High Incidence Of COVID-19 Research Articles

COVID-19 Incidence in Asymptomatic Cancer Patients Undergoing Chemotherapy

COVID-19 is an infectious disease caused by the virus SARS-CoV-2, which was first described at the end of 2019. Since then, it has affected a growing portion of the world's population because of its high transmissibility. Most patients are asymptomatic or present with mild symptoms, but approximately 5-10% of cases can develop more serious manifestations, such as severe acute respiratory syndrome, acute kidney injury, shock, myocardial injury and even death. These features seem to occur more commonly in patients with essential hypertension, diabetes mellitus, obesity and chronic pulmonary disease. However, there are few studies that clarify the natural history of the disease and its broad clinical spectrum owing to the fact that it is a new entity. Since individuals with malignancies tend to present some degree of immunological deficiency and are more prone to opportunistic infections, especially those being treated with immunosuppressive drugs, it is possible that this group has a higher incidence of COVID-19. The current recommendations of oncology specialists advise to postpone treatments and to use less toxic drugs when possible. However, we still do not know how much these measures will affect in cancer mortality. Also, the incidence of COVID-19 in this population remains undetermined. We do not know if infectious symptoms are a good parameter to motivate these therapeutic changes or if there is benefit to test asymptomatic patients. In this context, this research submitted 100 patients with hematological malignancies or solid tumors on chemotherapy at the Ribeirão Preto Medical School of the University of São Paulo's Hospital, asymptomatic for COVID-19, to RT PCR to determine the SARS-CoV-2 infection incidence in this population. Only two patients were diagnosed with COVID-19. Both had gastrointestinal cancer. One of them developed symptoms, but none presented severe manifestations. Both had their treatment postponed initially and reinitiated after the appropriate period of isolation. Hence, we believe that it's reasonable not to test every asymptomatic patient when the resource for that is scarce, prioritizing those at greater risk of infection and those more prone to severe outcomes as long as the appropriate preventive measures are being taken. DisclosuresCalado: Team Telomere, Inc.: Membership on an entity's Board of Directors or advisory committees; Agios: Membership on an entity's Board of Directors or advisory committees; Instituto Butantan: Consultancy; Alexion Brasil: Consultancy; AA&MDS International Foundation: Research Funding; Novartis Brasil: Honoraria.

A pilot study of PCR community mass testing for COVID-19: who attends and who tests positive?

BackgroundPCR community mass testing for COVID-19 was delivered in three sites in Greater Glasgow and Clyde with high incidence of COVID-19, between Nov 30 and Dec 9, 2020. The purpose of mass testing was active case finding in communities. The aim of the study was to examine who attends mass testing and who tests positive, and how this differs from regular testing where only asymptomatic people attend. Methodsχ2 tests compared age, sex, deprivation, and ethnicity data collected from the three sites with target population Ward profile data published by Glasgow City Council for each site. Regular symptomatic test data for a period before and after the mass testing period were also analysed (Sept 1–Nov 29, 2020, and Dec 11–15, 2020). Data were modelled using logistic regression for outcome test result (positive vs negative or void) for mass and regular testing datasets. Demographic variables, as well as symptomatic or asymptomatic were included in the model. Modelling of the dataset combining mass and regular testing included interaction terms to detect differences in determinants between testing methods. Findings7497 PCR tests were done. There was under-representation in attendance of more deprived quintiles (p<0·0001 under a χ2 test), Black or minority ethnic groups (p<0·0001), males (p=0·039), older people (≥65 years; p=0·012), and children (<16 years; p=0·0062). Two of the sites had a high proportion of symptomatic cases (1331 [31%] and 1939 [65%]), for whom the percentage positive was substantially higher (203 [15·3%] and 229 [11·8%]) than asymptomatic individuals (76 [2·6%] and 39 [3·7%]; p<0·0001). Multivariable modelling found that increasing age (odds ratio 4·64 [95% CI 1·95–11·06] for 45–64 years [3·77, 1·59–8·93 for 30–44 years] compared with 0–4 years), ethnicity (1·98 [1·19–3·29] for Asian compared with White) and symptoms (4·59 [3·09–6·83] for symptoms vs no symptoms) were significantly associated with testing positive in mass testing. When test data were modelled simultaneously, an interaction term found females, Africans, and people who identified as other ethnic background were significantly more likely to test positive in mass testing compared with regular testing. InterpretationSome groups were under-represented in PCR community mass testing. Specifically, people living in more deprived areas, ethnic groups, older people, and children were less likely to attend a mass testing site. Adults, older people, and ethnic minority groups were more likely to test positive, and testing of symptomatic individuals, as well as asymptomatic individuals, would maximise case finding. FundingNone.

