Several measures, including behavioral restrictions for individuals, have been taken throughout the world to control the spread of COVID-19. The aim of these measures is to prevent infected persons from coming into contact with susceptible persons. Since the behavioral restrictions for all citizens, such as city-wide lockdowns, were directly linked to the stagnation of economic activities, the assessment of such measures is crucial. In order to evaluate the effects of behavioral restrictions, we employed the broken-link model to compare the situation of COVID-19 in Shanghai, where a lockdown was implemented from March to June 2022, with the situation in Taiwan, where the spread of COVID-19 has been well controlled so far. The results show that the small link-connection probability was achieved by the substantial isolation of infected persons, including the lockdown measures. Although the strict measures for behavioral restrictions were effective to reduce the total number infected people, the daily reported cases per one million people followed the curve evaluated by the broken-link model. This result considers that infections are unavoidable for the population.
{"title":"The Effects of Behavioral Restrictions on the Spread of COVID-19","authors":"Kenji Sasaki, Y. Ikeda, T. Nakano","doi":"10.3390/reports5040037","DOIUrl":"https://doi.org/10.3390/reports5040037","url":null,"abstract":"Several measures, including behavioral restrictions for individuals, have been taken throughout the world to control the spread of COVID-19. The aim of these measures is to prevent infected persons from coming into contact with susceptible persons. Since the behavioral restrictions for all citizens, such as city-wide lockdowns, were directly linked to the stagnation of economic activities, the assessment of such measures is crucial. In order to evaluate the effects of behavioral restrictions, we employed the broken-link model to compare the situation of COVID-19 in Shanghai, where a lockdown was implemented from March to June 2022, with the situation in Taiwan, where the spread of COVID-19 has been well controlled so far. The results show that the small link-connection probability was achieved by the substantial isolation of infected persons, including the lockdown measures. Although the strict measures for behavioral restrictions were effective to reduce the total number infected people, the daily reported cases per one million people followed the curve evaluated by the broken-link model. This result considers that infections are unavoidable for the population.","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42912609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Vecchio, Francesca Moretto, S. Padelli, F. Grossi, R. Cantello, R. Vaschetto
Cerebral vasculitides, both isolated or in systemic disorders, could be triggered by infections, and few cases have been associated to coronavirus disease 2019 (COVID-19). This study searched for publications in Pubmed, EMBASE, and Cochrane library databases for case reports and series of isolated central nervous system (CNS) vasculitides triggered by severe acute respiratory syndrome coronavirus-2. We included 12 studies (published from June 2020 to July 2022) and collected 39 adult patients (5/39 pathologically or radiologically proven, 34/39 suggestive for primary CNS vasculitis or PCNSV). All cases had a positive real-time polymerase chain reaction on a nasopharyngeal swab or a respiratory tract specimen. About the 85% of the included cases were males, and disease onset occurred later than 50 years old in all but three subjects. In total, 33/39 patients presented severe COVID-19 pneumonia, frequently requiring intensive care unit care. The most common neurological features were headache, obnubilation, and coma. PCNSV was suspected mainly on radiological findings, whereas the cerebrospinal fluid analysis was minimally altered. Magnetic resonance imaging showed vessel wall enhancement in 32/39 cases, generally with the concomitant presence of microbleeds, subarachnoid haemorrhages, and/or multiple ischemic lesions. Despite the severe respiratory and neurological disease course, most cases (93%) improved spontaneously or after a course of high-dose intravenous steroids with no need for immunosuppression. In conclusion, PCNSV could rarely relate to COVID-19 and independently from pulmonary disease severity. Adults with COVID-19-related PCNSV could have a favourable prognosis.
