Positive Diagnosis Of COVID-19 Research Articles

Impact of High Troponin Level on the Outcome in COVID-19 Positive Patients.

COVID-19 is a new disease caused by the recently discovered SARS-CoV-2 virus. The COVID-19 disease manifests in several ways and it may affect various systems, including the gastrointestinal, musculoskeletal, neurological, cardiovascular, and pulmonary systems. Individuals who have ad-additional health conditions, such as cardiovascular disorders, are particularly more likely to experience illness and death. This study aimed to assess the clinical effect of COVID-19 on myocardial injury, as measured by troponin elevation, and to determine if this effect has an impact on the outcome. This retrospective study was conducted at King Saud Medical City. The electronic medical records used to identify all admitted patients between March 23 and June 15, 2020, with a laboratory-confirmed positive COVID-19 diagnosis who had troponin I measured. During the study period, 768 COVID-19-positive patients were hospitalized. Of those, 187 patients were excluded because the troponin level was not measured. The remaining 581 (75.7%) had troponin I measured. Overall, 89 of 581 (15.3%) patients died. Of those, 67.8% were in the markedly elevated cTnI group, 8.5% were in the mildly elevated cTnI group, whereas no deaths were reported in the group with normal cTnI levels. Myocardial injury was observed in COVID-19-admitted patients at a significant level that warrants attention to this consequence. In older individuals with pre-existing cardiovascular comorbidities, the diagnosis of myocardial injury was linked to a higher likelihood of being admitted to the intensive care unit, experiencing a worse prognosis, and ultimately, death.

Memory impairment after one year of the acute episode of Covid-19 infection

Abstract Introduction Memory impairment is one of the most frequently reported sequelae of COVID-19 infection. The aim of our study was to estimate the risk of memory disorders one year after the acute episode of COVID-19 infection in the Tunisian population of Monastir. Methods This is a cohort study conducted in Monastir University Hospital. The study included two groups: Exposed subjects were randomly selected among those with a positive diagnosis of COVID-19 between September 2021 and January 2022. The non exposed group was selectd among subjects with a negative COVID-19 diagnosis during the same period and who had no COVID infection during the following year. The Mac Nair scale was used to assess memory impairment after one year of follow up. Results Our study included 140 subjects diagnosed with Covid-19 and 139 subjects who had never been in contact with this virus. The incidence rate of memory impairment at one year post-Covid-19 infection was 17.9% (IC95% [11.5 - 24.2%]), whereas in the non exposed group it was 9.4% (IC95% [4.45% -14.5%]). Multivariate analysis revealed that the group exposed to Covid-19 had a significantly higher Mac-Nair Total score after one year of the acute episode of infection compared with the non exposed group (exp β = 1.25, IC95% [1.10; 1.42]). The other main predictors of memory impairment in the study population were age (exp β = 1.006, IC95% [1.001; 1.01]), diabetes (exp β = 1.67, IC95% [1.44; 1.95]), history of anxiety and depression ((exp β = 1.71, IC95% [1.35; 2.17]) and obesity (exp β = 1.25, IC95% [1.10; 1.42]), whereas vaccination with two or more doses prior to COVID-19 infection (exp β = 0.84, IC95% [0.74; 0.96]) and male gender (exp β = 0.65, IC95% [ 0.57; 0.73]) were found to be protective against these disorders. Conclusions Our study allowed us to estimate the risk of long-term memory disorders following Covid-19 infection. This could help better guide preventive measures to reduce the incidence of these disorders. Key messages • The incidence rate of memory impairment at one year post-Covid-19 infection was 17.9%. • The main other predictors of memory impairment were age, female gender, diabetes, history of anxiety and depression and obesity whereas vaccination prior to COVID-19 infection was a protective factor.

Clinical and sociodemographic factors associated with COVID-19 in non-hospitalized patients in southwest Goiás, Brazil, 2020 to 2022

