Highest Number Of Infections Research Articles

Infections and Patient Satisfaction in WALANT Hand Surgery in a Hospital Procedure Room.

Background: Wide-awake hand surgery has allowed many hand procedures to be moved out of the operating room and into minor procedure rooms while increasing efficiency, maintaining safety, and reducing both patient and hospital costs. The goal of this study was to evaluate patient satisfaction and postoperative complications of wide-awake local anesthesia with no tourniquet procedures performed in a community-based hospital procedure room. Methods: A total of 786 patients underwent 948 elective hand procedures in a hospital procedure room. At the conclusion of their surgeries, the patients were surveyed regarding their satisfaction. Following surgery, patients were evaluated for postoperative complications including infections. The trend in postoperative infection rates across 8 age groups was analyzed using a Cochran-Armitage test in R. Results: The overall infection rate was 6.2% (n = 59). All infections were superficial. Carpal tunnel had the highest number of infections (n = 25), followed by trigger finger (n = 8), and the combination trigger finger with carpal tunnel (n = 7). All infections were managed with antibiotics and/or soaks. Three patients did require a return to the operating room for irrigation and debridement. Ninety-nine percent of patients said the procedure room experience was better or the same as going to the dentist, would recommend wide-awake anesthesia to a friend or family member, and would undergo the procedure again. Conclusion: Wide-awake procedures performed in a hospital procedure room have low infection rates with high patient satisfaction.

Efficacy and tolerance of intravenous methylprednisolone pulses in children with severe bronchopulmonary dysplasia requiring respiratory support.

Bronchopulmonary dysplasia (BPD) is a chronic lung disease that affects premature babies and contributes to their morbidity. French BPD guidelines suggest the use of intravenous methylprednisolone pulses (IVMP) for those who require respiratory support (RS) following 36 weeks postmenstrual age (PMA). However, there is scant data on the efficacy and tolerance for this indication. Our objectives were to assess the efficacy and tolerance of IVMP in patients with severe BPD requiring RS. This retrospective observational study included preterm infants (<32 weeks gestational age) treated by IVMP between January 2016 and March 2021, in a single tertiary care hospital. The primary endpoint was signified by changes in the Pulmonary Severity Score (PSS). Our secondary endpoints were changes in RS and the tolerance of IVMP. Data of 14 children with BPD under RS were reviewed. Their median [IQR] gestational age at birth was (26[26-29.5] weeks). After IVMP administration, the PSS did not improve significantly from baseline day 0 (D0) (0.85[0.55-1.15]) to D7 (0.74 [0.48-1.00]) or Month 1 (1.02 [0.57-1.48]). Three children (21%) experienced a decrease in RS in the following month of IVMP. There was no negative short-term impact on growth. Five infants presented infectious complications. The development quotient was measured in 5 children at 2 years of age. In our study, IVMP did not improve PSS and it was associated with a high number of infections. Other studies are needed to better define the place of IVMP in these infants.

Employing Expressive Art to Explore Mexican Americans’ Grief Experiences of Loss Due to COVID-19

The COVID-19 pandemic changed people’s lives and resulted in tremendous pain, loss and suffering. The Rio Grande Valley (RGV), in the state of Texas in the U.S., was one of the regions with the highest number of infections and deaths during the pandemic. However, individuals’ bereavement in the RGV is rarely addressed. In this qualitative study, a snowball sample of 47 individuals who had lost their loved ones during the years 2020–2021 were interviewed and invited to engage in an art activity. The findings revealed four themes: peculiar funeral, grieving confusion, loved ones’ memories, and connection to self and the lost one through art. Results indicate that the collective aspect of the funeral was disrupted during the pandemic and created emotional numbness and denial. The intensity of grieving did not decrease with time. The participants mainly relied on their family support and rarely sought professional help. A culturally adapted intervention is needed to address long-term bereavement in this community. Analysis of the art activities indicated that all participants had a feeling of peace and relief afterward, especially male participants who had difficulty expressing their emotions. The participants reported that the artwork positively affected their grievances and that the process was satisfying.

P-018 Study of sperm DNA fragmentation in the infertile population before, during and after the SARS-CoV-2 pandemic: a nationwide retrospective cohort study