The association of wildfire air pollution with COVID-19 incidence in New South Wales, Australia

The 2020 COVID-19 outbreak in New South Wales (NSW), Australia, followed an unprecedented wildfire season that exposed large populations to wildfire smoke. Wildfires release particulate matter (PM), toxic gases and organic and non-organic chemicals that may be associated with increased incidence of COVID-19. This study estimated the association of wildfire smoke exposure with the incidence of COVID-19 in NSW. A Bayesian mixed-effect regression was used to estimate the association of either the average PM10 level or the proportion of wildfire burned area as proxies of wildfire smoke exposure with COVID-19 incidence in NSW, adjusting for sociodemographic risk factors. The analysis followed an ecological design using the 129 NSW Local Government Areas (LGA) as the ecological units. A random effects model and a model including the LGA spatial distribution (spatial model) were compared.A higher proportional wildfire burned area was associated with higher COVID-19 incidence in both the random effects and spatial models after adjustment for sociodemographic factors (posterior mean = 1.32 (99% credible interval: 1.05–1.67) and 1.31 (99% credible interval: 1.03–1.65), respectively). No evidence of an association between the average PM10 level and the COVID-19 incidence was found. LGAs in the greater Sydney and Hunter regions had the highest increase in the risk of COVID-19. This study identified wildfire smoke exposures were associated with increased risk of COVID-19 in NSW. Research on individual responses to specific wildfire airborne particles and pollutants needs to be conducted to further identify the causal links between SARS-Cov-2 infection and wildfire smoke. The identification of LGAs with the highest risk of COVID-19 associated with wildfire smoke exposure can be useful for public health prevention and or mitigation strategies.

Characteristics of the COVID-19 Epidemiological Situation in the Russian Federation in 2020

Background.The COVID-19 epidemic in the Russian Federation, which began in March 2020, caused serious damage to health of the population and led to severe economic losses. By December 28, 2020, 3 078 035 cases of COVID-19 and 55 265 lethal outcomes were registered in the country. The population of all territorial subjects of the country is involved in the epidemic process of COVID-19. The severe epidemiological situation made it necessary to conduct an analysis to identify the factors that determine the high intensity of the epidemic process, as well as the population groups with the highest risk of SARS-CoV-2 infection.&#x0D; Aims to study the patterns of SARS-CoV-2 spread and the epidemiological features of the initial stage of the COVID-19 pandemic in the Russian Federation in 2020.&#x0D; Methods.An epidemiological analysis of the COVID-19 situation in the Russian Federation was carried out to determine the dynamics of morbidity, the gender proportion and age structure of patients, the proportion of hospitalized patients, the ratio of various forms of infection, the social and professional status of patients. Standard methods of descriptive statistics Microsoft Excel and STATISTICA 12.0 (StatSoft, USA) were used for statistical processing. The mean values were estimated with a 95% confidence interval [95% CI] (the exact Klopper Pearson method).&#x0D; Results.During the observation time (2020), several periods were identified in the dynamics of the new COVID-19 cases detection: the period of importation of SARS-CoV-2 and the increase in morbidity, the period of epidemic decline, the period of autumn growth, the period of sustained high incidence of COVID-19. It was found that people over 70 years of age are the group with the highest risk of infection and a more severe course of COVID-19. The presence of target contingents among social and professional groups of the population, which should include medical workers, retired person, employees of educational institutions, law enforcement agencies, transport, who require special attention and medical and social support, was shown.&#x0D; Conclusions.The analysis showed that the large-scale spread of COVID-19 requires in-depth epidemiological studies and the development of additional disease control measures, taking into account the dynamics of the incidence of this socially significant infection.

