P611 Incidence, clinical presentation, and severity of SARS-CoV-2 infection in IBD patients in the second and the third wave of infection

Abstract Background Data about the SARS-CoV-2 infection in inflammatory bowel disease patients (IBD) are scarce. Our aim was to analyse the incidence, clinical presentation, and severity of SARS-CoV-2 infection in IBD patients in the second and the third wave of infection. Methods Cross-sectional, observational study in IBD patients with confirmed SARS-CoV-2 infection by RCP and/or antigen tests from 01 July 2020 to 01 March 2021. All data were collected by telephone interview and reviewing the electronical medical records. Results Fifty-one of 805 IBD patients followed in our Unit were diagnosed of SARS-CoV-2 infection in this period (6.3%; 95% CI 4.6–8.0). Mean age: 45±13 years old; 56.9% female, 23.5% smokers, 56.9% Crohn’s disease, 29.4% comorbidities and 17.6% asymptomatic. Digestive symptoms were reported in 22 patients (43.1%), with diarrhoea as the most common (39.2%, median duration: 4 days; IQR 1–7). The most frequent symptoms other than diarrhoea were low-grade fever/fever in 43.1% (median duration: 3 days; IQR 1–6.5) and dysosmia/dysgeusia in 39.2% (median duration: 15 days; IQR 7–30). Only one patient (2%) was diagnosed with IBD flare-up during infection. Six patients (11.8%) temporarily withdrew their IBD treatment because of COVID-19. Most of the patients had a mild disease (88.2%), no patient had to be admitted in the intensive care unit. Only one patient died (2%) due to SARS-CoV-2 infection and multiple previous comorbidities, 52 years old male with ulcerative colitis in treatment with Mesalazine and dendritic cell sarcoma, common variable inmunodefiency, and primary sclerosing cholangitis progressing to cirrhosis. In the multivariate analysis, the presence of dyspnoea was associated with more severe infection (p=0.007; OR:25.7; 95% CI 2.4–277.8). Patients on immunomodulators and/or biological therapy did not have more severe disease compared to non-immunosuppressed patients (p>0.05). Conclusion SARS-CoV-2 infection was relatively frequent is our series. Dyspnoea was associated with a more severe infection. Severity of SARS-CoV-2 infection was not related to immunosuppression or development of IBD flare-ups and only a small percentage of patients needed to modify IBD medication during infection

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Breakthrough Infection among Fully Vaccinated Physicians Working in COVID-19 Treatment Centers; Prevalence, Presenting Symptoms, Co-Morbidities and Outcome in the Third Wave of Epidemics in Myanmar

Journal of Biomedical Research & Environmental Sciences ◽

10.37871/jbres1303 ◽

2021 ◽

Vol 2 (8) ◽

pp. 721-730

Author(s):

Khin Phyu Pyar ◽

Sai Aik Hla ◽

Soe Min Aung ◽

Di Wunn ◽

Zar Ni Htet Aung ◽

...

Keyword(s):