Abstract Study question Did the values of single- and double-strand sperm DNA breaks (SSB and DSB) increase during the SARS-CoV-2 pandemic? Summary answer During the SARS-CoV-2 pandemic (2020), the mean values of SSB and DSB in infertile patients were statistically higher compared to the periods 2018-2019 and 2021-2022. What is known already Some studies have found lower sperm concentration and motility in patients during and after SARS-CoV-2 infection (COVID-19). These effects appear to be reversible, with significant improvements being observed after three months post-infection (complete spermatogenesis cycle). On the contrary, vaccination against this virus does not seem to affect semen parameters. The objective of the study was to compare the values of SSB and DSB sperm DNA fragmentation in the periods before the pandemic (2018-2019), during (2020, highest number of infections and social confinement), and after (2021-2022, lower infection rate, end of social confinement and vaccination period). Study design, size, duration The average SSB and DSB sperm DNA fragmentation values of 11,215 patients referred from 74 fertility centres throughout Spain from January 2018 to December 2022 were retrospectively compared. Participants/materials, setting, methods Semen samples from infertile patients were analysed using the Comet assay in alkaline or neutral pH conditions to evaluate SSB or DSB, respectively. Three periods were compared (two years before, during 2020, and two years after). Mean SSB and DSB values were statistically compared among these periods using the Kruskal-Wallis and Mann-Whitney tests. Differences were established at the 99% confidence interval. Main results and the role of chance The average SSB values obtained were: 41.67%±15.33 in 2018-2019; 43.92%±17.84 in 2020, and 41.68%±18.58 in 2021-2022. The average DSB values obtained were: 65.64%±14.27 in 2018-2019; 67.77%±13.90 in 2020, and 65.23%±15.18 in 2021-2022. The SSB and DSB values were statistically higher in 2020 compared to the periods 2018-2019 and 2021-2022 (p &amp;lt; 0.001 in both cases). No differences were detected between the previous period (2018-2019) and the following period (2021-2022) (p = 0.101 and p = 0.235, respectively). Limitations, reasons for caution The observed increase in SSB and DSB values during 2020 cannot be directly attributed to the SARS-CoV-2 infection (COVID-19). It is possible that it is associated with other concurrent factors. The studied samples were only from infertile patients, not from the general male population. Wider implications of the findings Given that the SARS-CoV-2 virus still exists in 2021-2022 but the social situation has normalized, the increase in fragmentation observed during 2020 could be more related to other aspects of the pandemic, such as social confinement, stress, among others. Trial registration number Not applicable

Pattern of CYP3A5 and MDR-1 single nucleotide polymorphism and its impact on Tacrolimus levels and clinical outcomes in living renal allograft recipient

Abstract Introduction Renal transplant is best form of renal replacement therapy. Most favored immunosuppression includes Tacrolimus, mycophenolate mofetil and steroids. Tacrolimus has narrow therapeutic index and requires therapeutic drug monitoring (TDM). However, there is wide variation in tacrolimus level with weight based fixed dosage regimens. This variability is due to polymorphism of major pathways of metabolism ie CYP3A5 and MDR1 genes. Fast metabolizer require higher dosage and slow metabolizer require lower dosage. Genotype based dosing strategy may be useful to achieve early therapeutic level and reduce infections and rejections. Methodology 160 transplant patients at tertiary care hospital in India were included in this study from 2016 to 2018. Genetic polymorphism analysis in CYP3A5 and MDR1 gene was carried out at time of transplant. All patients were given a fixed weight-based dosage of Tacrolimus. Data was analyzed in relation to genotype polymorphism. Results and discussion 69.2% of Wild variants of CYP 3A5 (Fast metabolizers) have low initial tacrolimus levels. 51.5% of Homo variants (Slow metabolizers) have high initial tac levels. However, all variants achieve optimum tacrolimus levels at same time (mean 12.4 days). There were higher number of infections among slow metabolizers. Conclusion A fixed dosing regimen with TDM result in high and low initial tacrolimus levels in slow and fast metabolizers respectively and more infections in slow metabolizers. However, graft rejections being fewer in number, were not different. A larger sample with genotype based dosing is required to test such a strategy.

Sick Leave and Absence Rate of Hospital Workers During the Sixth to Eighth Wave of COVID-19 in Japan

Abstract Background There are several reports of breakthrough infections of severe acute respiratory syndrome coronavirus 2 in vaccinated individuals and reinfections in previously infected individuals. Although the coronavirus disease (COVID-19) pandemic has increased the incidence of infections at healthcare facilities, the association between the increase in community spread and absence rate of hospital workers due to COVID-19 infection-related sick leave has not yet been fully elucidated. Method We reviewed the case files of patients with COVID-19 diagnosed at the Jikei University Katsushika Medical Center, Tokyo, Japan, between January 1, 2022, and February 28, 2023. The obtained data was used to determine the number of COVID-19 admissions and absence rate of hospital workers due to COVID-19 infection-related sick leave during the sixth to eighth wave of the COVID-19 pandemic. Results Of 1899 patients with confirmed COVID-19, 397 (20.9%) were hospital workers. Of the 397 patients, 71, 156, and 119 contracted the infection during the sixth (January–March 2022), seventh (July–September 2022), and eighth wave (November 2022–February 2023), respectively. The absence rate of hospital workers due to COVID-19 was 6.3%, excluding leaves of absence due to close contact in the seventh wave, which had the highest number of infections. Conclusions Given the difficulty of maintaining a usual work schedule during the COVID-19 outbreak, it may be necessary to re-evaluate the backgrounds of healthcare workers at high risk of contracting COVID-19 and to make aggressive adjustments to their work schedules by distributing assignments and restricting leave.

