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 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 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 SARS-CoV-2 Seroprevalence in Healthcare Workers in Germany: A Follow-Up Study

2021 ◽  
Vol 18 (9) ◽  
pp. 4540
Author(s):  
Johannes Korth ◽  
Benjamin Wilde ◽  
Sebastian Dolff ◽  
Jasmin Frisch ◽  
Michael Jahn ◽  
...  
Keyword(s):  
High Risk ◽  
Healthcare Workers ◽  
Risk Group ◽  
Close Contact ◽  
Virus Transmission ◽  
High Risk Group ◽  
Low Risk ◽  
University Hospital ◽  
Intermediate Risk ◽  
Igg Antibody

SARS-CoV-2 is a worldwide challenge for the medical sector. Healthcare workers (HCW) are a cohort vulnerable to SARS-CoV-2 infection due to frequent and close contact with COVID-19 patients. However, they are also well trained and equipped with protective gear. The SARS-CoV-2 IgG antibody status was assessed at three different time points in 450 HCW of the University Hospital Essen in Germany. HCW were stratified according to contact frequencies with COVID-19 patients in (I) a high-risk group with daily contacts with known COVID-19 patients (n = 338), (II) an intermediate-risk group with daily contacts with non-COVID-19 patients (n = 78), and (III) a low-risk group without patient contacts (n = 34). The overall seroprevalence increased from 2.2% in March–May to 4.0% in June–July to 5.1% in October–December. The SARS-CoV-2 IgG detection rate was not significantly different between the high-risk group (1.8%; 3.8%; 5.5%), the intermediate-risk group (5.1%; 6.3%; 6.1%), and the low-risk group (0%, 0%, 0%). The overall SARS-CoV-2 seroprevalence remained low in HCW in western Germany one year after the outbreak of COVID-19 in Germany, and hygiene standards seemed to be effective in preventing patient-to-staff virus transmission.

scholarly journals The impact of SARS-CoV-2 transmission fear and COVID-19 pandemic on the mental health of patients with primary immunodeficiency disorders, severe asthma, and other high-risk groups (Preprint)

2020 ◽  
Author(s):  
Fatih Çölkesen ◽  
Oguzhan Kilincel ◽  
Mehmet Sozen ◽  
Eray Yıldız ◽  
Sengul Beyaz ◽  
...  
Keyword(s):  
Mental Health ◽  
High Risk ◽  
Severe Asthma ◽  
Primary Immunodeficiency ◽  
Healthcare Workers ◽  
Depression Scale ◽  
High Risk Group ◽  
Primary Immunodeficiency Disorder ◽  
Significant Difference ◽  
The Impact

BACKGROUND The adverse effects of COVID-19 pandemic on the mental health of high-risk group patients for morbidity and mortality and its impact on public health in the long term have not been clearly determined. OBJECTIVE To determine the level of COVID-19 related transmission fear and anxiety in healthcare workers and patients with primary immunodeficiency disorder (PID), severe asthma, and the ones with other comorbidities. METHODS The healthcare workers and patients with PID, severe asthma (all patients receiving biological agent treatment), malignancy, cardiovascular disease, hypertension (90% of patients receiving ACEI or ARB therapy), diabetes mellitus (42 % of patients receiving DPP-4 inhibitor therapy) were included in the study. A total of 560 participants, 80 individuals in each group, were provided. The hospital anxiety and depression scale ( HADS ) and Fear of illness and virus evaluation (FIVE ) scales were applied to the groups with face to face interview methods. RESULTS The mean age was 49.30 years and 306 (55 %) were female. The FIVE Scale and HADS-A scale scores of health care workers were significantly higher than other groups' scores (p = 0.001 and 0.006). The second-highest scores belonged to patients with PID. There was no significant difference between the groups for the HADS-D score (p=0.07). The lowest score in all scales was observed in patients with hypertension. CONCLUSIONS This study demonstrated that in the pandemic process, patients with primary immunodeficiency, asthma patients, and other comorbid patients, especially healthcare workers, should be referred to the centers for the detection and treatment of mental health conditions.

Suicide and Fatal Accidents in Multiple Sclerosis

1973 ◽  
Vol 3 (4) ◽  
pp. 291-293 ◽  
Author(s):  
Melvin L. Schwartz ◽  
Margaret Pierron
Keyword(s):  
Multiple Sclerosis ◽  
High Risk ◽  
Suicidal Behavior ◽  
Risk Group ◽  
High Risk Group ◽  
Neurological Symptoms ◽  
Fatal Accidents ◽  
Neurologic Diseases ◽  
Life Threatening

Certificates of 408 deaths listing multiple sclerosis as cause were analyzed for co-existence of suicide and fatal accidents. Four suicides occurred, all in females, ages 30 to 49. Four of an additional six accidental deaths were related to heat, smoke, burns or fire. In addition to identifying the high risk group, hypothetical correlations between neurological symptoms in MS and life-threatening behaviors were drawn as a prediction schema for suicidal behavior in other neurologic diseases.

