address these challenges.&#x0D; Results: Expedited ethical review and approval facilitated timely initiation of research activities. The primary clinical care teams at each treatment centre performed all study procedures to minimize infection. Given concerns about fomite transmission, considerations arose on how best to handle consent forms that had been signed or thumb-printed by patients to ensure that both hospital and research staff were not exposed to infection. Consenting severely ill or mentally impaired patients was also a challenge, especially when the next of kin was not available. Patient compensation was done through a mobile money/digital platform to avoid potential risks associated with cash. Patients, health care workers and study staff faced significant psychosocial challenges and anxiety that needed to be addressed.&#x0D; Conclusions: These experiences demonstrate that more adaptable and innovative approaches may be needed to support the implementation of research activities during this COVID-19 pandemic. This pandemic should also spur institutional review boards and investigators to respond to emerging challenges by updating policies and procedures around research review and approvals, and modifications in research methods.