Exploring the Spatial and Temporal Patterns of Children and Adolescents with COVID-19 Infections in Slovakia during March 2020 to July 2022.

Background and Objectives: The COVID-19 pandemic has had a significant global impact, necessitating a comprehensive understanding of its spatiotemporal patterns. The objective of this study is to explore the spatial and temporal patterns of COVID-19 infections among five age groups (<1, 1-4, 5-9, 10-14, and 15-19 years) in 72 districts of Slovakia on a quarterly basis from March 2020 to July 2022. Material and Methods: During the study period, a total of 393,429 confirmed PCR cases of COVID-19 or positive antigen tests were recorded across all studied age groups. The analysis examined the spatiotemporal spread of COVID infections per quarter, from September 2021 to May 2022. Additionally, data on hospitalizations, intensive care unit (ICU) admissions, pulmonary ventilation (PV), and death cases were analyzed. Results: The highest number of COVID-19 infections occurred between September 2021 and May 2022, particularly in the 10-14-year-old group (68,695 cases), followed by the 15-19-year-old group (62,232 cases), while the lowest incidence was observed in the <1-year-old group (1235 cases). Out of the total confirmed PCR cases, 18,886 individuals required hospitalization, 456 needed ICU admission, 402 received pulmonary ventilation, and only 16 died. The analysis of total daily confirmed PCR cases for all regions showed two major peaks on 12 December 2021 (6114 cases) and 1 February 2022 (3889 cases). Spatial mapping revealed that during December 2021 to February 2022, the highest number of infections in all age groups were concentrated mainly in Bratislava. Moreover, temporal trends of infections within each age group, considering monthly and yearly variations, exhibited distinct spatial patterns, indicating localized outbreaks in specific regions. Conclusions: The spatial and temporal patterns of COVID-19 infections among different age groups in Slovakia showed a higher number of infections in the 10-14-year-old age group, mainly occurring in urban districts. The temporal pattern of the spread of the virus to neighboring urban and rural districts reflected the movement of infected individuals. Hospitalizations, ICU and PV admissions, and deaths were relatively low. The study highlights the need for more proactive measures to contain outbreaks promptly and ensure the resilience of healthcare systems against future pandemics.

#2431 Vascular access outcomes among patients on maintenance hemodialysis in Perpetual Succour Hospital: a 3-year cross-sectional analysis

Abstract Background and Aims Hemodialysis (HD) is the most widely used treatment modality worldwide in the care of patients with end stage renal disease (ESRD). The success of the therapy depends largely on the quality of the VA and its proper functioning, which has a bearing on the patient's quality of life. Vascular access dysfunction remains one of the leading causes of excessive morbidity, mortality, and healthcare costs in this group. A functional vascular access is mandatory to achieve good levels of dialytic efficiency, and it is considered the lifeline of patients on maintenance HD. The ideal vascular access should have specific characteristics among which the most important are the following: ease of placement; delivery of adequate blood flow for effective dialysis; good primary patency rates; low rates of complications and side effects; long-lasting life; and low economic costs. There are 3 types of vascular accesses (VAs): the internal arteriovenous fistula (IAVF); the central venous catheter, which can be tunneled (CVC-T) or not (CVC-nT); and the synthetic vascular graft. Internal arteriovenous fistula is considered the best option because it is safer, more durable, and less expensive. The catheter is essential for emergency onset in HD but is associated with a higher number of infections, higher mortality, and greater costs. Arteriovenous fistulae (AVF) have advantages over arteriovenous grafts (AVG) and central venous catheters (CVC), but whether AVF are associated independently with better survival is unclear. The aim of this study is to determine the vascular access outcomes of ESRD patients on maintenance hemodialysis. Specifically, this study (1) described the clinicodemographic profile of the patients in terms of age, sex, primary etiology of ESRD, employment status, comorbidities, hepatitis status and family history of the disease; (2) determined the vascular access used on the HD patients (AVF/AVG, CVC or IJ; (3) identified interventions performed to maintain vascular access for hemodialysis; (4) determined the categories of the vascular access site; (5) assessed the vascular access outcome; (6) determined the reason and number for vascular access change and the (7) clinical outcome of the HD patients. Method This is a single center, cross-sectional study of ESRD patients on maintenance hemodialysis enrolled in Perpetual Succour Hospital Hemodialysis Unit from April 1, 2021, to November 30, 2023. Results There were 260 hemodialysis patients included, with successful vascular access outcome (73.13%) and were younger (57.2 ± 14.1). Those who had failed vascular access were females (54.2%), unemployed (61.4%) and had diabetes mellitus (50.6%) as the primary etiology of their ESRD. Those with failed vascular access were hypertensive (86.7%), with history of CAD and MI (57.8%) and were having diabetes mellitus (56.6%). Proportion of those with failed and successful vascular access significantly differ among hypertensives $(p = .012)$, diabetics $(p = .039)$, with chronic glomerulonephritis $(p = .011)$, and among those with malignancy $(p = .003)$. Most of those who were alive had successful vascular access (76.8%), however, among those who had failed vascular access died (57.6%). And the association of clinical outcomes (death or not) and failure or success of vascular access is statistically significant, $(p = .001)$. Conclusion Our study showed that failed vascular access were more associated with female gender, diabetes mellitus as the primary etiology of ESRD and with other co-morbid conditions such as hypertension and CAD or MI. Successful vascular outcome were among those of younger age group compared to those whose vascular access failed, probably due to better vascular condition and fewer co-morbidities. As shown in Table 2, type of access, interventions performed, and vascular access site significantly differ among HD patients with failed vascular access outcome and with those who were successful $(p = .001)$Those with failure on the vascular access were changed to CVC (44.6%) while others had changed to IJ (22.9%). Eighty of those with failed vascular (96.4%) access has changed site due to no bruit (65.0%) and thrombosis (33.8%).