{"title":"Isolated Central Nervous System Vasculitides in COVID-19: A Systematic Review of Case Reports and Series","authors":"D. Vecchio, Francesca Moretto, S. Padelli, F. Grossi, R. Cantello, R. Vaschetto","doi":"10.3390/reports5030036","DOIUrl":"https://doi.org/10.3390/reports5030036","url":null,"abstract":"Cerebral vasculitides, both isolated or in systemic disorders, could be triggered by infections, and few cases have been associated to coronavirus disease 2019 (COVID-19). This study searched for publications in Pubmed, EMBASE, and Cochrane library databases for case reports and series of isolated central nervous system (CNS) vasculitides triggered by severe acute respiratory syndrome coronavirus-2. We included 12 studies (published from June 2020 to July 2022) and collected 39 adult patients (5/39 pathologically or radiologically proven, 34/39 suggestive for primary CNS vasculitis or PCNSV). All cases had a positive real-time polymerase chain reaction on a nasopharyngeal swab or a respiratory tract specimen. About the 85% of the included cases were males, and disease onset occurred later than 50 years old in all but three subjects. In total, 33/39 patients presented severe COVID-19 pneumonia, frequently requiring intensive care unit care. The most common neurological features were headache, obnubilation, and coma. PCNSV was suspected mainly on radiological findings, whereas the cerebrospinal fluid analysis was minimally altered. Magnetic resonance imaging showed vessel wall enhancement in 32/39 cases, generally with the concomitant presence of microbleeds, subarachnoid haemorrhages, and/or multiple ischemic lesions. Despite the severe respiratory and neurological disease course, most cases (93%) improved spontaneously or after a course of high-dose intravenous steroids with no need for immunosuppression. In conclusion, PCNSV could rarely relate to COVID-19 and independently from pulmonary disease severity. Adults with COVID-19-related PCNSV could have a favourable prognosis.","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41937592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zehuan Liao, Devika Menon, Le Zhang, Ye-Joon Lim, Wenhan Li, Xuexin Li, Yan Zhao
The first coronavirus disease 2019 (COVID-19) case was detected in Singapore on 23 January 2020. Over the two years, Singapore witnessed tightening and easing of policies in response to and in anticipation of new variants, stress on the healthcare sector, and new waves of infection. Upon confirming the reliability of the data using Benford’s analysis, the collated COVID-19 data and trends were analyzed alongside the policies between 2020 and 2021 in Singapore. Due to the proactive nature of these policies, Singapore was largely successful in reducing the imported cases that would spill over and result in community waves of infection and death. The government has taken necessary steps to support the citizens and reduce the impact of the pandemic on the economy of the country. Furthermore, there were policies that were more responsive and there are lessons to be learned from neighboring countries on their management of the pandemic. Given the endemic approach the government has adopted, the efficacy of these policies comes down to its sustainability. Since the pandemic requires frequent revisiting of these policies, Singapore’s long-term management of the pandemic (or endemic) and its impact comes down to the ability of the government to introduce sustainable policies and update these according to new developments in treatments, variants, and vaccines, bearing in mind the socioeconomic condition of the country.
{"title":"Management of the COVID-19 Pandemic in Singapore from 2020 to 2021: A Revisit","authors":"Zehuan Liao, Devika Menon, Le Zhang, Ye-Joon Lim, Wenhan Li, Xuexin Li, Yan Zhao","doi":"10.3390/reports5030035","DOIUrl":"https://doi.org/10.3390/reports5030035","url":null,"abstract":"The first coronavirus disease 2019 (COVID-19) case was detected in Singapore on 23 January 2020. Over the two years, Singapore witnessed tightening and easing of policies in response to and in anticipation of new variants, stress on the healthcare sector, and new waves of infection. Upon confirming the reliability of the data using Benford’s analysis, the collated COVID-19 data and trends were analyzed alongside the policies between 2020 and 2021 in Singapore. Due to the proactive nature of these policies, Singapore was largely successful in reducing the imported cases that would spill over and result in community waves of infection and death. The government has taken necessary steps to support the citizens and reduce the impact of the pandemic on the economy of the country. Furthermore, there were policies that were more responsive and there are lessons to be learned from neighboring countries on their management of the pandemic. Given the endemic approach the government has adopted, the efficacy of these policies comes down to its sustainability. Since the pandemic requires frequent revisiting of these policies, Singapore’s long-term management of the pandemic (or endemic) and its impact comes down to the ability of the government to introduce sustainable policies and update these according to new developments in treatments, variants, and vaccines, bearing in mind the socioeconomic condition of the country.","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44198868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Masato Hayakawa, Takaaki Nagano, Motomu Miyagi, R. Ikemura, S. Yamashiro, K. Iha
A 77-year-old woman who had undergone graft replacement of the descending aorta 18 years prior presented to our hospital complaining of a cough with bloody sputum. She was diagnosed with aortobronchial fistula by computed tomography. Thoracic endovascular aortic repair was performed, and the patient was discharged from the hospital without any major complications. Postoperatively, bloody sputum disappeared, and computed tomography examination at 12 months postoperatively showed that the preoperative infiltrative shadows in the lung fields were reduced. In conclusion, thoracic endovascular aortic repair is an effective treatment for aortobronchial fistula.