Health Care ◽

Sore Throat ◽

Severe Infection ◽

Third Wave ◽

Breakthrough Infection ◽

Symptomatic Infection ◽

Cross Sectional ◽

Runny Nose ◽

Presenting Symptoms ◽

The Third

Background: Coronavirus Disease 2019 (COVID-19), emerged in China at the end of 2019, became a major threat to health around the world. Breakthrough infection following COVID-19 vaccine has clinical and public health significance. The highest groups at risk of infection during the COVID-19 pandemic is health care workers; the physicians are the frontline workers. This study aimed to assess the prevalence of breakthrough COVID-19 infection and their clinical presentation, co-morbidities and outcome among physicians who were fully vaccinated, working in COVID-19 treatment centers in Myanmar. Methods: A cross-sectional descriptive study was conducted among physicians, at least 14 days after receiving second dose, working at COVID-19 treatment centers in Myanmar, during the third wave from end of May to August 2021. Data were collected by using standardized forms and analysis was done. Results: Among 410 physicians, 98.2% (221/225) received two dose of vaccination: Covaxin 90.0%, Covishield 9.5% and Sputink V 0.5%. They received first dose of vaccine in January/February 2021 and second dose in March/April 2021. In Myanmar, third wave started in end of May; the largest pandemic surge had reached its peak in July, 2021. In the third wave, most of them 72.9% (161/221) did not experience no infection. The prevalence of fully vaccinated break through infection was 27.1% (60/221); the majority 78.3% (47/60) were mild symptomatic infection. Severe infection was seen in 10% of physicians with breakthrough infection who required hospital admission and oxygen therapy. The common presenting symptoms in order of frequency were body aches and pain 62.6%, sneezing 56.6%, headache 53.5%, cough 52.5%, sore throat 45.5%, anosmia 33.3%, runny nose 23.2% and loose motion 27.3%. The uncommon symptoms were dyspnoea 9.1%, vertigo 6.1%, skin rash 5.1%, vomiting 5.1%, petechiae 3.0%, tinnitus 3.0% and silent hypoxia 3.0%, and non-per-os 1%. Most of them did not have any significant comorbidities. One out of six physicians having severe infection had diabetes mellitus and two were obese. The mean duration of hospital stay was 7 days. None of the cases was fatal. Conclusions: In this study, over 98% of physicians were fully vaccinated; majority with Covaxin. One in four physicians had breakthrough infection in third wave; mainly mild form. Nearly half of them had possible delta symptoms; aches and pain, sneezing, runny nose, headache, cough, and sore throat. Awareness of rare but important symptoms like Non-per-Os and vertigo should be highlighted both to public and health care personnel. Ten percent of physicians with breakthrough infection were severe. Mortality rate was zero.

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Perceived Stress and Increased Food Consumption during the ‘Third Wave’ of the COVID-19 Pandemic in Spain

Nutrients ◽

10.3390/nu13072380 ◽

2021 ◽

Vol 13 (7) ◽

pp. 2380

Author(s):

Eduardo Sánchez-Sánchez ◽

Jara Díaz-Jimenez ◽

Ignacio Rosety ◽

Maria José M. Alférez ◽

Antonio Jesús Díaz ◽

...

Keyword(s):

Food Consumption ◽

Perceived Stress ◽

High Stress ◽

Cross Sectional Study ◽

Third Wave ◽

Sectional Study ◽

Cross Sectional ◽

Stress Scale ◽

The Third ◽

Moderate Stress

The COVID-19 pandemic has impacted the mental health of people worldwide. An increase in perceived stress can lead to unhealthy behaviors such as increased food consumption. The aim of this study was to find the level of perceived stress and its relationship with increased food consumption during the “third wave” of the COVID-19 pandemic in Spain. This was a cross-sectional study that employed anonline self-reported frequency of consumption questionnaire and the Perceived Stress Scale-10. A total of 637 subjects participated and 83.6% of respondents had moderate or high stress—more prevalent in the female and young respondents. Moreover, 36.1% of respondents reported that they had increased the frequency of consumption of some foods, mainly nuts, snacks, and jellybeans, along with coffee, tea, cocoa, and soft drinks. Eating between meals was more pronounced in those with high stress (65.1%) than in those with moderate stress (40.4%) and low stress (20.2%). Furthermore, the respondents with high stress reported greater weight gain. Thus, the results show that the level of perceived stress during the ‘third wave’ of this pandemic increased food consumption.

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P070 TRENDS AND CHARACTERISTICS OF CLINICAL TRIALS PARTICIPATION IN THE IBD PARTNERS COHORT

Inflammatory Bowel Diseases ◽

10.1093/ibd/zaa010.027 ◽

2020 ◽

Vol 26 (Supplement_1) ◽

pp. S11-S12

Author(s):

Cole Johnson ◽

Edward Barnes ◽

Xian Zhang ◽

Millie Long

Keyword(s):

