post-COVID Period Research Articles

Vaccines are coming closer to you: the experience of the Corporate Healthcare Company (ASL) Rome 4

Abstract Issue The post-Covid period is characterised by vaccine fatigue and declining coverage, especially among children. Access to vaccination for adults and the elderly, outside of the influenza vaccination campaign, has historically been very low due to limited awareness of opportunities and difficulties in accessing vaccination centres. Description of the problem ASL Roma 4 is characterised by a dispersed population across a large territory of 28 municipalities, many of which are small and predominantly populated by elderly people. In order to reach this population, ‘proximity clinics’ were opened in 6 small municipalities in 2023, where the vaccination service offers a wide range of vaccines every 1-2 months. Since June 2023, two mobile vaccination units have also been used to extend the reach of vaccination activities. Results In 2023, vaccination activities at nearby clinics reached 343 people (166 males and 177 females), with a total of 473 vaccines administered. More than 70% of those vaccinated were over 65 years of age, including 47% over 80 years of age. Between September and December 2023, vaccination vans were deployed in high-traffic areas such as markets, supermarkets, squares, or in locations with hard-to-reach populations such as migrant reception centres, volunteer centres, and senior centres. As a result, 1183 people (585 men and 557 women) with an average age of 49 years were reached and 1699 vaccines were administered. 62% were over 65, 37% over 80, 41 were homeless and 87 were migrants. 56% of the vaccines administered were influenza and covid, but all types were provided. Lessons Although this method of vaccine delivery is still being implemented, its value lies mainly in vaccinating people who would not have voluntarily sought vaccination services, demonstrating the need to bring prevention as close to the user as possible. Key messages • The post-Covid period is characterised by vaccine fatigue and declining coverage. • It is necessary to bring vaccination prevention as close to the user as possible.

The Effect of Monetary Policies in COVID and Post-COVID on the Apple Stock Price and Beta

Abstract: Central bank interventions, such as monetary policies, influence market activities in many ways. For example, the stock price and beta value. Monetary policy is a mechanism to stabilize the market by adjusting the interest rate. Theoretically, the interest rate negatively relates to stock price and beta value. However, based on other previous research, the relationship can vary across industries and countries. Other determinants can also co-influence the stock activities, including business policies. Thus, each company experienced various results from the monetary policies during the COVID and post-COVID periods. Specifically, how did Apple Inc.s stock price and beta value react to the monetary policies released by FOMC? This paper explores Apple Inc. stock price and beta under the influence of monetary policies in the COVID and post-COVID period. Additionally, this paper finds that there is a significant negative relationship between the interest rates and stock price in COVID, and an insignificant negative relationship in post-COVID; There is an insignificant negative relationship between the interests rates and stock beta in COVID, and an insignificant positive relationship in post-COVID. Hence, stock price and beta are largely influenced by market dynamics and extrinsic factors. The contradictory result can be caused by the policies Apple Inc. released and the imprecise calculation.

Comparing Students’ Multicultural Awareness Development in Online vs. Face-to-Face Diversity Courses Before, During, and After COVID-19

Creating a global workforce is a driving need for our time. Higher education institutions are prioritizing helping students develop an awareness of their own and other cultures, as they are expected to participate in a diverse workforce. This study examines a large data set of learning assessment data for undergraduate students from an agriculture course focused on diversity and social justice, using the Beliefs, Events and Values Inventory (BEVI) instrument to assess the multicultural awareness development of the students. The study compared the impact of the medium of instruction (face-to-face versus online) in helping students develop multicultural awareness. The results revealed that students did not differ much in multicultural awareness across the medium of instruction. Moreover, to understand the multicultural awareness of the students in the pre-COVID period, during COVID and in the post-COVID period, the pre-test BEVI scores of the students were compared using ANOVA. The goal of this analysis was to capture the change in worldview of the students from the pre-COVID period to during COVID and post-COVID periods. The results revealed that pre-test BEVI scores for the pre-COVID period showed a lower degree of multicultural awareness than students during the COVID and post-COVID times. Also, there was no significant difference in the pre-test BEVI scores for the students in the COVID and post-COVID periods. Overall, the study makes important contributions to higher education literature as it reveals that (1) medium has negligible impact on the multicultural awareness of the students, and that (2) student worldviews have shifted significantly since the height of the global pandemic.