Considering that COVID-19 has had a major impact on public health around the world, we aimed to elucidate the clinical and sociodemographic characteristics of non-hospitalized patients in Quirinópolis, southwest Goiás, from 2020 to 2022. We performed a cross-sectional study, using secondary data on all suspected COVID-19 visits in Basic Health Units, bivariate data analysis and logistic regression. 18,036 suspected cases were registered with 56.1% laboratory confirmed. COVID-19 was concentrated in the central regions of the city and was more associated with the vaccinated group, which may be a reflection of the vaccine's protective effect on the worsening of symptoms. The final logistic regression model showed a higher risk of COVID-19 among mixed race (1.30; CI1:20-1.42) and young people as a protective factor (0.88; CI:0.78-0.98). Gustatory (2.78; IC:2.19-3.53) and olfactory (2.83; IC: 2.18-3.66) disorders, headache (1.11; IC: 1.02-1.11), fever (1.77; CI: 1.62-1.92) and cough (1.48; CI: 1.36-1.61) were also associated with a positive diagnosis of COVID-19. Only respiratory disease was found to be a risk factor, probably due to underreporting of other factors. COVID-19 is ubiquitous among non-hospitalized patients, with easy transmission in clusters and with striking demographic and clinical characteristics: Brown population, taste and olfactory disorders, headache, fever, cough and respiratory disease as risk factors; young people apparently as a protective factor and vaccinated more related to COVID-19 may be a reflection of the profile of the sampled group (outpatients). The ubiquity of SARS-CoV-2 in the municipality may be related to public policies promoting ineffective medicines and population behavior that contribute to the spread of the virus. In contrast, vaccines have proven effective in containing the severe disease. In the future, approaches to hospitalized patients are necessary to better understand the impacts of COVID-19.

Timing of total joint arthroplasty post-COVID-19: an evaluation of the optimal window to minimize perioperative risks

BackgroundTotal hip arthroplasty (THA) and total knee arthroplasty (TKA) are commonly performed orthopedic procedures. This study aimed to evaluate the impact of COVID-19 status on postoperative complications and mortality in patients undergoing THA and TKA.MethodsA total of 110,186 underwent either THA or TKA. Patients were grouped based on their COVID-19 status, gathered from the National COVID-19 Cohort Collaborative (N3C) in the 12 weeks preceding surgery and compared for various variables, including age, sex, BMI, and Charlson Comorbidity Index (CCI) scores. COVID-19 status was defined as a positive test result that was closest to the date of surgery regardless of testing positive previously. Postoperative complications such as venous thromboembolism (VTE), sepsis, surgical site infection, bleeding, acute kidney injury (AKI), 30-day, and 1-year all-cause mortality were examined. To compare the variables, an odds ratio with a 95% confidence interval was calculated with a significant level set at P < 0.05. Logistic regression using R programming was utilized for these calculations.ResultsUnivariate analysis was performed and rates of VTE (1.02% vs. 3.35%), 30-day mortality (0.25% vs. less than 5%), and 1-year mortality (1.42% vs. 5.43%) were higher in the COVID-19-positive group for THA patients (P < 0.001). For TKA patients, only 30-day mortality was significantly higher in the COVID-19-positive group (P = 0.034). Multivariate logistic regression revealed that a positive COVID-19 diagnosis within two weeks of surgery and a CCI score > 3 were significant predictors of postoperative complications and mortality for both TKA and THA.ConclusionsPatients with a positive COVID-19 diagnosis within 12 weeks of THA or TKA carried a significantly higher risk for postoperative complications and mortality. In addition, a CCI score > 3 is also a significant risk factor. These findings emphasize the importance of vigilant preoperative screening and risk stratification in the era of COVID-19.

Risk perception and reappraisal during the COVID-19 pandemic in southeast Alaska: Self-identified determinants of risk and protective health behaviors

Social and cultural context shapes how communities perceive health, well-being, and risk. Risk reappraisal can occur over time as a product of new information and improved understanding. We investigate risk perception and protective behaviors in Lingít Aaní (Southeast Alaska) during the first year of the COVID-19 pandemic. Surveys were circulated at two time points: (1) April–June 2020, before COVID-19 reached epidemic levels in the region, and (2) November 2020–February 2021. Ordinary least squares (OLS) regression models were used to analyze how demographic characteristics of the respondent population were related to risk perception. OLS models were again used to predict how individuals engaged in protective behaviors while controlling for risk perceptions. Controlling for demographic characteristics, risk perception increased as age increased for perceived risk of getting sick and dying from COVID-19, males perceived lower risk in general for all tested variables, and Alaska Native respondents perceived higher risk than non-Alaska Native respondents. Controlling for risk perception, results for protective behaviors were mixed; however, the strongest association identified was that knowing someone with a positive COVID-19 diagnosis increased protective behaviors. Between the two time points, risk perceptions increased significantly for variables related to oneself, others, and community members becoming infected with COVID-19. Protective behaviors like traveling less than normal, buying more cleaning products, and engaging in more subsistence gathering significantly increased. Identifying patterns of risk perception and protective behaviors, and especially how they change over time, are critical to developing place-specific public health recommendations, action, and preparedness plans against future infectious threats.

