Coronavirus Disease (COVID)-19: World Health Organization Definitions and Coding to Support the Allergy Community and Health Professionals

Implementing a Care-Based Nursing Workforce Model: Implications for Missed Care, Teamwork, and Satisfaction

BACKGROUND

Nursing care delivery models may serve as a significant factor contributing to nurse satisfaction, frequency of missed care, and patient outcomes.

LOCAL PROBLEM

The nursing leadership team at our institution sought to determine if an adaptation of our primary registered nurse (RN) nursing model would enhance satisfaction of bedside nurses and care of patients.

METHODS

An improvement study introducing a care-based delivery model was implemented between January 2023 and January 2024 on a medical-surgical neurology/spinal unit at our organization.

INTERVENTIONS

Adoption of a care-based nursing model was supported with the delivery of brief education sessions utilizing in situ simulations for development of competencies in teamwork and delegation.

RESULTS

During the pilot period, overall satisfaction with job role improved 23%. Six missed nursing care elements and 7 teamwork elements significantly improved.

CONCLUSIONS

A care-based nursing model may improve staff satisfaction and quality of nursing care.

Using Brainstorming and Affinity Diagramming for Recommending a Care-Based Nursing Workforce Model

BACKGROUND

Nursing care delivery models influence nursing workload.

PROBLEM

Poorly designed nursing workforce models may lead to lack of satisfaction in practice, inability to recruit staff, and nursing turnover.

APPROACH

This paper describes a process that our team undertook to evaluate one nursing unit's nursing care delivery model and provides a recommendation for a nursing workforce model that ensures practice to top of scope while maintaining a balanced workload. Team brainstorming and affinity diagramming tools were used.

OUTCOMES

The team findings resulted in a recommendation for an innovative care-based nursing model pilot.

CONCLUSIONS

The use of brainstorming and affinity diagramming is an effective method for identifying opportunities to improve a nursing workforce model.

A comprehensive survey on the beliefs, perceptions, and clinical manifestations of pre and post Covid-19 vaccinations among physiotherapy students in the United Arab Emirates

The World Health Organization has defined Coronavirus Disease (COVID-19) as an infectious pandemic, caused by a newly discovered SARS-CoV-2 virus. Students relied heavily on the internet, social media, parents, and friends, in addition to medical advice for information on its presentation, complications, prevention, and management. It is evident from the literature that healthcare professionals including students who play an important role in the healthcare system may be lacking important information on COVID-19 vaccinations. Thus, the study aims to identify and compare the pre-post covid-19 vaccination-related essential information among Physical Therapy university students. A cross-sectional survey was conducted among physiotherapy university students in the United Arab Emirates using a self-administrated structured questionnaire. The questionnaire comprised three sections covering beliefs, perceptions, and clinical manifestations of the pre- and post-COVID- 19 vaccination. The survey was shared with more than 300 students through email and social platforms during the time between January 2022 till December 2022. Most of the physiotherapy students believed the vaccines to be safe (71.3%) due to multiple reasons while others did not believe in the effectiveness of the vaccine (28.7%). Some students did report unusual symptoms (painful periods, hair loss, forgetfulness) after the vaccine (10%). Similar findings were reported for family members as well (14%). Students had a positive perception of the vaccine and reported willingness to take it even if not mandatory (68%). Some students did believe in the safety of the vaccine due to multiple reasons while some did not due to fear of long-term side effects and personal choices. The finding of the study could be useful to create confidence as well as awareness among physiotherapy students as they are often invited to aid during medical pandemics such as Covid 19. Also, higher rates of vaccination among healthcare professionals will impart higher acceptance in the medical organization due to safety guidelines. This could also help to counsel other students against fear and apprehension towards the vaccination of such kind in the future.

Utility of IL-6 in the Diagnosis, Treatment and Prognosis of COVID-19 Patients: A Longitudinal Study

COVID-19 has caused devastating effects worldwide ever since its origin in December 2019. IL-6 is one of the chief markers used in the management of COVID-19. We conducted a longitudinal study to investigate the role of IL-6 in diagnosis, treatment, and prognosis of COVID-19-related cytokine storm. Patients with COVID-19 who were admitted at AIIMS Rishikesh from March to December 2020 were included in the study. Patients with no baseline IL-6 value at admission and for whom clinical data were not available were excluded. Clinical and laboratory data of these patients were collected from the e-hospital portal and entered in an excel sheet. Correlation was seen with other inflammatory markers and outcomes were assessed using MS Excel 2010 and SPSS software. A total of 131 patients were included in the study. Of these, 74.8% were males, with mean age 55.03 ± 13.57 years, and mean duration from symptom onset being 6.69 ± 6.3 days. A total of 82.4% had WHO severe category COVID-19, with 46.56% having severe hypoxia at presentation and 61.8% of them having some comorbidity. Spearman rank correlation coefficient of IL-6 with D-dimer was 0.203, with LDH was -0.005, with ferritin was 0.3, and with uric acid was 0.123. A total of 11 patients received Tocilizumab at a mean duration from symptom onset of 18.09 days, and 100% mortality was observed. Deaths were reported more in the group with IL-6 ≥ 40 pg/mL (57.1% vs. 40.2%, p = 0.06). ICU admissions and ventilator requirement were higher in the IL-6 ≥ 40 pg/mL group (95.9% vs. 91.4%, p = 0.32 and 55.1% vs. 37.8%, p = 0.05). The study showed that IL-6 can be used as a possible "thrombotic cytokine marker". Higher values of IL-6 (≥40 pg/mL) are associated with more deaths, ICU admissions, and ventilator requirement.