Clinical Trials ◽

Controlled Trial ◽

Severe Disease ◽

Drug Approval ◽

Cross Sectional Study ◽

Participation Rates ◽

Cross Sectional ◽

Mild Disease ◽

Randomized Controlled ◽

Study Results

Abstract Background and Aims There are currently several recruitment challenges in randomized controlled trials (RCT) for inflammatory bowel disease (IBD) which prolong the drug approval process and affect the generalizability of study results. The purpose of this study is to characterize individuals who participate in IBD RCTs and identify factors which could influence future recruitment strategies. Methods We performed a cross-sectional study within the IBD Partners cohort comparing patients with current or prior participation in an interventional randomized controlled trial (RCT) of a medical therapy for IBD to those without any RCT participation. Bivariate statistics were used to compare RCT participation by IBD subtype and by other demographic and disease characteristics, and predictive modeling was used to identify factors predictive of RCT participation. We calculated the percent of the cohort that participated an in RCT during each calendar year from 2011–2018 and Clinicaltrials.gov was accessed to determine the number of active RCTs for IBD therapies per year during that same period. Results A total of 14,747 patients with IBD were included in the analysis and 1,116 (7.6%) reported RCT participation at any time. Demographic factors predictive of RCT participation (Table 1) included following at an academic institution (OR=1.8; 95%CI: 1.51–2.04) and age 36–75 (OR=1.6; 95%CI: 1.43–1.87). Patients with Crohn’s disease (CD) were more likely to participate than those with ulcerative colitis (UC) (OR=1.5; 95%CI: 1.35–1.77). Patients with more severe disease were more likely to participate, including those with prior IBD-related hospitalization (OR=2.6; 95%CI: 2.19–2.99), IBD-related surgery (OR=2.5; 95%CI: 2.24–2.87), biologic exposure (OR=3.2; 95%CI: 2.76–3.65), and “Poor” or worse quality of life (OR=1.7; 95%CI: 1.45–1.93). Steroid-free remission was associated with lower likelihood of RCT participation (OR=0.6; 95%CI: 0.53–0.70). While the number of active RCTs for IBD more than doubled between 2011 and 2018, RCT participation rates during that same time period decreased from 1.1% to 0.7% of the cohort (Figure 1). Conclusions RCT participation rates declined within this cohort between 2011–2018. Groups underrepresented in RCTs for IBD included younger patients, patients followed in community settings, and patients with more mild disease. The non-RCT group had mean sCDAI and SCCAI scores that did not meet remission thresholds, demonstrating populations in need of alternate therapies for whom clinical trials could be an option. Given anti-TNF exposure rates in this national cohort, studies should focus on anti-TNF failure populations. Investigators should make every effort to offer RCTs to all patients and network with community providers to increase awareness of RCTs.

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COVID-19 Infection among Older People Admitted to Hospital: A Cross-Sectional Analysis

Geriatrics ◽

10.3390/geriatrics6010025 ◽

2021 ◽

Vol 6 (1) ◽

pp. 25

Author(s):

Chiann Ni Thiam ◽

Kejal Hasmukharay ◽

Wan Chieh Lim ◽

Chai Chen Ng ◽

Gordon Hwa Mang Pang ◽

...

Keyword(s):

Older People ◽

Severe Disease ◽

Severe Infection ◽

University Hospital ◽

Hospital Treatment ◽

Comorbid Condition ◽

Complication Rates ◽

Inpatient Mortality ◽

Local Data ◽

Cross Sectional

(1) Background: Older people with COVID-19 infection report worse clinical outcomes. There is a paucity of local data and this study aimed to describe the clinical progression of older people admitted to a university hospital in Malaysia with COVID-19 infection. (2) Methods: Older people (≥60 years) admitted with COVID-19 infection confirmed with RT-PCR from 27 February 2020–25 May 2020 were included in this study. Data on patient characteristics, hospital treatment, and inpatient outcomes were collected via hospital-held electronic medical records. Analysis was done to describe the cohort and identify factors associated with inpatient mortality. (3) Results: 26 participants were included (mean age 76.2 years, female 57.7%). All had at least one comorbid condition and half were frail. About 19.2% had non-respiratory (atypical) symptoms; 23.1% had a severe disease that required intensive care unit monitoring; 46.2% were given COVID-19 targeted therapy. Inpatient mortality and overall complication rates were 23.1% and 42.3%, respectively. Delirium on presentation and lower Ct-value were associated with mortality. (4) Conclusions: Older people with COVID-19 infection have severe infection and poor hospital outcomes. Vigilant hospital care is necessary to address their multimorbidity and frailty, along with appropriate treatment for their infection.

