COVID-19 Status Research Articles

1834. Impact of COVID-19 and Socioeconomic Status on Food Insecurity in the US Adult Population: Analysis of the 2021 National Health Interview Survey

Abstract Background Food insecurity (FI) is a public health concern and negatively affects the health and well-being of many adults in the US, which may have been exacerbated since the COVID-19 pandemic. However, the relationship between COVID-19 and FI among US adults has not been elucidated. Methods Data were from the 2021 National Health Interview Survey that used stratified clustering sampling to interview US adults aged ≥ 18 years. COVID-19 infection (yes/no) was per self-report. FI, determined by a 10-item questionnaire assessing household food situations in the past 30 days, was dichotomized (yes/no). Unweighted frequencies and weighted percentages were calculated and compared using Rao-Scott chi-square tests. Multivariable logistic regression was used to examine differences in FI prevalence by COVID-19. All analyses accounted for complex survey design and weights. Results The unweighted sample size was 28,274 (mean age 48.3 years). Overall, 13.5% (95% CI: 13.0%-14.1%) had COVID-19, and 5.9% (95% CI: 5.5%-6.3%) experienced FI. Adults with COVID-19 reported a significantly higher percentage of FI than those without (7.3% [95% CI: 6.1%-8.6%] vs. 5.6% [95% CI: 5.2%-6.0%], p=0.003). Most (63.2%) were White, followed by 16.7% Hispanic, 11.5% Black, 5.9% Asian, and 2.6% other races; 22.6% were on Medicaid/Medicare and 9.8% were uninsured; 12.9% received food stamps in the past 12 months. In the adjusted model, adults with COVID-19 were more likely to have experienced FI than those without (adjusted odds ratio [aOR]=1.29, 95% CI: 1.07-1.56). Black (aOR=2.08, 95% CI: 1.72-2.50) or Hispanic (aOR=1.26, 95% CI: 1.03-1.53) adults were more likely than their White counterparts to have experienced FI. Uninsured adults (aOR=2.67, 95% CI: 2.15-3.31) or those on Medicaid/Medicare (aOR=1.94, 95% CI: 1.60-2.35) had greater odds of having experienced FI than those privately insured. Adults receiving food stamps were more likely to have experienced FI than those not receiving (aOR=2.87, 95% CI: 2.36-3.50). Conclusion In this study of a nationally representative sample, our findings highlight a higher prevalence of FI among adults with COVID-19, with lower socioeconomic status, or in racial/ethnic minority communities and suggest the need for intervention strategies addressing FI in these adult populations. Disclosures All Authors: No reported disclosures

Impact of COVID-19 and Vaccination During Pregnancy on Placenta-Mediated Complications (COVIGRO Study)

ObjectivesCOVID-19 has been associated with preterm birth (PTB) and placental-mediated complications, including fetal growth restriction and preeclampsia (PE). This study aimed to estimate the impact of COVID-19 and vaccination on adverse pregnancy outcomes and markers of placental function. MethodsWe performed a study on a prospective cohort of women recruited in the first trimester of pregnancy during the early COVID-19 pandemic period (December 2020 to December 2021). At each trimester of pregnancy, the assessment included a questionnaire on COVID-19 and vaccination status; serological tests for COVID-19 (for asymptomatic infection); measurement of placental growth factor (PlGF) and soluble fms-like tyrosine kinase 1 (sFlt-1) in maternal blood; measurement of mean uterine artery pulsatility index (UtA-PI); and pregnancy outcomes (PTB, PE, birth weight below the fifth and the tenth percentile). ResultsAmong 788 patients with complete data, we observed 101 (13%) cases of symptomatic infection and 74 (9%) cases of asymptomatic infection with SARS-CoV-2. Most cases (73%) of infection were among women with previous vaccination or COVID-19 infection before pregnancy. COVID-19 infection was not associated with adverse pregnancy outcomes, abnormal fetal growth, sFlt-1/PlGF ratio, or mean UtA-PI. Vaccination during pregnancy did not influence these outcomes either. We observed no case of severe COVID-19 infection requiring respiratory support. ConclusionMild symptomatic or asymptomatic COVID-19 during pregnancy did not influence the risk of adverse pregnancy outcomes and the markers of placental function in predominantly vaccinated women. Fetal growth monitoring is unlikely to be mandatory in women with mild symptoms of COVID-19.