Electrolyte Imbalance and COVID-19 Severity in Hospitalized Patients

Background: Various risk factors have been proposed for severe coronavirus disease 2019 (COVID-19); nonetheless, the prognostic role of serum electrolytes has not been widely studied. Objectives: The present study aimed to identify the potential prognostic role of electrolyte imbalance in hospitalized COVID-19 patients. Methods: This retrospective study was conducted in Imam Reza Hospital, Mashhad, Iran. The medical records of all COVID-19 patients admitted to the emergency department from May to August 2020 were evaluated. Demographic data and clinical findings upon admission were collected. Disease severity, lung involvement severity on imaging, inflammatory serum biomarkers, admission to the intensive care unit, and serum levels of sodium, potassium, magnesium, calcium (corrected by serum albumin level), and phosphorus were documented. Results: Most patients (60%) were male, and the mean age of the total population was 58.87 ± 1.82 years. Severe COVID-19 was detected in most cases (94.9%) who were significantly older (P = 0.037), had hypertension (P = 0.032), ischemic heart disease (P = 0.033), and higher serum urea (P = 0.001) and serum potassium (P < 0.001). Patients with poor prognosis based on computed tomography (CT) scores had significantly higher serum urea (P = 0.002) and magnesium (P = 0.035) than patients with good prognosis, while serum calcium was significantly higher in the latter group (P = 0.007). Furthermore, there was a significant relationship between COVID-19 severity and serum potassium (P < 0.001). Conclusions: Abnormal serum electrolytes are correlated with COVID-19 severity. Moreover, serum potassium level is a predictor of severe disease.

Strategies to evaluate outcomes in long-COVID-19 and post-COVID survivors

SARS-CoV-2 infection can impact the physical, cognitive, mental health of patients, especially in those recovered in intensive care units. Moreover, it was proved that the effects of the virus may persist for weeks or months. The term long-COVID or post-COVID syndrome is commonly used for indicating a variety of physical and psychological symptoms that continue after the resolution of the acute phase. This narrative review is aimed at providing an updated overview of the impact of physical, cognitive, and psychological health disorders in COVID-19 survivors, by summarizing the data already published in literature in the last year. Studies cited were found through PubMed searches. We also presented an overview of the post-COVID-19 health consequences on three important aspects: nutritional status, neurological disorders, and physical health. Moreover, to activate a correct health planning policy, a multidisciplinary approach for addressing the post- COVID-19 issue, has been proposed. Finally, the involvement of health professionals is necessary even after the pandemic, to reduce expected post-pandemic psychosocial responses and mental health disorders.

COVID-19 as the leading cause of hospital deaths in the Brazilian public health system in 2020

Objectives: To describe the profile of hospital deaths in Brazil according to cause of admission during the pre-pandemic (2019) and pandemic periods (2020).

Methods: Descriptive study based on individual-level records of all hospital admissions with death outcomes reimbursed by the Brazilian National Health System in 2019 and 2020.

Results: The number of hospital deaths increased by 16.7% in 2020 compared with 2019 (522,686 vs 609,755). Coronavirus disease 2019 (COVID-19) was associated with 19.5% (118,879) of all hospital deaths in 2020, surpassing diseases of the circulatory system (15.4%, 93,735) and diseases of the respiratory system (14.9%, 91,035).

Conclusions: COVID-19 was the main cause of death in public hospitals in Brazil in 2020.

Assessing dentists' knowledge and experience in restoring endodontically treated teeth using post & cores

OBJECTIVES

The restoration of endodontically, heavily filled teeth has been a challenge for the dental profession for decades. The aims of this study were to investigate dentists' experience and knowledge in the use of post & core when restoring endodontically treated teeth.

METHOD

This was a mixed method study incorporating quantitative and qualitative data collection. An online questionnaire was developed and distributed, comprised of 18 questions. It was calculated that 93 respondents were needed to validate the study of which 60% should meet a minimum knowledge requirement.