Worldwide Recessions and Herding Behaviour: A Comparative Analysis of Three Countries

The general suggestion that behavioral science plays a part in creating abnormalities within the financial sector has been studied and proposed many times in the past. This study aims to prove the existence of behavioral sciences, specifically herding behavior, in three countries with different market conditions: Indonesia (Emerging), Vietnam (Frontier), and the United States (Developed). We developed our methodology using quantile regression to study the existence of herding behavior, and our findings were as follows: (1) As expected, the US didn’t have any indication of a statistically significant herding presence; they do, however, indicate an insignificant presence of herding behavior in the post-covid period under bearish conditions (2) Vietnam does not indicate significant herding tendencies, (3) Surprisingly, Indonesia did not exhibit statistically significant herding presence, but both Indonesia and Vietnam exhibited the slight presence of herding behavior but still relatively insignificant.

Financial performance of emerging market companies during the COVID-19 pandemic: moderating role of sustainability performance

Purpose This study aims to investigate whether sustainability performance (SP) served as a safeguard for firm profitability (FP) and enhanced corporate resilience in emerging markets during the COVID-19 pandemic. Design/methodology/approach Using a sample of 1,091 firms in 25 emerging markets from 2017 to 2021, this study analyses the moderating role of SP on the relationship between FP and COVID-19 by using hierarchical linear modelling at three levels: (a) time-level; (b) firm-level; (c) country-level. Findings The results indicate that during the years 2020–2021, emerging market firms with robust SP showed better FP in the midst of the COVID-19 pandemic. The findings also indicate that all dimensions of sustainability, i.e. environmental, social and governance (ESG), have significantly affected the FP in the post-COVID period. Hence, adhering to ESG principles aids in alleviating adverse financial repercussions during times of crises. Practical implications This study provides valuable insights for companies and policymakers for finding solutions that may assist them in improving SP globally and enduring crises resiliently. The findings are also relevant to institutional investors that consider SP as an investment criteria. Although the COVID-19 pandemic was temporary, the lessons learned could protect firms from future similar global crises. Originality/value This study enhances the understanding of the contingency relationship between sustainability and financial performance by offering up-to-date empirical insights within the context of emerging markets during the pandemic. It demonstrates how different institutional frameworks influenced the SP–FP association during the crisis. Thus, this paper expands the understanding of crisis management literature and bridges the research void concerning the impact of SP on FP in an emerging market context.

Quality of life of covid-19 patients attending selected post-covid units

Background: Disease process and its outcome can create impacts on human life; it also impairs quality of life (QoL). During the COVID-19 pandemic situation, a devastating impairment of quality of human life has been occurred over the world. This study aimed to state the quality of life of COVID-19 patients attending post-COVID units of Dhaka Medical College Hospital and Bangabandhu Sheikh Mujib Medical University, Dhaka. Methods: A cross-sectional study was conducted among 90 COVID-19 Patients (post-COVID period) in post COVID unit of Dhaka Medical College Hospital and Bangabandhu Sheikh Mujib Medical University by pretested structured questionnaire, from July 2021 to December 2021, using a convenient sampling method. Data were collected through face-to-face interviews. Results: The majority of the respondents (46.7%) were within the 30 to 39 years of age group. In this study about 73.3% of respondents lead poor quality of life after recovery from COVID-19. The findings revealed that, Post COVID depression history of the respondents was associated with the quality of life of the respondents after recovery from COVID-19 (p=0.001). The findings also revealed that the type family of the respondents was associated with the quality of life of the respondents after recovery from COVID-19 (p=0.001). Those who were not admitted into hospital during COVID-19 period maintain good quality of life after recovery from COVID-19 than those who were admitted on hospital during COVID-19 period (p=0.006). Inferential statistics were done at a 95% confidence interval and 5% level of significance. Conclusions: This study described state of quality of life of COVID-19 patients attending on post-COVID units. It was found that near about three fourth of the respondents seemed that their quality of life became poor after recovery from COVID-19. JOPSOM 2023; 42(1):49-53

