pre-COVID Era Research Articles

COVID-19 reduced scleral buckling training in fellows and shifted young ophthalmologists' preference toward vitrectomy: An Asia-Pacific survey.

To assess rhegmatogenous retinal detachment (RRD) surgery trends and training among young ophthalmologists (YOs, vitreoretinal fellows or attendings/consultants with ≤10 years of independent practice) and the impact of the COVID-19 pandemic. An anonymous online survey was completed by 117 YOs in the Asia-Pacific regarding their RRD surgery experiences in 2021-2022. To achieve a 90% probability of surgical competency, 91 vitrectomy and 34 scleral buckling (SB) completions during fellowship were needed. In total, 49 (41.9%) YOs had fellowship affected by COVID-19. In the COVID versus pre-COVID era, however, the volume of SB completions per fellowship year decreased significantly (median [IQR] 3.3 [1.5, 9] vs. 13 [6.5, 23]; p < 0.001) and was lower than the required volume to achieve competency. YOs were less confident in conducting SB versus vitrectomy (3.5 ± 1.1 vs. 4.2 ± 0.8, p < 0.001), and they reported a decrease in the proportion of SB (-3.1%, p = 0.047) and an increase in the proportion of vitrectomy (+4.8%, p < 0.001) after the pandemic outbreak. Apart from RRD clinical characteristics, surgical confidence is among the main factors that affect surgical method decisions. During the pandemic, more YOs may have avoided SB due to the need for general anaesthesia, leading to longer surgical time and risk of viral transmission during intubation/extubation. SB surgical exposure is suboptimal in most fellowship programs in the 11 Asia-Pacific countries/regions we surveyed and further declined during the COVID-19 pandemic. YOs are less confident in performing SB, leading to a trend toward primary vitrectomy since the COVID-19 outbreak.

Exploring cloud computing adoption: COVID era in academic institutions

Cloud computing (CC) is a revolution that can provide information technology (IT) as a service. CC offers infrastructure, platform, and software services, as demand peaks and surges. This paper aims to investigate how prospective adopters behave when external factors such as “Coronavirus Pandemic- COVID-19” impact their technology adoption decision-making. The study also explores how a prospective adopter behaves i.e., if his/her intention to adopt any new innovation increases in presence of stronger disruptive factors (COVID-19). This research empirically examines if the intent to adopt secured (online) services impacts actual CC adoption (CCA) in pre-COVID-19 and during COVID-19 eras. It also provides an idea of how prospective adopters behave when they face disruptions caused by the pandemic situation, and how the holistic relation is reflected in terms of its influence on academic performance. This study has used Technology Acceptance Model (TAM) with sequential mediation effect of intent to adopt secured online services and CCA on Academic Performance (AP) using a sample of 867 students from 25 different Indian universities in Tier 1 and Tier 2 cities. Using AMOS, a structural equation modelling was conducted to test the research model. The results highlight that there is a significant difference between the influence of perceived usefulness (PU) as well as perceived ease of use (PEOU) on CCA due to COVID-19. The results also provide empirical evidence of gender moderating the relationship of PU as well as PEOU with CCA. This is the first study that provides comparative results from pre-COVID and post-COVID era, this work provides a reference point to practitioners and academicians, especially when evaluating factors before making a final decision regarding any emerging technology's adoption.

Digitize to reach and track: An retrospective analysis of digitalized immunization data for children under one year in Bangladesh from Pre-COVID and during-COVID era

Digitize to reach and track: An retrospective analysis of digitalized immunization data for children under one year in Bangladesh from Pre-COVID and during-COVID era