Navigating Ankle Fracture Surgery in the Shadow of COVID-19

Background This case control study aimed to evaluate the impact of preoperative COVID-19 diagnosis on postoperative complications in patients undergoing ankle fracture surgery using the National COVID-19 Cohort Collaborative (N3C) database. The investigation focused on the interplay between COVID-19 diagnosis timing, patient characteristics, and clinical outcomes, particularly considering the potential mechanisms by which COVID-19 may contribute to increased complications. Methods This case control study included patients who underwent ankle fracture surgery using the N3C database. The cohort was divided into two groups: patients without COVID-19 diagnosis within 12 weeks of surgery (n = 16 806) and those with a positive COVID-19 diagnosis within 12 weeks of surgery (n = 369). Demographic factors were analyzed. Clinical outcomes encompassed deep vein thrombosis (DVT), sepsis, surgical site infection, bleeding, acute kidney injury, 30-day mortality, and 365-day mortality. Multivariate logistic regression analyses were conducted. Results The COVID-19–positive cohort displayed a slightly higher mean age (52.95 ± 18.43 vs 51.62 ± 18.36, P = .169) and body mass index (34.88 ± 9.99 vs 33.86 ± 8.80, P = .028) compared to the negative cohort. Although some outcomes, such as DVT and sepsis, demonstrated slightly higher frequencies in the COVID-19–positive group, these differences were not statistically significant. Adjusted odds ratios (AORs) for various COVID-19 diagnosis periods were generally not significant, except for a heightened risk of 30-day all-cause mortality associated with COVID-19 positivity within 0 to 2 weeks of surgery (AOR = 6.29, P = .003). Conclusions Preoperative COVID-19 diagnosis within 12 weeks did not exhibit a significant association with most postoperative complications. While this study did not unveil substantial COVID-19–related effects, acknowledging the broader context of the pandemic remains essential in guiding comprehensive patient care strategies. Level of Evidence: Level III

Comparison of diagnostic accuracy of rapid antigen tests for COVID-19 compared to the viral genetic test in adults: a systematic review and meta-analysis.

The objective of this review was to determine the diagnostic accuracy of the currently available and upcoming point-of-care rapid antigen tests (RATs) used in primary care settings relative to the viral genetic real-time reverse transcriptase polymerase chain reaction (RT-PCR) test as a reference for diagnosing COVID-19/SARS-CoV-2 in adults. Accurate COVID-19 point-of-care diagnostic tests are required for real-time identification of SARS-CoV-2 infection in individuals. Real-time RT-PCR is the accepted gold standard for diagnostic testing, requiring technical expertise and expensive equipment that are unavailable in most primary care locations. RATs are immunoassays that detect the presence of a specific viral protein, which implies a current infection with SARS-CoV-2. RATs are qualitative or semi-quantitative diagnostics that lack thresholds that provide a result within a short time frame, typically within the hour following sample collection. In this systematic review, we synthesized the current evidence regarding the accuracy of RATs for detecting SARS-CoV-2 compared with RT-PCR. Studies that included nonpregnant adults (18 years or older) with suspected SARS-CoV-2 infection, regardless of symptomology or disease severity, were included. The index test was any available SARS-CoV-2 point-of-care RAT. The reference test was any commercially distributed RT-PCR-based test that detects the RNA genome of SARS-CoV-2 and has been validated by an independent third party. Custom or in-house RT-PCR tests were also considered, with appropriate validation documentation. The diagnosis of interest was COVID-19 disease and SARS-CoV-2 infection. This review considered cross-sectional and cohort studies that examined the diagnostic accuracy of COVID-19/SARS-CoV-2 infection where the participants had both index and reference tests performed. The keywords and index terms contained in relevant articles were used to develop a full search strategy for PubMed and adapted for Embase, Scopus, Qinsight, and the WHO COVID-19 databases. Studies published from November 2019 to July 12, 2022, were included, as SARS-CoV-2 emerged in late 2019 and is the cause of a continuing pandemic. Studies that met the inclusion criteria were critically appraised using QUADAS-2. Using a customized tool, data were extracted from included studies and were verified prior to analysis. The pooled sensitivity, specificity, positive predictive, and negative predictive values were calculated and presented with 95% CIs. When heterogeneity was observed, outlier analysis was conducted, and the results were generated by removing outliers. Meta-analysis was performed on 91 studies of 581 full-text articles retrieved that provided true-positive, true-negative, false-positive, and false-negative values. RATs can identify individuals who have COVID-19 with high reliability (positive predictive value 97.7%; negative predictive value 95.2%) when considering overall performance. However, the lower level of sensitivity (67.1%) suggests that negative test results likely need to be retested through an additional method. Most reported RAT brands had only a few studies comparing their performance with RT-PCR. Overall, a positive RAT result is an excellent predictor of a positive diagnosis of COVID-19. We recommend that Roche's SARS-CoV-2 Rapid Antigen Test and Abbott's BinaxNOW tests be used in primary care settings, with the understanding that negative results need to be confirmed through RT-PCR. We recommend adherence to the STARD guidelines when reporting on diagnostic data. PROSPERO CRD42020224250.

