scholarly journals 456. Implementing an At-Home Smell Test for Early Assessment of COVID-19 in High-Risk Healthcare Workers

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S295-S296
Author(s):  
Julian J Weiss ◽  
Tuki Attuquayefio ◽  
Elizabeth B White ◽  
Bertie Geng ◽  
Ryan Handoko ◽  
...  
Keyword(s):  
High Risk ◽  
Healthcare Workers ◽  
Low Cost ◽  
Self Report ◽  
Early Assessment ◽  
Symptom Questionnaire ◽  
Olfactory Stimuli ◽  
A Prospective Study ◽  
Smell Loss ◽  
At Home

Abstract Background Smell loss has been recognized as an important, and potentially early, sign of COVID-19. However, to date smell loss has only been assessed in retrospective, COVID+ cohorts, and largely through self-report. The objective of this study was to implement a daily standardized behavioral test of smell sensitivity in healthcare workers (HCW) to capture changes in smell sensitivity over time and to assess whether these changes occur prior to positive COVID test. Methods The study enrolled 500 high-risk COVID-negative HCW during the COVID-19 epidemic in Connecticut, beginning March 28, 2020 (80% F, mean age 38, 58% nurses). Initially, HCW received a daily symptom questionnaire with parosmia screening questions. On April 23 we introduced the “Jiffy”, a daily at-home psychophysical test of smell sensitivity, where olfactory stimuli are sampled and rated for perceived intensity. SARS-CoV-2 infection was tested every three days by PCR of nasopharyngeal swabs or saliva. Screening Questionnaire for Parosmia The “Jiffy” Survey and Test Results Of the first 500 enrolled HCW, 376 HCW (75%) completed the Jiffy 4528 times (mean 12 times/HCW). 17/500 HCW (3.4%) had a COVID+ test, of which 9/17 (53%) reported smell loss through the Jiffy or the daily symptom survey. 6/9 (67%) reported smell loss that preceded or was concurrent with a COVID+ test. 8/17 COVID+ HCW completed the Jiffy, with 5/8 (63%) reporting reductions in smell versus 42/368 (11%) COVID- HCW (OR=13, 95% CI: 2.4–85, p=.001). COVID+ HCW rated their greatest reduction in smell sensitivity as slight (40%) and severe (60%), versus slight (88%) and moderate (12%) in COVID- HCW. 16/17 COVID+ HCW completed a daily symptom survey (mean 14 times/HCW), with 8/16 (50%) ever reporting parosmia versus 90/466 (19%) of COVID- HCW (OR=4.2, 95% CI: 1.3–13, p=.007). Overall, parosmia was the first reported symptom in 3/13 (23%) COVID+ HCW who reported symptoms. Smell Changes in COVID+ and COVID- HCW Reported in the “Jiffy” Test Smell Changes in COVID+ and COVID- HCW Reported in Daily Symptom Questionnaire Smell Changes among COVID+ HCW by Day, Relative to Day of Positive PCR Test Conclusion We conducted a prospective study of smell testing in a population at high risk for COVID-19 using two parallel approaches. Our results demonstrate the feasibility of at-home smell testing for assessing parosmia during COVID-19, in some cases even prior to a positive PCR result. Given the urgent need for widespread, low-cost, non-invasive testing for COVID-19, we are now developing an easy-to-use app to distribute this survey more widely to high-risk populations. Disclosures Julian J. Weiss, BA, Nothing to disclose

scholarly journals Tracking smell loss to identify healthcare workers with SARS-CoV-2 infection

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248025
Author(s):  
Julian J. Weiss ◽  
Tuki N. Attuquayefio ◽  
Elizabeth B. White ◽  
Fangyong Li ◽  
Rachel S. Herz ◽  
...  
Keyword(s):  
High Risk ◽  
Healthcare Workers ◽  
Quantitative Polymerase Chain Reaction ◽  
Asymptomatic Infection ◽  
High Risk Group ◽  
Neurological Symptoms ◽  
Screening Questionnaire ◽  
Vulnerable Patients ◽  
Smell Loss ◽  
At Home

