Isolation Facilities Research Articles

Predictors for the Development of Hypoxia or Prolonged Acute Symptoms Among Non-Hospitalized Mild-To-Moderate Patients with Coronavirus Disease 2019.

The coronavirus disease 2019 (COVID-19) pandemic remains a global public health concern. The clinical course and risk of developing severe illness among patients with COVID-19 who are at low-risk of severe COVID-19 remain uncertain. This retrospective cohort study from an isolation facility for low-risk COVID-19 patients in Japan evaluated the potential risks for severe disease with hypoxia (SpO2 ≤ 93%) or experiencing prolonged isolation period longer than 14 days with persistent acute symptoms. The study was performed before the spread of the alpha variant in the country and before the start of a nationwide mass vaccination campaign against COVID-19. Among the 929 participants with reliable outcome data regarding the development of hypoxia, 63 (6.8%) developed severe disease with hypoxia during their stays at the facility. Higher age [adjusted odds ratio (aOR), 1.08; 95% confidence interval (CI), 1.06-1.10] and male sex (aOR, 4.70; 95% CI, 2.39-9.22) were associated with this outcome. As for the experience of prolonged isolation period, higher age (aOR, 1.02; 95% CI, 1.01-1.04), atopic diseases (aOR, 1.69, 95% CI, 1.09-2.64), presence of cough at onset (aOR, 1.64; 95% CI, 1.09-2.48), and prescription of oral antibiotics before positive test results for COVID-19 (aOR, 2.37; 95% CI, 1.33-4.22) were associated with this outcome. In summary, 5-10% of low-risk COVID-19 patients later develop hypoxia. Older age and male sex were associated with both the development of hypoxia and prolonged acute symptoms. The unnecessary prescription of antibiotics before COVID-19 diagnosis may prolong COVID-19 symptoms.

Modeling Assumptions, Mathematical Analysis and Mitigation Through Intervention

Ebola virus is a life-threatening virus and has two major characteristics; one potential to have high mortality rate and the other infection transmission through newly infected dead bodies. There are some relevant features of Ebola that were observed during its recent outbreak: including varying rate of access to isolation facilities by patients and transmission of infection via improper handling of the dead bodies of infected diseased. Quick and safe burial may play an important role in the control and prevention of this virus. In this study, we consider mathematical modeling framework with four different cases for dynamics of Ebola virus with safe and unsafe burial practices, vaccination and treatment interventions with varying efficiency. The goal of this study is to show how timely treatment to Ebola leads to an effective control of the virus and, most importantly, how safe burial of dead bodies helps control the spread.

Efficacy of traditional Chinese medicine on shortening the negative conversion time of SARS-CoV-2 ribonucleic acid in patients with mild COVID-19: a retrospective cohort study

BackgroundThe holistic view of the ‘The unity of man and nature’ promotes the development and application of traditional Chinese medicine (TCM). Despite the absence of modern pharmacological therapies with robust efficacy against coronavirus disease 2019 (COVID-19), TCM has exhibited potential utility for treating the disease in clinical practice. MethodsA retrospective cohort study was conducted to investigate the therapeutic effect of TCM treatment intensity (TCMTI) in patients with mild COVID-19. A total of 6120 laboratory-confirmed patients with mild COVID-19 were recruited from temporary isolation facilities. The primary outcome measure was severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ribonucleic acid conversion time. In addition, restricted cubic spline models were employed to elucidate nonlinear relationships. ResultsThe median age (range) of the study participants was 43.0 (2.0–75.0) years, with a median hospitalization duration of 9.7 (4.1–22.5) days. The median time for achieving SARS-CoV-2 ribonucleic acid negativity was 6.67 days. The restricted cubic spline models revealed a remarkable nonlinear association between TCMTI and the time-to-ribonucleic acid negativity. After adjusting for potential confounders, the high TCMTI group exhibited a markedly shorter median time to SARS-CoV-2 ribonucleic acid negativity and reduced hospitalization duration (P < 0.001) than the low TCMTI group. Moreover, the mean time to achieve SARS-CoV-2 ribonucleic acid negativity was shortened by 1.909 days (P < 0.001) in the high-TCMTI group compared to the low-TCMTI group. ConclusionThis study suggests that early initiation and intensified use of TCM may accelerate the time required to achieve SARS-CoV-2 ribonucleic acid negativity in patients with COVID-19, bearing considerable implications for public health.