Is SARS-CoV-2-induced disease a decisive factor influencing testosterone in males? Findings from a case-control ex post facto study.

Whether the observed lower total testosterone (tT) levels in male patients with COVID-19 are caused by a direct impact of SARS-CoV-2 infection or are collateral phenomena shared by other systemic inflammatory conditions has not yet been clarified. To investigate the independent role of COVID-19 in reducing circulating tT levels in men. We compared demographic, clinical, and hormonal values of patients with laboratory confirmed COVID-19 admitted during the first wave of the pandemic with a cohort of consecutive male patients admitted to the intensive care unit (ICU) of the same academic center because of severe acute respiratory distress syndrome (ARDS) but without SARS-CoV-2 infection and no previous history of COVID-19. Linear regression model tested the independent impact of COVID-19 on circulating tT levels. Logistic regression model was used to test predictors of death in the entire cohort. Of 286 patients with COVID-19, 70 men had been admitted to the ICU ( =cases) and were compared to 79 patients equally admitted to ICU because of severe ARDS but negative for SARS-CoV-2 infection and without previous history of COVID-19 ( =controls). Controls were further grouped into noninfective (n=49) and infective-ARDS (n=30) patients. At baseline, controls were older (p=0.01) and had more comorbidities (p<0.0001). Overall, cases admitted to ICU had significantly lower circulating tT levels compared to controls (0.9nmol/L vs. 2.1nmol/L; vs. 1.2nmol/L; p=0.03). At linear regression, being negative for COVID-19 was associated with higher tT levels (Coeff: 2.13; 95% confidence interval - CI 0.71-3.56; p=0.004) after adjusting for age, BMI, comorbidities and IL-6 levels. Only age and IL-6 levels emerged to be associated with higher risk of death regardless of COVID-19 status. This case-control ex post facto study showed lower tT levels in men with COVID-19 compared to those without COVID-19 despite both groups have been equally admitted to ICU for severe ARDS, thus suggesting a possible direct impact of SARS-CoV-2 infection toward circulating tT levels and a consequent more severe clinical outcome.

DO MEDICAL COMORBIDITIES PLAY A BIGGER ROLE IN MORTALITY IN NECK OF FEMUR FRACTURE PATIENTS THAN COVID? A MULTICENTRE STUDY

AbstractIntroductionSeveral studies have shown that patients over 65 years have a higher mortality with covid. Combine with inherently increased morbidity and mortality in neck of femur (NoFF) fractures, it is logical to think that this subset would be most at risk.AimsInvestigate whether there is actual increase in direct mortality from Covid infection in NoFF patients, also investigate other contributing factors to mortality with covid positivity and compare the findings with current available literature.Methods1-year cross sectional, retrospective study from 1st March 2020 at two DGHs, one in Wales and one in England. Surgically treated NoFF patients with isolated intra/extracapsular fracture included. Mortality analysis done by creating a matched comparison group for each risk factor and combinations known to confer highest mortality. Chi square test for independence used to compare COVID status with 1 year mortality.Results610 patients, 62 patients had COVID-19RTPCR+ive test during hospital stay/in the community. 21(34%) deaths in COVID positive and 95 (17.33%) deaths in COVID negative patients. There was no mortality in ASA 1 or 2 patients. Analysis of asa matching with 10-year age ranges from 65years revealed a nearly double mortality rate in covid+ group as opposed to covid negative for both ASA 3 and 4 groups. Parameters such as preinjury mobility, residential status, AMTS score, time to surgery, did not seem to play a significant role in mortality.ConclusionFirst of its kind study with a large subset of patients and unique parameters to identify causes leading to mortality in the vulnerable population of NoFF. Higher morality in Covid positive NoFF patients, but increase may not be as significant as identified by most current studies in the literature and still within the confines of NHFD stats(2019).Declaration of Interest(b) declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported:I declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Sequestration of imaging studies in MIDRC: stratified sampling to balance demographic characteristics of patients in a multi-institutional data commons.