Introduction Healthcare workers (HCW) treating COVID-19 patients are at high risk for infection and may also spread infection through their contact with vulnerable patients. Smell loss has been associated with SARS-CoV-2 infection, but it is unknown whether monitoring for smell loss can be used to identify asymptomatic infection among high risk individuals. In this study we sought to determine if tracking smell sensitivity and loss using an at-home assessment could identify SARS-CoV-2 infection in HCW. Methods and findings We performed a prospective cohort study tracking 473 HCW across three months to determine if smell loss could predict SARS-CoV-2 infection in this high-risk group. HCW subjects completed a longitudinal, behavioral at-home assessment of olfaction with household items, as well as detailed symptom surveys that included a parosmia screening questionnaire, and real-time quantitative polymerase chain reaction testing to identify SARS-CoV-2 infection. Our main measures were the prevalence of smell loss in SARS-CoV-2-positive HCW versus SARS-CoV-2-negative HCW, and timing of smell loss relative to SARS-CoV-2 test positivity. SARS-CoV-2 was identified in 17 (3.6%) of 473 HCW. HCW with SARS-CoV-2 infection were more likely to report smell loss than SARS-CoV-2-negative HCW on both the at-home assessment and the screening questionnaire (9/17, 53% vs 105/456, 23%, P < .01). 6/9 (67%) of SARS-CoV-2-positive HCW reporting smell loss reported smell loss prior to having a positive SARS-CoV-2 test, and smell loss was reported a median of two days before testing positive. Neurological symptoms were reported more frequently among SARS-CoV-2-positive HCW who reported smell loss compared to those without smell loss (9/9, 100% vs 3/8, 38%, P < .01). Conclusions In this prospective study of HCW, self-reported changes in smell using two different measures were predictive of SARS-CoV-2 infection. Smell loss frequently preceded a positive test and was associated with neurological symptoms.

scholarly journals Tracking Smell Loss to Identify Healthcare Workers with SARS-CoV-2 Infection

2020 ◽  
Author(s):  
Julian J Weiss ◽  
Tuki N Attuquayefio ◽  
Elizabeth B White ◽  
Fangyong Li ◽  
Rachel S Herz ◽  
...  
Keyword(s):  
High Risk ◽  
Healthcare Workers ◽  
Asymptomatic Infection ◽  
High Risk Group ◽  
Neurological Symptoms ◽  
Screening Questionnaire ◽  
Vulnerable Patients ◽  
Smell Function ◽  
Smell Loss ◽  
At Home

Background: Healthcare workers (HCW) treating COVID-19 patients are at high risk for infection and may also spread infection through their contact with vulnerable patients. Smell loss has been associated with SARS-CoV-2 infection, but it is unknown whether monitoring for smell loss can be used to identify asymptomatic infection among high risk individuals, like HCW. Methods: We performed a prospective cohort study, tracking 473 HCW across three months to determine if smell loss could predict SARS-CoV-2 infection in this high-risk group. HCW subjects completed a longitudinal, novel behavioral at-home assessment of smell function with household items, as well as detailed symptom surveys that included a parosmia screening questionnaire, and RT-qPCR testing to identify SARS-CoV-2 infection. Results: SARS-CoV-2 was identified in 17 (3.6%) of 473 HCW. Among the 17 infected HCW, 53% reported smell loss, and were more likely to report smell loss than COVID-negative HCW on both the at-home assessment and the screening questionnaire (P < .01). 67% reported smell loss prior to having a positive SARS-CoV-2 test, and smell loss was reported a median of two days before testing positive. Neurological symptoms were reported more frequently among COVID-positive HCW who reported smell loss (P < .01). Conclusions: In this prospective study of HCW, self-reported changes in smell using two different measures were predictive of COVID-19 infection. Smell loss frequently preceded a positive test and was associated with neurological symptoms.

