Risk Of Coronavirus Disease 2019 Infection Research Articles

The Association between Dietary Inflammatory Index with Risk of Coronavirus Infection and Severity: A Case-Control Study.

Recently, several have evaluated the association between the components of the dietary inflammatory index (DII) score with the risk and severity of Coronavirus Disease 2019 (COVID-19). For the first time, we examined the association between DII® with risk of coronavirus infection and symptom severity through a case-control study in Iran. The present case-control study was conducted on COVID-19 cases (n = 100) and healthy control (n = 100) volunteer, aged from 18 to 65 years. Dietary intake, DII, body mass index, COVID-19 infection, and the severity of its symptoms were assessed for each participant. A multivariable logistic regression analysis test was used to estimate the odds ratio and 95% confidence interval. Our results demonstrated that COVID-19-infected patients were significantly older and had longer history of diabetes as compared to the healthy control group (P <.05). Furthermore, the participants with COVID-19 had a significantly greater intake of total fat (P =0.259), saturated fat (P =0.005), and dietary fiber (P = .004). In contrast, individuals in the healthy control group had a higher intake of carbohydrate (P = .005), sodium (P <.001), and iron (P <.001). However, there was no significant difference in DII score between COVID-19 and healthy controls (P =.259). In addition, we did not detect any specific association between DII score and risk of COVID-19 infection (odds ratio = 1.08, 95% confidence interval: 0.92 to 1.27; P =.294) and the severity of its symptoms (P >.05). There appears to be no specific association between DII score and risk of COVID-19 infection and the severity of its symptoms. More prospective cohort studies are necessary to confirm the veracity of our results.

Safety and Effectiveness of SA58 Nasal Spray Against COVID-19 Infection in Medical Personnel: An Open-Label, Blank-Controlled Study - Hohhot City, Inner Mongolia Autonomous Region, China, 2022.

The active ingredient of the SA58 Nasal Spray is a broad-spectrum neutralizing antibody with a high neutralizing capacity against different Omicron sub-variants in vitro studies. This study demonstrated the safety and effectiveness of SA58 Nasal Spray against coronavirus disease 2019 (COVID-19) infection in medical personnel for the first time. This study provides an effective approach for the public to reduce their risk of COVID-19 infection. The findings of this research have the potential to significantly reduce the risk of infection and limit human-to-human transmission in the event of a COVID-19 outbreak.

Cerebral vasculopathy after COVID-19 infection in the central region of Saudi Arabia: a case report

Background: The most common symptoms of coronavirus disease 2019 (COVID-19) are dyspnea, fever, cough, headache, diarrhea, and myalgia. Case Presentation: We report a case of peripheral cortical borderline cerebral vasculopathy associated with COVID-19 infection in a young female patient who presented with seizures and a history of acute confusion and generalized tonic-clonic seizure. She was diagnosed with COVID-19 disease 1 week ago before the presentation. Her illness was mild and did not require hospitalization. The magnetic resonance imaging study revealed cerebral vasculopathy. COVID-19 infection and other risk factors can increase the risk of cerebral vasculopathy. To our knowledge, no other case of peripheral cortical borderline cerebral vasculopathy associated with COVID-19 infection has been reported in Saudi Arabia. Conclusion: This report highlights the importance of considering seizures and cerebral vasculopathy as manifestations of COVID-19 disease. Physicians should consider seizures due to cerebral vasculopathy among the expected neurological complications of COVID-19 to aid early detection and management of COVID-19- associated complications.

COVID-19 and health care worker exposure at Chris Hani Baragwanath Academic Hospital

