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Freund O, Harish A, Breslavsky A, Wand O, Zacks N, Bilenko N, Bar-Shai A. The humoral response to COVID-19 vaccinations can predict the booster effect on health care workers-toward personalized vaccinations? J Public Health (Oxf) 2024; 46:e78-e83. [PMID: 37872715 DOI: 10.1093/pubmed/fdad198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 09/21/2023] [Accepted: 09/24/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Waning immunity after the coronavirus disease 2019 (COVID-19) vaccinations creates the constant need of boosters. Predicting individual responses to booster vaccines can help in its timely administration. We hypothesized that the humoral response to the first two doses of the BNT162b2 vaccine can predict the response to the booster vaccine. METHODS A prospective cohort of hospital health care workers (HCW) that received three doses of the BNT162b2 vaccine. Participants completed serological tests at 1 and 6 months after the second vaccine dose and 1 month after the third. We analyzed predictive factors of antibody levels after the booster using multivariate regression analyses. RESULTS From 289 eligible HCW, 89 (31%) completed the follow-up. Mean age was 48 (±10) and 46 (52%) had daily interaction with patients. The mean (±standard deviation) antibody level 1 month after the second vaccine was 223 (±59) AU/ml, and 31 (35%) had a rapid antibody decline (>50%) in 6 months. Low antibody levels 1 month after the second vaccine and a rapid antibody decline were independent predictors of low antibody levels after the booster vaccine. CONCLUSIONS The characteristics of the humoral response to COVID-19 vaccinations show promise in predicting the humoral response to the booster vaccines.
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Affiliation(s)
- Ophir Freund
- The Institute of Pulmonary Medicine, Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Alma Harish
- Division of Pulmonary Medicine, Barzilai Medical Center, Ashkelon, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Anna Breslavsky
- Division of Pulmonary Medicine, Barzilai Medical Center, Ashkelon, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ori Wand
- Division of Pulmonary Medicine, Barzilai Medical Center, Ashkelon, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Nadav Zacks
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Natalya Bilenko
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Medical Office of Southern District, Ministry of Health, Ashkelon, Israel
| | - Amir Bar-Shai
- The Institute of Pulmonary Medicine, Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Division of Pulmonary Medicine, Barzilai Medical Center, Ashkelon, Israel
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Emerick GS, Zandonade E, Prado CBD, Pires LBC, Bezerra OIMDPA, Salaroli LB. Morbimortality profile by COVID-19 in telework and on-site work in an oil and gas company in Brazil. Work 2024; 78:883-893. [PMID: 38457165 DOI: 10.3233/wor-230114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND As a reflection of the health emergency caused by COVID-19, many countries adopted guidelines, which included activity restrictions. As a result, some companies maintained their activities with on-site work and telework. OBJECTIVE Analyzing the morbidity and mortality profile due to COVID-19 of workers in telework and on-site work in an oil and gas company. METHODS Cross-sectional, quantitative, and analytical study that included 8,394 workers diagnosed with COVID-19 at an oil and gas company in Brazil, from June 2020 to June 2021. The company's Surveillance Program database was used as an information source. RESULTS The total prevalence of cases was 21.7%. For teleworking and face-to-face workers, they were 20.7% and 23.3%, respectively. There was a predominance of women (19.7%), white ethnicity/colour (64.7%), higher level position (52.6%), age group over 40 years (36.7%), married (53, 8%), working at the company for a period that ranges from 7 to 10 years (17%), administrative activity (68.5%), and a higher number of symptomatic workers and deaths in telework compared to on-site work. CONCLUSIONS The results suggest that testing is important to refrain the virus spread in the company's work environments, as it allowed asymptomatic workers to be diagnosed with COVID-19. The study suggested that on-site work was not a transmission facilitator in the occupational environment, which points out the importance of preventive measures in the workplace and the adoption of remote work for the largest possible number of workers to improve the safety of employees, workers who remained in the on-site work modality.
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Affiliation(s)
- Giselly Storch Emerick
- Graduate Program in Public Health, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Eliana Zandonade
- Graduate Program in Public Health, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Camila Bruneli do Prado
- Research Group on Epidemiology Health and Nutrition, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Luciana Bicalho Cevolani Pires
- Graduate Program in Nutrition and Health, Health Sciences Center at the Federal University of Espírito Santo (UFES), Vitória, Brazil
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Dehghan G, Malekpour F, Jafari-Koshki T, Mohammadian Y, Rostami H. The status of work-related COVID-19 prevention measures and risk factors in hospitals. Work 2024; 77:445-453. [PMID: 37742681 DOI: 10.3233/wor-230006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND Health care workers (HCWs) in hospitals are at risk of infection with coronavirus disease 2019 (COVID-19). Prevention measures are necessary to protect HCWs against COVID-19. OBJECTIVE This study aimed to determine the status of occupational risk factors and prevention measures for COVID-19 in hospitals. METHODS This cross-sectional study was conducted in Iranian hospitals. Based on the results of reviewing the literature and guidelines, two checklists on occupational risk factors and prevention measures for COVID-19 in hospitals were designed and validated. The status of occupational risk factors and prevention measures against COVID-19 in governmental, non-governmental public, private, and military hospitals were determined using designed checklists. RESULTS Results confirmed the validity of checklists for assessing the status of COVID-19 prevention measures in hospitals. The military hospitals had the lowest mean risk factors compared to other hospitals, but there was no significant difference in occupational risk factors of infection with COVID-19 among governmental, non-governmental public, private, and military hospitals (P-value > 0.05). In the checklist of occupational risk factors of Covid-19, the type of hospital had a significant relationship with the provision and use of personal protective equipment (P-value<0.05). The mean of implementation of prevention measures among all hospitals were not statistically significant difference (P-value > 0.05). CONCLUSION The provided checklists could be a suitable tool for monitoring of status of prevention measures for COVID-19 in hospitals. Improving ventilation systems is necessary in most of the hospitals.
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Affiliation(s)
- Golnoush Dehghan
- Department of Occupational Health Engineering, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Malekpour
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Tohid Jafari-Koshki
- Department of Statistics and Epidemiology, Molecular Medicine Research Center, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Yousef Mohammadian
- Department of Occupational Health Engineering, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hossein Rostami
- Research Center for Cognitive and Behavioral Sciences in Police, Directorate of Health, Rescue and Treatment, Police Headquarter, Tehran, Iran
- FARAJA Institute of Law Enforcement Sciences and Social Studies, Tehran, Iran
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Liviero F, Volpin A, Furlan P, Battistella M, Broggio A, Fabris L, Favretto F, Mason P, Cocchio S, Cozzolino C, Baldo V, Moretto A, Scapellato ML. The impact of SARS-CoV-2 on healthcare workers of a large University Hospital in the Veneto Region: risk of infection and clinical presentation in relation to different pandemic phases and some relevant determinants. Front Public Health 2023; 11:1250911. [PMID: 38098828 PMCID: PMC10720910 DOI: 10.3389/fpubh.2023.1250911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 11/07/2023] [Indexed: 12/17/2023] Open
Abstract
Aim The aim of this study is to evaluate the incidence of SARS-CoV-2 infection and the prevalence of COVID-19-related symptoms in relation to pandemic phases and some relevant variables in a cohort of 8,029 HCWs from one of the largest Italian University Hospitals. Methods A single-center retrospective study was performed on data collected during SARS-CoV-2 infection surveillance of HCWs. Cox's multiple regression was performed to estimate hazard ratios of SARS-CoV-2 infection. Logistic multivariate regression was used to assess the risk of asymptomatic infections and the onset of the most frequent symptoms. All analyses were adjusted for sociodemographic and occupational factors, pandemic phases, vaccination status, and previous infections. Results A total of 3,760 HCWs resulted positive (2.0%-18.6% across five study phases). The total incidence rate of SARS-CoV-2 infection was 7.31 cases per 10,000 person-days, significantly lower in phase 1 and higher in phases 4 and 5, compared to phase 3. Younger HCWs, healthcare personnel, and unvaccinated subjects showed a higher risk of infection. Overall, 24.5% were asymptomatic infections, with a higher probability for men, physicians, and HCWs tested for screening, fully vaccinated, and those with previous infection. The clinical presentation changed over the phases in relation to vaccination status and the emergence of new variants. Conclusion The screening activities of HCWs allowed for the early detection of asymptomatic cases, limiting the epidemic clusters inside the hospital wards. SARS-CoV-2 vaccination reduced infections and symptomatic cases, demonstrating again its paramount value as a preventive tool for occupational and public health.