Sentiment Analysis on the Centralized Isolation Policy for Covid-19 Response in Bali Province

Coronavirus disease (Covid-19) is an infectious virus caused by SARS-CoV-2 virus, which has caused a global pandemic. The global pandemic is declared by the World Health Organization (WHO) on March 11th, 2020. Until late of April 2022, Covid-19 has caused the death of the total of more than 6 million people, and in Indonesia alone it has caused more than 150 thousand of death. The pandemic does not only impact health area, but also economy, politics, cultures, etc. In order to end the pandemic, WHO has sets out standard policies to be implemented, including by Indonesian government. Besides, each local goverment in Indonesia has also their own policies and regulations, including the government of Bali Province, for example the Community Activities Restrictions Enforcement or CARE (Indonesian: Pemberlakuan Pembatasan Kegiatan Masyarakat, commonly referred to as the PPKM), improvement in health care facilities and services, and also isolation policy for the people whom are infected by SARS-CoV-2 virus. To prevent the increase in death, Bali Province's COVID-19 Handling Task Force along with the district and city governments have prepared a centralized isolation policy and facilities for those whom are found to be Covid-19 positive without having any symptoms and for those with mild symtomps. This research has been conducted in order to get the public sentiment about this centralized isolation policy in Bali Province by using Tweet data from Twitter social media, based on Naive Bayes classification. From the experiments, the results of data Tweet classifications have accuracy more than 90%, which have shown that the public opinion is neutral. The results also mean that there is no contradition found in the application of centralized isolation policy in the province of Bali-Indonesia.

Assessment of Covid-19 pandemic quarantine and isolation programmes: A case study of the University of Limpopo

South Africa, like the rest of the world, was affected by the Selenga COVID-19 pandemic. From March 2020, the country’s president, Cyril Ramaphosa, imposed lockdown regulations in an attempt to curb the spread of the coronavirus, which led to the closure of universities. When the national regulations allowed for the resumption of university activities, the University of Limpopo had to set up quarantine and isolation facilities as a strategy to manage infections. As a new initiative, challenges would be expected in managing this unfolding situation. Against this background, this paper considers the findings of a study which focused on the establishment and operations of quarantine and isolation facilities at the university. Documents were analysed for the purpose of data construction and substantiated with data collected through semi-structured interviews. The university staff members responsible for the facilities were purposively selected to participate in this study. Data were analysed through thematic content analysis. The study found that the university established the quarantine and isolation facilities according to government guidelines; the facilities were well managed; and activities were implemented as expected. However, operational challenges that require improvements were identified and this article accordingly makes recommendations.