Dynamic changes of cytokines in COVID-19 and in the post-COVID period

Dynamic changes of cytokines in COVID-19 and in the post-COVID period

Efficacy and safety of inhaled molecular hydrogen therapy in patients with respiratory failure due to chronic obstructive pulmonary disease exacerbation in post-COVID period

Molecular hydrogen (H2) is a powerful antioxidant and anti-apoptotic agent. H2 has been studied in a number of clinical studies in the recent years.The aim of this research was to investigate the efficacy and safety of H2 inhalation therapy in patients with hypoxemic and hypercapnic respiratory failure (RF) against exacerbation of chronic obstructive pulmonary disease (COPD) in the post-COVID (Corona Virus Disease 2019) period.Methods. The randomized prospective parallel comparative study included patients (n = 60: 40 men aged 71.2 ± 1.8 years, 20 women aged 70.9 ± 2.8 years) with a post-COVID-19 exacerbation of COPD complicated by hypoxemic/hypercapnic RF. The patients were divided into 2 groups: group 1 (main) (n = 30: 18 men, 12 women), group 2 (control) (n = 30: 18 men, 12 women). To maintain arterial blood saturation ≥ 90 %, patients in both groups received respiratory support (non-invasive ventilation) using the Prisma 25ST device (Lowenstein Medical, Germany) in the BiPAP S/T mode (BiLevel Positive Airway Pressure Spontaneous/Time spontaneous/forced mode 20–24/4–6 cm H2O and O2, respectively; the fractional oxygen concentration in the inhaled gas mixture was ≥ 24%). In addition to standard treatment, patients in the main group received additional H2 therapy (Suisonia device, Japan) through a nasal cannula for 90 minutes daily for 14 days.Results. In patients of the main group, a decrease in the stiffness index was detected from 14.6 ± 1.2 to 6.2 ± 0.6 m/s, and the arterial blood lactate level – from 2.84 ± 0.1 to 0.02 ± 0.1 mmol/l (p < 0.001), the calculated shunt fraction Qs/Qt (venous admixture) – from 27.21 ± 3.4 to 7.14 ± 1.23 (p < 0.01) and an increase in the following parameters: reflection index – from 42.2 ± 2.0 to 66.2 ± 4.9% (p < 0.05), virus-specific IgG level – from 134 ± 125 to 669 ± 164 (p < 0. 05), blood flow velocity in arterioles – from 473 ± 108 to 868 ± 64 μm/s (p < 0.05), blood flow velocity in venules – from 299 ± 56 to 862 ± 69 μm/s (p < 0.05), the 6-minute walk distance – from 57.1 ± 4.4 to 328.9 ± 33.7 m (p < 0.05).Conclusion. H2 inhalations were safe and increased the therapeutic effect when added to standard therapy for patients with hypoxemic and hypercapnic RF during exacerbation of COPD in the post-COVID period.

8254 The Risk Of Thrombotic Complications In Patients With Post-COVID Syndrome Is High Even With Normal Coagulogram Values

Abstract Disclosure: A. Alieva: None. The high risk of thrombotic complications in patients with diabetes, even more increased in the post-Covid period, requires practicing physicians to be especially vigilant and carefully monitor the state of the hemostatic system and the function of the vascular endothelium. Routine laboratory tests may be insufficient for dynamic monitoring and timely detection of abnormalities. In this article, the author proposes the determination of cell adhesion molecules as a predictor of thrombotic complications in patients with type 2 diabetes mellitus in the post-Covid period. In our current study, VCAM-1 levels were elevated in all patients with type 2 diabetes within 24 months of COVID-19 infection and were not associated with increased von Willebrand factor or D-dimer or other coagulation abnormalities. This means that routine determination of coagulogram, D-dimer and von Willebrand factor may miss the stage of prothrombotic changes in the microvasculature. It is possible that an increase in the level of cell adhesion molecules precedes the appearance of other abnormalities in the hemostasiogram. Therefore, for patients with type 2 diabetes after a coronavirus infection with normal coagulogram values, it seems promising to determine the level of VCAM-1 molecules to prevent the occurrence of thrombotic complications. In addition, monitoring this indicator may be useful in determining the effectiveness of preventive therapy. Presentation: 6/3/2024

Effects of the COVID-19 Pandemic on Microbial Keratitis: A 5-Year Comparative Study.

