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Background: In 2020, SARS-CoV-2 and the COVID-19 pandemic had a huge impact on the access to and provision of ART treatments. Gradually, knowledge of the virus and its transmission has become available, allowing ART activities to resume. Still, questions on the impact of the virus on human gametes and fertility remain.Objective and Rationale: This article summarizes published data, aiming to clarify the impact of SARS-CoV-2 and the COVID-19 disease on human fertility and assisted reproduction, as well as the impact of vaccination, and from this, provide answers to questions that are relevant for people contemplating pregnancy and for health care professionals.Search Methods: PUBMED/MEDLINE and the WHO COVID-19 database were searched from inception to 5 October 2022 with search terms focusing on 'SARS-CoV-2' and gametes, embryos, reproductive function, fertility and ART. Non-English studies and papers published prior to 2020 were excluded, as well as reviews and non-peer reviewed publications. Full papers were assessed for relevance and quality, where feasible.Outcomes: From the 148 papers included, the following observations were made. The SARS-CoV-2-binding proteins, angiotensin-converting enzyme 2 (ACE2) and type II transmembrane serine protease (TMPRSS2), are expressed in the testis, but co-expression remains to be proven. There is some evidence of SARS-CoV-2 RNA in the ejaculate of COVID-19 patients with severe disease, but not in those with mild/moderate disease. SARS-CoV-2 infection can impair spermatogenesis, but this seems to resolve after one spermatogenic cycle. Testosterone levels seem to be lower during and after COVID-19, but long-term data are lacking; disease severity may be associated with testosterone levels. COVID-19 cannot be considered a sexually transmitted disease. There is no co-expression of ACE2 and TMPRSS2 in the myometrium, uterus, ovaries or fallopian tubes. Oocytes seem to have the receptors and protease machinery to be susceptible to SARS-CoV-2 infection; however, viral RNA in oocytes has not been detected so far. Women contemplating pregnancy following COVID-19 may benefit from screening for thyroid dysfunction. There is a possible (transient) impact of COVID-19 on menstrual patterns. Embryos, and particularly late blastocysts, seem to have the machinery to be susceptible to SARS-CoV-2 infection. Most studies have not reported a significant impact of COVID-19 on ovarian reserve, ovarian function or follicular fluid parameters. Previous asymptomatic or mild SARS-CoV-2 infection in females does not seem to negatively affect laboratory and clinical outcomes of ART. There are no data on the minimum required interval, if any, between COVID-19 recovery and ART. There is no evidence of a negative effect of SARS-CoV-2 vaccination on semen parameters or spermatogenesis, ovarian function, ovarian reserve or folliculogenesis. A transient effect on the menstrual cycle has been documented. Despite concerns, cross reactivity between anti-SARS-CoV-2 spike protein antibodies and Syncytin-1, an essential protein in human implantation, is absent. There is no influence of mRNA SARS-CoV-2 vaccine on patients' performance during their immediate subsequent ART cycle. Pregnancy rates post-vaccination are similar to those in unvaccinated patients.Wider Implications: This review highlights existing knowledge on the impact of SARS-CoV-2 infection or COVID-19 on fertility and assisted reproduction, but also identifies gaps and offers suggestions for future research. The knowledge presented should help to provide evidence-based advice for practitioners and couples contemplating pregnancy alike, facilitating informed decision-making in an environment of significant emotional turmoil. [ABSTRACT FROM AUTHOR]

Introduction Healthcare workers' work performance and mental health are associated with positive mental health outcomes and directly related to increased productivity and decreased disability costs. Methods We conducted a systematic review to identify factors associated with work performance of healthcare workers during a pandemic and conducted a meta-analysis of the prevalence of mental health outcomes in this context. Primary papers were collected and analysed using the Population/Intervention/Comparison/Outcome framework and using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. To critically appraise the studies included in the review, we used the AXIS appraisal tool to assess each cross-sectional study's quality. Results The study identified nine factors associated with the work performance and mental health of healthcare workers, including experiencing feelings of depression, anxiety, having inadequate support, experiencing occupational stress, decreased productivity, lack of workplace preparedness, financial concerns associated with changes in income and daily living, fear of transmission and burnout/fatigue. Conclusion There is a rapidly rising need to address the work performance and mental health of healthcare workers providing timely care to patients. Regular and sustained interventions, including the use of information and communication technologies such as telehealth, are warranted. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19) has been a global disaster, with over 746,312 confirmed cases and still counting in Indonesia, especially Jakarta, which has about 50 per cent asymptomatic confirmed cases. This paper aims to investigate the persistent factors of COVID-19 diagnosis using four scenarios of asymptomatic inclusion. We use Bayesian Logistic Regression to identify the factors of COVID-19 positivity, which can address issues in the traditional approach such as overfitting and uncertainty. This study discovers three main findings: (1) COVID-19 can infect people regardless of age; (2) Among twelve symptoms of coronavirus (COVID-19), five symptoms increase the COVID-19 likelihood, and two symptoms decrease the possibility of COVID-19 infection; and (3) From an epidemiological perspective, the contact history rises the probability of COVID-19, while healthcare workers and people who did travel are less likely to become infected from COVID-19. Therefore given this study, it is essential to be attentive to the people who have the symptoms and contact history. Surprisingly, health care workers and travelers who apply health protocols strictly according to the rules have a low risk of COVID19 infection. [ABSTRACT FROM AUTHOR]

Background: WHO has recommended personal hygiene (respiratory hygiene, using face masks, washing hands with warm water and soap, use of alcohol-based hand sanitizers, avoid touching mouth, eyes & nose, cleanliness), social distancing and careful handling of purchased products as an effective preventive measure for COVID-19 disease. The growing pandemic of COVID-19 disease requires social distancing and personal hygiene measures to protect public health. But this message is not clear and well understood among people. The aim of this study is to determine the awareness, knowledge and attitude about COVID-19 and relate the behaviour of Indian society, especially when the country is restarting all its economic activities, after the complete lockdown.Method: The present paper is based on an extensive survey among 21 406 adult participants of various sections of Indian society with different age groups between 18 and 80 years to introspect the level of public awareness with respect to cause, spread, prevention and treatment of disease caused by spread of COVID-19 viral outbreak, which will be automatically reflected in the societal behavioural response of rigorous precautionary measures.Conclusions: There is a need to extend the knowledge base among individuals to enhance their active participation in the prevention mechanisms with respect to the spread of the pandemic. There is a need to elaborate the Indian socio-cultural aspects, so that society starts appreciating and voluntarily following social distancing. This should improve the adaptability of people with livelihood resilience to let them protect themselves not only from the present pandemic but also from all other unforeseen infections, and to provide care to patients. [ABSTRACT FROM AUTHOR]

