Infectious Ward Research Articles

Prevalence of enteric adenovirus and co-infection with rotavirus in children under 15 years of age with gastroenteritis in Qom, Iran.

Aim:The current study is the first performed in Qom to determine the prevalence of adenovirus and co-infections with rotavirus in children aged <15 years with gastroenteritis symptoms.Background:Gastroenteritis-associated viral infections are a cause of death among young children worldwide, especially in developing countries. The Adenovirus species F (40 and 41) are responsible for a range of acute diarrhea cases among infants and children. Methods:Over a period of 9 months, a total of 130 children suffering from intestinal problems who referred to the infectious ward of Children's Hospital were enrolled in the current study. After clinical examination and collection of demographic information, fecal samples were obtained from the patients. Viral genomes were extracted with a commercial kit and amplified and typed by adenovirus-specific PCR assay. Adenovirus-positive samples were also evaluated for co-infection with rotavirus. Results:Patients had a mean±SD age of 2.66±2.72 years; 63.1% of patients were male and 36.9% were female. Adenovirus infection was identified in 23 cases (17.7%), 21 (91.0%) and 2 (9.0%) of which were type 41 and type 40, respectively. Fever was the most common clinical manifestation among adenovirus-positive patients. No significant difference was observed between adenovirus infection and clinical symptoms, seasonal pattern, or serum laboratory results. Co-infection was found in only 5 cases (21.7%).Conclusion:This study was the first to demonstrate adenovirus infection with a relatively high prevalence among children, especially infants, in Qom. The findings further revealed co-infection with rotavirus, indicating a health problem in this region.

Nurses’ Experiences of Care for Patients in Coronavirus Disease 2019 Infection Wards during the Early Stages of the Pandemic

Nurses’ Experiences of Care for Patients in Coronavirus Disease 2019 Infection Wards during the Early Stages of the Pandemic

Retrospective Drug Utilization Evaluation of Vancomycin Usage in Infectious Wards and Intensive Care Units in Hamedan Teaching Hospitals, April to September 2020

Background: Drug utilization evaluation (DUE) was performed to assess using drugs with special conditions such as antibiotics. Vancomycin is one of the essential antibiotics that is effective on methicillin-resistant Staphylococcus aureus, but unreasonable use of vancomycin, in addition to cost, leads to outbreak microbial resistance, which is a concern for health care systems all around the world. The aim of this study was to evaluate vancomycin use in teaching hospitals in Hamedan, Iran. Methods: This retrospective study was performed on patients who received vancomycin for at least 72 hours in intensive care units and infectious wards between April and September 2020 in the teaching hospitals of Hamedan. Data were obtained from patients’ medical records and entered into predesigned checklists. Results: From 661 patients, 441 were males and 247 were females. They received vancomycin for an average of 5.75 days. The most prevalent indication for vancomycin use was surgery. Only 40 patients had sensitive microbial culture to vancomycin, while 356 of them (53.9%) had no microbial culture at all. According to HICPAC guidelines, the overall appropriate use of vancomycin was 44.8%. Conclusion: According to the results, the irrational use of vancomycin must be corrected to achieve maximum optimal use; thus, performing and adhering to microbial culture, deploying clinical pharmacists, and holding explanatory sessions for health care are recommended for this purpose.

The Correlation between Nurses' COVID-19 Infections and Their Emotional State and Work Conditions during the SARS-CoV-2 Pandemic.

The COVID-19 pandemic caused by the SARS-CoV-2 virus has significantly influenced the functioning of Polish hospitals, and thus, the working conditions of nurses. Research on the presence of specific negative emotions in nurses may help identify deficits in the future, as well as directing preventive actions. The present research was performed among nurses (n = 158) working in Polish healthcare facilities during the third wave of the COVID-19 pandemic caused by the SARS-CoV-2 virus, where Group A (n = 79) consisted of nurses diagnosed with COVID-19, and Group B (n = 79) nurses who have never been infected with COVID-19. To perform the research, the Courtauld Emotional Control Scale (CECS), Trait Anxiety Scale (Polish: SL-C) and the authors’ survey questionnaire were used. A positive test result was generally determined more often among nurses who indicated a noninfectious ward as their main workplace, compared to nurses employed in infectious wards (64.55% positive vs 33.45% negative). Over a half of the subjects identified moderate levels of emotion suppression as the method to regulate strong emotions, while one-quarter cited high levels of suppression. Anxiety was suppressed at high and moderate levels by 97% of the subjects, depression by 86.71%, and anger by 79.48%. Infection with COVID-19 results in a higher level of anxiety and depression, as well as a feeling of increased work load.