A COMPARATIVE STUDY OF SCREEN TIME AND ITS EFFECTS IN PRE-COVID AND COVID-ERA IN CHILDREN OF 5 TO 15 YEARS

Objective: The objective of this study was to compare the screen time (ST) in pre-COVID and COVID era in children aged 5–15 years and to analyse the ST effect in pre-COVID and COVID era in the children. Methods: The study was done at Vivekananda Polyclinic and Institute of Medical Sciences, Lucknow. Two hundred and seventy-six children aged between 5 and 15 years, attending outpatient department or inpatient department were enrolled in the study. Results: It was observed that the ST was significantly increased in post-COVID as compared to pre-COVID time and the difference was statistically significant (p&lt;0.0001*). It was also observed that the screening time was significantly increased in post-COVID as compared to pre-COVID time and the difference was statistically significant (p&lt;0.0001*). Conclusion: The present study found that when screening duration was analysed, the screening time during COVID-19 was significantly longer than the screening time before COVID-19 which may be associated with the various health problems reported among children during COVID-19 pandemic.

SARS‐CoV‐2‐related polyradiculitis must be preceded by PCR‐confirmed COVID‐19

We read with interest the article by Pourbahtyaran et al. about a prospective study on seven pediatric patients with SARS-CoV-2-associated Guillain Barre syndrome (GBS) recruited between March 2020 and August 2021 in a single Iranian center.1 These patients were compared with 15 GBS patients who were negative for SARS-CoV-2 mRNA as well as antibodies recruited during the same period.1 It was found that the prevalence of GBS did not increase during the pandemic compared with previous years but that the outcome of SARS-CoV-2-related GBS was worse compared with non-COVID-related GBS.1 The study is appealing but carries limitations that raise concerns and should be discussed. The main limitation of the study is that SARS-CoV-2 infection was diagnosed in six patients with SARS-CoV-2-related GBS only by determination of antibodies against SARS-CoV-2.1 It was not communicated whether these antibodies were of the IgG or IgM subtype.1 It was also not discussed that these antibodies can persist for months, why establishing a causal relationship between SARS-CoV-2 infection and GBS is not reliable in these six patients. They should be excluded from the evaluation. Given the fact that the latency between the onset of infection and the onset of neurological manifestations ranged between 2 and 30 days, it is surprising that only one-seventh of patients was PCR-positive for SARS-CoV-2.1 A second limitation of the study is that no information about the cerebrospinal fluid (CSF) findings was provided.1 GBS is usually diagnosed according to the Brighton criteria2 and for level 1 diagnosis of GBS it is mandatory that patients have typical CSF findings. We should be told how many of the seven patients with SARS-CoV-2-related GBS had dissociation-cyto-albuminique and how many did not show this abnormality. Furthermore, CSF can be examined for cytokines, chemokines, glial factors, and 14-3-3, which have been shown elevated in patients with neuro-COVID.3 We disagree with the conclusion that the prevalence of GBS did not increase during the pandemic. First, the number of patients is too small to draw such conclusions. Strictly speaking, only a single patient had SARS-CoV-2-related GBS. In the remaining patients, the acute SARS-CoV-2 infection remained unconfirmed. Second, the pandemic is ongoing and thus lasts more than 3 years. To compare prepandemic prevalences with those during the pandemic patients from the entire pandemic period should be recruited. Third, the pre-COVID period with which COVID patients were compared with is not mentioned. Because GBS prevalences may have undulated in the pre-COVID era, it is crucial to know the exact time of recruitment. Regarding the 15 years old female with lupus erythematosus, we should know about her long-term immunosuppressive treatment. Immuno-suppressed patients are more susceptible to infectious diseases, and since she was SARS-CoV-2 negative, another pathogen is more likely to be the cause. Overall, the interesting study has limitations that call the results and their interpretation into question. SARS-CoV-2-related GBS should only be diagnosed in patients with a PCR-confirmed SARS-CoV-2 infection time linked with the onset of GBS. JF: design, literature search, discussion, first draft, critical comments, final approval. None. No funding was received. The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. This article is based on previously conducted studies and does not contain any new studies with human participants or animals performed by any of the authors. All data are available from the corresponding author.

