COVID-19 Infection Rates Research Articles

The relationship between person-centered care in nursing homes and COVID-19 infection, hospitalization, and mortality rates

ObjectivesThis cohort study compared rates of COVID-19 infections, admissions/readmissions, and mortality among a statewide person-centered model known as PEAK and non-PEAK NHs. MethodsRates per 1000 resident days were derived for COVID-19 cases and admissions/readmissions, and per 100 positive cases for mortality. A log-rank test compared rates between PEAK (n = 109) and non-PEAK NHs (n = 112). ResultsRates of COVID-19 cases, admission, and mortality were higher in non-PEAK compared to PEAK NHs. The median rates for all indicators had a zero value for all NHs, but in NHs above 90th percentiles, the non-PEAK case rate was 3.9 times more and the admission/readmission rate was 2.5 times more. Conclusions and implicationsCOVID-19 case, and mortality rates were lower in PEAK than non-PEAK NHs. Although PEAK and non-PEAK NHs may differ in other ways as well, person-centered care may be advantageous to promote infection control and improve outcomes.

COVID-19 infection, admission and death and the impact of corticosteroids among people with rare autoimmune rheumatic disease during the second wave of COVID-19 in England: results from the RECORDER Project.

To calculate the rates of COVID-19 infection and COVID-19-related death among people with rare autoimmune rheumatic diseases (RAIRD) during the second wave of the COVID-19 pandemic in England, and describe the impact of corticosteroids on outcomes. Hospital Episode Statistics data were used to identify people alive on 1 August 2020 with ICD-10 codes for RAIRD from the whole population of England. Linked national health records were used to calculate rates and rate ratios of COVID-19 infection and death up to 30 April 2021. Primary definition of COVID-19-related death was mention of COVID-19 on the death certificate. NHS Digital and Office for National Statistics general population data were used for comparison. The association between 30-day corticosteroid usage and COVID-19-related death, COVID-19-related hospital admissions and all-cause deaths was also described. Of 168 330 people with RAIRD, 9961 (5.92%) had a positive COVID-19 PCR test. The age-standardized infection rate ratio between RAIRD and the general population was 0.99 (95% CI: 0.97, 1.00). 1342 (0.80%) people with RAIRD died with COVID-19 on their death certificate and the age-sex-standardized mortality rate for COVID-19-related death was 2.76 (95% CI: 2.63, 2.89) times higher than in the general population. There was a dose-dependent relationship between 30-day corticosteroid usage and COVID-19-related death. There was no increase in deaths due to other causes. During the second wave of COVID-19 in England, people with RAIRD had the same risk of COVID-19 infection but a 2.76-fold increased risk of COVID-19-related death compared with the general population, with corticosteroids associated with increased risk.

Modeling COVID-19 Infection Rates by Regime-Switching Unobserved Components Models

The COVID-19 pandemic is characterized by a recurring sequence of peaks and troughs. This article proposes a regime-switching unobserved components (UC) approach to model the trend of COVID-19 infections as a function of this ebb and flow pattern. Estimated regime probabilities indicate the prevalence of either an infection up- or down-turning regime for every day of the observational period. This method provides an intuitive real-time analysis of the state of the pandemic as well as a tool for identifying structural changes ex post. We find that when applied to U.S. data, the model closely tracks regime changes caused by viral mutations, policy interventions, and public behavior.

A pilot trial of Thymalfasin (Ta1) to prevent covid-19 infection and morbidities in renal dialysis patients: Preliminary report.