The Medical Imaging and Data Resource Center (MIDRC) is a multi-institutional effort to accelerate medical imaging machine intelligence research and create a publicly available image repository/commons as well as a sequestered commons for performance evaluation and benchmarking of algorithms. After de-identification, approximately 80% of the medical images and associated metadata become part of the open commons and 20% are sequestered from the open commons. To ensure that both commons are representative of the population available, we introduced a stratified sampling method to balance the demographic characteristics across the two datasets. Our method uses multi-dimensional stratified sampling where several demographic variables of interest are sequentially used to separate the data into individual strata, each representing a unique combination of variables. Within each resulting stratum, patients are assigned to the open or sequestered commons. This algorithm was used on an example dataset containing 5000 patients using the variables of race, age, sex at birth, ethnicity, COVID-19 status, and image modality and compared resulting demographic distributions to naïve random sampling of the dataset over 2000 independent trials. Resulting prevalence of each demographic variable matched the prevalence from the input dataset within one standard deviation. Mann-Whitney U test results supported the hypothesis that sequestration by stratified sampling provided more balanced subsets than naïve randomization, except for demographic subcategories with very low prevalence. The developed multi-dimensional stratified sampling algorithm can partition a large dataset while maintaining balance across several variables, superior to the balance achieved from naïve randomization.

Functional recovery in a cohort of ECMO and non-ECMO acute respiratory distress syndrome survivors

BackgroundThe mortality benefit of VV-ECMO in ARDS has been extensively studied, but the impact on long-term functional outcomes of survivors is poorly defined. We aimed to assess the association between ECMO and functional outcomes in a contemporaneous cohort of survivors of ARDS.MethodsMulticenter retrospective cohort study of ARDS survivors who presented to follow-up clinic. The primary outcome was FVC% predicted. Univariate and multivariate regression models were used to evaluate the impact of ECMO on the primary outcome.ResultsThis study enrolled 110 survivors of ARDS, 34 of whom were managed using ECMO. The ECMO cohort was younger (35 [28, 50] vs. 51 [44, 61] years old, p < 0.01), less likely to have COVID-19 (58% vs. 96%, p < 0.01), more severely ill based on the Sequential Organ Failure Assessment (SOFA) score (7 [5, 9] vs. 4 [3, 6], p < 0.01), dynamic lung compliance (15 mL/cmH20 [11, 20] vs. 27 mL/cmH20 [23, 35], p < 0.01), oxygenation index (26 [22, 33] vs. 9 [6, 11], p < 0.01), and their need for rescue modes of ventilation. ECMO patients had significantly longer lengths of hospitalization (46 [27, 62] vs. 16 [12, 31] days, p < 0.01) ICU stay (29 [19, 43] vs. 10 [5, 17] days, p < 0.01), and duration of mechanical ventilation (24 [14, 42] vs. 10 [7, 17] days, p < 0.01). Functional outcomes were similar in ECMO and non-ECMO patients. ECMO did not predict changes in lung function when adjusting for age, SOFA, COVID-19 status, or length of hospitalization.ConclusionsThere were no significant differences in the FVC% predicted, or other markers of pulmonary, neurocognitive, or psychiatric functional recovery outcomes, when comparing a contemporaneous clinic-based cohort of survivors of ARDS managed with ECMO to those without ECMO.

Chronic overlapping pain conditions increase the risk of long COVID features, regardless of acute COVID status.