Information access and preventive measures during COVID-19 among migrants and general population

BackgroundAccess to information and adherence to preventive measures are crucial for containing the COVID-19 outbreak. This study examines access to information and adherence to preventive measures during the COVID-19 pandemic among migrant origin persons and the general population.MethodsData from the Finnish MigCOVID Survey conducted 10/2020 to 2/2021 among persons aged 20 to 66 years was used (n = 3 668). Participants in Health 2017 follow-up survey were the reference group (n = 3 490). We examined age and sex-adjusted access to information by language skills and adherence to preventive measures (staying home if fluish; keeping a safety distance; wearing a face mask; good hand and coughing hygiene; avoiding traveling abroad; avoiding shaking hands with others; downloading the Koronavilkku contact tracing app).ResultsPersons with excellent Finnish/Swedish language skills (96.8%; 95% CI 95.0-97.9) reported receiving sufficient information more often those with intermediate (92.3; 95% CI 88.8-94.8) or basic (91.0%; 95% CI 88.0-93.3) language skills. Overall high adherence to preventive measures was observed both among the migrant origin and the general population. However, significant differences in the migrant origin population by region of origin were observed. More pronounced differences between migrant origin persons and general population persons were observed for avoiding traveling abroad (83.7%; 95% CI 81.1-86.0 vs. 96.6%; 95% CI 95.6-97.3) and downloading the Koronavilkku app (42.8%; 95% CI 39.8-45.9 vs. 64.3%; 95% CI 61.7-66.8).ConclusionsPoorer perceived access to information by language skills points to the continuous need for use of simple language and multilingual communication materials. Self-reported adherence to key preventive measures campaigned by health authorities was generally high both among persons of migrant origin and the general population, although concerns were noted in adherence to these recommendation in some regional groups.Key messages Multilingual and multichannel communication is central in crisis situations to ensure adequate access to information among different population groups.Higher incidence of COVID-19 among migrant origin persons is likely related not only to information access and adherence to preventive measures, but also to various social and structural factors.

The impact of COVID-19 in chronic kidney disease stage 5 patients on haemodialysis in Romania

BackgroundCKD 5 is a life threatening condition irrespective of cause. Most patients reach RRT. Predominant therapy is HD. Pandemic preparedness is an important pro-active public health function.Objectives1) to describe the incidence of COVID19 and IFR among CKD HD patients; 2) to evaluate the vaccination coverage among HD patients (Jan-Mar 2021); 3) to update a spreadsheet CKD5 HD 12-scenario treatment model by considering two new scenarios based on IFR: before and after vaccination.MethodsFirst two objectives use secondary data: JHSU and ECDC (secondary sources of COVID19 data) for Apr 2020-Mar 2021. The 3 NPM periods are: Apr-May 2020 (state of emergency), Jun-Dec 2020 (state of alert; vaccination -), Jan-Mar 2021 (state of alert; vaccination +). Data are taken from the Romanian Renal Registry and population data from Eurostat (available July 2021). IFR was estimated with a modified Kaplan-Meier method (Ghani,2005). A calibrated and validated CKD5 treatment model has previously been defined (10.1093/eurpub/cku161.026). Scenarios are re-run with one parameter adjusted by IFR levels. Analyses used Excel, SPSS.Resultsn = 14300 adult HD patients in March 2020; highest incidence (risk) was recorded in Apr-May 2020: 4.5% (CI95% from 4.1 to 4.8) and 2.5% (CI95% from 2.2 to 2.7). Cumulative incidence was 6.9% vs 18.5 pmp in the general population (period 1). In the general pop COVID19 incidence was highest at 443 pmp in Nov 2020 (period 2). The IFR requires full data validation; CFR was 7.7% (CI95% from 5.97 to 9.46; period 1). It is estimated that by Mar 2021 the IFR has decreased by 50%. Vaccination coverage in HD patients reached 94% (Apr 2021). Preliminary results from the updated model are presented. The model upholds its validity as the IFR allows for a better fine tuning of one parameter (mortality).Conclusionstreatment need and inequality in service provision can be addressed with a spreadsheet model by including pandemic preparedness measures.Key messages Haemodialysis patients had a very high COVID-19 incidence and CFR during the first two months of the COVID-19 pandemic when compared with the incidence in the general population.Pandemic preparedness must include protection measures for patients with chronic diseases. Renal patients are particularly vulnerable given their co-morbidity.