Abstract Background: Health care workers (HCWs) are at increased risk of coronavirus disease 2019 (COVID-19). Appropriate risk assessments and testing are essential to reduce transmission and avoid workforce depletion. Objective: To investigate the risk of COVID-19 infection among HCWs who fulfil the person under investigation case definition or had exposure to a confirmed COVID-19 contact. Methods: We conducted a retrospective review of HCWs who were exposed to and/or tested for COVID-19 during the first wave of the pandemic. Data collected included demographics, exposure type, risk level, and COVID-19 test result. Frequency distribution tables, bivariate analyses, univariate and multivariate analyses were conducted. Results: Among the 1111 HCWs reviewed, 643 were tested with 35.6% positive results. PUI's accounted for 62.4% of positive cases. Symptomatic HCWs with no known contact were at a greater risk of infection than those with a patient exposure (p═0.001). The risk of testing positive was higher after a patient exposure (p═0.000) compared to a co-worker contact. Patient-facing designations had a higher risk of SARS-CoV-2 infection than non-clinical designations (p═0.013). The exception to this was security personnel who were 28 times more likely to test positive than any other designation (p═0.000). Conclusion: There is a higher positivity rate among HCWs than the general population. The presence of symptoms warrants testing. Nosocomial transmission was derived from patients more than co-worker contacts. Precautions in the workplace need to be reinforced to protect the health and safety of HCWs during this pandemic. These findings should assist with preparedness for future pandemics.

Association between ABO, Rh blood group, and COVID-19 illness

Background: The world is struggling still with the coronavirus disease 2019 (COVID-19) pandemic 3½ years since the first case was reported in December 2019 in a small province in China. Researchers and the global health community have been working tirelessly to ascertain all possible ways to treat and before that identify and protect any susceptible populace. Among many plausible factors, blood groups have also been hypothesized as one of the associated key risk factors. Aims and Objectives: This study was conducted to check for possible association if any between blood groups and COVID-19 illness. Materials and Methods: The present study was a cross-sectional, questionnaire-based study involving general population after approval by the Institutional Ethics Committee. A total of 434 individuals participated in this study. It was a Google form-based survey shared with general Indian population consisting of questions based on demography, status of COVID-19 positivity, illness if any, requirement of hospitalization. SPSS version 28 was used to analyze the data. Chi-square or Fisher’s exact test was used to assess the association between various parameters. Results: Our study shows that blood groups A and B are more disposed to COVID-19 infection, whereas blood groups O and AB are at a significantly lower risk of COVID-19 infection. The study did not show significant impact of the Rh types. Both group system, age, sex show non-significant impact on the susceptibility, progression of disease and are not associated with susceptibility to severity. Conclusion: There is a significant association between blood groups A and B and the development of COVID-19 illness. No significant association was found with Rh type and all other parameters.

Association between Vitamin D Status and Secondary Infections in Patients with Severe COVID-19 Admitted in the Intensive Care Unit of a Tertiary-Level Hospital in Turkey.

There are several studies showing that the vitamin D status can determine risk of COVID-19 infections, severity and mortality from coronavirus disease 2019 (COVID-19). However, the association between vitamin D (25(OH)D) and secondary infections in the prognosis of COVID-19 patients has not been reported yet. The aim was to investigate whether the vitamin D status affects the rates of secondary infections in patients with severe COVID-19 hospitalized in the intensive care unit (ICU) of a tertiary-level hospital in Turkey. The data of 194 patients with diagnosis of severe COVID-19 who were admitted to the ICU from March 2020 to June 2021 and older than 18 years were evaluated in this retrospective study. The patients were divided into two groups according to total serum 25(OH)D level as normal group (≥20 ng/mL) and low group (<20 ng/mL). The 25(OH)D level was low in 118 (60.8%) and normal in 76 (39.2%) patients. The mean age of the low group was significantly higher than that of the normal group (67.02 ± 14.47 vs. 61.70 ± 14.38; p = 0.013). The systolic and diastolic blood pressure as well as the Glasgow coma scale score of the low group were significantly lower than that of the normal group (p = 0.004, 0.002 and 0.001, respectively). The intubation rate and APACHE (Acute Physiology and Chronic Health Evaluation) score of the low group was significantly higher than that of the normal group (p = 0.001). The platelets number and blood pH decreased, and the neutrophil/lymphocyte ratio, procalcitonin, lactate, urea, creatinine and lactate dehydrogenase concentrations increased significantly in the low group (p < 0.05). The mortality rate was 79.7% in the low group and 22.4% in the normal group (p < 0.001). Microbiological growth was observed in 68.6% of the normal group and 52.6% of the normal group (p = 0.025). The number of cultures with resistant bacteria was significantly higher in the low group (25.9%) than that in the normal group (17.5%) (p = 0.035). The severe COVID-19 patients hospitalized with vitamin D deficiency may have increased risks of poor prognosis and mortality due to secondary infections in the ICU.