Patients with end-stage renal disease (ESRD) on hemodialysis (HD) are considered particularly susceptible to infection with SARS-CoV2 on the basis of the immunodeficiency associated with advanced age, comorbidity burden, medication use, and need for frequent visits to dialysis clinics. In prior studies, thymalfasin (thymosin alpha 1, Ta1) has been shown to enhance antibody response to influenza vaccine and reduce influenza infection in geriatric populations, including hemodialysis patients, when used as an adjunct to influenza vaccine. Early in the COVID-19 pandemic we speculated that administration of Ta1 to HD patients would result in reduced rate and severity of COVID-19 infection. We also hypothesized that HD patients treated with Ta1 who did become infected with COVID-19 would have a milder course of infection in terms of hospitalization rates, requirement for and length of ICU stays, requirement for mechanical ventilation, and survival. Further, we proposed that patients who avoided COVID-19 infection during the study would have decreased non-COVID-19 infections and hospitalizations compared to controls. The study launched in January 2021 and, as of July 1, 2022, 254 ESRD/ HD patients from five dialysis centers in Kansas City, MO have been screened. Of these, 194 patients have been randomized 1:1 to either Group A (1.6mg Ta1 given subcutaneously twice weekly for 8weeks), or Group B (control group not receiving Ta1). After the 8-week treatment period, subjects were followed for an additional 4months and monitored for safety and efficacy. A data safely monitoring board reviewed all reported adverse effects and commented on study progress. To date, only 3 deaths have occurred in subjects treated with Ta1 (Group A), compared to 7 in the control (Group B). There have been 12 COVID-19 related serious adverse effects (SAEs; 5 in Group A, and 7 in Group B). The majority of patients have received a COVID-19 vaccine (91 patients in group A, and 76 patients in Group B) at various times throughout the study. Nearing completion of the study, blood samples have been collected and antibody responses to COVID-19 will be analyzed along with safety and efficacy endpoints when all subjects have completed the study.

Associations between obstructive sleep apnea and COVID-19 infection and hospitalization among US adults.

Medical comorbidities increase the risk of severe COVID-19 infection. In some studies, obstructive sleep apnea (OSA) has been identified as a comorbid condition that is associated with an increased prevalence of COVID-19 infection and hospitalization, but few have investigated this association in a general population. This study aimed to answer the following research question: In a general population, is OSA associated with increased odds of COVID-19 infection and hospitalization and are these altered with COVID-19 vaccination? This was a cross-sectional survey of a diverse sample of 15,057 US adults. COVID-19 infection and hospitalization rates in the cohort were 38.9% and 2.9%, respectively. OSA or OSA symptoms were reported in 19.4%. In logistic regression models adjusted for demographic, socioeconomic, and comorbid medical conditions, OSA was positively associated with COVID-19 infection (adjusted odds ratio: 1.58, 95% CI: 1.39-1.79) and COVID-19 hospitalization (adjusted odds ratio: 1.55, 95% CI: 1.17-2.05). In fully adjusted models, boosted vaccination status was protective against both infection and hospitalization. Boosted vaccination status attenuated the association between OSA and COVID-19 related hospitalization but not infection. Participants with untreated or symptomatic OSA were at greater risk for COVID-19 infection; those with untreated but not symptomatic OSA were more likely to be hospitalized. In a general population sample, OSA is associated with a greater likelihood of having had a COVID-19 infection and a COVID-19 hospitalization with the greatest impact observed among persons experiencing OSA symptoms or who were untreated for their OSA. Boosted vaccination status attenuated the association between OSA and COVID-19-related hospitalization. Quan SF, Weaver MD, Czeisler MÉ, etal. Associations between obstructive sleep apnea and COVID-19 infection and hospitalization among U.S. adults. J Clin Sleep Med. 2023;19(7):1303-1311.

From protests into pandemic: demographic change in Hong Kong, 2019–2021

ABSTRACT Compared to other settings, COVID-19 infection and death rates in Hong Kong were very low until 2022, due to top-down interventions (e.g. quarantines, ‘mask mandates’) and community activation. However, in addition to these epidemiological circumstances, Hong Kong has also undergone significant social and political change stemming from the social movement beginning in 2019 through the enacting, and aftermath, of the National Security Law. We draw on registered birth and marriage data from 2015 through 2021 to explore how fertility and nuptiality changed after the social movement followed by the first four waves of the COVID pandemic. We describe how fertility and marriage rates have changed in Hong Kong and to what extent the changes are associated with the social movement and the COVID pandemic. We further disaggregate the fertility and nuptiality trends by Hong Kong-born and non-Hong Kong-born population, with a specific focus on migrants from the Mainland.