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Affiliation(s)
- Filippo Liviero
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, Padova, Italy
- Occupational Medicine Unit, University Hospital of Padova, Padova, Italy
| | - Anna Volpin
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, Padova, Italy
- Occupational Medicine Unit, University Hospital of Padova, Padova, Italy
| | - Patrizia Furlan
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Monica Battistella
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Alessia Broggio
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Laura Fabris
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Francesco Favretto
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Paola Mason
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, Padova, Italy
- Occupational Medicine Unit, University Hospital of Padova, Padova, Italy
| | - Silvia Cocchio
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, Padova, Italy
- Preventive Medicine and Risk Assessment Unit, University Hospital of Padova, Padova, Italy
| | - Claudia Cozzolino
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Vincenzo Baldo
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, Padova, Italy
- Preventive Medicine and Risk Assessment Unit, University Hospital of Padova, Padova, Italy
| | - Angelo Moretto
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, Padova, Italy
- Occupational Medicine Unit, University Hospital of Padova, Padova, Italy
| | - Maria Luisa Scapellato
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, Padova, Italy
- Occupational Medicine Unit, University Hospital of Padova, Padova, Italy
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Recanatini C, GeurtsvanKessel CH, Pas SD, Broens EM, Maas M, van Mansfeld R, Mutsaers-van Oudheusden AJG, van Rijen M, Schippers EF, Stegeman A, Tami A, Veldkamp KE, Visser H, Voss A, Wegdam-Blans MCA, Wertheim HFL, Wever PC, Koopmans MPG, Kluytmans JAJW, Kluytmans-van den Bergh MFQ. Seroprevalence of SARS-CoV-2 antibodies among healthcare workers in Dutch hospitals after the 2020 first wave: a multicentre cross-sectional study with prospective follow-up. Antimicrob Resist Infect Control 2023; 12:137. [PMID: 38031155 PMCID: PMC10688070 DOI: 10.1186/s13756-023-01324-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 10/22/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND We aimed to estimate the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence and describe its determinants and associated symptoms among unvaccinated healthcare workers (HCWs) after the first wave of the pandemic. METHODS HCWs from 13 Dutch hospitals were screened for antibodies against the spike protein of SARS-CoV-2 in June-July 2020 and after three months. Participants completed a retrospective questionnaire on determinants for occupational and community exposure to SARS-CoV-2 and symptoms suggestive of COVID-19 experienced since January 2020. The seroprevalence was calculated per baseline characteristic and symptom at baseline and after follow-up. Adjusted odds ratios (aOR) for seropositivity were determined using logistic regression. RESULTS Among 2328 HCWs, 323 (13.9%) were seropositive at enrolment, 49 of whom (15%) reported no previous symptoms suggestive of COVID-19. During follow-up, only 1% of the tested participants seroconverted. Seroprevalence was higher in younger HCWs compared to the mid-age category (aOR 1.53, 95% CI 1.07-2.18). Nurses (aOR 2.21, 95% CI 1.34-3.64) and administrative staff (aOR 1.87, 95% CI 1.02-3.43) had a higher seroprevalence than physicians. The highest seroprevalence was observed in HCWs in the emergency department (ED) (aOR 1.79, 95% CI 1.10-2.91), the lowest in HCWs in the intensive, high, or medium care units (aOR 0.47, 95% CI 0.31-0.71). Chronic respiratory disease, smoking, and having a dog were independently associated with a lower seroprevalence, while HCWs with diabetes mellitus had a higher seroprevalence. In a multivariable model containing all self-reported symptoms since January 2020, altered smell and taste, fever, general malaise/fatigue, and muscle aches were positively associated with developing antibodies, while sore throat and chills were negatively associated. CONCLUSIONS The SARS-CoV-2 seroprevalence in unvaccinated HCWs of 13 Dutch hospitals was 14% in June-July 2020 and remained stable after three months. A higher seroprevalence was observed in the ED and among nurses, administrative and young staff, and those with diabetes mellitus, while a lower seroprevalence was found in HCWs in intensive, high, or medium care, and those with self-reported lung disease, smokers, and dog owners. A history of altered smell or taste, fever, muscle aches and fatigue were independently associated with the presence of SARS-CoV-2 antibodies in unvaccinated HCWs.
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Affiliation(s)
- Claudia Recanatini
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
| | | | - Suzan D Pas
- Microvida Laboratory for Medical Microbiology, Bravis Hospital, Roosendaal, The Netherlands
- Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Els M Broens
- Department Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Martje Maas
- Department of Internal Medicine, Bernhoven Hospital, Uden, The Netherlands
| | - Rosa van Mansfeld
- Department of Medical Microbiology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Miranda van Rijen
- Department of Infection Control, Amphia Hospital, Breda, The Netherlands
| | - Emile F Schippers
- Department of Internal Medicine, Haga Hospital, The Hague, The Netherlands
| | - Arjan Stegeman
- Department of Population Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Adriana Tami
- Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Karin Ellen Veldkamp
- Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Hannah Visser
- Department of Internal Medicine, Beatrix Hospital, Gorinchem, The Netherlands
| | - Andreas Voss
- Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
- Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marjolijn C A Wegdam-Blans
- Catharina Hospital, Eindhoven, The Netherlands
- Hospital St. Jans Gasthuis, Weert, The Netherlands
- Department of Medical Microbiology, Stichting PAMM, Veldhoven, The Netherlands
| | - Heiman F L Wertheim
- Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Peter C Wever
- Department of Medical Microbiology and Infection Control, Jeroen Bosch Hospital, 's Hertogenbosch, The Netherlands
| | - Marion P G Koopmans
- Viroscience Department, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jan A J W Kluytmans
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Infection Control, Amphia Hospital, Breda, The Netherlands
- Department of Medical Microbiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Marjolein F Q Kluytmans-van den Bergh
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Infection Control, Amphia Hospital, Breda, The Netherlands
- Amphia Academy Infectious Disease Foundation, Amphia Hospital, Breda, The Netherlands
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Bonilla H, Quach TC, Tiwari A, Bonilla AE, Miglis M, Yang PC, Eggert LE, Sharifi H, Horomanski A, Subramanian A, Smirnoff L, Simpson N, Halawi H, Sum-Ping O, Kalinowski A, Patel ZM, Shafer RW, Geng LC. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome is common in post-acute sequelae of SARS-CoV-2 infection (PASC): Results from a post-COVID-19 multidisciplinary clinic. Front Neurol 2023; 14:1090747. [PMID: 36908615 PMCID: PMC9998690 DOI: 10.3389/fneur.2023.1090747] [Citation(s) in RCA: 43] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 02/06/2023] [Indexed: 02/26/2023] Open
Abstract
Background The global prevalence of PASC is estimated to be present in 0·43 and based on the WHO estimation of 470 million worldwide COVID-19 infections, corresponds to around 200 million people experiencing long COVID symptoms. Despite this, its clinical features are not well-defined. Methods We collected retrospective data from 140 patients with PASC in a post-COVID-19 clinic on demographics, risk factors, illness severity (graded as one-mild to five-severe), functional status, and 29 symptoms and principal component symptoms cluster analysis. The Institute of Medicine (IOM) 2015 criteria were used to determine the Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) phenotype. Findings The median age was 47 years, 59.0% were female; 49.3% White, 17.2% Hispanic, 14.9% Asian, and 6.7% Black. Only 12.7% required hospitalization. Seventy-two (53.5%) patients had no known comorbid conditions. Forty-five (33.9%) were significantly debilitated. The median duration of symptoms was 285.5 days, and the number of symptoms was 12. The most common symptoms were fatigue (86.5%), post-exertional malaise (82.8%), brain fog (81.2%), unrefreshing sleep (76.7%), and lethargy (74.6%). Forty-three percent fit the criteria for ME/CFS, majority were female, and obesity (BMI > 30 Kg/m2) (P = 0.00377895) and worse functional status (P = 0.0110474) were significantly associated with ME/CFS. Interpretations Most PASC patients evaluated at our clinic had no comorbid condition and were not hospitalized for acute COVID-19. One-third of patients experienced a severe decline in their functional status. About 43% had the ME/CFS subtype.