Evaluating Polish nurses' working conditions and patient safety during the COVID-19 pandemic.

AimTo study the relationship between Polish nurses' working conditions and their attitudes towards patient safety during the COVID‐19 pandemic.BackgroundFacing the COVID‐19 pandemic, caused by the SARS‐CoV‐2 virus, healthcare worldwide has been reorganised. How these changes affected patient safety for hospitalised persons is not well understood.IntroductionDifficult working conditions related to the outbreak of the COVID‐19 pandemic may affect the provision of safe and effective care by healthcare staff.MethodsThis observational research was performed on the group of 577 nurses working during the COVID‐19 pandemic in isolation infection wards (n = 201) and non‐infectious diseases wards (n = 376) in Polish hospitals. The evaluation of working conditions was performed with an author's questionnaire, while the evaluation of factors influencing attitudes towards safety of the hospitalised patients was performed using Safety Attitudes Questionnaire. The STROBE checklist was used to report this study.ResultsThe procedures developed by management in advance for COVID‐19 patient treatment had a statistically significant influence on nurses' ‘evaluation of teamwork climate, safety climate, job satisfaction, perception of management and work conditions’. Providing management with the ability to perform a swab polymerase chain reaction SARS‐CoV‐2 test for hospital staff in the workplace, and psychological support from professionals and employers were statistically significant for higher ratings of ‘teamwork climate, safety climate, job satisfaction, stress recognition, perception of management and work conditions’ by the Polish nurses. Hospital workload during the COVID‐19 pandemic was significantly correlated with lower evaluation of work conditions.DiscussionOur study reinforces the existing literature on many fronts and demonstrates how even when operating under the COVID‐19 pandemic conditions, some factors remain critical for fostering a culture of patient safety. Reinforcing patient safety practices is a imperative under these conditions.Conclusions and implications for nursingWorking conditions influence nurses' attitudes towards safety of the hospitalised patients. These are largely modifiable factors related to the workplace and include prior preparation of procedures, restrictions to extending daily work hours and psychological counselling for the staff.

Future challenges in hospital hygiene and public health due to air-associated health hazards

IssueIn recent decades, hospital hygiene has focused on effective control strategies against contact or waterborne transmissions. Outside operating theatres or infection wards, airborne pathogens have played a minor role so far. For public health, the airborne route of transmission also played a subordinate role. Apart from bioterrorism, the focus here is more on chemical and physical hazards. In future, air-associated health hazards will increase. Besides airborne pathogens, examples include insects, heatwaves, particulate matter as well as pollen, mould and radon.Description of the problemNo attention has been paid to systematic risk regulation of the transmission mode air. Hospital hygiene is ‘micro-level public health' with a particularly vulnerable population. The experience of hospital hygiene measures can help to develop appropriate public health interventions. Which air hygiene measures have we taken to counter SARS-CoV-2 and how can these be more efficient in the future?ResultsIn response to SARS-CoV-2, face masks were introduced. This has reduced the risk of transmission both in hospitals and in public, but has not completely prevented indirect transmission through aerosols indoors. Ventilation rules further reduced the risk of transmission, but were not applicable everywhere. Since most buildings do not have central air filtration units, the use of decentralised air filters increased, with unknown relevance.LessonsBreathing air cannot be substituted. Therefore, air hygiene is a primary prevention and needs to become more structured to be effective against future air-associated health hazards. Future construction projects for hospitals and public buildings must be adapted to prevention of air-associated health hazards. Hazard and risk analyses, technical, organisational and personal control measures, their monitoring and an incident management should be combined into an ‘Air Safety Plan' as part of a hygiene plan for hospitals and the public.Key messages Breathing air is increasingly polluted by natural or anthropogenic chemical, biological and physical influences and thus becomes a carrier of health hazards, especially for vulnerable groups.Since air cannot be replaced, primary preventive air hygiene based on “Air Safety Plans” will be important in the future as an efficient measure against air-associated hazards such as SARS-CoV-2.