{"title":"Thoracic Endovascular Aortic Repair for Aortobronchial Fistula 18 Years after Graft Replacement of the Descending Aorta","authors":"Masato Hayakawa, Takaaki Nagano, Motomu Miyagi, R. Ikemura, S. Yamashiro, K. Iha","doi":"10.3390/reports5030034","DOIUrl":"https://doi.org/10.3390/reports5030034","url":null,"abstract":"A 77-year-old woman who had undergone graft replacement of the descending aorta 18 years prior presented to our hospital complaining of a cough with bloody sputum. She was diagnosed with aortobronchial fistula by computed tomography. Thoracic endovascular aortic repair was performed, and the patient was discharged from the hospital without any major complications. Postoperatively, bloody sputum disappeared, and computed tomography examination at 12 months postoperatively showed that the preoperative infiltrative shadows in the lung fields were reduced. In conclusion, thoracic endovascular aortic repair is an effective treatment for aortobronchial fistula.","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44949481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Dubler, T. Brenner, S. Zimmermann, T. Mokry, Anka C. Röhr, D. Richter, A. Heininger, M. Weigand
Background: Hospital-acquired infections with extensively drug-resistant (XDR) Pseudomonas aeruginosa (PA) have become a worrisome concern because of unfavorable outcomes and limited antimicrobial treatment options. Studies with new antimicrobial substances against XDR-PA show very promising results in different infection types, but the data for central nervous system (CNS) infections are scarce. Case presentation: Here, we report the case of a young patient with healthcare-associated meningitis caused by XDR-PA following severe craniocerebral injury. An off-label use of high-dose ceftolozane/tazobactam (C/T) monotherapy was administered for 10 days in parallel with source-controlling measures. Clinical and microbial recovery could be accomplished promptly. Conclusion: In patients with hospital-acquired CNS infections due to XDR-PA, C/T might be a new, safe and effective alternative with fewer adverse effects compared to older polymyxin- or aminoglycoside-based regimens.
{"title":"Off-Label Use of Ceftolozane/Tazobactam for the Successful Treatment of Healthcare-Associated Meningitis Caused by Extensively Drug-Resistant Pseudomonas aeruginosa in a Polytraumatized Patient—A Case Report","authors":"S. Dubler, T. Brenner, S. Zimmermann, T. Mokry, Anka C. Röhr, D. Richter, A. Heininger, M. Weigand","doi":"10.3390/reports5030033","DOIUrl":"https://doi.org/10.3390/reports5030033","url":null,"abstract":"Background: Hospital-acquired infections with extensively drug-resistant (XDR) Pseudomonas aeruginosa (PA) have become a worrisome concern because of unfavorable outcomes and limited antimicrobial treatment options. Studies with new antimicrobial substances against XDR-PA show very promising results in different infection types, but the data for central nervous system (CNS) infections are scarce. Case presentation: Here, we report the case of a young patient with healthcare-associated meningitis caused by XDR-PA following severe craniocerebral injury. An off-label use of high-dose ceftolozane/tazobactam (C/T) monotherapy was administered for 10 days in parallel with source-controlling measures. Clinical and microbial recovery could be accomplished promptly. Conclusion: In patients with hospital-acquired CNS infections due to XDR-PA, C/T might be a new, safe and effective alternative with fewer adverse effects compared to older polymyxin- or aminoglycoside-based regimens.","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49456254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Camenzind, A. K. Eberhard-Moscicka, D. Cazzoli, R. Müri
The paper depicts and describes the observation of a remarkable post-stroke production of paintings made by a 54-year-old, right-handed man who suffered an acute right hemispheric stroke. The patient’s post-stroke productivity and the spatial distribution of text and drawings were assessed by means of structural analysis of the paintings, as well as neuropsychological and creativity testing. Compared to the age-matched healthy control group, the patient did not only produce more valid answers in the verbal creativity task, but he also drew more images in the figural creativity task. Most strikingly, the painted images were located on the right side in 70% of the paintings, while the text was aligned to the left side in 42% of the paintings. This dissociation between writing and painting behavior was further mirrored in the patient’s neuropsychological performance in a reading test and in a design fluency task. This observation of an increased post-stroke production of paintings may coin a new term, i.e., “hyperzographia”, in analogy to hypergraphia. Additionally, the puzzling dissociation of the writing and painting behavior highlights an important new clinical aspect concerning a differential influence of hemispatial neglect on writing and painting.