To report the clinical and microbiological profiles of microbial keratitis and its antimicrobial resistance before, during, and after COVID-19. This was a retrospective case-note review of all corneal scrape specimens collected from patients with microbial keratitis from January 2018 to December 2023. Case records were analyzed for demographic characteristics, microbiological diagnosis, and antibiograms. All outcome variables were collected, stratified, and compared between 3 periods: the pre-COVID-19 group (January-December 2019), the COVID-19 group (January 2020-December 2022), and the post-COVID-19 group (January-December 2023). A total of 947 corneal cultures from 947 patients were reviewed. Gram-positive bacteria predominated in all periods, with no significant differences in their distribution. Staphylococcus epidermidis was the most frequently identified organism. Pseudomonas aeruginosa was the most common Gram-negative bacterium, with its incidence significantly lower in the post-COVID period. Fungal infections showed a significant increase in the post-COVID group, with Fusarium sp. being the most common fungus and showing a significant increase in incidence in the post-COVID group. Despite a stable incidence of microbial keratitis, this study highlights a concerning trend in antibiotic resistance. Although some pathogens became less common, those that persisted have become increasingly difficult to treat. Understanding the clinical and microbiological profiles of microbial keratitis and antimicrobial resistance patterns before and after the COVID-19 pandemic is crucial for informed treatment decisions.

Mapping the patient journey: utilizing clinical informatics for a conceptual approach to identify aspects of emergency department access block

BackgroundThe study aims to map the patient journey in a regional Emergency Department (ED), identify factors causing extended Length of Stay (LOS) in ED during pre-COVID (2016–2019), COVID (2020–2022) and post-COVID (2023), and analyse the patient journey using clinical informatics. Through systematic analysis and root cause identification, the study seeks to establish a learning health system. This system will enhance patient experiences and improve timely and effective care delivery.MethodsSummarized data on ED presentations data were sourced from January 2016 to August 2023 for a 294-bed regional hospital in New South Wales (NSW). The patient’s journey from ED to admission inpatient wards was analysed using clinical informatics. The time spent in each segment of the ED journey was analysed separately and subdivided by specialty for further analysis.ResultsPatient characteristics remained similar year on year. The average ED LOS increased from 5.59 h during the pre-COVID period (2016–2019) to 8.48 h during the COVID period (2020–2022) and 8.52 h during the post-COVID period (2023). The hospital’s bed occupancy rate remained consistent before and during the COVID-19 pandemic, with a slight improvement afterwards, except for a decrease in 2020. The occupancy rate for ED-accessible beds during the pre-COVID period is higher than during the COVID and post-COVID periods. The admission from ED to Inpatient wards decreased from 35% pre-COVID to 28% during COVID. Of the total LOS, the ‘Bed Request’ to ‘Bed Ready’ time segment increased from 11.41% in 2016 to 41.19% in 2022. The admission of medical specialty consistently made up most admissions (32%) which increased during the COVID. The medical specialty also spent the most time in the ED, peaking at 880 min in 2022.ConclusionClinical Informatics is an effective tool to visualise the bottlenecks in clinical workflows. The ‘Bed Request’ to ‘Bed Ready’ time segment was the largest contributor to ED LOS and may have been attributed to a lack of bed availability. Patients took an average of 50 min to be transferred to Inpatient wards upon admission. Future studies could utilize insights gained to develop specific key performance indicators aimed at improving ED LOS. Moreover, we are currently working on improving real-time access to inpatient beds but are currently hampered by the ‘manual update’ of bed status that is controlled by the individual wards. We aim to build an automated system that can monitor and update bed availability (e.g., patient discharge) with minimal human intervention.

Correlation of the severity of the clinical presentation of SARS-CoV-2 pneumonia with respiratory function parameters in the post-COVID period.