Serology-based therapeutic strategy in SARS-CoV-2-infected patients

SARS-CoV-2 infection can be a life-threatening disease. The optimal treatment of patients is not yet standardized. We use a serology-based therapeutic strategy based on the presence of antibodies against the SARS-CoV-2 virus, in which patients with positive serology receive aggressive anti-inflammatory treatment with high-dose dexamethasone and/or tocilizumab and patients with negative serology receive early convalescent plasma therapy. We also analyze the immunological impact of this therapy in the recovery of T cells, B cells and NK cells during hospitalization in a COVID-19 infectious ward. Our results suggest that aggressive therapy with early administration of convalescent plasma and high-dose dexamethasone may be of benefit in patients with SARS-CoV-2 infection and might avoid progression of lung damage or need of admission in intensive care. This strategy did not impair immune responses against SARS-CoV-2, as 93% of the patients generated antibodies against the virus. Independently of previous immunological status of the patients, serology-guided therapy might benefit even patients with a high CIRS-G score, immunosuppressed or medically debilitated individuals and elderly patients. T cell disturbances were most frequent in patients who required high-dose dexamethasone, and B cell depletion was most frequent in patients who received tocilizumab. Early passive immunotherapy with convalescent plasma does not affect lymphoid recovery.

Use of Cephalosporin Type Antimicrobials in Infection Wards in Tertiary Hospital in West India

Background: Antibiotic resistance is exponentially increasing worldwide. Irrational prescription of antibiotic treatment contributes to the development of antibiotic resistance. Appropriate antibiotic use is vital in reducing the mortality caused by bacterial infections. Third generation cephalosporins are now considered as the backbone of antibiotic therapy for treatment of serious infections including those in hospitalized patients. These drugs are the commonly prescribed ꞵ-lactam antibiotics even before culture sensitivity reports arrive. Generation of resistance has been a growing concern for all clinicians and must be avoided at all costs. This drug utilization study was undertaken to understand the growing resistance acquired by the organisms against cephalosporins caused due to the superfluous and unrestrained use of cephalosporins in the medical wards of our institution.&#x0D; Objective: The study objectives were to assess:&#x0D; &#x0D; The cephalosporins generation which was most commonly prescribed&#x0D; The relevance of cephalosporins generations used in various diseases&#x0D; The shift or addition of other antimicrobials upon failure of cephalosporins treatment&#x0D; &#x0D; Methods: This was an observational study done amongst 350 patients admitted in infection wards of Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune over a period of one year between January 2019 to December 2019 after obtaining institutional ethical clearance. Data was analyzed and values were presented descriptively in number and percentage form.&#x0D; Results: Maximum usage of third generation cephalosporin was seen with ceftriaxone being the most commonly prescribed third generation cephalosporin in parenteral form (59.43%). Gender analysis revealed that males (60.28%) were prescribed more cephalosporins as compared to females (39.71%), whereas, frequent usage was seen in the age group 61 – 70 years. Bacteriological investigations were done in only 103 (29.42%) cases following which shift or addition of other antimicrobials was seen in 13 (3.71%) cases. Metronidazole was the most frequently co-prescribed with cephalosporins.&#x0D; Conclusion: Our study revealed extensive usage of third generation cephalosporin and the treatment regimens implemented in majority of the cases were without prior culture sensitivity test leading to irrational prescribing. Our study, along with the various other studies, would help in taking the corrective measures to curb the unnecessary use of antibiotics, and framing the guidelines for the doctors prescribing them.

Organization of a Hospital Ward Aimed at Admitting Patients with SARS-CoV-2: An Economic and Epidemiological Perspective.