1008. Implementation of Clinical Pathway for Management of Fever in Nursing Home Residents in Singapore

Abstract Background Ageing population is a major health care problem all over the world. In Singapore, as of 2020, senior citizen (65 years and above) consists of 15.2 % of total population. By 2030, one in five Singaporeans will be more than 65 years old. Thus, nursing home (NH) is an important pillar of a health care system. Nursing home staff are in the front line to manage common infections. However, the inexperience and the lack of guidance have led to inappropriate transfer to acute hospitals. Infectious Diseases Community Program (IDCP) is the project to enhance partnerships with NHs. We work with NHs to develop, adapt, and implement appropriate processes related to infection control, prevention, and management. One of our objectives is the enhancement of assessment and appropriate evaluation of fever. The aim is to reduce the inappropriate admissions to acute hospitals. Methods Fever and desaturation pathway (figure 1) was developed by IDCP team. Six participating NHs adopted the pathway and trained their staff. The study was approved by NHG domain specific review board (DSRB). Hospital records were reviewed. We compared the rate of inappropriate admission from 2015-2017 which serve as a baseline and 2019-2020. The wash-out period was 2018 when NHs were implementing the pathway. Inappropriate admission is defined as &amp;lt; ! 1. Admission is against advanced care planning / preferred plan of care or 2. Criteria in the pathway are not met on admission, 48 hours later and no other medical reason for admission. Figure 1 Results Total number of fever transfers was 950 in 2015-2017 and 688 in 2019-2020. Number of inappropriate admissions was 115 in 2015-2017 and 50 in 2019-2020. Inappropriate admission was 12.11% in 2015-2017 and 7.27 % in 2019-2020 (table 1). Figure 2 shows the rate of inappropriate admissions of six participating NHs from 2015-2020. There is a decreasing trend after the pathway has been implemented in 2018. Table 1 Figure 2 Conclusion Adopting fever and desaturation pathway has reduced the rate of inappropriate admission in six participating NHs in Singapore. However, there is an increasing trend in inappropriate admission in 2020. This could be due to the lack of isolation facility in the NHs during the COVID-19 pandemic. We are continuing the implementation of the pathway to the rest of the NHs in the western region of Singapore. Disclosures All Authors: No reported disclosures.

Follow-up of Patients After Total Pancreatectomy and Islet Cell Autotransplantation at Off-Site Islet Isolation Facility.

Total pancreatectomy with islet autotransplantation (TPIAT) is a definitive management for intractable pain in patients with chronic pancreatitis. Islet autotransplantation (IAT) allows for the preservation of beta-cells to prevent complications of long-term diabetes. Our study follows TPIAT recipients for up to 12 years to determine the procedure's efficacy completed with an off-site islet isolation facility. Patient demographics, mixed meal tolerance test measures, glycosylated hemoglobin, insulin requirements, and homeostatic model assessment for insulin resistance values were collected prior to surgery and at the most recent follow-up. Forty-four patients (median age, 46.0 years; range, 20-78 years) underwent TPIAT for CP. At an overall median follow-up time of 845.5 days (range, 195-4470 days) 8 patients were insulin independent and 36 patients were insulin dependent. At the most recent follow-up, islet yield per kilogram was the strongest indicator of insulin independence. Homeostatic model assessment for insulin resistance values were comparable between insulin independent and dependent cohorts. Our long-term follow-up data suggest that IAT can effectively reduce insulin requirements and improve post-operative glycemic control.

COVID-19 infection at a psychiatric hospital in KwaZulu-Natal, South Africa: Clinical service planning and challenges.

South Africa had over 4 million cases of coronavirus disease 2019 (COVID-19) infections and more than 1 million COVID-19-related deaths. Despite the devastating psychological impact of the COVID-19 pandemic, there is little qualitative, critical evaluation of government mental health services in this resource-limited setting. The authors describe the clinical service plan and response to the COVID-19 pandemic at a government psychiatric hospital. KwaZulu-Natal, South Africa. A descriptive narrative overview of the specialised psychiatric hospital's clinical response (April 2020 - March 2021) to the COVID-19 pandemic was undertaken in the following domains: screening policy; testing and swabbing policy; staff training and monitoring; and restructuring the wards to accommodate mental health care users (MHCUs) with suspected cases of COVID-19. The in-depth narrative reviews led to the introduction of staff training, routine COVID-19 reverse transcription polymerase chain reaction (RT-PCR) testing of all MHCUs, the creation of designated quarantine and isolation facilities and screening of physical health status of patients with COVID-19 prior to transfer being implemented to prevent an outbreak or increased morbidity or mortality. Implementing a service plan early which included staff training, screening and routine COVID-19 testing services for psychiatric admissions in a rapidly evolving environment with few additional resources was challenging. The absence of guidelines early in the pandemic that addressed the unique needs of a clinical psychiatric inpatient population is a noteworthy learning point. The article highlights that the inpatient infrastructural requirements and clinical management protocols of acutely psychiatrically ill inpatients, in the context of infectious outbreaks, require dedicated task teams and bespoke policies.