scholarly journals Differences Between the Psychiatric Symptoms of Healthcare Workers Quarantined at Home and in the Hospital After Contact With a Patient With Middle East Respiratory Syndrome

2021 ◽  
Vol 12 ◽  
Author(s):  
Su Jeong Seong ◽  
Hyung Joon Kim ◽  
Kyung Mi Yim ◽  
Ji Won Park ◽  
Kyung Hoon Son ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Middle East ◽  
Healthcare Workers ◽  
Acute Stress ◽  
Psychiatric Symptoms ◽  
Middle East Respiratory Syndrome ◽  
Self Report ◽  
Effective Measure ◽  
Psychiatric Problems ◽  
At Home

Objective: Although quarantine is an effective measure for the prevention of the spread of infectious diseases, it may have negative effects on the mental health of the isolated individual. During the 2015 outbreak of the Middle East Respiratory Syndrome (MERS) in Korea, healthcare workers came in contact with patients with MERS were quarantined either at home or in a hospital ward. In this study, we aimed to compare the psychiatric symptoms of these employees according to the method of quarantine.Methods: All 146 quarantined staff completed self-report questionnaires. Depressive symptoms were measured using the Patient Health Questionnaire-9, anxiety symptoms were assessed using Spielberger's State-Trait Anxiety Inventory, and acute stress disorder (ASD) symptoms were evaluated using the Stanford Acute Stress Reaction Questionnaire.Results: The in-hospital quarantine group had a higher rate of symptoms of depression (p &lt; 0.001) and ASD (p = 0.014) than the group quarantined at home. Logistic regression analysis showed that respondents quarantined in the hospital (OR = 6.342; 95% CI 1.853–21.708) and those quarantined for longer periods (OR = 1.153, 95% CI = 1.036–1.285) had a higher risk of depressive symptoms.Conclusions: In-hospital quarantine and quarantine for longer periods increase the risk of depressive symptoms. When quarantine measures are taken, certain measures are needed to minimize the risk of psychiatric problems. Appropriate interventions should be implemented if psychiatric problems occur.

scholarly journals The Nightmare Disorder Index: development and initial validation in a sample of nurses

SLEEP ◽  
2020 ◽  
Author(s):  
Jessica R Dietch ◽  
Daniel J Taylor ◽  
Kristi Pruiksma ◽  
Sophie Wardle-Pinkston ◽  
Danica C Slavish ◽  
...  
Keyword(s):  
High Risk ◽  
Psychosocial Functioning ◽  
Healthcare Workers ◽  
Self Report ◽  
Sleep Diaries ◽  
Dsm 5 ◽  
High Risk Populations ◽  
Good Internal Consistency ◽  
Nightmare Disorder ◽  
Report Measure

Abstract Study Objectives Nurses are a group at high risk for nightmares, yet little is known about the rate of nightmare disorder and associated psychosocial factors in this group in part attributable to the lack of a self-report questionnaire to assess DSM-5 criteria for nightmare disorder. Aims of the current study were to (1) report on development and initial validity of a self-report measure of DSM-5 nightmare disorder, and (2) examine the rate and associated factors of nightmare disorder among nurses. Methods Nurses (N = 460) completed baseline measures online including Nightmare Disorder Index (NDI), psychosocial and demographic questionnaires. A subset (n = 400) completed 14 days of sleep diaries and actigraphy. Results NDI demonstrated satisfactory psychometric characteristics as indicated by good internal consistency (α = 0.80), medium inter-item correlations (r = 0.50), medium to large item-total (r = 0.55–0.85) and convergent correlations (0.32–0.45), and small to medium discriminant correlations (–0.12–0.33). Per NDI, 48.7% of nurses reported no nightmares in the past month, 43.9% met partial/subthreshold criteria and 7.4% met full criteria for probable nightmare disorder. Nurses with nightmare disorder demonstrated significantly poorer psychosocial functioning (i.e. posttraumatic stress, depression, anxiety, stress) than those with subthreshold nightmare symptoms, who had poorer functioning than those with no nightmares. Conclusions NDI is an efficient and valid self-report assessment of nightmare disorder. Nurses have high rates of nightmares and nightmare disorder which are associated with poorer psychosocial functioning. We recommend increased nightmare screening particularly for high-risk populations such as healthcare workers.