RESULTS

173 respondents completed the questionnaire. 109 (63% (95%CI56%,70%) demonstrated proficient knowledge of post & core restorations. Recent graduates were more likely to follow current guidelines (F = 4.570: P<0.034). As the age of respondent dentists increases the number of posts placed (F = 18.85; p<0.001) and the perceived confidence level increases (Spearman's Rho 0.43: P<0.01). Experience of postgraduate education also positively influenced clinical confidence.

CONCLUSION

The placement of post & cores is influenced by age. Confidence is also influenced by age. More evidence on post usage is required and several questions remain to be answered on what drives decision making and perceived long-term success.

CLINICAL SIGNIFICANCE

There is a general acceptance of when a post and core restoration should be used. Clinician experience and age can have an impact on what type of restorations are used. Fibre posts are more commonly used due their accessibility and cost.

Covid-fatigued? A longitudinal study of Norwegian older adults' psychosocial well-being before and during early and later stages of the COVID-19 pandemic

As the pandemic continues, many older adults are facing prolonged isolation and stress while having less access to traditional ways of coping. There is widespread concern that the situation is increasingly taking its toll on older adults’ psychological and social well-being. We use linear mixed models to examine psychosocial impacts and predictors thereof among older Norwegians in early and later stages of the pandemic. Longitudinal data were collected online in the Norwegian Counties Public Health Survey right before the pandemic and in June and November–December 2020 in two counties (baseline n = 4,104; age 65–92). Outcomes include loneliness (single item, UCLA3), psychological ill-being (worried, anxious, depressed), and psychological well-being (satisfied, engaged, happy). From before to three months into the pandemic men’s psychosocial well-being remained stable, whereas women’s slightly declined. Five months later we observe broad and substantial declines in psychosocial well-being. These impacts disproportionately affect women (all outcomes) and single and older individuals (loneliness only) and are not moderated by educational level, urbanicity, or whether self or partner are reported “at risk” due to health problems. Pre-pandemic low social support and high psychological distress predict relatively improved psychosocial well-being. Older Norwegians seemed to manage the pandemic’s early stage without clear psychosocial impacts. However, we observe notably compromised well-being during the second wave of COVID-19 in late 2020. Lessons learned about the nature and distribution of the psychosocial impacts of prolonged health-threats and social distancing provide valuable knowledge for intervention design during this and future pandemics.

SARS-CoV-2 Vaccination and Anaphylaxis: Recommendations of the French Allergy Community and the Montpellier World Health Organization Collaborating Center

Vaccines against COVID-19 (and its emerging variants) are an essential global intervention to control the current pandemic situation. Anaphylactic reactions have been reported after SARS-CoV2 RNA vaccines. Anaphylaxis is defined as a severe life-threatening generalized or systemic hypersensitivity reaction. This risk is estimated at 1/1,000,000 in the context of vaccine safety surveillance programs. The COVID-19 vaccination is rolling-out vastly in different courtiers and surveillance programs are key to monitor severe adverse reactions, such as anaphylaxis. Anaphylaxis due to vaccine is extremely rare and specific cases should receive individualized investigation and care. The here presented recommendations and follow-up from the French allergy community and the Montpellier WHO Collaborating Center in order to support the vaccination program and intends to support to healthcare professionals in their daily basis.

A bibliometric analysis of the dental scientific literature on COVID-19

Objectives

The rapid production of a large volume of literature during the early phase of the COVID-19 outbreak created a substantial burden for clinicians and scientists. Therefore, this manuscript aims to identify and describe the scientific literature addressing COVID-19 from a dental research perspective, in terms of the manuscript origin, research domain, study type, and level of evidence (LoE).

Materials and methods

Data were retrieved from Web of Science, Scopus, and PubMed. A descriptive analysis of bibliographic data, collaboration network, and keyword co-occurrence analysis were performed. Articles were further classified according to the field of interest, main research question, type of study, and LoE.

Results

The present study identified 296 dental scientific COVID-19 original papers, published in 89 journals, and co-authored by 1331 individuals affiliated with 429 institutions from 53 countries. Although 81.4% were single-country papers, extensive collaboration among the institutions of single countries (Italian, British, and Brazilian institutions) was observed. The main research areas were as follows: the potential use of saliva and other oral fluids as promising samples for COVID-19 testing, dental education, and guidelines for the prevention of COVID-19 transmission in dental practice. The majority of articles were narrative reviews, cross-sectional studies, and short communications. The overall LoE in the analyzed dental literature was low, with only two systematic reviews with the highest LoE I.

Conclusion

The dental literature on the COVID-19 pandemic does not provide data relevant to the evidence-based decision-making process. Future studies with a high LoE are essential to gain precise knowledge on COVID-19 infection within the various fields of Dentistry.

