Suspected COVID-19 Symptoms Research Articles

Obstetric Outcomes of pregnant women with Covid-19 infection during first and second waves of Covid Pandemic in Lagos Nigeria

Background: Coronaviruses are a group of enveloped positive-stranded RNA viruses. They constitute a very important human and animal pathogens. COVID-19, a novel coronavirus was identified towards the end of 2019 following a cluster of pneumonia in Wuhan city in China. Our study aims to document the obstetrics parameters and outcomes of pregnant women diagnosed and managed at the Lagos University Teaching Hospital, Nigeria. Methods: The study was a retrospective review of the medical records of all pregnant women admitted to the Lagos University Teaching Hospital (LUTH) COVID 19 Isolation and Treatment Centre during the first wave (from April 2020 to October 2020) and second wave (from December 2020 to April 2021). The clinical characteristics (including COVID severity) and outcomes were retrieved. Results: During the study period thirty-four pregnant women with suspected COVID-19 symptoms for which nasopharyngeal samples for RTPCR for SARS-CoV-2 nucleic acid were positive were seen and managed following their admission into the isolation ward for COVID-19. Of the 34 women, 50.0% (17) of them were discharged to the antenatal clinic following recovery, 44.1% (15) had childbirth while on admission, and 5.9% (2) had maternal death. Of the 15 deliveries, 14 occurred at term with 15 babies (a set of twins) and one preterm stillbirth. Conclusion: The clinical manifestations of COVID-19 in pregnant mothers are similar to those described in the non-pregnant population as pregnancy does not seem to worsen the severity of the disease. Noticeably, severe infection occurred in women with comorbidities such as asthma and hypertensive disorders.

Investigating Depression in College Students During and After the COVID-19 Condition

ABSTRACT The COVID-19 pandemic has had a significant effect on the mental health of university students worldwide. The purpose of this study was to investigate changes in depression over a one-year period, during the COVID-19 pandemic (from 2021 to 2022), in a sample of Egyptian college students. University students were invited to complete the Beck Depression Inventory (BDI) twice. Additionally, students were asked to respond to questions on the COVID-19 condition. A total of 722 students completed the BDI twice. At baseline, the prevalence of depression was estimated to be 29.6%, however, the 12-month follow-up examination revealed that 37.8% of students had depression. At two time points, students who had suspected COVID-19 symptoms had significantly higher BDI scores than those who did not. Furthermore, the 12-month examination revealed a significant rise in depression as compared to the baseline assessment. There is an urgent need for specific interventions to address university students’ mental health concerns. Priorities should be set for teaching students effective coping mechanisms during times of crisis. The current study highlights the impact of the COVID-19 pandemic on mental health.

Impact of PEG-GCSF in Breast Cancer Patients Undergoing Chemotherapy During the COVID-19 Pandemic: Single Center Experience and Literature Review.

The COVID-19 pandemic brought many challenges in healthcare systems globally. Pegylated granulocyte colony stimulating factor (PEG-GCSF) is recommended to reduce febrile neutropenia (FN), however there are a few reports that G-CSF might worsen COVID-19 disease, and its appropriate use during the COVID-19 pandemic remains uncertain. This retrospective study aimed to analyze the association between PEG-GCSF use and COVID-19 infection and severity. Breast cancer patients who received chemotherapy at the Nagoya Tokushukai General Hospital between October 2020 and April 2023 were included. Patients with suspected COVID-19 symptoms during each chemotherapy cycle underwent COVID-19 antigen testing. To assess the potential impact of PEG-GCSF on COVID-19 severity, we collected data on patient background, chemotherapy regimens, PEG-GCSF use, COVID-19 antigen tests, and COVID-19 infection from their medical records. Thirty patients received chemotherapy. In total, 71 cycles were administered comprising adriamycin and cyclophosphamide (AC; 37 cycles), docetaxel (DTX; 26 cycles) and docetaxel and cyclophosphamide (TC; eight cycles). Among those patients, suspected COVID-19 symptoms were observed in only one of 62 cycles of the three regimens (1.6%) with PEG-GCSF compared to two of nine cycles (22.2%) without PEG-GCSF (p=0.0405). However, because none developed COVID-19 infection during chemotherapy, we could not assess COVID-19 severity and PEG-GCSF use. A potential role of PEG-GCSF in reducing suspected COVID-19 symptoms during chemotherapy, reducing the anxiety and need for hospital visits, thus improving patients' quality of life, is suggested. These insights could contribute to optimizing the care of breast cancer patients in situations like the current pandemic.