scholarly journals Could In-Home Sensors Surpass Human Observation of People with Parkinson’s at High Risk of Falling? An Ethnographic Study

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Emma Stack ◽  
Rachel King ◽  
Balazs Janko ◽  
Malcolm Burnett ◽  
Nicola Hammersley ◽  
...  
Keyword(s):  
High Risk ◽  
Wearable Sensors ◽  
Ethnographic Study ◽  
Self Report ◽  
Risk Of Falling ◽  
Open Spaces ◽  
Everyday Activity ◽  
Limited Mobility ◽  
Field Notes ◽  
At Home

Self-report underpins our understanding of falls among people with Parkinson’s (PwP) as they largely happen unwitnessed at home. In this qualitative study, we used an ethnographic approach to investigatewhichin-home sensors, inwhichlocations, could gather useful data about fall risk. Over six weeks, we observed five independently mobile PwP at high risk of falling, at home. We made field notes about falls (prior events and concerns) and recorded movement with video, Kinect, and wearable sensors. The three women and two men (aged 71 to 79 years) having moderate or severe Parkinson’s were dependent on others and highly sedentary. We most commonly noted balance protection, loss, and restoration during chair transfers, walks across open spaces and through gaps, turns, steps up and down, and tasks in standing (all evident walking between chair and stairs, e.g.). Our unobtrusive sensors were acceptable to participants: they could detect instability during everyday activity at home and potentially guide intervention. Monitoring the route between chair and stairs is likely to give information without invading the privacy of people at high risk of falling, with very limited mobility, who spend most of the day in their sitting rooms.

scholarly journals Psychological Distress and Post-Traumatic Symptomatology among Dental Healthcare Workers in Russia: Results of a Pilot Study

2021 ◽  
Vol 18 (2) ◽  
pp. 708 ◽  
Author(s):  
Maria Sarapultseva ◽  
Alena Zolotareva ◽  
Igor Kritsky ◽  
Natal’ya Nasretdinova ◽  
Alexey Sarapultsev
Keyword(s):  
Psychological Distress ◽  
Healthcare Workers ◽  
Mental Health Problems ◽  
Clinical Symptoms ◽  
Stress Disorders ◽  
Self Report ◽  
Ptsd Symptoms ◽  
Event Scale ◽  
Post Traumatic ◽  
The Impact

The spread of SARS-CoV-2 infection has increased the risk of mental health problems, including post-traumatic stress disorders (PTSD), and healthcare workers (HCWs) are at greater risk than other occupational groups. This observational cross-sectional study aimed to explore the symptoms of depression, anxiety, and PTSD among dental HCWs in Russia during the coronavirus disease 2019 (COVID-19) pandemic. The survey was carried out among 128 dental HCWs from three dental clinics of Ekaterinburg, Russia. The mean age of the sample was 38.6 years. Depression, anxiety, and stress were assessed using the Depression Anxiety and Stress Scale-21 (DASS-21); PTSD was assessed using the PTSD Symptom Scale-Self-Report (PSS-SR); subjective distress was assessed using the Impact of Event Scale-Revised (IES-R). The results indicated that 20.3–24.2% HCWs had mild to extremely severe symptoms of psychological distress, and 7.1–29.7% had clinical symptoms of PTSD. No differences between females and males were revealed. HCWs working directly with patients had significantly higher levels of PTSD symptoms and the risk of PTSD development compared to those working indirectly, whereas older HCWs had significantly higher levels of both psychological distress and PTSD symptoms compared to younger HCWs. Thus, dental HCWs are at high risk for psychological distress and PTSD symptoms during the COVID-19 pandemic.

