scholarly journals Characterizing the COVID-19 illness experience to inform the study of post-acute sequalae and recovery: a qualitative study

2021 ◽  
Author(s):  
Edda I. Santiago-Rodriguez ◽  
Andres Maiorana ◽  
Michael J. Peluso ◽  
Rebecca Hoh ◽  
Viva Tai ◽  
...  
Keyword(s):  
Psychological Distress ◽  
San Francisco ◽  
Information Seeking ◽  
Acute Infection ◽  
Recovery Process ◽  
Health Impact ◽  
Nucleic Acid Amplification ◽  
Illness Experience ◽  
Symptomatic Infection ◽  
Novel Coronavirus

AbstractWe aimed to characterize the variability in the illness experience and recovery process from COVID-19. We conducted in-depth individual interviews with participants enrolled in the Long-term Immunological Impact of Novel Coronavirus (LIINC) cohort study in San Francisco, California from June through October of 2020. Participants were adults who had a previously confirmed positive SARV-CoV-2 nucleic acid amplification test result, had recovered or were recovering from acute infection, and underwent serial evaluations at our clinical research center. We purposefully sampled 24 English- and Spanish-speaking adults with asymptomatic, mild and severe symptomatic infection, including those who were hospitalized, and those with HIV co-infection. Half of our sample (50.0%) identified as Latinx/Hispanic and most of the participants were men (62.5%). We used thematic analysis to characterize the illness experience, recovery process, and mental health impact of experiencing COVID-19 and present clinical data for each participant. Emergent themes were: (1) across symptom profiles and severity, experiencing COVID-19 was associated with psychological distress, (2) among participants with symptomatic infection, the illness experience was characterized by uncertainty in terms of managing symptoms and recovery, and (3) despite wide-ranging illness experiences, participants shared many common characteristics, including health information-seeking behavior facilitated by access to medical care, and uncertainty regarding the course of their illness and recovery. COVID-19 was associated with elevated levels of psychological distress, regardless of symptoms.

scholarly journals Beyond Overdose: Drug-Related Deaths in People With and Without HIV in San Francisco, 2007–2018

2020 ◽  
Vol 7 (12) ◽  
Author(s):  
Ayesha Appa ◽  
Christopher Rowe ◽  
Nancy A Hessol ◽  
Phillip Coffin
Keyword(s):  
San Francisco ◽  
Infection Prevention ◽  
Acute Infection

Abstract Despite elevated mortality in people with HIV (PWH) using drugs, drug-related deaths are poorly characterized. Among 6764 drug-related deaths, methamphetamine was more common in PWH than others. One in 4 deaths in PWH involved acute infection. Combatting mortality in PWH who use drugs should include stimulant-specific and infection prevention efforts.

Unemployment and Health: An Analysis of “Canada Health Survey” Data

1985 ◽  
Vol 15 (4) ◽  
pp. 609-635 ◽  
Author(s):  
Carl D'Arcy ◽  
C. M. Siddique
Keyword(s):  
Psychological Distress ◽  
Low Income ◽  
Emotional Health ◽  
Well Being ◽  
Health Impact ◽  
Health Problems ◽  
Cross Sectional ◽  
Physician Visits ◽  
Health Differences ◽  
The Unemployed

This paper provides a cross-sectional analysis of the physical and emotional well-being of employed and unemployed workers. The data used consists of a sub-sample ( N = 14,313) drawn from the Canada Health Survey's national probability sample ( N = 31,688). The analysis indicates substantial health differences between employed and unemployed individuals. The unemployed showed significantly higher levels of distress, greater short-term and long-term disability, reported a large number of health problems, had been patients more often, and used proportionately more health services. Consistent with these measures, derived from self-reported data, physician-diagnosed measures also indicate a greater vulnerability of unemployed individuals to serious physical ailments such as heart trouble, pain in heart and chest, high blood pressure, spells of faint-dizziness, bone-joint problems and hypertension. While these health differences between the employed and unemployed persisted across socio-economic and demographic conditions, further analysis indicated strong interaction effects of SES and demographic variables on the association of employment status with physical and emotional health. Females and older unemployed individuals reported more health problems and physician visits whereas the younger unemployed (under 40) reported more psychological distress. The blue-collar unemployed were found to be considerably more vulnerable to physical illness whereas the unemployed with professional background reported more psychological distress. The low-income unemployed who were also the principal family earners, were the most psychologically distressed. A regional look at the data showed that the low-income unemployed suffered the most in terms of depressed mood in each region of the country. It is apparent that unemployment and its health impact reflect the wider class-based inequalities of advanced industrial societies. The need for social policies that effectively reduce unemployment and the detrimental impact of unemployment is clear.