The Incidence of COVID-19 Among Primary Middle School Students and Co-residents in Nan'an District, Chongqing, China: A Cross-Sectional Study

<i>Objective:</i> To understand the infection situation of COVID-19 among primary and middle school students and co-residents in Nan'an District of Chongqing during the new stage of "a Class B infectious disease under Category B management", and to provide scientific basis for the subsequent timely analysis of the epidemic situation and prediction of the demand for medical treatment resources. <i>Methods:</i> From December 20 to 21, 2022, 19225 students from 86 primary and secondary schools in Nan'an District were selected by stratified random cluster sampling method to conduct an electronic questionnaire survey. <i>Results:</i> A total of 17744 valid questionnaires were received, the response rate was 92.30%, the average age was 11 years old. The infection rate of novel coronavirus was 64.09%, among which the infection rate of middle school study group was higher than that of primary school study group, accounting for 65.39%. The infection rate of male students was slightly higher than that of female students (63.02%) The infection rate of Nanping residential area was higher than that of other residential areas, accounting for 66.25%. The symptoms, infection, medical treatment and hospitalization of co-residents were statistically significant. <i>Conclusion:</i> The infection rate of COVID-19 among primary and secondary schools and co-residents in Nan'an District is higher than that of Chongqing in the same period, but the subjects have high health awareness and take the initiative to seek medical treatment or be hospitalized. In the future, it is necessary to focus on people in junior high schools, male, old urban areas, etc. Publicity and education on family COVID-19 prevention measures shall be well conducted to ensure medical treatment resources in the region and provide timely and satisfactory medical and health services for residents.

Multiple sclerosis and COVID-19: A retrospective study in Iran.

Previous studies suggested a higher rate of COVID-19 infection in patients with multiple sclerosis than in the general population, and limited studies addressed the impact of COVID-19 and its vaccination in patients with multiple sclerosis in Iran. We decided to investigate the factors associated with COVID-19 infection, the effects and side effects of the COVID-19 vaccination in patients with multiple sclerosis (MS). We used the data of the patients with multiple sclerosis registered in a referral clinic in Kerman, one of the large cities in Iran (a population of 537,000 inhabitants), to explore the association between demographic variables, the history of COVID-19 vaccination, and the clinical outcomes. Of the 367 participants in this study, 88.3% received the COVID-19 vaccine, 35.4% were confirmed COVID-19 cases, and the incidence of COVID-19 was much higher before vaccination (24.5% before vaccination versus 10.1% after vaccination). The multivariable logistic regression model showed that male gender (OR = 2.64, 95% confidence interval: 1.21, 5.74) and current employment (OR = 3.04, 95% confidence interval: 1.59, 5.80) were associated with an increased risk of COVID-19. The only factor associated with the adverse effects of COVID-19 vaccination was the type of vaccine (AstraZeneca). Our findings showed that the vaccination protected MS cases considerably against COVID-19. In addition, the side effects of the vaccines were not noticeably high in these cases as well. Among all COVID-19 vaccines, AstraZeneca had the most common side effects, so people must be aware of them before vaccination. The male gender and employment were the most important variables in the prevalence of COVID-19 in patients with multiple sclerosis in our study.

Sudden cardiac arrest during the COVID-19 pandemic: A two-year prospective evaluation in a North American community