The Inverted U-Shaped Relationship Between Socio-Economic Status and Infections During the COVID-19 Pandemic.

Although the World Health Organization has declared that the COVID-19 pandemic no longer qualifies as a global public health emergency, it still needs to explore the response of society to the COVID-19 pandemic. Socio-economic status (SES) was proven to be linearly associated with the COVID-19 pandemic, although this relationship may be more complex due to regional differences. In the study, we analyzed and revealed the effects and mechanisms of SES on infections among low, lower-middle, upper-middle and high SES group (LSG, LMSG, UMSG, and HSG, respectively). The results showed that the relationship between SES and infections was inverted U-shaped, especially in the first three phases. In Phase I, UMSG had the highest number of infections, with an average of 238.31/1M people (95%CI: 135.47-341.15/1M people). In Phases II and III, infections decreased insignificantly with increasing SES (r=-0.01, p=0.92; r=-0.11, p=0.22) and the highest number of infections were found in the LMSG. In Phase IV, SES was positively related to the number of infections (r=0.54, p<0.001). Furthermore, the nonlinear impact of multiple factors related to SES on the infections explains the complex relationships between SES and infections. SES affected infections mainly through medical resources, demographics and vaccination, and differed across the SES groups. Particularly, demographics could exert an impact on population mobility, subsequently influencing infections in LMSG, with an indirect effect of 0.01 (p<0.05) in Phase II. This study argues for greater attention to countries with middle SES and the need for future targeted measures to cope with infectious diseases.

An evaluation of driveline dressing protocols and infection rates for left ventricular assist devices across UK transplant centres

Background/Aims Left ventricular assist devices are used to improve the quality of life of people waiting for heart transplantation. Driveline infections are a significant complication of these devices, occurring in 30–40% of cases, which could lead to life threatening sepsis. This study aimed to review UK driveline dressing protocols and infection rates to determine if national standardisation is possible. Methods Six UK heart transplant centres were asked to share their driveline dressing protocols for comparison. National driveline infection data were obtained from the NHS Blood and Transplant database. Infection rates, patient demographics and device types were compared using Chi squared tests, with a P value of &lt;0.05 indicating statistical significance. Results The study found 38 driveline infections over a 3-year period, with an average infection rate was 4.4% per year. There were no significant difference in infection rates between device types. Dressing protocols varied between centres, but all centres followed international guidance. The timepoint where the highest number of infections were diagnosed was 12 months post implantations, accounting for 23.7% of infections. There were no significant differences in infection rates between centres in 2019–20 or 2021–22, but a significant difference was observed for 2020–21 (P=0.013). Conclusions UK driveline infection rates are below the average reported in the literature. Despite some differences in dressing protocols, all centres examined in this study maintained a level of infection comparable to reported rates. The feasibility of national standardisation remains uncertain, and further research is needed to determine the most effective dressing protocols for preventing driveline infections.