Background The COVID-19 outbreak is increasing and spreading rapidly globally, with over 20 million cases and 800, 000 thousand deaths reported in 216 countries as of 28th August 2020. Since the report of the index case in Nigeria in February 2020 by the Nigeria Center for Disease Control (NCDC), daily records of confirmed cases have been reported in all states in the country. On 3rd April 2020, an outbreak of Coronavirus disease-2019 (COVID-19) was confirmed in Ondo State, Southwest Nigeria. Field investigations were conducted by the State Ministry of Health (MoH) to identify and confirm additional cases. This paper provides the outcome of the epidemiological investigation of the outbreak to further guide outbreak response activities. Methods Outbreak settings Ondo State is in the South-West Zone of Nigeria with her capital at Akure. The State is situated between longitudes 40 151E and 60 001E of the Greenwich median and latitudes 50 451N and 70 451 N, which are to the North of the equator in the Southwestern geopolitical zones of the country. Field Investigation The investigation was conducted as part of outbreak control and response measures hence permission to conduct the study was obtained from the Ondo State Ministry of Health (OSMoH). Following an alert from clinicians at a government-owned Hospital, Akure, Ondo State on 30 March 2020, the index case of COVID-19, a 34-year-old male with recent travel history to India was investigated. He arrived at Ondo State on 21st March 2020 and presented at the hospital with cough, sore throat and running nose with the onset of symptoms on 23rd March 2020. The State public health emergency Rapid Response Team (RRT) comprising of Commissioner for Health, State Epidemiologist, State and LGA surveillance officers, and health development partners in the state visited the hospital to investigate and implement public health response. Nasopharygeal and oropharyngeal samples were collected and tested for COVID-19, and returned positive from the national reference laboratory on the 3rd of April 2020. Operational definitions During the onset of the outbreak, three categories of case definitions for COVID-19 were used to guide the outbreak investigations according to the Nigeria Center for Diseases Control (NCDC) guidelines. Suspect case: (1) This is a patient with acute respiratory illness (fever and at least one sign/ symptom of respiratory disease (e.g. cough, shortness of breath) and a history of travel to or residence in a country/area or territory reporting local transmission of COVID-19 disease during the 14 days prior to symptom onset; (2) or a patient/health care worker with any acute respiratory illness and has been in contact with a confirmed COVID-19 case in the last 14 days prior to the onset of symptoms; (3) or a patient with a severe acute respiratory infection (fever and at least one sign/symptom of respiratory disease (e.g. cough, shortness of breath) and requiring hospitalization and with no other aetiology that fully explains the clinical presentation; (4) or a case for whom testing for COVID-19 is inconclusive. Confirmed case: A person with laboratory confirmation of COVID-19 infection, irrespective of clinical signs and symptoms. Probable case: Any suspected case for whom testing for COVID-19 is indeterminate test result or for whom testing was positive on a pan-coronavirus assay Data analysis The State COVID-19 line-list and case investigation forms of all COVID-19 cases from 19th March to 9th August 2020 were retrieved from the state disease surveillance unit, information on key variables were extracted and exported into SPSS version 20 and analyzed. Descriptive statistics such as frequency table, mean (standard deviation) and charts were used to describe key variables including LGA, age, sex, occupation and education and clinical conditions of cases. The week of report of cases and outcomes were used to generate the epidemic curve. The Chi-square test was used to compare categorical variables including the socio-demographic characteristics, clinical condition and outcome of cases. Two-sided P-values <0.05 were considered statistically significant. Results Socio-demographic characteristics of cases A total of 4353 suspected cases were reported and tested for COVID-19, of which 1316 COVID-19 cases were confirmed, with a case fatality rate of 2.2% recorded in 7 of the 17 Local Government Areas that reported at least a confirmed case (Figure 1). Most of the confirmed cases (1169; 88.8%), resides in urban areas (LGAs) (Table 1). Majority [1110 (84.3%)] were within the age group 20 to 59 years, with a mean age of 37.8 ±14.8 years. Males (713; 54.2%) were more affected compare to females (603; 45.8). More than three quarters (1009; 76.7%) of the cases had a tertiary level of education. Health care workers (404; 30.7%) were most affected compared to other professionals as shown in Table 1. 1170 Figure 1: Open in new tab Download slide Distribution of suspected and confirmed COVID-19 cases in Ondo state, March to August 2020 1170 Figure 1: Open in new tab Download slide Distribution of suspected and confirmed COVID-19 cases in Ondo state, March to August 2020 1170 Table 1: Socio-demographic characteristics of respondents N = 1316 Variable.  Frequency.  Percentage.  Age in years       <5  18  1.4  5-19  84  6.4  20-39  666  50.6  40-59  444  33.7  60-79  96  7.3  ≥80  8  0.6  Gender       Male  713  54.2  Female  603  45.8  Location of cases       Rural  147  11.2  Urban  1169  88.8  Type of Education       None  15  1.1  Nursery  8  0.6  Primary  80  6.1  Secondary  204  15.5  Tertiary  1009  76.7  Occupation       Health workers  404  30.7  Businessman and woman  225  17.1  Civil servant  168  12.8  Others  182  13.8  Pupil/Student  129  9.8  Political office Holders  77  5.9  Engineer  48  3.6  Religious/traditional leader  24  1.8  Banker  24  1.8  Security officer  35  2.7  Variable.  Frequency.  Percentage.  Age in years       <5  18  1.4  5-19  84  6.4  20-39  666  50.6  40-59  444  33.7  60-79  96  7.3  ≥80  8  0.6  Gender       Male  713  54.2  Female  603  45.8  Location of cases       Rural  147  11.2  Urban  1169  88.8  Type of Education       None  15  1.1  Nursery  8  0.6  Primary  80  6.1  Secondary  204  15.5  Tertiary  1009  76.7  Occupation       Health workers  404  30.7  Businessman and woman  225  17.1  Civil servant  168  12.8  Others  182  13.8  Pupil/Student  129  9.8  Political office Holders  77  5.9  Engineer  48  3.6  Religious/traditional leader  24  1.8  Banker  24  1.8  Security officer  35  2.7  Open in new tab 1170 Table 1: Socio-demographic characteristics of respondents N = 1316 Variable.  Frequency.  Percentage.  Age in years       <5  18  1.4  5-19  84  6.4  20-39  666  50.6  40-59  444  33.7  60-79  96  7.3  ≥80  8  0.6  Gender       Male  713  54.2  Female  603  45.8  Location of cases       Rural  147  11.2  Urban  1169  88.8  Type of Education       None  15  1.1  Nursery  8  0.6  Primary  80  6.1  Secondary  204  15.5  Tertiary  1009  76.7  Occupation       Health workers  404  30.7  Businessman and woman  225  17.1  Civil servant  168  12.8  Others  182  13.8  Pupil/Student  129  9.8  Political office Holders  77  5.9  Engineer  48  3.6  Religious/traditional leader  24  1.8  Banker  24  1.8  Security officer  35  2.7  Variable.  Frequency.  Percentage.  Age in years       <5  18  1.4  5-19  84  6.4  20-39  666  50.6  40-59  444  33.7  60-79  96  7.3  ≥80  8  0.6  Gender       Male  713  54.2  Female  603  45.8  Location of cases       Rural  147  11.2  Urban  1169  88.8  Type of Education       None  15  1.1  Nursery  8  0.6  Primary  80  6.1  Secondary  204  15.5  Tertiary  1009  76.7  Occupation       Health workers  404  30.7  Businessman and woman  225  17.1  Civil servant  168  12.8  Others  182  13.8  Pupil/Student  129  9.8  Political office Holders  77  5.9  Engineer  48  3.6  Religious/traditional leader  24  1.8  Banker  24  1.8  Security officer  35  2.7  Open in new tab Admission and clinical conditions of confirmed cases From Table 2 , 88 (6.7%) of the confirmed cases were admitted as inpatient during investigation, while 325 (24.7%) were symptomatic. The first symptom reported by cases were as follows; cough (98; 30.2%), fever (74; 22.8%), headache (30; 9.2%), runny nose (39; 12.0%), sore throat (24; 7.4%) and difficulty in breathing (15; 4.6%). 1170 Table 2: Admission and clinical conditions of confirmed cases.  Frequency.  Percentage.  Admitted as inpatient before lab testing   Yes  88  6.7  No  1228  93.3  Symptomatic       Yes  325  24.7  No  991  75.3  First symptom reported by respondents (n = 325)   Cough  98  30.2  Fever  74  22.8  Headache  30  9.2  Runny nose  39  12.0  Sore throat/pharyngitis  24  7.4  Difficulty breathing  15  4.6  New loss of taste  9  2.7  New loss of smell  8  2.5  Chest pain  7  2.2  General Body weakness  6  1.8  Others  15  4.6  Outcome       Alive  1287  97.8  Dead  29  2.2 .  Frequency.  Percentage.  Admitted as inpatient before lab testing   Yes  88  6.7  No  1228  93.3  Symptomatic       Yes  325  24.7  No  991  75.3  First symptom reported by respondents (n = 325)   Cough  98  30.2  Fever  74  22.8  Headache  30  9.2  Runny nose  39  12.0  Sore throat/pharyngitis  24  7.4  Difficulty breathing  15  4.6  New loss of taste  9  2.7  New loss of smell  8  2.5  Chest pain  7  2.2  General Body weakness  6  1.8  Others  15  4.6  Outcome       Alive  1287  97.8  Dead  29  2.2  Others= abdominal pain; chills/sweats; joint pain; inability to walk; Nausea Open in new tab 1170 Table 2: Admission and clinical conditions of confirmed cases.  Frequency.  Percentage.  Admitted as inpatient before lab testing   Yes  88  6.7  No  1228  93.3  Symptomatic       Yes  325  24.7  No  991  75.3  First symptom reported by respondents (n = 325)   Cough  98  30.2  Fever  74  22.8  Headache  30  9.2  Runny nose  39  12.0  Sore throat/pharyngitis  24  7.4  Difficulty breathing  15  4.6  New loss of taste  9  2.7  New loss of smell  8  2.5  Chest pain  7  2.2  General Body weakness  6  1.8  Others  15  4.6  Outcome       Alive  1287  97.8  Dead  29  2.2 .  