Early during the coronavirus disease 2019 (COVID-19) pandemic, higher sudden cardiac arrest (SCA) incidence and lower survival rates were reported. However, ongoing effects on SCA during the evolving pandemic have not been evaluated. The purpose of this study was to assess the impact of COVID-19 on SCA during 2 years of the pandemic. In a prospective study of Ventura County, California (2020 population 843,843; 44.1% Hispanic), we compared SCA incidence and outcomes during the first 2 years of the COVID-19 pandemic to the prior 4 years. Of 2222 out-of-hospital SCA cases identified, 907 occurred during the pandemic (March 2020 to February 2022) and 1315 occurred prepandemic (March 2016 to February 2020). Overall age-standardized annual SCA incidence increased from 39 per 100,000 (95% confidence [CI] 37-41) prepandemic to 54 per 100,000 (95% CI 50-57; P <.001) during the pandemic. Among Hispanics, incidence increased by 77%, from 38 per 100,000 (95% CI 34-43) to 68 per 100,000 (95% CI 60-76; P <.001). Among non-Hispanics, incidence increased by 26%, from 39 per 100,000 (95% CI 37-42; P <.001) to 50 per 100,000 (95% CI 46-54). SCA incidence rates closely tracked COVID-19 infection rates. During the pandemic, SCA survival was significantly reduced (15% to 10%; P <.001), and Hispanics were less likely than non-Hispanics to receive bystander cardiopulmonary resuscitation (45% vs 55%; P = .005) and to present with shockable rhythm (15% vs 24%; P = .003). Overall SCA rates remained consistently higher and survival outcomes consistently lower, with exaggerated effects during COVID infection peaks. This longer evaluation uncovered higher increases in SCA incidence among Hispanics, with worse resuscitation profiles. Potential ethnicity-specific barriers to acute SCA care warrant urgent evaluation and intervention.

Identifying Adverse Events in Patients Hospitalized in Isolation or Quarantine Due to COVID-19.

This study evaluated the adverse events of COVID-19 isolation or quarantine in patients with nosocomial SARS-CoV-2 infection admitted to the Hospital Universitario Insular de Gran Canaria. This is a retrospective cohort study with 30-day follow-up of 126 patients diagnosed with nosocomial COVID-19 through polymerase chain reaction test, between May 1 and June 30, 2022, in a 500-bed university hospital in the island of Gran Canaria. Between May 1 and July 30, 2022, a total of 2250 patients were admitted to the Hospital Universitario Insular de Gran Canaria; 126 of them were diagnosed with nosocomial COVID-19 through a polymerase chain reaction test. The rate of nosocomial COVID-19 infection was 5.6%. From the 126 patients of the study population, 27 experienced an adverse event (21.4%) and 2 experienced 2 adverse events (1.6%) due to COVID-19 isolation or quarantine. Thus, a total of 31 adverse events occurred in 29 patients. These events included the following: delay in transfer to other centers of 11 patients who were pending of receiving a negative COVID-19 test result (35.5%), delay or cancellation of diagnostic tests in 9 patients (29%), delay or cancellation of doctor visit in 7 patients (22.6%), and delay or cancellation of surgical or other interventions in 4 patients (12.9%). Because of the adverse consequences of nosocomial COVID-19 infection in hospitalized patients, measures should be observed for the prevention and control of nosocomial infection transmission, and adverse events related to patient safety issues in health care in isolated or quarantined COVID-19 patients should be prevented.

Assessing efficacy of instructor based orientation to donning doffing protocols and modifications to doffing area infrastructure in reducing SARS-CoV-2 infection among Doctors assigned to COVID-19 patient care

We assess the efficacy of orientation programmes for doctors of proper donning, doffing techniques for personal protective equipment (PPE) and safe practices inside the COVID-19 hospital in reducing the COVID-19 infection rate among doctors. A total of 767 resident doctors and 197 faculty visits on weekly rotation were recorded over a six month period. Doctors were guided through orientation sessions before their entry into the COVID-19 hospital from 1 August 2020. The infection rate among doctors was used to study the efficacy of the programme. McNemars Chi-square test was used to compare the infection rate in the two groups before and after orientation sessions were commenced. A statistically significant reduction in SARS-CoV-2 infection was seen among resident doctors after orientation programmes and infrastructure modification (3% vs 7.4%, P=0.03). Twenty-eight of 32 (87.5%) doctors who tested positive developed asymptomatic to mild infection. The infection rate was 3.65% and 2.1% among residents and faculty respectively. There was no mortality recorded. Orientation programme for healthcare workers for PPE donning and doffing protocols with practical demonstration and trial of PPE usage can significantly reduce COVID-19 infection. Such sessions should be mandatory for all workers on deputation in designated area for Infectious Diseases and in pandemic situations.