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Affiliation(s)
- Hector Bonilla
- Department of Medicine, Stanford University, Stanford, CA, United States
| | - Tom C Quach
- Department of Medicine, Stanford University, Stanford, CA, United States
| | - Anushri Tiwari
- Department of Medicine, Stanford University, Stanford, CA, United States
| | - Andres E Bonilla
- Department of Molecular, Cell and Developmental Biology, University of Michigan, Ann Arbor, MI, United States
| | - Mitchell Miglis
- Department of Medicine, Stanford University, Stanford, CA, United States
| | - Phillip C Yang
- Department of Medicine, Stanford University, Stanford, CA, United States
| | - Lauren E Eggert
- Department of Medicine, Stanford University, Stanford, CA, United States
| | - Husham Sharifi
- Department of Medicine, Stanford University, Stanford, CA, United States
| | - Audra Horomanski
- Department of Medicine, Stanford University, Stanford, CA, United States
| | - Aruna Subramanian
- Department of Medicine, Stanford University, Stanford, CA, United States
| | - Liza Smirnoff
- Department of Medicine, Stanford University, Stanford, CA, United States
| | - Norah Simpson
- Department of Medicine, Stanford University, Stanford, CA, United States
| | - Houssan Halawi
- Department of Medicine, Stanford University, Stanford, CA, United States
| | - Oliver Sum-Ping
- Department of Medicine, Stanford University, Stanford, CA, United States
| | | | - Zara M Patel
- Department of Medicine, Stanford University, Stanford, CA, United States
| | | | - Linda C Geng
- Department of Medicine, Stanford University, Stanford, CA, United States
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Palladino R, Mercogliano M, Fiorilla C, Frangiosa A, Iodice S, Sanduzzi Zamparelli S, Montella E, Triassi M, Sanduzzi Zamparelli A. Association between COVID-19 and Sick Leave for Healthcare Workers in a Large Academic Hospital in Southern Italy: An Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9670. [PMID: 35955042 PMCID: PMC9368056 DOI: 10.3390/ijerph19159670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 07/26/2022] [Accepted: 08/02/2022] [Indexed: 06/15/2023]
Abstract
Studies have shown that the pandemic has led to an increase in sick leave periods among healthcare workers (HCWs); however, this might have changed over time considering increase in vaccination coverage and change in COVID-19 variant predominance. Therefore, we conducted an observational study to evaluate whether the type of symptoms and the duration of sick leave period for healthcare workers working in a large university hospital in the South of Italy changed between January 2021 and January 2022; 398 cases of COVID-19 were identified for a total of 382 subjects involved. A total of 191 subjects answered the questionnaire about symptoms; of these, 79 had COVID-19 during the period from March 2020 until February 2022. The results showed a decrease of about 1.2 days in sick leave period for each quarter without finding significant differences in the perception of symptoms. It is possible to hypothesize a contribution from the Omicron variant to the decrease in sick leave period in the last quarter, from vaccination coverage, from optimization of COVID-19 management, and from change in the regulations for the assessment of positivity.
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Affiliation(s)
- Raffaele Palladino
- Department of Public Health, University of Naples “Federico II”, 80125 Naples, Italy
- Department of Primary Care and Public Health, Imperial College London, London W6 8RP, UK
- Interdepartmental Center for Research in Healthcare Management and Innovation in Healthcare (CIRMIS), University of Naples “Federico II”, 80131 Naples, Italy
| | | | - Claudio Fiorilla
- Department of Public Health, University of Naples “Federico II”, 80125 Naples, Italy
| | - Alessandro Frangiosa
- Department of Public Health, University of Naples “Federico II”, 80125 Naples, Italy
| | - Sabrina Iodice
- Department of Public Health, University of Naples “Federico II”, 80125 Naples, Italy
| | | | - Emma Montella
- Department of Public Health, University of Naples “Federico II”, 80125 Naples, Italy
| | - Maria Triassi
- Department of Public Health, University of Naples “Federico II”, 80125 Naples, Italy
- Interdepartmental Center for Research in Healthcare Management and Innovation in Healthcare (CIRMIS), University of Naples “Federico II”, 80131 Naples, Italy
| | - Alessandro Sanduzzi Zamparelli
- Department of Clinical Medicine and Surgery, Section of Respiratory Diseases, University “Federico II”, Azienda Ospedaliera dei Colli-Monaldi Hospital, 80131 Naples, Italy
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8
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Clinical and occupational risk factors for coronavirus disease 2019 (COVID-19) in healthcare personnel. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2022; 2:e123. [PMID: 36505949 PMCID: PMC9727206 DOI: 10.1017/ash.2022.250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/25/2022] [Accepted: 04/28/2022] [Indexed: 12/15/2022]
Abstract
Objective To identify characteristics associated with positive severe acute respiratory coronavirus virus 2 (SARS-CoV-2) polymerase chain reaction (PCR) tests in healthcare personnel. Design Retrospective cohort study. Setting A multihospital healthcare system. Participants Employees who reported SARS-CoV-2 exposures and/or symptoms of coronavirus disease 2019 (COVID-19) between March 30, 2020, and September 20, 2020, and were subsequently referred for SARS-CoV-2 PCR testing. Methods Data from exposure and/or symptom reports were linked to the corresponding SARS-CoV-2 PCR test result. Employee demographic characteristics, occupational characteristics, SARS-CoV-2 exposure history, and symptoms were evaluated as potential risk factors for having a positive SARS-CoV-2 PCR test. Results Among 6,289 employees who received SARS-CoV-2 PCR testing, 873 (14%) had a positive test. Independent risk factors for a positive PCR included: working in a patient care area (relative risk [RR], 1.82; 95% confidence interval [CI], 1.37-2.40), having a known SARS-CoV-2 exposure (RR, 1.20; 95% CI, 1.04-1.37), reporting a community versus an occupational exposure (RR, 1.87; 95% CI, 1.49-2.34), and having an infected household contact (RR, 2.47; 95% CI, 2.11-2.89). Nearly all HCP (99%) reported symptoms. Symptoms associated with a positive PCR in a multivariable analysis included loss of sense of smell (RR, 2.60; 95% CI, 2.09-3.24) or taste (RR, 1.75; 95% CI, 1.40-2.20), cough (RR, 1.95; 95% CI, 1.40-2.20), fever, and muscle aches. Conclusions In this cohort of >6,000 healthcare system and academic medical center employees early in the pandemic, community exposures, and particularly household exposures, were associated with greater risk of SARS-CoV-2 infection than occupational exposures. This work highlights the importance of COVID-19 prevention in the community and in healthcare settings to prevent COVID-19.