Kawasaki like illness in COVID versus Kawasaki disease in pre-COVID era

Background: In children and adolescents, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is mostly responsible for mild respiratory symptoms, in contrast with severe forms reported in adults. An association between the disease caused by SARS-CoV-2, coronavirus disease 2019 (COVID-19), and late manifestations of vasculitis has been increasingly suspected. Method: All children and adolescents (aged ≤18 years) who were diagnosed with Kawasaki disease (KD) and KD shock syndrome (KDSS) as per AHA and Kanegaye et al criteria. From each patient we obtained at least two nasopharyngeal swabs to test for SARS-CoV-2 using reverse transcription- polymerase chain reaction (RT-PCR). We also took blood samples to test for IgG antibodies against SARS-CoV-2. Results: Leucocytosis was found in majority with median leucocyte count of 10100 predominant neutrophila. Inflammatory markers D dimer, serum ferritin and fibrinogen level were raised. The 43% patients had coronary artery aneurysm. The 75% patient had some form of Left ventricular systolic dysfunction. All patients received IVIG while 13 patients received both IVIG and methyl predinisolone. Ionotropes were used in 68%. Two patients received tocluzumab. Conclusions: In this study we found increased incidence of Kawasaki like illness temporally associated with COVID-19. Older age of presentation with more atypical presentation.

Impact of COVID-19 pandemic on general surgical practice at tertiary care hospital in Pakistan - A single center analysis

The Coronavirus Disease 2019 (COVID-19) has adversely affected the global healthcare system, especially the management of surgical diseases. Most guidelines issued during pandemic recommended deferral of elective surgeries to decrease transmission and conserve resources for COVID-19 management, which raised the risk of complications. This study was conducted to evaluate the impact of the COVID-19 pandemic on the general surgical practice of a tertiary healthcare facility in Sindh, Pakistan. The data were retrospectively retrieved from the operation room records for most common general surgical procedures performed between January 2019 to December 2020 (i.e. peak COVID-19 restriction period). Monthly frequencies of the enrolled procedures were compared to COVID-19-associated incidence, recoveries, and mortality in Sindh. The six enrolled procedures suffered a reduction of 23.9% from 2019 to 2020. However, the difference was not significant (p &gt;0.05) for the procedures collectively or individually, except for trucut biopsy (p =0.042). COVID-19-associated mortality significantly influences the frequency of the surgical procedures, compared to the pre-COVID era (p =0.042). However, the association was significant for the procedures collectively only, but in the individual procedure, only open inguinal hernia repair (p =0.011) showed a significant difference. In conclusion, there was a significant reduction in surgical cases with the potential risk of complications. Therefore in such situations, there must be a developed system to that the cases may be decided on an individual basis.

Pre-covid and peri-covid analysis of employees' work values and job quality

PurposeThe workspace has experienced several significant changes (shift in work culture) due to the Covid-19 pandemic thereby necessitating the need for a comparative assessment of differences that exist in work values and job quality of employees pre-covid 19 and “peri”-covid 19.Design/methodology/approachThe Statistical Package for Social Sciences (SPSS) version 21 was employed to conduct a correlation and T-test analysis from the quantitative data gathered from Ghanaian public and private sector employees.FindingsThe study found differences in what employees valued pre- and peri-covid era for job security, promotional opportunities, interesting work, using skills and experience, the usefulness of work to society and flexible work. During the pre-covid era, employees perceived autonomy, personal contact and stressful jobs, whereas promotional opportunities, good collegial relations and help to others were experienced peri-covid.Research limitations/implicationsAlthough the study tracked the work values and quality of employees, the respondents (pre-covid and peri-covid) were different. Responses here captured the views of formal sector workers only. These notwithstanding, the findings are important for explaining changes (work values and job quality) that occurred due to the pandemic. Future research might use a qualitative approach to understand reasons behind these changes.Practical implicationsDue to changes in the working space and the introduction of technology, stress has been impacted positively as employees need not commute frequently to work and work seems to have been simplified. It is therefore safe for organisations to retain changes to people management due to the pandemic.Originality/valueTo the best of my knowledge, this is the first study in the Ghanaian context comparing employees' values and job quality pre- and peri-covid.

