Elective tracheostomy during COVID-19 outbreak: to whom, when, how? Early experience from Venice, Italy

Abstract PurposeThe need for prolonged invasive mechanical ventilation in COVID-19 patients is placing the Otorhinolaryngologist in front of an increasing request for tracheostomy. Nowadays, there is uncertainty regarding the timing of tracheostomy, the prognosis of these patients and safety of healthcare workers. The aim of this study is to evaluate the efficacy and safety of tracheostomy placement in patients with COVID-19. MethodsIt wasconducted a retrospective cohort study on 23 COVID 19 patients, in order to analyse the timing of tracheostomy, the risk factors associated with in-hospital death and theinfection of the involved health care workers. Early tracheostomy was defined as ≤ 10 days and late ones > 10 days.ResultsThe mortality rate of COVID-19 patients admitted to ICU that underwent tracheostomy was 18%. The overall mortality of patients admitted to ICU was 53%. The univariate analysis revealed that early tracheostomy, SOFA score > 6, D-Dimer level > 4 were significantly associated with a greater risk of death. At the multivariate analysis SOFA score > 6 and D-Dimer level > 4 resulted as significant factors for a higher risk of death. No health care workers associated with tracheostomy are confirmed to be infected by SARS- CoV2.ConclusionWe suggest to wait at least 14 days to perform tracheostomy. In patients with SOFA score > 6, and D dimer > 4 tracheostomy should not be performed or should be postponed. Optimized procedures and enhanced personal protective equipment can make the tracheostomy safe and beneficial in COVID-19 patients.

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Risk of hospitalization and risk of death for health care workers with COVID-19 in nine European countries, January 2020–January 2021

Journal of Hospital Infection ◽

10.1016/j.jhin.2021.10.015 ◽

2021 ◽

Author(s):

Lisa Ferland ◽

Carlos Carvalho ◽

Joana Gomes Dias ◽

Favelle Lamb ◽

Cornelia Adlhoch ◽

...

Keyword(s):

Health Care ◽

Health Care Workers ◽

European Countries ◽

Risk Of Death ◽

Care Workers

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Seroconversion following H1N1 influenza vaccination among health care personnel in South Kerala, India

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20170267 ◽

2017 ◽

Vol 4 (2) ◽

pp. 428 ◽

Cited By ~ 2

Author(s):

Anuja U. ◽

Rajasi R. S. ◽

Ratheesh K. H. ◽

VijayaKumar K. ◽

Amar Fettil

Keyword(s):

Health Care ◽

Single Dose ◽

Health Care Workers ◽

Influenza Pandemic ◽

Univariate Analysis ◽

Health Care Personnel ◽

World Health ◽

Cross Sectional ◽

H1n1 Vaccine ◽

Care Workers

Background: Health care workers were prioritized by World Health Organization (WHO) for H1N1 vaccination during 2009 swine influenza pandemic following which in Kerala, a total of 72,000 people mostly health care personnel were immunized with a single dose of inactivated split influenza monovalent H1N1 vaccine in 2010. The present study was carried out with the objective to find out the proportion of health care workers seroconverted in Kerala following H1N1 vaccination.Methods:A cross-sectional study conducted in three districts of Kerala. Blood samples collected from 193 health staffs were analysed for H1N1 antibody titre 6 months following single dose of vaccination. Univariate analysis was done using proportions for qualitative variables.Results: 99.5% of health staffs seroconverted following vaccination and none of them developed disease even after getting exposed to H1N1 cases thereafter.Conclusions:Single dose of H1N1 vaccine is found to offer sufficient protection and should be recommended for health care workers. So all health care personnel shall consider H1N1 vaccination for their own protection.