Frequency.  Percentage.  Admitted as inpatient before lab testing   Yes  88  6.7  No  1228  93.3  Symptomatic       Yes  325  24.7  No  991  75.3  First symptom reported by respondents (n = 325)   Cough  98  30.2  Fever  74  22.8  Headache  30  9.2  Runny nose  39  12.0  Sore throat/pharyngitis  24  7.4  Difficulty breathing  15  4.6  New loss of taste  9  2.7  New loss of smell  8  2.5  Chest pain  7  2.2  General Body weakness  6  1.8  Others  15  4.6  Outcome       Alive  1287  97.8  Dead  29  2.2  Others= abdominal pain; chills/sweats; joint pain; inability to walk; Nausea Open in new tab Figure 2 described the epidemic curve of the outbreak from March to August 2020. The index case was confirmed on April 4, 2020. Thereafter, there was a surge in the number of confirmed COVID-19 cases with the outbreak reaching its peak on July 2, 2020. Afterwards, fluctuations in the number of cases were observed before a steady decline was recorded between August 3, 2020 and August 9, 2020. 1170 Figure 2 Open in new tab Download slide Epi-Curve of confirmed cases of COVID-19 in Ondo State, March to August 2020 1170 Figure 2 Open in new tab Download slide Epi-Curve of confirmed cases of COVID-19 in Ondo State, March to August 2020 Association between socio-demographic characteristics, clinical conditions and outcomes of cases In Table 3 , significant proportion of death occurred among cases within the age group 60 years and above (14; 13.5%) compared to other age groups (p < 0.001). Death occurred more among males (26; 3.6%) compared to the females (3; 0.5%) (p < 0.001). Furthermore, symptomatic cases had higher proportion (27; 8.3%) of deaths compared to asymptomatic cases (2; 0.2%) (P < 0.001). Among the symptomatic cases, a high proportion of death was found among those with difficulty in breathing (3; 20%), fever (11; 14.9%), new loss of taste (1; 11.1%), cough (9; 9.2%) and sore throat (2; 8.3%) (P < 0.001) 1170 Table 3: Association between socio-demographic characteristics and outcomes of cases Variable.  Outcome. .  Total.  P-value.  Dead.  Alive.  Age in years           <5  0 (0.0)  18 (100.0)  18  <0.001  5-19  0 (0.0)  84 (100.0)  84    20-39  2 (0.3)  664 (99.7)  666    40-59  13 (2.9)  431 (97.1)  444    ≥60  14 (13.5)  90 (86.5)  104    Gender           Male  26 (3.6)  687 (96.4)  713  <0.001  Female  3 (0.5)  600 (99.5)  603    Location of cases           Rural  5 (3.4)  142 (96.6)  147  0.294  Urban  24 (2.1)  1145 (97.9)  1169    Type of Education           None  1 (6.7)  14 (93.3)  15  0.630  Nursery  0 (0.0)  8 (100.0)  8    Primary  3 (3.8)  77 (96.2)  80    Secondary  4 (2.0)  200 (98.0)  204    Tertiary  21 (2.1)  988 (97.9)  1009    Occupation           Health workers  2 (0.5)  402 (99.5)  24    Businessman and woman  14 (6.2)  211 (93.8)  225    Civil servant  1 (0.6)  167 (99.4)  168  <0.001  Others  10 (5.5)  172 (94.5)  182    Pupil/Student  0 (0.0)  129 (100.0)  129    Politician  0 (0.0)  77 (100.0)  77    Engineer  0 (0.0)  48 (100.0)  48    Religious/traditional ruler  2 (8.3)  22 (91.7)  24    Banker  0 (0.0)  24 (100.0)  24    Security officer  0 (0.0)  35 (100.0)  35    Symptomatic           Yes  27 (8.3)  298 (91.7)  325  <0.001  No  2 (0.2)  989 (99.8)  991    First symptom       N = 325    Cough  9 (9.2)  89 (90.8)  98    Fever  11 (14.9)  63 (85.1)  74  <0.001  Headache  1 (3.3)  29 (96.7)  30    Running nose  0 (0.0)  39 (100.0)  39    Sore throat  2 (8.3)  22 (91.7)  24    New loss of taste  1 (11.1)  8 (88.9)  9    Difficulty in breathing  3 (20.0)  12 (80.0)  15    New loss of smell  0 (0.0)  5 (100.0)  5    Others  0 (0.0)  31 (100.0)  31    Variable.  Outcome. .  Total.  P-value.  Dead.  Alive.  Age in years           <5  0 (0.0)  18 (100.0)  18  <0.001  5-19  0 (0.0)  84 (100.0)  84    20-39  2 (0.3)  664 (99.7)  666    40-59  13 (2.9)  431 (97.1)  444    ≥60  14 (13.5)  90 (86.5)  104    Gender           Male  26 (3.6)  687 (96.4)  713  <0.001  Female  3 (0.5)  600 (99.5)  603    Location of cases           Rural  5 (3.4)  142 (96.6)  147  0.294  Urban  24 (2.1)  1145 (97.9)  1169    Type of Education           None  1 (6.7)  14 (93.3)  15  0.630  Nursery  0 (0.0)  8 (100.0)  8    Primary  3 (3.8)  77 (96.2)  80    Secondary  4 (2.0)  200 (98.0)  204    Tertiary  21 (2.1)  988 (97.9)  1009    Occupation           Health workers  2 (0.5)  402 (99.5)  24    Businessman and woman  14 (6.2)  211 (93.8)  225    Civil servant  1 (0.6)  167 (99.4)  168  <0.001  Others  10 (5.5)  172 (94.5)  182    Pupil/Student  0 (0.0)  129 (100.0)  129    Politician  0 (0.0)  77 (100.0)  77    Engineer  0 (0.0)  48 (100.0)  48    Religious/traditional ruler  2 (8.3)  22 (91.7)  24    Banker  0 (0.0)  24 (100.0)  24    Security officer  0 (0.0)  35 (100.0)  35    Symptomatic           Yes  27 (8.3)  298 (91.7)  325  <0.001  No  2 (0.2)  989 (99.8)  991    First symptom       N = 325    Cough  9 (9.2)  89 (90.8)  98    Fever  11 (14.9)  63 (85.1)  74  <0.001  Headache  1 (3.3)  29 (96.7)  30    Running nose  0 (0.0)  39 (100.0)  39    Sore throat  2 (8.3)  22 (91.7)  24    New loss of taste  1 (11.1)  8 (88.9)  9    Difficulty in breathing  3 (20.0)  12 (80.0)  15    New loss of smell  0 (0.0)  5 (100.0)  5    Others  0 (0.0)  31 (100.0)  31    Others = chest pain, diarrhea, fatigue, joint pain, malaise, nausea, vomiting Open in new tab 1170 Table 3: Association between socio-demographic characteristics and outcomes of cases Variable.  Outcome. .  Total.  P-value.  Dead.  Alive.  Age in years           <5  0 (0.0)  18 (100.0)  18  <0.001  5-19  0 (0.0)  84 (100.0)  84    20-39  2 (0.3)  664 (99.7)  666    40-59  13 (2.9)  431 (97.1)  444    ≥60  14 (13.5)  90 (86.5)  104    Gender           Male  26 (3.6)  687 (96.4)  713  <0.001  Female  3 (0.5)  600 (99.5)  603    Location of cases           Rural  5 (3.4)  142 (96.6)  147  0.294  Urban  24 (2.1)  1145 (97.9)  1169    Type of Education           None  1 (6.7)  14 (93.3)  15  0.630  Nursery  0 (0.0)  8 (100.0)  8    Primary  3 (3.8)  77 (96.2)  80    Secondary  4 (2.0)  200 (98.0)  204    Tertiary  21 (2.1)  988 (97.9)  1009    Occupation           Health workers  2 (0.5)  402 (99.5)  24    Businessman and woman  14 (6.2)  211 (93.8)  225    Civil servant  1 (0.6)  167 (99.4)  168  <0.001  Others  10 (5.5)  172 (94.5)  182    Pupil/Student  0 (0.0)  129 (100.0)  129    Politician  0 (0.0)  77 (100.0)  77    Engineer  0 (0.0)  48 (100.0)  48    Religious/traditional ruler  2 (8.3)  22 (91.7)  24    Banker  0 (0.0)  24 (100.0)  24    Security officer  0 (0.0)  35 (100.0)  35    Symptomatic           Yes  27 (8.3)  298 (91.7)  325  <0.001  No  2 (0.2)  989 (99.8)  991    First symptom       N = 325    Cough  9 (9.2)  89 (90.8)  98    Fever  11 (14.9)  63 (85.1)  74  <0.001  Headache  1 (3.3)  29 (96.7)  30    Running nose  0 (0.0)  39 (100.0)  39    Sore throat  2 (8.3)  22 (91.7)  24    New loss of taste  1 (11.1)  8 (88.9)  9    Difficulty in breathing  3 (20.0)  12 (80.0)  15    New loss of smell  0 (0.0)  5 (100.0)  5    Others  0 (0.0)  31 (100.0)  31    Variable.  Outcome. .  Total.  P-value.  Dead.  Alive.  Age in years           <5  0 (0.0)  18 (100.0)  18  <0.001  5-19  0 (0.0)  84 (100.0)  84    20-39  2 (0.3)  664 (99.7)  666    40-59  13 (2.9)  431 (97.1)  444    ≥60  14 (13.5)  90 (86.5)  104    Gender           Male  26 (3.6)  687 (96.4)  713  <0.001  Female  3 (0.5)  600 (99.5)  603    Location of cases           Rural  5 (3.4)  142 (96.6)  147  0.294  Urban  24 (2.1)  1145 (97.9)  1169    Type of Education           None  1 (6.7)  14 (93.3)  15  0.630  Nursery  0 (0.0)  8 (100.0)  8    Primary  3 (3.8)  77 (96.2)  80    Secondary  4 (2.0)  200 (98.0)  204    Tertiary  21 (2.1)  988 (97.9)  1009    Occupation           Health workers  2 (0.5)  402 (99.5)  24    Businessman and woman  14 (6.2)  211 (93.8)  225    Civil servant  1 (0.6)  167 (99.4)  168  <0.001  Others  10 (5.5)  172 (94.5)  182    Pupil/Student  0 (0.0)  129 (100.0)  129    Politician  0 (0.0)  77 (100.0)  77    Engineer  0 (0.0)  48 (100.0)  48    Religious/traditional ruler  2 (8.3)  22 (91.7)  24    Banker  0 (0.0)  24 (100.0)  24    Security officer  0 (0.0)  35 (100.0)  35    Symptomatic           Yes  27 (8.3)  298 (91.7)  325  <0.001  No  2 (0.2)  989 (99.8)  991    First symptom       N = 325    Cough  9 (9.2)  89 (90.8)  98    Fever  11 (14.9)  63 (85.1)  74  <0.001  Headache  1 (3.3)  29 (96.7)  30    Running nose  0 (0.0)  39 (100.0)  39    Sore throat  2 (8.3)  22 (91.7)  24    New loss of taste  1 (11.1)  8 (88.9)  9    Difficulty in breathing  3 (20.0)  12 (80.0)  15    New loss of smell  0 (0.0)  5 (100.0)  5    Others  0 (0.0)  31 (100.0)  31    Others = chest pain, diarrhea, fatigue, joint pain, malaise, nausea, vomiting Open in new tab Conclusions The outcome of this investigation indicating high transmission among urban residence and health care workers are key public health concerns in the response to the COVID-19 outbreak in Ondo State, Nigeria. Furthermore, high case mortality among the older age groups requires public health intervention. Thus, we recommend intensified risk communication, enhanced surveillance activities, and use of community structures such as community and religious leaders, market and commercial vehicles associations, Ward Development Committee (WDC) and Village Development Committee (VDC) to ensure compliance with public health COVID-19 preventive measures particularly in the urban areas and among those facing a high risk of death. Furthermore, there is a need to prioritize public health interventions including training and vaccination among the vulnerable groups including health care workers who serve as front liners during case investigation, testing and case management. Key messages Enforcement of public health preventive measures particularly in urban settings, and supporting government to strengthen and monitor Infection Prevention and Control practices in hospital settings. [ABSTRACT FROM AUTHOR]