Laser photo-ionization study of nat Ag using opto-galvanic signal at SPES offline laser lab

Resonant Ionization Laser Ion Source (RILIS) is one of the most advancing techniques for the production of radioactive ion beams (RIBs) in ISOL facilities. SPES project at INFN-LNL is a second generation ISOL facility which aims to produce several isotopes in a couple of years. Within the framework of this project, resonant photo-ionization schemes of several elements are studied in the offline laser lab, to be later implemented in the SPES Laser Ion Source. Silver is one of the elements being studied for the stated purpose. In this article, we report a resonant photo-ionization scheme of silver tested with a hollow cathode lamp (HCL). Evidence of high lying Rydberg states around 60945.32 cm−1 has also been observed by studying the fast opto-galvanic signal detected.

Managing COVID-19 in an Australian designated isolation facility: Implications for current and future healthcare crises based on in-depth interviews.

Health care workers' (HCWs) lived experiences and perceptions of the pandemic can prove to be a valuable resource in the face of a seemingly persistent Novel coronavirus disease 2019 (COVID-19)-to inform ongoing efforts, as well as identify components essential to a crisis preparedness plan and the issues pertinent to supporting relevant, immediate change. We employed a phenomenological approach and, using purposive sampling, conducted 39 semi-structured interviews with senior healthcare professionals who were employed at a designated COVID-19 facility in New South Wales (NSW), Australia during the height of the pandemic in 2020. Participants comprised administrators, heads of department and senior clinicians. We obtained these HCWs' (i) perspectives of their lived experience on what was done well and what could have been done differently and (ii) recommendations on actions for current and future crisis response. Four themes emerged: minimise the spread of disease at all times; maintain a sense of collegiality and informed decision-making; plan for future crises; and promote corporate and clinical agility. These themes encapsulated respondents' insights that should inform our capacity to meet current needs, direct meaningful and in situ change, and prepare us for future crises. Respondents' observations and recommendations are informative for decision-makers tasked with mobilising an efficacious approach to the next health crisis and, in the interim, would aid the governance of a more robust workforce to effect high quality patient care in a safe environment.

COVID-19 challenges and management of human resource in health, Bhutan’s unique approach: Medical University’s contribution

In March 2020, the country saw its first case when a foreign tourist tested positive for COVID-19 at Thimphu. There was immediate activation of national preparedness and response plan including the requirements for surge in human resource capacity to handle the novel infection. One key emphasis of the national response was to support the existing 3500 health care workforce by partnering with community in sharing pandemic-related activities. One such initiative was training a pool of people to shoulder basic responsibilities at quarantine and non-hospital isolation facilities. Therefore, Khesar Gyalpo University of medical Sciences of Bhutan was tasked to develop a training program and thus the De-suup plus program was designed with focus on people from non-medical background. This article attempts to describe the development and implementation of the training. The training constituted basic nursing competencies, personal protective equipment and essential public health preventive measures with the purpose of serving at quarantine and non-hospital isolation facilities in the Country.

Setting up a temporary isolation tent site for asymptomatic COVID-19 positive male migrant workers in Qatar.

Qatar has a unique demographic composition, involving hundreds of thousands of male blue-collar workers living in places where physical distancing measures are difficult to implement. This study aimed to describe the rapid development and operations of a temporary isolation facility, which was composed of tents, for asymptomatic COVID-19 positive migrant workers. The government established several temporary isolation facilities to house this important group of the community. This was achieved through daily meetings over a short period, thanks to the collaboration of government and private partners, in parallel to the facility being built and required resources procured. A 3,726-patient capacity isolation facility composed of large tents was constructed in 1 month and was kept operational from April 16 to June 20, 2020. Over that period, it received a total of 18,900 patients. It took 10 days from the decision to set up the first part of the isolation facility to admitting its first occupants. The COVID-19 pandemic necessitated the implementation of unprecedented global public health and physical distancing measures to contain the spread of the virus among the population. Rapidly opening a temporary COVID-19 isolation facility bought the healthcare sector time to set up more permanent solutions to contain the spread of the virus.