Since COVID-19 first surfaced in 2019, it has seriously threatened public health. The most prevalent symptoms are respiratory ones. This study aimed to present the correlation between the severity of the clinical presentation of the disease and the results of respiratory function tests conducted within 6 months after hospital discharge. This retrospective study included 99 patients with confirmed SARS-CoV-2 virus infection. Of all patients 24.2% had accentuated bronchovascular pattern, 9.1% had unilateral, and 29.3% had bilateral pneumonia. In comparison, 35.4% patients had diffuse changes, which were described as acute respiratory distress syndrome (ARDS) on computed tomography (CT). Patients with unilateral, bilateral pneumonia or diffuse lung damage had significantly lower forced vital capacity (FVC) values. They were treated with non-invasive mechanical ventilation (NIV) or invasive mechanical ventilation (MV) and had lower FVC values (0.039). A negative, weak correlation existed between CT findings during the infection and Diffusing capacity for carbon monoxide (DLCO) measured after the infection (0.003). A negative, weak correlation was found between oxygen therapy, the use of NIV, and MV findings during the infection with DLCO. A negative correlation was noted between leukocyte values during the infection and forced expiratory volume in the first second (FEV1) and FVC after the infection. Patients with COVID-19 infection who need oxygen support and MV continue to suffer from loss of respiratory function after the resolution of COVID-19 infection. These findings highlight the negative predictive value of pulmonary tests in the long-term follow-up for the development of PC-ILD as well as decreased pulmonary capacity.

Zinc pathogenic importance in correcting immunity and restoring public health in the post-COVID period: An overview

Context: The problem of correcting immune system function and compensating for co-morbidities becomes particularly clinically significant in the post-COVID period. There is evidence that certain trace elements in the human body, particularly zinc ions, play a critical role in restoring the function of the immune system and internal organs. Objective: To analyze the mechanisms of zinc action maintaining the body homeostasis in order to justify pathogenetically the inclusion of zinc drugs in the therapy of patients in the post-COVID period. Methods: Data from Elsevier, Global Health, PubMed-NCBI, Embase, MEDLINE, Scopus, Research gate, RSCI Scopus, Cochrane Library, Google Academy, e-LIBRARY.RU and CyberLeninka were used. Results: This review showed that the importance of zinc in maintaining body homeostasis in the post-COVID period is determined by its multifaceted effect on all parts of the immune system, its anti-inflammatory activity, antimicrobial properties and participation in the restoration of internal organ function. Elimination of zinc deficiency in the post-COVID period is essential to support immunity, compensate for comorbidities and reduce the risk of complications. The impossibility of synthesizing zinc in the body requires its constant intake in sufficient quantities. Zinc levels are significantly reduced after infectious diseases, as this element is specifically distributed to organs and tissues to maintain immunological and metabolic functions. The degree of zinc deficiency is associated with the severity of COVID-19 and the post-COVID period. It is pathogenetically justified to prescribe zinc drugs in the post-COVID period, the choice of which should take into account comorbidities and severity of hypozincemia. Conclusion: Regularly administered therapy with zinc drugs in the post-COVID period will help correct the population immunity and restore public health.

Abstract C129: Adapting to disruption?: Changes in colorectal cancer screening modalities and disparities during the COVID-19 pandemic