This is an account that should be heard of an important struggle: the struggle of a large group of experts who came together at the beginning of the COVID-19 pandemic to warn the world about the risk of airborne transmission and the consequences of ignoring it. We alerted the World Health Organization about the potential significance of the airborne transmission of SARS-CoV-2 and the urgent need to control it, but our concerns were dismissed. Here we describe how this happened and the consequences. We hope that by reporting this story we can raise awareness of the importance of interdisciplinary collaboration and the need to be open to new evidence, and to prevent it from happening again. Acknowledgement of an issue, and the emergence of new evidence related to it, is the first necessary step towards finding effective mitigation solutions. [ABSTRACT FROM AUTHOR]

Background Healthcare workers (HCWs) are at high risk of developing hand eczema (HE). This can be exacerbated by hygiene measures related to the coronavirus disease (COVID - 19). Using mild skin cleansers and emollients or moisturizers is central in the prevention of HE—especially with increased COVID-19 hygiene regimes. Aims This study aimed to assess parameters important for the acceptance of a skincare concept in HCWs. Methods In this proof-of-concept user trial, HCWs were provided ad libitum with hand wash oil and hand cream during the 6-month period, when occupationally acquired COVID-19 infections among HCWs were peaking in Germany and then surveyed about acceptance of the products using questionnaires. Results Of 135 HCWs, 115 (85%) responded. Skin tolerance of the hand wash oil and the hand cream was rated very good by 63% and 52% of the 115 participants, respectively. Of the 115 participants, 58% and 57% were very satisfied with the hand wash oil and the hand cream, respectively. Conclusions Acceptance of skin cleansing and skincare products in HCWs seems influenced by parameters such as self-assessed skin tolerance and self-reported overall satisfaction. It must be assumed that products are only used as recommended if they are well-accepted. Employers might survey employees about acceptance of products using the parameters identified to adjust concepts if necessary to sustainably contribute to the prevention of HE. [ABSTRACT FROM AUTHOR]

Background: Since the outbreak of COVID-19 disease, the environment, families, individuals, and their ways of living have been affected. Social distancing was one of the strategies for the prevention of SARS-CoV-2 infection. It led to limited social interactions for fear of contracting the infection, which ultimately affected relationships, among which is sexual health. Aim: To determine the risk of female sexual dysfunction and the effect of the COVID-19 pandemic on sexual function and activities among women of reproductive age in Ibadan, South-West Nigeria. Methods: This cross-sectional study of 218 reproductive-age women evaluated the sexual function before, during, and after the COVID-19 disease pandemic and lockdown. Pretested semistructured self-administered questionnaires with the Female Sexual Function Index (FSFI) were used for data collection. Information collected included sociodemographic and gynecologic characteristics and COVID-19 experiences, as well as sexual history and function before, during, and after the COVID-19 pandemic lockdown. The level of significance was set at P < .05. Outcomes: Respondents were aged 20 to 50 years (95%) with a mean ± SD age of 34.82 ± 8.52 years; the majority were married (75.58%); one-fifth (21.9%) tested positive for COVID-19 infection; and participants who tested positive for COVID-19 infections were mostly health care workers. Results: An absence of sexual activity was reported in 9.18% of participants during lockdown, 7.73% before lockdown, and 4.18% after lockdown. The risk of female sexual dysfunction was prevalent among participants, especially those who tested positive for COVID-19 infection. The prevalence was worse during the pandemic lockdown (53.57%) than before (48.39%) or after (51.61%), and a similar pattern was seen among those who tested negative. There was no statistically significant difference in risk of developing sexual dysfunction during the COVID-19 pandemic between those who tested positive and negative to COVID-19. The arousal and desire domains contributed the highest proportion of low FSFI scores. Clinical Implications: Nationwide lockdowns, which may be a method of control for pandemics, may result in psychosocial complications such as female sexual dysfunction. Strength and Limitations: Most respondents had tertiary education and were able to respond to self-administered questionnaires, yet the risk of recall bias remains a concern whereas the pandemic met the world unprepared and baseline FSFI prior the pandemic was not available for participants. There are no local validation studies for the FSFI in Nigeria, which could have aided interpretation of results. Conclusion: A low FSFI score is prevalent in Ibadan, South-West Nigeria, with a higher incidence reported during the COVID-19 pandemic lockdown. [ABSTRACT FROM AUTHOR]

We describe the time course of neutralizing antibody (NtAb) titer in a cohort of health care workers with mild or asymptomatic severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection. NtAb levels decreased over time; however, serum neutralizing activity remained detectable after a median of 7 months from SARS-CoV-2 diagnosis in the majority of cases. [ABSTRACT FROM AUTHOR]

Background This study investigated post-traumatic stress disorder (PTSD), anxiety, depression and their related factors among coronavirus disease 2019 (COVID-19) patients during the fourth wave of the pandemic in Vietnam. Methods Vietnamese-fluent confirmed COVID-19 patients for at least 3 d were recruited in this online cross-sectional study to answer a three-part questionnaire including participants' sociodemographic characteristics, PTSD (Impact of Event Scale-Revised) and anxiety and depression (Hospital Anxiety and Depression Scale). Associated factors were determined using multivariable binary logistic regression models. Results Of 1544 responses, the majority were female (53.0%), ages 18–39 y (74.8%) and were isolated and treated at field hospitals (72.2%). Family or friends were the greatest sources of mental support (68.2%), followed by healthcare providers (51.1%). The overall prevalence rates of PTSD, anxiety and depression among COVID-19 patients were 22.9%, 11.2% and 17.4%, respectively. Risk factors included older age, higher education, getting infected from the public, knowing someone who died from COVID-19 and high perception of life threat. Meanwhile, mental assistance from family or friends, a greater number of supporters, living with someone not vulnerable and higher salaries were significantly protective factors. Conclusions The psychological responses associated with some sociodemographic details. Family or friends should be the first line of mental interventions for COVID-19 patients. [ABSTRACT FROM AUTHOR]

There is a proliferation of digitalisation of urban and health services in India under the Smart City and Digital Health missions, respectively. This study brings digital and feminist geographies together to understand the role of technologies in urban areas, particularly in health service delivery and how healthcare workers mediate these health platforms. Using a case study of Varanasi city in Uttar Pradesh, India this study documents whether—and to what extent—digital technologies and services enable citizens and service providers to access and improve their lived experiences. The findings indicate a top-down, innovation-focussed model is adopted which excludes and alienates different user groups and citizens shaping their interaction and access to these services. [ABSTRACT FROM AUTHOR]

Objectives Personal protective equipment (PPE) use is associated with reduced risk of SARS-CoV-2 infection among healthcare personnel (HCP). There are limited data on the impact of the novel coronavirus disease 2019 (COVID-19) pandemic on the PPE use of HCP. We describe the changes in PPE use from just before the widespread of community outbreaks ('pre-pandemic') to intra-pandemic time points, and examine factors associated with not changing in PPE use behavior among HCP in four Thai hospitals. Methods We performed a retrospective cohort evaluation using two-time points: (i) February-March 2020 (pre-pandemic period); and (ii) January–March 2021 (intra-pandemic period). Self-reported frequency of appropriate PPE use was measured by a Likert scale. We used multivariable logistic regression to identify factors associated with no increase in self-reported PPE use. Results Of 343 HCP, the proportion of participants reporting 'always' using PPE rose from 66% during the pre-pandemic period to 80% during the pandemic. Factors associated with HCP who did not increase in PPE use included having high baseline reported PPE, being a non-registered HCP (e.g. nurse assistants, dental assistants, porters), being male, and having a low perceived risk of becoming infected with any respiratory virus while working in the hospital. Conclusion PPE education, training, and risk communication content should target all cadres of HCP, regardless of registered/non-registered status, with a focus on behavior change for improved prevention and control of SARS-CoV-2 and other respiratory viruses in healthcare settings. [ABSTRACT FROM AUTHOR]

Objectives We estimated influenza-like symptom (ILS) incidence among healthcare personnel (HCP) in four hospitals and the economic impact due to ILS in the Thai HCP population during July 2020–June 2021 (Thailand's expected 2020 influenza season), which also coincided with the novel coronavirus disease 2019 pandemic. Methods We followed HCP, in a prospective observational cohort, weekly for ≥1 of: muscle pain, cough, runny nose/nasal congestion, sore throat, or difficulty breathing. We fitted population-averaged Poisson regression models to identify factors associated with acquiring ILS and to calculate ILS incidence. We applied epidemiologic parameters to Thailand's HCP population (227 349 persons) to estimate economic impact. Results Of 2184 participants, adjusted all-cause ILS incidence was 6.1 episodes per 100 person-years (95% confidence interval 3.4–10.9). Among Thailand's HCP population, 13 909 ILS episodes were estimated to occur annually and would result in US$235 135 economic loss. Controlling for study site and calendar month, factors associated with acquiring ≥1 ILS versus no ILS included being female, having asthma, and using personal protective equipment 'frequently, but not always'. Conclusions All-cause ILS resulted in considerable economic loss among Thai HCP workforce. These findings underscore the importance of public health interventions to reduce the risk of acquiring ILS. [ABSTRACT FROM AUTHOR]

Background Reports on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spread across Africa have varied, including among healthcare workers (HCWs). This study assessed the comparative SARS-CoV-2 burden and associated risk factors among HCWs in three African countries. Methods A multicentre study was conducted at regional healthcare facilities in Côte d'Ivoire (CIV), Burkina Faso (BF) and South Africa (SA) from February to May 2021. HCWs provided blood samples for SARS-CoV-2 serology and nasopharyngeal/oropharyngeal swabs for testing of acute infection by polymerase chain reaction and completed a questionnaire. Factors associated with seropositivity were assessed with logistic regression. Results Among 719 HCWs, SARS-CoV-2 seroprevalence was 34.6% (95% confidence interval 31.2 to 38.2), ranging from 19.2% in CIV to 45.7% in BF. A total of 20 of 523 (3.8%) were positive for acute SARS-CoV-2 infection. Female HCWs had higher odds of SARS-CoV-2 seropositivity compared with males, and nursing staff, allied health professionals, non-caregiver personnel and administration had higher odds compared with physicians. HCWs also reported infection prevention and control (IPC) gaps, including 38.7% and 29% having access to respirators and IPC training, respectively, in the last year. Conclusions This study was a unique comparative HCW SARS-CoV-2 investigation in Africa. Seroprevalence estimates varied, highlighting distinctive population/facility-level factors affecting COVID-19 burden and the importance of established IPC programmes to protect HCWs and patients. [ABSTRACT FROM AUTHOR]