Assessment of the hematologic factors as a prognostic factor in COVID-19 patients

Introduction: Identifying laboratory predictors of disease progression should be a priority in current COVID-19 studies, which leads to an appropriate treatment for patients and reduce the risk of severe or critical illness. In this study we tend to analyze the hematologic and biochemical findings of COVID-19 patients as an easy-to-get diagnostic factor that can become the first choice for disease monitoring and the evaluation of general conditions. Methods: In this retrospective study, all patients with positive COVID-19 diagnosis that admitted to the emergency department, from 1st of April 2020, to 30th June, 2020 were included. For all patients, CBC, differential, urea, serum creatinine, and CRP were collected. Data analysis was performed using IBM® SPSS® Statistics 19.0 software. Pearson correlation and spearman correlation were used to analyze quantitative and qualitative data correlations respectively. Diagnostic ability of the variables was identified by their ROC curves. Results: A total number of 977 patients were included in this study. The median and mode of the age of the population are 50 and 29 respectively. ROC curves for diagnostic ability indicated that, Urea and creatinine have the highest diagnostic values with its optimum sensitivity and specificity for urea=62.5 mg/dL and creatinine=2.05 mg/dL, with sensitivities of 87.5% and 81.3%, and specificities of 80.6% and 82.1% respectively. Conclusion: The results from the current study show that no chemical or hematologic factor can properly detect COVID-19 in patients. Also, hematologic factors cannot determine patients’ prognosis; however creatinine and urea are able to estimate patients’ prognosis. Therefore, it is recommended to focus on the kidney injuries in COVID-10 patients for predicting their prognosis.

Oscillating autonomy: a grounded theory study of women’s experiences of COVID-19 infection during pregnancy, labour and birth, and the early postnatal period

BackgroundTesting positive for COVID-19 was associated with higher rates of detrimental psycho-social and physical health outcomes. The COVID-19 pandemic caused unprecedented disruption to everyday life. This included major reconfiguration of maternal, child, and perinatal mental health and care services and provision. This study aimed to investigate the experiences of those who tested positive for COVID-19 during pregnancy, labour and birth, or the early postnatal period.MethodsNational on-line recruitment from across the United Kingdom resulted in sixteen mothers being invited to qualitative semi-structured interviews to understand the experiences of mothers who had been infected by COVID-19 during pregnancy, labour and birth, or the early postnatal period. Interviews were conducted, recorded, and transcribed using video-conferencing software. A Grounded Theory approach was used to analyse the data gathered pertaining to women’s experiences of their positive COVID-19 diagnosis during pregnancy, labour and birth, or the early postnatal period.ResultsThe theory of ‘Oscillating Autonomy – Losing and Seeking to Regain Control by Striving for Agency’ was developed, comprising three main themes: ‘Anxious Anticipation: The fear of infection was worse than COVID-19 itself’; ‘Fluctuating Agency: What changed when COVID-19 took control’; and ‘Reclaiming Control: Seeking reassurance during COVID-19 positivity’. Testing positive for COVID-19 whilst pregnant, during labour or birth, or in the early postnatal period was associated with a perceived loss of control. Those who were able to regain that control felt more secure in their situation.ConclusionsSupport was paramount to manage increased vulnerability, as was reassurance achieved by information seeking and positive action including increased health monitoring and COVID-19 vaccination.

Positive Diagnosis of COVID-19 in an Integrated Teaching and Healthcare Service and Its Associated Factors.

Developing and implementing an epidemiological surveillance plan was necessary during the COVID-19 pandemic to ensure safe dental practice. This was due to the high risk faced by this occupational group during the COVID-19 pandemic. This study aimed to determine the factors associated with COVID-19 diagnosis in a Peruvian dental school's integrated teaching and care service. A cross-sectional study was conducted with a population made up of the records of students, teachers, and administrative personnel in a COVID-19 epidemiological surveillance plan of a dental school during the years 2021 to 2022. The year 2022 was positively associated with a positive diagnosis of COVID-19 (aPR: 1.51; 95% CI: 1.10-2.07; p = 0.010) and not having had contact with a patient with COVID-19 was negatively associated with being diagnosed with that disease (aPR: 0.20; 95% CI: 0.14-0.27; p < 0.001). In conclusion, 2022 was positively associated with having a positive COVID-19 diagnosis. In addition, not having had contact with a COVID-19 patient was negatively associated with the disease diagnosis and with the development of moderate to severe COVID-19.