Primary care gatekeeping during the COVID-19 pandemic: a survey of 1234 Norwegian regular GPs.

In the Nordic healthcare systems, GPs regulate access to secondary health services as gatekeepers. Limited knowledge exists about the gatekeeper role of GPs during public health crises seen from the perspective of GPs. To document GPs' gatekeeper role and organisational changes during the initial COVID-19 lockdown in Norway. A cross-sectional online survey was addressed to all regular Norwegian GPs (n = 4858) during pandemic lockdown in spring 2020. Each GP documented how patients with potential COVID-19 disease were triaged and handled during a full regular workday. The survey also covered workload, organisational changes, and views on advice given by the authorities. A total of 1234 (25.4%) of Norway's GPs participated. Together, they documented nearly 18 000 consultations, of which 65% were performed digitally (video, text, and telephone). Suspected COVID-19 symptoms were reported in 11% of the consultations. Nearly all these patients were managed in primary care, either in regular GP offices (55.7%) or GP-run municipal respiratory clinics (40.7%), while 3.7% (n = 73) were admitted to hospitals. The GPs proactively contacted an average of 0.8 at-risk patients per day. While 84% were satisfied with the information provided by the medical authorities, only 20% were able to reorganise their practice in accordance with national recommendations. During the early stage of the COVID-19 pandemic in Norway, the vast majority of patients with COVID-19-suspected symptoms were handled in primary care. This is likely to have protected secondary health services from potentially detrimental exposure to contagion and breakdown of capacity limits.

Possible advantage of granulocyte colony-stimulating factor in breast cancer chemotherapy during COVID-19 pandemic: A single center experience in Japan.

e12505 Background: The COVID-19 pandemic seems to be ongoing in many countries, including Japan. ASCO and ESMO guidelines recommend treatment with during chemotherapy, and their use also reduces the risk of febrile neutropenia. On the other hand, there is a report that use of granulocyte colony-stimulating factor (G-CSF) increases the risk of admission and mortality due to COVID-19, so appropriate G-CSF use is still under discussion. Methods: Breast cancer patients treated with chemotherapy at our hospital from October 2020 to December 2022 were included in this study. We retrospectively collected patient data, including chemotherapy regimens, G-CSF use, COVID-19 infection, and COVID-19 severity, from electronic medical records. Results: Twenty-four patients (two bilateral breast cancers) received chemotherapy during this period. Twenty-three patients were female (95.8%) and one was male (4.2%), the mean age was 58.7 (34–79) years; 11 (45.8%) had early-stage breast cancer and 14 (58.3%) had advanced or recurrent breast cancer (one patient with early-stage breast cancer developed recurrent breast cancer during the study period). Seventeen cases (65.4%) were ER positive and nine cases (34.6%) were negative, 15 cases (57.7%) were PgR positive and 11 cases (42.3%) were negative, and six cases (23.1%) were HER2 positive and 20 cases (76.9%) were negative. The major chemotherapy regimens were ddAC in three patients (12.5%), AC in eight patients (33.3%), wPTX in 11 patients (45.8%), DTX in four patients (16.7%), TC in one patient (4.2%) and S-1 in eight patients (33.3%). Some patients also received treatment with anti-HER2 or anti-VEGF drugs or an immune check-point inhibitor but we did not consider these. Of the 13 patients who received AC, DTX and TC, 11 patients received PEG-GCSF in all their cycles. Among all patients receiving, COVID-19 symptoms were suspected on four occasions, and the COVID-19 antigen test was conducted, but all were negative, so no cases of COVID-19 were observed. Of the 46 cycles of AC, DTX, and TC, the proportion of patients with suspected COVID-19 symptoms who underwent antigen testing tended to be lower in the PEG-GCSF group (37 cycles) than in the no PEG-GCSF group (nine cycles) (2.7% vs. 22.2%; p = 0.0933, Fisher’s exact test). Conclusions: In this study, we did not find any cases of COVID-19 infection during chemotherapy, and so were unable to analyze the association between G-CSF use and COVID-19 infection severity. However, we did observe a trend toward a lower rate of potential COVID-19 with administration of PEG-GCSF. This might reflect a better quality of life for breast cancer chemotherapy patients.