scholarly journals Evaluation of a home-based 7-day infection control strategy for healthcare workers following high-risk exposure to severe acute respiratory coronavirus virus 2 (SARS-CoV-2): A cohort study

2020 ◽  
pp. 1-4
Author(s):  
Carla Benea ◽  
Laura Rendon ◽  
Jesse Papenburg ◽  
Charles Frenette ◽  
Ahmed Imacoudene ◽  
...  
Keyword(s):  
High Risk ◽  
Infection Control ◽  
Control Strategy ◽  
Healthcare Workers ◽  
Control Strategies ◽  
Risk Exposure ◽  
Nasopharyngeal Swab ◽  
Home Based ◽  
Respiratory Coronavirus ◽  
Second Wave

Abstract Objective: Evidence-based infection control strategies are needed for healthcare workers (HCWs) following high-risk exposure to severe acute respiratory coronavirus virus 2 (SARS-CoV-2). In this study, we evaluated the negative predictive value (NPV) of a home-based 7-day infection control strategy. Methods: HCWs advised by their infection control or occupational health officer to self-isolate due to a high-risk SARS-CoV-2 exposure were enrolled between May and October 2020. The strategy consisted of symptom-triggered nasopharyngeal SARS-CoV-2 RNA testing from day 0 to day 7 after exposure and standardized home-based nasopharyngeal swab and saliva testing on day 7. The NPV of this strategy was calculated for (1) clinical coronavirus disease 2019 (COVID-19) diagnosis from day 8–14 after exposure, and for (2) asymptomatic SARS-CoV-2 detected by standardized nasopharyngeal swab and saliva specimens collected at days 9, 10, and 14 after exposure. Interim results are reported in the context of a second wave threatening this essential workforce. Results: Among 30 HCWs enrolled, the mean age was 31 years (SD, ±9), and 24 (80%) were female. Moreover, 3 were diagnosed with COVID-19 by day 14 after exposure (secondary attack rate, 10.0%), and all cases were detected using the 7-day infection control strategy: the NPV for subsequent clinical COVID-19 or asymptomatic SARS-CoV-2 detection by day 14 was 100.0% (95% CI, 93.1%–100.0%). Conclusions: Among HCWs with high-risk exposure to SARS-CoV-2, a home-based 7-day infection control strategy may have a high NPV for subsequent COVID-19 and asymptomatic SARS-CoV-2 detection. Ongoing data collection and data sharing are needed to improve the precision of the estimated NPV, and here we report interim results to inform infection control strategies in light of a second wave threatening this essential workforce.

scholarly journals Household transmission and incidence of positive SARS-CoV-2 RT-PCR in symptomatic healthcare workers, clinical course and outcome: a French hospital experience

2020 ◽  
pp. oemed-2020-106866
Author(s):  
Evguenia Krastinova ◽  
Valérie Garrait ◽  
Marie-Thérèse Lecam ◽  
André Coste ◽  
Emmanuelle Varon ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Current Smoker ◽  
Infection Rates ◽  
Rt Pcr ◽  
Living Situation ◽  
Household Transmission ◽  
Occupational Profile ◽  
Household Members ◽  
French Hospital ◽  
At Home

