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Polat SE, Arıkan FM, Gençoğlu MY, Akyan ŞS, Uytun S, Tabakçı SÖ, Bilgiç I, Çakar MK, Ademhan Tural D, Tuğcu GD, Cinel G. Experience with flexible bronchoscopy for noncoronavirus disease of 2019 indications in pediatric patients during the coronavirus disease of 2019 pandemic. Pediatr Pulmonol 2024; 59:2867-2874. [PMID: 38896067 DOI: 10.1002/ppul.27144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 06/06/2024] [Accepted: 06/11/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND AND AIM Flexible bronchoscopy (FB) poses a risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission due to aerosol generation. This study aimed to assess the utilization, indications, outcomes, and safety of FB in pediatric patients for noncoronavirus disease of 2019 (COVID-19) reasons during the pandemic. MATERIALS AND METHODS We retrospectively analyzed pediatric patients who underwent FB for non-COVID-19 indications at a tertiary children's hospital's pulmonary clinic during the COVID-19 pandemic. Patients showed no COVID-19 symptoms and tested negative for SARS-CoV-2 by real-time polymerase chain reaction (PCR) of nasopharyngeal and throat swabs within 24 h before the procedure. FBs were conducted in the operating room, with healthcare professionals (HCPs) wearing personal protective equipment, including medical N95 masks, gloves, gowns, and eye protection. RESULTS Between March 2020 and April 2022, 167 pediatric patients underwent FB for non-COVID-19 indications. Common indications included foreign body aspiration (22.7%), stridor (10.1%), and atelectasis (8.9%). No COVID-19 symptoms were observed in patients on the 1st and 10th days post-FB. During the 1-month follow-up, 52 patients underwent SARSCoV-2 PCR testing, and one patient tested positive in the third week after the procedure. None of the HCPs in the FB team experienced COVID-19 symptoms or tested positive for SARS-CoV-2. CONCLUSION A bronchoscopy protocol with safety precautions minimized the risk of COVID-19 transmission, allowing safe FB performance for non-COVID-19 indications in pediatric patients during the pandemic. The experience gained in FB during COVID-19 is valuable for similar situations in the future.
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Affiliation(s)
| | | | | | - Şule Selin Akyan
- Division of Pediatric Pulmonology, Ankara City Hospital, Ankara, Turkey
| | - Salih Uytun
- Division of Pediatric Pulmonology, Ankara City Hospital, Ankara, Turkey
| | | | - Işıl Bilgiç
- Division of Pediatric Pulmonology, Ankara City Hospital, Ankara, Turkey
| | | | | | - Gökçen D Tuğcu
- Division of Pediatric Pulmonology, Ankara City Hospital, Ankara, Turkey
| | - Güzin Cinel
- Division of Pediatric Pulmonology, Ankara City Hospital, Ankara, Turkey
- Division of Pediatric Pulmonology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey
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Wang P, Gao E, Wang T, Feng Y, Xu Y, Su L, Gao W, Ci Z, Younis MR, Chang J, Yang C, Duan L. Copper hydrogen phosphate nanosheets functionalized hydrogel with tissue adhesive, antibacterial, and angiogenic capabilities for tracheal mucosal regeneration. J Nanobiotechnology 2024; 22:652. [PMID: 39443926 DOI: 10.1186/s12951-024-02920-8] [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: 10/31/2023] [Accepted: 10/10/2024] [Indexed: 10/25/2024] Open
Abstract
Timely and effective interventions after tracheal mucosal injury are lack in clinical practices, which elevate the risks of airway infection, tracheal cartilage deterioration, and even asphyxiated death. Herein, we proposed a biomaterial-based strategy for the repair of injured tracheal mucosal based on a copper hydrogen phosphate nanosheets (CuHP NSs) functionalized commercial hydrogel (polyethylene glycol disuccinimidyl succinate-human serum albumin, PH). Such CuHP/PH hydrogel achieved favorable injectability, stable gelation, and excellent adhesiveness within the tracheal lumen. Moreover, CuHP NSs within the CuHP/PH hydrogel effectively stimulate the proliferation and migration of endothelial/epithelial cells, enhancing angiogenesis and demonstrating excellent tissue regenerative potential. Additionally, it exhibited significant inhibitory effects on both bacteria and bacterial biofilms. More importantly, when injected injured site of tracheal mucosa under fiberoptic bronchoscopy guidance, our results demonstrated CuHP/PH hydrogel adhered tightly to the tracheal mucosa. The therapeutic effects of the CuHP/PH hydrogel were further confirmed, which significantly improved survival rates, vascular and mucosal regeneration, reduced occurrences of intraluminal infections, tracheal stenosis, and cartilage damage complications. This research presents an initial proposition outlining a strategy employing biomaterials to mitigate tracheal mucosal injury, offering novel perspectives on the treatment of mucosal injuries and other tracheal diseases.
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Affiliation(s)
- Pengli Wang
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, 200433, China
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Key Laboratory of Tissue Engineering, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
- Zhejiang Engineering Research Center for Tissue Repair Materials, Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, 325000, China
| | - Erji Gao
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, 200433, China
| | - Tao Wang
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, 200433, China
| | - Yanping Feng
- Joint Centre of Translational Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
- Zhejiang Engineering Research Center for Tissue Repair Materials, Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, 325000, China
| | - Yong Xu
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, 200433, China
| | - Lefeng Su
- Joint Centre of Translational Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
- Zhejiang Engineering Research Center for Tissue Repair Materials, Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, 325000, China
| | - Wei Gao
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Key Laboratory of Tissue Engineering, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Zheng Ci
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, 200433, China
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Key Laboratory of Tissue Engineering, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Muhammad Rizwan Younis
- Department of Chemical and Biomolecular Engineering, University of California, Los Angeles, CA, 90095, USA
| | - Jiang Chang
- Joint Centre of Translational Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China.
- Zhejiang Engineering Research Center for Tissue Repair Materials, Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, 325000, China.
| | - Chen Yang
- Joint Centre of Translational Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China.
- Zhejiang Engineering Research Center for Tissue Repair Materials, Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, 325000, China.
| | - Liang Duan
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, 200433, China.
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Al-Shaarani AAQA, Pecoraro L. A review of pathogenic airborne fungi and bacteria: unveiling occurrence, sources, and profound human health implication. Front Microbiol 2024; 15:1428415. [PMID: 39364169 PMCID: PMC11446796 DOI: 10.3389/fmicb.2024.1428415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 09/05/2024] [Indexed: 10/05/2024] Open
Abstract
Airborne fungi and bacteria have been extensively studied by researchers due to their significant effects on human health. We provided an overview of the distribution and sources of airborne pathogenic microbes, and a detailed description of the detrimental effects that these microorganisms cause to human health in both outdoor and indoor environments. By analyzing the large body of literature published in this field, we offered valuable insights into how airborne microbes influence our well-being. The findings highlight the harmful consequences associated with the exposure to airborne fungi and bacteria in a variety of natural and human-mediated environments. Certain demographic groups, including children and the elderly, immunocompromised individuals, and various categories of workers are particularly exposed and vulnerable to the detrimental effect on health of air microbial pollution. A number of studies performed up to date consistently identified Alternaria, Cladosporium, Penicillium, Aspergillus, and Fusarium as the predominant fungal genera in various indoor and outdoor environments. Among bacteria, Bacillus, Streptococcus, Micrococcus, Enterococcus, and Pseudomonas emerged as the dominant genera in air samples collected from numerous environments. All these findings contributed to expanding our knowledge on airborne microbe distribution, emphasizing the crucial need for further research and increased public awareness. Collectively, these efforts may play a vital role in safeguarding human health in the face of risks posed by airborne microbial contaminants.
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Affiliation(s)
- Amran A. Q. A. Al-Shaarani
- College of Pharmaceutical Science & Moganshan Research Institute at Deqing County, Zhejiang University of Technology, Hangzhou, China
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China
| | - Lorenzo Pecoraro
- College of Pharmaceutical Science & Moganshan Research Institute at Deqing County, Zhejiang University of Technology, Hangzhou, China
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Moseley B, Archer J, Orton CM, Symons HE, Watson NA, Saccente-Kennedy B, Philip KEJ, Hull JH, Costello D, Calder JD, Shah PL, Bzdek BR, Reid JP. Relationship between Exhaled Aerosol and Carbon Dioxide Emission Across Respiratory Activities. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2024; 58. [PMID: 39138123 PMCID: PMC11360368 DOI: 10.1021/acs.est.4c01717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 07/31/2024] [Accepted: 08/01/2024] [Indexed: 08/15/2024]
Abstract
Respiratory particles produced during vocalized and nonvocalized activities such as breathing, speaking, and singing serve as a major route for respiratory pathogen transmission. This work reports concomitant measurements of exhaled carbon dioxide volume (VCO2) and minute ventilation (VE), along with exhaled respiratory particles during breathing, exercising, speaking, and singing. Exhaled CO2 and VE measured across healthy adult participants follow a similar trend to particle number concentration during the nonvocalized exercise activities (breathing at rest, vigorous exercise, and very vigorous exercise). Exhaled CO2 is strongly correlated with mean particle number (r = 0.81) and mass (r = 0.84) emission rates for the nonvocalized exercise activities. However, exhaled CO2 is poorly correlated with mean particle number (r = 0.34) and mass (r = 0.12) emission rates during activities requiring vocalization. These results demonstrate that in most real-world environments vocalization loudness is the main factor controlling respiratory particle emission and exhaled CO2 is a poor surrogate measure for estimating particle emission during vocalization. Although measurements of indoor CO2 concentrations provide valuable information about room ventilation, such measurements are poor indicators of respiratory particle concentrations and may significantly underestimate respiratory particle concentrations and disease transmission risk.
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Affiliation(s)
- Benjamin Moseley
- Department
of Respiratory Medicine, Royal Brompton
Hospital, London SW3 6NP, U.K.
| | - Justice Archer
- School
of Chemistry, University of Bristol, Bristol BS8 1TS, U.K.
| | - Christopher M. Orton
- Department
of Respiratory Medicine, Royal Brompton
Hospital, London SW3 6NP, U.K.
- Department
of Respiratory Medicine, Chelsea & Westminster
Hospital, London SW10 9NH, U.K.
- National
Heart and Lung Institute, Guy Scadding Building,
Imperial College London, London SW3 6LY, U.K.
| | - Henry E. Symons
- School
of Chemistry, University of Bristol, Bristol BS8 1TS, U.K.
| | - Natalie A. Watson
- Department
of Ear, Nose and Throat Surgery, Guy’s
& St. Thomas NHS Foundation Trust, London SE1 9RT, U.K.
| | - Brian Saccente-Kennedy
- Department
of Speech and Language Therapy (ENT), Royal National Ear, Nose and
Throat and Eastman Dental Hospitals, University
College London Hospitals NHS Foundation Trust, London WC1E 6DG, U.K.
| | - Keir E. J. Philip
- Department
of Respiratory Medicine, Royal Brompton
Hospital, London SW3 6NP, U.K.
- National
Heart and Lung Institute, Guy Scadding Building,
Imperial College London, London SW3 6LY, U.K.
| | - James H. Hull
- Department
of Respiratory Medicine, Royal Brompton
Hospital, London SW3 6NP, U.K.
- Institute
of Sport, Exercise and Health (ISEH), UCL, London W1T 7HA, U.K.
| | - Declan Costello
- Ear,
Nose and Throat Department, Wexham Park
Hospital, Slough SL2 4HL, U.K.
| | - James D. Calder
- Department
of Bioengineering, Imperial College London, London SW7 2AZ, U.K.
- Fortius Clinic, London W1H 6EQ, U.K.
| | - Pallav L. Shah
- Department
of Respiratory Medicine, Royal Brompton
Hospital, London SW3 6NP, U.K.
- Department
of Respiratory Medicine, Chelsea & Westminster
Hospital, London SW10 9NH, U.K.
- National
Heart and Lung Institute, Guy Scadding Building,
Imperial College London, London SW3 6LY, U.K.
| | - Bryan R. Bzdek
- School
of Chemistry, University of Bristol, Bristol BS8 1TS, U.K.
| | - Jonathan P. Reid
- School
of Chemistry, University of Bristol, Bristol BS8 1TS, U.K.
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5
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Tandjaoui-Lambiotte Y, Elabbadi A, Marouane B, Besset S, Roux D, Ebstein N, Pineau P, Marchio A, Bloch-Queyrat C, Lomont A, Alloui CA, Gerber A, Delagrèverie H, Cohen Y, Zahar JR, Voiriot G. Routes of SARS-Cov2 transmission in the intensive care unit: A multicentric prospective study. J Infect Public Health 2024; 17:102454. [PMID: 38936235 DOI: 10.1016/j.jiph.2024.05.042] [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: 10/07/2023] [Revised: 05/04/2024] [Accepted: 05/15/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND The risk of SARS-CoV-2 transmission to health care workers in intensive care units (ICU) and the contribution of airborne and fomites to SARS-CoV-2 transmission remain unclear. To assess the rate of air and surface contamination and identify risk factors associated with this contamination in patients admitted to the ICU for acute respiratory failure due to SARS-CoV-2 pneumonia. METHODS Prospective multicentric non-interventional study conducted from June 2020 to November 2020 in 3 French ICUs. For each enrolled patient, 3 predefined surfaces were swabbed, 2 air samples at 1 m and 3 m from the patient's mouth and face masks of 3 health care workers (HCW) were collected within the first 48 h of SARS-CoV-2 positive PCR in a respiratory sample. Droplet digital PCR and quantitative PCR were performed on different samples, respectively. RESULTS Among 150 included patients, 5 (3.6%, 95%CI: 1.2% to 8.2%) had positive ddPCR on air samples at 1 m or 3 m. Seventy-one patients (53.3%, CI95%: 44.5% to 62.0%) had at least one surface positive. Face masks worn by HCW were positive in 6 patients (4.4%, CI: 1.6% to 9.4%). The threshold of RT-qPCR of the respiratory sample performed at inclusion (odds ratio, OR= 0.88, 95%CI: 0.83 to 0.93, p < 0.0001) and the presence of diarrhea (OR= 3.28, 95%CI: 1.09 to 9.88, p = 0.037) were significantly associated with the number of contaminated surfaces. CONCLUSION In this study, including patients admitted to the ICU for acute respiratory failure " contact route " of transmission, i.e. through fomites, seems dominant. While presence of SARS-CoV-2 in the air is rare in this specific population, the presence of diarrhea is associated to surface contamination around Covid patients.