Development of COVID-19 Isolation Facility Management System with Scrum Framework

A COVID-19 pandemic hit Indonesia in early 2020, and on the 31st of March 2020, President Joko Widodo declared a public health emergency. By June 2021, the Delta variant hit Indonesia, causing shortages of hospital beds and resources. People who were tested positive for COVID-19 were asked to self-isolate at home. However, many houses in Indonesia are not suitable for self-isolation. Meanwhile, President University’s and President Community College’s students’ dormitories were empty as students returned to their homes and resumed their studies remotely using online classes. Therefore, the President University Foundation decided to repurpose the students’ dormitories as COVID-19 isolation facilities. To support its daily operation, an isolation facility management system was developed. To ensure the timely delivery of the system, Scrum was chosen as its development framework. Ten (10) participants tested the system for its usability, and the system scored an average of 94.5. This indicates that the developed system is easy to use and highly usable. The system was completed within a month, according to the planned schedule. The use of the Scrum framework has allowed the development team to produce a useful and effective information system in the shortest amount of time possible. Therefore, the system developed by this research provides services and facilities that are not only important in helping COVID-19 patients but also a better environment and has an integrated information system with various parties involved in handling COVID-19 patients.

Restoring non-COVID-19 clinical research and surveillance in Oyo state, Nigeria during the SARS-CoV-2pandemic.

Many sub-Saharan African patients receive clinical care from extramurally-supported research and surveillance. Dur- ing the COVID-19 pandemic, pausing these activities reduces pa- tient care, surveillance, and research staff employment, increasing pandemic losses. In Oyo State, Nigeria, we paused a multi-country invasive salmonellosis surveillance initiative and a rural clinical bac- teriology project. Working with research partners raises health facility con- cerns about SARS-CoV-2 transmission risks and incurs infection pre- vention costs, so we developed and implemented re-opening plans to protect staff and patients and help health facilities deliver care. Our reopening plan included appointing safety and per- sonal protective equipment (PPE) managers from existing project staff cadres, writing new standard operating procedures, implement- ing extensive assessed training, COVID-19 testing for staff, procuring and managing PPE, and providing secondary bacteraemia blood culture support for COVID-19 patients in State isolation facilities. Surveillance data showed that the pandemic reduced care access and negatively affected patient unsupervised antibacterial use. The re-opening plan repurposed human and material resources from national and international extramurally-supported programs to mitigate these effects on public health. A structured reopening plan restarted care, surveil- lance, and infection prevention and control.

Co-Evolutionary Location-Routing Model of Medical Isolation Areas for Major Public Health Emergencies Considering the Uncertainty of Future Traffic Environment

With the continuous development of the COVID-19 pandemic, the selection of locations for medical isolation areas has not always been optimal for the timely transportation of infected people, or those suspected of being infected. This has resulted in failure to control the rate of spread of infection cases in time. To address this problem, this paper proposes a co-evolutionary location-routing optimization (CELRO) model of medical isolation areas for use in major public health emergencies to develop a rapid location-routing scheme for epidemic isolation, including the selection of locations of medical isolation facilities per area and the optimal route per vehicle to each infected person. Specifically, this paper solves the following two sub-problems: (i) calculate the shortest transportation times and corresponding routes from any medical isolation area to any person infected or suspected of being infected, and (ii) calculate the location scheme for distribution of isolation areas. Different from previous studies, the vehicle operating characteristics and the interference of uncertainty of the traffic environment are considered in the proposed model. To find an appropriate scheme for location of medical isolation areas with the shortest travel times, a co-evolutionary clustering algorithm (CECA), which is a combination of some separated evolutionary programming operations, is proposed to solve the model. Various network sizes and uncertainty combinations are used to design some comparative tests, which aim to verify the effectiveness of the proposed model. In the experiment section, CELRO reduced travel time by at least 14% compared with other methods. This finding can provide an effective theoretical basis for optimizing the spatial layout of medical isolation areas or the location planning of new medical facilities.