Predictors of face mask use during the COVID-19 pandemic in Indonesia: Application of the health belief model, psychological distress and health motivation.

High infection rates of COVID-19 in Indonesia require attention,especially transmission and prevention behaviors. One way to lower infection rates is the use of face masks. However, people's adherence to its usage when in public is still low. This necessitates the exploration of predictors of the use of masks to increase community compliance. This study further aims to investigate the predictors of face mask use by applying the Health Belief Model, anxiety, stress, depression, and health motivation. A total of 255 respondents from Jakarta, Bandung, Tangerang, and Banten filled out an online questionnaire. Furthermore, hierarchical multiple regression was used to detect predictors associated with face mask use. The results showed that the high perceived benefits and health motivation were higher in individuals who used a face mask when in public, while those who have high perceived barriers likely do not use masks. The respondent's level of psychological distress, including depression, anxiety, and stress were not associated with face mask use. These findings highlight the importance of personal appraisal regarding COVID-19 and its prevention behaviors. Comfortable mask design, and emphasizing the benefits of using masks in the community improve compliance.

A248 OUTCOMES OF COVID-19 ILLNESS AND ACCESS TO APPROPRIATE TREATMENT IN LIVER TRANSPLANT RECIPIENTS IN BRITISH COLUMBIA THROUGHOUT THE PANDEMIC

Abstract Background COVID-19 continues to cause significant illness and mortality worldwide. Solid Organ Transplant Recipients (SOTR) have a higher rate of COVID-19 infection and worse outcomes than those who are immunocompetent. Dexamethasone, tocilizumab, and baricitinib have improved inpatient outcomes. Sotrovimab, remdesivir, and nirmatrelvir/ritonavir have recently been approved for used in high risk, minimally symptomatic outpatients. Previous experience has shown that use of monoclonal antibodies and oral antiviral agents have reduced morbidity and mortality of COVID-19 in SOTR. Purpose To assess the experiences and outcomes of COVID-19 and access to directed therapy in SOTR in British Columbia (BC). Method Data was compiled from patient disclosure to liver transplant clinicians on COVID-19 infection and gathered from patient charts in the SOTR Clinic at Vancouver General Hospital. Inclusion criteria were patients followed at the clinic with a positive COVID-19 test or clinical confirmation of COVID-19 syndrome. This is a retrospective, quality assurance study and did not require ethics review. Result(s) 158 SOTR reported COVID-19 infections between March 2020 and September 2022. 3 patients died within 30 days of COVID-19 infection, 2 (1.26%) of which the cause of death was directly due to COVID-19, and the other who had cholangitis with severe sepsis and multi-organ system failure. 24 patients required admission to hospital, 7 requiring critical care support. 41 patients did not receive any therapy for COVID-19: there was none available at that time (n=26), it was contraindicated due to a drug interaction (n=2) or medical condition (n=1), was refused (n=1), or the infection was reported too late to qualify (n=10). 83% (92/112) of outpatients received available anti-viral treatment: sotrovimab (n=27), remdesivir (n=63), or nirmatrelvir/ritonavir (n=2). In inpatients (n=24), 13 received corticosteroids, 6 dual treated with tocilizumab (n=4) or baracitinib (n=2). 4 inpatients received remdesivir. Three patients were treated in hospital after initiating outpatient therapy, one with progression of COVID-19 illness despite starting remdesivir. Two patients had adverse effects of medications provided: one was prescribed nirmatrelvir/ritonavir by a physician outside of the transplant program, which caused tacrolimus toxicity (serum concentration of 69.4 ng/mL) with nausea, vomiting, and diarrhea. Another patient had an episode of hypotension after receiving sotrovimab and sustained an acute kidney injury (AKI). Both patients fully recovered. There were no deaths on antiviral therapy. Of 145 patients who had laboratory investigations done within 30 days of COVID-19 infection, 16 had a transient rise in liver enzymes, 14 had an AKI and 11required an adjustment in their tacrolimus dose. Conclusion(s) Involving the liver transplant team early in the course of COVID-19 illness allows patients to safely access COVID-19 directed therapy to avoid progression of illness, and medication interactions or toxicity. Please acknowledge all funding agencies by checking the applicable boxes below None Disclosure of Interest None Declared