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Affiliation(s)
- Yacine Tandjaoui-Lambiotte
- Delafontaine Hospital, Department of Pulmonology and Infectious Diseases, Saint Denis, France; INSERM UMR 1272 Hypoxia & Lung, Bobigny, France; INSERM UMR 1137 IAME, Paris, France.
| | - Alexandre Elabbadi
- Sorbonne Université, Centre de Recherche Saint-Antoine UMRS_938 INSERM, Assistance Publique - Hôpitaux de Paris, Service de Médecine Intensive Réanimation, Hôpital Tenon, Paris, France
| | - Boubaya Marouane
- University Sorbonne Paris Nord, APHP, Avicenne hospital, Clinical Research Unit, Bobigny, France
| | - Sebastien Besset
- University Paris Cité, APHP, Louis Mourier Hospital, DMU ESPRIT, Intensive Care Unit, Colombes, France
| | - Damien Roux
- University Paris Cité, APHP, Louis Mourier Hospital, DMU ESPRIT, Intensive Care Unit, Colombes, France
| | - Nathan Ebstein
- University Sorbonne Paris Nord, APHP, Avicenne Hospital, Intensive Care Unit, Bobigny, France
| | - Pascal Pineau
- Pasteur Institute, Nuclear organization and oncogenesis, INSERM U993, France
| | - Agnes Marchio
- Pasteur Institute, Nuclear organization and oncogenesis, INSERM U993, France
| | - Coralie Bloch-Queyrat
- University Sorbonne Paris Nord, APHP, Avicenne hospital, Clinical Research Unit, Bobigny, France
| | - Alexandra Lomont
- University Sorbonne Paris Nord, APHP, Avicenne Hospital, Microbiology Department, Infection Control Unit, Bobigny, France Sorbonne Paris Nord University, Bobigny, France
| | - Chakib-Ahmed Alloui
- University Sorbonne Paris Nord, APHP, Avicenne Hospital, Microbiology Department Virology Unit, Bobigny, France, Sorbonne Paris Nord University, Bobigny, France
| | - Athenaïs Gerber
- University Sorbonne Paris Nord, APHP, Avicenne Hospital, Microbiology Department Virology Unit, Bobigny, France, Sorbonne Paris Nord University, Bobigny, France
| | - Heloise Delagrèverie
- University Sorbonne Paris Nord, APHP, Avicenne Hospital, Microbiology Department Virology Unit, Bobigny, France, Sorbonne Paris Nord University, Bobigny, France
| | - Yves Cohen
- University Sorbonne Paris Nord, APHP, Avicenne Hospital, Intensive Care Unit, Bobigny, France
| | - Jean Ralph Zahar
- University Paris Cité, APHP, Louis Mourier Hospital, DMU ESPRIT, Intensive Care Unit, Colombes, France
| | - Guillaume Voiriot
- Sorbonne Université, Centre de Recherche Saint-Antoine UMRS_938 INSERM, Assistance Publique - Hôpitaux de Paris, Service de Médecine Intensive Réanimation, Hôpital Tenon, Paris, France
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Luján M, Cinesi Gómez C, Peñuelas O, Ferrando C, Heili-Frades SB, Carratalá Perales JM, Mas A, Sayas Catalán J, Mediano O, Roca O, García Fernández J, González Varela A, Sempere Montes G, Rialp Cervera G, Hernández G, Millán T, Ferrer Monreal M, Egea Santaolalla C. Multidisciplinary Consensus on the Management of Non-Invasive Respiratory Support in the COVID-19 Patient. Arch Bronconeumol 2024; 60:285-295. [PMID: 38521646 DOI: 10.1016/j.arbres.2024.02.017] [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: 02/19/2024] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 03/25/2024]
Abstract
Acute respiratory failure due to COVID-19 pneumonia often requires a comprehensive approach that includes non-pharmacological strategies such as non-invasive support (including positive pressure modes, high flow therapy or awake proning) in addition to oxygen therapy, with the primary goal of avoiding endotracheal intubation. Clinical issues such as determining the optimal time to initiate non-invasive support, choosing the most appropriate modality (based not only on the acute clinical picture but also on comorbidities), establishing criteria for recognition of treatment failure and strategies to follow in this setting (including palliative care), or implementing de-escalation procedures when improvement occurs are of paramount importance in the ongoing management of severe COVID-19 cases. Organizational issues, such as the most appropriate setting for management and monitoring of the severe COVID-19 patient or protective measures to prevent virus spread to healthcare workers in the presence of aerosol-generating procedures, should also be considered. While many early clinical guidelines during the pandemic were based on previous experience with acute respiratory distress syndrome, the landscape has evolved since then. Today, we have a wealth of high-quality studies that support evidence-based recommendations to address these complex issues. This document, the result of a collaborative effort between four leading scientific societies (SEDAR, SEMES, SEMICYUC, SEPAR), draws on the experience of 25 experts in the field to synthesize knowledge to address pertinent clinical questions and refine the approach to patient care in the face of the challenges posed by severe COVID-19 infection.
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Affiliation(s)
- Manel Luján
- Servei de Pneumologia, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain; CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain.
| | - César Cinesi Gómez
- Servicio de Urgencias, Hospital General Universitario Reina Sofía, Murcia, Spain
| | - Oscar Peñuelas
- CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain; Servicio de Medicina Intensiva Hospital Universitario de Getafe, Madrid, Spain
| | - Carlos Ferrando
- CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain; Department of Anesthesia and Critical Care, Hospital Clínic, Institut D'investigació August Pi i Sunyer, Barcelona, Spain
| | - Sarah Béatrice Heili-Frades
- CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain; Hospital Universitario Fundación Jiménez Díaz Quirón Salud, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD, UAM), CIBERES, REVA Network, Madrid, Spain
| | | | - Arantxa Mas
- Servei de Medicina Intensiva, Hospital de Sant Pau, Barcelona, Spain
| | | | - Olga Mediano
- CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain; Sleep Unit, Pneumology Department. Hospital Universitario de Guadalajara, Instituto de Investigación Sanitaria de Castilla la Mancha (IDISCAM), Universidad de Alcalá, Madrid, Spain
| | - Oriol Roca
- CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain; Servei de Medicina Intensiva, Parc Taulí Hospital Universitari, Institut de Recerca Parc Taulí-I3PT, Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Javier García Fernández
- Servicio de Anestesiología, UCI Quirúrgica y U. Dolor. H. U. Puerta de Hierro, Madrid, Spain
| | | | | | - Gemma Rialp Cervera
- Servicio de Medicina Intensiva, Hospital Universitari Son Llàtzer, Palma de Mallorca, Spain
| | - Gonzalo Hernández
- Servicio de Medicina Intensiva, Hospital Virgen de la Salud, Toledo, Spain
| | - Teresa Millán
- Servicio de Medicina Intensiva Hospital Universitario Son Espases, Facultad de Medicina de las Islas Baleares, Spain
| | - Miquel Ferrer Monreal
- CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain; UVIIR, Servei de Pneumologia, Institut de Respiratori, Clínic Barcelona, IDIBAPS. Universitat de Barcelona, Barcelona, Spain
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7
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Souza JA, Pasqualoto AS, Cielo CA, Andriollo DB, Moraes DAO. Can We Use the Maximum Phonation Time as a Screening of Pulmonary Forced Vital Capacity in Post-COVID-19 Syndrome Patients? J Voice 2024:S0892-1997(24)00118-8. [PMID: 38649315 DOI: 10.1016/j.jvoice.2024.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 03/30/2024] [Accepted: 04/01/2024] [Indexed: 04/25/2024]
Abstract
OBJECTIVE To verify the accuracy of the maximum phonation time of the vowel /a/ (MPT/a/), fricative /s/ (MPT/s/), number counting (MPTC), and number reached in this count (CN) to estimate forced vital capacity (FVC) in patients with post-COVID-19 syndrome. METHOD Cross-sectional study involving adult patients, who were admitted to the intensive care unit and referred to the Post-COVID-19 Rehabilitation Outpatient Clinic. Voice function was assessed using a Vocal Handicap Index (VHI) self-assessment questionnaire and MPT tests. To perform the phonatory tests, the patients remained in a standing posture and were instructed to inhale as much air as possible and, during a single exhalation, at usual pitch and loudness, sustain the emission of /a/ and /s/; and in another breath, to perform the ascending numerical count, starting from the number one up to the highest number they could reach. Pulmonary function was assessed by spirometry. The receiver operating characteristic (ROC) curve was plotted, and FVC values lower than the normal limit by Z-score (fifth percentile) were classified as impaired lung function. The predictive values and likelihood ratios were calculated. RESULTS A total of 70 patients participated, with 20-30% having a high VHI. Approximately 24% had an FVC impairment and significantly low values of MPT/a/, MPT/s/, MPTC, and CN. The test results showed overall accuracy of 70% and the cutoff points of 9.69, 6.78, 10.60, and 13, respectively, with high sensitivity, predictive negative value and low specificity, predictive positive value, and positive likelihood ratio. CONCLUSIONS Our results suggest that the MPT has moderate discriminatory power for FVC impairment, indicating that it is not a reliable indicator of pulmonary function in the population studied. Therefore, in patients with an MPT of less than 10.60 seconds, or a CN lower than 13, other criteria should be added to improve the diagnostic accuracy and support the decision to perform more complex investigations.
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Affiliation(s)
- Juliana Alves Souza
- Department of Speech, Hearing and Language Sciences and Postgraduate Program in Human Communication Disorders, Voice Laboratory of he Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil.
| | - Adriane Schmidt Pasqualoto
- Department of Speech, Hearing and Language Sciences and Postgraduate Program in Human Communication Disorders, Voice Laboratory of he Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil; Department of Physiotherapy and Postgraduate Program in Human Communication Disorders at Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil
| | - Carla Aparecida Cielo
- Department of Speech, Hearing and Language Sciences and Postgraduate Program in Human Communication Disorders, Voice Laboratory of he Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil
| | - Débora Bonesso Andriollo
- Department of Speech, Hearing and Language Sciences and Postgraduate Program in Human Communication Disorders, Voice Laboratory of he Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil
| | - Denis Altieri Oliveira Moraes
- Department of Speech, Hearing and Language Sciences and Postgraduate Program in Human Communication Disorders, Voice Laboratory of he Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil; Departament of Statistics and Postgraduate Program in Human Communication Disorders at Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil
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8
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Rikos N, Mema E, Triantafyllou C, Kleftonikolou H, Mazaraki E, Gounelas G, Kourlaba G. Professional quality of life, psychological well-being, and work engagement of healthcare professionals in two Greek hospitals during COVID-19: A cross-sectional study. Work 2024; 78:613-624. [PMID: 38251089 DOI: 10.3233/wor-230386] [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: 01/23/2024] Open
Abstract
BACKGROUND During the COVID-19 pandemic, the mental health of healthcare professionals has emerged as an issue of great concern. OBJECTIVE To investigate the levels of professional quality of life, psychological well-being, and work engagement among healthcare professionals in two Greek hospitals during the COVID-19 pandemic. METHODS A cross-sectional study was conducted in December 2021 in two public hospitals in Greece. To assess the levels of professional quality of life, psychological well-being, and work engagement, respondents completed the Professional Quality of Life Scale Version 5 (ProQOL-V), the Psychological Well-being (PWB) scale, and the Utrecht Work Engagement Scale (UWES-17). RESULTS A total of 150 questionnaires were distributed, and 102 were returned (response rate: 68%). It was found that as burnout levels increased, the levels of work engagement decreased (rho = -0.36, p-value < 0.01). Higher levels of compassion satisfaction were associated with higher work engagement (rho = 0.48, p-value < 0.01). Multivariable analysis revealed that healthcare personnel's contact with patients or service users exposed to or who have experienced traumatic events was associated with less positive relationships with others (and, consequently, lower levels of psychological well-being) (p-value = 0.035). CONCLUSIONS Healthcare professionals in the two public hospitals in Greece, experienced moderate levels of compassion satisfaction, burnout, and secondary traumatic stress during the COVID-19 pandemic. Their psychological well-being was also found to be moderate, and their levels of work engagement were moderate to high. Supporting the physical and psychological well-being of healthcare professionals is essential for their ability to provide high-quality care in times of crisis, such as during the COVID-19 pandemic.
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Affiliation(s)
- Nikos Rikos
- Department of Nursing, School of Health Sciences, Hellenic Mediterranean University, Heraklion, Greece
| | - Erion Mema
- Department of Nursing, School of Health Sciences, Hellenic Mediterranean University, Heraklion, Greece
| | | | - Hellen Kleftonikolou
- Department of Nursing, School of Health Sciences, Hellenic Mediterranean University, Heraklion, Greece
| | - Emmanouella Mazaraki
- Department of Nursing, School of Health Sciences, Hellenic Mediterranean University, Heraklion, Greece
| | | | - Georgia Kourlaba
- Department of Nursing, School of Health Sciences, University of Peloponnese, Tripoli, Greece
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9
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Koïvogui A, Abihsera G, Le Trong T, Ait-Hadad H, Bernoux A, Delattre H, Vincelet C, Caroll R, Nicolet J. [Évaluation de la gravité du cancer colorectal dépisté dans le contexte de la crise sanitaire liée au COVID19 en région Ile-de-France]. Rev Epidemiol Sante Publique 2023; 71:102124. [PMID: 37451076 PMCID: PMC10291290 DOI: 10.1016/j.respe.2023.102124] [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: 11/17/2022] [Revised: 06/14/2023] [Accepted: 06/15/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND After the announcement in March 2020 of the COVID-19 pandemic, colorectal cancer (CRC) screening programs were suspended in several countries. Compared to the lesions detected during previous campaigns, this study aims to assess the severity of CRC detected during the 2020 screening campaign in Île-de-France, the French region most affected by the 1st wave of the pandemic. METHODS The descriptive and etiological study included all faecal immunochemical test (FIT) results carried out between January 2017 and December 2020 on people aged 50-74, living in Île-de-France. First, the proportion of colonoscopies performed within one month (One-month-colo) following FIT; the yield of colonoscopy (proportion of colonoscopies with a neoplasm lesion among those performed) and CRC severity (TNM Classification, Level-0: T0/N0/M0, Level-1: T1/T2/N0/M0, Level-2: T3/T4/N0/M0; Level-3: T3/T4/N1/M0; Level-4: M1) were described in 2020 compared to previous campaigns (2017, 2018, and 2019). Subsequently, the link between the level of CRC severity and the predictive factors, including campaign year and time to colonoscopy, was analysed using polytomous multivariate regression. RESULTS The one-month-colo (2017: 9.1% of 11,529 colonoscopies; 2018: 8.5% of 13,346; 2019: 5.7% of 7,881; 2020: 6.7% of 11,040; p < 0.001), the yield (65.2%, 64.1%, 62.4%, 60.8% respectively, p < 0.001) were significantly different between campaigns. The proportion of CRC level-4 (4.8% in 2017 (653 CRC); 7.6% in 2018 (674 CRC); 4.6% in 2019 (330 CRC) and 4.7% in 2020 (404 CRC); p < 0.29) was not significantly different between campaigns. The probability of having CRC with a high severity level was inversely related to the time to colonoscopy but not to the campaign year. Compared to patients having undergone colonoscopy within 30 days, the odds were significantly reduced by 60% in patients having undergone colonoscopy after 7 months (adjusted Odds-Ratio: 0.4 [0.3; 0.6]; p < 0.0001). CONCLUSIONS The French indicators were certainly degraded before the first wave of the COVID-19. The delay in access to colonoscopy as well as its extension induced by the COVID-19 crisis had no impact in terms of cancer severity, due to a discriminatory approach prioritizing patients with evident symptoms.
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Affiliation(s)
- Akoï Koïvogui
- CRCDC-IDF, Site de Seine-Saint-Denis, 41 avenue de Verdun, 93146 Bondy, France.
| | - Gaëlle Abihsera
- CRCDC-IDF, Site du Val-de-Marne, Le banc de Sable 7, Quai Gabriel Péri, 94340 Joinville-le-Pont, France
| | - Tu Le Trong
- CRCDC-IDF, Site du Val-d'Oise, Immeuble Le Centaure, 14A Avenue du Centaure, 95800 Cergy Saint-Christophe, France
| | - Hamou Ait-Hadad
- CRCDC-IDF, Site de Seine-et-Marne, 333 Rue Marguerite Perey CS50058, 77563 Lieusaint, France
| | - Agnès Bernoux
- CRCDC-IDF, Site de l'Essonne, Centre Hospitalier de Bligny CS30365, 91640 Fontenay les Briis, France
| | - Hélène Delattre
- CRCDC-IDF, Site des Hauts-de-Seine, 26 rue des Amandiers, 92000 Nanterre, France
| | - Catherine Vincelet
- CRCDC-IDF, Site des Yvelines, 18 av Dutartre, BP 120 - 78153 - Le Chesnay Cedex, France
| | - Rachel Caroll
- CRCDC-IDF, Site du Val-de-Marne, Le banc de Sable 7, Quai Gabriel Péri, 94340 Joinville-le-Pont, France
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10
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Pratt AA, Brown GD, Walsh JE, Hoffman HT, Nonnenmann MW. Evaluation of face shields used during aerosol generating procedures. Sci Rep 2023; 13:15617. [PMID: 37730888 PMCID: PMC10511466 DOI: 10.1038/s41598-023-42403-8] [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: 04/18/2023] [Accepted: 09/09/2023] [Indexed: 09/22/2023] Open
Abstract
Transnasal flexible laryngoscopy is considered an aerosol generating procedure. A negative pressure face shield (NPFS) was developed to control aerosol from the patient during laryngoscopy. The purpose of this study was to determine the effectiveness of the NPFS at controlling virus aerosol compared to a standard disposable plastic face shield. The face shields were placed on a simulated patient coughing machine. MS2 bacteriophage was used as a surrogate for SARS-CoV-2 and was aerosolized using the coughing machine. The aerosolized virus was sampled on the inside and outside of the face shields. The virus aerosol concentration was not significantly different between the inside and outside of the traditional plastic face shield (p = 0.12). However, the particle concentrations across all particle sizes measured were significantly decreased outside the face shield. The virus and particle concentrations were significantly decreased (p < 0.01) outside the NPFS operating at a flow rate of 38.6 L per minute (LPM). When the NPFS was operated at 10 LPM, virus concentrations were not significantly different (p = 0.09) across the face shield. However, the number particle concentrations across all particle sizes measured were significantly different (p < 0.05).