Wound care during the COVID-19 pandemic: improving outcomes through the integration of telemedicine

2021 ◽  
Vol 30 (Sup2) ◽  
pp. S12-S17
Author(s):  
Alisha Oropallo ◽  
John Lantis ◽  
Alexander Martin ◽  
Ammar Al Rubaiay ◽  
Na Wang
Keyword(s):  
High Risk ◽  
Healthcare System ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Wound Care ◽  
Protective Equipment ◽  
Medical Resources ◽  
Social Distancing ◽  
Vulnerable Patients ◽  
Rapid Spread

COVID-19 is highly contagious and its rapid spread burdens the healthcare system. As the number of confirmed cases goes up, the shortage of medical resources has become a challenge. To avoid the collapse of the healthcare system during the fight with COVID-19, all healthcare workers, including wound care practitioners, should adapt to new roles and use any appropriate methods available to slow the spread of the virus. Integrating telemedicine into wound care during the outbreak helps maintain social distancing, preserve personal protective equipment and medical resources, and eliminate unnecessary exposure for both vulnerable patients and high-risk healthcare workers.

scholarly journals From Resilience to Burnout in Healthcare Workers During the COVID-19 Emergency: The Role of the Ability to Tolerate Uncertainty

2021 ◽  
Vol 12 ◽  
Author(s):  
Michela Di Trani ◽  
Rachele Mariani ◽  
Rosa Ferri ◽  
Daniela De Berardinis ◽  
Maria G. Frigo
Keyword(s):  
High Risk ◽  
Healthcare Workers ◽  
Linear Models ◽  
Short Form ◽  
Maslach Burnout Inventory ◽  
Well Being ◽  
High Risk Group ◽  
Lazio Region ◽  
Resilience Scale ◽  
The Impact

The COVID-19 outbreak has placed extraordinary demands upon healthcare systems worldwide. Italy's hospitals have been among the most severely overwhelmed, and as a result, Italian healthcare workers' (HCWs) well-being has been at risk. The aim of this study is to explore the relationships between dimensions of burnout and various psychological features among Italian healthcare workers (HCWs) during the COVID-19 emergency. A group of 267 HCWs from a hospital in the Lazio Region completed self-administered questionnaires online through Google Forms, including the Maslach Burnout Inventory (MBI), Resilience Scale, and Intolerance of Uncertainty Scale Short Form (IU). Cluster analysis highlighted two opposite burnout risk profiles: low burnout and high-risk burnout. The high-risk group had lower resilience and greater difficulties in tolerating the uncertainty than the low-burnout group. A set of general linear models confirmed that both IU subscales, prospective and inhibition, moderated the relationship between resilience and burnout (specifically in the depersonalization dimension). In conclusion, the results showed that individual levels of resilience and one's ability to tolerate uncertainty have been significant factors in determining the impact of the COVID-19 emergency on HCWs. The use of emotional strategies that allow individuals to stay in a critical situation without the need to control it appears to protect against burnout in these circumstances.

scholarly journals The impact of SARS-CoV-2 transmission fear and COVID-19 pandemic on the mental health of patients with primary immunodeficiency disorders, severe asthma, and other high-risk groups

2020 ◽  
Author(s):  
Fatih Çölkesen ◽  
Oğuzhan Kılınçel ◽  
Mehmet Sözen ◽  
Eray Yıldız ◽  
Şengül Beyaz ◽  
...  
Keyword(s):  
Mental Health ◽  
High Risk ◽  
Severe Asthma ◽  
Primary Immunodeficiency ◽  
Healthcare Workers ◽  
Depression Scale ◽  
High Risk Group ◽  
Primary Immunodeficiency Disorder ◽  
Significant Difference ◽  
The Impact