Public Mental Health services in the European region during the COVID-19 pandemic

The European Public Health Association (EUPHA), in conjunction with the Mental Health Foundation UK, conducted a purposely designed online survey of public and mental health professionals from across Europe, exploring public mental health responses to the pandemic in different regions, nations and localities. Participants were recruited from EUPHAs mental health division and through snowballing. Four broad areas were explored, namely; (1) perceived changes in available mental health supports during the pandemic; (2) whether or not a public mental health response plan had been developed; (3) if any demographic groups or priority areas had been given particularly consideration in this response and (4) how the response had been developed (i.e. whether intersectoral approaches had been adopted and the perceived degree to which service users and carers had been included in its development). Forty-four survey responses from twenty different European nations were collected and grouped according to whether respondents were practising in countries with low, medium or high COVID-19 incidence rates. The majority of responses were from public health professionals with over 20 years of experience. Results indicated wide variations in policy responses to the crisis and in the way mental health services have adapted to date. However, in the majority of countries surveyed, while an increase in online mental health supports during the pandemic was reported, no change in long term funding for mental health supports was observed. In addition, in the majority of countries, several vulnerable groups were rarely given specific attention in policy responses, namely low-income families, people with long-term health conditions or disabilities and ethnic minorities. In this workshop we will discuss the findings from this survey and explore what insights might be learned from experiences across Europe to date.

Androgen deprivation therapy and excess mortality in men with prostate cancer during the initial phase of the COVID-19 pandemic

BackgroundMen have a higher risk of death from COVID-19 than women and androgens facilitate entrance of the SARS-CoV-2 virus into respiratory epithelial cells. Thus, androgen deprivation therapy may reduce infection rates and improve outcomes for COVID-19. In the spring of 2020, Sweden was highly affected by COVID-19. The aim was to estimate the impact of androgen deprivation therapy on mortality from COVID-19 in men with prevalent prostate cancer by comparing all-cause mortality in the spring of 2020 to that in previous years.Patients and methodsUsing the Prostate Cancer data Base Sweden all men with prostate cancer on March 1 each year in 2015–2020 were followed until June 30 the same year. Exposure to androgen deprivation therapy was ascertained from filled prescriptions for bicalutamide monotherapy, gonadotropin-releasing hormone agonists (GnRH), or bilateral orchidectomy.ResultsA total of 9,822 men died in March-June in the years 2015–2020, of whom 5,034 men were on androgen deprivation therapy. There was an excess mortality in 2020 vs previous years in all men. The crude relative mortality rate ratio for 2020 vs 2015–2019 was 0.93 (95% confidence interval (CI) 0.83 to 1.04) in men on GnRH, and 0.90 (95% CI 0.78 to 1.05) in men on bicalutamide monotherapy. After multivariable adjustment these ratios were attenuated to 1.00 (95% CI 0.89 to 1.12) and 0.97 (95% CI 0.84 to 1.12), respectively. When restricting the analysis to the regions with the highest incidence of COVID-19 or to the time period between 2 April to 10 June when mortality in 2020 was increased >30% compared to previous years, the results were similar to the main analysis.ConclusionsIn this large national population-based cohort of men with prevalent prostate cancer, there was no clear evidence in support for an effect of androgen deprivation therapy on COVID-19 mortality.

Parental Stress, Depression, and Participation in Care Before and During the COVID-19 Pandemic: A Prospective Observational Study in an Italian Neonatal Intensive Care Unit.

Background: Recent studies reported, during the COVID-19 pandemic, increased mental distress among the general population and among women around the childbirth period. COVID-19 pandemic may undermine the vulnerable well-being of parents in Neonatal Intensive Care Units (NICUs).Objective: Our study aimed to explore whether parental stress, depression, and participation in care in an Italian NICU changed significantly over three periods: pre-pandemic (T0), low (T1), and high COVID-19 incidence (T2).Methods: Enrolled parents were assessed with the Parental Stressor Scale in the NICU (PSS:NICU), Edinburgh Postnatal Depression Scale (EPDS), and Index of Parental Participation (IPP). Stress was the study primary outcome. A sample of 108 parents, 34 for each time period, was estimated to be adequate to detect a difference in PSS:NICU stress occurrence level score (SOL) of 1.25 points between time periods. To estimate score differences among the three study periods a non-parametric analysis was performed. Correlation among scores was assessed with Spearman rank coefficient.Results: Overall, 152 parents were included in the study (62 in T0, 56 in T1, and 34 in T2). No significant differences in the median PSS:NICU, EPDS, and IPP scores were observed over the three periods, except for a slight increase in the PSS:NICU parental role sub-score in T2 (T0 3.3 [2.3–4.1] vs. T2 3.9 [3.1–4.3]; p = 0.038). In particular, the question regarding the separation from the infant resulted the most stressful aspect during T2 (T0 4.0 [4.0–5.0] vs. T2 5.0 [4.0–5.0], p = 0.008). The correlation between participation and stress scores (r = 0.19–022), and between participation and depression scores (r = 0.27) were weak, while among depression and stress, a moderate positive correlation was found (r = 0.45–0.48).Conclusions: This study suggests that parental stress and depression may be contained during the COVID-19 pandemic, while participation may be ensured.