An Interactive Dashboard for Statistical Analysis of Intensive Care Unit COVID-19 Data

Background: COVID-19 caused a pandemic, due to its ease of transmission and high number of infections. The evolution of the pandemic and its consequences for the mortality and morbidity of populations, especially the elderly, generated several scientific studies and many research projects. Among them, we have the Predictive Models of COVID-19 Outcomes for Higher Risk Patients Towards a Precision Medicine (PREMO) research project. For such a project with many data records, it is necessary to provide a smooth graphical analysis to extract value from it. Methods: In this paper, we present the development of a full-stack Web application for the PREMO project, consisting of a dashboard providing statistical analysis, data visualization, data import, and data export. The main aspects of the application are described, as well as the diverse types of graphical representations and the possibility to use filters to extract relevant information for clinical practice. Results: The application, accessible through a browser, provides an interactive visualization of data from patients admitted to the intensive care unit (ICU), throughout the six waves of COVID-19 in two hospitals in Lisbon, Portugal. The analysis can be isolated per wave or can be seen in an aggregated view, allowing clinicians to create many views of the data and to study the behavior and consequences of different waves. For instance, the experimental results show clearly the effect of vaccination as well as the changes on the most relevant clinical parameters on each wave. Conclusions: The dashboard allows clinicians to analyze many variables of each of the six waves as well as aggregated data for all the waves. The application allows the user to extract information and scientific knowledge about COVID-19’s evolution, yielding insights for this pandemic and for future pandemics.

Pola Kejadian Malaria Pada Tenaga Kerja Di Area Lowland PT Freeport Indonesia

Malaria is caused by the plasmodium parasite and is transmitted through the bite of an infected female Anopheles mosquito. Plasmodium falciparum and plasmodium vivax are the most common types of plasmodium in Indonesia. Plasmodium malariae is found in several regions, such as Lampung and Papua, and plasmodium ovale is found in the eastern and northern regions of North Sumatra. The aim of this research is to determine the pattern of malaria incidence among workers in the lowland areas of PT Freeport Indonesia. The research method is descriptive observation, by collecting data through interviews and questionnaires. The results of research in the lowland areas of PTFI found that 160 people (91.1%) had a history of malaria, they were exposed to malaria during PTFI, namely low frequency (1-3 times) 76 people (47.5%) and high frequency (4-7 times) 84 people (53.5%). Infection by plasmodium vivax was 133 people (52.6%), plasmodium falciparum 111 people (43.9%), plasmodium ovale 7 people (2.8%), plasmodium malariae 2 people (0.8%). However, most people with a history of malaria, at PT Freeport Indonesia, had the highest frequency (4-7 times) and the highest number of infections by plasmodium was plasmodium vivax.

Exploring complications following cranioplasty after decompressive hemicraniectomy: A retrospective bicenter assessment of autologous, PMMA and CAD implants

Cranioplasty (CP) after decompressive hemicraniectomy (DHC) is a common neurosurgical procedure with a high complication rate. The best material for the repair of large cranial defects is unclear. The aim of this study was to evaluate different implant materials regarding surgery related complications after CP. Type of materials include the autologous bone flap (ABF), polymethylmethacrylate (PMMA), calcium phosphate reinforced with titanium mesh (CaP-Ti), polyetheretherketone (PEEK) and hydroxyapatite (HA). A retrospective, descriptive, observational bicenter study was performed, medical data of all patients who underwent CP after DHC between January 1st, 2016 and December 31st, 2022 were analyzed. Follow-up was until December 31st, 2023. 139 consecutive patients with a median age of 54 years who received either PMMA (56/139; 40.3%), PEEK (35/139; 25.2%), CaP-Ti (21/139; 15.1%), ABF (25/139; 18.0%) or HA (2/139; 1.4%) cranial implant after DHC were included in the study. Median time from DHC to CP was 117 days and median follow-up period was 43 months. Surgical site infection was the most frequent surgery-related complication (13.7%; 19/139). PEEK implants were mostly affected (28.6%; 10/35), followed by ABF (20%; 5/25), CaP-Ti implants (9.5%; 2/21) and PMMA implants (1.7%, 1/56). Explantation was necessary for 9 PEEK implants (25.7%; 9/35), 6 ABFs (24.0%; 6/25), 3 CaP-Ti implants (14.3%; 3/21) and 4 PMMA implants (7.1%; 4/56). Besides infection, a postoperative hematoma was the most common cause. Median surgical time was 106 min, neither longer surgical time nor use of anticoagulation were significantly related to higher infection rates (p = 0.547; p = 0.152 respectively). Ventriculoperitoneal shunt implantation prior to CP was noted in 33.8% (47/139) and not significantly associated with surgical related complications. Perioperative lumbar drainage, due to bulging brain, inserted in 38 patients (27.3%; 38/139) before surgery was protective when it comes to explantation of the implant (p = 0.035). Based on our results, CP is still related to a relatively high number of infections and further complications. Implant material seems to have a high effect on postoperative infections, since surgical time, anticoagulation therapy and hydrocephalus did not show a statistically significant effect on postoperative complications in this study. PEEK implants and ABFs seem to possess higher risk of postoperative infection. More biocompatible implants such as CaP-Ti might be beneficial. Further, prospective studies are necessary to answer this question.

Pharmaceutical and non-pharmaceutical interventions for controlling the COVID-19 pandemic.