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Affiliation(s)
- Alessandra A Pratt
- Department of Occupational and Environmental Health, University of Iowa, 145 N Riverside Dr., Iowa City, IA, 52242, USA.
- Iowa City VA Health Care System (152), 601 Highway 6 West, Building 42, Iowa City, IA, 52242, USA.
| | - Grant D Brown
- Department of Biostatistics, University of Iowa, 145 N Riverside Dr., Iowa City, IA, 52242, USA
| | - Jarrett E Walsh
- Department of Otolaryngology, Carver College of Medicine, University of Iowa, 375 Newton Road, Iowa City, IA, 52242, USA
| | - Henry T Hoffman
- Department of Otolaryngology, Carver College of Medicine, University of Iowa, 375 Newton Road, Iowa City, IA, 52242, USA
| | - Matthew W Nonnenmann
- Department of Environmental, Agricultural and Occupational Health, University of Nebraska Medical Center, 42nd and Emilie, Omaha, NE, 68198, USA
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11
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Shen J, Shi W. Post-Pandemic: Investigation of the Degradation of Various Commercial Masks in the Marine Environment. LANGMUIR : THE ACS JOURNAL OF SURFACES AND COLLOIDS 2023; 39:10553-10564. [PMID: 37462155 PMCID: PMC10399566 DOI: 10.1021/acs.langmuir.3c01087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 07/02/2023] [Indexed: 08/02/2023]
Abstract
During COVID-19, personal protective equipment such as face masks was in urgent demand in the daily life. As the pandemic may have withdrawn from public attention, the disposal of face masks is a significant issue, especially plastic pollution. To address the degradation of the polymers in the marine environment, seven commercial masks were investigated via artificial weathering procedures in substitute ocean water. A suite of structural and chemical characterization techniques was employed, including scanning electron microscopy (SEM), X-ray photoelectron spectroscopy (XPS), Fourier transform infrared spectroscopy (FT-IR), Raman spectroscopy, X-ray diffraction (XRD), and contact angle goniometry, to probe the treatment impact on commercially available N95, surgical, polyurethane, polyester, nylon, silk, and cotton masks. This work provides insights into the comprehensive analysis of material degradation in nature and raises public awareness of environmental issues post-pandemic.
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Affiliation(s)
- Jiayi Shen
- Division of Natural and Applied
Sciences, Duke Kunshan University, Kunshan, Jiangsu Province 215316, China
| | - Weiwei Shi
- Division of Natural and Applied
Sciences, Duke Kunshan University, Kunshan, Jiangsu Province 215316, China
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12
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Schulz-Stübner S, Hauer T, Nopper K. [Experiences and Resilience of Hygiene Team Members During the SARS-CoV-2 Pandemic]. DAS GESUNDHEITSWESEN 2023; 85:609-621. [PMID: 36084946 PMCID: PMC11248247 DOI: 10.1055/a-1851-4287] [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: 10/14/2022]
Abstract
BACKGROUND In compliance with German data protections regulations, we conducted an anonymous survey among participants of the annual infectious disease and control meeting in Freiburg, Germany in October 2021. MATERIAL AND METHODS We report the results of nurse and physician members of infection control teams on their perceptions and emotions during the pandemic. Descriptive statistics and Chi Square Test with P<0.05 (SPSS Statistics Standard Version) were used when applicable. RESULTS Of the 391 of 750 distributed surveys, 391 were returned; 48% were infection control practitioners (IP), 12% Link Nurses (LN), 12% Board Certified Hospital Epidemiologists (HE), 17% infection control-trained physicians (ITP), 1% Occupational Health or Public Health specialists and 10% others. 72% were female, 25.3% male, 0.2% divers and 2.5% gave no answers. The 349 members of infection control teams (IP, LN, HE, ITP) reported a high level of competency, importance and appreciation and a low rate of anxiety or hopelessness. A quarter reported anger and frustration which nevertheless did not result in reduced motivation. Information provided by the German national health agency Robert Koch-Institute (RKI) was utilized most by participants. Social media, on the other hand, were criticized frequently. Cooperation within the institution and local public health authorities was good. Free text answers regarding lessons learned showed wide potential for improvement. CONCLUSION Our survey results indicate a high level of resilience among members of infection control teams in German medical institutions despite obvious shortcomings in supplies during the first wave of the pandemic. The high level of self-perceived competency and appreciation possibly helped deal with the situation and prevented the feeling of loss of control implied in the question items "feeling overwhelmed" and "hopeless". However, the lessons learned from the pandemic need to be implemented to maintain this high level of resilience not only for infection control teams but the medical system in general.
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Affiliation(s)
- Sebastian Schulz-Stübner
- Wissenschaftlicher Dienst, Deutsches Beratungszentrum für
Hygiene (BZH GmbH), Freiburg, Germany
- Klinik für Anästhesiologie und Intensivmedizin,
Universitätsklinikum Freiburg Medizinische Universitätsklinik,
Freiburg im Breisgau, Germany
- Gesundheitspädagogik, Pädagogische Hochschule Freiburg,
Freiburg im Breisgau, Germany
| | - Thomas Hauer
- Hygiene, Deutsches Beratungszentrum für Hygiene (BZH GmbH),
Freiburg, Germany
| | - Katharina Nopper
- Akademie, Deutsches Beratungszentrum für Hygiene (BZH GmbH),
Freiburg, Germany
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13
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Mao Y, Xie H, Liang J, He J, Ren J. Experimental study on the control effects of different strategies on particle transportation in a conference room: Mechanical ventilation, baffle, portable air cleaner, and desk air cleaner. ATMOSPHERIC POLLUTION RESEARCH 2023; 14:101716. [PMID: 36942301 PMCID: PMC9996463 DOI: 10.1016/j.apr.2023.101716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 03/08/2023] [Accepted: 03/08/2023] [Indexed: 06/18/2023]
Abstract
To control the spread and transmission of airborne particles (especially SARS-CoV-2 coronavirus, recently) in the indoor environment, many control strategies have been employed. Comparisons of these strategies enable a reasonable choice for indoor environment control and cost-effectiveness. In this study, a series of experiments were conducted in a full-scale chamber to simulate a conference room. The control effects of four different strategies (a ventilation system (320 m3/h) with and without a baffle, a specific type of portable air cleaner (400 m3/h) and a specific type of desk air cleaner (DAC, 160 m3/h)) on the transportation of particles of different sizes were studied. In addition, the effects of coupling the ventilation strategies with five forms of indoor airflow organization (side supply and side or ceiling return, ceiling supply and ceiling or side return, floor supply and ceiling return) were evaluated. The cumulative exposure level (CEL) and infection probability were selected as evaluation indexes. The experimental results showed that among the four strategies, the best particle control effect was achieved by the PAC. The reduction in CEL for particles in the overall size range was 22.1% under the ventilation system without a baffle, 34.3% under the ventilation system with a baffle, 46.4% with the PAC, and 10.1% with the DAC. The average infection probabilities under the four control strategies were 11.3-11.8%, 11.1-11.8%, 9.1-9.5%, and 18.2-19.7%, respectively. Among the five different forms of airflow organization, the floor supply and ceiling return mode exhibited the best potential ability to remove particles.
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Affiliation(s)
- Yanhui Mao
- School of Architecture and Transportation Engineering, Ningbo University of Technology, Ningbo, 315211, China
| | - Honglei Xie
- Architectural Design & Research Institute of Ningbo University, Ningbo, 315211, China
| | - Jianzhou Liang
- School of Architecture and Transportation Engineering, Ningbo University of Technology, Ningbo, 315211, China
| | - Junjie He
- School of Energy and Environmental Engineering, Hebei University of Technology, Tianjin, 300401, China
| | - Jianlin Ren
- School of Energy and Environmental Engineering, Hebei University of Technology, Tianjin, 300401, China
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14
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Altuntas G, Cetin M, Canakci ME, Yazıcı MM. The Effect of Meteorological Factors on the COVID-19 Pandemic in Northeast Turkiye. Cureus 2023; 15:e36934. [PMID: 37131559 PMCID: PMC10148944 DOI: 10.7759/cureus.36934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2023] [Indexed: 04/03/2023] Open
Abstract
Introduction Although various studies have been conducted on the relationship between meteorological factors and coronavirus disease 2019 (COVID-19), this issue has not been sufficiently clarified. In particular, there are a limited number of studies on the course of COVID-19 in the warmer-humidity seasons. Methods Patients presenting to the emergency departments of health institutions and to clinics set aside for cases of suspected COVID-19 in the province of Rize between 1 June and 31 August 2021 and who met the case definition based on the Turkish COVID-19 epidemiological guideline were included in this retrospective study. The effect of meteorological factors on case numbers throughout the study was investigated. Results During the study period, 80,490 tests were performed on patients presenting to emergency departments and clinics dedicated to patients with suspected COVID-19. The total case number was 16,270, with a median daily number of 64 (range 43-328). The total number of deaths was 103, with a median daily figure of 1.00 (range 0.00-1.25). According to the Poisson distribution analysis, it is found that the number of cases tended to increase at temperatures between 20.8 and 27.2°C. Conclusion It is predicted that the number of COVID-19 cases will not decrease with the increase in temperature in temperate regions with high rainfall. Therefore, unlike influenza, there may not be seasonal variation in the prevalence of COVID-19. The requisite measures should be adopted in health systems and hospitals to manage increases in case numbers associated with changes in meteorological factors.
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15
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Batioglu-Karaaltin A, Yigit O, Cakan D, Akgul O, Yigit E, Yilmaz YZ, Cakir KIB, Ciftci G, Boyoğlu NS, Cagliyan A, Can E, Dikme O, Hacioglu Y, Balkan II, Enver O, Ozdogan HA. Effect of the povidone iodine, hypertonic alkaline solution and saline nasal lavage on nasopharyngeal viral load in COVID-19. Clin Otolaryngol 2023. [PMID: 36973223 DOI: 10.1111/coa.14056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 02/13/2023] [Accepted: 03/12/2023] [Indexed: 03/29/2023]
Abstract
OBJECTIVE The present study aimed to investigate the in vivo activity of nasal irrigation (NI) with saline, NI with povidone-iodine (PVP-I) 1%, NI with a mix of hypertonic alkaline and PVP-I 1% against Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). DESIGN This study was a prospective randomised clinical trial. SETTING A multicenter study involving tertiary care centres. PARTICIPANTS The study included adult outpatients whose qualitative SARS-CoV-2 RT-PCR tests in nasopharyngeal swabs were positive. One hundred twenty patients were divided into four equal groups. Standard COVID-19 treatment was given to Group 1, NI containing saline was added to patients' treatment in Group 2, NI containing 1% PVP-I solution was added to patients' treatment in Group 3, and NI containing 1% PVP-I solution and the hypertonic alkaline solution was added to patients' treatment in Group 4. MAIN OUTCOME MEASURES On the first day of diagnosis (Day 0), nasopharyngeal swab samples were taken, on the third and fifth days the nasopharyngeal viral load (NVL) reduction in quantitative RT-PCR test was calculated. RESULTS Between the zeroth to third days and zeroth to fifth days, the NVL reduction was significant in all groups (p < .05). In paired comparisons of groups, the NVL decrease in Group 4 in the first 3 days was significantly lower than all groups (p < .05). The NVL decrease in Groups 3 and 4 in the first 5 days were significantly lower than Group 1 (p < .05). CONCLUSION This study revealed that the use of NI of 1% PVP-I and the hypertonic alkaline solution mixture was more effective in reducing NVL.
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Affiliation(s)
- Aysegul Batioglu-Karaaltin
- Department of Otorhinolaryngology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ozgur Yigit
- Department of Otorhinolaryngology, Istanbul Education and Research Hospital, Istanbul, Turkey
| | - Dogan Cakan
- Department of Otorhinolaryngology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ozer Akgul
- Department of Medical Microbiology, Istanbul Aydın University, Istanbul, Turkey
| | - Enes Yigit
- Department of Otorhinolaryngology, Istanbul Education and Research Hospital, Istanbul, Turkey
| | - Yetkin Zeki Yilmaz
- Department of Otorhinolaryngology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Kays-I Burak Cakir
- Department of Otorhinolaryngology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Gamze Ciftci
- Department of Otorhinolaryngology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Nihal Seden Boyoğlu
- Department of Otorhinolaryngology, Istanbul Education and Research Hospital, Istanbul, Turkey
| | - Abdurrahman Cagliyan
- Department of Otorhinolaryngology, Istanbul Education and Research Hospital, Istanbul, Turkey
| | - Efe Can
- Department of Otorhinolaryngology, Istanbul Education and Research Hospital, Istanbul, Turkey
| | - Ozgur Dikme
- Department of Emergency Medicine, Istanbul Education and Research Hospital, Istanbul, Turkey
| | - Yalcin Hacioglu
- Department of Family Medicine, Istanbul Education and Research Hospital, Istanbul, Turkey
| | - Ilker Inanc Balkan
- Department of Infectious Diseases and Clinical Microbiology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ozgur Enver
- Department of Otorhinolaryngology, Istanbul Aydın University, Istanbul, Turkey
| | - Hasan Ahmet Ozdogan
- Department of Otorhinolaryngology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
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16
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Chao I, Lee S, Brenker J, Wong D, Low C, Desselle M, Bernard A, Alan T, Keon-Cohen Z, Coles-Black J. The effect of clinical face shields on aerosolized particle exposure. JOURNAL OF 3D PRINTING IN MEDICINE 2023; 7:3DP2. [PMID: 38051985 PMCID: PMC9870239 DOI: 10.2217/3dp-2022-0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 11/16/2022] [Indexed: 12/07/2023]
Abstract
Background Face shields protect healthcare workers (HCWs) from fluid and large droplet contamination. Their effect on smaller aerosolized particles is unknown. Materials & methods An ultrasonic atomizer was used to simulate particle sizes equivalent to human breathing and forceful cough. Particles were measured at positions correlating to anesthetic personnel in relation to a patient inside an operating theatre environment. The effect of the application of face shields on HCW exposure was measured. Results & Conclusion Significant reductions in particle concentrations were measured after the application of vented and enclosed face shields. Face shields appear to reduce the concentration of aerosolized particles that HCWs are exposed to, thereby potentially conferring further protection against exposure to aerosolized particles in an operating theatre environment.
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Affiliation(s)
- Ian Chao
- Department of Anaesthesia, Box Hill Hospital, Eastern Health, Melbourne, Australia
| | - Sarah Lee
- Department of Anaesthesia, Box Hill Hospital, Eastern Health, Melbourne, 3128, Australia
| | - Jason Brenker
- Department of Mechanical & Aerospace Engineering, Monash University, Melbourne, 3800, Australia
| | - Derrick Wong
- Department of Anaesthesia, Box Hill Hospital, Eastern Health, Melbourne, Australia
| | - Caitlin Low
- Department of Anaesthesia, Box Hill Hospital, Eastern Health, Melbourne, Australia
| | - Mathilde Desselle
- Herston Biofabrication Institute, Metro North Hospital & Health Service, Herston, Queensland, 4029, Australia
| | - Anne Bernard
- QCIF Facility for Advanced Bioinformatics, St Lucia, Queensland, 4072, Australia
| | - Tuncay Alan
- Department of Mechanical & Aerospace Engineering, Monash University, Melbourne, 3800, Australia
| | - Zoe Keon-Cohen
- Department of Anaesthesia, Box Hill Hospital, Eastern Health, Melbourne, Australia
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17
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Shabana N, Arjun AM, Ankitha M, Mohandas SA, Gangadharan P, Rasheed PA. A flexible and sensitive electrochemical sensing platform based on dimethyl sulfoxide modified carbon cloth: towards the detection of dopamine and carvedilol. ANALYTICAL METHODS : ADVANCING METHODS AND APPLICATIONS 2023; 15:685-692. [PMID: 36655654 DOI: 10.1039/d2ay01922a] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
The determination of neurotransmitters and adrenoreceptor drugs is highly essential due to their specific functions in the human body. In this work, the determination of carvedilol (CAR) and dopamine (DA) was carried out using carbon cloth (CC), which was modified using a facile strategy of drop-casting dimethyl sulfoxide (DMSO). This induced the formation of functional groups without any loss in the structural integrity of CC. The DMSO modified CC (CC-DMSO) was used for the detection of CAR in the range of 1 nM to 10 μM with a limit of detection (LOD) of 120 pM. Similarly, the CC-DMSO was able to detect DA in the range of 10 pM to 10 μM with a highly promising LOD of 0.3 pM. A bending test was also carried out on the electrode and it could be seen that only a negligible variation in sensing capability was observed when the electrode was in the bent form. In addition, the detection of CAR and DA was also carried out in real samples such as human serum. This study reveals that this modification strategy can serve as a versatile and flexible sensing platform for the detection of CAR and DA together in real world medical scenarios.