Chronic overlapping pain conditions (COPCs) refer to conditions that have similar central nervous system pathophysiologic mechanisms driving widespread pain as well as common comorbid symptoms such as fatigue and problems with sleep, memory, and mood. If COPCs predict the onset of long COVID, this could offer a valuable orientation for long COVID-related research and clinical care. This retrospective cohort study aimed to determine whether having a COPC predicts the onset of long COVID features using US electronic health records and 1:1 propensity score matching without replacement. The study cohorts included (1) people with acute COVID (n = 1,038,402), (2) people with acute influenza (n = 262,092), and (3) a noninfected cohort comprising people with a routine healthcare encounter (n = 1,081,593). Having a COPC increased the risk of long COVID features in all 3 study cohorts. Among those with COVID, having a pre-existing COPC increased the risk by 1.47 (95% CI = 1.46, 1.47). In the influenza cohort, COPCs increased the risk by 1.39 (95% CI = 1.38, 1.40). In the noninfected cohort, COPCs increased the risk by 1.57 (95% CI = 1.56, 1.59). These findings reinforce the likelihood that nociplastic mechanisms play a prominent role in long COVID. Recognizing that this ubiquitous nonspecific syndrome occurs frequently in the population can inform precision medicine therapies that avoid the pitfalls of viewing long COVID exclusively in the framework of postinfectious disease.

Abstract 15152: One-Year Evolution of Patients With Pulmonary Embolism During the Highest Epidemic Peak of COVID-19: COVID-EP Study

Introduction: During the first COVID peak, among patients admitted to intensive care unit, pulmonary embolism (PE) diagnosis frequency was high. In April 2020 (highest epidemic peak of COVID), no PE management guidelines were effective, and PE evolution in this context was uncertain. Although several studies had explored a potential link between COVID and PE, none had focused on PE evolution according to COVID status excepted for death and short-term complications. Hypothesis: Our aim was to investigate whether COVID status and/or treatments used at the time of PE could affect PE evolution in longer-term. Aims: The main objectives were: (1) To assess the occurrence at 6 and 12 months after PE diagnosis of one of the following complications of interest: interstitial pathology, recurrence of PE, pulmonary arterial hypertension (PAH) or death, (2) to investigate the impact of the treatment dispensed on PE evolution. Methods: A National multicenter prospective cohort study was conducted in patients diagnosed with PE in April 2020. Patients were divided into two groups according to their COVID viral status (COVID-positive and COVID-negative) and were followed up to 12 months. Results: A total of 87 patients were included into 12 centers. No difference in global complication rates was observed between the groups at 6 and 12 months (p=0.4682 and p=0.5045 respectively). However, we observed that COVID-Positive patients had more interstitial pathology at 3, 6 and 12 months than COVID-Negative patients (p=0.0075, p=0.0088 and p=0.0033 respectively). Furthermore, the PE complication rate was significantly higher in patients treated with heparin-alone in COVID-negative patients (p=0.0002). Conclusions: COVID status did not appear to influence PE evolution, in accordance with the literature. Interstitial pathology has recently been shown to be a complication of COVID, which may explain its higher incidence in the COVID-positive group. Because of the exceptional context of the COVID pandemic in which this study was conducted and the short duration of inclusion, it might be interesting to confirm these results with a study on a larger population and over a longer period, in order to possibly update the management of patients with PE.