Correlation between clinical symptomatology and RT-PCR results in the diagnosis of COVID-19: An analysis using routine data in Burkina Faso

This study aimed to evaluate the correlation between suspected COVID-19 symptoms and RT-PCR results in the diagnosis of SARS-CoV-2 infection in Burkina Faso. We analyzed SARS-CoV-2 RT-PCR routine diagnostic data in Burkina Faso. Data were collected from March 9, 2020 to September 30, 2020 in the framework of the COVID-19 surveillance. Sensitivity, specificity, predictive values, and Kappa concordance were used to check the correlation between COVID-19 symptoms and the RT-PCR results. A total of 2217 participants were tested for COVID-19 using RT-PCR, of them 779 COVID-19 positive. The mean age of the participants was 38.7± 17.69 years. Suspected symptoms presented by participants were fever (40.4%), cough (38.6%), asthenia (27.3%), headache (23.6%), dyspnea (20.8%), and odynophagia (16.3%). The sensitivity of presence of at least a clinical sign compared to RT-PCR results was 62.13% and the specificity was 39.85%. The kappa agreement between the presence of COVID-19 suspected symptoms and RT-PCR results was 0.017. The presence of aguesia and/or anosmia in patients induced a positive predictive value of RT-PCR of 91.30%. : The correlation between the COVID-19 symptoms and RT-PCR results in the diagnosis of COVID-19 was very weak. The present study confirms that most clinical signs associated with SARS-CoV-2 infection are not specific to COVID-19, hence the need to always combine RT-PCR or other biological tests with the clinical diagnosis. However, aguesia and anosmia are of interest with a high degree of RT-PCR positivity when present in a COVID-19 suspected patient.

Contribution of Live Video to Physicians' Remote Assessment of Suspected COVID-19 Patients in an Emergency Medical Communication Centre: A Retrospective Study and Web-Based Survey.

The COVID-19 pandemic had a major impact on emergency medical communication centres (EMCC). A live video facility was made available to second-line physicians in an EMCC with a first-line paramedic to receive emergency calls. The objective of this study was to measure the contribution of live video to remote medical triage. The single-centre retrospective study included all telephone assessments of patients with suspected COVID-19 symptoms from 01.04.2020 to 30.04.2021 in Geneva, Switzerland. The organisation of the EMCC and the characteristics of patients who called the two emergency lines (official emergency number and COVID-19 number) with suspected COVID-19 symptoms were described. A prospective web-based survey of physicians was conducted during the same period to measure the indications, limitations and impact of live video on their decisions. A total of 8957 patients were included, and 2157 (48.0%) of the 4493 patients assessed on the official emergency number had dyspnoea, 4045 (90.6%) of 4464 patients assessed on the COVID-19 number had flu-like symptoms and 1798 (20.1%) patients were reassessed remotely by a physician, including 405 (22.5%) with live video, successfully in 315 (77.8%) attempts. The web-based survey (107 forms) showed that physicians used live video to assess mainly the breathing (81.3%) and general condition (78.5%) of patients. They felt that their decision was modified in 75.7% (n = 81) of cases and caught 7 (7.7%) patients in a life-threatening emergency. Medical triage decisions for suspected COVID-19 patients are strongly influenced by the use of live video.

Relationship between Mental Health and Quality of Life among Health Care Workers during COVID-19 Pandemic in Vietnam