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Time trends in social contacts of individuals according to comorbidity and vaccination status, before and during the COVID-19 pandemic: repeated cross-sectional population-based surveys

10.1101/2021.12.02.21267205 ◽

2021 ◽

Author(s):

Aurélie Godbout ◽

Mélanie Drolet ◽

Myrto Mondor ◽

Marc Simard ◽

Chantal Sauvageau ◽

...

Keyword(s):

Time Trends ◽

Population Based ◽

Vaccination Status ◽

Physical Contact ◽

Third Wave ◽

Cross Sectional ◽

Social Contacts ◽

The Third ◽

Significant Difference ◽

Second Wave

ABSTRACTObjectivesTo describe time trends in social contacts of individuals according to comorbidity and vaccination status before and during the first three waves of the COVID-19 pandemic in Quebec, Canada.DesignRepeated cross-sectional population-based surveys.SettingGeneral population.ParticipantsNon-institutionalized adults from Quebec, Canada, recruited by random digit dialling before (2018/2019) and during the pandemic (April 2020 to July 2021). A total of 1441 and 5185 participants with and without comorbidities, respectively, were included in the analyses.Main outcome measuresNumber of social contacts (two-way conversation at a distance ≤2 meters or a physical contact, irrespective of masking) documented in a self-administered web-based questionnaire. We compared the mean number of contacts according to the comorbidity status of participants (pre-existing medical conditions with symptoms/medication in the past 12 months) and 1-dose vaccination status during the third wave. All analyses were performed using weighted generalized linear models with a Poisson distribution and robust variance.ResultsContacts significantly decreased from a mean of 6.1 (95% confidence interval 4.9 to 7.3) before the pandemic to 3.2 (2.5 to 3.9) during the first wave among individuals with comorbidities, and from 8.1 (7.3 to 9.0) to 2.7 (2.2 to 3.2) among individuals without comorbidities. Individuals with comorbidities maintained fewer contacts than those without comorbidities in the second wave, with a significant difference before the Christmas 2020/2021 holidays (2.9 (2.5 to 3.2) v 3.9 (3.5 to 4.3); P<0.001). During the third wave, contacts were similar for individuals with (4.1, 3.4 to 4.7) and without comorbidities (4.5, 4.1 to 4.9; P=0.27). This could be partly explained by individuals with comorbidities vaccinated with their first dose who increased their contacts to the level of those without comorbidities.ConclusionsThe lower level of contacts maintained by individuals with comorbidities could have influenced the burden of hospitalisations and deaths of the second wave in Quebec. It will be important to closely monitor COVID-19-related outcomes and social contacts by comorbidity and vaccination status to inform targeted or population-based interventions.

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Exploring t he Relationship Between “COVID-19” Experiences and People’s Health Anxiety: Evidence from the Third Wave of COVID-19

Journal of Human Ecology ◽

10.31901/24566608.2021/74.1-3.3315 ◽

2021 ◽

Vol 74 (1-3) ◽

Author(s):

Aman Ullah

Keyword(s):

Logistic Regression Model ◽

Multivariate Analyses ◽

Health Anxiety ◽

Primary Data ◽

Third Wave ◽

Cross Sectional ◽

The Third ◽

Sustained Recovery ◽

The Relationship ◽

Structured Questionnaire

ABSTRACT The current study aims to explore and investigate the relationship between the experiences of COVID-19 and health anxiety among people. The study design adopted in this study was cross-sectional and primary data were collected from 500 respondents through a structured questionnaire in District Mardan-Pakistan. Bivariate and Multivariate analyses were carried out for measuring the relationship between “COVID-19” experiences and health anxiety, while cause and effects of the mentioned variables were analysed through a logistic regression model. The findings of the study revealed that the prevalence of health anxiety was found highly significant with the “COVID-19” experience. It has been inferred from the study’s findings that those people who experienced “COVID-19” had symptoms of health anxiety. The prevalence of health anxiety was found highly significant with “COVID-19” among older people. Establishing psychological and rehabilitation centres for sustained recovery of the “COVID-19” affected people, has also been suggested.