Abstract 14303: COVID-19 and the Gender Impact on Sudden Cardiac Death

Background: Sudden Cardiac Death (SCD) is an unexpected death attributed to a cardiac cause that occurs within one hour of symptom onset. Males have a higher likelihood of experiencing sudden cardiac arrest compared to females, as evidenced by previous studies indicating a substantial disparity in mortality rates between the genders. The outbreak of the COVID-19 pandemic has had a profound impact on cardiovascular population health patterns. Therefore, our study aimed to assess the influence of the pandemic on the gender-related variation in SCD rates among males and females. Methods: We used the National Inpatient Sample (NIS) to identify all patients admitted to hospitals in 2019 and 2020 with a primary diagnosis of sudden cardiac arrest. To analyze associations, we employed both logistic and linear regression methods, adjusting for potential confounding variables. We set the threshold for statistical significance at a 2-tailed p-value of 0.05. Results: Between 2019 and 2020, a total of 27,430 individuals were admitted to hospitals with a primary diagnosis of sudden cardiac arrest, with 11,705 (42.7%) of these patients being female. When factors such as age, race, hospital bed size, location and teaching status, insurance, and income level, as well as Elixhauser comorbidities and COVID-19 status were considered through multivariate regression analysis, a distinct trend emerged. In the year 2020, which was marked by the COVID-19 pandemic, there was a significant increase in in-hospital mortality among female patients (adjusted Odds Ratio aOR 1.34, 95% Confidence Interval CI 1.04 - 1.79). This trend was not present in the previous year, 2019, prior to the pandemic (aOR 1.03, 95% CI 0.87 - 1.22). Conclusion: Our study revealed a significant increase in mortality among female patients presenting with sudden cardiac arrest during the Covid-19 pandemic. We attribute this increase to the intricate interplay between Covid-19 and the healthcare system. While a direct association between SCD and Covid-19 is possible, it is crucial to acknowledge the indirect ramifications such as the impact of lockdown measures, alterations in behavior, and challenges faced by the healthcare system, all of which may be contributing factors.

67 COVID-19 Mobile Brain Health

Objective:Over 80% of hospitalized COVID-19 patients have neurological symptoms, including memory loss, attention difficulties, and trouble thinking clearly that can last for months. The long-term neurological impact of the SARS-CoV-2 virus is unknown and it remains to be seen whether it would create a surge in cases of dementia and cognitive decline years later, which is already a global public health challenge. Examining the cognitive effects of the virus will help with understanding its impact on the brain and inform treatment options. The goal of the present study was to examine cognitive performance among those who have had COVID-19 via mobile-based assessments using smartphone-based cognitive tests. Participants with a previous COVID-19 diagnosis (COVID+) were expected to have worse cognitive performance at baseline than those without COVID-19 (COVID-).Participants and Methods:Participants (n=23) with self-reported positive or negative COVID-19 statuses based on polymerase chain reaction or antigen testing were recruited from the Boston area. Inclusion criteria included access to a smartphone with an Android or iOS operationsystem and to internet connectivity, along with proficiency in English. Cognitive performance was measured using Defense Automated Neurobehavioral Assessment (DANA) from AnthroTronix. Welch’s 2-sample t-test was used to compare cognitive performance among those with and without COVID-19.Results:The sample was comprised primarily of COVID+ (59%), female (59%), and Caucasian (50%) participants that were generally well educated (77% with a bachelor’s degree), and had &gt;1 COVID vaccination (95%). About 50% of the sample reported symptoms of depression and mild anxiety. Results were not indicative of significant differences between COVID+ and COVID- groups at baseline: Simple Reaction Time (Immediate; M = 5.62; p = 0.81), Code Substitution (M = 1.25; p = 0.77), Procedural Reaction Time (M = -7.26; p = 0.49), Spatial Processing (M = -3.14; p = 0.50), Go No Go (M = -1.37; p = 0.89), Match to Sample (M = 2.00; p = 0.57), Memory Search (M = -2.62; p = 0.75), and Simple Reaction Time (Delayed; M = 2.99; p = 0.81).Conclusions:Results indicate that cognitive performance at baseline does not differ based on COVID status, emphasizing the need for examination of longitudinal cognitive performance. Future directions include examining the impact of COVID disease severity and reinfection on cognition.

COVID-19 infection and efficacy of vaccination in patients with rheumatic diseases during Omicron outbreak in South Korea: a prospective cohort study

ObjectivesThis study aims to investigate COVID-19 epidemiological data in patients with autoimmune inflammatory rheumatic diseases (AIRDs) during Omicron wave and to identify clinical factors associated with infection, including COVID-19 vaccination.MethodsThis...

During the Omicron Pandemic Wave, the Severe Systemic Inflammatory Status of COVID-19 Indicated a Higher Risk of In-Hospital Mortality and Mediated the Clinical Efficacy of Corticosteroids.