1963. Peripartum Outcomes Associated With COVID-19 Vaccination during Pregnancy: A Systematic Review and Meta-analysis

Abstract Background The risk and benefits of coronavirus disease 2019 (COVID-19) vaccination during pregnancy are under investigation. Pooled evidence regarding neonatal and maternal outcomes in relation to COVID-19 vaccination during pregnancy is scarce. Methods We searched PubMed and EMBASE databases in April 2022 without language restrictions. We included Prospective trials and observational studies comparing the women who received at least one COVID-19 vaccination during pregnancy with those who did not and reporting neonatal outcomes. Two independent investigators extracted relevant data from each study. Odds ratios (ORs) were calculated using random-effects models. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. The primary outcomes were the neonatal outcomes, including preterm birth, small-for-gestational-age (SGA), low Apgar score (&amp;lt; 7 at 5 min), neonatal intensive care units (NICU) admission, and intrauterine fetal death (IFD). The secondary outcomes were maternal outcomes, including maternal SARS-CoV-2 infection, cesarean delivery, postpartum hemorrhage, and chorioamnionitis. Results Nine observational studies involving 81,349 vaccinated (mean age, 32.0±4.6 years) and 255,346 unvaccinated women during pregnancy (mean age, 30.5±5.1 years) were included. COVID-19 vaccination during pregnancy was associated with lower risk of NICU admission (OR, 0.88; 95% confidence intervals [CI], 0.80-0.97) and IFD (OR, 0.73; 95% CI, 0.57-0.94), whereas it was not associated with preterm birth (OR, 0.89; 95% CI, 0.76-1.04), SGA (OR, 0.99; 95% CI, 0.94-1.04), and low Apgar score (OR, 0.94; 95% CI, 0.87-1.02). COVID-19 vaccination during pregnancy was associated with a lower risk of maternal SARS-CoV-2 infection (OR, 0.46; 95% CI, 0.22-0.93), but not associated with increased risk of cesarean delivery (OR, 1.05; 95% CI, 0.93-1.20), postpartum hemorrhage (OR, 0.95; 95% CI, 0.83-1.07), and chorioamnionitis (OR, 0.95; 95% CI, 0.83-1.07). Flowchart of study selection Forest plots showing the odds ratio of neonatal outcomes a: neonatal intensive care units admission, b: intrauterine fetal death, c: preterm birth, d: small for gestational age, e: low Apgar score Forest plots showing the odds ratio of maternal outcomes a: maternal SARS-CoV-2 infection, b: cesarean delivery, c: postpartum hemorrhage, d: chorioamnionitis Conclusion COVID-19 vaccination during pregnancy did not increase the risk of peripartum outcomes but decreased the risk of NICU admission, IFD, and maternal COVID-19 infection. COVID-19 vaccination should be encouraged for pregnant women. Disclosures All Authors: No reported disclosures.

Literature review of the relative importance of household, community and social, and workplace settings on the probability of COVID-19 infection

Background and Objective: Coronavirus disease 2019 (COVID-19) is a highly infectious respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Risk of COVID-19 is often assessed in relation to different settings where transmission may occur; for example, in the household, workplace, or in community or social situations. However, determining the source or specific scenario resulting in an individual’s infection is quite difficult. Our objective was to evaluate patterns in the literature regarding the risk of COVID-19 infection in the workplace relative to other settings.

Efficacy and safety profile of corticosteroids and non-steroidal anti-inflammatory drugs in COVID-19 management: A narrative review.