scholarly journals Direct fluorescence antibody testing augments syphilis diagnosis, compared to serology alone

2021 ◽  
pp. 095646242110486
Author(s):  
Lauren Orser ◽  
Patrick O’Byrne
Keyword(s):  
Acute Infection ◽  
Nucleic Acid Amplification ◽  
Health Clinic ◽  
Common Symptom ◽  
Antibody Testing ◽  
Syphilis Infection ◽  
Clinical Encounters ◽  
Direct Fluorescence ◽  
Fluorescence Antibody ◽  
Syphilis Serology

In Ottawa, Canada, we initiated protocols to include non-serologic syphilis testing, as direct fluorescence antibody (DFA) for patients with syphilis symptoms. The purpose was to assess the ability of DFA to detect syphilis during acute infection and to determine if non-serologic testing could yield an increased number of syphilis diagnoses. We reviewed charts of patients of our local sexual health clinic for whom syphilis was suspected. A total of 69 clinical encounters were recorded for 67 unique patients, most of whom were male. The most common symptom was a painless genital lesion. Of the 67 patients, 29 were found to have a new syphilis diagnosis, among whom, 52% had positive syphilis serology and positive DFA, 34% had a positive syphilis serology and negative DFA, and 14% had negative syphilis serology and positive DFA. While DFA testing did not yield an abundance of new cases, it was useful to support findings from syphilis serology or confirm diagnosis where serology was negative. Where available, alternate non-serologic tests, such as nucleic acid amplification tests, should be considered above DFA due to its higher sensitivity for detecting syphilis in primary lesions; however, in clinical situations, when new syphilis infection is suspected, empiric treatment should not be delayed.

Is strongyloidiasis currently autochthonous in Croatia? A retrospective study

2021 ◽  
Author(s):  
Mirjana Balen Topić ◽  
Ena Marjanović ◽  
Domagoj Tomasović ◽  
Mario Sviben
Keyword(s):  
Clinical Presentation ◽  
Acute Infection ◽  
Direct Methods ◽  
Strongyloides Stercoralis ◽  
Organ Donors ◽  
Cure Rate ◽  
Symptomatic Infection ◽  
Asymptomatic Patients ◽  
Stool Samples ◽  
Human Infections

Abstract Background Autochthonous human infections with Strongyloides stercoralis have been well documented in many European regions. By exploring patients’ data, we aimed to find elements for its current endemicity in Croatia. Methods This retrospective descriptive study analysed epidemiological and clinical data of patients treated for strongyloidiasis from January 2010 to May 2019 at a teaching hospital in Zagreb, Croatia. The diagnosis was made by direct methods using light microscopy and/or serology. Results Among 65 patients with strongyloidiasis, 60% were men, and 78.5% were 50–79 y of age. The sensitivity of the examination of three stool samples after concentration, saline provocation and serology was 26.2, 80.7 and 86.2%, respectively. Clinical presentation included asymptomatic patients with eosinophilia (41.5%), chronic symptomatic infection (33.8%), acute infection (18.5%) and hyperinfection (6.2%). Twenty patients (30.8%) were immunosuppressed; among four of whom developed hyperinfection, two died. Initially 71.7% of patients were treated with albendazole and 13.3% with ivermectin, with an equal parasitological cure rate (72.2% and 75%; p=0.09). In 11 patients, acute infection was autochthonous in its origin. Conclusions Strongyloidiasis is currently endemic in Croatia and immunosuppressed travellers to this region should be advised to take precautions. Patients undergoing immunosuppression and organ donors from Croatia should be screened.

scholarly journals Emergency department preparation for COVID-19: accelerated care units