{"title":"Hyperzographia in Neglect Exposing a Spatial Dissociation between Painting and Writing—A Case Study","authors":"M. Camenzind, A. K. Eberhard-Moscicka, D. Cazzoli, R. Müri","doi":"10.3390/reports5030032","DOIUrl":"https://doi.org/10.3390/reports5030032","url":null,"abstract":"The paper depicts and describes the observation of a remarkable post-stroke production of paintings made by a 54-year-old, right-handed man who suffered an acute right hemispheric stroke. The patient’s post-stroke productivity and the spatial distribution of text and drawings were assessed by means of structural analysis of the paintings, as well as neuropsychological and creativity testing. Compared to the age-matched healthy control group, the patient did not only produce more valid answers in the verbal creativity task, but he also drew more images in the figural creativity task. Most strikingly, the painted images were located on the right side in 70% of the paintings, while the text was aligned to the left side in 42% of the paintings. This dissociation between writing and painting behavior was further mirrored in the patient’s neuropsychological performance in a reading test and in a design fluency task. This observation of an increased post-stroke production of paintings may coin a new term, i.e., “hyperzographia”, in analogy to hypergraphia. Additionally, the puzzling dissociation of the writing and painting behavior highlights an important new clinical aspect concerning a differential influence of hemispatial neglect on writing and painting.","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49467175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Kamal, M. Baudo, J. Joseph, Yimin Geng, A. Qdaisat
Background: This study aims to describe COVID-19–related clinical outcomes after immunotherapies (ICIs) for cancer patients. Methods: In this meta-analysis, we searched databases to collect data that addressed outcomes after immunotherapies (ICIs) during the COVID-19 pandemic. The primary endpoint was COVID-19–related mortality. Secondary endpoints included COVID-related hospital readmission, emergency room (ER) visits, opportunistic infections, respiratory complications, need for ventilation, and thrombo-embolic events. Pooled event rates (PERs) were calculated and a meta-regression analysis was performed. Results: A total of 262 studies were identified. Twenty-two studies with a total of forty-four patients were eligible. The PER of COVID-19–related mortality was 39.73%, while PERs of COVID-19–related ER visits, COVID-19–related pulmonary complications, and COVID-19–related ventilator needs were 40.75%, 40.41%, and 34.92%, respectively. The PER of opportunistic infections was 34.92%. The PERs of the use of antivirals, antibiotics, steroids, prophylactic anticoagulants, and convalescent plasma were 62.12%, 57.12%, 51.36%, 41.90%, and 26.48%, respectively. There was a trend toward an association between previous respiratory diseases and COVID-19–related mortality. Conclusion: The rates of COVID-19–related mortality, ER visits, pulmonary complications, need for a ventilator, and opportunistic infections are still high after ICIs during the COVID-19 pandemic. There was a trend toward an association between previous respiratory diseases and COVID-19–related mortality.