ObjectivesAlthough healthcare workers (HCWs) have been particularly affected by SARS-CoV-2, detailed data remain scarce. In this study, we investigated infection rates, clinical characteristics, occupational exposure and household transmission among all symptomatic HCWs screened by SARS-CoV-2 RT-PCR between 17 March (French lockdown) and 20 April.MethodsSARS-CoV-2 RT-PCR was proposed to symptomatic (new cough or dyspnoea) HCWs at Creteil Hospital in one of the Parisian suburbs most severely affected by COVID-19. Data on occupational profile, living situation and household, together with self–isolation and mask use at home were collected, as well as the number of cases in the household.ResultsThe incidence rate of symptomatic SARS-CoV-2 was estimated to be 5% (110/2188). A total of 110 (35%) of the 314 HCWs tested positive and 9 (8%) were hospitalised. On multivariate analysis, factors independently associated with positive RT-PCR were occupational profile with direct patient facing (OR 3.1, 95% CI 1.1 to 8.8), p<0.03), and presence of anosmia (OR 5.7, 95% CI 3.1 to 10.6), p<0.0001). Being a current smoker was associated with negative RT-PCR (OR 0.3, 95% CI 0.1 to 0.7), p=0.005). Transmission from HCWs to household members was reported in 9 (14%) cases, and 2 deaths occurred. Overall, self-isolation was possible in 52% of cases, but only 31% of HCWs were able to wear a mask at home.ConclusionThis is the first study to report infection rates among HCWs during the peak of the SARS-CoV-2 epidemic in France and the lockdown period, highlighting the risk related to occupational profile and household transmission.

scholarly journals CHARGE-AF in a national routine primary care electronic health records database in the Netherlands: validation for 5-year risk of atrial fibrillation and implications for patient selection in atrial fibrillation screening

Open Heart ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e001459
Author(s):  
Jelle C L Himmelreich ◽  
Wim A M Lucassen ◽  
Ralf E Harskamp ◽  
Claire Aussems ◽  
Henk C P M van Weert ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Primary Care ◽  
High Risk ◽  
The Netherlands ◽  
Patient Selection ◽  
Low Cost ◽  
Calibration Plot ◽  
Primary Care Data ◽  
C Statistic ◽  
Kaplan Meier

AimsTo validate a multivariable risk prediction model (Cohorts for Heart and Aging Research in Genomic Epidemiology model for atrial fibrillation (CHARGE-AF)) for 5-year risk of atrial fibrillation (AF) in routinely collected primary care data and to assess CHARGE-AF’s potential for automated, low-cost selection of patients at high risk for AF based on routine primary care data.MethodsWe included patients aged ≥40 years, free of AF and with complete CHARGE-AF variables at baseline, 1 January 2014, in a representative, nationwide routine primary care database in the Netherlands (Nivel-PCD). We validated CHARGE-AF for 5-year observed AF incidence using the C-statistic for discrimination, and calibration plot and stratified Kaplan-Meier plot for calibration. We compared CHARGE-AF with other predictors and assessed implications of using different CHARGE-AF cut-offs to select high-risk patients.ResultsAmong 111 475 patients free of AF and with complete CHARGE-AF variables at baseline (17.2% of all patients aged ≥40 years and free of AF), mean age was 65.5 years, and 53% were female. Complete CHARGE-AF cases were older and had higher AF incidence and cardiovascular comorbidity rate than incomplete cases. There were 5264 (4.7%) new AF cases during 5-year follow-up among complete cases. CHARGE-AF’s C-statistic for new AF was 0.74 (95% CI 0.73 to 0.74). The calibration plot showed slight risk underestimation in low-risk deciles and overestimation of absolute AF risk in those with highest predicted risk. The Kaplan-Meier plot with categories <2.5%, 2.5%–5% and >5% predicted 5-year risk was highly accurate. CHARGE-AF outperformed CHA2DS2-VASc (Cardiac failure or dysfunction, Hypertension, Age >=75 [Doubled], Diabetes, Stroke [Doubled]-Vascular disease, Age 65-74, and Sex category [Female]) and age alone as predictors for AF. Dichotomisation at cut-offs of 2.5%, 5% and 10% baseline CHARGE-AF risk all showed merits for patient selection in AF screening efforts.ConclusionIn patients with complete baseline CHARGE-AF data through routine Dutch primary care, CHARGE-AF accurately assessed AF risk among older primary care patients, outperformed both CHA2DS2-VASc and age alone as predictors for AF and showed potential for automated, low-cost patient selection in AF screening.

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