Introduction To treat and properly care for COVID-19 patients it is vital to have healthy healthcare workers to ensure the continued function of the healthcare system and to prevent transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to patients, co-workers, and the community. Personal protective equipment (PPE) can prevent healthcare workers from being infected with and transmitting SARS-CoV-2. Experience and training are pivotal to ensure optimal protection. This study aims to examine the use and failure of PPE and compliance with PPE guidelines during the first and the second wave of the COVID-19 pandemic among Danish healthcare workers. Methods Healthcare workers from the Central Denmark Region and the Capital Region of Denmark were invited to participate April–June 2020 during the first wave and November 2020–April 2021 during the second wave. Day-by-day, participants reported work procedures, use and failure of PPE, and compliance with PPE guidelines. Register-based information on sex, age, department, and profession was available for all participants. Results In total, 21 684 and 10 097 healthcare workers participated during the first and the second wave, respectively. During the first wave, 1.7% used filtering face piece-2 or -3 (FFP2 or FFP3) respirators and 8.2% used face masks [fluid resistant (type IIR) masks, masks with visor (typically type IIR), and other unspecified face masks] during physical contact with patients. During the second wave, the corresponding figures increased to 17.8% and 80.7%. During respiratory procedures, the use of FFP2 or FFP3 respirators increased from 5.6 to 24.3%, and the use of face masks from 14.7 to 77.8%. The no PPE use decreased from 21.3% during the first wave to 0.4% in the second wave, during respiratory procedures. Total PPE failures decreased from 0.7 to 0.4% from the first to second wave. The proportion not complying with PPE guidelines declined from 3.6 to 2.2% during physical contact with patients and from 6.5 to 4.6% during respiratory procedures. PPE failure and non-compliance varied by age, sex and type of department. Frequent reasons for non-compliance were forgetfulness and lack of time , and during the first but not during the second wave, limited availability of PPE. Conclusion We found a substantial increase in the use of PPE and a substantial decrease in PPE failures from the first to the second wave of COVID-19 in Denmark. However, there is still a need for continuous focus on compliance in use of PPE among healthcare workers. [ABSTRACT FROM AUTHOR]

Background: The families of healthcare professionals are one of the most vulnerable groups whose lives have been severely damaged by the COVID-19 pandemic. So far, the experiences and perceptions of these individuals have not been explored. The present study aims to investigate the experiences and perceptions of the family members of the healthcare professionals during COVID-19.Methods: The present study is a qualitative research with a phenomenological design. The participants were 25 family members of healthcare professionals which were selected from the medical centres in Iran via purposeful sampling from August 2021 to October 2021. The sampling was kept on until the data became saturated. To collect data, individual semi-structured interviews were conducted online. The Colaizzi approach was used to analyse the data collected.Results: The findings of the study emerged as two main themes: psychological tension with five categories (indescribable fear and worry, longing to see their loved ones, patient stone, bitter farewell, fear of the future) and dignity with four categories (acclamation, appreciation, feeling proud, spiritual growth).Conclusion: During the COVID-19 pandemic, the family members of healthcare professionals have experienced dignity combined with the degrees of psychological tension which were beyond the experiences of the majority of people in the society, but similar to the psychological tension experienced by the families of COVID-19 victims. The families of healthcare workers are continuously anxious about the safety of their loved ones who are responsible to obtain the treatment of COVID-19 patients, which potentially jeopardizes their physical and psychological well-being. Therefore, the appreciation and support of people in the community of the family members of healthcare professionals have increased their tolerance. Healthcare providers can successfully promote the health of healthcare professionals' families by providing comprehensive assistance to healthcare personnel and their families. [ABSTRACT FROM AUTHOR]

Studies on the differential effects of health emergencies have largely overlooked women health workers. Whilst the literature has shown the impact of Coronavirus disease-19 (COVID-19) on women and on healthcare workers, little research has considered the gendered effects of the health workforce. This article analyses the impact of COVID-19 on healthcare workers and working conditions in Brazil's public healthcare system, through consideration of gendered and racialized understandings of care and work. Data were taken from an online survey of 1,263 health workers, undertaken between September and October 2020, disaggregated by sex and by race in order to understand health workers' experiences of the pandemic in one of the countries most significantly affected by the crisis. [ABSTRACT FROM AUTHOR]

Objective COVID-19 in post-partum women is commonly overlooked. The present study assessed whether puerperium is an independent risk factor of COVID-19 related in-hospital maternal death and whether fatality is preventable in the Brazilian context. Methods We retrospectively studied the clinical data of post-partum/pregnant patients hospitalized with COVID-19 gathered from a national database that registered severe acute respiratory syndromes (SIVEP-Gripe) in Brazil. Logistic regressions were used to examine the associations of in-hospital mortality with obstetric status and with the type of public healthcare provider, adjusting for socio-demographic, epidemiologic, clinical and healthcare-related measures. Results As of 30 November 2021, 1943 (21%) post-partum and 7446 (79%) pregnant patients of age between 15 and 45 years with COVID-19 that had reached the clinical endpoint (death or discharge) were eligible for inclusion. Case-fatality rates for the two groups were 19.8% and 9.2%, respectively. After the adjustment for covariates, post-partum patients had almost twice the odds of in-hospital mortality compared with pregnant patients. Patients admitted to private (not-for-profit) hospitals, those that had an obstetric centre or those located in metropolitan areas were less likely to succumb to SARS-CoV-2 infection. Those admitted to the Emergency Care Unit had similar mortality risk to those admitted to other public healthcare providers. Conclusion We demonstrated that puerperium was associated with an increased odds of COVID-19-related in-hospital mortality. Only part of the risk can be reduced by quality healthcare such as non-profit private hospitals, those that have an obstetric centre or those located in urban areas. [ABSTRACT FROM AUTHOR]

Background: Boston Medical Center (BMC) is a safety net hospital in Boston, and from the initial wave of COVID-19 there has been an overwhelming concern about the exposure of healthcare workers (HCWs) to SARS-CoV-2. Methods: We conceived a study to follow a cohort of BMC HCWs, beginning in July 2020 and continuing for 15 months, collecting survey data and serum samples at approximately 3-month intervals. Serum samples were analyzed using the Abbott Architect i2000 for SARS-CoV-2 antibodies (anti-spike1-Receptor Binding Domain IgG and anti-nucleoprotein IgG). Positive anti-n IgG results were used, in addition to reverse transcription-PCR results, for identifying cases of infection. History of COVID-19 and vaccination status were confirmed, where possible, using electronic medical records. Participants were grouped according to vaccination and infection status in September 2021 for analysis of anti-s IgG trends. Results: A majority of HCWs remain well above the positivity threshold for anti-spike IgG antibodies for up to 11 months post-vaccination and 15 months post-infection, regardless of combinations and permutations of vaccination and infection. Those with COVID-19 infection before vaccination had significantly higher median serum antibody concentrations in comparison to HCWs with no prior infection at each follow-up time point. Conclusions: These findings further support what is known regarding the decline in serum antibody concentrations following natural infection and vaccination, adding knowledge of serum antibody levels for up to 15 months post- infection and 11 months post-vaccination. [ABSTRACT FROM AUTHOR]

Background: Point-of-care SARS-CoV-2 antigen tests have great potential to help combat the COVID-19 pandemic. In the performance of a rapid, antigen-based SARS-CoV-2 test (RAT), our study had 3 main objectives: to determine the accuracy of nasal swabs, the accuracy of using nasopharyngeal swabs for nasal collection (nasalNP), and the effectiveness of using residual extraction buffer for real-time reverse-transcriptase PCR (RT–PCR) confirmation of positive RAT (rPan). Methods: Symptomatic adults recently diagnosed with COVID-19 in the community were recruited into the study. Nasal samples were collected using either a nasalNP or nasal swab and tested immediately with the RAT in the individual's home by a health care provider. 500 µL of universal transport media was added to the residual extraction buffer after testing and sent to the laboratory for SARS-CoV-2 testing using RT–PCR. Parallel throat swabs tested with RT–PCR were used as the reference comparators. Results: One hundred and fifty-five individuals were included in the study (99 nasal swabs, 56 nasalNP). Sensitivities of nasal samples tested on the RAT using either nasal or nasalNP were 89.0% [95% confidence interval (CI) 80.7%–94.6%] and 90.2% (95% CI 78.6%–96.7%), respectively. rPan positivity agreement compared to throat RT–PCR was 96.2%. Conclusions: RAT reliably detect SARS-CoV-2 from symptomatic adults in the community presenting within 7 days of symptom onset using nasal swabs or nasalNP. High agreement with rPan can avoid the need for collecting a second swab for RT–PCR confirmation or testing of variants of concern from positive RAT in this population. [ABSTRACT FROM AUTHOR]

Background Reactogenicity of coronavirus disease 2019 (COVID-19) vaccines can result in inability to work. The object of this study was to evaluate health care workers' sick leave after COVID-19 vaccination and to compare it with sick leave due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and quarantine leave. Methods A multicenter cross-sectional survey was conducted at Regensburg University Medical Center and 10 teaching hospitals in South-East Germany from July 28 to October 15, 2021. Results Of 2662 participants, 2309 (91.8%) were fully vaccinated without a history of SARS-CoV-2 infection. Sick leave after first/second vaccination occurred in 239 (10.4%) and 539 (23.3%) participants. In multivariable logistic regression, the adjusted odds ratio for sick leave after first/second vaccination compared with BNT162b2 was 2.26/3.72 for mRNA-1237 (95% CI, 1.28–4.01/1.99–6.96) and 27.82/0.48 for ChAdOx1-S (95% CI, 19.12–40.48/0.24–0.96). The actual median sick leave (interquartile range [IQR]) was 1 (0–2) day after any vaccination. Two hundred fifty-one participants (9.4%) reported a history of SARS-CoV-2 infection (median sick leave [IQR] 14 [10–21] days), 353 (13.3%) were quarantined at least once (median quarantine leave [IQR], 14 [10–14] days). Sick leave due to SARS-CoV-2 infection (4642 days) and quarantine leave (4710 days) accounted for 7.7 times more loss of workforce than actual sick leave after first and second vaccination (1216 days) in all fully vaccinated participants. Conclusions Sick leave after COVID-19 vaccination is frequent and is associated with the vaccine applied. COVID-19 vaccination should reduce the much higher proportion of loss of workforce due to SARS-CoV-2 infection and quarantine. [ABSTRACT FROM AUTHOR]