Molecular Characterization and Selection of Indigenous SARS-CoV-2 Delta Variant for the Development of the First Inactivated SARS-CoV-2 Vaccine of Pakistan

Vaccines are one of the efficient means available so far for preventing and controlling the infection rate of COVID-19. Several researchers have focused on the whole virus's (SARS-CoV-2) inactivated vaccines which are economically efficient to produce. In Pakistan, multiple variants of SARS-CoV-2 have been reported since the start of the pandemic in February 2020. Due to the continuous evolution of the virus and economic recessions, the present study was designed to develop an indigenous inactivated SARS-CoV-2 vaccine that might help not only to prevent the COVID-19 in Pakistan, it will also save the country's economic resources. The SARS-CoV-2 were isolated and characterized using the Vero-E6 cell culture system. The seed selection was carried out using cross-neutralization assay and phylogenetic analysis. The selected isolate of SARS-CoV-2 (hCoV-19/Pakistan/UHSPK3-UVAS268/2021) was inactivated using beta-propiolactone followed by vaccine formulation using Alum adjuvant, keeping the S protein concentration as 5 μg/dose. The vaccine efficacy was evaluated by in vivo immunogenicity testing in laboratory animals and in in vitro microneutralization test. The phylogenetic analysis revealed that all the SARS-CoV-2 isolates reported from Pakistan nested into different clades, representing multiple introductions of the virus into Pakistan. The antisera raised against various isolates from different waves in Pakistan showed a varied level of neutralization titers. However, the antisera produced against a variant (hCoV-19/Pakistan/UHSPK3-UVAS268/2021; fourth wave) efficiently neutralized (1:64-1:512) all the tested SARS-CoV-2 isolates. The inactivated whole virus vaccine of SARS-CoV-2 was safe and it also elicited a protective immune response in rabbits and rhesus macaques on the 35th-day post-vaccination. The activity of neutralizing antibodies of vaccinated animals was found at 1:256-1:1024 at 35 days post-vaccination, indicating the effectiveness of the double-dose regime of the indigenous SARS-CoV-2 vaccine.

Polydopamine Nanoparticles-Based Three-Line Lateral Flow Immunoassay for COVID-19 Detection.

Currently, the global trend of several hundred thousand new confirmed COVID-19 patients per day has not abated significantly. Serological antibody detection has become an important tool for the self-screening of people. While the most commonly used colorimetric lateral flow immunoassay (LFIA) methods for the detection of COVID-19 antibodies are limited by low sensitivity and a lack of quantification ability. This leads to poor accuracy in the screening of early COVID-19 patients. Therefore, it is necessary to develop an accurate and sensitive autonomous antibody detection technique that will effectively reduce the COVID-19 infection rate. Here, we developed a three-line LFIA immunoassay based on polydopamine (PDA) nanoparticles for COVID-19 IgG and IgM antibodies detection to determine the degree of infection. The PDA-based three-line LFIA has a detection limit of 1.51 and 2.34 ng/mL for IgM and IgG, respectively. This assay reveals a good linearity for both IgM and IgG antibodies detection and is also able to achieve quantitative detection by measuring the optical density of test lines. In comparison, the commercial AuNP-based LFIA showed worse quantification results than the developed PDA-based LFIA for low-concentration COVID-19 antibody samples, making it difficult to distinguish between negative and positive samples. Therefore, the developed PDA-based three-line LFIA platform has the accurate quantitative capability and high sensitivity, which could be a powerful tool for the large-scale self-screening of people.

How Effective are Policy Interventions Against the COVID-19 Infection Rates?