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Affiliation(s)
- Neermunda Shabana
- Department of Biological Sciences and Engineering, Indian Institute of Technology Palakkad, Palakkad, 678 557, Kerala, India.
- Department of Chemistry, Indian Institute of Technology Palakkad, Palakkad, 678 557, Kerala, India
| | - Ajith Mohan Arjun
- Department of Biological Sciences and Engineering, Indian Institute of Technology Palakkad, Palakkad, 678 557, Kerala, India.
| | - Menon Ankitha
- Department of Chemistry, Indian Institute of Technology Palakkad, Palakkad, 678 557, Kerala, India
| | - Sabarija A Mohandas
- Department of Civil Engineering, Indian Institute of Technology Palakkad, Palakkad, 678 557, Kerala, India
| | - Praveena Gangadharan
- Department of Civil Engineering, Indian Institute of Technology Palakkad, Palakkad, 678 557, Kerala, India
- Environmental Sciences and Sustainable Engineering Center, Indian Institute of Technology, Palakkad, Kerala, India
| | - Pathath Abdul Rasheed
- Department of Biological Sciences and Engineering, Indian Institute of Technology Palakkad, Palakkad, 678 557, Kerala, India.
- Department of Chemistry, Indian Institute of Technology Palakkad, Palakkad, 678 557, Kerala, India
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Branson RD, Rodriquez D. COVID-19 Lessons Learned: Response to the Anticipated Ventilator Shortage. Respir Care 2023; 68:129-150. [PMID: 36566030 PMCID: PMC9993519 DOI: 10.4187/respcare.10676] [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: 12/26/2022]
Abstract
Early in the COVID-19 pandemic predictions of a worldwide ventilator shortage prompted a worldwide search for solutions. The impetus for the scramble for ventilators was spurred on by inaccurate and often unrealistic predictions of ventilator requirements. Initial efforts looked simply at acquiring as many ventilators as possible from national and international sources. Ventilators from the Strategic National Stockpile were distributed to early hotspots in the Northeast and Northwest United States. In a triumph of emotion over logic, well-intended experts from other industries turned their time, talent, and treasure toward making a ventilator for the first time. Interest in shared ventilation (more than one patient per ventilator) was ignited by an ill-advised video on social media that ignored the principles of gas delivery in deference to social media notoriety. With shared ventilation, a number of groups mistook a physiologic problem for a plumbing problem. The United States government invoked the Defense Production Act to push automotive manufacturers to partner with existing ventilator manufacturers to speed production. The FDA granted emergency use authorization for "splitters" to allow shared ventilation as well as for ventilators and ancillary equipment. Rationing of ventilators was discussed in the lay press and medical literature but was never necessary in the US. Finally, planners realized that staff with expertise in providing mechanical ventilation were the most important shortage. Over 200,000 ventilators were purchased by the United States government, states, cities, health systems, and individuals. Most had little value in caring for patients with COVID-19 ARDS. This paper attempts to look at where miscalculations were made, with an eye toward what we can do better in the future.
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Affiliation(s)
- Richard D Branson
- Division of Trauma/Critical Care, Department of Surgery, University of Cincinnati, Cincinnati, Ohio.
| | - Dario Rodriquez
- Division of Trauma/Critical Care, Department of Surgery, University of Cincinnati, Cincinnati, Ohio; and Airman Biosciences Division, Airman Systems Directorate, Wright-Patterson Air Force Base, Dayton, Ohio
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19
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Dehghani S, SeyedAlinaghi S, Karimi A, Afroughi F, Abshenas S, Azad K, Tantuoyir MM, Mohammadi P, Ghavam SM, Mojdeganlou H, Dadras O, Nazarian N, Vahedi F, Barzegary A, Mehraeen E. Evaluating the effects of air disinfectants in decontamination of COVID-19 aerosols. Health Sci Rep 2023; 6:e1042. [PMID: 36644313 PMCID: PMC9831143 DOI: 10.1002/hsr2.1042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/20/2022] [Accepted: 12/22/2022] [Indexed: 01/12/2023] Open
Abstract
Introduction Airborne transmission is the most crucial mode of COVID-19 transmission. Therefore, disinfecting the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) aerosols float can have important implications in limiting COVID-19 transmission. Herein, we aimed to review the studies that utilized various disinfectants to decontaminate and inactivate the SARS-CoV-2 aerosols. Methods This study was a review that studied related articles published between December 1, 2019 and August 23, 2022. We searched the online databases of PubMed, Scopus, Web of Science, Cochrane, on August 23, 2021. The studies were downloaded into the EndNote software, duplicates were removed, and then the studies were screened based on the inclusion/exclusion criteria. The screening process involved two steps; first, the studies were screened based on their title and abstract and then their full texts. The included studies were used for the qualitative analysis. Results From 664 retrieved records, only 31 met the inclusion criteria and were included in the final qualitative analysis. Various materials like Ozone, H2O2, alcohol, and TiO2 and methods like heating and using Ultraviolet were described in these studies to disinfect places contaminated by COVID-19. It appeared that the efficacy of these disinfectants varies considerably depending on the situation, time, and ultimately their mode of application. Conclusion Following reliable protocols in combination with the proper selection of disinfectant agents for each purpose would serve to achieve desired elimination of the SARS-CoV-2 transmission.
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Affiliation(s)
- Soheil Dehghani
- School of medicineTehran University of Medical SciencesTehranIran
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk BehaviorsTehran University of Medical SciencesTehranIran
| | - SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk BehaviorsTehran University of Medical SciencesTehranIran
| | - Amirali Karimi
- School of medicineTehran University of Medical SciencesTehranIran
| | - Fatemeh Afroughi
- Pars HospitalIran University of Medical SciencesTehranIran
- School of medicineIslamic Azad UniversityTehranIran
| | - Shayan Abshenas
- School of medicineKashan University of Medical SciencesKashanIran
| | - Kimia Azad
- School of medicineIslamic Azad UniversityTehranIran
| | - Marcarious M. Tantuoyir
- School of medicineTehran University of Medical SciencesTehranIran
- Biomedical Engineering UnitUniversity of Ghana Medical Center (UGMC)AccraGhana
| | - Parsa Mohammadi
- School of medicineTehran University of Medical SciencesTehranIran
| | - Seyed Mohammad Ghavam
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk BehaviorsTehran University of Medical SciencesTehranIran
| | - Hengameh Mojdeganlou
- Department of PathologyThe Johns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Omid Dadras
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk BehaviorsTehran University of Medical SciencesTehranIran
- Department of Global Public Health and Primary CareUniversity of BergenBergenNorway
| | | | - Farzin Vahedi
- School of medicineTehran University of Medical SciencesTehranIran
| | | | - Esmaeil Mehraeen
- Department of Health Information TechnologyKhalkhal University of Medical SciencesKhalkhalIran
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20
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Chabot K, Yang SS. Pharmacologic methods to minimise coughing during extubation in the era of COVID-19. J Perioper Pract 2022:17504589221132404. [PMID: 36482722 PMCID: PMC9742728 DOI: 10.1177/17504589221132404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
BACKGROUND/AIM Given the current severe acute respiratory syndrome coronavirus 2 pandemic, coughing at the time of extubation is at risk of creating aerosolisation. This may place health care workers at risk of nosocomial infection during the perioperative period. This study aims to summarise the current pharmacologic methods to minimise cough at the time of extubation, and to determine whether some strategies could be more beneficial than others. METHODS This is a summary of systematic reviews. A comprehensive search through MEDLINE was performed. Thirty-three publications were screened for eligibility. Only the manuscripts discussing pharmacologic methods to minimise coughing on extubation were included in this review. FINDINGS Many pharmacological agents have been proposed to decrease the incidence of cough at the time of extubation. Of these, intravenous administration of dexmedetomidine (relative risk 0.4; 95% CI: 0.4-0.5) or remifentanil (RR 0.4; 95% CI: 0.4-0.5) seems to have the largest effect to reduce cough on extubation. CONCLUSION The available data in the current literature is sparse. Yet, dexmedetomidine and remifentanil seem to be the most efficient agents to decrease the incidence of emergence coughing.
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Affiliation(s)
- Katherine Chabot
- Department of Anaesthesia, McGill University, Montreal, QC, Canada
| | - Stephen Su Yang
- Department of Anaesthesia, McGill University, Montreal, QC, Canada
- Division of Critical Care, McGill University, Montreal, QC, Canada
- Lady Davis Institute of Research, Jewish General Hospital, Montreal, QC, Canada
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21
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McGrath JA, O’Sullivan A, Joyce M, Byrne MA, Li J, Fink JB, MacLoughlin R. In vitro model for investigating aerosol dispersion in a simulated COVID-19 patient during high-flow nasal cannula treatment. Front Med (Lausanne) 2022; 9:1002659. [PMID: 36530866 PMCID: PMC9751314 DOI: 10.3389/fmed.2022.1002659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 11/14/2022] [Indexed: 08/05/2023] Open
Abstract
The use of high-flow nasal cannula in the treatment of COVID-19 infected patients has proven to be a valuable treatment option to improve oxygenation. Early in the pandemic, there were concerns for the degree of risk of disease transmission to health care workers utilizing these treatments that are considered aerosol generating procedures. This study developed an in vitro model to examine the release of simulated patient-derived bioaerosol with and without high-flow nasal cannula at gas flow rates of 30 and 50 L/min. Aerosol dispersion was evaluated at 30 and 90 cm distances. Reduction of transmission risk was assessed using a surgical facemask on the manikin. Results indicated that the use of a facemask facilitated a 94-95% reduction in exhaled aerosol concentration at 30 cm and 22-60% reduction for 90 cm distance across both gas flow rates. This bench study confirms that this in vitro model can be used as a tool to assess the risk of disease transmission during aerosol generating procedures in a simulated patient and to test factors to mitigate the risk.
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Affiliation(s)
- James A. McGrath
- Department of Physics, School of Natural Science, Ryan Institute’s Centre for Climate & Air Pollution Studies, University of Galway, Galway, Ireland
| | - Andrew O’Sullivan
- Research & Development, Science & Emerging Technologies, Aerogen Limited, Galway, Ireland
| | - Mary Joyce
- Research & Development, Science & Emerging Technologies, Aerogen Limited, Galway, Ireland
| | - Miriam A. Byrne
- Department of Physics, School of Natural Science, Ryan Institute’s Centre for Climate & Air Pollution Studies, University of Galway, Galway, Ireland
| | - Jie Li
- Division of Respiratory Care, Department of Cardiopulmonary Sciences, Rush University Medical Center, Chicago, IL, United States
| | - James B. Fink
- Aerogen Pharma Corporation, San Mateo, CA, United States
| | - Ronan MacLoughlin
- Research & Development, Science & Emerging Technologies, Aerogen Limited, Galway, Ireland
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland
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22
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Taher A, Glazer P, Culligan C, Crump S, Guirguis S, Jones J, Dharamsi A, Chartier LB. Improving safety and communication for healthcare providers caring for SARS-COV-2 patients. Int J Emerg Med 2022; 15:62. [PMCID: PMC9652974 DOI: 10.1186/s12245-022-00464-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 10/23/2022] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Decreasing healthcare provider (HCP) exposure to the severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) virus in emergency departments (EDs) is crucial. Approaches include limiting the HCP presence and ensuring sealed isolation rooms, which can result in communication difficulties. This quality improvement (QI) initiative aimed to decrease by 50% duration of isolation room door opening and increasing HCP-perceived communication clarity by one point on a five-point Likert scale.
Methods
This was a prospective, multi-stage project with three Plan-Do-Study-Act (PDSA) cycles between May and July 2020: (1) an educational intervention, (2) the introduction of a novel transceiver communication device, and (3) utilizing a clinical champion. Statistical Process Control XbarR charts were used to assess for special cause variation, and two-tailed Mann-Whitney U tests were used for statistical significance between Likert survey means. Qualitative responses underwent thematic analysis.
Results
Observation of 174 patient encounters was completed over 33 days, with 95 meeting the inclusion criteria. Door opening decreased from baseline (n=40; mean 72.97%) to PDSA 3 (n=21; mean 1.58%; p<0.0001). HCP-perceived communication clarity improved from baseline (n=36; mean 3.36) to PDSA-3 (n=49; mean 4.21; p<0.001). Survey themes included positive effects on communication and workflow, with some challenges on the integration of the new device into the clinical workflow. HCP-perceived errors, workarounds, and workflow pauses showed significant improvements.
Conclusion
This QI initiative with a novel transceiver showed significant decreases in isolation room door opening and increases in communication clarity. Future work will expand to operating rooms and intensive care units.
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23
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Andrés M, García MC, Fajardo A, Grau L, Pagespetit L, Plasencia V, Martínez I, Abadía C, Sanahuja A, Bella F. Nosocomial outbreak of COVID-19 in an internal medicine ward: Probable airborne transmission. Rev Clin Esp 2022; 222:578-583. [PMID: 35798645 PMCID: PMC9239913 DOI: 10.1016/j.rceng.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 04/09/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND OBJECTIVES Despite the increasing evidence supporting the importance of airborne transmission in SARS-CoV-2 infection, it has not been considered relevant in the vast majority of reported nosocomial outbreaks of COVID-19. The aim of this study is to describe a nosocomial outbreak of SARS-CoV-2 infection whose features suggest that aerosol transmission had an important role. METHODS This is a descriptive analysis of a nosocomial outbreak of SARS-CoV-2 infection in an internal medicine ward that occurred in December 2020. All cases were confirmed by a positive PCR test for SARS-CoV-2. RESULTS From December 5 to December 17, 21 patients and 44 healthcare workers (HCWs) developed a nosocomial SARS-CoV-2 infection. Fifty-one of the 65 cases (78.5%) were diagnosed between December 6 and 9. The attack rate in patients was 80.8%. Among HCWs, the attack rate was higher in those who had worked at least one full working day in the ward (56.3%) than in those who had occasionally been in the ward (25.8%; p = 0.005). Three days before the first positive case was detected, two extractor fans were found to be defective, affecting the ventilation of three rooms. Sixteen cases were asymptomatic, 48 cases had non-severe symptoms, and 2 cases required admission to the intensive care unit. All patients eventually recovered. CONCLUSION The high attack rate, the explosive nature of the outbreak, and the coincidence in time with the breakdown in air extractors in some rooms of the ward suggest that airborne transmission played a key role in the development of the outbreak.
