OBJECTIVE: The objectives of this paper are to gain a better understanding of the key presenting symptoms of COVID-19 in HCWs in a district specialist hospital, to establish the proportion of symptomatic COVID-19 cases among HCWs and its severity and to determine the time taken from onset of symptoms or perceived exposure to diagnostic testing.
METHODOLOGY: This is a retrospective descriptive analysis of clinical characteristics of subjects infected with COVID-19 among HCW in HTI. Their demography and clinical characteristics were recorded.
RESULTS: There were 47 HCW in HTI who tested positive for COVID-19. The mean age of the patients was 37.5 years old. 7 patients (15.2%) had at least more than one comorbidity. Average duration of time from perceived close contact to onset of symptom was 4.5 days, while the mean duration of time from symptoms to first positive RT-PCR result was 3.4 days. Six patients (13.0%) were asymptomatic throughout, whereas 40 (87.0%) had at least one symptom prior to hospitalization. The most commonly reported symptoms were fever (65.2%), sore throat (39.1%) and cough (37.0%). In terms of severity of symptoms, the majority of patients experienced mild symptoms (Group 2, 52.2%). Two patients (4.3%) with multiple comorbidities had severe disease requiring ICU admission and mechanical ventilation. There were no mortalities, and the longest staying patient was hospitalized for 18 days. The high rates of infectivity among HCW in HTI can be attributed to working in close proximity while in the asymptomatic incubation phase, while no HCW directly involved in the care of COVID-19 positive patients were tested positive.
CONCLUSION: We report that HCW share similar clinical characteristics of COVID-19 infection as those of non HCW patients in earlier studies. The infection can spread rapidly within healthcare settings via close contacts among infected HCWs. As such, we advocate distancing when working and usage of personal protective equipment when treating patients with respiratory illness to reduce transmission of COVID-19.
OBJECTIVES: To determine the HRQoL and developmental outcome of children on HMV.
METHODS: This cross-sectional study used the TNO-AZL Preschool children's Quality Of Life (TAPQOL; <5 years old) and Health Utilities Index (HUI) 2/3 (≥5 years old) to assess the quality of life and the Schedule of Growing Skills-II to assess development. Instruments were used on children currently or previously on HMV (≥3 months) and compared with age and sex-matched controls.
RESULTS: Sixty-five patients and 130 controls were recruited. Patients' median (interquartile range) age was 3.12 (1.65, 5.81) years. Patients had significantly lower TAPQOL scores in the domains of lung, liveliness, positive mood, social functioning, motor functioning, and communication, and lower HUI 2/3 scores in hearing, sensation, pain, speech, mobility, ambulatory, dexterity, and self-care domains. The developmental outcome of patients was poorer in all domains. However, patients had fewer behavioral problems. Those with respiratory tract disease and without comorbidities had better HRQoL and developmental scores. Having a parent as the primary caregiver was associated with better speech and language skills.
CONCLUSIONS: HRQoL and the developmental outcome are lower in children on HMV compared to controls. Children with respiratory tract disease and without comorbidities have a better outcome. Parents play a crucial role in the acquisition of speech.
MATERIALS AND METHODS: This was a retrospective cohort study undertaken at a public tertiary care centre in the state of Perak, Malaysia. Information of obese patients who underwent bariatric surgery was obtained from their medical records. The changes in the BMI, HbA1C, systolic and diastolic blood pressure (SBP and DBP), and lipid levels between three months before and after the surgery were assessed.
RESULTS: The patients (n=106) were mostly Malay (66.0%), had at least one comorbidity (61.3%), and had a mean age of 40.38±11.75 years. Following surgery, the BMI of the patients was found to reduce by 9.78±5.82kg/m2. For the patients who had diabetes (n=24) and hypertension (n=47), their mean HbA1C, SBP and DBP were also shown to reduce significantly by 2.02±2.13%, 17.19±16.97mmHg, and 11.45±12.63mmHg, respectively. Meanwhile, the mean total cholesterol, triglyceride and low-density lipoprotein levels of those who had dyslipidaemia (n=21) were, respectively, lowered by 0.91±1.18mmol/L, 0.69±1.11mmol/L and 0.47±0.52mmol/L.
CONCLUSION: The findings suggest that in addition to weight reduction, bariatric surgery is helpful in improving the diabetes, hypertension and dyslipidaemia control among obese patients. However, a large-scale trial with a control group is required to verify our findings.
METHODS: Research questions were formulated focusing on diagnosis and treatment of adult patients with RMD within the context of the pandemic, including the management of RMD in patients who developed COVID-19. MEDLINE was searched for eligible studies to address the questions, and the APLAR COVID-19 task force convened 2 meetings through video conferencing to discuss its findings and integrate best available evidence with expert opinion. Consensus statements were finalized using the modified Delphi process.
RESULTS: Agreement was obtained around key aspects of screening for or diagnosis of COVID-19; management of patients with RMD without confirmed COVID-19; and management of patients with RMD with confirmed COVID-19. The task force achieved consensus on 25 statements covering the potential risk of acquiring COVID-19 in RMD patients, advice on RMD medication adjustment and continuation, the roles of telemedicine and vaccination, and the impact of the pandemic on quality of life and on treatment adherence.