The Psychological Impact of Isolation on Hospitalised Patients with COVID-19 Infection in the UAE

Infection prevention and control measures for COVID-19 may include immediate admission to an isolation facility for the infected. However, the mental health impact of this isolation worldwide is not fully documented. This study aims to contribute to global data on the psychological impact of COVID-19 and to be the first study to assess psychological distress among hospitalised patients with COVID-19 in the UAE. Using a cross-sectional study design on 132 hospitalised patients, we found that 90% of participants scored within the normal levels for psychological distress. The length of stay was associated with higher levels of psychological distress and those aged 41–60 years had lower levels of psychological distress compared to the 31–40 years group. Our results contributed to global data on the psychological impact of COVID-19 and may help to identify those at risk for psychological distress due to COVID-19 hospitalisation for targeted prevention and future pandemic preparedness plans.

SARS-CoV-2 RNA Is Readily Detectable at Least 8 Months after Shedding in an Isolation Facility.

Environmental monitoring of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) for research and public health purposes has grown exponentially throughout the coronavirus disease 2019 (COVID-19) pandemic. Monitoring wastewater for SARS-CoV-2 provides early warning signals of virus spread and information on trends in infections at a community scale. Indoor environmental monitoring (e.g., swabbing of surfaces and air filters) to identify potential outbreaks is less common, and the evidence for its utility is mixed. A significant challenge with surface and air filter monitoring in this context is the concern of "relic RNA," noninfectious RNA found in the environment that is not from recently deposited virus. Here, we report detection of SARS-CoV-2 RNA on surfaces in an isolation unit (a university dorm room) for up to 8 months after a COVID-19-positive individual vacated the space. Comparison of sequencing results from the same location over two time points indicated the presence of the entire viral genome, and sequence similarity confirmed a single source of the virus. Our findings highlight the need to develop approaches that account for relic RNA in environmental monitoring. IMPORTANCE Environmental monitoring of SARS-CoV-2 is rapidly becoming a key tool in infectious disease research and public health surveillance. Such monitoring offers a complementary and sometimes novel perspective on population-level incidence dynamics relative to that of clinical studies by potentially allowing earlier, broader, more affordable, less biased, and less invasive identification. Environmental monitoring can assist public health officials and others when deploying resources to areas of need and provides information on changes in the pandemic over time. Environmental surveillance of the genetic material of infectious agents (RNA and DNA) in wastewater became widely applied during the COVID-19 pandemic. There has been less research on other types of environmental samples, such as surfaces, which could be used to indicate that someone in a particular space was shedding virus. One challenge with surface surveillance is that the noninfectious genetic material from a pathogen (e.g., RNA from SARS-CoV-2) may be detected in the environment long after an infected individual has left the space. This study aimed to determine how long SARS-CoV-2 RNA could be detected in a room after a COVID-positive person had been housed there.

Air and surface sampling for monkeypox virus in a UK hospital: an observational study

BackgroundAn outbreak of monkeypox virus infections in non-endemic countries was recognised on May 12, 2022. As of September 29, more than 67 000 infections have been reported globally, with more than 3400 confirmed cases in the UK by September 26. Monkeypox virus is believed to be predominantly transmitted through direct contact with lesions or infected body fluids, with possible involvement of fomites and large respiratory droplets. A case of monkeypox in a health-care worker in the UK in 2018 was suspected to be due to virus exposure while changing bedding. We aimed to measure the extent of environmental contamination in the isolation rooms of patients with symptomatic monkeypox.MethodsWe investigated environmental contamination with monkeypox virus from infected patients admitted to isolation rooms at the Royal Free Hospital (London, UK) between May 24 and June 17, 2022. Surface swabs of high-touch areas in five isolation rooms, of the personal protective equipment (PPE) of health-care workers in doffing areas in three rooms, and from air samples collected before and during bedding changes in five rooms were analysed using quantitative PCR to assess monkeypox virus contamination levels. Virus isolation was performed to confirm presence of infectious virus in selected positive samples.FindingsWe identified widespread surface contamination (56 [93%] of 60 samples were positive) in occupied patient rooms (monkeypox DNA cycle threshold [Ct] values 24·7–37·4), on health-care worker PPE after use (Ct 26·1–35·6), and in PPE doffing areas (Ct 26·3–36·8). Of 20 air samples taken, five (25%) were positive. Three (75%) of four air samples collected before and during a bedding change in one patient's room were positive (Ct 32·7–36·2). Replication-competent virus was identified in two (50%) of four samples selected for viral isolation, including from air samples collected during bedding change.InterpretationThese data show contamination in isolation facilities and potential for suspension of monkeypox virus into the air during specific activities. PPE contamination was observed after clinical contact and changing of bedding. Contamination of hard surfaces in doffing areas supports the importance of cleaning protocols, PPE use, and doffing procedures.FundingNone.