Abstract Research Objective: At-home colorectal cancer screening methods, such as Fecal Immunochemical Tests (FIT), offered a safer, convenient alternative to in-clinic procedures like colonoscopies during the COVID-19 pandemic. Racial and ethnic minorities were more likely to use these tests prior to the pandemic, but it is unclear whether disparities in colorectal cancer screening changed because of the pandemic. We examined rates of colorectal cancer screening before and after shutdown periods across race/ethnicity, age, and income among health plan enrollees in the United States to inform screening catch-up strategies after COVID-19 disruptions. Study Design: We conducted a retrospective analysis of cancer screening claims from Optum Clinformatics Data Mart among enrollees from 2019-2021. Monthly screening volume was calculated for a three-year period, with January 2019-February 2020 as the pre-pandemic period, and July 2020-December 2021 as the post-pandemic period. We conducted an event study to calculate group-level monthly predicted probabilities of screening using a linear probability model with group interactions by month, controlling for demographic variables and comorbidities. Additionally, we used difference-in-difference (DD) regressions including group interacted with a post-pandemic dummy. The pandemic closure period months were excluded from our DD analysis. Eligible enrollees included those ages 40-75 with continuous enrollment 12 months prior to screening index month. Colorectal cancer screening claims included codes for colonoscopies and other endoscopic procedures as well as FIT and FOBT tests. Results: 2,576,760 health plan enrollees were included. Colonoscopy rates did not change significantly between the pre-COVID period and post-COVID period, however FIT test screening rates dropped from an average of 0.66% of age-eligible enrollees screened per month in the pre-pandemic period to 0.58%. Our difference-in-difference results suggested Hispanic-NH White disparities in FIT tests widened. For colonoscopy, Hispanic-NH White and Asian-White disparities widened, while Black-White disparities decreased. Conclusions: Despite the promise that in-home FIT testing would substitute for colonoscopy during the pandemic, we saw a much larger decline in FIT testing rates during the pandemic than for colonoscopy and increasing disparities. This study highlights the need for targeted strategies to address screening disparities exacerbated by the COVID-19 pandemic, particularly among Hispanic and NH-Asian populations. Citation Format: Cameron M. Kaplan, Willow Pastard, John Thacker, Todd Schneberk, Chun Nok Lam, Sarah Axeen, Jennifer Tsui. Adapting to disruption?: Changes in colorectal cancer screening modalities and disparities during the COVID-19 pandemic [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C129.

Changes in the medical admissions and mortality amongst children in four South African hospitals following the COVID-19 pandemic: A five-year review.

Vulnerable children from poor communities with high HIV and Tuberculosis(TB) burdens were impacted by COVID-19 lockdowns. Concern was raised about the extent of this impact and anticipated post-pandemic surges in mortality. Interrupted time series segmented regression analyses were done using routinely collected facility-level data of children admitted for medical conditions at four South African referral hospitals. Monthly admission and mortality data over 60 months from 01 April 2018 to 31 January 2023 was analysed using models which included dummy lockdown level variables, a dummy post-COVID period variable, Fourier terms to account for seasonality, and excess mortality as a proxy for healthcare burden. Of the 45 015 admissions analysed, 1237(2·75%) demised with significant decreases in admissions during all the lockdown levels, with the most significant mean monthly decrease of 450(95%, CI = 657·3, -244·3) p<0·001 in level 5 (the most severe) lockdown. There was evidence of loss of seasonality on a six-month scale during the COVID periods for all admissions (p = 0·002), including under-one-year-olds (p = 0·034) and under-five-year-olds (p = 0·004). No decreases in mortality accompanied decreased admissions. Post-pandemic surges in admissions or mortality were not identified in children with acute gastroenteritis, acute pneumonia and severe acute malnutrition.During the COVID-19 pandemic, paediatric admissions in 4 hospitals serving communities with high levels of HIV, TB and poverty decreased, similar to global experiences; however, there was no change in in-hospital mortality. No post-pandemic surge in admissions or mortality was documented. Differences in the impact of pandemic control measures on the transmission of childhood infections and access to health care may account for differing outcomes seen in our setting compared to the global experiences. Further studies are needed to understand the impact of pandemic control measures on healthcare provision and transmission dynamics and to better inform future responses amongst vulnerable child populations.

Impact of coronavirus disease 2019 pandemic on dental student's performance across disciplines during community site rotations: A comparative analysis.

The coronavirus disease 2019 (COVID-19) pandemic disrupted educational frameworks worldwide, particularly affecting health professions education. The impact on students varied based on local pandemic severity, public health policies, and institutional capacities. Our observational, retrospective study evaluated the impact of the COVID-19 pandemic on senior dental students' performance during community rotations at Indiana University School of Dentistry. Data from student self-assessments and faculty evaluations, collected as part of the Community-Based Dental Education (CBDE) course between 2018 to 2022 was utilized. Five key domains of patient care: diagnosis and treatment planning, clinical skills, time management, interprofessional collaboration, and professionalism was assesed using a 5-point Likert scale. Pre- and post-pandemic comparisons of self-reported student evaluation and faculty assessment scores were conducted using two-sample t-tests, with ANOVA used to analyze cohort differences. Significant declines were observed in mean scores for diagnosis and treatment planning, clinical skills, time management, and interprofessional collaboration during the post-COVID period compared to pre-COVID levels (p<0.05). Conversely, an increase in average scores related to students' professionalism was noted, although this difference was not statistically significant (p>0.05). Class cohort-wise analysis showed similar patterns, with all cohorts experiencing significant declines in the aforementioned areas (p<0.05) and non-significant increases in professionalism scores (p>0.05). This study findings underscore the challenges faced by dental education in adapting to pandemic-induced disruptions and highlight the importance of adaptive approaches and support systems to address these challenges. Moving forward, resolving disparities in assessments and comprehending the various factors influencing student performance will be crucial to preserving the adaptability and effectiveness of dentistry education in the face of adversity.