Due to the fact that coronavirus disease 2019 (COVID-19) is still prevalent, and current reports show that some parts of the world have seen increase in incidence, it is relevant that health professionals and scientists know about recent or novel trends, especially drug treatments. Additionally, the safety profiles of these drug treatments need to be documented and shared with the public. Some studies have demonstrated the clinical benefits of non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids in COVID-19 treatment. On the contrary, others have also reported that NSAIDs and corticosteroids may worsen symptoms associated with COVID-19. While some researchers have suggested that corticosteroids may be helpful if used in the early stages of COVID-19, there are still some conflicting findings regarding the use of corticosteroids in certain viral infections. Our review suggests that methylprednisolone, dexamethasone, and ibuprofen have therapeutic potential in reducing mortality due to COVID-19 among hospitalized patients. This review also highlights the fact that the use of NSAIDs is not associated with adverse outcomes of COVID-19. In reality, evidence suggests that NSAIDs do not increase the risk of COVID-19 infections. Also, the literature reviewed suggests that corticosteroid treatment in COVID-19 was linked with a decrease in all-cause mortality and disease progression, without increase in adverse events when compared to no corticosteroid treatment.

Impact of the COVID-19 pandemic on patients with myasthenia gravis: A survey of the Myasthenia Gravis Foundation of America MG patient registry.

Factors associated with coronavirus disease 2019 (COVID-19) infection among the myasthenia gravis (MG) population are incompletely understood. This study aimed to characterize the behavior of MG patients during the pandemic and to examine risk factors associated with COVID-19 infection. A "COVID-19 Survey" was sent to MG Patient Registry participants in the summer of 2020 (CSS20) and winter of 2021 (CWS21). Survey results were summarized descriptively. Demographics, disease characteristics, medication use, and survey results were compared between those reporting COVID-19 diagnosis (COVID), COVID-19 like symptoms without diagnosis (COVID-Like), and asymptomatic participants. A total of 454 and 665 participants completed the CSS20 and CWS21 surveys respectively; 326 participants completed both. Most continued follow-up visits and MG treatments. The frequency of COVID-like symptoms was similar between CSS20 and CWS21, while COVID-19 exposure (6% vs. 27%), COVID-19 testing among symptomatic individuals (35% vs. 78%), and COVID-19 diagnosis (0.2% vs. 6%) were higher in the CWS21. Cough, fever, fatigue, myalgia, anosmia/ageusia, and hospital and intensive care unit (ICU) admissions were more frequent in the COVID compared to the COVID-Like group. COVID-19 exposure (odds ratio [OR] 7.88), number of people in the household (OR 1.31), and report of MG exacerbation before the pandemic (OR 2.6) were independently associated with COVID-19 infection. COVID-19 affected MG patients increasingly through the early pandemic. While face-to-face contact with a COVID-19 infected individual was an obvious risk factor, MG patients who had more people in the household and unstable disease were at elevated risk for COVID-19 infection.

Plasma exchange and COVID 19

Plasma exchange and COVID 19

Risk of COVID-19 infection, hospitalization and mortality in psoriasis patients treated with interleukin-17 inhibitors: A systematic review and meta-analysis.

Coronavirus disease 2019 (COVID-19) have brought great disaster to mankind, and there is currently no globally recognized specific drug or treatment. Severe COVID-19 may trigger a cytokine storm, manifested by increased levels of cytokines including interleukin-17 (IL-17), so a new strategy to treat COVID-19 may be to use existing IL-17 inhibitors, which have demonstrated efficacy, safety and tolerability in the treatment of psoriasis. However, the use of IL-17 inhibitors in patients with psoriasis during the COVID-19 pandemic remains controversial due to reports that IL-17 inhibitors may increase the risk of respiratory tract infections. The systematic review and meta-analysis aimed to evaluate the effect of IL-17 inhibitors on the risk of COVID-19 infection, hospitalization, and mortality in patients with psoriasis. Databases (including Embase, PubMed, SCI-Web of Science, Scopus, CNKI, and the Cochrane Library) were searched up to August 23, 2022, for studies exploring differences in COVID-19 outcomes between psoriasis patients using IL-17 inhibitors and those using non-biologics. Two authors independently extracted data and assessed the risk of bias in a double-blind manner. The risk ratios (RRs) and 95% confidence intervals (CIs) were calculated and heterogeneities were determined by the Q test and I 2 statistic. And the numbers needed to treat (NNTs) were calculated to assess the clinical value of IL-17 inhibitors in preventing SARS-CoV-2 infection and treating COVID-19. Nine observational studies involving 7,106 participants were included. The pooled effect showed no significant differences in the rates of SARS-CoV-2 infection (P = 0.94; I 2 = 19.5%), COVID-19 hospitalization (P = 0.64; I 2 = 0.0%), and COVID-19 mortality (P = 0.32; I 2 = 0.0%) in psoriasis patients using IL-17 inhibitors compared with using non-biologics. Subgroup analyses grouped by age and COVID-19 cases, respectively, revealed consistent results as above. Meanwhile, the pooled NNTs showed no significant differences between the two groups in the clinical value of preventing SARS-CoV-2 infection and treating COVID-19. The use of IL-17 inhibitors in patients with psoriasis does not increase the risk of SARS-CoV-2 infection or worsen the course of COVID-19. https://www.crd.york.ac.uk/prospero/, identifier CRD42022335195.