Background: The COVID-19 pandemic has serious consequences around the world, especially in the healthcare system. With a crucial role in the pandemic, mental health and quality of life among health care workers (HCWs) needs to be addressed. Purposes: The study aimed to describe mental health and the health-related quality of life among HCWs and explore the relationship between mental health and quality of life among HCWs during the COVID-19 pandemic. Methods: A cross-sectional study was conducted from 6 April to 19 April 2020 at nine hospitals in Vietnam. The questionnaire included participant's characteristics, health-related quality of life (HRQoL), Patient Health Questionnaire (PHQ), and Generalized Anxiety Disorder (GAD). De-pression and anxiety were defined as PHQ scoregreater than or equal to 10 and GAD scoregreater than or equal to 8, respectively. Descriptive, bivariate, and multiple regression analyses were used to analyze the data with a significant level at p less than 0.05. Results: A total of 3,757 HCWs were enrolled in the study. Proportions of de-pression and anxiety were 4.5 Percentage and 3.1 Percentage, respectively. The overall mean score of HRQoL was 73.4 ± 14.9 (possible score range from 0 to 100). Protective factors of HRQoL consisted of physical activity, ability to pay for medication, gender, and social status, while its risk factors included suspected COVID-19 symptoms, smoking status. HRQoL was associated with depression (B(95 PercentageCI) = -8.15 (-10.76 to -5.55) and anxiety (B(95 PercentageCI) = -6.87 (-9.99 to -3.75)), p less than0.001. Conclusion: There was a relationship between mental health and the health-related quality of life among HCWs. Integration of healthy lifestyles and psychological support can help improve mental health and quality of life for HCWs during the pandemic.

Relationship between mental health and quality of life among health care workers during COVID-19 pandemic in Vietnam

Background: The COVID-19 pandemic has serious consequences around the world, especially in the healthcare system. With a crucial role in the pandemic, mental health and quality of life among health care workers (HCWs) needs to be addressed. Purposes: The study aimed to describe mental health and the health-related quality of life among HCWs and explore the relationship between mental health and quality of life among HCWs during the COVID-19 pandemic. Methods: A cross-sectional study was conducted from 6 April to 19 April 2020 at nine hospitals in Vietnam. The questionnaire included participant's characteristics, health-related quality of life (HRQoL), Patient Health Questionnaire (PHQ), and Generalized Anxiety Disorder (GAD). De-pression and anxiety were defined as PHQ score ≥ 10 and GAD score ≥ 8, respectively. Descriptive, bivariate, and multiple regression analyses were used to analyze the data with a significant level at p < 0.05. Results: A total of 3,757 HCWs were enrolled in the study. Proportions of de-pression and anxiety were 4.5% and 3.1%, respectively. The overall mean score of HRQoL was 73.4 ± 14.9 (possible score range from 0 to 100). Protective factors of HRQoL consisted of physical activity, ability to pay for medication, gender, and social status, while its risk factors included suspected COVID-19 symptoms, smoking status. HRQoL was associated with depression (B(95%CI) = -8.15 (-10.76 to -5.55) and anxiety (B(95%CI) = -6.87 (-9.99 to -3.75)), p<0.001. Conclusion: There was a relationship between mental health and the health-related quality of life among HCWs. Integration of healthy lifestyles and psychological support can help improve mental health and quality of life for HCWs during the pandemic.

210.7: Undetectable Recipient COVID-19 Plasma PCR Following COVID-19 Positive Donor Kidney Transplant: Proof of Concept Analysis