COVID-19 in patients with tuberculosis: epidemiological and clinical features

Aim. To study the epidemiological and clinical features of COVID-19 among patients with tuberculosis.Materials and Methods. We studied the incidence of COVID-19 in various population groups in Kemerovo Region in 2020 (from March, 13 to December, 31). The study cohort consisted of 3929 tuberculosis patients, including 113 with a verified COVID-19 diagnosis. The control cohort included tuberculosis-free subjects with COVID-19 (25,774 individuals). Out of these subjects, we enrolled 71 patients with tuberculosis and 71 age- and gender-matched controls. All patients underwent complete blood count, urinalysis, biochemical analysis, and coagulation testing.Results. The incidence of COVID-19 in patients with tuberculosis was 2.96-fold higher than in the tuberculosis-free population (2876.05 and 971.17 per 100,000 population, respectively). In patients with tuberculosis, the highest incidence of COVID-19 was recorded in two age categories: from 18 to 29 years and ≥ 65 years of age. In tuberculosis patients, COVID-19 was mostly mild, was characterised by a 9.2-fold lower frequency of pneumonia, 11.8-fold less use of antibiotics, and oxygen therapy was required only in 1.41% of cases in comparison with 16.9% in the tuberculosis-free subjects. In addition, patients with tuberculosis less often suffered from hyperthermia, cough and weakness. Regarding the comorbid conditions, patients with tuberculosis showed lower prevalence of arterial hypertension, chronic heart failure, peripheral artery disease, and obesity. Further, patients with tuberculosis generally had higher glomerular filtration rate and rarely had neutrophilia or lymphopenia when compared with the control individuals with COVID-19, although having higher fibrinogen and aspartate aminotransferase serum levels.Conclusion. Tuberculosis is a risk factor of COVID-19 but not a predictor of morbidity and mortality from this disease.

Counties with Lower Insurance Coverage and Housing Problems Are Associated with Both Slower Vaccine Rollout and Higher COVID-19 Incidence.

Equitable vaccination distribution is a priority for outcompeting the transmission of COVID-19. Here, the impact of demographic, socioeconomic, and environmental factors on county-level vaccination rates and COVID-19 incidence changes is assessed. In particular, using data from 3142 US counties with over 328 million individuals, correlations were computed between cumulative vaccination rate and change in COVID-19 incidence from 1 December 2020 to 6 June 2021, with 44 different demographic, environmental, and socioeconomic factors. This correlation analysis was also performed using multivariate linear regression to adjust for age as a potential confounding variable. These correlation analyses demonstrated that counties with high levels of uninsured individuals have significantly lower COVID-19 vaccination rates (Spearman correlation: −0.460, p-value: <0.001). In addition, severe housing problems and high housing costs were strongly correlated with increased COVID-19 incidence (Spearman correlations: 0.335, 0.314, p-values: <0.001, <0.001). This study shows that socioeconomic factors are strongly correlated to both COVID-19 vaccination rates and incidence rates, underscoring the need to improve COVID-19 vaccination campaigns in marginalized communities.

Acute Coronary Syndrome in the COVID-19 Pandemic: Reduced Cases and Increased Ischaemic Time