{"title":"Clinical Outcomes after Immunotherapies in Cancer Setting during COVID-19 Era: A Systematic Review and Meta-Regression","authors":"M. Kamal, M. Baudo, J. Joseph, Yimin Geng, A. Qdaisat","doi":"10.3390/reports5030031","DOIUrl":"https://doi.org/10.3390/reports5030031","url":null,"abstract":"Background: This study aims to describe COVID-19–related clinical outcomes after immunotherapies (ICIs) for cancer patients. Methods: In this meta-analysis, we searched databases to collect data that addressed outcomes after immunotherapies (ICIs) during the COVID-19 pandemic. The primary endpoint was COVID-19–related mortality. Secondary endpoints included COVID-related hospital readmission, emergency room (ER) visits, opportunistic infections, respiratory complications, need for ventilation, and thrombo-embolic events. Pooled event rates (PERs) were calculated and a meta-regression analysis was performed. Results: A total of 262 studies were identified. Twenty-two studies with a total of forty-four patients were eligible. The PER of COVID-19–related mortality was 39.73%, while PERs of COVID-19–related ER visits, COVID-19–related pulmonary complications, and COVID-19–related ventilator needs were 40.75%, 40.41%, and 34.92%, respectively. The PER of opportunistic infections was 34.92%. The PERs of the use of antivirals, antibiotics, steroids, prophylactic anticoagulants, and convalescent plasma were 62.12%, 57.12%, 51.36%, 41.90%, and 26.48%, respectively. There was a trend toward an association between previous respiratory diseases and COVID-19–related mortality. Conclusion: The rates of COVID-19–related mortality, ER visits, pulmonary complications, need for a ventilator, and opportunistic infections are still high after ICIs during the COVID-19 pandemic. There was a trend toward an association between previous respiratory diseases and COVID-19–related mortality.","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43100046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Malara, M. Noale, A. Abbatecola, G. Borselli, C. Cafariello, S. Fumagalli, P. Gareri, E. Mossello, C. Trevisan, S. Volpato, F. Monzani, A. Coin, G. Bellelli, C. Okoye, S. del Signore, G. Zia, R. Incalzi
Background: Long-term care facility (LTCF) residents often present asymptomatic or paucisymptomatic features of SARS-CoV-2 infection. We aimed at investigating signs/symptoms, including their clustering on SARS-CoV-2 infection and mortality rates associated with SARS-CoV-2 infection in LTCF residents. Methods: This is a cohort study of 586 aged ≥ 60 year-old residents at risk of or affected with COVID-19 enrolled in the GeroCovid LTCF network. COVID-19 signs/symptom clusters were identified using cluster analysis. Cluster analyses associated with SARS-CoV-2 infection and mortality were evaluated using logistic regression and Cox proportional hazard models. Results: Cluster 1 symptoms (delirium, fever, low-grade fever, diarrhea, anorexia, cough, increased respiratory rate, sudden deterioration in health conditions, dyspnea, oxygen saturation, and weakness) affected 39.6% of residents and were associated with PCR swab positivity (OR = 7.21, 95%CI 4.78–10.80; p < 0.001). Cluster 1 symptoms were present in deceased COVID-19 residents. Cluster 2 (increased blood pressure, sphincter incontinence) and cluster 3 (new-onset cognitive impairment) affected 20% and 19.8% of residents, respectively. Cluster 3 symptoms were associated with increased mortality (HR = 5.41, 95%CI 1.56–18.8; p = 0.008), while those of Cluster 2 were not associated with mortality (HR = 0.82, 95%CI 0.26–2.56; p = 730). Conclusions: Our study highlights that delirium, fever, and low-grade fever, alone or in clusters should be considered in identifying and predicting the prognosis of SARS-CoV-2 infection in older LTCF patients.