AbstractBackgroundThe adverse effects of COVID-19 pandemic on the mental health of high-risk group patients for morbidity and mortality and its impact on public health in the long term have not been clearly determined.ObjectiveTo determine the level of COVID-19 related transmission fear and anxiety in healthcare workers and patients with primary immunodeficiency disorder (PID), severe asthma, and the ones with other comorbidities.MethodsThe healthcare workers and patients with PID, severe asthma (all patients receiving biological agent treatment), malignancy, cardiovascular disease, hypertension (90% of patients receiving ACEI or ARB therapy), diabetes mellitus (42 % of patients receiving DPP-4 inhibitor therapy) were included in the study. A total of 560 participants, 80 individuals in each group, were provided. The hospital anxiety and depression scale (HADS) and Fear of illness and virus evaluation (FIVE) scales were applied to the groups with face to face interview methods.ResultsThe mean age was 49.30 ± 13.74 years and 306 (55 %) were female. The FIVE Scale and HADS-A scale scores of health care workers were significantly higher than other groups scores (p = 0.001 and 0.006). The second-highest scores belonged to patients with PID. There was no significant difference between the groups for the HADS-D score (p=0.07). The lowest score in all scales was observed in patients with hypertension.ConclusionsThis study demonstrated that in the pandemic process, patients with primary immunodeficiency, asthma patients, and other comorbid patients, especially healthcare workers, should be referred to the centers for the detection and treatment of mental health conditions.

Wound care during the COVID-19 pandemic: improving outcomes through the integration of telemedicine

2021 ◽  
Vol 3 (Sup4) ◽  
pp. S14-S20
Author(s):  
Alisha Oropallo ◽  
John Lantis ◽  
Alexander Martin ◽  
Ammar Al Rubaiay ◽  
Na Wang
Keyword(s):  
High Risk ◽  
Healthcare System ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Wound Care ◽  
Protective Equipment ◽  
Medical Resources ◽  
Social Distancing ◽  
Vulnerable Patients ◽  
Rapid Spread

COVID-19 is highly contagious and its rapid spread burdens the healthcare system. As the number of confirmed cases goes up, the shortage of medical resources has become a challenge. To avoid the collapse of the healthcare system during the fight with COVID-19, all healthcare workers, including wound care practitioners, should adapt to new roles and use any appropriate methods available to slow the spread of the virus. Integrating telemedicine into wound care during the outbreak helps maintain social distancing, preserve personal protective equipment and medical resources, and eliminate unnecessary exposure for both vulnerable patients and high-risk healthcare workers.

Phenotype of Memory HCV CD8+ T Cells in Chronic HCV

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Aisha Yasin ◽  
Hala Talkhan ◽  
Afaf Abd El-Aleem ◽  
Rania Abo Shady ◽  
Rania El-Kabareety ◽  
...  
Keyword(s):  
T Cells ◽  
High Risk ◽  
Cd8 T Cells ◽  
Healthcare Workers ◽  
Risk Group ◽  
High Risk Group ◽  
Proliferation Index ◽  
Memory Cd8 T Cells ◽  
Specific Memory ◽  
Chronic Hcv

Abstract Background Hepatitis C virus (HCV) infection is a major cause of chronic liver disease, with approximately 71 million chronically infected individuals worldwide. After acute infection, a majority of healthy adults will develop persistent viremia. An infection with HCV activates the immune system to defend the host with a broad range of innate and adaptive immune responses. Cellular immune response shows antiviral immunity by means of virus specific CD8+ T cytotoxic lymphocytes and CD4+ T helper cells. After resolution of infection, a population of the virus-specific memory CD8+ T cells protects the host against reinfection. These subsets of memory cells differ with respect to their anatomical localization, their phenotype and their protective potential. Objectives The aim of the present study is to find out the phenotype pattern of HCV specific memory CD8+ T cells in chronic HCV patients in comparison to HCV exposed seronegative high-risk individuals. Patients and Methods This case control study included 60 individuals categorized into two main groups, (group I) included 20 chronic HCV patients and (group II= control group) included 40 HCV seronegative healthcare workers. Both groups were subjected to carboxyfluorescein diacetate succinimidyl ester (CFSE) proliferation assay in response to HCV specific peptides. Group II was divided into 2 subgroups according to proliferation index (cut-off&lt;2) into, proliferation index +ve high-risk group (+PIHRG) (20 healthcare workers) and proliferation index -ve high-risk group (-PIHRG) (20 healthcare workers). Then flow cytometric analysis of HCV specific CD8+ T cells was done for the all subjects to determine the expression of CD127, CCR7, CD45RO and CD45RA on both proliferating and non-proliferating fractions of cells. Results We found that expression of CD45RA was significantly increased and CCR7 was significantly decreased on HCV CD8+ T cells in the chronic HCV group than in the high risk groups in response to different HCV peptides. Conclusion During persistent viremia in chronic HCV infection subthreshold signal levels established by HCV different proteins provide anergy of virus specific memory CD8+ T cells that are unable to differentiate into full effector cells upon a possible reencounter with the antigen. So, chronic HCV patients in our study showed predominance of less differentiated effector memory phenotype (CD45RA+, CCR7-) in peripheral blood in comparison to HCV exposed seronegative high-risk individuals who don’t show overt infection.

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