Multiplex analysis of post-Covid cardiorenal complications in patients with type 1 and type 2 diabetes mellitus according to the mobile diagnostic and treatment center (Diamobil)

BACKGROUND: Patients with diabetes mellitus (DM) are at risk for a higher incidence and severity of COVID-19, as well as its adverse outcomes, including post-Covid syndrome.AIM: to assess the incidence of cardiorenal complications in patients with type 1 and type 2 diabetes (T1DM/T2DM) who have had COVID-19, and to analyze the structure and severity of disorders according to examination data at the Diamobil mobile medical diagnostic and treatment center.MATERIALS AND METHODS: a cohort of T1DM and T2DM patients examined in Diamobil (n=318), with a confirmed anamnesis of COVID-19 (n=236). The time interval between COVID-19 and the visit to Diamobil was 8.7/8.2 months for T1DM/T2DM. The parameters of the last visit before COVID-19 recorded in the Federal Register of Diabetes (FRD) were used as initial data.RESULTS: Clinical characteristics of patients with T1DM/T2DM: age — 49.2/64.5 years, duration of DM — 22/11 years, proportion of women — 64/73%, respectively. After analysis the data from visits before and after COVID-19 there weren’t statistically significant differences in HbA1c levels for both types of DM (before 9.0/8.3%; after 8.4/8.2%, respectively), there was the intensification of glucose lowering therapy (the proportion of patients with T2DM on 2 and 3 component therapy increased by 4.3% and 1.6%, the proportion of patients on insulin therapy by 16%). After COVID-19, there was a statistically significant decrease in glomerular filtration rate (GFR) in T1DM from 88.1 to 62 ml/min/1.73 m2; with T2DM from 74.7 to 54.1 ml/min/1.73 m2. When assessing acute diabetic complications, there was an increase in the frequency of coma in T1DM by 1.5 times, severe hypoglycemia in T1DM by 3 times, and in T2DM by 1.7 times. Analysis of the frequency of cardiorenal complications before and after COVID-19 showed a total increase of 8.5% in T1DM, by 13.2% in T2DM, of which myocardial infarction, ischemic heart disease, and CHF increased in T1DM in the range from 1.5 to 5 times, with T2DM by 1.3 times, the frequency of CKD with T1DM by 1.5 times, with T2DM by 5.6 times.CONCLUSION: There was a decline of kidney filtration function (decrease in GFR) and an increase in the frequency of cardiovascular complications in both types of diabetes in post-Covid period while patients achieved a stable HbA1c levels by intensifying therapy during the COVID-19 infection. This fact reflects combined damage to the kidney and cardiovascular system as a part of the post-Covid syndrome and determines a key set of measures for the development of preventive strategies.

Lung function in patients with asthma in the post-COVID period

Aim. To assess the lung function in patients with bronchial asthma (BA) after new-onset coronavirus infection.Materials and methods. Fifty-five patients who underwent COVID-19 participated in the study under conditions of voluntary informed consent. The main group consisted of 30 patients with mild BA, the comparison group – 25 patients without chronic respiratory diseases (CRD). According to chest computed tomography (CT) findings, the degree of lung parenchyma involvement was classified as follows: mild COVID-19 (CT 0 stage) in 14 patients; moderate COVID-19 (CT 1-2 stages) in 27 patients; and severe COVID-19 (CT 3-4 stages) in 14 patients. Lung function tests were conducted once, adhering to both Russian and international standards.Results. In patients with BA, obstructive pulmonary function impairment was predominant at CT 1-2 stages (79%), CT 0 stage (67%), and CT 3-4 stages (43%). Lung diffusion capacity (LDC) was impaired predominantly in CT 3-4 stages in both BA patients and those without CRD, occurring in 57% of cases. Analysis of lung function showed that LDC reduction was detected in 17% of BA cases and 24% of non-CRD cases. There were no statistically significant changes in pulmonary ventilation among BA patients with impaired LDC compared to patients without CRD.Conclusion. All patients with respiratory symptoms after COVID-19 should undergo comprehensive lung function assessment to identify bronchial obstruction, impaired lung diffusion capacity, and ensure timely intervention.