{"title":"COVID-19 Signs and Symptom Clusters in Long-Term Care Facility Residents: Data from the GeroCovid Observational Study","authors":"A. Malara, M. Noale, A. Abbatecola, G. Borselli, C. Cafariello, S. Fumagalli, P. Gareri, E. Mossello, C. Trevisan, S. Volpato, F. Monzani, A. Coin, G. Bellelli, C. Okoye, S. del Signore, G. Zia, R. Incalzi","doi":"10.3390/reports5030030","DOIUrl":"https://doi.org/10.3390/reports5030030","url":null,"abstract":"Background: Long-term care facility (LTCF) residents often present asymptomatic or paucisymptomatic features of SARS-CoV-2 infection. We aimed at investigating signs/symptoms, including their clustering on SARS-CoV-2 infection and mortality rates associated with SARS-CoV-2 infection in LTCF residents. Methods: This is a cohort study of 586 aged ≥ 60 year-old residents at risk of or affected with COVID-19 enrolled in the GeroCovid LTCF network. COVID-19 signs/symptom clusters were identified using cluster analysis. Cluster analyses associated with SARS-CoV-2 infection and mortality were evaluated using logistic regression and Cox proportional hazard models. Results: Cluster 1 symptoms (delirium, fever, low-grade fever, diarrhea, anorexia, cough, increased respiratory rate, sudden deterioration in health conditions, dyspnea, oxygen saturation, and weakness) affected 39.6% of residents and were associated with PCR swab positivity (OR = 7.21, 95%CI 4.78–10.80; p < 0.001). Cluster 1 symptoms were present in deceased COVID-19 residents. Cluster 2 (increased blood pressure, sphincter incontinence) and cluster 3 (new-onset cognitive impairment) affected 20% and 19.8% of residents, respectively. Cluster 3 symptoms were associated with increased mortality (HR = 5.41, 95%CI 1.56–18.8; p = 0.008), while those of Cluster 2 were not associated with mortality (HR = 0.82, 95%CI 0.26–2.56; p = 730). Conclusions: Our study highlights that delirium, fever, and low-grade fever, alone or in clusters should be considered in identifying and predicting the prognosis of SARS-CoV-2 infection in older LTCF patients.","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48100645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rebecca A. Moorhead, J. O'Brien, B. Kelly, Devki Shukla, D. Bolton, N. Kyprianou, P. Wiklund, A. Lantz, N. Mohamed, H. Goltz, D. Lundon, Ashutosh K Tewari
Background: The COVID-19 pandemic exploits existing inequalities in the social determinants of health (SDOH) that influence disease burden and access to healthcare. The role of health behaviours and socioeconomic status in genitourinary (GU) malignancy has also been highlighted. Our aim was to evaluate predictors of patient-level and neighbourhood-level factors contributing to disparities in COVID-19 outcomes in GU cancer patients. Methods: Demographic information and co-morbidities for patients screened for COVID-19 across the Mount Sinai Health System (MSHS) up to 10 June 2020 were included. Descriptive analyses and ensemble feature selection were performed to describe the relationships between these predictors and the outcomes of positive SARS-CoV-2 RT-PCR test, COVID-19-related hospitalisation, intubation and death. Results: Out of 47,379 tested individuals, 1094 had a history of GU cancer diagnosis; of these, 192 tested positive for SARS-CoV-2. Ensemble feature selection identified social determinants including zip code, race/ethnicity, age, smoking status and English as the preferred first language—being the majority of significant predictors for each of this study’s four COVID-19-related outcomes: a positive test, hospitalisation, intubation and death. Patient and neighbourhood level SDOH including zip code/ NYC borough, age, race/ethnicity, smoking status, and English as preferred language are amongst the most significant predictors of these clinically relevant outcomes for COVID-19 patients. Conclusion: Our results highlight the importance of these SDOH and the need to integrate SDOH in patient electronic medical records (EMR) with the goal to identify at-risk groups. This study’s results have implications for COVID-19 research priorities, public health goals, and policy implementations.