For the distinct immune/inflammatory responses from Omicron variant infection, this study aimed to investigate the diagnostic efficacy of systemic inflammatory indicators and the clinical efficacy of corticosteroids on the in-hospital mortality among COVID-19 patients. Under a retrospective cohort study, 1081 COVID-19 patients were recruited from Beijing Youan Hospital, Capital Medical University between November 16, 2022 and January 30, 2023. We chose neutrophil-to-lymphocyte ratio (NLR), CRP-to-lymphocyte ratio (CLR), and CRP-to-albumin ratio (CAR) as the systemic inflammatory indicators. Receiver operating curve (ROC) and multivariate logistic regression analysis were used to determine the diagnostic efficacy of systemic inflammatory indicators and the association between systemic inflammatory indicators and in-hospital mortality. Among 684 patients included in analysis, 96 died during hospitalization. NLR, CLR and CAR performed well (with an area under the curve (AUC) greater than 0.75) in discriminating in-hospital mortality among COVID-19 patients. The severe status of systemic inflammation, with optimal cut-off value derived from ROC analysis, significantly associated higher risk of in-hospital mortality (OR = 3.81 for NLR ≥ 6.131; OR = 3.76 for CLR ≥ 45.455; OR = 5.10 for CAR ≥ 1.436). Corticosteroids use within 72 hours of admission increased the in-hospital mortality 2.88-fold for COVID-19 patients. In the subgroup of patients with severe systemic inflammation, corticosteroids increased the risk of in-hospital mortality (OR = 2.11 for NLR, p = 0.055; OR = 2.94 for CLR, p = 0.005; OR = 2.31 for CAR, p = 0.036). Systemic inflammatory indicators had good diagnostic performance for in-hospital mortality. Patients with severe systemic inflammatory status should not receive corticosteroid treatment and further studies are warranted for confirmation.

Impact of SARS-CoV-2 infection on patients with systemic lupus erythematosus in England prior to vaccination: a retrospective observational cohort study

ObjectivesDetermine the prevaccination healthcare impact of COVID-19 in patients with systemic lupus erythematosus (SLE) in England.DesignRetrospective cohort study of adult patients with SLE from 1 May to 31 October 2020.SettingClinical...

Butuh Dukungan Bukan Teror saat Berjuang dalam Pemulihan dari COVID-19

This research aims to explore in depth the experiences of COVID-19 patients in motivating themselves to recover. This research method uses a phenomenological study approach with in-depth interviews, sampling techniques using purposive sampling, and analysis using the Colaizzi stage. The results of the research show that there are four themes, namely hiding a positive status for COVID-19 as a coping mechanism that is considered the safest for achieving self-healing, the experience of helplessness is a driving factor for recovery, a support system that is not excessive provides enthusiasm to rise and recover from COVID-19, The support system forms positive affirmations to get up and undergo treatment. In conclusion, there are four themes that participants perceive when struggling to recover from COVID-19. It is essential to provide support to COVID-19 patients so that they can recover optimally, but not excessive reliance that could be considered terror.&#x0D; Keywords: COVID-19, Helplessness, Coping Mechanisms, Motivation, Support System

Perceptions of Coronavirus Disease 2019 (COVID-19) in Patients With Schizophrenia

Objectives: The aim of this study was to investigate whether patients with schizophrenia are aware of the current status and have accurate information about COVID-19.Methods: The participants consisted of 161 inpatients and 117 outpatients with schizophrenia and 40 normal controls. The subjects completed self-report questionnaires measuring changes in their daily life, their perceptions of the current status of COVID-19 and their basic knowledge about the disease.Results: Compared to the normal control group, the inpatients and outpatients with schizophrenia underestimated the cumulative number of confirmed COVID-19 cases and overestimated the mortality rate of COVID-19. The mortality rates of COVID-19 and the common cold were higher in the order of inpatients, outpatients, and normal controls. The main route of SARS-CoV-2 infection and the main symptoms of COVID-19 were accurately recognized by more than 95% in the normal group and more than 80% in outpatients, but inpatients chose the correct answers at a lower rate. In the questions about misperceptions about COVID-19, the correct answer rate was high in the order of normal controls, outpatients, and inpatients. Most patients with schizophrenia obtained information about COVID-19 on TV, while most normal controls collected information through the internet.Conclusion: This study showed that awareness of COVID-19 among patients with schizophrenia is insufficient. Additional measures are needed to provide accurate information and the current status of COVID-19 to patients with schizophrenia.