May changes in nutritional habits be an indicator of fear during the COVID-19 pandemic period?

Purpose The aim of this study was to determine the effect of anxiety levels of adults on their nutritional status during the COVID-19 pandemic in Kayseri province, Turkey. Design/methodology/approach A total of 898 adults consisting of 479 individuals with and 419 individuals without a positive diagnosis of COVID-19 were included in the study. The individuals’ socio-demographic characteristics, health status, nutritional habits, anthropometric measurement and Fear of COVID-19 Scale (FCV-19S) information were obtained online. Findings The mean FCV-19S score of the participants was 17.49 ± 6.02. FCV-19S score was higher in those who reduced their consumption of protein sources compared to those who did not change and those who increased (p &lt; 0.001). It was determined that FCV-19S scores of participants who increased their consumption of fruit/vegetables, sweets and sugar were higher than those who did not change their consumption of such items (p = 0.007). The FCV-19S scores of individuals who did not change their onion/garlic and snack consumption were lower than those who decreased or increased the consumption of these nutrients (p = 0.001, p = 0.002). Practical implications Education programs can be organized especially targeting vulnerable populations, such as women, individuals with chronic diseases and those experiencing COVID-19 symptoms. These programs can be conducted by dietitians and psychologists in collaboration, focusing on promoting healthy eating habits and coping strategies during stressful times. Originality/value It was determined that those who changed their nutrition habits during the COVID-19 pandemic had higher fear levels than those who did not. Individuals with high fear paid more attention to healthy nutrition than individuals without fear.

Incidence of perioperative complications in COVID-19 survivors: Prospective observational clinical trial.

As long as the COVID-19 pandemic continued, the continuation of elective surgery had been unavoidable. There is still no consensus on the timing of elective surgery in patients who have recovered from COVID-19. The primary aim of this study was to determine the effect of time after COVID-19 infection on perioperative complications. This prospective observational single center included adult patients who had recovered from COVID-19 and underwent surgery between February and July 2021. Data were prospectively collected from the patient and hospital database, the preoperative evaluation form and the perioperative anesthesia forms. A total of 167 patients were included in our study. Preoperative COVID-19 RT-PCR test results were negative in all patients. The mean time of positive COVID-19 diagnosis was 151.0 ± 74.0 days before the day of surgery. Intraoperative general and airway complications occurred in 33 (19.8%) and 17 (10.2%) patients, respectively. Although the time from COVID-19 positivity to surgery was shorter in patients with intraoperative general and airway complications, the difference between the groups did not reach statistical significance (P = .241 and P = .133, respectively). The median time from COVID-19 positivity to surgery in patients with and without postoperative complications was 156.0 (min: 27.0-max: 305.0) and 148.5 (min: 14.0-max: 164.0) days, respectively (P = .757). In patients with and without oxygen support in the postoperative period, the median time from COVID-19 positivity to surgery was 98.0 (min: 27.0-max: 305.0) and 154.0 (min: 14.0-max: 364.0) days, respectively. In patients who received oxygen support in the postoperative period, the time from COVID-19 positivity to surgery was shorter and the difference between the groups was statistically significant (P = .014). The incidence of perioperative complications decreased with increasing time after a positive SARS-CoV-2 infection, but there was no difference in perioperative complications between the groups. As the time between COVID-19 positivity and surgery increased, the need for oxygen support in the postoperative period decreased. It is not possible to share clear data on the timing of operation after SARS-CoV-2 infection.