THE RELATIONSHIP BETWEEN DYSLIPIDEMIA AND THE RISK OF COVID 19 INFECTION

OBJECTIVE: The recent coronavirus disease 2019 (COVID-19) outbreak has become a worldwide public health problem. Hypertension, diabetes mellitus, obesity, chronic heart and lung diseases increase the risk of development of COVID-19 infection and severe COVID-19 disease. In this study; we aimed to investigate whether hyperlipidemia alone increases the risk of development of COVID-19 infection.MATERIAL AND METHODS: One hundred-thirty four patients who were hospitalized with the diagnosis of COVID-19 and did not have any chronic disease and one hundred-twenty-two healthy controls were included in this study. The average of the lipid values of the patient group in the last 6 months before admission was calculated. Likewise, the average of the lipid parameters of the control group in the last 6 months was taken.RESULTS: There were no differences between two groups with regard to age, gender, and laboratory characteristics. Triglyceride and Low-density lipoprotein cholesterol values were significantly higher and High-density lipoprotein cholesterol levels were significantly lower in the COVID-19 patients compared to the control subjects (p &amp;lt; 0.01).CONCLUSIONS: Although research on the association of dyslipidemia with COVID-19 is still insufficient, our findings show that serum cholesterol levels are significantly associated with the risk of COVID-19 infection.

Prerequisite for COVID-19 Prediction: A Review on Factors Affecting the Infection Rate.

Since the year 2020, coronavirus disease 2019 (COVID-19) has emerged as the dominant topic of discussion in the public and research domains. Intensive research has been carried out on several aspects of COVID-19, including vaccines, its transmission mechanism, detection of COVID-19 infection, and its infection rate and factors. The awareness of the public related to the COVID-19 infection factors enables the public to adhere to the standard operating procedures, while a full elucidation on the correlation of different factors to the infection rate facilitates effective measures to minimize the risk of COVID-19 infection by policy makers and enforcers. Hence, this paper aims to provide a comprehensive and analytical review of different factors affecting the COVID-19 infection rate. Furthermore, this review analyses factors which directly and indirectly affect the COVID-19 infection risk, such as physical distance, ventilation, face masks, meteorological factor, socioeconomic factor, vaccination, host factor, SARS-CoV-2 variants, and the availability of COVID-19 testing. Critical analysis was performed for the different factors by providing quantitative and qualitative studies. Lastly, the challenges of correlating each infection risk factor to the predicted risk of COVID-19 infection are discussed, and recommendations for further research works and interventions are outlined.

Dysregulation of glutamine/glutamate metabolism in COVID-19 patients: A metabolism study in African population and mini meta-analysis.

