Heterogeneity in testing, diagnosis and outcome in SARS-CoV-2 infection across outbreak settings in the Greater Toronto Area, Canada: an observational study

BACKGROUND Disproportionate risks of COVID-19 in congregate settings including long-term care homes, retirement homes, and shelters both affect and are affected by SARS-CoV-2 infections among facility-staff. In cities across Canada, there has been a consistent trend of geographic clustering of COVID-19 cases. However, there remain limited data on how COVID-19 among facility-staff reflect urban neighbourhood disparities, particularly stratified by the social and structural determinants of community-level transmission. OBJECTIVE To compare the concentration of cumulative cases by geography and social/structural determinants across three mutually exclusive subgroups in the Greater Toronto Area (population 7.1 million): community, facility-staff, and healthcare workers (HCW) in other settings. METHODS We conducted a retrospective, observational study using surveillance data on laboratory-confirmed COVID-19 cases (January 23 to December 13, 2020; prior to vaccination roll-out). We derived neighbourhood-level social/structural determinants from census data, and generated Lorenz curves and Gini coefficients to visualize and quantify inequalities in cases. RESULTS The hardest-hit neighbourhoods (comprising 20% of the population) accounted for 53.4% of community cases, 48.6% of facility-staff cases, and 42.3% of other HCW cases. Compared with other HCW, cases in facility-staff more closely reflected the distribution of community cases. Cases in facility-staff reflected greater social and structural inequalities (larger Gini coefficients) than other HCW across all determinants. Facility-staff cases were also more likely than community cases to be concentrated in lower income neighbourhoods (Gini 0.24[0.15-0.38] vs 0.14[0.08-0.21] with lower household density (Gini 0.23[0.17-0.29] vs 0.17[0.12-0.22]) and with a greater proportion working in other essential services (Gini 0.29 [0.21-0.40], 0.22[0.17-0.28]). CONCLUSIONS COVID-19 cases among facility-staff largely reflects neighbourhood-level heterogeneity and disparities; even more so than cases in other HCW. Findings signal the importance of interventions prioritized and tailored to home geographies of facility-staff in addition to workplace measures, including prioritization and reach of vaccination at home (neighbourhood-level) and at work.

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Abstract #842: Novel Action of Saroglitazar in Patients with Diabetic Dyslipidemia – An Observational Study.

Endocrine Practice ◽

10.1016/s1530-891x(20)45176-6 ◽

2016 ◽

Vol 22 ◽

pp. 183-184

Author(s):

Hemant Thacker ◽

Rupal Shrimanker ◽

Rahul Tulle

Keyword(s):

Observational Study ◽

Diabetic Dyslipidemia

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47 Long-term outcome of patients treated with cardiac resynchronization. Results of a multicenter European observational study

European Journal of Heart Failure Supplements ◽

10.1016/s1567-4215(05)80013-x ◽

2005 ◽

Vol 4 (1) ◽

pp. 6-6

Keyword(s):

Observational Study ◽

Cardiac Resynchronization ◽

Term Outcome ◽

Long Term Outcome

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First clinical experience with the Multi-LOC multiple stent delivery system for focal stenting in long femoro-popliteal lesions

VASA ◽

10.1024/0301-1526/a000658 ◽

2017 ◽

Vol 46 (6) ◽

pp. 452-461 ◽

Cited By ~ 4

Author(s):

Klaus Amendt ◽

Ulrich Beschorner ◽

Matthias Waliszewski ◽

Martin Sigl ◽

Ralf Langhoff ◽

...

Keyword(s):

Observational Study ◽

Clinical Experience ◽

Delivery System ◽

Target Lesion ◽

Lesion Length ◽

Elastic Recoil ◽

Delivery Device ◽

Clinical Assessments ◽

Balloon Catheters ◽

Considerable Length

Abstract. Background: The purpose of this observational study is to report the six-month clinical outcomes with a new multiple stent delivery system in patients with femoro-popliteal lesions. Patients and methods: The LOCOMOTIVE study is an observational multicentre study with a primary endpoint target lesion revascularization (TLR) rate at six months. Femoro-popliteal lesions were prepared with uncoated and/or paclitaxel-coated peripheral balloon catheters. When flow limiting dissections, elastic recoil or recoil due to calcification required stenting, up to six short stents per delivery device, each 13 mm in length, were implanted. Sonographic follow-ups and clinical assessments were scheduled at six months. Results: For this first analysis, a total of 75 patients 72.9 ± 9.2 years of age were enrolled. The majority of the 176 individually treated lesions were in the superficial femoral artery (76.2 %, 134/176) whereas the rate of TASC C/D amounted to 51.1 % (90/176). The total lesion length was 14.5 ± 9.0 cm with reference vessel diameters of 5.6 ± 0.7 mm. Overall 47 ± 18 % of lesion lengths could be saved from stenting. At six months, the patency was 90.7 % (68/75) and all-cause TLR rates were 5.3 % (4/75) in the overall cohort. Conclusions: The first clinical experience at six months suggests that the MSDS strategy was safe and effective to treat femoro-popliteal lesions of considerable length (14.5 ± 9.0 cm). Almost half of the lesion length could be saved from stenting while patency was high and TLR rates were acceptably low.

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