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Affiliation(s)
- M Andrés
- Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital de Terrassa (Consorci Sanitari de Terrassa), Terrassa (Barcelona), Spain.
| | - M-C García
- Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital de Terrassa (Consorci Sanitari de Terrassa), Terrassa (Barcelona), Spain
| | - A Fajardo
- Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital de Terrassa (Consorci Sanitari de Terrassa), Terrassa (Barcelona), Spain
| | - L Grau
- Equipo de Control de Infecciones, Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital de Terrassa (Consorci Sanitari de Terrassa), Terrassa (Barcelona), Spain
| | - L Pagespetit
- Equipo de Control de Infecciones, Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital de Terrassa (Consorci Sanitari de Terrassa), Terrassa (Barcelona), Spain
| | - V Plasencia
- Laboratorio de Microbiología, CATLAB, Viladecavalls (Barcelona), Spain
| | - I Martínez
- Servicio de Prevención de Riesgos Laborales, Hospital de Terrassa (Consorci Sanitari de Terrassa), Terrassa (Barcelona), Spain
| | - C Abadía
- Servicio de Salud Laboral, Hospital de Terrassa (Consorci Sanitari de Terrassa), Terrassa (Barcelona), Spain
| | - A Sanahuja
- Departamento de Recursos Físicos, Hospital de Terrassa (Consorci Sanitari de Terrassa), Terrassa (Barcelona), Spain
| | - F Bella
- Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital de Terrassa (Consorci Sanitari de Terrassa), Terrassa (Barcelona), Spain
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24
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Andrés M, García MC, Fajardo A, Grau L, Pagespetit L, Plasencia V, Martínez I, Abadía C, Sanahuja A, Bella F. [Nosocomial outbreak of COVID-19 in an internal medicine ward: Probable airborne transmission]. Rev Clin Esp 2022; 222:578-583. [PMID: 35541500 PMCID: PMC9072947 DOI: 10.1016/j.rce.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 04/09/2022] [Indexed: 11/28/2022]
Abstract
Background and objectives Despite the increasing evidence supporting the importance of airborne transmission in SARS-CoV-2 infection, it has not been considered relevant in the vast majority of reported nosocomial outbreaks of COVID-19. The aim of this study is to describe a nosocomial outbreak of SARS-CoV-2 infection whose features suggest that aerosol transmission had an important role. Methods This is a descriptive analysis of a nosocomial outbreak of SARS-CoV-2 infection in an internal medicine ward that occurred in December 2020. All cases were confirmed by a positive PCR test for SARS-CoV-2. Results From December 5 to December 17, 21 patients and 44 healthcare workers developed a nosocomial SARS-CoV-2 infection. Fifty-one of the 65 cases (78.5%) were diagnosed between December 6 and 9. The attack rate in patients was 80.8%. Among workers, the attack rate was higher in those who had worked at least one full working day in the ward (56.3%) than in those who had occasionally been in the ward (25.8%, p = 0.005). Three days before the first positive case was detected, 2 extractor fans were found to be defective, affecting the ventilation of 3 rooms. Sixteen cases were asymptomatic, 48 cases had non-severe symptoms, and 2 cases required admission to the intensive care unit. All patients eventually recovered. Conclusion The high attack rate, the explosive nature of the outbreak, and the coincidence in time with the breakdown in air extractors in some rooms of the ward suggest that airborne transmission played a key role in the development of the outbreak.
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Affiliation(s)
- M Andrés
- Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital de Terrassa (Consorci Sanitari de Terrassa), Tarrassa (Barcelona), España
| | - M-C García
- Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital de Terrassa (Consorci Sanitari de Terrassa), Tarrassa (Barcelona), España
| | - A Fajardo
- Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital de Terrassa (Consorci Sanitari de Terrassa), Tarrassa (Barcelona), España
| | - L Grau
- Equipo de Control de Infecciones, Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital de Terrassa (Consorci Sanitari de Terrassa) , Tarrassa (Barcelona), España
| | - L Pagespetit
- Equipo de Control de Infecciones, Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital de Terrassa (Consorci Sanitari de Terrassa) , Tarrassa (Barcelona), España
| | - V Plasencia
- Laboratorio de Microbiología, CATLAB, Viladecavalls (Barcelona), España
| | - I Martínez
- Servicio de Prevención de Riesgos Laborales, Hospital de Terrassa (Consorci Sanitari de Terrassa) , Tarrassa (Barcelona), España
| | - C Abadía
- Servicio de Salud Laboral, Hospital de Terrassa (Consorci Sanitari de Terrassa) , Tarrassa (Barcelona), España
| | - A Sanahuja
- Departamento de Recursos Físicos, Hospital de Terrassa (Consorci Sanitari de Terrassa) , Tarrassa (Barcelona), España
| | - F Bella
- Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital de Terrassa (Consorci Sanitari de Terrassa), Tarrassa (Barcelona), España
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25
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Kim H, Chang JE, Kim DK, Won D, Lee JM, Kim TK, Min SW, Lim H, Ma S, Hwang JY. Evaluation of the conventional and modified aerosol boxes during tracheal intubation in normal and difficult airways: a randomized, crossover, manikin simulation study. J Clin Monit Comput 2022; 36:1697-1702. [PMID: 35059912 PMCID: PMC8773385 DOI: 10.1007/s10877-022-00814-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 01/16/2022] [Indexed: 12/01/2022]
Abstract
The aim of this study was to evaluate conventional and modified aerosol boxes in terms of intubation time, first-pass intubation success, and mouth-to-mouth distance between the laryngoscopist and patient during tracheal intubation in simulated patients with normal and difficult airways. Sixteen anesthesiologists performed tracheal intubations with direct laryngoscope or three different videolaryngoscopes (McGRATH MAC videolaryngoscope, C-MAC videolaryngoscope, and Pentax-AWS) without an aerosol box or with a conventional or a modified aerosol boxes in simulated manikins with normal and difficult airways. Intubation time, first-pass intubation success, and mouth-to-mouth distance during tracheal intubation were recorded. Compared to no aerosol box, the use of a conventional aerosol box significantly increased intubation time in both normal and difficult airways (Bonferroni-corrected P-value (Pcorrected) = 0.005 and Pcorrected = 0.003, respectively). Intubation time was significantly shorter with the modified aerosol box than with the conventional one for both normal and difficult airways (Pcorrected = 0.003 and Pcorrected = 0.011, respectively). However, no significant differences were found in intubation time between no aerosol box and the modified aerosol box for normal and difficult airways (Pcorrected = 0.336 and Pcorrected = 0.112, respectively). The use of conventional or modified aerosol boxes significantly extended the mouth-to-mouth distances compared to not using an aerosol box during tracheal intubation with each laryngoscope (all Pcorrected < 0.05), and the distances were not different between the conventional and modified boxes in normal and difficult airways. The use of modified aerosol box did not increase intubation time and could help maintain a distance from the simulated patients with normal and difficult airways.
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Affiliation(s)
- Hyerim Kim
- Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae Medical Center, Boramae-ro, Dongjak-gu, Seoul, 156-707, Republic of Korea
| | - Jee-Eun Chang
- Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae Medical Center, Boramae-ro, Dongjak-gu, Seoul, 156-707, Republic of Korea
| | - Dae Kon Kim
- Department of Emergency Medicine, Seoul National University Bundang Hospital, Gyeonggido, Republic of Korea
| | - Dongwook Won
- Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae Medical Center, Boramae-ro, Dongjak-gu, Seoul, 156-707, Republic of Korea
| | - Jung-Man Lee
- Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae Medical Center, Boramae-ro, Dongjak-gu, Seoul, 156-707, Republic of Korea
| | - Tae Kyong Kim
- Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae Medical Center, Boramae-ro, Dongjak-gu, Seoul, 156-707, Republic of Korea
- Department of Anesthesiology & Pain Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Seong-Won Min
- Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae Medical Center, Boramae-ro, Dongjak-gu, Seoul, 156-707, Republic of Korea
- Department of Anesthesiology & Pain Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Haeun Lim
- Department of Anesthesiology & Pain Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Seoyoung Ma
- Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae Medical Center, Boramae-ro, Dongjak-gu, Seoul, 156-707, Republic of Korea
| | - Jin-Young Hwang
- Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae Medical Center, Boramae-ro, Dongjak-gu, Seoul, 156-707, Republic of Korea.
- Department of Anesthesiology & Pain Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea.
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26
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Ramesh AV, Collin I, Gregson FKA, Brown J. Aerosol generation during percutaneous tracheostomy insertion. J Intensive Care Soc 2022; 23:498-499. [PMID: 36751358 PMCID: PMC9679908 DOI: 10.1177/1751143720977278] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Affiliation(s)
- Aravind V Ramesh
- Intensive Care Unit, Southmead Hospital, North Bristol NHS Trust, Bristol,
UK
| | - Ivan Collin
- Intensive Care Unit, Southmead Hospital, North Bristol NHS Trust, Bristol,
UK
| | | | - Jules Brown
- Intensive Care Unit, Southmead Hospital, North Bristol NHS Trust, Bristol,
UK,Jules Brown, Department of Anaesthesia, Southmead
Hospital, North Bristol NHS Trust, Bristol BS10 5NB, UK.
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27
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Tabone L, Rivest D, Levy A, Buyck M, Jouvet P, Aubin CE, François T, Robert E, Baudin F. Prevention of submicron aerosolized particle dispersion: evaluation of an aerosol box using a pediatric simulation model. Exp Lung Res 2022; 48:266-274. [PMID: 36269071 DOI: 10.1080/01902148.2022.2135795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Background and Aim: The SplashGuard CG (SG) is a barrier enclosure developed to protect healthcare workers from SARS-CoV-2 transmission during aerosol-generating procedures. Our objective was to evaluate the protection provided by the SG against aerosolized particles (AP), using a pediatric simulation model of spontaneous ventilation (SV) and noninvasive ventilation (NIV). Methods: An aerosol generator was connected to the airways of a pediatric high-fidelity manikin with a breathing simulator. AP concentrations were measured both in SV and NIV in the following conditions: with and without SG, inside and outside the SG, with and without suction applied to the device. Results: In the SV simulated setting, AP peaks were lower with SG: 0.1 × 105 particles/L compared to without: 1.6 × 105, only when the ports were closed and suction applied. In the NIV simulated setting, AP peaks outside the SG were lower than without SG (20.5 × 105 particles/L), whatever the situation, without suction (14.4 × 105particles/L), with suction and ports open or closed: 10.3 and 0.7 × 105 particles/L. In SV and NIV simulated settings, the AP peaks measured within the SG were much higher than the AP peaks measured without SG, even when suction was applied to the device. Conclusions: The SG seems to decrease peak AP exposure in the 2 ventilation contexts, but only with closed port and suction in SV. However, high concentrations of AP remain inside even with suction and SG should be used cautiously.
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Affiliation(s)
- Laurence Tabone
- Pediatric Intensive Care, Department of Pediatrics, CHU Sainte Justine, Université de Montréal, Montréal, Québec, Canada.,Pediatric Intensive Care Unit and Pediatric Emergency Department, CHRU de Tours, Tours, France
| | - Dominic Rivest
- Department of Mechanical Engineering, Ecole Polytechnique de Montreal, Montreal, Québec, Canada
| | - Arielle Levy
- Department of Emergency Care, CHU Sainte Justine, Université de Montréal, Montréal, Québec, Canada
| | - Michael Buyck
- Department of Emergency Care, CHU Sainte Justine, Université de Montréal, Montréal, Québec, Canada
| | - Philippe Jouvet
- Pediatric Intensive Care, Department of Pediatrics, CHU Sainte Justine, Université de Montréal, Montréal, Québec, Canada
| | - Carl-Eric Aubin
- Department of Mechanical Engineering, Ecole Polytechnique de Montreal, Montreal, Québec, Canada
| | - Tine François
- Pediatric Intensive Care, Department of Pediatrics, CHU Sainte Justine, Université de Montréal, Montréal, Québec, Canada
| | - Etienne Robert
- Department of Mechanical Engineering, Ecole Polytechnique de Montreal, Montreal, Québec, Canada
| | - Florent Baudin
- Department of Anesthesiology, CHU Sainte Justine, Université de Montréal, Montréal, Québec, Canada.,Pediatric Intensive Care Unit, Lyon University Hospital, Hôpital Femme Mère Enfant, Bron, France
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Ayala‐Peña VB, Martin MJ, Favatela F, Otarola J, Morán P, Ventura M, Gentili C, Salcedo MF, Mansilla A, Pérez S, Dolcini G, Alvarez V, Lassalle V. Chitosan-Based Formulations Intended as Protective Spray for Mask Surfaces in Prevention of Coronavirus Dissemination. ChemistrySelect 2022; 7:e202202410. [PMID: 36711229 PMCID: PMC9874787 DOI: 10.1002/slct.202202410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 09/13/2022] [Indexed: 02/01/2023]
Abstract
The extraordinary occurrence of COVID-19 by the fast expansion of viral infections has propelled particular interest in developing novel antiviral and virucidal agents to guarantee personal security. The main objective of this work is to propose novel formulations able to optimize the use of personal protection elements. In recent years, chitosan (CH) has attracted attention for being an interesting multifunctional, biodegradable, non-antigenic, non-toxic, and biocompatible natural polymer with antimicrobial properties. In this work, formulations based on a CH matrix containing silver, and Copper based nanoparticles have been developed. The novelty of this proposal is that almost liquid formulations have been reached, possessing verified properties to inhibit evolved virus such as herpes simplex type 1 (HSV-1) and bovine betacoronavirus (BCoV), the latter belonging to the same family of the well-known the well-known SARS-CoV-2. Besides antibacterial bioactivity; as well as the ability of these formulations to be easily sprayed on various surfaces, including conventional face masks, have been verified and discussed. The results presented in this contribution provide strong evidence on CH films as an ideal biosafe surface-protective for several daily used materials including the conventional face masks.
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Affiliation(s)
- Victoria Belen Ayala‐Peña
- INIBIBBDepartamento de BiologíaBioquímica y FarmaciaUniversidad Nacional del Sur (UNS)-CONICET.Camino La Carrindanga km 7B8000Bahía BlancaProvincia de Buenos AiresArgentina
| | - María Julia Martin
- INQUISURDepartamento de QuímicaUniversidad Nacional del Sur (UNS)-CONICET.Av. Leandro Niceforo Alem 1253B8000Bahía BlancaProvincia de Buenos AiresArgentina
- INBIOSURDepartamento de BiologíaBioquímica y FarmaciaUniversidad Nacional del Sur (UNS)-CONICETSan Juan 671B8000Bahía BlancaProvincia de Buenos AiresArgentina
| | - Florencia Favatela
- INQUISURDepartamento de QuímicaUniversidad Nacional del Sur (UNS)-CONICET.Av. Leandro Niceforo Alem 1253B8000Bahía BlancaProvincia de Buenos AiresArgentina
| | - Jessica Otarola
- INQUISURDepartamento de QuímicaUniversidad Nacional del Sur (UNS)-CONICET.Av. Leandro Niceforo Alem 1253B8000Bahía BlancaProvincia de Buenos AiresArgentina
| | - Pedro Morán
- CIVETAN - CONICET, Facultad de Ciencias Veterinarias, UNCPBA, Pje ArroyoSeco s/n campus universitarioB7000TandilArgentina
| | - María Ventura
- IAE-Instituto Analítico EspecializadoCórdoba3935, B1653BJKVilla Ballester - Pcia.deBuenos AiresArgentina
| | - Claudia Gentili
- INBIOSURDepartamento de BiologíaBioquímica y FarmaciaUniversidad Nacional del Sur (UNS)-CONICETSan Juan 671B8000Bahía BlancaProvincia de Buenos AiresArgentina
| | - María Florencia Salcedo
- Instituto de Investigaciones BiológicasUE-CONICET-UNMdPFacultad de Ciencias Exactas y NaturalesUniversidad Nacional de Mar del Plata. DéanFunes 3240B7600Mar del PlataArgentina
| | - Andrea Mansilla
- Instituto de Investigaciones BiológicasUE-CONICET-UNMdPFacultad de Ciencias Exactas y NaturalesUniversidad Nacional de Mar del Plata. DéanFunes 3240B7600Mar del PlataArgentina
| | - Sandra Pérez
- CIVETAN - CONICET, Facultad de Ciencias Veterinarias, UNCPBA, Pje ArroyoSeco s/n campus universitarioB7000TandilArgentina
| | - Guillermina Dolcini
- CIVETAN - CONICET, Facultad de Ciencias Veterinarias, UNCPBA, Pje ArroyoSeco s/n campus universitarioB7000TandilArgentina
| | - Vera Alvarez
- INTEMAFacultad de IngenieríaUniversidad Nacional de Mar del Plata (UNMdP)-CONICET.Av. Cristóbal Colón 10850B7600Mar del PlataArgentina
| | - Verónica Lassalle
- INQUISURDepartamento de QuímicaUniversidad Nacional del Sur (UNS)-CONICET.Av. Leandro Niceforo Alem 1253B8000Bahía BlancaProvincia de Buenos AiresArgentina
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Phillips F, Crowley J, Warburton S, Gordon GSD, Parra-Blanco A. Aerosol and droplet generation in upper and lower GI endoscopy: whole procedure and event-based analysis. Gastrointest Endosc 2022; 96:603-611.e0. [PMID: 35659608 PMCID: PMC9386278 DOI: 10.1016/j.gie.2022.05.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 04/18/2022] [Accepted: 05/24/2022] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Aerosol-generating procedures have become an important healthcare issue during the coronavirus disease 2019 (COVID-19) pandemic because the severe acute respiratory syndrome coronavirus 2 virus can be transmitted through aerosols. We aimed to characterize aerosol and droplet generation in GI endoscopy, where there is little evidence. METHODS This prospective observational study included 36 patients undergoing routine peroral gastroscopy (POG), 11 undergoing transnasal endoscopy (TNE), and 48 undergoing lower GI (LGI) endoscopy. Particle counters took measurements near the appropriate orifice (2 models were used with diameter ranges of .3-25 μm and 20-3000 μm). Quantitative analysis was performed by recording specific events and subtracting background particles. RESULTS POG produced 1.96 times the level of background particles (P < .001) and TNE produced 2.00 times (P < .001), but a direct comparison showed POG produced 2.00 times more particles than TNE. LGI procedures produced significant particle counts (P < .001) with 2.4 times greater production per procedure than POG but only .63 times production per minute. Events that were significant relative to the room background particle count were POG, with throat spray (150.0 times, P < .001), esophageal extubation (37.5 times, P < .001), and coughing or gagging (25.8 times, P < .01); TNE, with nasal spray (40.1 times, P < .001), nasal extubation (32.0 times, P < .01), and coughing or gagging (20.0, P < .01); and LGI procedures, with rectal intubation (9.9 times, P < .05), rectal extubation (27.2 times, P < .01), application of abdominal pressure (9.6 times, P < .05), and rectal insufflation or retroflexion (7.7 times, P < .01). These all produced particle counts larger than or comparable with volitional cough. CONCLUSIONS GI endoscopy performed through the mouth, nose, or rectum generates significant quantities of aerosols and droplets. Because the infectivity of procedures is not established, we therefore suggest adequate personal protective equipment is used for all GI endoscopy where there is a high population prevalence of COVID-19. Avoiding throat and nasal spray would significantly reduce particles generated from upper GI procedures.