COVID-19 vaccination and potential predictors for vaccination among students in Bulgarian medical universities

University students, especially those in healthcare sciences, are of particular importance in COVID-19 vaccine views since their future careers will allow them to educate citizens regarding vaccination. The study examined COVID-19 immunisation coverage, behaviours, and attitudes towards COVID-19 vaccines among students in Bulgarian medical universities. A prospective cross-sectional study was undertaken in September 2021- January 2022. Demographics, university programme, year of study, general vaccine attitudes and behaviour, and personal experience with COVID-19 and vaccines were collected. The chi-square test was used to test for associations and binominal logistic regression to identify possible predictors for vaccination. A total of 3050 students with a median age of 22 years, predominantly female participated. Three-quarters of the students (73.5%) have been vaccinated against COVID-19. An association was found between COVID-19 vaccination and influenza vaccination in the previous season (χ2 = 67.15, p < 0.001) as well as the intention to receive the flu vaccine in the current season (χ2 = 142.83, p < 0.001). Vaccine hesitation mainly stemmed from fear of side effects and safety concerns, but non-vaccinated students voiced them more often. Respondents who were less likely to be vaccinated considered themselves to have: (a) limited access to sufficient information to allow them to make an informed decision to vaccinate against COVID-19; (b) lack of public awareness and education campaigns about COVID-19 vaccines; (c) insufficient information about COVID-19 vaccines during university education that would allow them to make an informed decision to vaccinate; and (d) had a positive COVID-19 diagnosis. Informational initiatives that emphasise vaccine safety will boost COVID-19 immunisation coverage.

Social inequalities in self-reported SARS-CoV-2 infection in Brazilian adults: PNAD COVID-19.

To investigate inequalities related to race/ethnicity and socioeconomic status in self-reported positive diagnosis for COVID-19 in Brazilian adults. Data available from the National Household Sample Survey COVID-19 (PNAD COVID 19) (July/September/November, 2020) were used in this retrospective investigation. The analyses considered the sampling design, primary sampling units, strata and sample weights. Poisson regression with robust variance was used to estimate prevalence ratio (PR) and the 95% confidence interval (95%CI) of the associations. In July, September and November 2020, with regard to the rapid test, indigenous people were 2.45 (95%CI 1.48-4.08), 2.53 (95%CI 1.74-4.41) and 1.23 (95%CI 1.11-1.86) times more likely to report a positive history of SARS-CoV-2 infection, respectively. With regard to the RT-PCR test in November, indigenous people were more likely to test positive for COVID-19 (PR: 1.90; 95%CI 1.07-3.38). It was observed that the indigenous group was 1.86 (95%CI 1.05-3.29) and 2.11 (95%CI 1.12-3.59) times more likely to test positive for COVID-19 in September and November (2020). Income was associated with testing positive for COVID-19: in November, individuals whose income ranged from R$0.00-R$1.044 were more likely (PR: 1.69; 95%CI 1.16-23.06) to test positive using the RT-PCR test; participants whose income was in this range were also more likely to be diagnosed with COVID-19 using blood tests (PR: 1.72; 95%CI 1.43-2.07). The data presented show an association between race/ethnicity and economic status with a positive diagnosis of COVID-19.

Association of Severe COVID-19 and Persistent COVID-19 Symptoms With Economic Hardship Among US Families

Little is known about the association of severe COVID-19 and post-COVID-19 conditions with household finances. To examine associations between COVID-19 outcomes, pandemic-related economic hardship, and prepandemic socioeconomic status among families in the US. This cohort study used data from the Panel Study of Income Dynamics (PSID), a nationally representative, longitudinal study. Data included 6932 families active in the PSID in both 2019 and 2021. Ordinal exposure categories were defined based on whether the reference person or spouse or partner reported a positive COVID-19 diagnosis and (1) persistent COVID-19 symptoms, (2) previous severe COVID-19, or (3) previous moderate, mild, or asymptomatic COVID-19. Families with no history of COVID-19 served as the reference group. Outcomes included whether a resident family member was laid off or furloughed, lost earnings, or had any financial difficulties due to the COVID-19 pandemic. In this cohort study of 6932 families (772 Hispanic families [weighted, 13.5%; 95% CI, 12.4%-14.6%], 2725 non-Hispanic Black families [weighted, 13.1%; 95% CI, 12.3%-14.1%], and 3242 non-Hispanic White families [weighted, 66.8%; 95% CI, 65.2%-68.3%]), close to 1 in 4 (2222 [weighted, 27.0%; 95% CI, 25.6%-28.6%]) reported income below 200% of the US Census Bureau poverty threshold. In survey-weighted regression models adjusted for prepandemic sociodemographic characteristics and experiences of economic hardship, the odds of reporting pandemic-related economic hardship were 2.0 to 3.7 times higher among families headed by an adult with persistent COVID-19 symptoms (laid off or furloughed: adjusted odds ratio [AOR], 1.98 [95% CI, 1.37-2.85]; lost earnings: AOR, 2.86 [95% CI, 2.06-3.97]; financial difficulties: AOR, 3.72 [95% CI, 2.62-5.27]) and 1.7 to 2.0 times higher among families headed by an adult with previous severe COVID-19 (laid off or furloughed: AOR, 1.69 [95% CI, 1.13-2.53]; lost earnings: AOR, 1.99 [95% CI, 1.37-2.90]; financial difficulties: AOR, 1.87 [95% CI, 1.25-2.80]) compared with families with no history of COVID-19. Families headed by an adult with persistent COVID-19 symptoms had increased odds of reporting financial difficulties due to the pandemic regardless of prepandemic socioeconomic status (families with lower income: AOR, 3.71 [95% CI, 1.94-7.10]; families with higher income: AOR, 3.74 [95% CI, 2.48-5.63]). Previous severe COVID-19 was significantly associated with financial difficulties among families with lower income (AOR, 2.59 [95% CI, 1.26-5.31]) but was not significantly associated with financial difficulties among those with high income (OR, 1.56 [95% CI, 0.95-2.56]). This cohort study suggests that persistent COVID-19 symptoms and, to a lesser extent, previous severe COVID-19 were associated with increased odds of pandemic-related economic hardship in a cohort of US families. The economic consequences of COVID-19 varied according to socioeconomic status; families with lower income before the pandemic were more vulnerable to employment disruptions and earnings losses associated with an adult family member's COVID-19 illness.