CONCLUSIONS: Available evidence primarily from descriptive research supported new recommendations for aspects of RMD care not covered in the previous document, particularly with regard to risk factors for complicated COVID-19 in RMD patients, modifications to RMD treatment regimens in the context of the pandemic, and COVID-19 vaccination in patients with RMD.
METHODS: A total of 141 patients (77 HD and 64 CAPD) from 1 federal and four state hospitals participated in this cross-sectional study. Patients were randomly selected from the National Renal Registry (NRR) using a stratified random sampling. The EQ-5D-3 L questionnaire was used to measure HRQOL. Variables investigated include dialysis modalities, sociodemographic characteristics, co-morbidities and biochemical markers. Utilities are measured on an ordinal scale of 0-1, where 1 indicates full health and 0 indicates death.
RESULTS: The mean utility scores were 0.854 ± 0.181 and 0.905 ± 0.124 (p > 0.05) and the mean Visual Analogue Scale (VAS) scores were 76.2 ± 12.90 and 77.1 ± 10.26 (p > 0.05) for HD and CAPD patients respectively. There was a significant difference in problems reported between HD (35.1%) and CAPD (15.6%) on usual activities dimension (p = 0.009). The proportion of patients having problems in the pain/discomfort domain in both modalities was high (34.0%). Haemoglobin (
METHODS: All laboratory-confirmed COVID-19 cases reported to the Petaling District Health Office between 1 February and 26 June 2020 were analysed. Socio-demographic characteristics, symptoms, date of onset, date of exposure, travel history and history of comorbidities were obtained by phone interviews using one of two investigation forms. The descriptive analysis was conducted according to time, place and person.
RESULTS: There were 437 COVID-19 cases, for an incidence rate of 24/100 000 population. Ten (2.3%) deaths and 427 recovered cases were recorded. Of the 437 cases, 35.5% remained asymptomatic and 64.5% were symptomatic. Common symptoms included fever (43.8%), cough (31.6%) and sore throat (16.2%); 67.3% had no comorbidities, 62.5% reported close contact with a confirmed case, and 76.7% were local infections. Transmission occurred in four main groups: religious gatherings (20.4%), corporations (15.1%), health facilities (10.3%) and a wholesale wet market (6.4%). In 31.9% of confirmed cases, an epidemiological link to an asymptomatic case was found.
CONCLUSION: Transmission of the disease by asymptomatic cases should be emphasized to ensure continuous wearing of face masks, hand hygiene and social distancing. Further research should be conducted to better understand the transmission of SARS-CoV-2 from asymptomatic cases.
MATERIALS AND METHODS: The Well-being of the Singapore Elderly (WiSE) study was a comprehensive single phase, cross-sectional survey. Stage 1 Geriatric Mental State-Automated Geriatric Examination for Computer Assisted Taxonomy (GMS-AGECAT) depression syndrome was used for this analysis. Association of depression and subsyndromal depression with sociodemographic characteristics, social support as well as comorbidity with chronic physical illnesses and quality of life was assessed.
RESULTS: The prevalence of GMS-AGECAT depression and subsyndromal depression was 3.7% and 13.4%, respectively. The odds of depression were significantly higher among those aged 75 to 84 (2.1) as compared to those aged 60 to 74 years and in those who had a history of depression diagnosis by a doctor (4.1). The odds of depression were higher among those of Indian and Malay ethnicities (5.2 and 3.2 times, respectively) as compared to those of Chinese ethnicity. Those with depression and subsyndromal depression were associated with more disability, poorer life satisfaction, and medical comorbidities.
CONCLUSION: Our study suggests that the prevalence of depression seems to have decreased as compared to a decade ago wherein the prevalence of depression was estimated to be 5.5%. This positive trend can be ascribed to concerted efforts across various disciplines and sectors, which need to be continually strengthened, monitored and evaluated.
MATERIALS AND METHODS: Data for the current study came from the Well-being of the Singapore Elderly (WiSE) study; a single phase, cross-sectional survey conducted among Singapore residents aged 60 years and above. A total of 2565 respondents completed the survey; depression was assessed using the Automated Geriatric Examination for Computer Assisted Taxonomy (AGECAT) while a diagnosis of DM was considered if respondents stated that a doctor had diagnosed them with DM.
RESULTS: DM was reported by 25.5% of the population. The prevalence of depression was significantly higher in those diagnosed with DM than those without DM (6% vs 3%). After adjusting for sociodemographic correlates, smoking and other chronic conditions, DM remained significantly associated with depression and subsyndromal depression. However, after including measures of functioning and cognitive impairment as covariates, DM was not significantly related to depression and subsyndromal depression. Those with comorbid DM and depression were more likely to be of Indian and Malay ethnicity, aged 75 to 84 years (versus 60 to 74 years) and widowed.
CONCLUSION: Given the significant association of certain sociodemographic groups with comorbid depression among those with DM, targeted interventions for prevention and early diagnosis in these groups should be considered.