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Affiliation(s)
- Frank Phillips
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | | | - Samantha Warburton
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK; Faculty of Engineering, Nottingham, UK
| | | | - Adolfo Parra-Blanco
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
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Martins MS, Lourenção DCDA, Pimentel RRDS, de Oliveira JM, Manganoti LTDCN, Modesto RC, Silva MSDS, Dos Santos MJ. Recommendations for the safety of hospitalised patients in the context of the COVID-19 pandemic: a scoping review. BMJ Open 2022; 12:e060182. [PMID: 36123068 PMCID: PMC9485646 DOI: 10.1136/bmjopen-2021-060182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 08/03/2022] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE To map the recommendations for hospitalised patient safety in the context of the COVID-19 pandemic. DESIGN Scoping review using the method recommended by the Joanna Briggs Institute. DATA SOURCES Databases: Medline, SCOPUS, EMBASE, ScienceDirect, LILACS, CINAHL and IBECS; grey literature platform: Google Scholar; and 11 official websites of leading healthcare institutions were searched on 27 April 2021 and updated on 11 April 2022. ELIGIBILITY CRITERIA We included documents that present recommendations for the safety of hospitalised patients in the context of the COVID-19 pandemic, published in any language, from 2020 onwards. DATA EXTRACTION AND SYNTHESIS Data extraction was performed in pairs with consensus rounds. A descriptive analysis was carried out to present the main characteristics of the articles. Qualitative data from the extraction of recommendations were analysed through content analysis. RESULTS One hundred and twenty-five documents were included. Most papers were identified as expert consensus (n=56, 44.8%). Forty-six recommendations were identified for the safety of hospitalised patients: 17 relating to the reorganisation of health services related to the flow of patients, the management of human and material resources and the reorganisation of the hospital environment; 11 on the approach to the airways and the prevention of the spread of aerosols; 11 related to sanitary and hygiene issues; 4 about proper use of personal protective equipment and 3 for effective communication. CONCLUSIONS The recommendations mapped in this scoping review present the best practices produced so far and serve as a basis for planning and implementing good practices to ensure safe hospital care, during and after COVID-19. The engagement of everyone involved in the care of hospitalised patients is essential to consolidate the mapped recommendations and provide dignified, safe and quality care.
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Affiliation(s)
| | | | | | - Janine Melo de Oliveira
- Escola de Enfermagem, Universidade Federal de Alagoas, Maceio, Brazil
- Curso de Enfermagem, Universidade Estadual de Ciências da Saúde de Alagoas, Maceio, Brazil
| | | | | | | | - Marcelo José Dos Santos
- Career Guidance Department, Universidade de São Paulo Escola de Enfermagem, Sao Paulo, Brazil
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Gedge DA, Chilcott RP, Williams J. Quantifying the Risk to Health Care Workers of Cough as an Aerosol Generating Event in an Ambulance Setting: A Research Report. Prehosp Disaster Med 2022; 37:515-519. [PMID: 35713106 PMCID: PMC9280060 DOI: 10.1017/s1049023x22000917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/12/2022] [Accepted: 04/30/2022] [Indexed: 11/07/2022]
Abstract
INTRODUCTION AND OBJECTIVE United Kingdom Health Security Agency (UKHSA) guidance related to mask use for health care workers in a non-aerosol generating procedure (AGP) setting has remained as Level 2 water repellent paper mask (surgical mask) only. Energetic respiratory events, such as coughing, can generate vast numbers of droplets and aerosols. Coughing, considered to be a non-AGP event, frequently occurs in the relatively small, confined space of an ambulance (∼25 m3). The report seeks to explore whether existing research can provide an indication of the risk to ambulance staff, via aerosol transmission, of an acute respiratory infection (ARI) during a coughing event within the clinical setting of an ambulance. METHODS International bibliographic databases were searched (CINAHL Plus, SCOPUS, PubMed, and CENTRAL) using appropriate search strings and a combination of relevant medical subject headings with appropriate truncation. Methodological filters were not applied. Papers without an English language abstract were excluded from the review. Grey literature was sought by searching specialist databases OpenGrey and GreyNet, as well as key organizations' websites. The initial search identified 2,405 articles. Following screening, along with forward and backward citation of key papers identified within the literature search, 36 papers were deemed eligible for the scoping review. DISCUSSION Attempts to replicate a clinical environment to investigate the risk of transmission of airborne viruses to health care workers during a coughing event provided evidence for the generation of respirable aerosol particles and thus potential transmission of pathogens. In cases of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), potential to infect versus true airborne transmission is a debate that continues, but there is general consensus that a large variation of cough characteristics and aerosol generation amongst individuals exists. Studies widely endorsed face masks as a source control device, but there were conflicting views about the impact of mask leakage. CONCLUSION Further research is required to provide clarity of the risk to health care workers when caring for a coughing patient in the confined clinical ambulance setting and to provide an evidence base to assist in the determination of appropriate respiratory protective equipment (RPE).
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Affiliation(s)
- Dale A. Gedge
- University of Hertfordshire, School of Health and Social Work, Hatfield, Hertfordshire, United Kingdom
- Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, Norfolk, United Kingdom
| | - Robert P. Chilcott
- University of Hertfordshire, Toxicology Research Group, Hatfield, Hertfordshire, United Kingdom
| | - Julia Williams
- University of Hertfordshire, School of Health and Social Work, Hatfield, Hertfordshire, United Kingdom
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Cortese G, Sorbello M, Di Giacinto I, Cedrone M, Urdaneta F, Brazzi L. Human Factors and Airway Management in COVID-19 Patients: The Perfect Storm? J Clin Med 2022; 11:4271. [PMID: 35893372 PMCID: PMC9330625 DOI: 10.3390/jcm11154271] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/08/2022] [Accepted: 07/19/2022] [Indexed: 01/27/2023] Open
Abstract
The SARS-CoV-2 pandemic heavily impacted healthcare workers, increasing their physical and psychological workload. Specifically, COVID-19 patients' airway management is definitely a challenging task regarding both severe and acute respiratory failure and the risk of contagion while performing aerosol-generating procedures. The category of anesthesiologists and intensivists, the main actors of airway management, showed a poor psychological well-being and a high stress and burnout risk. Identifying and better defining the specific main SARS-CoV-2-related stressors can help them deal with and effectively plan a strategy to manage these patients in a more confident and safer way. In this review, we therefore try to analyze the relevance of human factors and non-technical skills when approaching COVID-19 patients. Lessons from the past, such as National Audit Project 4 recommendations, have taught us that safe airway management should be based on preoperative assessment, the planning of an adequate strategy, the optimization of setting and resources and the rigorous evaluation of the scenario. Despite, or thanks to, the critical issues and difficulties, the "take home lesson" that we can translate from SARS-CoV-2 to every airway management is that there can be no more room for improvisation and that creating teamwork must become a priority.
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Affiliation(s)
- Gerardo Cortese
- Department of Anaesthesia, Intensive Care and Emergency, AOU Città della Salute e della Scienza, Corso Dogliotti 14, 10126 Turin, Italy; (G.C.); (L.B.)
| | | | - Ida Di Giacinto
- Anesthesia and Intensive Care, Mazzoni Hospital, 63100 Ascoli Piceno, Italy;
| | - Martina Cedrone
- Department of Surgical Sciences, University of Turin, 10126 Turin, Italy;
| | - Felipe Urdaneta
- Department of Anesthesiology, North Florida/South Georgia Veteran Health Systems, University of Florida, Gainesville, FL 32608, USA;
| | - Luca Brazzi
- Department of Anaesthesia, Intensive Care and Emergency, AOU Città della Salute e della Scienza, Corso Dogliotti 14, 10126 Turin, Italy; (G.C.); (L.B.)
- Department of Surgical Sciences, University of Turin, 10126 Turin, Italy;
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Duarte-Medrano G, Sorbello M, Susunaga-Hope RR, Fuentes-Castro PI, Avila-OrtIz BC, Velasco-Godinez AP, Contreras-Garcia WY, Pineda-Castillo MA, Urdaneta F, Téllez-Ávila FI. Aerosol boxes for airway management in coronavirus disease patients: a clinical retrospective study in Mexico. JOURNAL OF ANESTHESIA, ANALGESIA AND CRITICAL CARE 2022; 2:32. [PMID: 37386573 PMCID: PMC10246106 DOI: 10.1186/s44158-022-00061-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 07/07/2022] [Indexed: 07/01/2023]
Abstract
INTRODUCTION Significant concerns raise for the healthcare workers involved in airway management of patients diagnosed with coronavirus 2019 disease (COVID-19). Due to shortages of personal protective equipment (PPE), barrier enclosure systems such as aerosol box (AB) have been proposed worldwide. The aim of this study was to evaluate our experience using AB as protective equipment in patients with COVID-19 in a third-level center in Mexico. METHODS A retrospective study of COVID-19 patients requiring airway management using an AB in the Hospital Central Sur de Alta Especialidad de Pemex in Mexico City from March 1 to June 1, 2020. Antropometric data, pre-intubation vital signs, and laboratory tests were recorded; the primary endpoints were intubation success rate and complications associated with AB and patients' mortality. As a secondary endpoint, AB subjective evaluation was explored by administering a survey after airway management procedures. RESULTS Thirty-nine patients for a total of 40 intubations were documented. Thirty-one (77.5%) were men, with a mean age of 61.65 years; successful intubation occurred in 39 (97.55%) of the procedures, and AB was used in 36 (90%) of intubations, with success in 28 (70.0%); A Cormack-Lehane grade 3 view was recorded in 18 patients (46.2%), and during the procedure, the AB had to be removed in 8 (22.2%) cases, with migration documented in 91.6% of cases. The 30-day mortality was 48.71%, with 23.0% of patients discharged. 83.3% of surveyed anesthesiologists reported significant limitations in manipulating airway devices with AB used. CONCLUSION Our data indicate that in clinical practice, the use of AB may hinder airway management and decrease the intubation success rate and may also result in patients' injury. Further studies are necessary to validate the use of AB in clinical practice, and they should not replace certified PPE.
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Affiliation(s)
- Gilberto Duarte-Medrano
- Anesthesiology Department of the South-Central Hospital of High Specialty Pemex, Mexico City, Mexico
| | - Massimiliano Sorbello
- Anaesthesia, and Intensive Care, Policlinico San Marco University Hospital, Viale C. A. Ciampi, 95100, Catania, Italy.
| | | | | | - Beatriz C Avila-OrtIz
- Anesthesiology Department of the South-Central Hospital of High Specialty Pemex, Mexico City, Mexico
| | | | - Wendy Y Contreras-Garcia
- Anesthesiology Department of the South-Central Hospital of High Specialty Pemex, Mexico City, Mexico
| | | | - Felipe Urdaneta
- Clinical Professor Anesthesiology, Department of Anesthesiology, University of Florida/NFSGVHS, Florida, USA
| | - Félix Ignacio Téllez-Ávila
- Gastrointestinal Endoscopy Department of the National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico
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Winck JC, Almeida SM, Correia G, Gabriel MF, Marques G, Silva MG. A call for a national strategy for indoor air quality. Pulmonology 2022; 28:245-251. [PMID: 35351401 PMCID: PMC8957366 DOI: 10.1016/j.pulmoe.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 02/13/2022] [Accepted: 02/14/2022] [Indexed: 12/04/2022] Open
Affiliation(s)
- J C Winck
- Faculdade de Medicina da Universidade do Porto, Porto 4200-319, Portugal.
| | - S M Almeida
- Centro de Ciências e Tecnologias Nucleares, Instituto Superior Técnico, Universidade de Lisboa, EN10, km 139.7, Bobadela LRS 2695-066, Portugal
| | - G Correia
- Institute of Microbiology, FMUC - Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Medical Microbiology Research Group, CIBB -Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal
| | - M F Gabriel
- INEGI, Institute of Science and Innovation in Mechanical and Industrial Engineering, Campus da FEUP, Rua Dr. Roberto Frias 400, Porto 4200-465, Portugal
| | - G Marques
- Polytechnic of Coimbra, ESTGOH, Rua General Santos Costa, 3400-124 Oliveira do Hospital, Portugal
| | - M G Silva
- Universidade de Coimbra, Associação para o Desenvolvimento da Aerodinâmica Industrial, Departamento de Engenharia Mecânica, Rua Luís Reis Santos, Pólo II, Coimbra 3030-788, Portugal
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Akahane T, Nakanishi Y, Yoshiji H, Akahane M. Esophagogastroduodenoscopy screening intentions during the COVID-19 pandemic in Japan. A web-based survey (Preprint). JMIR Cancer 2022; 8:e40600. [DOI: 10.2196/40600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 10/29/2022] [Accepted: 11/04/2022] [Indexed: 11/09/2022] Open
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Hajissa K, Islam MA, Hassan SA, Zaidah AR, Ismail N, Mohamed Z. Seroprevalence of SARS-CoV-2 Antibodies in Africa: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127257. [PMID: 35742506 PMCID: PMC9223681 DOI: 10.3390/ijerph19127257] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 05/31/2022] [Accepted: 06/06/2022] [Indexed: 02/06/2023]
Abstract
A reliable estimate of SARS-CoV-2-specific antibodies is increasingly important to track the spread of infection and define the true burden of the ongoing COVID-19 pandemic. A systematic review and a meta-analysis were conducted with the objective of estimating the seroprevalence of SARS-CoV-2 infection in Africa. A systematic search of the PubMed, Scopus, Web of Science and Google Scholar electronic databases was conducted. Thirty-five eligible studies were included. Using meta-analysis of proportions, the overall seroprevalence of anti-SARS-CoV-2 antibodies was calculated as 16% (95% CI 13.1-18.9%). Based on antibody isotypes, 14.6% (95% CI 12.2-17.1%) and 11.5% (95% CI 8.7-14.2%) were seropositive for SARS-CoV-2 IgG and IgM, respectively, while 6.6% (95% CI 4.9-8.3%) were tested positive for both IgM and IgG. Healthcare workers (16.3%) had higher seroprevalence than the general population (11.7%), blood donors (7.5%) and pregnant women (5.7%). The finding of this systematic review and meta-analysis (SRMA) may not accurately reflect the true seroprevalence status of SARS-CoV-2 infection in Africa, hence, further seroprevalence studies across Africa are required to assess and monitor the growing COVID-19 burden.
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Affiliation(s)
- Khalid Hajissa
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia; (K.H.); (S.A.H.); (A.R.Z.); (N.I.)
- Department of Zoology, Faculty of Science and Technology, Omdurman Islamic University, P.O. Box 382, Omdurman 14415, Sudan
| | - Md Asiful Islam
- Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham B15 2TT, UK
- Correspondence: or (M.A.I.); (Z.M.)
| | - Siti Asma Hassan
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia; (K.H.); (S.A.H.); (A.R.Z.); (N.I.)