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Novelli V, Fassio F, Resani G, Bussa M, Durbano A, Meloni A, Oliva G, Cutti S, Girardi D, Odone A, Villani S, Marena C, Muzzi A, Monti MC. Clinical Characteristics and Potential Risk Factors Associated with the SARS-CoV-2 Infection: Survey on a Health Care Workers (HCWs) Population in Northern Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138194. [PMID: 35805853 PMCID: PMC9266542 DOI: 10.3390/ijerph19138194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/01/2022] [Accepted: 07/02/2022] [Indexed: 11/16/2022]
Abstract
During the two years of the COVID-19 pandemic, more than 400 million cases all over the world have been identified. Health care workers were among the first to deal with this virus and consequently a high incidence of infection was reported in this population. The aim of the survey was to investigate health care workers’ (HCWs) clinical characteristics and potential risk factors associated with the SARS-CoV-2 infection in a referral hospital in Northern Italy after the first and second waves of the pandemic. We administered a questionnaire during the flu vaccination campaign that took place at the end of 2020; among 1386 vaccinated HCWs, data was collected and analyzed for 1065 subjects. 182 HCWs (17%) declared that they had tested positive on at least a molecular or a serological test since the beginning of the pandemic. Comparing the infected vs. not infected HCWs, median age, BMI, smoking habit, presence of hypertension or other comorbidities were not significantly different, while having worked in a COVID ward was associated with the infection (ORadj = 1.54, 95% CI: 1.07–2.20). Respondents declared that more than 70% of contacts occurred in the hospital with patients or colleagues, while about 15% in domestic environments. Among the infected, the most reported symptoms were fever (62.1%), asthenia (60.3%), anosmia/ageusia (53.5%), arthralgia/myalgia (48.3%), headache or other neurological symptoms (46.6%), cough (43.1%) and flu-like syndrome (41.4%). The percentage of subjects who have been infected with SARS-CoV-2 seems to be higher in HCWs than in the general population; hence, in hospitals, protective measures and preventive strategies to avoid the spreading of the contagion remain crucial.
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Affiliation(s)
- Viola Novelli
- Medical Direction, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (V.N.); (G.R.); (A.D.); (S.C.); (D.G.); (C.M.); (A.M.)
| | - Federico Fassio
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (M.B.); (S.V.); (M.C.M.)
- Correspondence:
| | - Guido Resani
- Medical Direction, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (V.N.); (G.R.); (A.D.); (S.C.); (D.G.); (C.M.); (A.M.)
- Unit of Hygiene, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (A.M.); (G.O.); (A.O.)
| | - Martino Bussa
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (M.B.); (S.V.); (M.C.M.)
| | - Alessandro Durbano
- Medical Direction, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (V.N.); (G.R.); (A.D.); (S.C.); (D.G.); (C.M.); (A.M.)
| | - Alessandro Meloni
- Unit of Hygiene, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (A.M.); (G.O.); (A.O.)
| | - Giovanni Oliva
- Unit of Hygiene, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (A.M.); (G.O.); (A.O.)
| | - Sara Cutti
- Medical Direction, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (V.N.); (G.R.); (A.D.); (S.C.); (D.G.); (C.M.); (A.M.)
| | - Daniela Girardi
- Medical Direction, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (V.N.); (G.R.); (A.D.); (S.C.); (D.G.); (C.M.); (A.M.)
- Unit of Hygiene, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (A.M.); (G.O.); (A.O.)
| | - Anna Odone
- Unit of Hygiene, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (A.M.); (G.O.); (A.O.)
| | - Simona Villani
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (M.B.); (S.V.); (M.C.M.)
| | - Carlo Marena
- Medical Direction, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (V.N.); (G.R.); (A.D.); (S.C.); (D.G.); (C.M.); (A.M.)
| | - Alba Muzzi
- Medical Direction, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (V.N.); (G.R.); (A.D.); (S.C.); (D.G.); (C.M.); (A.M.)
| | - Maria Cristina Monti
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (M.B.); (S.V.); (M.C.M.)
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Serology suggests adequate safety measures to protect healthcare workers from COVID-19 in Shiga Prefecture, Japan. PLoS One 2022; 17:e0270334. [PMID: 35749426 PMCID: PMC9231724 DOI: 10.1371/journal.pone.0270334] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 06/08/2022] [Indexed: 01/24/2023] Open
Abstract
Healthcare workers (HCWs), especially frontline workers against coronavirus disease 2019 (COVID-19), are considered to be risky because of occupational exposure to infected patients. This study evaluated the correlation between seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies among HCWs and the implementation of personal protective equipment (PPE) & infection prevention and control (IPC). We recruited 1237 HCWs from nine public COVID-19-designated hospitals in Shiga Prefecture, central Japan, between 15-26 February 2021. All participants answered a self-administered questionnaire and provided blood samples to evaluate SARS-CoV-2 antibodies. A total of 22 cases (1·78%) were seropositive among the 1237 study participants. An unavoidable outbreak of SARS-CoV-2 had occurred at the terminal care unit of one hospital, before identifying and securely isolating this cluster of cases. Excluding with this cluster, 0·68% of HCWs were suspected to have had previous SARS-CoV-2 infections. Binomial logistic regression from individual questionnaires and seropositivity predicted a significant correlation with N95 mask implementation under aerosol conditions (p = 8.63e-06, aOR = 2.47) and work duration in a red zone (p = 2.61e-04, aOR = 1.99). The institutional questionnaire suggested that IPC education was correlated with reduced seropositivity at hospitals. Seroprevalence and questionnaire analyses among HCWs indicated that secure implementation of PPE and re-education of IPC are essential to prevent SARS-CoV-2 infection within healthcare facilities. Occupational infections from SARS-CoV-2 in healthcare settings could be prevented by adhering to adequate measures and appropriate use of PPE. With these measures securely implemented, HCWs should not be considered against as significantly risky or dirty by local communities.
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11
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Incidence of COVID-19 infection in hospital workers from March 1, 2020 to May 31, 2021 routinely tested, before and after vaccination with BNT162B2. Sci Rep 2022; 12:2533. [PMID: 35169127 PMCID: PMC8847551 DOI: 10.1038/s41598-021-04665-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 12/22/2021] [Indexed: 01/19/2023] Open
Abstract
To evaluate the incidence of COVID-19 infection in health care workers from the start of the COVID-19 pandemic in NE Italy, vaccination with BNT162b2. This was a retrospective cohort study. Healthcare workers were routinely tested for SARS-CoV-2 infection using real-time polymerase chain reaction tests in nasopharyngeal swabs. Logistic regression was used to calculate the incidence rate ratios (IRRs) of the factors associated with COVID-19. A total of 4251 workers were followed up, and the prevalence of COVID-19 was 13.6%. In March 2021 the incidence of infection was 4.88 and 103.55 cases for 100,000 person-days in vaccinated and non-vaccinated workers, respectively, with an adjusted IRRs of 0.05 (95% CI 0.02–0.08). Our study evaluated the monthly incidence in health care workers in Trieste hospitals before and after vaccination, finding an estimated vaccine effectiveness of 95% in health care workers routinely tested.
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Rojas-Serrano J, Portillo-Vásquez AM, Thirion-Romero I, Vázquez-Pérez J, Mejía-Nepomuceno F, Ramírez-Venegas A, Pérez-Kawabe KM, Pérez-Padilla R. Hydroxychloroquine for prophylaxis of COVID-19 in health workers: A randomized clinical trial. PLoS One 2022; 17:e0261980. [PMID: 35139097 PMCID: PMC8827445 DOI: 10.1371/journal.pone.0261980] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 11/24/2021] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Health care workers are at high risk of being infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Our aim is to evaluate the efficacy and safety of hydroxychloroquine (HCQ) for prophylaxis of coronavirus disease 19 (COVID-19) in health personnel exposed to patients infected by SARS-CoV-2. METHODS Double-blind randomized, placebo-controlled single center clinical trial. Included subjects were health care workers caring for severe COVID-19 patients. Main outcome was time to symptomatic SARS-CoV-2 infection. RESULTS 127 subjects with a confirmed baseline negative RT-PCR SARS-CoV2 test were included in the trial. 62 assigned to HCQ and 65 to placebo. One subject (1.6%) in the HCQ group and 6 (9.2%) subjects in the placebo group developed COVID-19 (Log-Rank test p = 0.07). No severe COVID-19 cases were observed. The study was suspended because of a refusal to participate and losses to follow up after several trials reported lack of effectiveness of hydroxychloroquine in hospitalized patients with COVID-19. CONCLUSION The effect size of hydroxychloroquine was higher than placebo for COVID-19 symptomatic infection in health personnel, although this was not statistically significant. The trial is underpowered due to the failure to complete the estimated sample size.