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Clinical Characteristics and degree of severity of COVID-19 in Hemodialysis Patients in Armed Forces Institute of Urology.

Pakistan Journal of Kidney Diseases ◽

10.53778/pjkd54169 ◽

2021 ◽

Vol 5 (4) ◽

pp. PP1-6

Author(s):

Saba Umar ◽

Sohail Sabir ◽

Khalid Raja ◽

Khurram Mansoor ◽

Tanveer Sajid ◽

...

Keyword(s):

Abdominal Pain ◽

Clinical Characteristics ◽

Severe Disease ◽

Armed Forces ◽

Hemodialysis Patients ◽

Maintenance Hemodialysis ◽

Cross Sectional ◽

Mild Disease ◽

Spread Of Infection ◽

Degree Of Severity

Introduction This study was conducted to evaluate the clinical characteristics and severity of COVID -19 in hemodialysis patients at from 1st March 2020 to 15th August 2020. Methodology It was a prospective and Cross Sectional Observational Study. We collected data prospectively that includes all patients on maintenance hemodialysis and reviewed clinical characteristics of those with laboratory-confirmed COVID-19 between March 1and August 15, 2020. Results 39 out of 268 dialysis dependent patients had COVID-19. Mean age of patients was 55.9yrs. Only 35.8% patients were symptomatic. 15 out of 39 were having mild disease,12 had moderate and 12 had severe disease. Females (54.5%) were found to be more affected than males(45.5%). Dry cough was the commonest symptom (53.8%) followed by fever (46.1%) and abdominal pain(18.1%). Patients with multiple comorbidities were found to have severe disease. Conclusion We concluded that patients receiving maintenance hemodialysis are susceptible to COVID-19 and that hemodialysis centers are high risk for spread of infection. Isolating patients with COVID-19 can help in preventing the spread of COVID-19.

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Universal testing for COVID-19 in patients undergoing cancer treatment during the second outbreak in Brescia

Tumori Journal ◽

10.1177/03008916211034917 ◽

2021 ◽

pp. 030089162110349

Author(s):

Stefano M. Magrini ◽

Andrea E. Guerini ◽

Paolo Borghetti ◽

Giulia Volpi ◽

Luca Triggiani ◽

...

Keyword(s):

Clinical Presentation ◽

Severe Disease ◽

High Rate ◽

Mild Disease ◽

Patients With Cancer ◽

Universal Testing ◽

Antineoplastic Treatment ◽

Asymptomatic Infections ◽

Testing Schedule ◽

The Impact

Background: The impact of coronavirus disease 2019 (COVID-19) has been overwhelming on patients with cancer, who may be at higher risk of developing severe disease. During the second COVID-19 outbreak in Italy, we planned universal microbiologic screening for patients scheduled for antineoplastic treatment. Methods: All patients with planned active treatment at Brescia University Radiation Oncology Department were screened for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA with repeated nasopharyngeal swabs (NPS) from October 31, 2020. Treatment continuation, suspension, or delay was modulated for patients testing positive according to clinical presentation. Results: From October 31, 2020, to February 6, 2021, 636 patients were enrolled and 1243 NPS were performed, of which 28 (2.25%) were positive. The infection rate was 2.52%; 81.3% of the patients with a positive NPS were asymptomatic, 2 had mild disease, and 1 severe disease that led to death. All patients already on treatment with mild or asymptomatic COVID-19 carried on the therapy with no or minimal delay. Median delay for patients with infection detected before treatment start was 16.5 days. Conclusions: Detected incidence of COVID-19 was lower during the second outbreak in our patients (2.52% vs 3.23%), despite the extensive testing schedule, and substantiates the high rate of asymptomatic infections and the low mortality among patients with COVID-19 (6.3% vs 38.5% during the first outbreak). Universal SARS-CoV-2 screening for all patients with planned treatment might allow early identification of patients with COVID-19, resulting in timely management that could improve clinical outcomes and prevent spread of the infection.