Intolerance of Uncertainty Levels in Families of Children with Special Needs During Covid-19 Process

The objective of this study was to investigate the levels of intolerance of uncertainty among families of children with special needs during the Covid-19 pandemic, with respect to various factors. The study utilized a relational survey model and included 250 families of children with special needs who participated in the research during the Fall academic year of 2020-2021. Due to the Covid-19 pandemic's unavoidable circumstances, data were collected electronically via Google Forms. To gather the data, a "Demographic Information Form" and an "Intolerance of Uncertainty Scale" were administered. The obtained data were analyzed using the SPSS 26.0 software. The results indicated that families of children with special needs had a higher level of intolerance of uncertainty, as indicated by the scale's overall scores and the prospective anxiety sub-dimension(p&amp;gt;0.05). The study further revealed that the families' income level and whether one of their relatives had Covid-19 significantly impacted their intolerance of uncertainty levels(p&amp;gt;0.05). However, there were no significant differences based on the families' age, gender, marital status, Covid-19 status, loss of a loved one due to Covid-19, chronic illness, or job loss during the pandemic(p&amp;gt;0.05).Based on studies examining the intolerance of families of children with special needs to uncertainty, efforts can be made to provide psychological support to families of children with special needs.Seminars can be organized for families of children with special needs by institution managers or special education teachers.

COVID-19 vaccine and test data management – practice report from a university hospital

Abstract Issue The COVID-19 pandemic generated the urgency for creating and implementing new tools, specifically for data collection, sharing. The data governance of healthcare workers (HCW) was layered on top of pre-existing digitalisation issues in health authorities as well as in health facilities. Description of the problem The vaccination act for the German healthcare sector adopted in December 2021, established the compulsory report of HCWs’ COVID-19 vaccination status. The LMU University Hospital management required an overview of the COVID-19 status (illness, isolation, vaccination, infection) of HCWs in order to ensure continuous clinical service. For the timely and accurate report, it was necessary to create a centralised real-time overview of data that were collected and managed by decentralised structures. Results We connected five in-hospital systems into one platform that was being synced three times a day. For each HCW, we created a dataset with three main categories: core personnel data, COVID-19 status and reason for absence. Two user groups were defined: strategic management (1) and operational management (2), where users of group 2 were only given access to their own unit and were required to update and verify data of their team. Overall, the platform contained data of 14,419 HCWs and had 656 users (Ngroup1 = 16, Ngroup2 = 640). Lessons The data merger revealed issues in interoperability and accuracy and thus expedited data standardisation. The decentralised approach facilitated the operational efficiency, digitalisation, service delivery and managerial empowerment at the hospital. The main challenges pertained to data accuracy and to the continuously changing regulatory requirements as well as privacy protection. As all data were previously hosted on different platforms, an exhaustive process of cleansing was needed prior to merging. Each HCW was assigned to an organisational unit with a respective responsible person in order to achieve data quality. Key messages • Dedicated digital human resources solutions in a university hospital pose a specific challenge for the balance between data privacy, availability and interoperability. • To enable a centralised information display, data must be collected where it originates and made available through short paths. Our solution united decentralised collection and centralised management.

Prevalence of sleep disturbances in patients with long COVID assessed by standardised questionnaires and diagnostic criteria: A systematic review and meta-analysis