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Affiliation(s)
- Jorge Rojas-Serrano
- Interstitial Lung Disease and Rheumatology Unit, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City, Mexico
| | | | - Ireri Thirion-Romero
- Department of Investigation on Tobacco and Chronic Obstructive Pulmonary Disease, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City, Mexico
| | - Joel Vázquez-Pérez
- Department of Investigation on Tobacco and Chronic Obstructive Pulmonary Disease, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City, Mexico
| | - Fidencio Mejía-Nepomuceno
- Department of Investigation on Tobacco and Chronic Obstructive Pulmonary Disease, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City, Mexico
| | - Alejandra Ramírez-Venegas
- Department of Investigation on Tobacco and Chronic Obstructive Pulmonary Disease, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City, Mexico
| | - Karla Midori Pérez-Kawabe
- Department of Investigation on Tobacco and Chronic Obstructive Pulmonary Disease, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City, Mexico
| | - Rogelio Pérez-Padilla
- Department of Investigation on Tobacco and Chronic Obstructive Pulmonary Disease, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City, Mexico
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13
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Mattingly AS, Rose L, Eddington HS, Trickey AW, Cullen MR, Morris AM, Wren SM. Trends in US Surgical Procedures and Health Care System Response to Policies Curtailing Elective Surgical Operations During the COVID-19 Pandemic. JAMA Netw Open 2021; 4:e2138038. [PMID: 34878546 PMCID: PMC8655602 DOI: 10.1001/jamanetworkopen.2021.38038] [Citation(s) in RCA: 113] [Impact Index Per Article: 37.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
IMPORTANCE The COVID-19 pandemic has affected every aspect of medical care, including surgical treatment. It is critical to understand the association of government policies and infection burden with surgical access across the United States. OBJECTIVE To describe the change in surgical procedure volume in the US after the government-suggested shutdown and subsequent peak surge in volume of patients with COVID-19. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study was conducted using administrative claims from a nationwide health care technology clearinghouse. Claims from pediatric and adult patients undergoing surgical procedures in 49 US states within the Change Healthcare network of health care institutions were used. Surgical procedure volume during the 2020 initial COVID-19-related shutdown and subsequent fall and winter infection surge were compared with volume in 2019. Data were analyzed from November 2020 through July 2021. EXPOSURES 2020 policies to curtail elective surgical procedures and the incidence rate of patients with COVID-19. MAIN OUTCOMES AND MEASURES Incidence rate ratios (IRRs) were estimated from a Poisson regression comparing total procedure counts during the initial shutdown (March 15 to May 2, 2020) and subsequent COVID-19 surge (October 22, 2020-January 31, 2021) with corresponding 2019 dates. Surgical procedures were analyzed by 11 major procedure categories, 25 subcategories, and 12 exemplar operative procedures along a spectrum of elective to emergency indications. RESULTS A total of 13 108 567 surgical procedures were identified from January 1, 2019, through January 30, 2021, based on 3498 Current Procedural Terminology (CPT) codes. This included 6 651 921 procedures in 2019 (3 516 569 procedures among women [52.9%]; 613 192 procedures among children [9.2%]; and 1 987 397 procedures among patients aged ≥65 years [29.9%]) and 5 973 573 procedures in 2020 (3 156 240 procedures among women [52.8%]; 482 637 procedures among children [8.1%]; and 1 806 074 procedures among patients aged ≥65 years [30.2%]). The total number of procedures during the initial shutdown period and its corresponding period in 2019 (ie, epidemiological weeks 12-18) decreased from 905 444 procedures in 2019 to 458 469 procedures in 2020, for an IRR of 0.52 (95% CI, 0.44 to 0.60; P < .001) with a decrease of 48.0%. There was a decrease in surgical procedure volume across all major categories compared with corresponding weeks in 2019. During the initial shutdown, otolaryngology (ENT) procedures (IRR, 0.30; 95% CI, 0.13 to 0.46; P < .001) and cataract procedures (IRR, 0.11; 95% CI, -0.11 to 0.32; P = .03) decreased the most among major categories. Organ transplants and cesarean deliveries did not differ from the 2019 baseline. After the initial shutdown, during the ensuing COVID-19 surge, surgical procedure volumes rebounded to 2019 levels (IRR, 0.97; 95% CI, 0.95 to 1.00; P = .10) except for ENT procedures (IRR, 0.70; 95% CI, 0.65 to 0.75; P < .001). There was a correlation between state volumes of patients with COVID-19 and surgical procedure volume during the initial shutdown (r = -0.00025; 95% CI, -0.0042 to -0.0009; P = .003), but there was no correlation during the COVID-19 surge (r = -0.00034; 95% CI, -0.0075 to 0.00007; P = .11). CONCLUSIONS AND RELEVANCE This study found that the initial shutdown period in March through April 2020, was associated with a decrease in surgical procedure volume to nearly half of baseline rates. After the reopening, the rate of surgical procedures rebounded to 2019 levels, and this trend was maintained throughout the peak burden of patients with COVID-19 in fall and winter; these findings suggest that after initial adaptation, health systems appeared to be able to self-regulate and function at prepandemic capacity.
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Affiliation(s)
| | - Liam Rose
- Health Economics Resource Center, Department of Veterans Affairs, Palo Alto, California
- Stanford-Surgery Policy Improvement Research and Education Center, Stanford, California
| | - Hyrum S. Eddington
- Stanford-Surgery Policy Improvement Research and Education Center, Stanford, California
| | - Amber W. Trickey
- Stanford-Surgery Policy Improvement Research and Education Center, Stanford, California
| | - Mark R. Cullen
- Stanford Center for Population Health Sciences, Stanford, California
| | - Arden M. Morris
- Stanford-Surgery Policy Improvement Research and Education Center, Stanford, California
- Surgical Service, Palo Alto Veterans Affairs Health Care System, Palo Alto, California
- Department of Surgery, Stanford University School of Medicine, Stanford, California
| | - Sherry M. Wren
- Surgical Service, Palo Alto Veterans Affairs Health Care System, Palo Alto, California
- Department of Surgery, Stanford University School of Medicine, Stanford, California
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14
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Ota MOC, Badur S, Romano-Mazzotti L, Friedland LR. Impact of COVID-19 pandemic on routine immunization. Ann Med 2021; 53:2286-2297. [PMID: 34854789 PMCID: PMC8648038 DOI: 10.1080/07853890.2021.2009128] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 11/16/2021] [Indexed: 11/04/2022] Open
Abstract
The current COVID-19 global pandemic continues to impact healthcare services beyond those directly related to the management of SARS-CoV-2 transmission and disease. We reviewed the published literature to assess the pandemic impact on existing global immunization activities and how the impact may be addressed. Widespread global disruption in routine childhood immunization has impacted a majority of regions and countries, especially in the initial pandemic phases. While data indicate subsequent recovery in immunization rates, a substantial number of vulnerable people remain unvaccinated. The downstream impact may be even greater in resource-limited settings and economically poorer populations, and consequently there are growing concerns around the resurgence of vaccine-preventable diseases, particularly measles. Guidance on how to address immunization deficits are available and continue to evolve, emphasizing the importance of maintaining and restoring routine immunization and necessary mass vaccination campaigns during and after pandemics. In this, collaboration between a broad range of stakeholders (governments, industry, healthcare decision-makers and frontline healthcare professionals) and clear communication and engagement with the public can help achieve these goals.Key messagesThe COVID-19 pandemic has a substantial impact on essential immunization activities.Disruption to mass vaccination campaigns increase risk of VPD resurgence.Catch-up campaigns are necessary to limit existing shortfalls in vaccine uptake.Guidance to mitigate these effects continues to evolve.