Introduction: With one-third of the United States still not fully vaccinated for COVID-19 and almost one-half unvaccinated in Arkansas, it is common to see patients presenting with non-survivable diagnosis, incidentally testing COVID-19+ or with recent history of mild COVID-19 infection. In the absence of COVID-19, such patients could become organ donors. Limited case series have demonstrated no COVID-19 syndrome following transplantation from such donors. However, hematogenous asymptomatic transmission of the COVID-19 virus following transplant remains unclear. Aim of this study was to assess COVID-19 virus presence in the recipient’s bloodstream at the early post-transplant period following COVID-19+ organ transplantation. Methods: An institutional protocol was drafted for the use of COVID-19+ donor organs. Eligible donors included those test COVID-19+, however with cause of death not related to COVID-19, and no evidence of moderate to severe COVID-19. Eligible recipients included those who tested negative for COVID-19 at the time of transplant, had been fully vaccinated against COVID-19, and consented to receive such organs. A protocol deviation occurred when a COVID-19+ organ was transplanted into a non-vaccinated recipient with recent history of resolved COVID-19 infection. Plasma was drawn to test for COVID-19 polymerase chain reaction (PCR) prior to hospital discharge post-transplant. All recipients received tixagevimab-cilgavimab (Evusheld) after plasma COVID-19 PCR testing. Results: Six recipients underwent kidney transplantation from COVID-19+ donors. One donor had reported mild symptoms of COVID-19 prior to hospitalization. Two donors tested Hepatitis C positive by nucleic amplification testing. 83.3% (N=5) of recipients were fully vaccinated prior to transplant (Table 1). An additional recipient had not been vaccinated but had history of recent COVID-19 infection. None of the recipients developed COVID-19 symptoms post-transplant. All had undetectable serum plasma COVID-19 PCR prior to discharge (testing range post-operative day 2 to 5). Post-transplant median length of stay was 3 days. Median follow-up was 39 days (33, 62). Two recipients had delayed renal allograft function. One patient developed antibody-mediated rejection diagnosed on post-operative day 30. No recipients required post-transplant testing for suspected COVID-19 symptoms. There was no mortality (Table 2). Discussion: This case series provides proof of concept that there is no evidence of hematogenous transfer of COVID-19 from donor positive organs to recipients immune to the virus. Therefore, otherwise transplantable organs from donors incidentally diagnosed with COVID-19 at the time of donation, with no indication of severe COVID-19 disease at the time of donation, should be considered for non-thoracic organ transplantation to suitable recipients, after appropriate consenting.

COVID-19 infection rate after urgent versus elective total hip replacement among unvaccinated individuals: A multicenter prospective cohort amid the COVID-19 pandemic

BackgroundDue to the COVID-19 pandemic, hospitals have become unsafe for patients as potential sources of virus transmission. This study aims to determine the COVID-19 infection rate after primary total hip arthroplasty (THA) among unvaccinated patients. THA patients undergoing elective or traumatic (urgent) THA were compared regarding COVID-19 contraction. MethodsPrimary THA patients were prospectively followed from three hospitals in *two great cities* of the country between April 2020 to August 2021. If the patient had suspected COVID-19 symptoms, had a SARS-CoV-2 PCR test from nasopharyngeal and oropharyngeal swabs and/or chest CT scan. ResultsFinally, information was received from 436 patients, including 345 (79.1%) elective and 91 (20.9%) traumatic THAs. Eight patients (1.8%) contracted COVID-19 within a month after THA discharge, and two died due to COVID-19. There was no statistical difference between COVID-19 disease and type of surgery (elective 1.4% versus traumatic 3.3%, P = 0.24). Women (Odds ratio (95% CI) = 8.5 (2.1–35.2), P = 0.01) and those who have heart disease (Odds ratio with Haldane-Anscombe correction ≈ 14.0, P = 0.01) were more likely to contract COVID-19 postoperatively. ConclusionIn both elective and urgent cases of THA, researchers found that there is not a high risk of contracting the virus during the peri-surgery period. Urgent THA surgeries are comparable to elective THA-with those strict pre-elective surgery protocols-in terms of COVID-19 risk of infection from the hospital stay if appropriate health protocols are followed.

The Associations of Suspected COVID-19 Symptoms with Anxiety and Depression as Modified by Hemodialysis Dietary Knowledge: A Multi-Dialysis Center Study.