BackgroundThe COVID-19 pandemic has led to unprecedented stress on health care systems, and has affected acute coronary syndrome treatment at every step. This study aimed to examine the impact of COVID-19 on patient presentations with acute coronary syndromes during the first and second pandemic wave in Melbourne, Victoria.MethodA retrospective cohort study of adults presenting with cute coronary syndrome during the first pandemic wave from 1 March 2020 to 31 April 2020 and the second pandemic wave from 1 July 2020 to 31 August 2020 was compared to a control period from 1 March to 31 April 2019 at a single sub-tertiary referral centre in Melbourne, Victoria servicing a catchment area with a relatively high incidence of COVID-19 cases.ResultsThree-hundred-and-thirty-five (335) patients were hospitalised with acute coronary syndromes across all three time periods. The total number of patients presenting with an acute coronary syndrome was reduced during the pandemic, with a higher proportion of ST elevation myocardial infarctions. Ischaemic times increased with time from symptom onset to first medical contact rising from 191 minutes in the control period to 292 minutes in the first wave (p=0.06) and 271 minutes in the second wave (p=0.06). Coronary angiography with subsequent revascularisation significantly increased from 55% in the control period undergoing revascularisation to 69% in the first wave (p<0.001) and 74% in the second wave (p<0.001).ConclusionA concerning reduction in acute coronary presentations occurred during the COVID-19 pandemic, associated with longer ischaemic times and a higher proportion requiring revascularisation. It is crucial that public awareness campaigns are instituted to address the contributing patient factors in future waves.

Covid-19 pandemic impact on maternal and child health services access in Nampula, Mozambique: a mixed methods research

BackgroundThe Covid-19 pandemic has so far infected more than 30 million people in the world, having major impact on global health with collateral damage. In Mozambique, a public state of emergency was declared at the end of March 2020. This has limited people’s movements and reduced public services, leading to a decrease in the number of people accessing health care facilities. An implementation research project, The Alert Community for a Prepared Hospital, has been promoting access to maternal and child health care, in Natikiri, Nampula, for the last four years. Nampula has the second highest incidence of Covid-19. The purpose of this study is to assess the impact of Covid-19 pandemic Government restrictions on access to maternal and child healthcare services. We compared health centres in Nampula city with healthcare centres in our research catchment area. We wanted to see if our previous research interventions have led to a more resilient response from the community.MethodsMixed-methods research, descriptive, cross-sectional, retrospective, using a review of patient visit documentation. We compared maternal and child health care unit statistical indicators from March–May 2019 to the same time-period in 2020. We tested for significant changes in access to maternal and child health services, using KrushKall Wallis, One-way Anova and mean and standard deviation tests.We compared interviews with health professionals, traditional birth attendants and patients in the two areas. We gathered data from a comparable city health centre and the main city referral hospital. The Marrere health centre and Marrere General Hospital were the two Alert Community for a Prepared Hospital intervention sites.ResultsComparing 2019 quantitative maternal health services access indicators with those from 2020, showed decreases in most important indicators: family planning visits and elective C-sections dropped 28%; first antenatal visit occurring in the first trimester dropped 26%; hospital deliveries dropped a statistically significant 4% (p = 0.046), while home deliveries rose 74%; children vaccinated down 20%.ConclusionOur results demonstrated the negative collateral effects of Covid-19 pandemic Government restrictions, on access to maternal and child healthcare services, and highlighted the need to improve the health information system in Mozambique.

Psychological state, family functioning and coping strategies among undergraduate students in a Nigerian University during the COVID-19 lockdown.

SummaryIntroductionThe curtailment of social gatherings and the lack of online academic engagement during the COVID-19 lockdown could have potentially damaging effects on the psychological state of university students in Nigerian public universities. This study examined the prevalence of anxiety and depression, including associated factors and coping methods, among undergraduate students.MethodsThis cross-sectional study, which involved 386 undergraduate students, was assigned approval number UI/EC/20/0242. An online questionnaire consisting mainly of the Hospital Anxiety and Depression Scale and the McMaster Family Assessment Device was circulated among the students. The results were analysed by means of descriptive statistics, chi-square, Analysis of Variance (ANOVA) and linear logistical regression, at α 0.05.ResultsMean age was 21 ± 2.9 years, with females constituting 60.1% of the sample. The prevalence rates of anxiety and depression were 41.5 and 31.9%, respectively. Students in health-related faculties were significantly less anxious than others. Inability to afford three square meals, negative family functioning, chronic illness and living in a State/Region with a high incidence of COVID-19 were significantly associated with depression. These factors jointly accounted for 14% of depression. Coping methods included the use of social media, watching movies and participating in online skills-development programs.ConclusionThe overall level of anxiety and depression among undergraduate students during the COVID-19 lockdown was higher than the levels previously reported. Inadequate nutrition and poor family functioning contributed significantly to this. Proactive measures ought to be taken to support undergraduate students in order to prevent the negative consequences of poor mental health.