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15
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Case-control study of the association of chronic acid suppression and social determinants of health with COVID-19 infection. Sci Rep 2021; 11:20987. [PMID: 34697319 PMCID: PMC8545937 DOI: 10.1038/s41598-021-00367-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 09/28/2021] [Indexed: 11/23/2022] Open
Abstract
Acid suppressants are widely-used classes of medications linked to increased risks of aerodigestive infections. Prior studies of these medications as potentially reversible risk factors for COVID-19 have been conflicting. We aimed to determine the impact of chronic acid suppression use on COVID-19 infection risk while simultaneously evaluating the influence of social determinants of health to validate known and discover novel risk factors. We assessed the association of chronic acid suppression with incident COVID-19 in a 1:1 case–control study of 900 patients tested across three academic medical centers in California, USA. Medical comorbidities and history of chronic acid suppression use were manually extracted from health records by physicians following a pre-specified protocol. Socio-behavioral factors by geomapping publicly-available data to patient zip codes were incorporated. We identified no evidence to support an association between chronic acid suppression and COVID-19 (adjusted odds ratio 1.04, 95% CI 0.92–1.17, P = 0.515). However, several medical and social features were positive (Latinx ethnicity, BMI ≥ 30, dementia, public transportation use, month of the pandemic) and negative (female sex, concurrent solid tumor, alcohol use disorder) predictors of new infection. These findings demonstrate the value of integrating publicly-available databases with medical data to identify critical features of communicable diseases.
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Tempany M, Leonard A, Prior AR, Boran G, Reilly P, Murray C, O'Brien M, Maguire G, Ennis D, Rakovac A, Reid A. The potential impact of post-COVID symptoms in the healthcare sector. Occup Med (Lond) 2021; 71:284-289. [PMID: 34415352 DOI: 10.1093/occmed/kqab109] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The phenomenon of post-COVID syndrome (PCS) is evolving from an abstract array of non-specific symptoms to an identifiable clinical entity of variable severity. Its frequency and persistence have implications for service delivery and workforce planning. AIMS This study was aimed to assess the prevalence of symptoms consistent with PCS and the subjective degree of recovery in a cohort of healthcare workers, focusing on those who have returned to work. METHODS A study population of 1176 was surveyed when attending for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody testing. Two sub-groups were identified: those with known (i.e. diagnosed on PCR testing) and assumed (i.e. antibody evidence of previous infection) SARs-CoV-2 infection, at least 12 weeks prior to the study. Each group was asked about their subjective degree of recovery and the nature of their persistent symptoms. Results were analysed via excel and SPSS. RESULTS In total, 144 employees showed PCR evidence of previous infection, with 139 of these being infected at least 12 weeks prior to the study. Of these 139, only 19% (n = 26) reported feeling 100% recovered, and 71% reported persistent symptoms. Of those with assumed SARS-CoV-2 infection (n = 78), 32 (41%) were truly asymptomatic since the commencement of the pandemic, while 46 (59%) described symptoms suggestive of possible infection at least 12 weeks prior to the study. Of this latter group, 23% (n = 18) also reported residual symptoms. CONCLUSIONS PCS is prevalent among this group, including those not previously diagnosed with COVID-19. Its' frequency and duration present challenges to employers with regards to the management of work availability and performance.
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Affiliation(s)
- M Tempany
- Department of Occupational Health and Wellbeing, Tallaght University Hospital, Dublin, Ireland
| | - A Leonard
- Department of Clinical Chemistry and Laboratory Medicine, Tallaght University Hospital, Dublin, Ireland.,School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - A R Prior
- Department of Clinical Microbiology, Tallaght University Hospital, Dublin, Ireland
| | - G Boran
- Department of Clinical Chemistry and Laboratory Medicine, Tallaght University Hospital, Dublin, Ireland.,School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - P Reilly
- Department of Clinical Chemistry and Laboratory Medicine, Tallaght University Hospital, Dublin, Ireland.,School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - C Murray
- Department of Clinical Chemistry and Laboratory Medicine, Tallaght University Hospital, Dublin, Ireland.,School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - M O'Brien
- Department of Clinical Chemistry and Laboratory Medicine, Tallaght University Hospital, Dublin, Ireland.,School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - G Maguire
- Department of Clinical Chemistry and Laboratory Medicine, Tallaght University Hospital, Dublin, Ireland.,School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - D Ennis
- Department of Clinical Chemistry and Laboratory Medicine, Tallaght University Hospital, Dublin, Ireland.,School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - A Rakovac
- Department of Clinical Chemistry and Laboratory Medicine, Tallaght University Hospital, Dublin, Ireland.,School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - A Reid
- Department of Occupational Health and Wellbeing, Tallaght University Hospital, Dublin, Ireland
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Vahey GM, McDonald E, Marshall K, Martin SW, Chun H, Herlihy R, Tate JE, Kawasaki B, Midgley CM, Alden N, Killerby ME, Staples JE. Risk factors for hospitalization among persons with COVID-19-Colorado. PLoS One 2021; 16:e0256917. [PMID: 34473791 PMCID: PMC8412293 DOI: 10.1371/journal.pone.0256917] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 08/19/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Most current evidence on risk factors for hospitalization because of coronavirus disease 2019 (COVID-19) comes from studies using data abstracted primarily from electronic health records, limited to specific populations, or that fail to capture over-the-counter medications and adjust for potential confounding factors. Properly understanding risk factors for hospitalization will help improve clinical management and facilitate targeted prevention messaging and forecasting and prioritization of clinical and public health resource needs. OBJECTIVES To identify risk factors for hospitalization using patient questionnaires and chart abstraction. METHODS We randomly selected 600 of 1,738 laboratory-confirmed Colorado COVID-19 cases with known hospitalization status and illness onset during March 9-31, 2020. In April 2020, we collected demographics, social history, and medications taken in the 30 days before illness onset via telephone questionnaire and collected underlying medical conditions in patient questionnaires and medical record abstraction. RESULTS Overall, 364 patients participated; 128 were hospitalized and 236 were non-hospitalized. In multivariable analysis, chronic hypoxemic respiratory failure with oxygen requirement (adjusted odds ratio [aOR] 14.64; 95% confidence interval [CI] 1.45-147.93), taking opioids (aOR 8.05; CI 1.16-55.77), metabolic syndrome (aOR 5.71; CI 1.18-27.54), obesity (aOR 3.35; CI 1.58-7.09), age ≥65 years (aOR 3.22; CI 1.20-7.97), hypertension (aOR 3.14; CI 1.47-6.71), arrhythmia (aOR 2.95; CI 1.00-8.68), and male sex (aOR 2.65; CI 1.44-4.88), were significantly associated with hospitalization. CONCLUSION We identified patient characteristics, medications, and medical conditions, including some novel ones, associated with hospitalization. These data can be used to inform clinical and public health resource needs.