The Impact of COVID-19 on Mental Health Outcomes among Recipients of Ontario Social Assistance Benefits

Objectives/ApproachWe linked the Ontario Social Assistance (OSA) Benefit Unit file from the Ministry of Children, Community and Social Services to provincial health administrative datasets housed at ICES to examine the impact of COVID-19 on Mental Health and Addictions (MHA) service use among OSA recipients. Those receiving OSA benefits for February 2020 were matched to Ontario residents not receiving benefits based on age (±1 year), sex, income, expected resource utilization, and area of residence (N=771,891 matched pairs). We computed rates of MHA-related emergency department (ED) visits and hospitalizations in the 16-month period before (November 2018-February 2020) and after (March 2020-June 2021) pandemic onset. ResultsMHA-related ED visit rates were much greater among OSA recipients (8.82 per 1,000 person-months) compared with matched controls (1.83 per 1,000 person-months) in the post-COVID period (Relative Rate [RR]=4.82; 95% Confidence Interval [95%CI] 4.75-4.89). Comparatively, MHA-related ED visit rates were also greater among OSA recipients (9.85 per 1,000 person-months) compared with controls (2.38 per 1,000 person-months) during the pre-COVID period (RR=4.13; 95%CI 4.08-4.18). The pre-COVID and post-COVID period RRs comparing OSA recipients and matched controls were significantly different (p&lt;0.001). Results were consistent when examining MHA-related hospitalizations. Conclusions/ImplicationsWhile MHA-related ED visits and hospitalizations rates were significantly higher in OSA recipients than matched controls in both time periods, this difference increased following the onset of COVID-19. Increased reliance on hospital-based MHA services post-COVID represents the greater ongoing need for, and/or reduced access to, MHA-related ambulatory care for OSA recipients during the pandemic.

Lessons from the pandemic era: do we need new strategies to improve conservative treatment adherence in adolescent idiopathic scoliosis? A retrospective analysis.

This study aims to examine whether the COVID-19 pandemic affected the adherence to conservative AIS treatment. Adolescent Idiopathic Scoliosis (AIS) is characterized by a lateral curvature of the spine of at least 10 degrees. Compliance rates in conservative treatments are influenced by various factors. From a database of AIS patients, we selected 30 AIS patients who were assessed before, during, and after the COVID-19 pandemic. Data regarding Cobb's angle, brace prescription, prescribed brace wear time, brace wear compliance, and time dedicated to sports activities were collected over a six-year period from January 2018 to December 2023, divided into three 2-year time periods (before, during, and after COVID-19). There was an increased percentage of AIS patients prescribed with a brace during the pandemic. However, no significant differences in Cobb's angle were observed. Additionally, the prescribed wear time showed a significant decrease from the pre-COVID period to the post-COVID period (p-value = 0.03). Wear compliance exhibited a decreasing trend from pre- to during- and post-COVID-19 periods without reaching statistically significant differences, and the time dedicated to sports statistically significantly decreased. These differences were statistically significant when comparing the pre- vs. post- and pre- vs. during-COVID-19 periods (p-values 0.01, 0.04, respectively). Our study highlights changes in AIS conservative treatment during and after the COVID-19 pandemic. The increase in the number of patients prescribed with a brace during the pandemic, although not supported by an increase in Cobb's angle, may be attributed to the concerns about regular monitoring during the reduction of rehabilitation services. The observed decreases in brace compliance and involvement in sport activities, which persisted even in the post-pandemic period, emphasizes the lasting impact of the pandemic on AIS management, necessitating innovative approaches to address these ongoing concerns.