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Duration of COVID-19: Data from an Italian Cohort and Potential Role for Steroids

Microorganisms ◽

10.3390/microorganisms8091327 ◽

2020 ◽

Vol 8 (9) ◽

pp. 1327 ◽

Cited By ~ 1

Author(s):

Damiano D’Ardes ◽

Michela Pontolillo ◽

Lucia Esposito ◽

Mara Masciarelli ◽

Andrea Boccatonda ◽

...

Keyword(s):

Median Duration ◽

Lymphocyte Count ◽

Potential Role ◽

Disease Duration ◽

Clinical Presentation ◽

Severe Disease ◽

Viral Shedding ◽

Severe Clinical Presentation ◽

Clinical Healing ◽

Italian Cohort

The diffusion of SARS-CoV-2, starting from China in December 2019, has led to a pandemic, reaching Italy in February 2020. Previous studies in Asia have shown that the median duration of SARS-CoV-2 viral shedding was approximately 12–20 days. We considered a cohort of patients recovered from COVID-19 showing that the median disease duration between onset and end of COVID-19 symptoms was 27.5 days (interquartile range (IQR): 17.0–33.2) and that the median duration between onset of symptoms and microbiological healing, defined by two consecutive negative nasopharyngeal swabs, was 38 days (IQR: 31.7–50.2). A longer duration of COVID-19 with delayed clinical healing (symptom-free) occurred in patients presenting at admission a lower PaO2/FiO2 ratio (p < 0.001), a more severe clinical presentation (p = 0.001) and a lower lymphocyte count (p = 0.035). Moreover, patients presenting at admission a lower PaO2/FiO2 ratio and more severe disease showed longer viral shedding (p = 0.031 and p = 0.032, respectively). In addition, patients treated with corticosteroids had delayed clinical healing (p = 0.013).

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CLINICAL PROFILE OF COVID-19 PATIENTS ADMITTED IN A TERTIARY CARE COVID HOSPITAL-AN OBSERVATIONAL STUDY

10.36106/ijar/3007073 ◽

2020 ◽

pp. 15-16

Author(s):

S. Durga Prasad ◽

K.V. Seshaiah ◽

K.S.S.S.Surya Prakash ◽

N. Lavanya ◽

Ch.Akhil Reddy ◽

...

Keyword(s):

Observational Study ◽

Viral Infections ◽

Clinical Symptoms ◽

Severe Disease ◽

Tertiary Care ◽

Care Hospital ◽

Cross Sectional ◽

Multiple Systems ◽

Mild Disease ◽

System Methodology

BACKGROUND: Since the origin of Covid-19, a plethora of symptoms have been described in the past few months, which indicate involvement of multiple systems with much more impact on the respiratory system. METHODOLOGY: We retrospectively evaluated from the medical records of 100 Covid-19 patients diagnosed with RT-PCR. It was a cross-sectional observational study of Covid-19 patients admitted in our tertiary COVID care hospital, Vijayawada, Andhra Pradesh during the period of two months i.e.,01-04-2020 to 31-05-2020. RESULTS: We observed the different clinical symptoms with varying frequency in Covid-19 patients. In our study the clinical symptoms in the descending order of frequency were fever (59%), cough (48%), diarrhoea (6%), dyspnoea (4%), running nose (3%), headache (3%), chest pain (1%). These symptoms are not specific to covid-19 but similar to those found in other viral infections. CONCLUSION: Based on clinical picture, disease has been classified as mild, moderate and severe. More than 80% patients have mild disease and will recover.14% will have severe disease and 5% will progress to respiratory failure, shock and multiorgan dysfunction.1-2% are fatal.

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