Disease spread can be affected by pharmaceutical interventions (such as vaccination) and non-pharmaceutical interventions (such as physical distancing, mask-wearing and contact tracing). Understanding the relationship between disease dynamics and human behaviour is a significant factor to controlling infections. In this work, we propose a compartmental epidemiological model for studying how the infection dynamics of COVID-19 evolves for people with different levels of social distancing, natural immunity and vaccine-induced immunity. Our model recreates the transmission dynamics of COVID-19 in Ontario up to December 2021. Our results indicate that people change their behaviour based on the disease dynamics and mitigation measures. Specifically, they adopt more protective behaviour when mandated social distancing measures are in effect, typically concurrent with a high number of infections. They reduce protective behaviour when vaccination coverage is high or when mandated contact reduction measures are relaxed, typically concurrent with a reduction of infections. We demonstrate that waning of infection and vaccine-induced immunity are important for reproducing disease transmission in autumn 2021.

Human infections by the rat tapeworm Hymenolepis diminuta in China.

The rat tapeworm Hymenolepis diminuta is a parasite that usually uses rats as a definitive host. It also infects humans and non-human primates. Human infections have been reported in 80 countries worldwide, including China. Nevertheless, nearly all the literature on human infections in China by the rat tapeworm is in Chinese journals, which are very difficult to access by readers outside China. The main aim of the current manuscript was to systematically review human infections by the rat tapeworm in China for readers inside and outside the country. Chinese characters for H. diminuta were used to search several databases, including Google Scholar. In total, 511 infections were reported in 24 Chinese provinces/autonomous regions, which surpassed 320 in Costa Rica as the country with the highest number of infections. Furthermore, three nationwide surveys on parasitic infections in the past 3 decades revealed detailed prevalence of this parasite along with that of roundworm, whipworm, hookworm and pinworm in Chinese populations. These data contribute to better understanding of this greatly neglected zoonosis in the world's most populated country.

HYPOGAMMAGLOBULINEMIA AT DIAGNOSIS IS ASSOCIATED WITH INFERIOR SURVIVAL AND HIGHER RISK OF INFECTIONS IN DIFFUSE LARGE B CELL LYMPHOMA: A RETROSPECTIVE STUDY FROM SWEDEN

Introduction: Low level of antibody production does not only increase the risk of infections, but also the incidence of malignancies, especially lymphoma. The primary aim of this study was to explore if hypogammaglobulinemia in untreated diffuse large B cell lymphoma (DLBCL) was associated with inferior overall survival (OS) or inferior progression free survival (PFS). Secondary aims were to assess the relationships between low immunoglobulins (Ig), other laboratory tests and infections. Methods: Using data from the Swedish Lymphoma Register (SLR), we identified all adult patients (18 years or older) diagnosed with DLBCL, receiving anthracycline-based curative therapy during year 2001–2015 in two health regions in southern Sweden (one university hospital and one region hospital). Data from the SLR were supplemented by patient record review, including data on baseline Ig levels and infections of CTC-AE grade 3–5 (in-hospital stay and intravenous antibiotics). Survival was analyzed by Kaplan-Meier estimates. Simple and multivariate linear regression were performed to determine relationships between laboratory tests and number of infections. Results: 596 patients were included, median age was 69 years (20–96), 57% were men, median OS 72 months, and median PFS 64 months. Median follow-up time for living patients was 106 months (62–117). 25% had low Ig, defined as any deficiency, 18% had low IgG, 37% lymphopenia and 13% both low Ig and lymphopenia. Hypogammaglobulinemia was associated with inferior OS (HR 1.4, 95% CI 1.0–1.9, p-value 0.018) and inferior PFS (HR 1.3, 95% CI 1.0–1.7, p-value 0.032). The combination of low Ig and lymphopenia aggravated OS (HR 1.2, 95% CI 1.0–1.2, p-value 0.023) and PFS (HR 1.2, 95% CI 1.0–1.3, p-value 0.002). Hypogammaglobulinemia was also associated with a higher number of infections (p-value 0.021), adjusted for International Prognostic Index (IPI) the associations weakened (p-value 0.097). The combination of low Ig and lymphopenia was not related to more infections than low Ig alone. Keywords: aggressive B-cell non-Hodgkin lymphoma, diagnostic and prognostic biomarkers No conflicts of interests pertinent to the abstract.

17th International Conference on Malignant Lymphoma, Palazzo dei Congressi, Lugano, Switzerland, 13 - 17 June, 2023.