2020 ◽  
Vol 37 (7) ◽  
pp. 402-406 ◽  
Author(s):  
Jeanne Noble ◽  
Nida Felicija Degesys ◽  
Elizabeth Kwan ◽  
Edward Grom ◽  
Cortlyn Brown ◽  
...  
Keyword(s):  
Emergency Department ◽  
San Francisco ◽  
Negative Pressure ◽  
Potential Model ◽  
Adaptive Leadership ◽  
Protective Equipment ◽  
The Novel ◽  
Leadership Challenges ◽  
Novel Coronavirus ◽  
Rapid Deployment

By 11 February 2020 when the WHO named the novel coronavirus (SARS-CoV-2) and the disease it causes (COVID-19), it was evident that the virus was spreading rapidly outside of China. Although San Francisco did not confirm its first locally transmitted cases until the first week of March, our ED and health system began preparing for a potential COVID-19 surge in late February 2020.In this manuscript, we detail how the above responses were instrumental in the rapid deployment of two military-grade negative-pressure medical tents, named accelerated care units (ACU). We describe engagement of our workforce, logistics of creating new care areas, ensuring safety through personal protective equipment access and conservation, and the adaptive leadership challenges that this process posed.We know of no other comprehensive examples of how EDs have prepared for COVID-19 in the peer-reviewed literature. Many other EDs both in and outside of California have requested access to the details of how we operationalised our ACUs to facilitate their own planning. This demonstrates the urgent need to disseminate this information to our colleagues. Below we describe the process of developing and launching our ACUs as a potential model for other EDs around the country.

scholarly journals 2150. Detection and Characterization of Viral and Bacterial Pathogens in Tonsillar Tissues of Children Undergoing Tonsillectomy

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S729-S729
Author(s):  
Huanyu Wang ◽  
Li Xu ◽  
Kathy Everhart ◽  
Amy Leber
Keyword(s):  
Respiratory Infections ◽  
Group A Streptococcus ◽  
Acute Infection ◽  
Fusobacterium Necrophorum ◽  
Nucleic Acid Amplification ◽  
Age Group ◽  
Detection Rates ◽  
Adenotonsillar Hypertrophy ◽  
Wide Range ◽  
The Impact

Abstract Background The diagnosis of upper respiratory infections is commonly made using nucleic acid amplification technologies for viruses and bacteria. The impact of latency and colonization are not often appreciated. We aimed to detect viruses and bacteria present in tonsil and adenoid tissues from children during the absence of acute infection symptoms. Methods Remnant tonsil and adenoid tissues were obtained from children undergoing tonsillectomy procedures. Nucleic acids of viruses and bacteria were detected using laboratory developed PCRs targeting Epstein–Barr virus (EBV), Adenoviruses (AdV), human herpes virus 6 (HHV6), human enteroviruses (HEV), Group A streptococcus (GAS), Kingella kingae (KKN), Staphylococcus aureus (SA), Streptococcus pneumoniae (SPN), Arcanobacterium haemolyticus (AHE), Fusobacterium necrophorum (FNE), Mycobacterium pneumoniae (MPN) and Neisseria meningitidis (NM). The genogroup of AdV and the type of HHV6 were determined as well. Demographics, clinical presentation and detection rates of these viruses and bacteria were analyzed. Results During the study period (April 2018 and March 2019), 239 samples were collected from patients <18 years with an average age of 5.1 years. More male subjects than female subjects were included (57.7% vs. 42.3%). Most of the patients underwent tonsillectomy due to adenotonsillar hypertrophy (93.3%). Thirty (12.5%) also had a history of tonsillitis, 224 (93.7%) sleep apnea, 36 (15.1%) otitis media, 35 (14.6%) Eustachian tube dysfunction and 46 (19.2%) had other conditions. The detection of the pathogens among each age group is presented in Table 1. The seasonal distributions of virus positivity are shown in Figure 1. Conclusion The detection rates of each virus and bacterium in the tonsillar tissues from children absent of acute infection symptoms vary in each age group and fluctuate among seasons. In the molecular era when syndromic real-time multiplex PCR kits can provide sensitive and rapid results for a wide range of pathogens, it is important to understand the meaning of detection and differentiate between an infection and colonization or latency. Disclosures All authors: No reported disclosures.

scholarly journals Comparison of different samples for 2019 novel coronavirus detection by nucleic acid amplification tests