Role of economic, and social parameters affecting life satisfaction and happiness during pre and post Covid era: a study with Marx’s perspective

A cognitive, objective, and subjective evaluation of the judgment of one's perspective of looking at life defines as life satisfaction and happiness. There is a strong association between life satisfaction, joy, and external parameters, including environmental and socioeconomic factors and green innovation technologies. Marx's theory on life satisfaction provides an exciting insight and defines that economic resources are necessary to live comfortably. The core objective of this paper is to examine the effects of contributing parameters concerning life satisfaction and happiness (LSH) in China from 2005 to 2020. For this purpose, data collected for the dependent variable collect World Happiness Index and World Bank official website. Nine independent variables related to LSH discuss freedom to make life choices (FMLC); GDP growth; Social contribution (SC); Employment rate (ER); Social support (SS); Innovation and development (ID); Life expectancy (LE); Coverage of social safety (CSS); High qualification (HQ). The maximum LSH value is 5.77, with a mean value of 5.13. The highest coefficient correlation value with LSH is CO2, with a positive correlation coefficient value of 0.80, followed by GDPG, with a negative coefficient value of 0.80. PC1 explains 76.74% of results, whereas MLR produces 0.91 R2 (p-value: 0.093, Residual standard error: 0.181). There is a need to understand correlates and determinants in further detail to set up a framework that enables policy-makers to incorporate well-being and life satisfaction measures in carving new public policies.

Treatment Patterns and Outcomes of Patients with Grade 4 Glioma Treated with Radiation during the COVID-19 Pandemic

During the first year of the COVID-19 pandemic there was a global disruption in the provision of healthcare. Grade 4 gliomas are rapidly progressive tumors, and these patients are at risk of poorer outcomes due to delays in diagnosis or treatment. We retrospectively evaluated the impact of the pandemic on treatment patterns and outcomes of patients with grade 4 gliomas in British Columbia. We identified a cohort of 85 patients treated with radiotherapy between March 2020-2021 (COVID era) and compared baseline characteristics, treatments, and outcomes with a control cohort of 79 patients treated between March 2018-2019 (pre-COVID era). There were fewer patients treated with radiotherapy over age 65 in the COVID era compared to the pre-COVID era (p = 0.037). Significantly more patients were managed with biopsy relative to partial or gross total resection during the COVID era compared to the pre-COVID era (p = 0.04), but there were no other significant differences in time to assessment, time to treatment, or administration of adjuvant therapy. There was no difference in overall survival between eras (p = 0.189). In this assessment of outcomes of grade 4 gliomas during the pandemic, we found that despite less aggressive surgical intervention during the COVID era, outcomes were similar between eras.

Marching Ahead through the Pandemic: Continuing Anesthesia Services in COVID Era-Our Experience from a Tertiary Care Cancer Centre.

Swati BhanIntroduction This paper aims to provide an overview of the administrative and clinical preparations done in a tertiary care cancer hospital in continuing operation theatre (OT) services through the COVID pandemic. Methods Retrospective data collection, data for the past 1.5 years (COVID period) March 2020 to August 2021 were compared to surgical output for a similar duration of time before the COVID era (September 2018-February 2020). Results A total of 1,022 surgeries were done under anesthesia in the COVID period as against 1,710 surgeries done in a similar time frame in the pre-COVID era. Overall, we saw a 40%drop in the total number of cases. Thorax, abdominal, and miscellaneous surgeries (soft tissue sarcomas, urology, and gyneconcology) saw a maximum fall in numbers; however, head and neck cases saw an increase in numbers during the pandemic. Surgical morbidity and mortality were similar in the COVID and pre-COVID era. No cases of severe COVID infection were reported among the healthcare staff working in OT. Discussion We could successfully continue our anesthesia services with minimal risk to healthcare staff throughout the pandemic by adopting major guidelines in a pragmatic and practical approach with minor changes to suit our setup.