Background The COVID-19 pandemic has put immense pressure on the National Health Service (NHS) and all healthcare professionals, not only physically but also mentally and the need to fully develop and implement a strategy to protect the mental health of healthcare professionals has never been more urgent. Research has demonstrated that staff can be supported by strengthening teams and offering frequent well-being support. Aims To assess the feedback from delivery of a strategy to provide psychological well-being support to NHS staff during the COVID-19 pandemic and whether this 'Support for Teams' initiative made a positive impact on staff and in what way. Methods A mixed methods design was used to gain quantitative and qualitative feedback from staff. Feedback was collected from two groups: Well-being Leads and clinicians providing support and resources to Well-being Leads. Feedback was collected via online forms. Results Collectively, feedback responses were received from 70 staff members. The majority of staff members felt supported and benefitted from the provisions provided. Conclusions This evaluation showed that our healthcare system must continue to proactively implement and adapt staff support strategies to protect the mental well-being of healthcare professionals, both in the context of future health crises and in everyday practice. This study will assist and guide development and adaptations to health and psychological well-being support, ahead of future pandemics and to provide suitable support beyond the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Aims Since its emergence in early 2020, the novel severe acute respiratory syndrome coronavirus 2 causing coronavirus disease 2019 (COVID-19) has reached pandemic levels, and there have been repeated outbreaks across the globe. The aim of this two part series is to provide practical knowledge and guidance to aid clinicians in the diagnosis and management of cardiovascular (CV) disease in association with COVID-19. Methods and results A narrative literature review of the available evidence has been performed, and the resulting information has been organized into two parts. The first, which was reported previously, focused on the epidemiology, pathophysiology, and diagnosis of CV conditions that may be manifest in patients with COVID-19. This second part addresses the topics of: care pathways and triage systems and management and treatment pathways, both of the most commonly encountered CV conditions and of COVID-19; and information that may be considered useful to help patients with CV disease (CVD) to avoid exposure to COVID-19. Conclusion This comprehensive review is not a formal guideline but rather a document that provides a summary of current knowledge and guidance to practicing clinicians managing patients with CVD and COVID-19. The recommendations are mainly the result of observations and personal experience from healthcare providers. Therefore, the information provided here may be subject to change with increasing knowledge, evidence from prospective studies, and changes in the pandemic. Likewise, the guidance provided in the document should not interfere with recommendations provided by local and national healthcare authorities. [ABSTRACT FROM AUTHOR]

Background: Saliva has garnered great interest as an alternative specimen type for molecular detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Data are limited on the relative performance of different molecular methods using saliva specimens and the relative sensitivity of saliva to nasopharyngeal (NP) swabs. Methods: To address the gap in knowledge, we enrolled symptomatic healthcare personnel (n = 250) from Barnes-Jewish Hospital/Washington University Medical Center and patients presenting to the Emergency Department with clinical symptoms compatible with coronavirus disease 2019 (COVID-19; n = 292). We collected paired saliva specimens and NP swabs. The Lyra SARS-CoV-2 assay (Quidel) was evaluated on paired saliva and NP samples. Subsequently we compared the Simplexa COVID-19 Direct Kit (Diasorin) and a modified SalivaDirect (Yale) assay on a subset of positive and negative saliva specimens. Results: The positive percent agreement (PPA) between saliva and NP samples using the Lyra SARS-CoV-2 assay was 63.2%. Saliva samples had higher SARS-CoV-2 cycle threshold values compared to NP swabs (P < 0.0001). We found a 76.47% (26/34) PPA for Simplexa COVID-19 Direct Kit on saliva and a 67.6% (23/34) PPA for SalivaDirect compared to NP swab results. Conclusion: These data demonstrate molecular assays have variability in performance for detection of SARS-CoV-2 in saliva. [ABSTRACT FROM AUTHOR]

Cases of coronavirus disease 2019 (COVID-19) have been reported in more than 200 countries. Thousands of health workers have been infected, and outbreaks have occurred in hospitals, aged care facilities, and prisons. The World Health Organization (WHO) has issued guidelines for contact and droplet precautions for healthcare workers caring for suspected COVID-19 patients, whereas the US Centers for Disease Control and Prevention (CDC) has initially recommended airborne precautions. The 1- to 2-meter (≈3–6 feet) rule of spatial separation is central to droplet precautions and assumes that large droplets do not travel further than 2 meters (≈6 feet). We aimed to review the evidence for horizontal distance traveled by droplets and the guidelines issued by the WHO, CDC, and European Centre for Disease Prevention and Control on respiratory protection for COVID-19. We found that the evidence base for current guidelines is sparse, and the available data do not support the 1- to 2-meter (≈3–6 feet) rule of spatial separation. Of 10 studies on horizontal droplet distance, 8 showed droplets travel more than 2 meters (≈6 feet), in some cases up to 8 meters (≈26 feet). Several studies of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) support aerosol transmission, and 1 study documented virus at a distance of 4 meters (≈13 feet) from the patient. Moreover, evidence suggests that infections cannot neatly be separated into the dichotomy of droplet versus airborne transmission routes. Available studies also show that SARS-CoV-2 can be detected in the air, and remain viable 3 hours after aerosolization. The weight of combined evidence supports airborne precautions for the occupational health and safety of health workers treating patients with COVID-19. [ABSTRACT FROM AUTHOR]

Background Few studies have assessed depression in healthcare workers (HCWs) in Japan owing to the coronavirus disease 2019 (COVID-19) pandemic, and no studies have proposed effective interventions to help support their mental health. Aims To test the hypothesis that enhancing access to mental healthcare professionals helps to improve HCWs' mental health. Methods This cross-sectional study assessed depressive symptoms in HCWs at three hospitals in Osaka prefecture between May and July, 2020. The survey obtained information on HCWs' mental state and related situations/perceptions. Multivariable logistic regression analysis was performed to identify factors associated with depressive symptoms. Results Of the 3291 eligible HCWs, 1269 (39%) completed the survey. Of all HCWs, 87 (7%) were physicians, and 700 (55%) were nurses. A total of 181 (14%) HCWs had moderate-to-severe symptoms of depression. Being a frontline worker was not significantly associated with depressive symptoms (odds ratio: 0.86 [95% confidence intervals: 0.54–1.37], P = 0.50). The unwillingness to consult with anyone was significantly associated with more severe depressive symptoms (1.70 [1.10–2.63], P < 0.01). HCWs who had no opportunity to confide in family/friends (1.66 [1.10–2.52], P < 0.01) or colleagues/supervisors (3.19 [2.22–4.58], P < 0.001) were significantly more likely to have depressive symptoms. Conclusions Being a frontline HCW in a Japanese hospital treating patients with COVID-19 was not significantly associated with having depressive symptoms. The study highlights that encouraging daily communication with close persons (family, friends, colleagues and supervisors), rather than improving access to mental health professionals, might help to prevent depression in HCWs during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

By applying multivariate regression to 2020 survey data from four Tehran hospitals, we measure eight recognized sources of Coronavirus disease 2019 (COVID-19) pandemic-related anxiety among 723 healthcare workers (HCWs) with diverse sociodemographic characteristics employed across different hospital areas and positions. The most prominent anxiety source identified is the risk of workplace COVID-19 contraction and transmission to family, followed by uncertainty about organizational support for personal and family needs in the event of worker infection. A supplemental qualitative analysis of 68 respondents in the largest hospital identifies four additional anxiety sources, namely, health, finances, workload, and leadership. This evidence of the multifaceted nature of anxiety sources among HCWs highlights the differentiated approaches that hospital policymakers must take to combat anxiety. [ABSTRACT FROM AUTHOR]

Background The spread of severe acute respiratory coronavirus 2 (SARS-CoV-2) among active workers is poor known. The aim of our study was to evaluate the seroprevalence of immunoglobulin G (IgG) among a convenience sample of workers and to identify high-risk job sectors during the first pandemic way. Methods We conducted a cross-sectional study among workers tested for SARS-CoV-2 between 28 March and 7 August 2020, recorded by a private healthcare center located in North-West Italy. Association among seroprevalence and demographic and occupational variables was evaluated using chi square test and the seroprevalence and 95% confidence intervals (CI) were calculated. Results We collected the results for 23568 serological tests from a sample of 22708 workers from about 1000 companies. Median age was 45 years and about 60% of subjects were male. The overall seroprevalence was 4.97% [95%CI 4.69–5.25]. No statistical difference was found among gender while seroprevalence was associated with subjects' age, geographical location, and occupational sector. Significantly higher values of positivity were observed for the logistics sector (31.3%), weaving factory (12.6%), nursing homes (9.8%), and chemical industry (6.9%) workers. However, we observed some clusters of cases in single companies independently from the sector. Then, a detailed focus on 940 food workers shown a seroprevalence of 5.21% [95%CI 3.79–6.63] and subjects who self-reported COVID-19 symptoms and who worked during lockdown had a higher probability of being infected (p < 0.001). Conclusions Data obtained might be useful for future public health decision; more than occupation sector, it seems that failure on prevention system in single companies increase the SARS-CoV-2 transmission. [ABSTRACT FROM AUTHOR]