2020 ◽  
Vol 93 ◽  
pp. 264-267 ◽  
Author(s):  
Chunbao Xie ◽  
Lingxi Jiang ◽  
Guo Huang ◽  
Hong Pu ◽  
Bo Gong ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Nucleic Acid Amplification ◽  
Nucleic Acid Amplification Tests ◽  
Novel Coronavirus

scholarly journals Characterization of New HIV Infections among Adults ≥45 Years—New York City, North Carolina, San Francisco, 2011–2013

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S15-S15
Author(s):  
Mary Evans ◽  
Anne Patala ◽  
Ellsworth Campbell ◽  
Emily Westheimer ◽  
Cynthia L Gay ◽  
...  
Keyword(s):  
Older Adults ◽  
Hiv Prevention ◽  
Hiv Infection ◽  
San Francisco ◽  
Acute Infection ◽  
Study Participant ◽  
Rapid Test ◽  
Bivariate Analysis ◽  
Similar Frequency ◽  
Hiv 1

Abstract Background While HIV prevention activities are often focused on younger people, older people can also be at risk for HIV infection. We aimed to characterize HIV transmission in older adults. Methods The STOP study was a multi-site prospective study of persons with acute HIV infection (AHI) from 2011 to 2013. Older adults were defined as ≥45 years and younger persons were 13–44 years. AHI was defined by a negative rapid test but a reactive antigen/antibody or HIV RNA test. We performed bivariate analysis using Pearson’s chi-square and odds ratios to examine associations between older age and transmission characteristics. Among persons with HIV-1 polymerase (pol) sequences, transmission linkages were inferred when the genetic distance between sequences was &lt;1.5% and did not indicate directionality of transmission. Results Among 86,836 participants (median age, 29 years; 75.0% male; 51.8% MSM), HIV infection was diagnosed in 176 (1.46%) of 12,036 older adults compared with 1,150 (1.53%) of 74,800 younger people (P = 0.56). Among HIV-infected persons, AHI was diagnosed in similar proportions of older and younger people (13.1% vs. 12.6%; P = 0.86). Among HIV-infected persons who participated in partner notification (n = 1,326), older adults were less likely to report meeting a sex partner online (11.3% vs. 26.9%; OR 0.52, 95% CI = 0.35–0.78) and were less likely to name ≥2 sex partners (31.5% vs. 46.8%; OR = 0.28, 95% CI = 0.15–0.53) compared with younger people. Among HIV-infected persons with HIV-1 pol sequences (n = 537), similar proportions of older and younger people had viruses that genetically linked with another study participant (15.9% vs. 23.5%; OR 0.62, 95% CI 0.31–1.22) (Figure). Conclusion In this study, older adults had a similar frequency of newly diagnosed HIV infection, acute infection, and genetic linkage compared with younger people, suggesting that increased HIV prevention efforts may be needed in this population. Disclosures All authors: No reported disclosures.

scholarly journals COVID-19 in Newborns and Infants—Low Risk of Severe Disease: Silver Lining or Dark Cloud?

2020 ◽  
Vol 37 (08) ◽  
pp. 845-849 ◽  
Author(s):  
Munmun Rawat ◽  
Praveen Chandrasekharan ◽  
Mark D. Hicar ◽  
Satyan Lakshminrusimha
Keyword(s):  
Influenza Pandemic ◽  
Severe Disease ◽  
The United States ◽  
Dark Cloud ◽  
Symptomatic Infection ◽  
Key Points ◽  
High Incidence ◽  
1918 Influenza ◽  
Novel Coronavirus ◽  
Low Prevalence

One hundred years after the 1918 influenza pandemic, we now face another pandemic with the severe acute respiratory syndrome–novel coronavirus-2 (SARS-CoV-2). There is considerable variability in the incidence of infection and severe disease following exposure to SARS-CoV-2. Data from China and the United States suggest a low prevalence of neonates, infants, and children, with those affected not suffering from severe disease. In this article, we speculate different theories why this novel agent is sparing neonates, infants, and young children. The low severity of SARS-CoV-2 infection in this population is associated with a high incidence of asymptomatic or mildly symptomatic infection making them efficient carriers. Key Points

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