Global Supply Chain in Covid-19 Crisis

Amid the Covid-19 crisis, one of the biggest challenges that developing and even developed countries faced was the disruption in the global supply chain. In past decades, there has been an over-reliance on China, the largest manufacturing hub. But when the pandemic hit the world, subsequent lockdowns were imposed. This greatly affected the efficiency of supply chain management. The paper discusses the importance of the global supply chain and how Covid-19 affected the chain. Also, the difference between the pre-Covid era and the post-Covid era has been studied so to understand the necessity of moving from efficiency to resilience.

Abstract P1-05-22: The Impact of the COVID-19 Pandemic on Breast Cancer Diagnoses in San Antonio, TX

Abstract Introduction: Breast cancer is the most frequently diagnosed cancer and the second leading cause of cancer death in women in the United States. The significant advances in care over the last decades are largely attributable to early detection and treatment. The pre-COVID-19 pandemic 5-year survival rate of breast cancer was in the range of 90%, however, there has been public concern that the pandemic has led to delayed diagnosis. The objective of this study was to determine if patients diagnosed during the pandemic had more advanced breast cancer at presentation compared to those diagnosed prior. Methods: This is a retrospective study of patients with an ICD code for Breast Cancer seen within the University of Texas Health San Antonio MD Anderson Cancer Center between 1/1/2018 and 12/31/2021. Data abstractors collected information on gender, age, race, ethnicity, funding, screening mammogram dates, date of cancer diagnosis, stage at diagnosis, and treatment. Those diagnosed before 1/1/2018 or that received initial treatment outside our institution were excluded from the analysis. Pearson’s Chi-squared and logistic regression tests were used to determine the relationship between time and stage at diagnosis. The timeline was divided into three periods: from 01/01/2018 to 03/31/2020 as the pre-COVID era, from 04/01/2020 to 12/31/2020 as the lockdown period, and from 01/01/2021 to the present as the post-vaccine era. Results: A total of 696 patients with breast cancer were included. There was a significant statistical difference between the cancer stage at diagnosis in the pre-COVID-19 era compared to the lockdown period and the post-vaccine era (p= 0.003, table 1). Therefore, patients diagnosed after the beginning of lockdown were more likely to have more advanced cancer as time progressed. The odds ratio for Tis stage was 0.38 (95% CI: 0.23-0.60; P &amp;lt; 0.001) in the post-vaccine era compared to the pre-COVID era. The OR for Tis stage was not statistically significant (OR, 0.68; 95% CI: 0.42-1.10; P &amp;lt; 0.12) when comparing the lockdown period to the pre-COVID era. Conclusion: Patients diagnosed with breast cancer in the COVID-19 pandemic were more likely to present with more advanced disease at diagnosis compared to those diagnosed in the pre-COVID-19 era confirming our hypothesis. The OR of presenting with Tis disease when diagnosed during the post-vaccine compared to the pre-COVID-19 era was 0.38, however, this was not seen when comparing the lockdown period to the pre-pandemic era. We believe this difference was not significant because delays in cancer care may take months to years to take full effect. Table 1. Breast cancer stage at diagnosis per period. Citation Format: Gabriel Roman Souza, Tamarah Aldawoodi, Juzar Hussain, Lauren C. Jameson, Lauren Rahman, Nomso C. Agim, Jonathan Gelfond, Marcela Mazo-Canola. The Impact of the COVID-19 Pandemic on Breast Cancer Diagnoses in San Antonio, TX [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P1-05-22.