The SARS-CoV-2 epidemic requires dynamic action on the part of the entire health care system to provide infected patients whose condition requires hospitalization with access to appropriate medical care and infrastructure, including oxygen devices and ventilators. The demand for specialized inpatient care has increased rapidly and in many areas exceeds the resources available to date. Individual hospitals must make investment and organizational decisions to increase their capacity to handle patients with SARS-CoV-2. The aim of the article is to present the organizational and investment steps taken to establish and maintain an infectious hospital ward as well as the clinical and financial consequences of this decision. The study was conducted in a hospital ward that was launched at the end of October 2020 to care for patients with SARS-CoV-2. A case study method was used. The department was characterized taking into account its importance for: (1) the regional level of health coverage of the population, (2) the organization of the hospital’s activities, (3) the financial and economic situation of the hospital.

Emotional Control among Nurses against Work Conditions and the Support Received during the SARS-CoV-2 Pandemic.

Introduction. Working in the state of a pandemic is a huge mental load for the medical environment. Aim. Evaluation of emotional control among nurses against work conditions and the support received during the SARS-CoV-2 pandemic. Material and methods. The research was performed among nurses (n = 577) working during the pandemic caused by the SARS-CoV-2 virus in infectious (n = 201) and non-infectious (n = 376) wards in 11 Polish hospitals. To evaluate work conditions, the questionnaire prepared by the authors and the Emotional Control Scale (Courtauld Emotional Control Scale—CECS), which rates the control of anger, depression, and fear were used. Results. In the entire research group, fear had the highest rate of suppression among the negative emotions—18.25 points, 17.91 points in infectious wards and 18.44 points among nurses working in non-infectious wards; p > 0.05. The nurses fear was significantly repressed when there was no possibility of the nurses having to perform a COVID-19 test in the workplace; p < 0.05. A larger emotional supressed occurred in nurses who simultaneously declared the perception of increased stress level; p < 0.05. Conclusions. A high level of emotion suppression, especially regarding fear, combined with higher stress levels, occurring irrespective of the ward, points at the need for mental support for the researched nurses.

Hip arthoplasty in a forester after numerous tick bites

Arthritis is one of the most important symptoms of late-stage borreliosis, observed in approximately 60% of untreated patients with Lyme disease. In several percent of them, this manifestation is of interest to orthopedic surgeons. The authors present a case of a patient, working as a forester, who underwent left hip replacement arthroplasty having contracted a Borrelia burgdorferi infection in the past, and who was hospitalized 12 years before in the infectious ward due to suspected neuroborreliosis for which he was treated with Ceftriaxone 2 × 2.0 g intravenously for 4 weeks. At that time, a tomographic examination of the spinal cord revealed herniated nuclei at levels L4/L5 and L5/S1, which filled the left lateral recess, narrowing the intervertebral holes and compressing the nerve roots on the left side of L4 and L5. In September 2019, total hip replacement in the patient's left hip joint was performed. It is concluded that an active role of neuroborreliosis in this process of hip joint destruction may be suggested. Int J Occup Med Environ Health. 2021;34(5):693-9.

Factors Influencing Anxiety of Health Workers During Pandemic Covid-19

The Corona Virus has become a world health problem in early 2020. Coronavirus Disease 2019 (COVID-19) is a disease that has never been previously identified in humans. Health workers who are at the forefront of handling Covid-19 have high psychological disorders, one of which is anxiety. The purpose is to identify the factors that influence anxiety in health workers during the Covid-19 pandemic. The databases used include Google Scholar, PubMed Central and ResearchGate. 528 articles were found based on selected keywords, the number of articles after duplication-checking was 164 articles. Then screening was carried out according to the inclusion criteria (n = 20) and a total of 144 articles were eliminated because they did not match the inclusion criteria. The number of articles following the due diligence test (n = 10) and 10 articles were eliminated because they did not meet the due diligence requirements. Then 10 articles were taken for review. The results showed that the factors that influence anxiety in health workers are gender, age, family status, availability of PPE, knowledge, contact with COVID-19 patients, chronic disease, a physical and psychological workload that threatens the health, cooperation between colleagues, working in an infectious isolation ward. Psychological disorders such as anxiety have long-term impacts and can affect the work efficiency of health workers. If this anxiety is not managed properly, it can affect the performance of health workers in dealing with Covid-19. The most dominant factors affecting anxiety are age, the availability of PPE and concerns about transmission