Introduction: Patients with lymphoid malignancies such as chronic lymphocytic leukaemia (CLL)/small lymphocytic lymphoma (SLL) are at risk of developing secondary immunodeficiency disease (SID), which can lead to increased susceptibility to severe, recurrent or persistent infections. This study evaluated burden of infection in patients with and without SID following diagnosis of CLL/SLL. Methods: This observational, retrospective cohort study was conducted using anonymized data from the Optum-Humedica database in the USA (1-Oct-15–10-Mar-20). Patients with SID (SID cohort) and without SID (no-SID cohort) were identified 1-Apr-16–10-Mar-19 (selection window). The definition of SID included International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) hypogammaglobulinaemia (HGG) codes, low immunoglobulin G (IgG) levels (<5.0 g/L) and signs/symptoms of SID. The SID index date was the earliest occurrence of an ICD-10-CM HGG code or record of low IgG levels. In patients without SID, the index date was randomly assigned to replicate the distribution of index dates in the SID cohort. CLL/SLL diagnosis and baseline characteristics were identified during a 6-month pre-index period. Included patients were aged ≥18 years with a confirmed diagnosis of CLL/SLL. Infection-related outcomes and overall survival were assessed in patients with ≥12-month and ≥3 months follow-up post-index date, respectively. Results: Of patients with CLL/SLL, 502 and 3928 with and without SID, respectively, were included (SID vs no-SID: mean [standard deviation; SD] age 70.6 [9.7] vs. 71.6 [10.5] years; 59.2% vs 57.7% male). At 12-month follow-up, a larger proportion of patients with SID had ≥1 infection than those without SID (SID: 70.1%; no-SID: 30.4%; p < 0.001). Compared with the no-SID cohort, in the SID cohort there was also a higher number of infections (SID vs no-SID: mean [SD]: 8.4 [12.7] vs. 4.1 [5.4]; p < 0.001), proportion of patients with ≥1 SBI (SID: 39.8%; no-SID: 9.2%; p < 0.001) and proportion of patients with ≥1 infection-associated hospitalization (SID: 27.7%; no-SID: 5.8%; p < 0.001). The most common type of infection was bacterial (SID: 63.7%; no-SID: 24.9%); in those patients who experienced an SBI, the most frequently reported infection was bacterial pneumonia. To assess overall survival, 646 and 4719 patients with and without SID, respectively, were included. Overall survival at 24 months was lower in the SID cohort (77.3%) than the no-SID cohort (87.2%). Conclusions: Patients with CLL/SLL who subsequently developed SID had a greater burden of infection than patients who did not develop SID. Increasing understanding of this burden of infection may help to improve outcomes in this population Encore Abstract—previously submitted to EHA 2023 The research was funded by: Takeda Development Center Americas, Inc. Writing support was funded by: Takeda Pharmaceuticals International AG. Keywords: cancer health disparities, chronic lymphocytic leukemia (CLL), indolent non-Hodgkin lymphoma Conflicts of interests pertinent to the abstract M. S. Davids Consultant or advisory role AbbVie, Adaptive Biotechnologies, Aptitude Health, BeiGene, Bioascend, Celgene, Curio Science, Eli Lilly, Janssen, Merck, Research to Practice and Takeda Other remuneration: Grant support (paid to his institution): Bristol Myers Squibb, Secura Bio and Surface Oncology; grant support (paid to his institution) and consulting fees: Ascentage Pharma, AstraZeneca, Bristol Myers Squibb, Genentech, MEI Pharma, Pharmacyclics and TG Therapeutics. J. Richter Consultant or advisory role Adaptive Biotechnologies, AstraZeneca, Bristol Myers Squibb, Celgene, Janssen, Karyopharm Therapeutics, Oncopeptides, Sanofi, Secura Bio, Takeda and X4 Pharmaceuticals. Honoraria: Bristol Myers Squibb and Janssen C. Anderson-Smits Employment or leadership position: Takeda Development Center Americas, Inc. Stock ownership: Takeda M. Kamieniak Employment or leadership position: Takeda Development Center Americas, Inc. Stock ownership: Takeda K. Ren Employment or leadership position: Takeda Development Center Americas, Inc. Stock ownership: Takeda D. Shah Employment or leadership position: Takeda Development Center Americas, Inc. Stock ownership: Takeda C. Siffel Employment or leadership position: Takeda Development Center Americas, Inc. Stock ownership: Takeda