Hong Kong poison information centre: Annual report 2020

Background:The Hong Kong Poison Information Centre has provided consultation service to healthcare professionals and collected epidemiological data on poisoning in Hong Kong since 2005.Objective:To analyse and report the poisoning data of Hong Kong Poison Information Centre in 2020 during the COVID‐19 pandemic.Methods:A retrospective review of all poisoning cases recorded in the Poison Information and Clinical Management System of Hong Kong Poison Information Centre in 2020.Results:A total of 3633 poisoning cases were analysed. Compared to 2019 (pre‐COVID era), there was a reduction of ~10% of total poisoning cases recorded (383 cases), with a majority (&gt; 90%) of reduction from poisoning cases with no clinical effect (353 cases). A greater proportion of reduction was observed among the children (0–12 years), patients with general unintentional poisoning, poisoning due to therapeutic error and food poisoning. An increased number of cases was noted from abusive use, adverse herb/proprietary Chinese medicine reaction and poisoning related to household bleaches. Teenage (13–19 years) poisoning seemed to be unaffected by the COVID‐19 pandemic and the previously observed increasing trend continued (up to 11.8% of total poisoning cases this year). Despite a total reduction in poisoning cases recorded, the number of deaths increased by 37% from 35 in 2019 to 48 in 2020 (mortality rate 1.5%). A total of seven interesting cases were discussed.Conclusion:This 15th annual report provides updated epidemiological information on poisoning patterns in Hong Kong during the COVID‐19 pandemic. It also highlighted important changes and possible effects of the COVID‐19 pandemic on poisoning in Hong Kong in comparison with our previous reports.

Abstract P1-06-06: Access to medical coverage in newly diagnosed Breast cancer patients a minority population during the COVID 19 pandemic

Abstract Background: Hispanics are among the most significant minorities in the United States, and assessing their health needs is vital in formulating health policies. The social, environmental, and biological background affect their morbidity and mortality, with cancer being the leading cause of mortality in Hispanics. Although implementing the Affordable Care Act improved access to health care, disparities and challenges in Hispanics’ access to health care remain. (1) In our study, we are trying to assess the COVID-19 pandemic implications on the socioeconomic status of Hispanics with newly diagnosed breast cancer and how that is affecting their outcome. Methods: This is a retrospective study demonstrating the nature of breast cancer screening, diagnosis, and management during COVID-19 lockdown and post-vaccine compared to the pre-COVID-19 era. The restrospective review was conducted at Mays Cancer Center in San Antonio, IRB approved by UT Health San Antonio. The data were abstracted from the medical record system (EPIC). Pearson’s Chi-squared and logistic regression tests were used to determine the relationship between time and stage at diagnosis and association with funding status Result: 696 subjects with newly diagnosed breast cancer were identified and divided into three cohorts: Cohort A: 264 pts in a pre-covid era: From 2018-February 2020, Cohort B: 171 patients during the covid-19 lockdown, and Cohort C: from April 2020-Dec-2020 with 261 patients in the post-vaccine era. A higher percentage of patients had Tis identified in Cohort A (26%) compared to Cohort B (19%) and Cohort C(12%) (p0.003). These numbers have changed to an increasing percentage of patients with T1 or T2. N0 or N1in Cohort B (62%) and Chohort C (68%), p0.003). Presentation of locally advanced (T3/T4 with any N) and metastatic disease remained relatively similar in all cohorts, with more metastatic cases at presentation in Cohort A (p0.003). Many patients of Hispanic ethnicity (OR 1.47, p0.1) were not funded by commercial insurance or Medicare. (OR 2.33, 95% CI 1.43, 3.77, p&amp;lt; 0.001). A high proportion of Hispanic ethnicity in post covid era (cohort B and C) OR 1.78, 95% CI (1.16,2.79) (p0.009) required neoadjuvant chemotherapy suggesting more advanced and possibly aggressive cancer histology. We observed that unfunded patients are less likely to have hormonal receptor-positive breast cancer (p0.001). Conclusion: Population health is likely affected by socioeconomic status, which eventually affects their health care. In a minority Hispanic population, low average income and educational attainment are likely the obstacles to getting timely appropriate health.(2) A higher proportion of Hispanic patients were not insured when compared to non-Hispanics leading possibly to more advanced and aggressive histologies at presentation.

