Articles: sars-cov-2.
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The coronavirus disease 2019 (COVID-19) pandemic created shortages of operating room (OR) supplies, forcing healthcare systems to make concessions regarding "standard" OR attire. At our institution, we were required to reduce shoe covers, reuse face masks, and allow washable head coverings. We determined if these changes affected surgical site infection (SSI) rates. ⋯ This analysis has practical applications as we emerge from the pandemic and make decisions regarding OR attire. These data suggest that disposable head covers and shoe covers and frequent changes of face masks are unnecessary, and discontinuation of these practices will have significant cost and environmental implications. These data also reinforce the importance of good hand hygiene for infection prevention.
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Emergency department (ED) workers have an increased seroprevalence of SARS-CoV-2 antibodies. However, breakthrough infections in ED workers have led to a reduced workforce within a strained healthcare system. By measuring levels of IgG antibodies to the SARS-CoV-2 nucleocapsid and spike antigens in ED workers, we determined the incidence of infection and described the course of antibody levels. We also measured the antibody response to vaccination and examined factors associated with immunogenicity. ⋯ ED workers experienced a low incidence of SARS-CoV-2 infection and developed antibodies in response to vaccines and prior infection. Antibody levels decreased markedly with time since infection or vaccination.
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J Coll Physicians Surg Pak · Apr 2022
Breastfeeding/Breast Milk Safety in Infants of Mothers with Suspected or Confirmed COVID-19 Infection.
The purpose of this systematic review was to determine whether suspected or confirmed COVID-19 infected mothers in the lactation period can breastfeed their infants; and whether suspected or confirmed COVID-19 infected mothers can breastfeed their infants by taking some precautions. The study also aimed to present the measures that can be taken in line with the evidence. The studies conducted after November 2019 and including infants of suspected or confirmed COVID-19 infected mothers were reviewed between 2019 and 2020. ⋯ In most of the sources examined, it was concluded that most of the breastfed infants had negative findings for SARS-Cov-2 infection in PCR. In line with the limited data available, it was concluded that most of the breastfed infants had negative findings for SARS-Cov-2 infection in PCR; and breastfeeding mothers should initiate breastfeeding by taking protective measures. Key Words: Breastfeeding, COVID-19, Suspected COVID-19 infected mothers, Confirmed COVID-19 infected mothers.
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Early neurorehabilitation improves outcomes in patients with disorders of consciousness (DoC) after brain injury, but its applicability in COVID-19 is unknown. We describe our experience implementing an early neurorehabilitation protocol for patients with COVID-19-associated DoC in the intensive care unit (ICU) and evaluate factors associated with recovery. ⋯ More than half of our cohort of patients with prolonged unresponsiveness following severe COVID-19 recovered to MCS or better before hospital discharge, achieving a clinical benchmark known to have relatively favorable long-term prognostic implications in DoC of other etiologies. Hypoxia, systemic inflammation, sedation, and neuromuscular blockade may impact diagnostic assessment and prognosis, and fluctuations in level of consciousness make serial assessments essential. Early neurorehabilitation of these patients in the ICU can be accomplished but is associated with unique challenges. Further research should evaluate factors associated with longer-term neurologic recovery and benefits of early rehabilitation in patients with severe COVID-19.
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Annals of family medicine · Apr 2022
Racial and ethnic disparities in access to primary care during COVID-19.
Context: Early evidence suggests that many patients chose to forgo or delay necessary medical care during the COVID-19 pandemic. Existing and well-documented racial and ethnic disparities in access to care were exacerbated by the pandemic for many reasons, potentially including the additional barriers involved in a rapid shift to telehealth for certain groups of patients. Objectives: 1) Examine changes in primary care visit volume and telehealth during the COVID-19 pandemic. 2) Test for racial and ethnic differences in primary care in-person and telehealth visits during the pandemic relative to pre-pandemic levels. ⋯ Conclusion: Declines in primary care visits during the pandemic were partially offset by an increase in telehealth use. Utilization in our sample suggests less decline in Black and Hispanic patient primary care utilization during the pandemic than expected, in contrast to Asian patients, who demonstrated the largest declines. This metric and these results are novel and foundational for ongoing & further study using other data sources.