Coronavirus disease 2019 (COVID‐19) remains a serious global threat. The metabolic analysis had been successfully applied in the efforts to uncover the pathological mechanisms and biomarkers of disease severity. Here we performed a quasi‐targeted metabolomic analysis on 56 COVID‐19 patients from Sierra Leone in western Africa, revealing the metabolomic profiles and the association with disease severity, which was confirmed by the targeted metabolomic analysis of 19 pairs of COVID‐19 patients. A meta‐analysis was performed on published metabolic data of COVID‐19 to verify our findings. Of the 596 identified metabolites, 58 showed significant differences between severe and non‐severe groups. The pathway enrichment of these differential metabolites revealed glutamine and glutamate metabolism as the most significant metabolic pathway (Impact=0.5; ‐Log10P=1.959). Further targeted metabolic analysis revealed six metabolites with significant inter‐group differences, with glutamine/glutamate ratio significantly associated with severe disease, negatively correlated with 10 clinical parameters and positively correlated with SPO2 (rs=0.442, P=0.005). Mini meta‐analysis indicated elevated glutamate was related to increased risk of COVID‐19 infection (pooled OR=2.02; 95% CI: 1.17–3.50) and severe COVID‐19 (pooled OR=2.28; 95% CI: 1.14–4.56). In contrast, elevated glutamine related to decreased risk of infection and severe COVID‐19, the pooled OR were 0.30 (95% CI: 0.20–0.44), and 0.44 (95% CI: 0.19–0.98), respectively. Glutamine and glutamate metabolism are associated with COVID‐19 severity in multiple populations, which might confer potential therapeutic target of COVID‐19, especially for severe patients.This article is protected by copyright. All rights reserved.

Quantification of how mechanical ventilation influences the airborne infection risk of COVID-19 and HVAC energy consumption in office buildings.

This paper presents an EnergyPlus-based parametric analysis to investigate the infection risk of Coronavirus Disease 2019 (COVID-19) under different mechanical ventilation scenarios for a typical medium-sized office building in various climate zones. A Wells-Riley (WR) based Gammaitoni-Nucci (GN) model was employed to quantitatively calculate the airborne infection risk. The selected parameters for the parametric analysis include the climate zone, outdoor air fraction, fraction of infectors, quanta generation rate, and exposure time. The loss and deposition of particles are not considered. The results suggest that the COVID-19 infection risk varies significantly with climate and season under different outdoor air fraction scenarios since the building heating and cooling load fundamentally impacts the supply airflow rate and thus directly influences the amount of mechanical ventilation, which determines the dilution ratio of contaminants. This risk assessment identified the climate zones that benefit the most and the least from increasing the outdoor air fraction. The climate zones such as 1A (Honolulu, HI), 2B (Tucson, AZ), 3A (Atlanta, GA), and 7 (International Falls, MN) are the most energy-efficient locations when it comes to increasing the outdoor air fraction to reduce the COVID-19 infection risk. In contrast, the climate zones such as 6A (Rochester, MN) and 6B (Great Falls, MT) are the least energy-efficient ones. This paper facilitates understanding a widely recommended COVID-19 risk mitigation strategy (i.e., increase the outdoor airflow rate) from the perspective of energy consumption.Electronic Supplementary MaterialSupplementary material is available for this article at 10.1007/s12273-022-0937-5 and is accessible for authorized users.

Seroprevalence of SARS-CoV-2 antibodies among public transport workers in Sweden

IntroductionPublic transportation is an essential societal function in crisis situations like the coronavirus disease 2019 (COVID-19) pandemic. Bus drivers and other public transport workers are essential workers that need to keep working despite the risk of contagion. The SARS-CoV-2 virus may pose an occupational health risk to public transport workers and especially to bus drivers as they interact with passengers in a confined area. By analyzing antibodies towards SARS-CoV-2 proteins in blood samples it is possible to measure if an individual has been infected by COVID-19. Here, we report the prevalence of antibodies among bus drivers and other public transport employees in Stockholm, Sweden and relate it to socio-demographic factors. MethodsSeroprevalence of IgG antibodies towards SARS-CoV-2 proteins was investigated in a sample of 262 non-vaccinated public transport workers (182 men and 40 women) recruited between April 26 and May 7, 2021. Most of the participants were bus drivers (n = 222). The relationship between socio-demographic factors and seroprevalence was investigated with logistic regression. ResultsThe seroprevalence was 50% in the total sample of public transport workers. Among bus drivers, 51% were seropositive compared to 44% seropositive among the other public transport workers. The difference was not significant. The seroprevalence was higher than the national seroprevalence in Sweden during the same period (18.3% in non-vaccinated people aged 20–64 years). The logistic regression model using Wald forward selection showed that men had a higher risk of being seropositive (OR 2.7, 95% CI 1.3 – 5.8) and there was a higher risk with increasing number of people in the household (OR 1.3, 95% CI 1.1 – 1.6). ConclusionsThese findings could imply an occupational risk for COVID-19 infection among public transport workers. Infection control measures are warranted during virus epidemics to assure bus drives’ safety and reduce transmission in public transport.