Lesões de pele associadas ao uso de respiradores N95 entre profissionais de saúde no Brasil em 2020

Objective: to investigate the prevalence of skin lesions and factors associated with the use of N95 respirators among health professionals in Brazil. Method: cross-sectional study conducted with 11,368 health professionals using a respondent-driven sampling method adapted for online environments. Univariate and multivariate analyses were performed to investigate the association between the “skin lesions with the use of N95 respirators” variable and gender, professional category, workplace, training, COVID-19 diagnosis, and availability of sufficient and high-quality Personal Protective Equipment. Results: the prevalence of skin lesions was 61.8%. Women were 1.203 times (95% CI: 1.154-1.255) more likely to develop a lesion than men. The chances of skin lesions in psychologists (PR=0.805; 95% CI: 0.678-0.956) and dentists (PR=0.884; 95% CI: 0.788-0.992), were lower when compared to Nursing professionals. Professionals with a positive COVID-19 diagnosis and working in the Intensive Care Unit have an increased chance of presenting skin lesions (PR=1.074; 95% CI: 1.042-1.107); (PR=1.203; 95% CI: 1.168-1.241), respectively. Conclusion: the prevalence of skin lesions caused by the use of N95 respirators was 61.8% and was associated with female gender, professional category, workplace, training, COVID-19 diagnosis, and availability of sufficient and highquality Personal Protective Equipment.

Skin lesions associated with the use of N95 respirators among health professionals in Brazil in 2020.

to investigate the prevalence of skin lesions and factors associated with the use of N95 respirators among health professionals in Brazil. cross-sectional study conducted with 11,368 health professionals using a respondent-driven sampling method adapted for online environments. Univariate and multivariate analyses were performed to investigate the association between the "skin lesions with the use of N95 respirators" variable and gender, professional category, workplace, training, COVID-19 diagnosis, and availability of sufficient and high-quality Personal Protective Equipment. the prevalence of skin lesions was 61.8%. Women were 1.203 times (95% CI: 1.154-1.255) more likely to develop a lesion than men. The chances of skin lesions in psychologists (PR=0.805; 95% CI: 0.678-0.956) and dentists (PR=0.884; 95% CI: 0.788-0.992), were lower when compared to Nursing professionals. Professionals with a positive COVID-19 diagnosis and working in the Intensive Care Unit have an increased chance of presenting skin lesions (PR=1.074; 95% CI: 1.042-1.107); (PR=1.203; 95% CI: 1.168-1.241), respectively. the prevalence of skin lesions caused by the use of N95 respirators was 61.8% and was associated with female gender, professional category, workplace, training, COVID-19 diagnosis, and availability of sufficient and highquality Personal Protective Equipment. (1) The overall prevalence of skin lesions was 61.8%. (2) The most affected professional category was Nursing. (3) Women were more likely to develop skin lesions than men.