B-PO01-089 SUDDEN CARDIAC ARREST DURING THE COVID-19 PANDEMIC: SIGNIFICANT EFFECTS ON INCIDENCE AND OUTCOMES

Recent reports suggest that higher COVID-19 incidence may be associated with higher out-of-hospital sudden cardiac arrest (SCA) burden and worse outcomes. To compare SCA incidence and outcomes during the COVID-19 pandemic (March 1 - Dec 31, 2020) to the corresponding period in 2019 in a US community. All out of hospital SCA cases with likely cardiac etiology attended by emergency medical services (EMS) were prospectively identified during the COVID-19 pandemic period in Ventura County, CA (pop. 848,112). We compared SCA incidence, resuscitation variables (Utstein elements) and outcomes in 2020 to 2019. COVID monthly counts were obtained from US Centers for Disease Control data. In 2019 there were 314 SCA cases in Ventura County (average 31.4 per month), corresponding to a 10-month incidence of 36.9 per 100,000. In 2020 there were 410 SCA cases (41.0 per month; 30% higher than 2019 average), for a 10-month incidence of 48.2 per 100,000 (p<0.001). A spike in both COVID and SCA incidence was observed in December 2020 (Figure). The proportion of SCAs with shockable rhythm also declined (25% to 19%, p=0.05), as did survival to hospital discharge (14.7% to 8.8%, p=0.01). There were no significant differences in the percent with witnessed arrest (48% to 43%, p=0.20), bystander CPR (54% to 48%, p=0.10), and return of spontaneous circulation (33% to 28%, p=0.15). SCA incidence was significantly higher and survival outcomes lower during the COVID-19 pandemic period, with evidence of overlap between the two conditions. These findings have implications for community public health and EMS response planning during the pandemic and subsequent outbreaks.

COVID-19–associated discrimination in Germany

This study examines whether ethnic minorities in general and Asian minorities in particular have perceived an increase in discrimination during the COVID-19 pandemic, a phenomenon known as COVID-19–associated discrimination (CAD). Drawing on the CILS4COVID data, which were collected among 3,517 individuals in the initial phase of the pandemic (mainly between April and June 2020), we demonstrate that especially Asian minorities (n = 80) report instances of CAD. Furthermore, CAD is reported more by Asian respondents residing in administrative districts that have been particularly affected by the COVID-19 pandemic, i.e., that had high seven-day COVID-19 incidence rates. Higher levels of perceived CAD are also reported by respondents originating from the Americas (n = 61) and the former Soviet Union (n = 197), but only in administrative districts with high incidence rates. We conclude that CAD reported by these groups is likely due to these groups being perceived to pose a higher threat of infection transmission. CAD reported by Asian-origin respondents is not entirely due to the actual threat posed by COVID-19, but rather to a mix of perceived threat, overt discrimination and the attribution of various negative experiences suffered since the outbreak of the pandemic to CAD.

PENGARUH EDUKASI PERAWAT TERHADAP KETEPATAN KELUARGA PASIEN MELAKUKAN CUCI TANGAN DALAM PENCEGAHAN PENULARAN COVID-19 DI RSUD ARIFIN ACHMAD PROVINSI RIAU

Corona virus is a virus that attacks the respiratory system. The high incidence of Covid-19 is due to low public awareness of applying health protocols. So the need for prevention and control efforts by complying with health protocols to wear masks, keep your distance and wash your hands properly. Washing hands is an easy routine and is important in infection control, and is the best method to prevent the transmission of microorganisms. The purpose of this study was to determine the effect of nurse education on the accuracy of the patient's family through hand washing in preventing Covid-19 transmission at Arifin Achmad Hospital, Riau Province. This research uses quantitative research with a quasi experimental design, with a population of 20 people. Data collection tools used observation sheets and data analysis was carried out univariate and bivariate with the Wilcoxson test. The results of this study show that the average value before being given education about hand washing is low compared to the average value after being given education about hand washing. So that hand washing education is effective in increasing hand washing to prevent Covid-19 transmission with a p-value of 0.000. The results of this study are expected to be a source of information and knowledge for the nursing profession regarding the effect of providing nurse education on the accuracy of the patient's family in washing hands.

