scholarly journals COVID ‐19 Risk in Elective Surgery during a Second Wave: a Prospective Cohort Study

2020 ◽  
Author(s):  
Paul S Myles ◽  
Sophie Wallace ◽  
David A Story ◽  
Wendy Brown ◽  
Allen C Cheng ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Elective Surgery ◽  
Second Wave

scholarly journals Healthcare workers' SARS-CoV-2 infection rates during the second wave of the pandemic: prospective cohort study

2021 ◽  
Author(s):  
Anne Mette Wurtz ◽  
Martin B. Kinnerup ◽  
Kirsten Pugdal ◽  
Vivi Schlunssen ◽  
Jesper Medom Vestergaard ◽  
...  
Keyword(s):  
Cohort Study ◽  
Incidence Rate ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Healthcare Workers ◽  
Close Contact ◽  
Infection Rates ◽  
Positive Polymerase Chain Reaction ◽  
Preventive Actions ◽  
Second Wave

Objectives: To assess if healthcare workers during the second wave of the COVID-19 pandemic had increased SARS-CoV-2 infection rates following close contact with patients, co-workers and persons outside work with COVID-19. Design: Prospective cohort study. Setting: Public hospital employees in Denmark. Participants: 5985 healthcare workers (88.6% women) who daily on a smartphone reported COVID-19 contact. Main outcome measures: SARS-CoV-2 infection rates defined by the first positive polymerase chain reaction (PCR) test recorded in a register with complete test coverage. Results: 159 positive and 35 996 negative PCR tests for SARS-CoV-2 were recorded during 514 165 person-days of follow-up November 25, 2020 - April 30, 2021. The SARS-CoV-2 infection rate for healthcare workers who during the previous 3-7 days had close contact with COVID-19 patients was 153.7 per 100 000 person-days (0.15% per day) corresponding with an incidence rate ratio of 3.17 (40 cases, 95% CI 2.15 to 4.66) when compared with no close contact with COVID-19 patients. SARS-CoV-2 incidence rate ratios following close contact with co-workers and persons outside work with COVID-19 were 2.54 (10 cases, 95% CI 1.30 to 4.96) and 17.79 (35 cases, 95% CI 12.05 to 26.28). These estimates were mutually adjusted and further adjusted for age, sex, month and number of previous PCR tests. Conclusions: Despite strong focus on preventive actions during the second wave of the pandemic, healthcare workers were still at increased risk of SARS-CoV-2 infection when in close contact with patients with COVID-19. The numbers affected were comparable to the numbers affected following COVID-19 contact outside work. Close contact with co-workers was also a risk factor. This stresses the need for increased focus on preventive actions to secure healthcare workers' health during ongoing and future waves of SARS-CoV-2 and other infections.

scholarly journals Evolution of SARS-CoV-2 seroprevalence and clusters in school children from June 2020 to April 2021 reflect community transmission: prospective cohort study Ciao Corona

2021 ◽  
Author(s):  
Agne Ulyte ◽  
Thomas Radtke ◽  
Irene A Abela ◽  
Sarah R Haile ◽  
Priska Ammann ◽  
...  
Keyword(s):  
Middle School ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Participation Rate ◽  
School Level ◽  
June July ◽  
Age Range ◽  
Second Wave ◽  
Middle School Level