Factors Influencing Anxiety of Health Workers During Pandemic Covid-19

The Corona Virus has become a world health problem in early 2020. Coronavirus Disease 2019 (COVID-19) is a disease that has never been previously identified in humans. Health workers who are at the forefront of handling Covid-19 have high psychological disorders, one of which is anxiety. The purpose is to identify the factors that influence anxiety in health workers during the Covid-19 pandemic. The databases used include Google Scholar, PubMed Central and ResearchGate. 528 articles were found based on selected keywords, the number of articles after duplication-checking was 164 articles. Then screening was carried out according to the inclusion criteria (n = 20) and a total of 144 articles were eliminated because they did not match the inclusion criteria. The number of articles following the due diligence test (n = 10) and 10 articles were eliminated because they did not meet the due diligence requirements. Then 10 articles were taken for review. The results showed that the factors that influence anxiety in health workers are gender, age, family status, availability of PPE, knowledge, contact with COVID-19 patients, chronic disease, a physical and psychological workload that threatens the health, cooperation between colleagues, working in an infectious isolation ward. Psychological disorders such as anxiety have long-term impacts and can affect the work efficiency of health workers. If this anxiety is not managed properly, it can affect the performance of health workers in dealing with Covid-19. The most dominant factors affecting anxiety are age, the availability of PPE and concerns about transmission

Clinical Profile of COVID-19 Illness in Children-Experience from a Tertiary Care Hospital.

ObjectiveTo detail clinical profile and outcome in children infected with SARS-CoV-2.MethodsThis retrospective study was undertaken at a tertiary care pediatric teaching hospital in Northern India. The data on clinical characteristics and outcome of children (< 18 y) with COVID-19 illness from April 2020–October 2020 were reviewed and analyzed.ResultsA total of 2919 children with suspected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) illness were tested for novel COVID-19 virus in the flu emergency (n = 1744), severe acute respiratory infection (SARI) ward (n = 825), and non-COVID area (n = 350) of the hospital. 8.73% (255/2919) children tested positive for SARS-CoV-2 infection. Of the 255 positive cases, 144 (56.47%) were managed on an outpatient basis and 100 (59 boys) required admission in COVID ward. The mortality rate of patients with SARS-CoV-2 was 11.4% (29/255). Majority of children admitted with COVID-19 had severe to critical illness due to the presence of malnutrition and underlying comorbidities.ConclusionsChildren of all age groups were susceptible to COVID-19 illness with a slight male preponderance. Amongst infected, two-third were asymptomatic or had mild symptoms that required outpatient management and home isolation. The adverse outcomes were more commonly seen in infants and children > 10 y of age with malnutrition and comorbid illness.Supplementary InformationThe online version contains supplementary material available at 10.1007/s12098-021-03822-5.

Mortal disseminated intravascular coagulopathy and cutaneous involvement in a COVID-19 positive patient; case report

Coronavirus 2019 disease (COVID-19) is a highly deadly disease that causes 77 million cases and 1.6 million deaths worldwide. Many cutaneous manifestations are seen in COVID-19 disease.Cutaneous pathologies such as vascular endothelial damage, prothrombotic conditions, hemorrhagic cutaneous lesions, vasculitis, disseminated intravascular coagulopathy (DIC), ecchymotic skin lesions, purpura, dry gangrene are seen in patients with COVID-19.While our 84-year-old male patient was being treated with COVID-19 pneumonia in the infection ward, DIC developed on the 9th day of his treatment and widespread petechia, purpura, ecchymosis, necrosis, gangrene, bullous skin lesions were observed in his left arm related to this.In our case, we aimed to present a case of DIC that developed as a complication as a result of COVID-19 infection and having a mortal course with cutaneous involvement due to it, to the literature.