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Affiliation(s)
- Grace M. Vahey
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Emily McDonald
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Kristen Marshall
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Colorado Department of Public Health and Environment, Denver, Colorado, United States of America
| | - Stacey W. Martin
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Helen Chun
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Rachel Herlihy
- Colorado Department of Public Health and Environment, Denver, Colorado, United States of America
| | - Jacqueline E. Tate
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Breanna Kawasaki
- Colorado Department of Public Health and Environment, Denver, Colorado, United States of America
| | - Claire M. Midgley
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Nisha Alden
- Colorado Department of Public Health and Environment, Denver, Colorado, United States of America
| | - Marie E. Killerby
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - J. Erin Staples
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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18
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Boldrini T, Girardi P, Clerici M, Conca A, Creati C, Di Cicilia G, Ducci G, Durbano F, Maci C, Maone A, Nicolò G, Oasi O, Percudani M, Polselli GM, Pompili M, Rossi A, Salcuni S, Tarallo F, Vita A, Lingiardi V. Consequences of the COVID-19 pandemic on admissions to general hospital psychiatric wards in Italy: Reduced psychiatric hospitalizations and increased suicidality. Prog Neuropsychopharmacol Biol Psychiatry 2021; 110:110304. [PMID: 33737215 PMCID: PMC8569419 DOI: 10.1016/j.pnpbp.2021.110304] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 03/04/2021] [Accepted: 03/09/2021] [Indexed: 12/22/2022]
Abstract
AIMS The present investigation aimed at evaluating differences in psychiatric hospitalizations in Italy during and after the lockdown due to the novel coronavirus disease 2019 (COVID-19), compared to the same periods in 2018 and 2019. METHODS We obtained and analyzed anonymized data on psychiatric admissions (n = 4550) from 12 general hospital psychiatric wards (GHPWs) in different Italian regions (catchment area = 3.71 millions of inhabitants). Using a mixed-effects Poisson regression model, we compared admission characteristics across three periods: (a) March 1-June 30, 2018 and 2019; (b) March 1-April 30, 2020 (i.e., lockdown); and (c) May 1-June 30, 2020 (i.e., post-lockdown). RESULTS During the COVID-19 lockdown, there was a 41% reduction (IRR = 0.59; p < 0.001, CI: 0.45-0.79) in psychiatric admissions in the enrolled GHPWs with respect to the 2018 and 2019 control period. Conversely, admission rates in the post-lockdown period were similar to those observed in the control period. Notably, a consistent and significant reduction in psychiatric hospitalizations of older patients (aged >65 years) was observed in the lockdown (40%; IRR = 0.60; 95% CI: 0.44-0.82) and post-lockdown (28%; IRR = 0.72; 95% CI: 0.54-0.96) periods. Long-stay admissions (>14 days) increased (63%; IRR = 1.63; 95% CI: 1.32-2.02) during the lockdown and decreased by 39% thereafter (IRR = 0.61; 95% CI: 0.49-0.75). A significant 35% increase in patients reporting suicidal ideation was observed in the post-lockdown period, compared to the rate observed in the 2018 and 2019 control period (IRR = 1.35; 95% CI: 1.01-1.79). CONCLUSION The COVID-19 lockdown was associated with changes in the number of psychiatric admissions, particularly for older patients and long-stay hospitalizations. Increased admission of patients reporting suicidal ideation in the post-lockdown period merits special attention. Further studies are required to gain insight into the observed phenomena.
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Affiliation(s)
- Tommaso Boldrini
- Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy
| | - Paolo Girardi
- Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy.
| | - Massimo Clerici
- Department of Mental Health and Addiction, ASST of Monza; Psychiatric Clinic, University of Milan Bicocca, Italy
| | - Andreas Conca
- General Hospital of Bolzano, Department of Psychiatry, Bolzano, Italy
| | - Chiara Creati
- Department of Dynamic and Clinical Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Di Cicilia
- Department of Dynamic and Clinical Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Ducci
- Mental Health Department, ASL Roma 1, S.Spirito Hospital, Rome, Italy
| | - Federico Durbano
- Department of Mental Health and Addiction, ASST of Melegnano and Martesana, Italy
| | - Carlo Maci
- Psychiatric Unit, Sandro Pertini Hospital, ASL Roma2, Rome, Italy
| | - Antonio Maone
- Mental Health Department, ASL Roma 1, S.Spirito Hospital, Rome, Italy
| | - Giuseppe Nicolò
- Department of Mental Health and Addiction, ASL Roma5, Rome, Italy
| | - Osmano Oasi
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Mauro Percudani
- Department of Mental Health and Addiction Services, Niguarda Hospital, Milan, Italy
| | | | - Maurizio Pompili
- Department of Neuroscience, Mental Health and Sensory Organs, S. Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Alessandro Rossi
- Section of Psychiatry, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Mental Health Department ASL 1 Abruzzo, Psychiatric Unit, L'Aquila, Italy
| | - Silvia Salcuni
- Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy
| | - Federica Tarallo
- Department of Mental Health and Addiction, ASL Roma5, Rome, Italy
| | - Antonio Vita
- Department of Mental Health and Addiction, ASST of Brescia, Psychiatric Clinic, University of Brescia, Italy
| | - Vittorio Lingiardi
- Department of Dynamic and Clinical Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
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19
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Vicenti I, Gatti F, Scaggiante R, Boccuto A, Modolo E, Zago D, Basso M, Dragoni F, Bartolini N, Zazzi M, Parisi SG. Time Course of Neutralizing Antibody in Health Care Workers With Mild or Asymptomatic COVID-19 Infection. Open Forum Infect Dis 2021; 8:ofab312. [PMID: 34295945 PMCID: PMC8291533 DOI: 10.1093/ofid/ofab312] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 06/09/2021] [Indexed: 11/13/2022] Open
Abstract
We describe the time course of neutralizing antibody (NtAb) titer in a cohort of health care workers with mild or asymptomatic severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection. NtAb levels decreased over time; however, serum neutralizing activity remained detectable after a median of 7 months from SARS-CoV-2 diagnosis in the majority of cases.
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Affiliation(s)
- Ilaria Vicenti
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Francesca Gatti
- Department of Molecular Medicine University of Padova, Padova, Italy
| | | | - Adele Boccuto
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | | | - Daniela Zago
- Department of Molecular Medicine University of Padova, Padova, Italy
| | - Monica Basso
- Department of Molecular Medicine University of Padova, Padova, Italy
| | - Filippo Dragoni
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Niccolo’ Bartolini
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Maurizio Zazzi
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
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20
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McDiarmid M, Condon M, Gaitens J. The Healthcare Sector Employer's Duty of Care: Implications for Worker Well-Being. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6015. [PMID: 34205069 PMCID: PMC8199909 DOI: 10.3390/ijerph18116015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 05/25/2021] [Accepted: 05/27/2021] [Indexed: 11/20/2022]
Abstract
Pandemic diseases of this century have differentially targeted healthcare workers globally. These infections include Severe Acute Respiratory Syndrome SARS, the Middle East respiratory syndrome coronavirus Middle East respiratory syndrome coronavirus (MERS-CoV) and Ebola. The COVID-19 pandemic has continued this pattern, putting healthcare workers at extreme risk. Just as healthcare workers have historically been committed to the service of their patients, providing needed care, termed their "duty of care", so too do healthcare employers have a similar ethical duty to provide care toward their employees arising from historical common law requirements. This paper reports on results of a narrative review performed to assess COVID-19 exposure and disease development in healthcare workers as a function of employer duty of care program elements adopted in the workplace. Significant duty of care deficiencies reported early in the pandemic most commonly involved lack of personal protective equipment (PPE) availability. Beyond worker safety, we also provide evidence that an additional benefit of employer duty of care actions is a greater sense of employee well-being, thus aiding in the prevention of healthcare worker burnout.
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Affiliation(s)
| | - Marian Condon
- School of Medicine, University of Maryland, Baltimore, MD 21201, USA; (M.M.); (J.G.)
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21
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Ponzo V, Pellegrini M, D’Eusebio C, Bioletto F, Goitre I, Buscemi S, Frea S, Ghigo E, Bo S. Mediterranean Diet and SARS-COV-2 Infection: Is There Any Association? A Proof-of-Concept Study. Nutrients 2021; 13:nu13051721. [PMID: 34069656 PMCID: PMC8160854 DOI: 10.3390/nu13051721] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 05/11/2021] [Accepted: 05/17/2021] [Indexed: 02/06/2023] Open
Abstract
The aim of this observational study was investigating the possible correlation between adherence to the Mediterranean diet (MeD) and SARS-COV-2 infection rates and severity among healthcare professionals (HCPs). An online self-administrated questionnaire (evaluating both MeD adherence and dietary habits) was filled out by HCPs working in Piedmont (Northern Italy) from 15 January to 28 February 2021. Out of the 1206 questionnaires collected, 900 were considered reliable and analyzed. Individuals who reported the SARS-COV-2 infection (n = 148) showed a significantly lower MeD score, with a lower adherence in fruit, vegetables, cereals, and olive oil consumption. In a logistic regression model, the risk of infection was inversely associated with the MeD score (OR = 0.88; 95% CI 0.81–0.97) and the consumption of cereals (OR = 0.64; 0.45–0.90). Asymptomatic individuals with SARS-COV-2 infection reported a lower intake of saturated fats than symptomatic; individuals requiring hospitalization were significantly older and reported worse dietary habits than both asymptomatic and symptomatic individuals. After combining all symptomatic individuals together, age (OR = 1.05; 1.01–1.09) and saturated fats intake (OR = 1.09; 1.01–1.17) were associated with the infection severity. HCPs who reported a SARS-COV-2 infection showed a significantly lower MeD score and cereal consumption. The infection severity was directly associated with higher age and saturated fat intake.