Objectives: To longitudinally assess severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence and clustering of seropositive children within school classes in March-April 2021 compared to June-July and October-November 2020. To examine the evolution of symptoms and the extent of under-detection of SARS-CoV-2 in children. Design: Prospective cohort study of randomly selected schools and classes. Setting: Schools remained open for physical attendance in Switzerland from May 2020 to the end of 2020/2021 school year. Lower school level (age range 7-10 years) and middle school level (8-13 years) children in primary schools, and upper school level (12-17 years) children in secondary schools were invited for SARS-CoV-2 serological testing in the Ciao Corona study in the canton of Zurich, Switzerland. Three testing rounds were completed in June-July 2020 (T1; after the first wave of SARS-CoV-2 infections), October-November 2020 (T2; during the peak of the second wave), and March-April 2021 (T3; after the second wave and with SARS-CoV-2 variants of concern becoming dominant). Parents completed questionnaires on sociodemographic information and symptoms. Participants: 2487 children (median age 12 years, age range 7-17 years) recruited from 275 classes in 55 schools participated in the testing in March-April 2021; total of 2974 children participated in at least one of the 3 testing rounds. Main outcome measures: SARS-CoV-2 serology results; clustering of seropositive children within classes; reported symptoms. Results: The proportion of children who were SARS-CoV-2 seropositive increased from 1.5% (95% credible interval (CrI) 0.6% to 2.6%) in June-July 2020, to 6.6% (95% CrI 4.0% to 8.9%) in October-November, and to 16.4% (95% CrI 12.1% to 19.5%) in March-April 2021. By March-April 2021, children in upper school level (12.4%; 95% CrI 7.3% to 16.7%) were less likely to be seropositive than those in middle (19.5%; 95% CrI 14.2% to 24.4%) or lower school levels (16.0%; 95% CrI 11.0% to 20.4%). Children in the upper school level had a 5.1% (95% CI -9.4% to -0.7%) lower than expected seroprevalence by March-April 2021 than those in middle school level, based on difference-in-differences analysis. The ratio of PCR-diagnosed to all seropositive children changed from 1 to 21.7 (by June-July 2020) to 1 to 3.5 (by March-April 2021). Symptoms were reported by 37% of newly seropositive and 16% seronegative children. Potential clusters of 3 or more newly seropositive children were detected in 24 of 119 (20%) classes with a high participation rate, from which a median of 17 clusters could be expected due to random distribution of seropositive children within the classes. Clustering was lowest in middle and upper school levels. Retention rate in the cohort was high (84% of T1 participants attended T3). Among participants, supporting society and research were reported more commonly for participation than personal reasons. Fear of blood sampling was the most frequently reported reason for non-participation, reported for 64% of children. Conclusions: By March-April 2021, 16.4% of children and adolescents were seropositive in the canton of Zurich, Switzerland. The majority of clusters of SARS-CoV-2 seropositive children in school classes could be explained by community rather than intra-class transmission of infections. Seroprevalence and clustering was lowest in upper school levels during all timepoints. Trial registration: ClinicalTrials.gov NCT04448717. Key words: SARS-CoV-2, COVID-19, children, adolescents, school, SARS-CoV-2 symptoms, non-participation, participation rate, cohort.

1271 The Management of Acutely Symptomatic Hernia (MASH): A UK Wide Prospective Cohort Study

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
F A Burns ◽  
Keyword(s):  
Quality Of Life ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Elective Surgery ◽  
Suture Repair ◽  
Phone Calls ◽  
Absorbable Sutures ◽  
The Uk

Abstract Introduction Acutely symptomatic abdominal wall and groin hernias (ASH) are a common presentation, accounting for approximately 25% of acute surgical admissions in the UK. There is limited data to guide the treatment of such presentations. This study aimed to assess outcomes of emergency hernia surgery, and identify common management strategies, to improve care for these high-risk patients. Method A 12 week, UK-based, multi-centre, collaborative, prospective cohort study (NCT04197271) recruited adults with ASH. Data on inpatient management, specific surgical intervention, in-hospital morbidity and mortality and quality of life (EQ-5D-5L) was measured. 30 and 90-day follow-up phone calls collected complications and quality of life. Descriptive analyses were performed to describe population and outcomes. Results Twenty-three acute trusts recruited 264 patients. Inguinal (37.9%) and umbilical (37.1%) hernias were most common. 17% were awaiting elective surgery and 17% had been previously declined intervention. 46% were incarcerated at presentation, and 31% symptomatic (painful/irreducible). 82% of patients had operations within 48 hours, with 95% performed open. Mesh was used in 55%, the majority (86%) being synthetic non-absorbable. Sutures used for suture repair varied widely. Complications were infrequent; 2% developed pneumonia or delirium. Surgical site infection occurred in 3% and mortality was 1.2%. Quality of life improved between baseline and 30-days following repair. Conclusions There is variation in the management of ASH in the UK, particularly with repair techniques, use of mesh and laparoscopy. One in five patients was awaiting repair; this might indicate a need for expedited pathways and reprioritising elective hernia repair.

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