Background The frequency of asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections is unclear and may be influenced by how symptoms are evaluated. In this study, we sought to determine the frequency of asymptomatic SARS-CoV-2 infections in a prospective cohort of health care workers (HCWs). Methods A prospective cohort of HCWs, confirmed negative for SARS-CoV-2 exposure upon enrollment, were evaluated for SARS-CoV-2 infection by monthly analysis of SARS-CoV-2 antibodies as well as referral for polymerase chain reaction testing whenever they exhibited symptoms of coronavirus disease 2019 (COVID-19). Participants completed the standardized and validated FLU-PRO Plus symptom questionnaire scoring viral respiratory disease symptom intensity and frequency at least twice monthly during baseline periods of health and each day they had any symptoms that were different from their baseline. Results Two hundred sixty-three participants were enrolled between August 25 and December 31, 2020. Through February 28, 2021, 12 participants were diagnosed with SARS-CoV-2 infection. Symptom analysis demonstrated that all 12 had at least mild symptoms of COVID-19, compared with baseline health, near or at time of infection. Conclusions These results suggest that asymptomatic SARS-CoV-2 infection in unvaccinated, immunocompetent adults is less common than previously reported. While infectious inoculum doses and patient factors may have played a role in the clinical manifestations of SARS-CoV-2 infections in this cohort, we suspect that the high rate of symptomatic disease was due primarily to participant attentiveness to symptoms and collection of symptoms in a standardized, prospective fashion. These results have implications for studies that estimate SARS-CoV-2 infection prevalence and for public health measures to control the spread of this virus. [ABSTRACT FROM AUTHOR]

Background In the third quarter of 2021, government entities enacted vaccine requirements across multiple employment sectors, including healthcare. Experience from previous vaccination campaigns within healthcare emphasize the need to translate community modalities of vaccine outreach and education that partner with Black communities, Indigenous communities, and communities of Color stakeholders to increase vaccine confidence broadly. Methods This was an observational feasibility study conducted from August through October 2021 that deployed and measured the effect of a multimodal approach to increasing vaccine uptake in healthcare employees. Vaccine data were acquired through the Center for Disease Control Immunization Information Systems across Oregon and Washington. Rates of complete vaccination before the intervention were compared with rates after as a measure of feasibility of this intervention. These data were subdivided by race/ethnicity, age, gender, and job class. Complete vaccination was defined as completion of a 2-dose mRNA SARS-CoV-2 vaccine series or a 1-dose adenoviral vector SARS-CoV-2 vaccine. Results Overall preintervention and postintervention complete vaccination rates were 83.7% and 93.5%, respectively. Of those employees who identified as a certain race, black employees demonstrated the greatest percentage difference increase, 18.5% (preintervention, 72.1%; postintervention, 90.6%), followed by Hispanic employees, 14.1% (preintervention, 79.4%; postintervention, 93.5%), and employees who identify as 2 or more races, 13.9% (preintervention, 78.7%; postintervention, 92.6%) Conclusions We found that a multimodal approach to improving vaccination uptake in employees was feasible. For organizations addressing vaccine requirements for their workforce, we recommend a multimodal strategy to increase vaccine confidence and uptake. [ABSTRACT FROM AUTHOR]

Background Health care workers (HCWs) have been recognized as being at higher risk for coronavirus disease 2019 (COVID-19) infection; however, relevant factors and magnitude have not been clearly elucidated. Aim This study was aimed to describe COVID-19 infections among hospital employees at a large tertiary care hospital located in Ontario, Canada from March to July 2020, towards better understanding potential risk factors. Methods Data on all HCWs with either a positive COVID test or a high-risk exposure from March to July 2020 were analyzed. HCWs with positive COVID test results and high-risk exposures were described. Those who developed COVID-19 following high-risk exposure were compared to those who did not. Data were also analyzed to determine trends over time. Results Over the period of observation, 193 staff (2% of total working staff) had a positive COVID-19 test. Incidence of HCW infections closely followed community incidence. Overall, 31% of COVID-19 cases were deemed occupationally acquired. Of these, 41% were acquired from a patient, with the remainder (59%) from fellow staff. Over the same period, 204 staff were identified as having a high-risk exposure. The majority of exposures (55%) were patient-associated, with the remaining (45%) resulting from staff-to-staff contact. Overall, 13% went on to develop COVID-19. Of these cases, 58% were patient-associated and 42% were a result of staff-to-staff transmission. Conclusions HCWs are at risk for work-related COVID-19. Given the number of infections attributed to staff–staff transmission, greater attention could be paid to implementing prevention measures in non-clinical areas. [ABSTRACT FROM AUTHOR]

Background: In North America, both messenger RNA (mRNA) vaccines, Pfizer-BioNTech BNT162b2, and Moderna mRNA-1273, each utilizing a 2-dose regimen, have started to be administered to individuals. Methods: We evaluated the quantitative serologic antibody response following administration of either a single dose or both doses of an mRNA severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine in a cohort of 98 participants (88 healthcare workers [HCW] and 10 solid organ transplant [SOT] recipients). Antibody levels were compared across 3 immunoassays: Elecsys Anti-SARS-CoV-2 S (Roche Diagnostics), SARS-CoV-2 TrimericS IgG (DiaSorin), and SARS-CoV-2 IgG II Quant (Abbott). Results: Among HCW, sensitivity ranged from 100% (Roche), 99% (Abbott) and 98% (DiaSorin). The SARS-CoV-2 IgG II Quant and SARS-CoV-2 TrimericS IgG assays showed good agreement with a Pearson correlation coefficient of R = 0.95. Pearson correlation coefficients of R = 0.82 and 0.83 were obtained for Elecsys Anti-SARS-CoV-2 S vs SARS-CoV-2 TrimericS IgG and SARS-CoV-2 IgG II Quant vs Elecsys Anti-SARS-CoV-2 S, respectively. Significant differences in antibody levels between HCW and SOT recipients were observed. A decrease in antibody levels from time of vaccine administration to blood draw was evident. Among those with a second dose, an increase in antibody levels with increased time between administration of the first and second dose was observed. Conclusions: The absolute values generated from each of the assay platforms are not interchangeable. Antibody levels differed with increased time between vaccine administration and with increased time between administration of the first and second dose. Further, significant differences in antibody levels between HCW and SOT recipients were observed. [ABSTRACT FROM AUTHOR]

Background Iraq has been exceptionally challenged by the COVID-19 pandemic due to the already exhausted healthcare system. Objectives To describe the epidemiological situation of COVID-19 in Iraq, the government's response to the pandemic, and provide recommendations for further action. Methods A desk review of secondary data using the available reports on the epidemiological situation in Iraq as well as official governmental sources was conducted. Results The major surge in the number of COVID-19 cases occurred in the first week of June and continued to increase dramatically until mid-October when a significant decrease happened. With a few exceptions, the reproductive number R has been consistently above 1. Patients aged 30–39 years (25.6%) were the most affected, while those aged 60–69 years (26.7%) had the highest deaths rates. Iraq tried to contain the pandemic through several regulations: border control, enforcing curfew, mask-wearing, and social distancing, COVID-19 isolation centers, expanding lab capacity, contact tracing, as well as several supportive economic measures. However, the extent of implementing these regulations is questionable. Conclusion Additional administrative and scientific measures with special emphasis on handling mass gathering, coordination with media and better training of healthcare workers particularly on infection prevention and control. [ABSTRACT FROM AUTHOR]

Background: COVID-19 is the fifth and most significant infectious disease epidemic this century. Primary health care providers, which include those working in primary care and public health roles, have critical responsibilities in the management of health emergencies.Objective: To synthesize accounts of primary care lessons learnt from past epidemics and their relevance to COVID-19.Methods: We conducted a review of lessons learnt from previous infectious disease epidemics for primary care, and their relevance to COVID-19. We searched PubMed/MEDLINE, PROQUEST and Google Scholar, hand-searched reference lists of included studies, and included research identified through professional contacts.Results: Of 173 publications identified, 31 publications describing experiences of four epidemics in 11 countries were included. Synthesis of findings identified six key lessons: (i) improve collaboration, communication and integration between public health and primary care; (ii) strengthen the primary health care system; (iii) provide consistent, coordinated and reliable information emanating from a trusted source; (iv) define the role of primary care during pandemics; (v) protect the primary care workforce and the community and (vi) evaluate the effectiveness of interventions.Conclusions: Evidence highlights distinct challenges to integrating and supporting primary care in response to infectious disease epidemics that have persisted over time, emerging again during COVID-19. These insights provide an opportunity for strengthening, and improved preparedness, that cannot be ignored in a world where the frequency, virility and global reach of infectious disease outbreaks are increasing. It is not too soon to plan for the next pandemic, which may already be on the horizon. [ABSTRACT FROM AUTHOR]

Objectives The aim of the present study was to investigate changes in the psychological state of medical personnel in the Department of Radiotherapy during the COVID-19 epidemic. Methods Psychological state was evaluated using the Pittsburgh Sleep Quality Index (PSQI), Self-Rating Depression Scale (SDS), and Self-Rating Anxiety Scale (SAS). All three questionnaires were first completed by medical personnel on 17–18 February 2020 and were repeated every 3 months thereafter until 17–18 August. The number and intentions of patients receiving radiotherapy (RT) in our department were also collected. Results Twenty medical personnel participated in the present study. The global PSQI score recorded in August was significantly lower than that recorded in February (P = 0.045). Among the seven components of the PSQI, sleep quality (P = 0.048) and daytime dysfunction (P = 0.006) in August were significantly improved compared with February, whereas SDS and SAS did not significantly differ among the three different time points. The proportion of patients who received palliative radiotherapy was significantly higher on 18 May than on 17 February (P = 0.005). Conclusions Medical personnel in the Department of Radiotherapy experienced a significantly elevated incidence of sleeping problems during the early COVID-19 outbreak period. Multiple combinations of protective measures to avoid infection could improve sleep quality and ensure the safe delivery of RT to cancer patients. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 has taken a severe toll on the transplant community, with significant morbidity and mortality not just among transplant patients and those on the waiting list, but also among colleagues. It is therefore not surprising that clinicians in this field have viewed the events of the last 18 months as predominantly negative. As the pandemic is gradually ebbing away, we argue that this is also a unique opportunity to rethink transplant assessment. First, we have witnessed a step-change in the use of technology and virtual assessments. Another effect of the pandemic is that we have had to make do with what was available—which has often worked surprisingly well. Finally, we have learned to think the unthinkable: maybe things do not have to continue the way they have always been. As we emerge on the other side of the pandemic, we should rethink which parts of the transplant assessment process are necessary and evidence-based. We emphasize the need to involve patients in the redesign of pathways and we argue that the assessment process could be made more transparent to patients. We describe a possible roadmap towards transplant assessment pathways that are truly fit for the 21st century. [ABSTRACT FROM AUTHOR]