During the COVID-19 pandemic, it is essential to evaluate hemodialysis patients’ dietary knowledge, especially among those with COVID-19 related symptoms, in order to identify appropriate strategies in managing their mental health. The study’s purposes were to test the psychometric properties of the hemodialysis dietary knowledge (HDK) scale, and to investigate the modifying impact of HDK on the associations of suspected COVID-19 symptoms (S-COVID-19-S) with anxiety and depression among hemodialysis patients. A cross-sectional study was conducted from July 2020 to March 2021 at eight hospitals across Vietnam. Data of 875 hemodialysis patients were analyzed, including socio-demographic, anxiety (the generalized anxiety disorder scale, GAD-7), depression (the patient health questionnaire, PHQ-9), S-COVID-19-S, HDK, health literacy, and digital healthy diet literacy. Confirmatory factor analysis (CFA) and logistic regression models were used to analyze the data. The HDK scale demonstrates the satisfactory construct validity with good model fit (Goodness of Fit Index, GFI = 0.96; Adjusted Goodness of Fit Index, AGFI = 0.90; Standardized Root Mean Square Residual, SRMR = 0.05; Root Mean Square Error of Approximation, RMSEA = 0.09; Normed Fit Index, NFI = 0.96; Comparative Fit Index, CFI = 0.96, and Parsimony goodness of Fit Index, PGFI = 0.43), criterion validity (as correlated with HL (r = 0.22, p < 0.01) and DDL (r = 0.19, p < 0.01), and reliability (Cronbach alpha = 0.70)). In the multivariate analysis, S-COVID-19-S was associated with a higher likelihood of anxiety (odds ratio, OR, 20.76; 95% confidence interval, 95%CI, 8.85, 48.70; p < 0.001) and depression (OR, 12.95; 95%CI, 6.67, 25.14, p < 0.001). A higher HDK score was associated with a lower likelihood of anxiety (OR, 0.70; 95%CI, 0.64, 0.77; p < 0.001) and depression (OR, 0.72; 95%CI, 0.66, 0.79; p < 0.001). In the interaction analysis, the negative impacts of S-COVID-19-S on anxiety and depression were mitigated by higher HDK scores (p < 0.001). In conclusion, HDK is a valid and reliable tool to measure dietary knowledge in hemodialysis patients. Higher HDK scores potentially protect patients with S-COVID-19-S from anxiety and depression during the pandemic.

Barriers to Community Pharmacists Referring Patients With Suspected COVID-19 Symptoms

Background: With the necessary skills available to community pharmacists, they are well equipped to relieve pressure on hospitals and general practices by providing referral services for symptomatic patients for COVID-19 testing. Objective: The assessment of potential barriers that limit the successful implementation of a community pharmacy referral service for patients with suspected COVID-19 symptoms. Methods: A questionnaire comprising of 100 questions was administered to one pharmacist by interview in 1023 working community pharmacies in 4 regions of Egypt between May 17 and May 30th 2020. Results: Forty-five barriers were identified. Respondents (79%, n = 803) had difficulty obtaining an accurate patient history. Patient data confidentiality was a significant issue for pharmacists who had not received referral training, with these respondents being significantly (P = .010) less able to differentiate between COVID-19 and similar conditions. Respondents (68.8%, n = 698) were not confident in determining whether COVID-19 was the cause of the patient’s presenting symptoms. A large majority (73.7%, n = 747) of respondents were worried about referring misdiagnosed patients and were concerned about the negative implications of proceeding with such a referral, including legal consequences. Of Respondents (71.7%, n = 727) reported that online referral was not easy, and 71.6% (n = 722) were unable to locate paper referral forms. Only a small number of pharmacists (11%, n = 112) preferred to report a referral in their own name. Conclusions: This study has demonstrated the potential of the community pharmacist’s role as a point of referral for COVID-19 testing, and identified some major barriers to implementation of this. The lack of pharmacists’ education, legal support, availability of referral forms, clarity of responsibility and unsupportive management teams are key obstacles that must be overcome for the successful implementation of a COVID-19 referral service.

"Post-traumatic Stress Disorder and Difficulties in Emotion Regulation Among University Students under the COVID-19 Condition"

"The new global situation of COVID-19 affects the whole world in all aspects of life including mental health. The study’s goal is to detect the relationship between post-traumatic stress disorder (PTSD) and Emotion Regulation (ER) difficulties under the COVID-19 condition. Methods: University students were asked to complete: 1) Emotion Regulation Difficulties Questionnaire (DERS) 2) PTSD Checklist (PCL- 5). 3) Life Events Checklist for DSM-5 (LEC-5). Results: There were 441 students with suspected COVID-19 symptoms out of 1195 students. When compared to students who did not have suspected COVID-19 symptoms, those who did had a greater prevalence of PTSD symptoms (18.2% vs. 4.7%) and DERS (34.5% vs. 23.3%). Additionally, correlation studies demonstrated a significant positive link (Ps&lt; .01) between the PCL, the overall DERS, and all six categories of emotion regulation difficulties. Conclusion: Students with suspected COVID-19 symptoms have more difficulty with emotion regulation and post-traumatic stress disorder than students without such symptoms. This research recommends that during the pandemic, health professionals should implement a suitable psychological intervention for students who exhibit COVID-19 symptoms."