Studies on the COVID-19 pandemic are more likely to concentrate on the effects of the virus while ignoring its time-series characteristics, particularly its stationarity characteristics. Thus, this study attempts to investigate the effectiveness of policy interventions against COVID-19 by determining the permanent or transitory effects in 5 major regions and the ten most infected countries. Using the endogenous multiple breaks unit root tests introduced by Kapetanios (2005), the findings indicate that only the impacts of shocks to COVID-19 infection rates in France are likely to be permanent. However, the transitory effect is found in Brazil, Germany, Iran, Italy, Russia, Spain, Turkey, the United Kingdom, and the United States. The country where the shock has a permanent impact is suitable for policy interventions, including lockdowns, social isolation, and local isolation. While herd immunity, which protects the entire population against COVID-19, is better ideal for application in countries that experience shocks with a transitory effect.JEL Classification: C1, I15, I18How to Cite:Tang, C.F., &amp; Tan, B.W. (2023). How Effective are Policy Interventions Against the COVID-19 Infection Rates? Etikonomi, 22(1), 1–14. https://doi.org/10.15408/etk.v22i1.28486.

COVID-19 causes and influences: rethinking neighborhood design in Jordan

ABSTRACT This research aims to propose recommendations to improve neighborhood urban design in Amman, the capital of Jordan; decreasing the risk of spreading pandemics such as COVID-19. The research methodology follows a mixed-methods comparative approach, comparing three neighborhoods in Amman with different COVID-19 infection rates; Ar-Rawabi, Ash-Shmeisani, and Al-Qwesmeh. These more sensitive locationsare selected using a multi-stage cluster-sampling technique that overlaps COVID-19 infection heat maps, population density maps, and neighborhood areas. The study analyzes these neighborhoods’ land-use patterns, and distributes a survey to the neighborhoods’ residents to study their demographic information, compliance with COVID-19 safety measures, daily activities during the COVID-19 pandemic’s peak in Amman, satisfaction level with their neighborhood’s spatial characteristics, and the emotional impact of social distancing on them. The conclusion contributes a list of recommendations for post-pandemic neighborhood design to help mitigate the spread of highly infectious diseases and improve residents’ quality of life, creating pandemic-resilient, healthy, and walkable neighborhoods. These recommendations include planning for commercial land-use to be spread throughout a neighborhood, allocating a higher percentage of land-use for public green spaces, and planning for smaller-scale residential buildings. These recommendations can be applied to neighborhood design internationally to help reduce the spread of pandemics worldwide.

Vocal Habilitation in Post-Acute Symptomatic COVID-19 Recovery: A Narrative Review of Strategies for Singing Teachers

The World Health Organisation declared a global health pandemic on March 11, 2020. Over two and a half years later, symptomatic COVID-19 infection and reinfection rates remain problematically high throughout the world. Singers, singing teachers, and other professional voice users affected by COVID-19 report significant vocal, respiratory, psychological, and stamina disturbances that impact their work. Mitigating recovery time is essential for the professional voice user. Limited research has been conducted on vocal health and production for singers affected by COVID-19. This narrative literature review aims to synthesise knowledge of symptoms that affect vocal health and production. Multidisciplinary literature from the vocology, speech pathology, otolaryngology, psychology, education, singing voice pedagogy, and voice science fields were comprehensively searched, screened, reviewed, and synthesised. Findings were used to frame practice-based strategies to support the vocal habilitation of singers recovering from symptomatic COVID-19. KEYWORDS: vocology, singing voice pedagogy, voice disorders, COVID-19