Abstract 14035: Clinical Outcomes Following Hospitalization for COVID-19 in Patients With Cardiac Sarcoidosis in the United States

Background: Chronic immunosuppressive therapy and concomitant pulmonary involvement are two possible factors that could contribute towards adverse outcomes for patients with a history of Cardiac Sarcoidosis (CS) who are hospitalised with Covid-19. In this study, we aimed to identify co-morbidities and clinical outcomes for patients with CS post hospitalization for Covid-19. Methods: Patients aged ≥18 years, with a positive diagnosis of COVID-19 (via ICD-10 code “U071”) between 1st April 2020 to 31st December 2020, were identified from National Inpatient Sample Database. Patients with CS were compared for patient characteristics, demographics and hospital-related outcomes against patients without CS using multivariable regression analysis. Results: We identified a total of 1,608,285 cases of COVID-19 infection admitted to the hospital out of whom 60 patients were confirmed to have CS. CS patients were younger (mean 57.8 vs. 63.3 years, p&lt;0.01), had a higher mean Charlson comorbidity index (CCI: 5.17 vs. 2.72, p&lt;0.01) with greater prevalence of previous myocardial infarction (25.0% vs. 4.2%, p&lt;0.01), atrial fibrillation (58.3% vs. 15.6%, p&lt;0.01), smoking (50% vs. 26.1%, p&lt;0.01), chronic kidney disease (66.7% vs. 20.6%, p&lt;0.01) and diabetes (75.0% vs. 40.0%, p&lt;0.01) as compared to patients without CS. Moreover, clinical outcomes of patients with CS were more adverse following hospitalization for COVID-19 including use of mechanical ventilation (25.0% vs. 11.2%, p&lt;0.01, adjusted OR 1.39 95% CI: 1.37-1.41), acute kidney injury (50.0% vs. 28.2%, p&lt;0.01, adjusted OR 1.86, 95% CI: 1.84-1.88) and death (25.0% vs. 13.1%, p&lt;0.01, adjusted OR 3.15, 95% CI: 3.10- 3.20) (Table 1). Conclusion: CS patients hospitalized for COVID- 19 infection had greater CCI and worse clinical outcomes such as mechanical ventilation use, acute kidney injury and death when compared to patients without cardiac sarcoidosis. Keywords: Cardiac sarcoidosis, COVID- 19, outcomes.

Going home positive: a qualitative study of the experiences of care for patients with COVID-19 who are not hospitalized.

Most Canadians diagnosed with COVID-19 have had mild symptoms not requiring hospitalization. We sought to understand the patient experience of care while being isolated at home after testing positive for SARS-CoV-2 infection. We conducted a phenomenologically informed qualitative descriptive study using in-depth semistructured interviews to identify common themes of experience for patients sent home from hospital with a positive COVID-19 diagnosis. Between July and December 2020, we conducted interviews with patients who were followed by the North York General Hospital COVID Follow-Up Clinic. Patients with mild to moderate symptoms were interviewed 4 weeks after their COVID-19 diagnosis. We conducted the interviews and performed a thematic analysis of the data concurrently, in keeping with the iterative process of qualitative methodology. We conducted interviews with 26 patients. From our analysis, 3 themes were developed regarding participants' overall experience: lack of adequate communication, inconsistency of information from various sources, and the social implications of a COVID-19 diagnosis. The implications of a positive test for SARS-CoV-2 infection are substantial, even when symptoms are mild and patients self-isolate as recommended. Participants noted communication challenges and inconsistent information, leading to exacerbated stress. Participants shared their experiences of the stigma of testing positive and the frustration of poor communication structures and inconsistent information. Experiencing care during self-isolation at home is an area of increasing importance, and these findings can inform improved support, ensuring access to equitable and safe COVID-19 care for these patients.

Factors Associated with COVID-19 Vaccine Hesitancy and Case Status among New Jersey Secondary Educational Professionals.

Vaccine hesitancy remains a societal problem, including during the COVID-19 pandemic. New Jersey (NJ) Safe Schools Program provides work-based learning training to supervisory-level career-technical-vocational education teachers and administrators who have to consider varied state and local mandates concerning COVID-19 vaccination and exemptions. In early 2022, we distributed an online survey via PsychData to individuals trained between 2014 and 2022 to understand NJ teachers' practices and concerns regarding COVID-19 vaccines. Overall, 269 completed the survey. We stratified data by vaccination status, number of doses, booster status, age, teaching experience, gender, race, county of work, and COVID-19 diagnosis status. Overall, results suggested differences in COVID-19-related concerns, including access to, perceptions of, and confidence in COVID-19 vaccines and COVID-19-related practices. About 90.7% received the initial vaccine; 77.7% received the booster. About half the participants had received a positive COVID-19 diagnosis by the time of the survey; they were less likely to get the vaccine or booster if they had received the initial vaccine. Data suggested differences in levels of COVID-19-related concerns and confidence in, or importance of, vaccines when comparing different demographic factors and vaccination practices. The data informs efforts to understand factors affecting vaccine hesitancy among educational professionals.