Medical Center for Remote Monitoring of COVID-19 patients: organization experience and efficiency assessment

Aim. To summarize the experience of organizing and evaluating the efficiency of the Medical Center for Remote Monitoring of patients with COVID-19 and community-acquired pneumonia in Tomsk. Materials and methods. The project of the Medical Center for Remote Monitoring was developed on the basis of data from theoretical and empirical analyses of the current state of the healthcare system in the Tomsk region and the epidemiological situation with regard to COVID-19. The Center efficiency was assessed based on the analysis of quantitative and time indicators of the load on the emergency medical service and outpatient service. Statistical processing of the results was carried out using the Statistica 12.0 software package. Results. On October 20, 2020, in Tomsk, on the premises of the “Emergency medical unit”, a Medical Center for Remote Monitoring was established. It was aimed at providing remote consultations for patients with COVID-19 and community-acquired pneumonia. According to its algorithm, operators of the Center assessed a patient’s condition on a point scale using standardized speech modules to make a decision on the tactics of their support. During the second wave of COVID-19, when the Center operated, a statistically significant decrease in the load on the ambulance service (average number of calls per day, average waiting time for all calls and coronavirusrelated calls) as well as on the outpatient service (average number of house calls per day, including calls for acute respiratory diseases) was registered. Conclusion . The work of the Medical Center for Remote Monitoring based on the described model is associated with a decrease in the load on the healthcare system in an unfavorable epidemiological situation due to high COVID-19 incidence. This experience can be spread to other regions of Russia and adapted for other categories of citizens.

Problems in patient management and the impact of osteoporosis therapy on the incidence of clinical infection

The global diversion of health resources during the COVID-19 pandemic from the provision of routine medical care, and the more frequent and severe course of this infection in older patients justify the need to study the impact of the pandemic on the management of patients with osteoporosis.Aim – to assess the impact of the COVID-19 pandemic on the management of patients with osteoporosis, as well as the impact of anti-osteoporotic drugs on the incidence of COVID-19.Material and methods. A cross-sectional study was conducted, including a telephone survey and analysis of outpatient records of 304 patients with osteoporosis, who were recommended therapy with anti-osteoporotic medications. The average age was 70.8±8.8 years. The vast majority of patients took bisphosphonates in oral or parenteral forms.Results. Problems with the timely conduct of laboratory tests were noted by 91 (30.4%) subjects, DXA testing – 98 (32.8%). 65 (22.1%) were unable to receive the drug in a timely manner. Problems were more common when taking parenteral drugs (p=0.002). The cumulative incidence of COVID-19 was 12.2%, which is twice as high as in the population. There was a tendency to a lower incidence of confirmed SARS-CoV-2 infection when treated with denosumab or zoledronic acid. COVID-19 cases were not associated with either a vitamin D dose or a 25(OH)D level.Conclusions. During the COVID-19 pandemic, there is a significant decline in the quality of medical care for patients with osteoporosis, which cannot but lead to a new epidemic in the future – an epidemic of low-energy fractures. Our data confirmed the predisposition of older age groups to a higher incidence of COVID-19. However, there is no clear association of osteoporosis therapy with the risk of developing clinical manifestations of COVID-19.

Depression, Death Anxiety, and the Related Factors in Nurses Caring for COVID-19 Patients at Kosar Hospital, Semnan, Iran

Background: The high incidence of COVID-19 has provided a challenge for healthcare systems in Iran, and may result in some psychological problems. Objectives: The study aims at describing depression, death anxiety, and the related factors in nurses caring for COVID-19 Patients at Kosar Hospital, Semnan, Iran. Methods: In this cross-sectional study, 89 nurses caring for COVID-19 patients were selected in October 2020 via the census method. A demographic questionnaire, Beck’s Depression inventory, and Templer Death Anxiety scale were used to collect the required data. The collected data were analyzed using SPSS software version 20. Results: The mean scores of death anxiety and depression among nurses were 7.32 ± 1.75 and 10.82 ± 8.50 respectively. The results of the Pearson’s correlation-coefficient showed a significant positive correlation between death anxiety and depression (P = 0.05), death anxiety and nurses’ age (P &lt; 0.05), death anxiety, and nurses’ work experience (P &lt; 0.05). Conclusions: The findings of the study revealed that nurses caring for COVID-19 patients are at high risk of death anxiety and depression. Thus, there is a need to identify these problems to prevent or reduce them with effective interventions.