ObjectiveWe aimed to study the prevalence of sleep disturbances in patients with long COVID-19. MethodsWe conducted a systematic review and meta-analysis of the pooled prevalence of sleep disturbances in patients post COVID-19. We systematically searched relevant studies from three databases, including Medline, Embase and Scopus. Original articles were included based on specific criteria: peer-reviewed, observational studies involving adults (18 or older) with confirmed post COVID-19 status through PCR testing and focused on sleep in the context of post COVID-19. Exclusion criteria included non-English articles, studies with insufficient data, and narrative/systematic reviews. The search was performed from 31st July 2023 to 15th August 2023. We identified 35 eligible papers; however, we excluded 6 studies which did not describe the sleep assessment. We used a random-effects meta-analysis model to estimate the pooled prevalence of sleep disturbances. Results29 studies involved 13,935 long COVID-19 patients; approximately 39% of participants were male aged 18 to 97 years. The overall pooled prevalence of sleep disturbance was 46% (95% CI: 38–54%). Subgroup analyses revealed that the pooled prevalence of poor sleep quality was 56% (95% CI: 47–65%). The pooled prevalence of insomnia was 38% (95% CI: 28–48%). Finally, the pooled prevalence of excessive daytime sleepiness was 14% (95% CI: 0–29%). ConclusionSleep disturbances are common in long COVID-19 patients. The healthcare sector should recognise these sleep issues and provide an early, effective treatment to prevent long-term sequelae of sleep problems.

Impact of COVID-19 Infection on Health-Related Quality of Life, Work Productivity and Activity Impairment by Symptom-Based Long COVID Status and Age in the US.

COVID-19 infection adversely impacts patients' wellbeing and daily lives. This survey-based study examined differences in patient-reported COVID-19 symptoms, Health-Related Quality of Life (HRQoL) and Work Productivity and Activity Impairment (WPAI) among groups of patients defined based on age and symptom-based long COVID status. Symptomatic, COVID-19-positive US outpatients were recruited from 31 January-30 April 2022. Outcomes were collected via validated instruments at pre-COVID, Day 3, Week 1, Week 4, Month 3 and Month 6 following infection, with changes assessed from pre-COVID and between groups, adjusting for covariates. EQ-5D-5L HRQoL and WPAI scores declined in all groups, especially during the first week. Long COVID patients reported significantly higher symptoms burden and larger drops in HRQoL and WPAI scores than patients without long COVID. Their HRQoL and WPAI scores did not return to levels comparable to pre-COVID through Month 6, except for absenteeism. Patients without long COVID generally recovered between Week 4 and Month 3. Older (>50) and younger adults generally reported comparable symptoms burden and drops in HRQoL and WPAI scores. During the first week of infection, COVID-19-related health issues caused loss of 14 to 26 work hours across the groups. These data further knowledge regarding the differential impacts of COVID-19 on clinically relevant patient groups.

Determinant Factors of Acceptance of COVID-19 Booster Vaccine in Elderly in Bogor City

Objective: WHO issued a PHEIC revocation status for COVID-19. Prevention efforts with vaccination must still be carried out for long-term plans due to decreased effectiveness and virus mutations. The most severe impact was felt by the elderly, with 49.40% of the total 151,951 deaths recorded in Indonesia due to COVID-19. The aim of this research was to determine the determinants factor of receiving the COVID-19 booster vaccine for the elderly in Bogor City. Methods: uses the document review method sourced from the website www.covid-19.go.id and qualitatively uses the Social Ecological Model and the Health Belief Model theory. Documents were reviewed from 2020 to June 2023. Qualitative data were collected by selecting informants using purposive sampling and processed using the Nvivo application. Results: Based on extrinsic factors, there were 40 policies issued by the government specifically regarding the COVID-19 vaccine but have not been issued in Bogor City. The role of the community, organizations, and elderly families has not been maximized because of low knowledge regarding vaccines, dissemination of information on the COVID-19 vaccine still in general, and some families have not allowed the elderly to be vaccinated. Based on intrinsic factors, it shows that perceived susceptibility, perceived barriers, and cues to action have an influence on the acceptance of the COVID-19 vaccine in the elderly in Bogor City. Conclusion: The determinants of the achievement of the COVID-19 booster vaccine in the elderly, there is no policy that has been issued specifically for the elderly in Bogor City. Community, organizations and elderly families have not played a sufficient role in implementing vaccinations and the elderly have low knowledge about vaccines, remote vaccine locations, unpleasant side effects after being vaccinated, and family directions that are not fully supportive.