Abstract P1-05-20: COVID-19 Lockdown Resulting in Advanced Cancer and Worse Histology at Presentation in Hispanics

Abstract Background In breast cancer, prognosis is marked by histology and stage at diagnosis. Patients presenting with HER-2 positive or triple negative breast (TNBC) often have a worse prognosis. Early detection of breast cancer is mainly based on yearly screening mammograms, which were disrupted during the lockdown stages of the COVID-19 pandemic. In general, underserved populations, especially the Hispanic population often lack access to preventive care due to lack of funding causing delays in access to timely care. The COVID-19 pandemic caused many patients to miss their annual mammogram screening due to lockdown causing subsequent presentation of more advanced cancer. We, therefore, hypothesized that more patients were diagnosed with advanced cancer after lockdown and worse histology in the Hispanic population compared to the non-Hispanic population of San Antonio, Texas. Methods We identified 3 cohorts retrospectively using chart review: Pre-covid-19 era was defined between 2018 to March 2020. Lockdown is defined as a period between April 2020 to December 2020 followed by the post-vaccine era from January 1st 2021 to 2022. Pearson’s Chi-squared and logistic regression tests were used to determine the relationship between time, histology at diagnosis and ethnicity. Results More Hispanic patients were found to present with HER2+ disease (OR: 1.65. p-value .047) compared to non-Hispanic women. When looking at presentation of HER2+ disease in the pre-covid-19 era, there was a 15.11% increase in the presentation of HER2+ disease in the post-vaccine era. When looking at the presentation of TNBC disease in women, there was not a significant correlation seen in the lockdown or post-vaccine period in Hispanic compared non-Hispanic women. Other factors such as funding status were associated with TNBC at presentation independently of ethnicity. In the lockdown era, the number of newly diagnosed breast cancer patients reached an all-time low and during the post-vaccine era, the patient numbers are back to the pre-covid era. Conclusion Ethnicity in part played a role in the number of patients presenting with more aggressive histology such as TNBC and Her 2 positive breast cancer in the post-vaccine era. These findings may be secondary to fact that certain ethnic groups are more likely to miss preventive screenings and the covid 19 pandemic lockdown exacerbated this problem. Diagnosis of advance cancer can further deter patients from seeking care due to socioeconomic factors and possibly increase mortality in these populations. These findings suggest that there seems to be a correlation between race and presentation of more aggressive histology caused by the effects of the pandemic in cancer care affecting minorities. Citation Format: Juzar Hussain, Gabriel Roman Souza, Tamarah Aldawoodi, Lauren C. Jameson, Lauren Rahman, Nomso C. Agim, Jonathan Gelfond, Marcela Mazo-Canola. COVID-19 Lockdown Resulting in Advanced Cancer and Worse Histology at Presentation in Hispanics [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P1-05-20.

The Psychological Sequelae of COVID-19 Among Disease Survivors in Argentina

Background: While more than a year has passed since the COVID-19 outbreak, it is still a growing health concern. Moreover, ample consensus exists for the presence of not only a physical but also a psychological impact of the COVID-19 pandemic. Those reported as hardest hit were individuals who had been infected with COVID-19. Survivors have exhibited a higher prevalence of psychological morbidity i.e., PTSD, depression, and anxiety- as compared with the general population and health workers. Additionally, COVID-19 patients and survivors have been psychologically impacted by a staggering number of disease-related stressors. Objective: The study was aimed at analyzing COVID-19's impact on the psychological state of Argentinian disease survivors. Method: Two hundred and ninety-six COVID-19 survivors (67.2% female; Mage = 44.81; SDage = 12.16) from a major Buenos Aires hospital completed a questionnaire and a set of psychological measures - COVID-19 emotional impact, psychological sequelae, disease-related stressors, PTSD, and psychological distress. Results: The most impactful psychological sequelae and disease stressors revolved around having the disease awaiting test results, fear of infecting loved ones, being apart from family and friends during the disease, fear of physical sequelae and symptoms, and returning to isolation. PTSD prevalence rates were 33.8%. Survivor's psychological distress levels were moderately higher than pre-COVID-era general population levels, yet not significantly different from pre- COVID-era clinical inpatients. Female gender, age, and hospital admission emerged as significant predictors of increased adverse psychological outcomes. Conclusion: Intervention for COVID-19 survivors is urgently needed, with particular attention to the alarming PTSD prevalence rates, as discussed in the study.