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Affiliation(s)
- Valentina Ponzo
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy; (V.P.); (M.P.); (C.D.); (F.B.); (I.G.); (E.G.)
| | - Marianna Pellegrini
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy; (V.P.); (M.P.); (C.D.); (F.B.); (I.G.); (E.G.)
| | - Chiara D’Eusebio
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy; (V.P.); (M.P.); (C.D.); (F.B.); (I.G.); (E.G.)
| | - Fabio Bioletto
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy; (V.P.); (M.P.); (C.D.); (F.B.); (I.G.); (E.G.)
| | - Ilaria Goitre
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy; (V.P.); (M.P.); (C.D.); (F.B.); (I.G.); (E.G.)
| | - Silvio Buscemi
- Unit of Clinical Nutrition, AOU Policlinico “P. Giaccone”, 90127 Palermo, Italy;
- Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza (PROMISE), University of Palermo, 90127 Palermo, Italy
| | - Simone Frea
- Cardiology Unit, Città della Salute e della Scienza Hospital, University of Torino, 10126 Torino, Italy;
| | - Ezio Ghigo
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy; (V.P.); (M.P.); (C.D.); (F.B.); (I.G.); (E.G.)
| | - Simona Bo
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy; (V.P.); (M.P.); (C.D.); (F.B.); (I.G.); (E.G.)
- Correspondence: ; Tel.: +39-011-633-6036
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22
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Knowledge and Perception of COVID-19 Pandemic during the First Wave (Feb-May 2020): A Cross-Sectional Study among Italian Healthcare Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073767. [PMID: 33916577 PMCID: PMC8038455 DOI: 10.3390/ijerph18073767] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/01/2021] [Accepted: 04/01/2021] [Indexed: 01/08/2023]
Abstract
Italy was the first country in Europe to face the coronavirus pandemic. The aim of the study was to analyze healthcare workers’ (HCWs) level of information, practice, and risk perception towards COVID-19. We set up a cross-sectional study through SurveyMonkey® and distributed the link through Facebook and Whatsapp closed groups. The research instrument was a 31 items questionnaire distributed using Facebook and Whatsapp. It was conducted in Italy from February to May 2020. The study participants were general practitioners, pediatricians and other health professionals. A total of 958 participants were included: 320 (33.4%) general practitioners, 248 (25.9%) pediatricians and 390 (40.7%) other health professionals. The highest response rate was from Northern Italy (48.1%), followed by Central Italy (29.9%) and Southern Italy (22.0%). Less than a half (46%) of respondents felt they had a good level of information of COVID-19 case definition and of national prevention guidelines. Respondents reported to have changed their clinical practice; particularly, they increased the use of masks (87.1%, p < 0.001), disinfection and sanitization of doctors’ offices (75.8%, p < 0.001), the use of protective glasses (71.2%, p < 0.001), alcoholic hand solution (71.2%, p < 0.001), and hand washing (31.8%, p = 0.028). HCWs are at high risk of infection; less than a half of them felt adequately prepared to face COVID-19 pandemic, so they need extensive information and awareness of the disease to take adequate precautionary measures, and they are crucial to disseminate good practices.
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23
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Piapan L, Mazzolini E, Tomietto M, Barbone F, Larese Filon F. Epidemiology of SARS-CoV-2 among healthcare workers in North-Eastern Italy from March 1, 2020 to May 10, 2020. LA MEDICINA DEL LAVORO 2021; 112:422-428. [PMID: 34939620 PMCID: PMC8759052 DOI: 10.23749/mdl.v112i6.12186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 10/20/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND During major epidemic outbreaks, the preparedness of public health systems is challenged and -healthcare workers (HCWs) are at the frontline. Italy was among the first- and worst-hit countries by COVID-19. AIM To analyze the prevalence and incidence of infection among HCWs in Friuli Venezia Giulia region (north-eastern Italy) from March 1 to the end of the Italian lock-down, May 10, 2020. METHODS HCWs exposed to COVID-19 patients were actively surveyed and all HCWs were routinely tested with nasopharyngeal and oropharyngeal swab for RNA virus detection (n. 54,670). RESULTS Infected HCWs (n. 595) represented the 32.3% of all COVID-19 cases in the region under 65 years of age, and incidence of infection was 11.4 cases/1000 workers. HCWs accounted for a significant proportion of coronavirus infection and experienced high infection incidence after unprotected contact. CONCLUSIONS HCWs' knowledge of SARS-CoV-2 epidemiology and proper infection control practices are critical to the control of the disease.
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Affiliation(s)
- Linda Piapan
- Unità Clinico Operativa di Medicina del Lavoro, Università degli Studi di Trieste, Trieste, Italy
| | - Elena Mazzolini
- Istituto Zooprofilattico Sperimentale delle Venezie and Direzione Centrale Salute, Politiche Sociali e Disabilità, Regione Friuli Venezia Giulia, Italy
| | - Marco Tomietto
- Direzione Centrale Salute, Politiche Sociali e Disabilità, Regione Friuli Venezia Giulia, Italy
| | - Fabio Barbone
- Dipartimento di Area Medica, Università degli Studi di Udine, Udine, Italy
| | - Francesca Larese Filon
- Unità Clinico Operativa di Medicina del Lavoro, Università degli Studi di Trieste, Trieste, Italy
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24
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Darwish NM, Iqbal MR, Dhahri AA, Jacob N, Jebamani J, Easthope A, Vijay V. Informed Consent for Surgery at Resumption of Elective Activity After the First Wave of COVID-19. Cureus 2020; 12:e11642. [PMID: 33262919 PMCID: PMC7689874 DOI: 10.7759/cureus.11642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has changed the dynamics of healthcare, and the elective surgical consent process has also evolved. The Royal College of Surgeons of England published guidance on consent during COVID-19. Through this study, we aimed to assess our local consent adherence to these guidelines on the resumption of elective activity after the first wave of COVID-19. Methods This prospective review of consecutive elective surgical consent forms was conducted from 20 July 2020 to 16 August 2020 at the Princess Alexandra Hospital NHS Trust, England. The primary outcome was evidence of COVID-19 risk documentation on the consent forms. Results A total of 116 patients’ consent forms were reviewed. Most patients were American Society of Anaesthesiologists (ASA) grade 2 (n=70; 60.34%). Only 25 consent forms (21.55%) had COVID -19 and its associated risks documented, with registrars being the most compliant (19/46; 41.3%) followed by consultants (6/51; 11.7%). With regards to the surgical sub-specialities, general surgery, orthopaedics and ENT had the highest compliance with the guidance. Conclusions As the elective activity resumes, peri-operative risks of COVID-19 should be weighted in during the informed consent process, as mentioned in the latest international guidelines on consent to avoid litigation and negligence claims.
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Affiliation(s)
| | | | | | - Neville Jacob
- General Surgery, Princess Alexandra Hospital NHS Trust, Harlow, GBR
| | | | - Amy Easthope
- General Surgery, Princess Alexandra Hospital NHS Trust, Harlow, GBR
| | - Vardhini Vijay
- General Surgery, Princess Alexandra Hospital NHS Trust, Harlow, GBR
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