The Bacterial Pneumonia Characteristics based on Climate and Meteorological Parameters in Indonesia, the Tropical Country: A Preliminary Study

Introduction: As a tropical country, Indonesia has the potential to influence the characteristics of infectious diseases. The purpose of this study was to see how the pattern of pneumonia on various weather components such as rainfall, humidity, and temperature.Methods: This study was carried by retrospective screening in the infectious ward in one of the tertiary referral hospitals.Results: A total of 876 cases of pneumonia from eight treatment rooms were included in the study. The highest pneumonia cases occurred in February with 239 (27.2%) cases followed in April and May with 169 (19.2%) and 159 (18.2%) cases respectively. After microbiological examination, bacterial growth was found in 191 cases. The highest number of bacteria was found in February with 62 (32%), followed by May with 33 (17.2%) and April with 31 (16.2%) samples. Most of the bacterial grown were gram-negative (94.3%), dominated by Klebsiella pneumoniae (35%), followed by Acinetobacter baumanii 17.2% and Pseudomonas aeruginosa 12%. On the examination of antibiotic sensitivity, it was found that amikacin has a consistently high sensitivity (90%) for pneumonia caused by most bacterial causes (Acinetobacter baumanii, Klebsiella pneumoniae, and Escherichia coli).Conclusion: The study did not show any remarkable bacterial patterns based on weather components such as rainfall, humidity, and temperature during the rainy season. However, increasing the surveillance period will provide a better insight into the bacterial pattern and can compare it in the rainy and dry seasons.

Awareness assessment for viral hepatitis among patients in different departments of medical institutions and students.

The significant spread of chronic viral hepatitis in Ukraine and the whole world, an increase in the incidence of medical personnel, and the lack of wariness of the population regarding the diseases of this group make it necessary to have a statistical analysis of the etiology, diagnosis, treatment, and prevention of viral hepatitis among different population groups.Aim. To study and analyze the awareness about viral hepatitis B (HBV) and C (HCV) of patients who undergo treatment in various departments (infectious, surgical, therapeutic) and the students who didn't take the course of infectious diseases.Materials and methods. A questionnaire was developed to establish the level of awareness among patients with viral hepatitis. The study was conducted through a sociological survey (full-time, one-time, individual) with the preservation of confidentiality conditions. The study was conducted in the infectious department of Sumy Regional Infectious Diseases Clinical Hospital named after ZY Krasovitsky, Surgical Department of Sumy City Clinical Hospital №5, therapeutic department of Sumy Regional Clinical Hospital of the 4th year of Sumy State University Medical Institute in 2019. In total, 147 people took part in the survey: 20 were in treatment at the therapeutic ward, 20 - in the surgical ward, 20 - in the infectious diseases department, and 20 - 4th-year students.Conclusions. Viral hepatitis is currently one of the most pressing health problems. It is used for the sociological survey we developed to determine the level of knowledge of the population about the causative agent of viral hepatitis, transmission, prevention (not specific and specific), clinical features, laboratory methods of diagnosis, and treatment.Among all the surveyed results, recipients gave most of the correct answers to questions about the causative agent of viral hepatitis and transmission routes. The worst known are patients in the surgical wards about the presence of an effective hepatitis B vaccine (20.00%); patients of infectious and therapeutic wards (20.00% each) and 4th-year students (25.00%) - about the presence of effective hepatitis C therapy; (95.00%) and a reference group of physicians (100.00%) on the etiology of viral hepatitis. Patients in surgical wards (84.30%) answered the most frequently asked questions about the ways of transmission of viral hepatitis.