Chest CT Scan Involvement Patterns in Patients with Suspected Covid-19 Symptoms

Chest CT Scan Involvement Patterns in Patients with Suspected Covid-19 Symptoms

COVID-19 Infection in Kidney Transplant Recipients From a Single Center in Iran.

COVID-19 has been spreading rapidly throughout the world, with nearly every country thus far documenting this infection. In this study, our aim was to evaluate the risk factors for increased mortality in deceased donor kidney transplant recipients with COVID-19 at a single center in Iran. This was a retrospective study in a single center. During the 17-month ongoing COVID19 pandemic in Iran, there were 153 deceased donor kidney recipients at our center with suspected COVID19 symptoms. Of these patients, 138 had positive COVID-19 tests, and thus a therapeutic regimen was commenced for these patients. Data were analyzed with SPSS version 16 software. The patients were predominantly male (83, 60.1%) with a median age of 47.09 ± 13.75 years and a median time since transplant of 51 months (IQR, 1-276 months). Among these patients, 84 (60.8%) had hypertension and 43 (31.2%) had diabetes mellitus. We observed a significant relationship between disease severity and mortality (P < .001). After risk adjustments for age, presence of diabetes mellitus and hypertension and blood group type were factors that showed a significantly higher risk of death. Deceased donor kidney transplant recipients with confirmed COVID-19 experienced less fever as an initial symptom. However, recipients with COVID-19 and an underlying disease had a higher rate of mortality, severity of infection, and progression of disease. Appropriate management of renal complications and vaccinations in deceased donor kidney transplant recipients may help lead to more favorable outcomes.

Rapid antigen test to identify COVID-19 infected patients with and without symptoms admitted to the Emergency Department.

PurposeEarly detection of SARS-CoV-2 patients is essential to contain the pandemic and keep the hospital secure. The rapid antigen test seems to be a quick and easy diagnostic test to identify patients infected with SARS-CoV-2. To assess the possible role of the antigen test in the Emergency Department (ED) assessment of potential SARS-CoV-2 infection in both symptomatic and asymptomatic patients.MethodsBetween 1 July 2020 and 10 December 2020, all patients consecutively assessed in the ED for suspected COVID-19 symptoms or who required hospitalisation for a condition not associated with COVID-19 were subjected to a rapid antigen test and RT-PCR swab. The diagnostic accuracy of the antigen test was determined in comparison to the SARS-CoV-2 PCR test using contingency tables. The possible clinical benefit of the antigen test was globally evaluated through decision curve analysis (DCA).ResultsA total of 3899 patients were subjected to antigen tests and PCR swabs. The sensitivity, specificity and accuracy of the antigen test were 82.9%, 99.1% and 97.4% (Cohen's K = 0.854, 95% CI 0.826–0.882, p < 0.001), respectively. In symptomatic patients, sensitivity was found to be 89.8%, while in asymptomatic patients, sensitivity was 63.1%. DCA appears to confirm a net clinical benefit for the preliminary use of antigen tests.ConclusionsThe antigen test performed in the ED, though not ideal, can improve the overall identification of infected patients. While it appears to perform well in symptomatic patients, in asymptomatic patients, although it improves their management, it seems not to be definitive.

Mental health difficulties in students with suspected COVID-19 symptoms and students without suspected COVID-19 symptoms: A cross-sectional comparative study during the COVID-19 pandemic