{"title":"Social Determinants Contribute to Disparities in Test Positivity, Morbidity and Mortality: Data from a Multi-Ethnic Cohort of 1094 GU Cancer Patients Undergoing Assessment for COVID-19","authors":"Rebecca A. Moorhead, J. O'Brien, B. Kelly, Devki Shukla, D. Bolton, N. Kyprianou, P. Wiklund, A. Lantz, N. Mohamed, H. Goltz, D. Lundon, Ashutosh K Tewari","doi":"10.3390/reports5030029","DOIUrl":"https://doi.org/10.3390/reports5030029","url":null,"abstract":"Background: The COVID-19 pandemic exploits existing inequalities in the social determinants of health (SDOH) that influence disease burden and access to healthcare. The role of health behaviours and socioeconomic status in genitourinary (GU) malignancy has also been highlighted. Our aim was to evaluate predictors of patient-level and neighbourhood-level factors contributing to disparities in COVID-19 outcomes in GU cancer patients. Methods: Demographic information and co-morbidities for patients screened for COVID-19 across the Mount Sinai Health System (MSHS) up to 10 June 2020 were included. Descriptive analyses and ensemble feature selection were performed to describe the relationships between these predictors and the outcomes of positive SARS-CoV-2 RT-PCR test, COVID-19-related hospitalisation, intubation and death. Results: Out of 47,379 tested individuals, 1094 had a history of GU cancer diagnosis; of these, 192 tested positive for SARS-CoV-2. Ensemble feature selection identified social determinants including zip code, race/ethnicity, age, smoking status and English as the preferred first language—being the majority of significant predictors for each of this study’s four COVID-19-related outcomes: a positive test, hospitalisation, intubation and death. Patient and neighbourhood level SDOH including zip code/ NYC borough, age, race/ethnicity, smoking status, and English as preferred language are amongst the most significant predictors of these clinically relevant outcomes for COVID-19 patients. Conclusion: Our results highlight the importance of these SDOH and the need to integrate SDOH in patient electronic medical records (EMR) with the goal to identify at-risk groups. This study’s results have implications for COVID-19 research priorities, public health goals, and policy implementations.","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41668780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Catherine Becker, M. Regulski, Scott A. Martin, T. Barrett
The management of diabetic foot ulcers (DFUs) presents challenges to even the most experienced wound-care providers. Because of the chronic, non-healing nature of many DFUs, advances in the treatment and care of this disease process are particularly relevant. This case study aims to report the efficacy of the application of dehydrated amniotic membrane allograft (DAMA) to a diabetic foot ulcer. The patient in this study is a 44-year-old male who presented with an aggressive infection on his right foot, which resulted in an open wound of 18-month duration. This patient received weekly applications of dual-layer DAMA over seven weeks. Upon examination at the initial application, the wound was classified as a Wagner grade 3 with necrosis of the underlying muscle. Upon inspection at the final visit, the wound was closed entirely. The results that were shown include improvements in the size, depth, edges, necrotic tissue amount, and epithelization of the wound. This case study demonstrates that the application of DAMA has the potential to augment the body’s natural DFU healing response; however, future nonrandomized and randomized controlled trials are needed to establish its efficacy further.
{"title":"Application of Dehydrated Amniotic Membrane Allografts in Advanced Diabetic Foot Ulceration: Case Report and Review of Literature","authors":"Catherine Becker, M. Regulski, Scott A. Martin, T. Barrett","doi":"10.3390/reports5030028","DOIUrl":"https://doi.org/10.3390/reports5030028","url":null,"abstract":"The management of diabetic foot ulcers (DFUs) presents challenges to even the most experienced wound-care providers. Because of the chronic, non-healing nature of many DFUs, advances in the treatment and care of this disease process are particularly relevant. This case study aims to report the efficacy of the application of dehydrated amniotic membrane allograft (DAMA) to a diabetic foot ulcer. The patient in this study is a 44-year-old male who presented with an aggressive infection on his right foot, which resulted in an open wound of 18-month duration. This patient received weekly applications of dual-layer DAMA over seven weeks. Upon examination at the initial application, the wound was classified as a Wagner grade 3 with necrosis of the underlying muscle. Upon inspection at the final visit, the wound was closed entirely. The results that were shown include improvements in the size, depth, edges, necrotic tissue amount, and epithelization of the wound. This case study demonstrates that the application of DAMA has the potential to augment the body’s natural DFU healing response; however, future nonrandomized and randomized controlled trials are needed to establish its efficacy further.","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45885768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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