A study of antibody response to Covid-19 infection

: The Coronavirus disease 2019 is a disease caused by the etiological agent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It was a newly identified β-coronavirus that had spread rapidly around the world, resulting in a very high number of infections and deaths, threatening public security, and placing a heavy burden on global healthcare systems and economy. The present study was done to study antibody response in COVID-19 infection.: The study was carried out in the Department of Respiratory Medicine, R.D. Gardi Medical College, Ujjain, India after approval by ethics committee. The post COVID-19 cases attending respiratory medicine OPD were included in the study.: The present study was conducted in 122 patients. The mean age of the patients was 51.20±14.21 years, median age was 54.5 years, the minimum age was 14 years and the maximum age was 80 years, the most number of COVID-19 infection cases was in the elderly age group of more than 50 years. The severity of disease was seen in those above 50 years of age (57.3%) with p&amp;#62;0.05. Among the severe cases mean age of the cases was 49±17 years, in moderate cases mean age 52±14 and among mild group of cases mean age was 51±15 years.In the present study there were 73.8% males and females were 26.2% Among COVID-19 cases who reported in the OPD the maximum that is 86 (&amp;#62;70%) patients had moderately severe disease, while severe cases were only about 14 %. Mild cases were 15.6%.In the present study RT-PCR were negative in 36(29.5%) as against 86 (70.5%) were confirmed cases of COVID-19 and among positive cases 40 % cases became negative between 6-10 daysAmong severe disease cases mean SARS COV2 antibody 650.06±240.47 was significantly higher as compare to moderate cases 461.49±331.41 and mild cases 404.11±240.47.: India has the world’s largest vaccination program. COVID-19 antibodies estimation are important tests carried out to determine the response of the body against COVID-19 infection.Our results show a significant association between SARS COV2 antibody and the severity of disease.

SARS-CoV-2 in Mexico: An Association Among Geography, Comorbidities, and Vitamin D Deficiency

Objective: The aim of this study was to determine the association among temperature, relative humidity, latitude, vitamin D content and comorbidities in the spread of SAR-CoV-2 in Mexico in 2 different waves. Methods: The data on SARS-CoV-2 infections and comorbidities were obtained from the Mexican entities with the highest number of positive cases and deaths in the 2 waves that have most damaged the population. Results: Low temperature, high relative humidity, vitamin D deficiency and high percentage of comorbidities were factors that correlated with a high spread of SARS-CoV-2. Interestingly, 73.8% of the population had one of the most common comorbidities that favor the spread of the virus. Conclusion: The high percentage of comorbidities and the deficient concentration of vitamin D were determining factors in the high number of infections and deaths in Mexico. Furthermore, weather conditions could contribute to and alert to the spread of SARS-CoV-2.

Transmission Characteristics and Inactivated Vaccine Effectiveness Against Transmission of SARS-CoV-2 Omicron BA.5 Variants in Urumqi, China

In 2022, Omicron variants circulated globally, and Urumqi, China, experienced a COVID-19 outbreak seeded by Omicron BA.5 variants, resulting in the highest number of infections in the city's record before the exit of the zero COVID-19 strategy. Little was known about the characteristics of Omicron variants in mainland China. To evaluate transmission characteristics of Omicron BA.5 variants and the effectiveness of inactivated vaccine (mainly BBIBP-CorV) against their transmission. This cohort study was conducted using data from an Omicron-seeded COVID-19 outbreak in Urumqi from August 7 to September 7, 2022. Participants included all individuals with confirmed SARS-CoV-2 infections and their close contacts identified between August 7 and September 7, 2022 in Urumqi. A booster dose was compared vs 2 doses (reference level) of inactivated vaccine and risk factors were evaluated. Demographic characteristics, timeline records from exposure to laboratory testing outcomes, contact tracing history, and contact setting were obtained. The mean and variance of the key time-to-event intervals of transmission were estimated for individuals with known information. Transmission risks and contact patterns were assessed under different disease-control measures and in different contact settings. The effectiveness of inactivated vaccine against the transmission of Omicron BA.5 was estimated using multivariate logistic regression models. Among 1139 individuals diagnosed with COVID-19 (630 females [55.3%]; mean [SD] age, 37.4 [19.9] years) and 51 323 close contacts who tested negative for COVID-19 (26 299 females [51.2%]; mean [SD] age, 38.4 [16.0] years), the means of generation interval, viral shedding period, and incubation period were estimated at 2.8 days (95% credible interval [CrI], 2.4-3.5 days), 6.7 days (95% CrI, 6.4-7.1 days), and 5.7 days (95% CrI, 4.8-6.6 days), respectively. Despite contact tracing, intensive control measures, and high vaccine coverage (980 individuals with infections [86.0%] received ≥2 doses of vaccine), high transmission risks were found in household settings (secondary attack rate, 14.7%; 95% CrI, 13.0%-16.5%) and younger (aged 0-15 years; secondary attack rate, 2.5%; 95% CrI, 1.9%-3.1%) and older age (aged >65 years; secondary attack rate, 2.2%; 95% CrI, 1.5%-3.0%) groups. Vaccine effectiveness against BA.5 variant transmission for the booster-dose vs 2 doses was 28.9% (95% CrI, 7.7%-45.2%) and 48.5% (95% CrI, 23.9%-61.4%) for 15-90 days after booster dose. No protective outcome was detected beyond 90 days after the booster dose. This cohort study revealed key transmission characteristics of SARS-CoV-2 as they evolved, as well as vaccine effectiveness against variants. These findings suggest the importance of continuously evaluating vaccine effectiveness against emerging SARS-CoV-2 variants.