IntroductionMental health problems are taking a heavy toll on students during the COVID-19 pandemic. The purpose of this study was to compare the level of anxiety symptoms, depressive symptoms, post-traumatic stress symptoms (PTSS), and fear of COVID-19 between students with suspected COVID-19 symptoms and students without any suspected symptoms during the pandemic in Bangladesh. MethodsThis cross-sectional comparative study was conducted online among Bangladeshi students from May to July 2020. Anxiety symptoms, depressive symptoms, PTSS, and fear of COVID-19 were assessed by using the Generalized Anxiety Disorder scale, Patient Health Questionnaire, the Impact of Event Scale, and Fear of COVID-19 Scale, respectively. College and University students were the participants of the study. ResultsAmong 3777 students, 1259 had suspected COVID-19 symptoms and 2518 had no suspected COVID-19 symptoms. Students who experienced suspected COVID-19 symptoms had higher prevalence (moderate to severe) of depressive symptoms (61.15% vs. 47.62%), anxiety symptoms (44.96% vs. 36.97%), and PTSS (48.3% vs. 39.75%) compared to those who had no such symptoms. The study identified having suspected COVID-19 symptoms as a significant associated factor for anxiety symptoms (β1′ = 1.39; 95% CI: 1.03–1.74), depressive symptoms (β1′ = 1.88; 95% CI: 1.43–2.32), PTSS (β1′ = 3.66; 95% CI: 2.66–4.65), and fear of COVID-19 (β1′ = 0.48; 95% CI: 0.02 to 0.94). Students with suspected COVID-19 symptoms thought more that they would be better off dead, or of hurting themselves (P < 0.01) and felt more afraid as if something awful might happen (P < 0.01) than their counterparts. ConclusionMental health difficulties are more prevalent among students with suspected COVID-19 symptoms than the students without having such symptoms. This finding suggests that public health practitioners should deploy a rapid diagnostic system and consider psychological intervention in addition to clinical management for those who have COVID-19 like symptoms during the pandemic.

Associations of Underlying Health Conditions With Anxiety and Depression Among Outpatients: Modification Effects of Suspected COVID-19 Symptoms, Health-Related and Preventive Behaviors.

Objectives: We explored the association of underlying health conditions (UHC) with depression and anxiety, and examined the modification effects of suspected COVID-19 symptoms (S-COVID-19-S), health-related behaviors (HB), and preventive behaviors (PB). Methods: A cross-sectional study was conducted on 8,291 outpatients aged 18–85 years, in 18 hospitals and health centers across Vietnam from 14th February to May 31, 2020. We collected the data regarding participant's characteristics, UHC, HB, PB, depression, and anxiety. Results: People with UHC had higher odds of depression (OR = 2.11; p < 0.001) and anxiety (OR = 2.86; p < 0.001) than those without UHC. The odds of depression and anxiety were significantly higher for those with UHC and S-COVID-19-S (p < 0.001); and were significantly lower for those had UHC and interacted with “unchanged/more” physical activity (p < 0.001), or “unchanged/more” drinking (p < 0.001 for only anxiety), or “unchanged/healthier” eating (p < 0.001), and high PB score (p < 0.001), as compared to those without UHC and without S-COVID-19-S, “never/stopped/less” physical activity, drinking, “less healthy” eating, and low PB score, respectively. Conclusion: S-COVID-19-S worsen psychological health in patients with UHC. Physical activity, drinking, healthier eating, and high PB score were protective factors.

COVID-19 among young adults in Sweden: self-reported long-term symptoms and associated factors.

Aims:The main aim of the study was to describe self-reported symptoms of COVID-19 and examine if long-term symptoms are associated with lifestyle factors or common chronic diseases among Swedish young adults. A secondary aim was to compare the prevalence of smoking and snuff use before and during the COVID-19 pandemic.Methods:The study population includes 1644 participants aged 23–26 years from the Swedish population-based birth cohort BAMSE. From August to November 2020, the participants answered a web questionnaire on COVID-19 symptoms, lifestyle and health. Information on tobacco use was compared against the previous study follow-up in 2016–2019.Results:The prevalence of suspected COVID-19 symptoms was 45.3% (n=742), and 80 of these (10.8%) reported long-term symptoms (⩾4 weeks). There was no significant difference in sociodemographic or lifestyle factors in relation to the duration of suspected COVID-19 symptoms. Rhinitis, migraine and lower self-rated health before the pandemic was more common among participants with long-term symptoms. In addition, there was a tendency for higher prevalences of asthma, chronic bronchitis and depression in this group. The prevalence of smoking decreased from 18.9% before the pandemic to 14.7% during the pandemic, while snuff use increased from 12.7% to 22.4% (P<0.001).Conclusions:Almost half of Swedish young adults have had symptoms of suspected COVID-19 from February up to August 2020. Among these, one out of 10 have had long-term symptoms for at least 4 weeks. Long-term symptoms of suspected COVID-19 were associated with several common chronic conditions. Smoking may have decreased during the pandemic, while snuff use may have increased.