Clinical scoring system to predict viable viral shedding in patients with COVID-19.

Background: The Centers for Disease Control and Prevention (CDC) recommends 5–10 days of isolation for patients with COVID-19, depending on symptom duration and severity. However, in clinical practice, an individualized approach is required. We thus developed a clinical scoring system to predict viable viral shedding.Methods: We prospectively enrolled adult patients with SARS-CoV-2 infection admitted to a hospital or community isolation facility between February 2020 and January 2022. Daily dense respiratory samples were obtained, and genomic RNA viral load assessment and viral culture were performed. Clinical predictors of negative viral culture results were identified using survival analysis and multivariable analysis.Results: Among 612 samples from 121 patients including 11 immunocompromised patients (5 organ transplant recipients, 5 with hematologic malignancy, and 1 receiving immunosuppressive agents) with varying severity, 154 (25%) revealed positive viral culture results. Multivariable analysis identified symptom onset day, viral copy number, disease severity, organ transplant recipient, and vaccination status as independent predictors of culture-negative rate. We developed a 4-factor predictive model based on viral copy number (-3 to 3 points), disease severity (1 point for moderate to critical disease), organ transplant recipient (2 points), and vaccination status (-2 points for fully vaccinated). Predicted culture-negative rates were calculated through the symptom onset day and the score of the day the sample was collected.Conclusions: Our clinical scoring system can provide the objective probability of a culture-negative state in a patient with COVID-19 and is potentially useful for implementing personalized de-isolation policies beyond the simple symptom-based isolation strategy.

Psychosocial Distress among Family Members of COVID-19 Patients Admitted to Hospital and Isolation Facilities in the Philippines: A Prospective Cohort Study.

This study determined the psychosocial impact of COVID-19 on families of adult COVID-19 patients in isolation facilities in Metro Manila, Philippines. This prospective cohort study was conducted in COVID-19 healthcare facilities. Data collection was undertaken 2 weeks and 8 weeks after discharge. Logistic regression was performed to determine the socioeconomic and clinical factors influencing anxiety, depression, and family function. Based on HADS-P, 43.2% of the participants had anxiety symptoms, and 16.2% had depression symptoms 2 weeks after the discharge of their relative with COVID-19 infection. The prevalence of anxiety and depression significantly decreased to 24.3% and 5.4%, respectively, 8 weeks after discharge. The percentage of participants with a perceived moderate family dysfunction was 9.5% in the 2nd week and 6.8% in the 8th week post discharge. Participants with perceived severe family dysfunction increased from none to 4.1%. The most inadequate family resources for the participants were economic, medical, and educational resources. Patient anxiety (p = 0.010) and perceived inadequate family resources (p = 0.032) were associated with anxiety symptoms among family members. Patient anxiety (p = 0.013) and low educational attainment (p = 0.002) were associated with anxiety symptoms among family members 8 weeks after discharge. On the other hand, patient depression (p = 0.013) was a factor related to depressive symptoms among family members 2 weeks after discharge. This study provided an in-depth understanding of the mental health status of family members caring for relatives with COVID-19 infection. This can be used to guide healthcare professionals caring for COVID-19 patients and their family members.