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Clinical Characteristics and Mortality of Health-Care Workers With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection in Mexico City

Clinical Infectious Diseases ◽

10.1093/cid/ciaa1465 ◽

2020 ◽

Cited By ~ 2

Author(s):

Lorena Guerrero-Torres ◽

Yanink Caro-Vega ◽

Brenda Crabtree-Ramírez ◽

Juan G Sierra-Madero

Keyword(s):

Health Care ◽

Severe Acute Respiratory Syndrome ◽

Mexico City ◽

Health Care Workers ◽

Hospitalized Patients ◽

Multivariate Logistic Regression Model ◽

Risk Of Death ◽

Care Workers ◽

Specific Occupation ◽

Potential Factors

Abstract Background We evaluated the risk of death for health-care workers (HCW) with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in Mexico City during the coronavirus disease 2019 (COVID-19) pandemic, and describe the associated factors in hospitalized HCW, compared with non-HCW. Methods We analyzed data from laboratory-confirmed SARS-CoV-2 cases registered from 27 February–31 August 2020 in Mexico City’s public database. Individuals were classified as non-HCW or HCW (subcategorized as physicians, nurses, and other HCW). In hospitalized individuals, a multivariate logistic regression model was used to analyze the potential factors associated with death and compare mortality risks among groups. Results A total of 125 665 patients were included. Of these, 13.1% were HCW (28% physicians, 38% nurses, and 34% other HCW). Compared with non-HCW, HCW were more frequently female, were younger, and had fewer comorbidities. Overall, 25 771 (20.5%) were treated as inpatients and 11 182 (8.9%) deaths were reported. Deaths in the total population (9.9% vs 1.9%, respectively; P < .001) and in hospitalized patients (39.6% vs 19.3%, respectively; P < .001) were significantly higher in non-HCW than in HCW. In hospitalized patients, using a multivariate model, the risk of death was lower in HCW in general (odds ratio [OR], 0.53) than in non-HCW, and the risks were also lower by specific occupation (OR for physicians, 0.60; OR for nurses, 0.29; OR for other HCW 0.61). Conclusions HCW represent an important proportion of individuals with SARS-CoV-2 infection in Mexico City. While the mortality risk is lower in HCW compared to non-HCW, a high mortality rate in hospitalized patients was observed in this study. Among HCW, nurses had a lower risk of death compared to physicians and other HCW.

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Urgency in Improving Child Health Care Workers' Awareness and Knowledge of ASD: Findings From a Cross-Sectional Study in Southwest China

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.703609 ◽

2021 ◽

Vol 12 ◽

Author(s):

Yu Ma ◽

Yan Zhou ◽

Ye Liu ◽

Yue Ping ◽

Yaozhou Wang ◽

...

Keyword(s):

Health Care ◽

Child Health ◽

Health Care Workers ◽

Southwest China ◽

Univariate Analysis ◽

Demographic Characteristics ◽

Child Health Care ◽

General Knowledge ◽

Cross Sectional ◽

Care Workers

Objective: To evaluate the levels of awareness and knowledge of ASD among child health care workers in China, we conducted a cross-sectional, questionnaire-based study to assess the participants' awareness and knowledge of ASD.Methods: A total of 159 child health care workers from Southwest China participated in the survey and filled out the questionnaire.Descriptive analysis was conducted on the five parts of the questionnaire, including general knowledge, symptomology, screening and diagnosis, and intervention and treatment. Univariate analysis was used to assess impacts of the participants' basic demographic characteristics on the questionnaire scores. Multivariate analysis was used to analyze association of the participants' basic demographic characteristics and the questionnaire scores.Results: Less than 15% of the participants knew that ASD is a developmental, congenital and genetic disorder. Few participants knew that the symptoms include language disorder (38.4%) and social dysfunction (29.6%). A minority of the participants knew the diagnostic criteria (22.6%) and the age for early screening (14.5%). A total of 23.9% of the participants agreed that there are no effective drugs to treat ASD, and 6.3% agreed that ASD is incurable. A number of years in practice of ≥10 (OR = 0.3249, 95% CI: 0.1080–0.9189) was the main factor related to a high questionnaire score.Conclusions: Most participants had relatively low levels of awareness and knowledge of ASD, especially in terms of general knowledge as well as knowledge of intervention and treatment. Working for more than 10 years was a significant predictor of higher levels of awareness and knowledge of ASD. ASD-related training and knowledge dissemination are crucial for the early diagnosis and intervention of ASD. Child health care workers' awareness and knowledge of ASD needs to be improved to help build public awareness about ASD.

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