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
| | - Abdul Rahman Zaidah
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia; (K.H.); (S.A.H.); (A.R.Z.); (N.I.)
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
| | - Nabilah Ismail
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia; (K.H.); (S.A.H.); (A.R.Z.); (N.I.)
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
| | - Zeehaida Mohamed
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia; (K.H.); (S.A.H.); (A.R.Z.); (N.I.)
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
- Correspondence: or (M.A.I.); (Z.M.)
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Virant FS, Randolph C, Nanda A, Baptist AP, Akuthota P, Adams K, Quinn JM, Pongdee T, Nyenhuis SM. Pulmonary Procedures During the COVID-19 Pandemic: A Work Group Report of the AAAAI Asthma Diagnosis and Treatment (ADT) Interest Section. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY: IN PRACTICE 2022; 10:1474-1484. [PMID: 35431153 PMCID: PMC9009724 DOI: 10.1016/j.jaip.2022.02.044] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 02/15/2022] [Accepted: 02/15/2022] [Indexed: 01/08/2023]
Abstract
The COVID-19 pandemic has placed increased demands on the ability to safely perform pulmonary procedures in keeping with Centers for Disease Control and Prevention (CDC), American Thoracic Society (ATS), and the Occupational Safety and Health Administration (OSHA) recommendations. Accordingly, the American Academy of Allergy, Asthma & Immunology (AAAAI) Asthma Diagnosis and Treatment convened this work group to offer guidance. The work group is composed of specialist practitioners from academic and both large and small practices. Individuals with special expertise were assigned sections on spirometry, fractional exhaled nitric oxide, nebulized treatments, and methacholine challenge. The work group met periodically to achieve consensus. This resulting document has recommendations for the allergy/asthma/immunology health care setting based on available evidence including reference documents from the CDC, ATS, and OSHA.
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Effect of enhanced personal protective equipment on colonoscopy performance and pain linked to procedure during the COVID-19 pandemic. Acta Gastroenterol Belg 2022; 85:269-275. [DOI: 10.51821/85.2.9621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background and study aim: During the COVID-19 pandemic, the use of standard personal protective equipment (SPPE) reduces transmission risks during endoscopic procedures. Our aim was to assess the effect of enhanced personal protective equipment (EPPE) on colonoscopy performance and pain linked to the procedure compared with SPPE.
Patients and methods: During two similar periods with three- month duration (in 2019 and in 2020 during the COVID-19 pandemic), electronic medical records and colonoscopy reports were investigated for sequential patients undergoing colonoscopy. SPPE was used in 2019 and EPPE in 2020. The patients’ clinical data and information related to the procedure were collected and analyzed. Primary outcomes were the duration to intubate the cecum, total procedure duration and patient pain score at the end of the procedure. Secondary outcomes were adenoma detection rate (ADR), polyp detection rate (PDR) and cecal intubation rate (CIR).
Results: A total of 426 patients with colonoscopy performed were analyzed. The demographic features and indications for colonoscopy were similar for patients in both groups. The EPPE group had higher values for the parameters assessed as primary endpoints of cecal intubation time, withdrawal time, total procedure time and pain at the end of the procedure compared to the SPPE group and the differences were statistically significant. Conclusion: Our findings show that though the use of EPPE negatively affected colonoscopy performance and patient pain at the end of the procedure, it had no effect on the colonoscopy quality indices such as ADR, PDR and CIR.
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Projection of the Epidemics Trend of COVID-19 in Qom, Iran: A Modeling Study. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2022. [DOI: 10.5812/archcid-113091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Coronavirus is one of the major pathogens of the human respiratory system and a major threat to the human health. Objectives: This modeling study aimed to project the epidemics trend of coronavirus disease 2019 (COVID-19) in Qom, Iran Methods: This study projected the COVID-19 outbreak in Qom using a modified susceptible-exposed-infectious-recovered (SEIR) compartmental model by the end of December 2020. The model was calibrated based on COVID-19 epidemic trend in Qom from 1 January to 11 July. The number of infected, hospitalized, and death cases were projected by 31 December. A Monte Carlo uncertainty analysis was applied to obtain 95% uncertainty interval (UI) around the estimates. Results: According to the results, the reduced contact rate and increased isolation rate were effective in reducing the size of the epidemic in all scenarios. By reducing the contact rate from eight to six, the number of new cases on the peak day, as well as the total number of cases admitted to the hospital by the end of the period (31 December), decreased. For example, in Scenario A, compared to Scenario E, with a decrease in contact rate from eight to six, the number of new cases on peak days decreased from 15,700 to 1,100. The largest decrease in the number of new cases on peak days was related to Scenario F with 270 cases. Also, the total number of cases decreased from 948,000 to 222,000 between the scenarios, and the largest decrease in this regard was related to Scenario F, with 188,000 cases. Conclusions: The parameters of contact rate and isolation rate can reduce the number of infected cases and prevent the outbreak, or at least delay the onset of the peak. This can help health policymakers and community leaders to upgrade their health care systems.
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Loizidou A, Tatla TS, Harvey I, Aibibula M, Roe J, Sethi N, Schilder AGM. COVID-VU - ENT-UK national survey of flexible nasendoscopy in the upper aerodigestive tract amidst the COVID-19 pandemic. BMC Health Serv Res 2022; 22:625. [PMID: 35534827 PMCID: PMC9083478 DOI: 10.1186/s12913-021-07416-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 12/15/2021] [Indexed: 11/18/2022] Open
Abstract
Background Flexible nasendoscopy (FNE) is an invaluable multi-disciplinary tool for upper aerodigestive tract (UADT) examination. During the COVID-19 pandemic concerns were raised that FNE had the potential of generating aerosols resulting in human cross-contamination when performed on SARS-COV2 carriers. In the UK, and other European countries, national guidelines were issued restricting FNE to essential cases. We surveyed ENT-UK members and Royal College of Speech and Language Therapists (RCSLT) members to determine the impact of the COVID-19 pandemic (first peak) on FNE practice in the UK. Methods An observational internet-based survey constructed in accordance to the CHERRIES checklist and setup in SurveyMonkey of FNE practice amongst UK-based ENT surgeons and speech and language therapists in community clinics, the outpatient department, inpatient wards, ICU, emergency department and operating theatres (through the NHS and private sector) prior to, during and following the first COVID-19 wave in the UK. Results 314 responses collected (24% response rate), 82% from ENT clinicians, 17% from SLTs and 1% from other allied healthcare professionals. Overall, there has been a large reduction in the volume and indications for FNE during the first peak of the COVID-19 pandemic with limited recovery by mid-August 2020. Cancer and airway assessments were impacted less. A wide range of FNE protocols influenced by local factors are reported, varying in endoscope preference, Personal Protective Equipment (PPE) and sterilization methods. Where dedicated Aerosol Generating Procedure (AGP) rooms were unavailable, clinicians resorted to window opening and variable room “down-time” between patients. Endoscope preference reflected availability and user familiarity, ENT trainees favoring the use of single-use video endoscopes. Conclusion Despite national guidance, local practice of FNE remains interrupted and highly variable in the UK. A collaborative inter-disciplinary approach is required to re-introduce FNE safely in volume across healthcare settings, re-establishing timely endoscopic diagnosis and pre-pandemic levels of patient care.
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Affiliation(s)
- Avgi Loizidou
- Deptment of ENT-Head & Neck Surgery, London North West University Healthcare NHS Trust, London, Harrow, HA1 3UJ, UK.
| | - Taranjit Singh Tatla
- Deptment of ENT-Head & Neck Surgery, London North West University Healthcare NHS Trust, London, Harrow, HA1 3UJ, UK
| | - Ian Harvey
- School of Public Health, San Diego State University, San Diego, CA, USA
| | - Miriayi Aibibula
- Ambu Limited, Incubator 2, Alconbury Weald Enterprise Campus, Alconbury Weald, Cambridgeshire, PE28 4XA, UK
| | - Justin Roe
- Department of Speech, Voice and Swallowing, The Royal Marsden NHS Foundation Trust, London, UK.,National Centre for Airway Reconstruction, Department of Otolaryngology, Head and Neck Surgery, Imperial College Healthcare NHS Trust, London, UK.,Department of Surgery and Cancer, Imperial College, London, UK
| | - Neeraj Sethi
- Dept of Otolaryngology-Head & Neck Surgery, Queens Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UK
| | - Anne G M Schilder
- evidENT, Ear Institute, University College London, London, UK.,National Institute for Health Research University College London Biomedical Research Centre, London, UK
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Renzo S, Scarallo L, Antoniello LM, Bramuzzo M, Chiaro A, Cisarò F, Contini ACI, De Angelis GL, De Angelis P, Di Nardo G, Felici E, Iuliano S, Macchini F, Mantegazza C, Martelossi S, Oliva S, Parrinello F, Rea F, Pizzol A, Romano C, Russo G, Sansotta N, Lionetti P. Impact of COVID-19 pandemic on pediatric endoscopy: A multicenter study on behalf of the SIGENP Endoscopy Working Group. Dig Liver Dis 2022; 54:572-579. [PMID: 35361566 PMCID: PMC8904157 DOI: 10.1016/j.dld.2022.02.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 02/14/2022] [Accepted: 02/16/2022] [Indexed: 12/11/2022]
Abstract
BACKGROUND Aim of the present report was to investigate the repercussions of COVID-19 pandemic on the procedural volumes and on the main indications of pediatric digestive endoscopy in Italy. METHODS An online survey was distributed at the beginning of December 2020 to Italian digestive endoscopy centers. Data were collected comparing two selected time intervals: the first from 1st of February 2019 to 30th June 2019 and the second from 1st February 2020 to 30th June 2020. RESULTS Responses to the survey came from 24 pediatric endoscopy Units. Globally, a reduction of 37.2% was observed between 2019 and 2020 periods with a significant decrease in median number of procedures (111 vs 57, p < 0.001). Both the median number of procedures performed for new diagnoses and those for follow-up purposes significantly decreased in 2020 (63 vs 36, p < 0.001 and 42 vs 21, p< 0.001, respectively). We reported a drastic reduction of procedures performed for suspected Celiac Disease and Functional Gastrointestinal Disorders (55.1% and 58.0%, respectively). Diagnostic endoscopies for suspected IBD decreased of 15.5%, whereas procedures for Mucosal Healing (MH) assessment reduced of 48.3%. CONCLUSIONS Our study provides real-world data outlining the meaningful impact of COVID-19 on pediatric endoscopy practice in Italy.
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Affiliation(s)
- Sara Renzo
- Gastroenterology and Nutrition Unit, Meyer Children's Hospital, Florence, Italy
| | - Luca Scarallo
- Gastroenterology and Nutrition Unit, Meyer Children's Hospital, Florence, Italy
| | - Luca Maria Antoniello
- Pediatric Surgery Unit and Pediatric Gastroenterology Unit, Department of Women's and Children's Health, University of Padua, Padova, Italy
| | - Matteo Bramuzzo
- Pediatric Gastroenterology, Digestive Endoscopy and Clinical Nutrition Unit, Department of Pediatric, Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
| | - Andrea Chiaro
- Pediatric Gastroenterology and Endoscopy Unit, Institute Giannina Gaslini, Genoa, Italy
| | - Fabio Cisarò
- Pediatric Gastroenterology Unit, Regina Margherita Children's Hospital, Azienda Ospedaliera-Universitaria, Città della Salute e della Scienza di Torino, Turin, Italy
| | | | - Gian Luigi De Angelis
- Gastroenterology and Endoscopy Unit, University Hospital of Parma, University of Parma, Parma, Italy
| | - Paola De Angelis
- Digestive Surgery and Endoscopy Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Giovanni Di Nardo
- Sapienza University of Rome, NESMOS Department, Pediatric Unit, Sant'Andrea University Hospital, Italy
| | - Enrico Felici
- Pediatric and Pediatric Emergency Unit, "Umberto Bosio" Center for Digestive Diseases, The Children Hospital, AO SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Silvia Iuliano
- Gastroenterology and Endoscopy Unit, University Hospital of Parma, University of Parma, Parma, Italy
| | - Francesco Macchini
- Department of Pediatric Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Cecilia Mantegazza
- Digestive Endoscopic Unit, Department of Pediatrics and Pediatric Surgery, University of Milan, Buzzi Children's hospital, Italy
| | | | - Salvatore Oliva
- Maternal and Child Health Department, Pediatric Gastroenterology and Liver Unit, Sapienza - University of Rome, Rome, Italy
| | - Flavia Parrinello
- Pediatric Gastroenterology and Endoscopy Unit, Institute Giannina Gaslini, Genoa, Italy
| | - Francesca Rea
- Digestive Surgery and Endoscopy Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Antonio Pizzol
- Pediatric Department, Ospedale Ca' Foncello, Treviso, Italy
| | - Claudio Romano
- Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology, University of Messina, Italy
| | - Giusy Russo
- Maternal and Child Health Department, Pediatric Gastroenterology and Liver Unit, Sapienza - University of Rome, Rome, Italy
| | - Naire Sansotta
- Pediatric Hepatology Gastroenterology and Transplantation, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Paolo Lionetti
- Gastroenterology and Nutrition Unit, Meyer Children's Hospital, Florence, Italy; Department NEUROFARBA, University of Florence, Florence, Italy.
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Archer J, McCarthy LP, Symons HE, Watson NA, Orton CM, Browne WJ, Harrison J, Moseley B, Philip KEJ, Calder JD, Shah PL, Bzdek BR, Costello D, Reid JP. Comparing aerosol number and mass exhalation rates from children and adults during breathing, speaking and singing. Interface Focus 2022; 12:20210078. [PMID: 35261733 PMCID: PMC8831083 DOI: 10.1098/rsfs.2021.0078] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 01/04/2022] [Indexed: 12/14/2022] Open
Abstract
Aerosol particles of respirable size are exhaled when individuals breathe, speak and sing and can transmit respiratory pathogens between infected and susceptible individuals. The COVID-19 pandemic has brought into focus the need to improve the quantification of the particle number and mass exhalation rates as one route to provide estimates of viral shedding and the potential risk of transmission of viruses. Most previous studies have reported the number and mass concentrations of aerosol particles in an exhaled plume. We provide a robust assessment of the absolute particle number and mass exhalation rates from measurements of minute ventilation using a non-invasive Vyntus Hans Rudolf mask kit with straps housing a rotating vane spirometer along with measurements of the exhaled particle number concentrations and size distributions. Specifically, we report comparisons of the number and mass exhalation rates for children (12-14 years old) and adults (19-72 years old) when breathing, speaking and singing, which indicate that child and adult cohorts generate similar amounts of aerosol when performing the same activity. Mass exhalation rates are typically 0.002-0.02 ng s-1 from breathing, 0.07-0.2 ng s-1 from speaking (at 70-80 dBA) and 0.1-0.7 ng s-1 from singing (at 70-80 dBA). The aerosol exhalation rate increases with increasing sound volume for both children and adults when both speaking and singing.
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Affiliation(s)
| | | | | | - Natalie A. Watson
- Department of Ear, Nose and Throat Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Christopher M. Orton
- Department of Respiratory Medicine, Royal Brompton Hospital, London, UK
- Department of Respiratory Medicine, Chelsea and Westminster Hospital, London, UK
- National Heart and Lung Institute, Imperial College London, Guy Scadding Building, London, UK
| | | | | | - Benjamin Moseley
- Department of Respiratory Medicine, Chelsea and Westminster Hospital, London, UK
| | - Keir E. J. Philip
- Department of Respiratory Medicine, Royal Brompton Hospital, London, UK
- National Heart and Lung Institute, Imperial College London, Guy Scadding Building, London, UK
| | - James D. Calder
- Department of Bioengineering, Imperial College London, London, UK
- Fortius Clinic, Fitzhardinge Street, London, UK
| | - Pallav L. Shah
- Department of Respiratory Medicine, Royal Brompton Hospital, London, UK
- Department of Respiratory Medicine, Chelsea and Westminster Hospital, London, UK
- National Heart and Lung Institute, Imperial College London, Guy Scadding Building, London, UK
| | | | - Declan Costello
- Ear, Nose and Throat Department, Wexham Park Hospital, Slough, UK
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Li Y, Fu Y, Zhang Y, Yu S, Luo J, Li Y, Wang C, Zhu J, Li H. An overview of COVID-19 aerosol box for preventing droplet and aerosol contaminations in healthcare providers performing airway intubation. Drug Dev Ind Pharm 2022; 47:1693-1699. [PMID: 35285771 DOI: 10.1080/03639045.2022.2053984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The COVID-19 is caused by the SARS-CoV-2, which is extremely infectious. Numerous virologist suggestions and guidelines advised using P2/N95 masks, gloves, goggles, face-shields, and frocks or gowns as routine specific protective tools during airway management to protect healthcare personnel from infection (PPE). However, numerous imitation research has indicated that conventional PPE cannot adequately protect healthcare personnel. Since then, numerous firms and healthcare professionals have created their personal reformed devices "aerosol containment devices" (ACD). Their usage has expanded throughout the world without being properly evaluated for usefulness, efficacy, or safety. The practice of "ACD" has been shown to make tracheal intubation (TI) more problematic in several simulated tests. Furthermore, the device should limit the transmission of droplets from a patient; however, it might put healthcare personnel at danger of being exposed to greater levels of viral aerosols. Consequently, the existing state of information suggests that "ACD" deprived of a vacuum mechanism can simply protect healthcare personnel against viral transmission to a limited extent. We search various databases for the literatures with keywords "COVID-19", "aerosol box", "aerosol contaminations" and "droplet contaminations. The current review focused on the aerosol box from various perspectives, including their mechanism, optimum time of use, the spread of aerosol control, current gaps and future perspective for bridging those gaps.