Clinical correlates of COVID-19 disease in psychiatric outpatients

IntroductionPatients suffering from psychiatric illness represent a population that is particularly vulnerable to the SARS-CoV-2 virus and to the pandemic situation due to several factors.ObjectivesWe aimed in our study to determine the rate of COVID-19 infection and to identify its correlated factors in outpatients of the psychiatry department of Monastir, Tunisia.MethodsThis is a descriptive and analytical cross-sectional study conducted on 178 outpatients at the department of psychiatry (Monastir, Tunisia) over a period of one month (from March 2022 to April 2022). Data was collected via a questionnaire focused on two main attributes: (1) sociodemographic and clinical characteristics; (2) questions about the COVID-19 personal and family history.ResultsThe mean age of our population was 44.9±13.7 years. The majority of them (81.5%) had a chronic evolution of their psychiatric disorder (&gt; 2 years) and 68.7% were hospitalized at least once in psychiatry. Psychosis was the most represented disorder with 57.3% compared to mood disorders and anxiety disorders. Among our population, thirty seven patients (21%) had a SARS-CoV-2 infection and 3.1% required hospital care. The infection by the virus of a family member was reported by 46% of cases and 2.5% had intrafamilial death due to COVID-19 disease. Patients with depressive disorder were the most affected (55%). COVID-19 infection was significantly associated with gender (p=0.02), marital status (p=0.016), diagnosis (p=0.001), treatment (p=0.02) and intrafamilial spread of the disease (p&lt;10-3).ConclusionsPatients with psychiatric disorders experience a distinct burden of the COVID-19 disease. Awareness of the vulnerability of this population and psychiatric institutions is necessary in order to adapt mental health care planning and implement preventive measures during potential subsequent pandemics.Disclosure of InterestNone Declared

Abstract P363: Knowledge of COVID-19-Related Risk Factors and Conditions Among Asian American, Native Hawaiian, and Pacific Islander Adults, February-April 2022

Introduction: Communities of color, including Asian Americans (AAs), Native Hawaiians and Pacific Islanders (NH/PIs), experienced higher rates of COVID-19 infection, hospitalization and death compared to white populations during the early pandemic. Further, there are known disparities in cardiovascular disease (CVD) risk factors among AA and NH/PI groups that existed pre-pandemic (e.g., greater prevalence of diabetes among Filipino and Asian Indian compared to white adults). These outsized risks are combined with the increased experience of anti-Asian racism in this period along with historical distrust of health institutions, and legacies of structural racism that have made communities of color vulnerable to the pandemic. The purpose of this study was to understand knowledge of COVID-19-related conditions among AA and NH/PI ethnic groups, in order to anticipate and mitigate further COVID-19 and CVD disparities. Hypothesis: We hypothesize that knowledge of post-COVID-19 conditions and variants would vary by disaggregated AA and NH/PI ethnic group. Methods: The National COVID-19 Rapid Needs Assessment was conducted among AA and NH/PI adults from February to April 2022 with the help of ten community partners (n = 1,358; 1,197 AAs and 153 NH/PIs). The survey was primarily administered online in English and 11 Asian languages. We examined the following COVID-19 knowledge outcomes: vaccine breakthrough infections, COVID-19 variants, and long COVID. Responses included: ‘I know a lot about it,’ ‘I know a moderate amount about it,’ ‘I have heard of it, but don’t know much about it,’ and ‘I haven’t heard of it.’ Outcomes were disaggregated by seven AA (Chinese, Taiwanese, Filipino, Japanese, Korean, Vietnamese, South Asian) and two NH/PI (Polynesian, Micronesian) subgroups. Additional analyses will examine differences in knowledge based on misinformation and disinformation in the absence of timely, language concordant COVID-19 information. Results: Among AAs overall, 14.0% had not heard of vaccine breakthrough infections; 7.4% had not heard of COVID-19 variants; and 11.7% had not heard of long COVID. South Asian adults reported the lowest knowledge of COVID-19, while Filipinos reported the highest knowledge. Among NH/PI adults, 27.2% had not heard of vaccine breakthrough infections; 6.6% had not heard of COVID-19 variants; and 28.4% had not heard of long COVID. Both NH/PI subgroups reported very low knowledge of breakthrough infections and long COVID. Conclusion: Findings indicate COVID-19-related knowledge disparities across AA and NH/PI ethnic subgroups which may be more pronounced among South Asian and NH/PI communities. The COVID-19 pandemic will exacerbate known CVD health disparities if the pandemic mitigation strategies (e.g., disaggregated racial/ethnic data collection) are not inclusive of communities of color, immigrants and limited English fluent populations.