MEDICO-STATISTICAL ANALYSIS OF THE INCIDENCE OF PNEUMONIA, INCLUDING THOSE CAUSED BY COVID-19 IN THE CHERNIVTSI REGION DURING 2018–2021

One of the most urgent problems of modern health care is currently a viral infection caused by SARS-CoV-2, which has acquired both significant medical and social significance. The World Health Organization declared the COVID-19 pandemic on March 11, 2020. The disease is characterized by a polymorphism of the clinical picture from damage to the respiratory tract to pronounced intestinal manifestations, nevertheless, the most severe form remains viral pneumonia caused by COVID-19.&#x0D; The goal. Conducting a medical-statistical analysis of hospital morbidity and mortality from pneumonia caused by COVID-19 in the territory of Chernivtsi region according to the data of 2020-2021, with an overview of the dynamics of morbidity and mortality from pneumonia (J12-J16, J18) in 2018-2019.&#x0D; Object and research methods. The leading research method was the biostatistical method, which was used to confirm the representativeness of the sample population and statistical processing of the materials of form No. 20 for the Chernivtsi region, and data on the average annual population, obtained according to the data of the State Statistics Service of Ukraine (2018-2021).&#x0D; The results. COVID-19-induced pneumonia (IP) has significantly affected the pattern and incidence rate of upper respiratory tract diseases, increasing the proportion of pneumonia more than thrice. COVID-19 IP does not affect children which is to some extent related to the impossibility of transmitting the disease during the pre- and intrauterine periods. In 2020, the average mortality from COVID-19 among the adult population was 0.54‰ and in 2021 – 1.1‰. Mortality in the pre-COVID era, in turn, was not significant, did not exceed 0.015‰.&#x0D; Conclusions. The average mortality in 2021 exceeded the peak mortality of 2019 by 7.3 times which indicates the unpreparedness of the health care system for a challenge of a similar scale, which to a certain extent can be related to both the uncertainty regarding the issues of epidemiology, diagnosis and treatment of this disease and the imperfection of the health care system, which was at an intermediate stage of reformation.

Human capital heterogeneity of the unemployed and jobless recoveries

The jobless recovery enigma remains largely unsolved. As a special case of broader unemployment, the term “jobless recovery” describes an economic recovery where output recovers—and even expands—yet employment growth remains anemic. While the effects of these prolonged recoveries are significant—from increased crime to a lifetime reduction in wages—they are not well understood. Building on the insights of labor market matching models that incorporate heterogeneity among workers, this paper sheds light on jobless recoveries, developing a first-of-its-kind index of human capital heterogeneity for the unemployed, and testing that index using of a Structural Vector Autoregression. I demonstrate that the extent to which unemployed human capital is heterogeneous and specific, rather than homogeneous and general, plays a key and under-appreciated role in the labor market; increases in human capital heterogeneity can account for between one-quarter to three-quarters of the joblessness of the past three recoveries in the pre-COVID era.

Morbidity of elective surgery for breast cancer and propensity score matched analysis of surgical site infection (SSI) in pre-COVID and COVID era

Morbidity of elective surgery for breast cancer and propensity score matched analysis of surgical site infection (SSI) in pre-COVID and COVID era