MO839URGENCY OF RENAL REPLACEMENT THERAPY INITIATION AS A PREDICTOR FOR POOR PROGNOSIS IN PATIENTS WITH KIDNEY DISEASE

Background and AimsIt is known that mortality from COVID-19 among patients with kidney disease is significantly higher than in general population. The worst prognosis is seen for patients receiving renal replacement therapy (RRT). At the same time, many patients undergo an urgency start of hemodialysis (HD) while suffering from COVID-19. The aim of the study was to determine the significance of the RRT urgency for the prognosis in patients with COVID-19.MethodA retrospective analysis of case histories for 253 patients who received RRT at the infectious ward of St. Petersburg State Healthcare Institution City Hospital No. 15 from May to December 2020 was performed. All patients had a diagnosis of COVID-19, confirmed by PCR and/or clinical symptoms. Urgency RRT was performed in case of detection of indications, both in acute kidney injury (AKI), and in the diagnosis of end-stage chronic kidney disease (esCKD). Kaplan-Meier curves and multivariate Cox regression were used to perform cohort analyzes of survival and relative risk of death. For the calculations, the applied statistical software package SPSS 21.0, SPSS Ink (USA) was used.ResultsOf the 253 treated patients, 197 were patients with chronic outpatient HD, in 56 HD therapy was started urgently: 45 for AKI, 11 for esCKD. Totally 83 patients died. The overall mortality rate was 33%, while in outpatient HD group it was 18% and in the urgent HD start group - 84%. After adjusting for gender and age the fact of the urgency of starting RRT was an independent risk factor that increased the probability of death by 2.5 times (95% Cl 1.6÷3.9) compared to outpatients HD (Log Rank: P<0.001, Fig. 1). The patients age over 60 was also a factor significantly worsening the prognosis (Log Rank: P <0.001).MO839 Figure 1: Risk of death from all causes among patients with renal disease and COVID-19, depending on the urgency of initiation of hemodialysis therapyConclusionAmong patients with COVID-19 and kidney disease the urgency of RRT initiating is a factor that significantly worsens the prognosis, especially among patients of the older age group.

Evaluation of nutritional status in pediatric patients diagnosed with Covid-19 infection.

AimThe aim of this study was to evaluate the nutritional status, the nutritional effect on the risk of infection and the severity of the disease, and the contribution of nutrition to the course of the infection in pediatric patients diagnosed with coronavirus disease who required additional nutritional support after hospitalization.MethodsThe body weight, height, body mass index, upper arm circumference, and triceps skinfold thickness of 49 patients aged 1 month to 18 years and diagnosed with Covid-19 and then hospitalized at the Ankara City Hospital, Pediatric Health and Diseases Hospital, Pediatric Infection ward between 15 May and 15 June 2020 were measured. Total protein, albumin, prealbumin, selenium, zinc, ferritin, folate, and selenium, C, D, E, and B12 levels were studied from blood drawn simultaneously from the patients.ResultsA total of 49 patients aged 8–18 years were evaluated. The median age was 13 years (age range 8–18). The females made up 53% and the males 47% of the group. No patient needed intensive care admission. Only 3 patients received antibiotic treatment and the others were followed up without treatment. The weight was normal in 75% and the height was normal in 90%. Mid-arm circumference and triceps thickness were normal in 72% of the patients. Vitamin D deficiency was present in 82%, vitamin B12 deficiency in 18%, vitamin C deficiency in 17%, ferritin deficiency in 16%, folate deficiency in 15%, vitamin A deficiency in 13%, and vitamin E deficiency in 7%.ConclusionNo patient required intensive care admission. Only 3 patients received antibiotic treatment and the others were followed up without treatment. Malnourishment was present in 3% of the patients while 9% were obese. Vitamin D deficiency was the most common vitamin deficiency while vitamin B12, vitamin C, Ferritin, vitamin A, vitamin E, and Folate deficiency were less common. Selenium and zinc levels were normal in all patients. There was no correlation between anthropometric values and susceptibility to childhood COVID-19 infection or the clinical course. It is possible that vitamin D deficiency increases susceptibility to the infection.

A new SEIAR model on small-world networks to assess the intervention measures in the COVID-19 pandemics

A new susceptible-exposed-infected-asymptomatically infected-removed (SEIAR) model is developed to depict the COVID-19 transmission process, considering the latent period and asymptomatically infected. We verify the suppression effect of typical measures, cultivating human awareness, and reducing social contacts. As for cutting off social connections, the feasible measures encompass social distancing policy, isolating infected communities, and isolating hub nodes. Furthermore, it is found that implementing corresponding anti-epidemic measures at different pandemic stages can achieve significant results at a low cost. In the beginning, global lockdown policy is necessary, but isolating infected wards and hub nodes could be more beneficial as the situation eases. The proposed SEIAR model emphasizes the latent period and asymptomatically infected, thus providing theoretical support for subsequent research.