COVID-19 Infection Risk Following Elective Arthroplasty and Surgical Complications in COVID-19-vaccinated Patients: A Multicenter Comparative Cohort Study.

BackgroundWe aimed to determine symptomatic Coronavirus disease 2019 (COVID-19) rates within 1 month of elective arthroplasty for vaccinated individuals and to determine whether vaccination guarantees protection against COVID-19 after arthroplasty (primary outcome). In addition, the 90-day surgical complications were compared to those of an unvaccinated group (secondary outcome).MethodsA prospective cohort study was conducted on elective joint arthroplasty patients at 3 tertiary hospitals in 2 major cities (Tehran and Isfahan) in our country (Iran). The outcomes of the COVID-19-vaccinated group were assessed between October 2021 and March 2022. Ninety-day surgical complications were compared with a historical cohort of unvaccinated patients treated earlier in the pandemic (April 2020-March 2021).ResultsThe study included 1717 consecutive patients: 962 vaccinated and 755 unvaccinated. In the vaccinated group, 38 patients (3.9%) contracted COVID-19, 4 (10.5%) were hospitalized again, and none required intensive care unit admission. The multivariate logistic regression analysis revealed that COVID-19-positive cases are more likely to be female (odds ratio [OR] = 12.5), to have visitors to their home (OR = 4.7), and to stay longer in the hospital (OR = 1.2) than COVID-19-negative cases. Compared to unvaccinated patients, the postoperative COVID-19 rate was not significantly different (3.9% vs 2.4%, P = .07). The incidence of surgical complications was similar between the 2 groups (P > .05).ConclusionsThe vaccination does not provide a guarantee that a patient will not contract COVID-19 following their arthroplasty surgery, especially in a region with a high rate of COVID-19. We believe reasonable perioperative COVID-19 precautions may be warranted even in vaccinated patients.

Longitudinal behavioral changes and factors related to reinforced risk aversion behavior among patients with chronic kidney disease during the COVID-19 pandemic

In patients with chronic kidney disease (CKD), coronavirus disease 2019 (COVID-19) has a higher mortality rate than the general population; therefore, prevention is vital. To prevent COVID-19 infection, it is important to study individuals’ risk aversion behavior. The objective of this study was to understand how the behavioral characteristics of physical distancing, hygiene practice, and exercise changed in patients with CKD during the COVID-19 pandemic and to identify the characteristics of patients who showed weakened or strengthened behavioral changes. We analyzed data from the Study on Kidney Disease and Environmental Chemicals (Clinical Trial No. NCT04679168), that examined a prospective cohort of patients with CKD. This cohort included patients with CKD who visited the participating hospitals for the first time between June and October 2020 and the second time between October 2020 and January 2021. Data on demographics, socio-economic details, and behavioral characteristics were collected through a questionnaire survey. Using a multivariable logistic regression model, we identified whether COVID-19 infection risk perception and previous strong behavioral changes affected behavioral changes during the first and second visits. A total of 277 patients (33.2% females) were included in the analysis. Nine out of 12 behaviors were reinforced at the first visit, and five out of nine reinforced behaviors were weakened at the second visit. A high-risk perception of COVID-19 infection was not associated with the tendency of overall behavioral reinforcement or maintaining behaviors in an enhanced state at the second visit. Strong behavioral changes at the patients’ first visit to the hospital were associated with a tendency to strengthen or maintain reinforced behaviors at the second visit (adjusted odds ratio 1.99, 95% confidence interval 1.19–3.34; P = 0.009). Even if the initial COVID-19 risk perception is high, behavioral changes worsen over time. Individuals who showed more active behavioral changes at the beginning of the COVID-19 pandemic tended to maintain reinforced behavior over time. Continuous education and monitoring are needed to maintain changed behaviors, especially in patients with a high initial COVID-19 risk perception.

COVID-19 in Immunocompromised Children and Adolescents.

COVID-19 in Immunocompromised Children and Adolescents.