Background: The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has infected over 110 million individuals and led to 2.5 million deaths worldwide. As more individuals are vaccinated, the clinical performance and utility of SARS-CoV-2 serology platforms needs to be evaluated. Methods: The ability of 4 commercial SARS-CoV-2 serology platforms to detect previous infection or vaccination were evaluated using a cohort of 53 patients who were SARS-CoV-2 PCR positive, 89 SARS-CoV-2-vaccinated healthcare workers (Pfizer or Moderna), and 127 patients who were SARS-CoV-2 negative. Serology results were compared to a cell-based SARS-CoV-2 pseudovirus (PSV) neutralizing antibodies assay. Results: The Roche S-(spike) antibody and Diazyme neutralizing antibodies (NAbs) assays detected adaptive immune response in 100.0% and 90.1% of vaccinated individuals who received 2 doses of vaccine (initial and booster), respectively. The Roche N-(nucleocapsid) antibody assay and Diazyme IgG assay did not detect adaptive immune response in vaccinated individuals. The Diazyme NAbs assay correlated with the PSV SARS-CoV-2 median infective dose (ID50) neutralization titers (R2 = 0.70), while correlation of the Roche S-antibody assay was weaker (R2 = 0.39). Median PSV SARS-CoV-2 ID50 titers more than doubled in vaccinated individuals who received 2 doses of the Moderna vaccine (ID50, 597) compared to individuals who received a single dose (ID50, 284). Conclusions: The Roche S-antibody and Diazyme NAbs assays robustly detected adaptive immune responses in SARS-CoV-2 vaccinated individuals and SARS-CoV-2 infected individuals. The Diazyme NAbs assay strongly correlates with the PSV SARS-CoV-2 NAbs in vaccinated individuals. Understanding the reactivity of commercially available serology platforms is important when distinguishing vaccination response versus natural infection. [ABSTRACT FROM AUTHOR]

Background Psychiatric patients are perceived to be especially vulnerable during a pandemic, as it increases stress and uncertainty. Several current publications have considered obsessive-compulsive disorder (OCD) patients to be particularly vulnerable during the coronavirus disease 2019 (COVID-19), and clinicians were advised to adjust treatments accordingly. The purpose of this study was to evaluate the 2- and 6-month impacts of COVID-19 on the symptom severity of OCD patients. Methods A cohort of OCD patients actively treated with Exposure and Response Prevention (ERP) combined with pharmacological treatment was evaluated as part of their regular psychiatric assessment twice: 113 patients were evaluated at their 2-month follow-up and 90 patients (from that cohort) were evaluated at their 6-month follow up. Results Obsessive-compulsive symptom deterioration was not present in 84% of the patients at the 2-month follow-up and 96% of the patients at the 6-month follow-up. The results were also replicated in the OCD subgroup that included patients with contamination (washers) and illness obsessions, who were believed to be particularly vulnerable considering their obsessional content. Conclusions OCD patients (including those with obsessions related to contamination and health) who were under active ERP and pharmacological treatment did not experience exacerbated symptoms during COVID-19 at their 2- and 6-month follow-ups. [ABSTRACT FROM AUTHOR]

In early 2020, the COVID-19 pandemic swept through the UK and had a major impact on healthcare services. The Birmingham hand centre, one of the largest hand trauma units in the country, underwent a dramatic service reconfiguration to enable robust and safe provision of care that would withstand the peak of the pandemic. Streamlining our service significantly reduced patient footfall and hospital admission while preventing intra-hospital viral transmission. Many of the changes implemented have been kept as permanent adjustments to our practice as this new model of care yields higher patient satisfaction and efficacy to withstand the pressures of further peaks in the pandemic. [ABSTRACT FROM AUTHOR]

The rapid spread of severe acute respiratory syndrome coronavirus 2 infection across the globe triggered an unprecedented increase in research activities that resulted in an astronomical publication output of observational studies. However, most studies failed to apply fully the necessary methodological techniques that systematically deal with different biases and confounding, which not only limits their scientific merit but may result in harm through misleading information. In this article, we address a few important biases that can seriously threaten the validity of observational studies of coronavirus disease 2019 (COVID-19). We focus on treatment selection bias due to patients' preference on goals of care, medical futility and disability bias, survivor bias, competing risks, and the misuse of propensity score analysis. We attempt to raise awareness and to help readers assess shortcomings of observational studies of interventions in COVID-19. [ABSTRACT FROM AUTHOR]

Background Health care workers are at a higher risk of getting infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) than the general population. Knowledge about medical students' exposure to SARS-CoV-2 is lacking. Thus, we measured the prevalence of SARS-CoV-2 antibodies in a cohort of Danish medical students. Methods We invited all medical students at the University of Copenhagen (UCPH) to participate. Students underwent venous blood sampling and a questionnaire about work-life behaviors possibly associated with SARS-CoV-2 exposure and coronavirus disease 2019 (COVID-19) symptoms. Samples were analyzed for total immunoglobulin G (IgG) antibodies against SARS-CoV-2, and seropositive samples were screened for IgG, immunoglobulin M, and immunoglobulin A antibodies. We determined associations between seropositivity and clinical and social activities and self-reported symptoms. Results Between October 19 and 26, 1120 students participated in the questionnaire and 1096 were included. Of all included, 379 (34.58%) were seropositive. Seropositivity was associated with attendance at 2 parties at UCPH, on February 29 and March 6, 2020 (odds ratio [OR], 5.96; 95% CI, 4.34–8.24; P  < .001). Four hundred sixty-one students (42.06%) worked with COVID-19 patients, which was significantly associated with seropositivity (OR, 1.38; 95% CI, 1.03–1.85; P  = .033). The symptom most associated with seropositivity was loss of smell and/or taste (n = 183 of all, 31.35%; OR, 24.48; 95% CI, 15.49–40.60; P  < .001). Bachelor's students were significantly more likely to be seropositive than Master's students (42.28% vs 16.87%; P  < .001). Conclusions Medical students have the highest reported seropositivity in the Danish health care system. In this cohort of students at UCPH, seropositivity was associated with social behavior markers and, to a lesser extent, with self-reported contact with SARS-CoV-2-infected patients. [ABSTRACT FROM AUTHOR]

In response to coronavirus disease 2019 (COVID-19), the Shanghai Burn Clinical Quality Control Center organized experts to formulate and implement a set of rapid, simple, and effective prevention and control measures, and there have not been any cases of health care professionals or inpatients in burn units suspected or confirmed with COVID-19. This article elaborates on the specific measures in burn units in response to the epidemic, including the implementation of standardized procedures, remote consultations, strengthened follow-up, exchange of experience, and popular science, among others. We share experience from Shanghai to benefit related disciplines in other countries and regions. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has brought with it many challenges in the field of healthcare around the world. Managing burn patients has its own challenges as they require a long duration of care and are more susceptible to infection. We conducted a retrospective observational study from January 30 to July 15, 2020 at our center to study the epidemiology of burns treated & patients and healthcare workers affected by COVID-19 during this period. The number of burn admissions showed a 42.6% reduction as compared to last year. A total of 17 patients (3.67%) and 29 health care workers (8.68%) tested positive for COVID-19 in the burns department. Our strategy underwent changes based on the changing dynamics of COVID-19 and changes in government and institutional policies. We have described the various challenges we faced in managing burns during this time. We found that effective screening of patients and healthcare workers, proper segregation of negative and positive/ suspect population and a low threshold for COVID-19 testing were essential to mitigate transmission of infection. [ABSTRACT FROM AUTHOR]

Background Nursing homes for older adults have concentrated large numbers of severe cases and deaths for coronavirus disease 2019 (COVID-19). Methods Point seroprevalence study of nursing homes to describe the demography and characteristic of severe acute respiratory syndrome by coronavirus 2 (SARS-CoV-2) immunoglobulin G (IgG)-positive residents and staff. Results Clinical information and blood samples were available for 9,332 residents (mean age 86.7 ± 8.1 years, 76.4% women) and 10,614 staff (mean age 45.6 ± 11.5, 86.2% women). Up to 84.4% of residents had frailty, 84.9% co-morbidity and 69.3% cognitive impairment; 65.2% of workers were health-aides. COVID-19 seroprevalence was 55.4% (95% confidence interval (CI), 54.4–56.4) for older adults and 31.5% (30.6–32.4) for staff. In multivariable analysis, frailty of residents was related with seropositivity (odds ratio (OR): 1.19, P  = 0.02). In the case of staff, age > 50 years (2.10, P  < 0.001), obesity (1.19, P  = 0.01), being a health-aide (1.94, P  < 0.001), working in a center with high seroprevalence in residents (3.49, P  < 0.001) and contact with external cases of COVID-19 (1.52, P  < 0.001) were factors associated with seropositivity. Past symptoms of COVID-19 were good predictors of seropositivity for residents (5.41, P  < 0.001) and staff (2.52, P  < 0.001). Conclusions Level of dependency influences risk of COVID-19 among residents. Individual and work factors, contacts outside the nursing home are associated with COVID-19 exposure in staff members. It is key to strengthen control measures to prevent the introduction of COVID-19 into care facilities from the community. [ABSTRACT FROM AUTHOR]

In October 2020, anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin G seroprevalence among truck drivers and their assistants (TDA) in Kenya was 42.3%, higher than among healthcare workers and blood donors. Truck drivers and their assistants transport essential supplies during the coronavirus disease 2019 pandemic, placing them at increased risk of being infected and of transmitting SARS-CoV-2 over a wide geographical area. [ABSTRACT FROM AUTHOR]

Amid personal protective equipment shortage, clinicians, nurses, and other frontline workers across the world have faced threatening and/or firing for self-protection during this coronavirus disease 2019 (COVID-19) pandemic. This perspective describes the different challenges that the stressed and overworked frontline workers encounter when they raise concerns despite being right. It also highlights the importance of communication and appropriate execution upon hearing those concerns. [ABSTRACT FROM AUTHOR]