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Affiliation(s)
- Yan Li
- The outpatient department, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, China
| | - Yujun Fu
- Institute of Tropical Medicine, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, China
| | - Yunwei Zhang
- Institute of Tropical Medicine, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, China
| | - Shuai Yu
- Institute of Tropical Medicine, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, China
| | - Jinhong Luo
- Institute of Tropical Medicine, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, China
| | - Yuanyuan Li
- Institute of Tropical Medicine, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, China
| | - Caihong Wang
- Institute of Tropical Medicine, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, China
| | - Jingjing Zhu
- Institute of Tropical Medicine, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, China
| | - Huiling Li
- Institute of Tropical Medicine, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, China.,Hainan Clinical Medical school of Southern Medical University, Sanya, Hainan, China
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Janssens H, Heytens S, Meyers E, De Schepper E, De Sutter A, Devleesschauwer B, Formukong A, Keirse S, Padalko E, Geens T, Cools P. Pre-vaccination SARS-CoV-2 seroprevalence among staff and residents of nursing homes in Flanders (Belgium) in fall 2020. Epidemiol Infect 2022; 150:1-25. [PMID: 35234113 PMCID: PMC8943225 DOI: 10.1017/s095026882200036x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 02/14/2022] [Accepted: 02/18/2022] [Indexed: 11/15/2022] Open
Abstract
Seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) IgG antibodies, using dried blood spots, was determined in October–November 2020, among residents and staff randomly selected from 20 nursing homes (NH) geographically distributed in Flanders, Belgium. Sociodemographic and medical data [including coronavirus disease 2019 (COVID-19) symptoms and results of RT-PCR tests] were retrieved using questionnaires. The overall seroprevalence was 17.1% [95% confidence interval (CI) 14.9–19.5], with 18.9% (95% CI 15.9–22.2) of the residents and 14.9% (95% CI 11.9–18.4) of the staff having antibodies, which was higher than the seroprevalence in blood donors. The seroprevalence in the 20 NH varied between 0.0% and 45.0%. Fourteen per cent of the staff with antibodies, reported no typical COVID-19 symptoms, while in residents, 51.0% of those with antibodies had no symptoms. The generalised mixed effect model showed a positive association between COVID-19 symptoms and positive serology, but this relation was weaker in residents compared to staff. This study shows that NH are more affected by SARS-CoV-2 than the general population. The large variation between NH, suggests that some risk factors for the spread among residents and staff may be related to the NH. Further, the results suggest that infected people, without the typical COVID-19 symptoms, might play a role in outbreaks.
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Affiliation(s)
- Heidi Janssens
- Research and Analytics, Liantis, Belgium
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Stefan Heytens
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Eline Meyers
- Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Ellen De Schepper
- Biostatistics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - An De Sutter
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Sciences, Ghent University, Merelbeke, Belgium
| | - Asangwing Formukong
- Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | | | - Elizaveta Padalko
- Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Department of Medical Microbiology, Ghent University Hospital, Ghent, Belgium
| | - Tom Geens
- Research and Analytics, Liantis, Belgium
| | - Piet Cools
- Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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Zhang S, Wang B, Yin L, Wang S, Hu W, Song X, Feng H. Novel Evidence Showing the Possible Effect of Environmental Variables on COVID-19 Spread. GEOHEALTH 2022; 6:e2021GH000502. [PMID: 35317468 PMCID: PMC8923516 DOI: 10.1029/2021gh000502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 11/09/2021] [Accepted: 11/17/2021] [Indexed: 06/09/2023]
Abstract
Coronavirus disease (COVID-19) remains a serious issue, and the role played by meteorological indicators in the process of virus spread has been a topic of academic discussion. Previous studies reached different conclusions due to inconsistent methods, disparate meteorological indicators, and specific time periods or regions. This manuscript is based on seven daily meteorological indicators in the NCEP reanalysis data set and COVID-19 data repository of Johns Hopkins University from 22 January 2020 to 1 June 2021. Results showed that worldwide average temperature and precipitable water (PW) had the strongest correlation (ρ > 0.9, p < 0.001) with the confirmed COVID-19 cases per day from 22 January to 31 August 2020. From 22 January to 31 August 2020, positive correlations were observed between the temperature/PW and confirmed COVID-19 cases/deaths in the northern hemisphere, whereas negative correlations were recorded in the southern hemisphere. From 1 September to 31 December 2020, the opposite results were observed. Correlations were weak throughout the near full year, and weak negative correlations were detected worldwide (|ρ| < 0.4, p ≤ 0.05); the lag time had no obvious effect. As the latitude increased, the temperature and PW of the maximum confirmed COVID-19 cases/deaths per day generally showed a decreasing trend; the 2020-year fitting functions of the response latitude pattern were verified by the 2021 data. Meteorological indicators, although not a decisive factor, may influence the virus spread by affecting the virus survival rates and enthusiasm of human activities. The temperature or PW threshold suitable for the spread of COVID-19 may increase as the latitude decreases.
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Affiliation(s)
- Sixuan Zhang
- College of Atmospheric ScienceChengdu University of Information TechnologyChengduChina
| | - Bingyun Wang
- College of Atmospheric ScienceChengdu University of Information TechnologyChengduChina
| | - Li Yin
- Panzhihua Central HospitalPanzhihuaChina
| | - Shigong Wang
- College of Atmospheric ScienceChengdu University of Information TechnologyChengduChina
- Zunyi Academician Work CenterZunyiChina
| | - Wendong Hu
- College of Atmospheric ScienceChengdu University of Information TechnologyChengduChina
| | - Xueqian Song
- College of ManagementChengdu University of Information TechnologyChengduChina
| | - Hongmei Feng
- College of Atmospheric ScienceChengdu University of Information TechnologyChengduChina
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46
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Dusefante A, Negro C, D’Agaro P, Segat L, Purpuri A, Cegolon L, Larese Filon F. Occupational Risk Factors for SARS-CoV-2 Infection in Hospital Health Care Workers: A Prospective Nested Case-Control Study. Life (Basel) 2022; 12:life12020263. [PMID: 35207550 PMCID: PMC8874671 DOI: 10.3390/life12020263] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/02/2022] [Accepted: 02/03/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction: Health Care Workers (HCWs) are at a particular high risk of SARS-CoV-2 infection due to direct and indirect exposure to COVID-19 patients and Aerosol-Generating Procedures (AGPs). The aim of the study was to assess the risk factors for SARS-CoV-2 infection in HCWs exposed to COVID-19 patients, to evaluate the adherence and effectiveness of Infection Prevention and Control (IPC) measures, to describe the clinical presentation for SARS-CoV-2 infection in HCWs and to determine serological responses in HCWs. Methods: HCWs exposed to COVID-19 patients during the previous 14 days with a confirmed case status were recruited as cases; HCWs exposed to COVID-19 patients during the previous 14 days in the same ward without a suspected/probable/confirmed case status were recruited as controls. Serum samples were collected as soon as possible and after 21–28 days from all participants. Data were collected with a WHO standardized questionnaire as soon as possible and after 21–28 days. Results: All social, occupational and personal variables considered were not associated with an increased risk of SARS-CoV-2 infection. Conclusions: Our study showed a high knowledge of IPC measures and very high PPE use among HCWs.
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Affiliation(s)
- Alex Dusefante
- Clinical Unit of Occupational Medicine, Department of Medical, Surgical & Health Sciences, University of Trieste, 34129 Trieste, Italy; (C.N.); (A.P.); (F.L.F.)
- Correspondence: (A.D.); (L.C.)
| | - Corrado Negro
- Clinical Unit of Occupational Medicine, Department of Medical, Surgical & Health Sciences, University of Trieste, 34129 Trieste, Italy; (C.N.); (A.P.); (F.L.F.)
| | - Pierlanfranco D’Agaro
- Hygiene & Public Health Clinical Unit, Department of Medical, Surgical & Health Sciences, University of Trieste, 34129 Trieste, Italy;
- Hygiene & Public Health Clinical Unit, Department of Laboratory, University Health Agency Giuliano-Isontina (ASUGI), 34129 Trieste, Italy;
| | - Ludovica Segat
- Hygiene & Public Health Clinical Unit, Department of Laboratory, University Health Agency Giuliano-Isontina (ASUGI), 34129 Trieste, Italy;
| | - Antonio Purpuri
- Clinical Unit of Occupational Medicine, Department of Medical, Surgical & Health Sciences, University of Trieste, 34129 Trieste, Italy; (C.N.); (A.P.); (F.L.F.)
| | - Luca Cegolon
- Clinical Unit of Occupational Medicine, Department of Medical, Surgical & Health Sciences, University of Trieste, 34129 Trieste, Italy; (C.N.); (A.P.); (F.L.F.)
- Public Health Department, University Health Agency Giuliano-Isontina (ASUGI), 34129 Trieste, Italy
- Correspondence: (A.D.); (L.C.)
| | - Francesca Larese Filon
- Clinical Unit of Occupational Medicine, Department of Medical, Surgical & Health Sciences, University of Trieste, 34129 Trieste, Italy; (C.N.); (A.P.); (F.L.F.)
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47
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Wilson NM, Cook TM, Tovey ER. Effect of frequency and amplitude of respiratory activity on aerosol emissions. Anaesthesia 2022; 77:609-611. [PMID: 35139239 DOI: 10.1111/anae.15683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 11/26/2022]
Affiliation(s)
- N M Wilson
- Royal Infirmary of Edinburgh, Edinburgh, UK
| | - T M Cook
- Royal United Hospitals NHS Trust, Bath, UK
| | - E R Tovey
- Woolcock Institute of Medical Research, Sydney, Australia
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48
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Crimi C, Pierucci P, Renda T, Pisani L, Carlucci A. High-Flow Nasal Cannula and COVID-19: A Clinical Review. Respir Care 2022; 67:227-240. [PMID: 34521762 PMCID: PMC9993935 DOI: 10.4187/respcare.09056] [Citation(s) in RCA: 48] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
During the coronavirus disease 2019 (COVID-19) pandemic, noninvasive respiratory support has played a central role in managing patients affected by moderate-to-severe acute hypoxemic respiratory failure, despite inadequate scientific evidence to support its usage. High-flow nasal cannula (HFNC) treatment has gained popularity because of its effectiveness in delivering a high fraction of humidified oxygen, which improves ventilatory efficiency and the respiratory pattern, as well as its reported high tolerability, ease of use, and application outside of ICUs. Nevertheless, the risk of infection transmission to health-care workers has raised some concerns about its use in the first wave of the pandemic outbreak, with controversial recommendations provided by different scientific societies. This narrative review provides an overview of the recent evidence on the physiologic rationale, risks, and benefits of using HFNC instead of conventional oxygen therapy and other types of noninvasive respiratory support devices, such as continuous positive airway pressure and noninvasive ventilation in patients affected by COVID-19 pneumonia with associated acute hypoxemic respiratory failure. It also summarizes the available evidence with regard to the clinical use of HFNC during the current pandemic and its reported outcomes, and highlights the risks of bioaerosol dispersion associated with HFNC use.
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Affiliation(s)
- Claudia Crimi
- Respiratory Medicine Unit, "Policlinico-Vittorio Emanuele-San Marco," University Hospital, Catania, Italy.
| | - Paola Pierucci
- Respiratory Medicine Unit, Policlinico "Aldo Moro" University Hospital, Bari, Italy
| | - Teresa Renda
- Respiratory and Critical Care Unit, Cardio-thoracic and Vascular Department, Careggi Teaching Hospital, Florence, Italy
| | - Lara Pisani
- Respiratory and Critical Care Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, University Hospital Sant'Orsola-Malpighi, Bologna, Italy
- Department of Clinical, Integrated and Experimental Medicine, Alma Mater Studiorum University, Bologna, Italy
| | - Annalisa Carlucci
- Department of Medicine and Surgery, Università Insubria, Varese-Como, Italy
- Pulmonary Rehabilitation Unit, Istituti Clinici Scientifici Maugeri, Pavia, Italy
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Mehmood R, Mansoor Z, Atanasov GP, Cheian A, Davletova A, Patel A, Ahmed D. High-Flow Nasal Oxygenation and Its Applicability in COVID Patients. SN COMPREHENSIVE CLINICAL MEDICINE 2022; 4:49. [PMID: 35128319 PMCID: PMC8801314 DOI: 10.1007/s42399-022-01132-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 01/26/2022] [Indexed: 11/24/2022]
Abstract
High-flow nasal oxygenation (HFNO) is a type of oxygen therapy that provides humidified and heated oxygen through a nasal cannula at much higher flow rates than standard oxygen therapy, while also allowing control over the fraction of inspired oxygen (FIO2). Compared to standard oxygen therapy, it is much more comfortable for the patient and seems to alleviate most of the problems associated with standard oxygen therapy, such as dry nose, dry throat and nasal pain. It also provides a variety of benefits that can reduce the incidence of escalating treatment and initiating mechanical ventilation in COVID patients with acute hypoxemic respiratory failure (AHRF). This article provides an overview of HFNO and its current applications in COVID patients during the pandemic.
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Affiliation(s)
- Raafay Mehmood
- First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Zainab Mansoor
- First Faculty of Medicine, Charles University, Prague, Czech Republic
| | | | - Alexei Cheian
- First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Alina Davletova
- First Faculty of Medicine, Charles University, Prague, Czech Republic
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DERİN O, AKSOY N, ÇAYDAŞI O, YILMAZ M, MERT A. A Multi-center Retrospective Analysis of Healthcare Workers after COVID-19: Epidemiological and Clinical Features. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2022. [DOI: 10.33808/clinexphealthsci.1012880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Objective: Concerns regarding the high-level risk of infection among healthcare workers (HCWs) increased after COVID19 was declared as a pandemic in March 2020. Inadequate infection control owing to a shortage of personal protective equipment or an inconvenient usage of infection control measures may play a significant role in transmission to/among healthcare personnel. The study aimed to determine the characteristics and outcomes of COVID-19 patients who are healthcare workers along with possible transmission routes of COVID-19 in four different healthcare facilities in Istanbul.
Methods: All hospital records were reviewed retrospectively. Demographic and clinical characteristics of HCWs were documented, and all infected HCWs were subjected to a phone-based mini-questionnaire and three-dimensional test (TDT). All statistical analyses were done using statistical packages SPSS Demo Ver 22 (SPSS Inc. Chicago, IL, USA).
Results: Clinical features of COVID-19 were similar to the general public’s characteristics. The most frequent symptoms were cough, fever, and headache. HCWs with the O blood group tend to have asymptomatic COVID-19 infection. Hospital workers other than medical professionals have a lack of convenience of infection control measures. The median duration of PCR negativity was 9 days. HCWs who had a sore throat at the beginning of COVID-19 have a longer PCR-positive duration.
Conclusion: Understanding the clinical features or characteristics of asymptomatic COVID-19 carriers may aid in the implementation of a feasible screening program for early detection. It is strongly advised that proper infection control precautions, education, and auditing of nonclinical staff be implemented. As a result, transmission among healthcare workers can be avoided.
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