Clinical relevance

The published dental literature on COVID-19 consists principally of articles with a low level of scientific evidence which do not provide sufficient reliable high-quality evidence that is essential for decision making in clinical dental practice.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00784-021-03916-6.

Epidemiology of anaphylaxis

PURPOSE OF REVIEW

To understand the current global epidemiological data of anaphylaxis and identify potential strategies to improve patients' care and prevention.

RECENT FINDINGS

Anaphylaxis mortality and morbidity statistics (MMS) may gain new perspectives with the implementation of the International Classification of Diseases (ICD)-11 in the forthcoming years. Improving the quality of epidemiological data related to anaphylaxis should clarify some areas of uncertainty about risk factors, leading to better targeting of strategies to protect those patients at risk, and support decision-making to facilitate healthcare planning and implementation of public health measures to prevent anaphylaxis.

SUMMARY

Anaphylaxis is a complex noncommunicable diseases with adverse impact on health-related quality of life of patients and their carriers and a significant proportion of deaths may be preventable. It requires an integrated holistic plan to improve quality of healthcare and gathering accurate and comparable epidemiological data is key. Morbidity related to anaphylaxis seems to be increasing worldwide whereas mortality of anaphylaxis appears to be low and stable, but this still has great challenges in capturing quality anaphylaxis MMS. Improving the quality of epidemiological data related to anaphylaxis should clarify some areas of uncertainty about risk factors, leading to better targeting of strategies to protect those patients at risk. As knowledge derived from populations is key information for more realistic decision-making, the construction of the new section addressed to anaphylaxis in the ICD-11 will allow the collection of more accurate epidemiological data to support quality management of patients, and better facilitate healthcare planning to implement public health measures to prevent and reduce the morbidity and mortality attributable to these conditions.

Severe acute respiratory syndrome coronavirus-2- or pregnancy-related cardiomyopathy, a differential to be considered in the current pandemic: a case report

Background

There are limited data on cardiovascular complications of coronavirus disease 2019 in pregnancy, and there are only a few case reports on coronavirus disease 2019 related cardiomyopathy in pregnancy. Differentiation between postpartum cardiomyopathy and coronavirus disease 2019 related cardiomyopathy in pregnant women who develop severe acute respiratory syndrome coronavirus-2 infection during peripartum could be challenging. Here, we present a case of possible coronavirus disease 2019 related cardiomyopathy in a pregnant patient, followed by a discussion of potential differential diagnosis.

Case presentation

In this case report, we present the case of a young pregnant Iranian woman who developed heart failure with pulmonary edema after cesarean section. She was treated because of low left ventricular ejection fraction and impression of postpartum cardiomyopathy, and her severe dyspnea improved by intravenous furosemide. On day 3, she exhibited no orthopnea or leg edema, but she was complaining of severe and dry cough. Further evaluation showed severe acute respiratory syndrome coronavirus-2 infection.

Conclusions

The possibility of severe acute respiratory syndrome coronavirus-2 infection should be considered in any pregnant woman who develops cardiomyopathy and pulmonary edema.

Allergy and coronavirus disease (COVID-19) international survey: Real-life data from the allergy community during the pandemic

Background

The COVID-19 outbreak brought an unprecedented challenge to the world. Knowledge in the field has been increasing exponentially and the main allergy societies have produced guidance documents for better management of allergic patients during this period. However, few publications so far have provided real-life data from the allergy community concerning allergy practice during the COVID-19 outbreak. Therefore, we proposed an international survey on the management of allergic patients during the current pandemic.

Methods

We performed an online survey undertaken to reach out the worldwide allergy community by e-mail and social media. The web-based questionnaire contained 24 questions covering demographic data from the participants, clinical practice during this period, and questions related to the new international classification and coding tools addressed for COVID-19. It was circulated for 8 weeks and had anonymous and volunteer context.

Results

Data are presented for 635 participants from 78 countries of all continents. Allergists with long-term professional experience were the main audience. As expected, we received many responses as “I have no data” or “I don't know” to the questions of the survey. However, most with more experience on managing allergic patients during the pandemic agreed that patients suffering from allergic or hypersensitivity conditions have no increased risk of contracting COVID-19 or developing SARS CoV-2. Also, participants mentioned that none of the allergy treatments (inhaled corticosteroids, allergen immunotherapy, biological agents) increased the risk of contracting COVID-19 infection including severe presentations.

Conclusion

The data presented are a starting point in the process of getting feedback on all the recommendations provided by the allergy societies; it could also be the basis of new strategies to support health professionals while new COVID-19 specific treatments and vaccines are being explored. The information here presented intends to be helpful to the community but represents a course of action in a highly specific situation due to the state of emergency, and it should be helpful to health systems.