Invasive prenatal diagnosis during COVID-19 pandemic.
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ABSTRACT:
SUBMITTER: Carbone L
PROVIDER: S-EPMC8495187 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description: Not available
| S-BSST1055 | biostudies-other
Project description:ObjectiveThe coronavirus disease 2019 (COVID-19) pandemic disrupted healthcare delivery, including prenatal care. The study objective was to assess if timing of routine prenatal testing changed during the COVID-19 pandemic.MethodsRetrospective observational cohort study using claims data from a regional insurer (Highmark) and electronic health record data from two academic health systems (Penn Medicine and Yale New Haven) to compare prenatal testing timing in the pre-pandemic (03/10/2018-12/31/2018 and 03/10/2019-12/31/2019) and early COVID-19 pandemic (03/10/2020-12/31/2020) periods. Primary outcomes were second trimester fetal anatomy ultrasounds and gestational diabetes (GDM) testing. A secondary analysis examined first trimester ultrasounds.ResultsThe three datasets included 31,474 pregnant patients. Mean gestational age for second trimester anatomy ultrasounds increased from the pre-pandemic to COVID-19 period (Highmark 19.4 vs. 19.6 weeks; Penn: 20.1 vs. 20.4 weeks; Yale: 18.8 vs. 19.2 weeks, all p < 0.001). There was a detectable decrease in the proportion of patients who completed the anatomy survey <20 weeks' gestation across datasets, which did not persist at <23 weeks' gestation. There were no consistent changes in timing of GDM screening. There were significant reductions in the proportion of patients with first trimester ultrasounds in the academic institutions (Penn: 57.7% vs. 40.6% and Yale: 78.7% vs. 65.5%, both p < 0.001) but not Highmark. Findings were similar with multivariable adjustment.ConclusionWhile some prenatal testing happened later in pregnancy during the pandemic, pregnant patients continued to receive appropriately timed testing. Despite disruptions in care delivery, prenatal screening remained a priority for patients and providers during the COVID-19 pandemic.
| S-EPMC9682111 | biostudies-literature
Project description:To understand and analyse the global impact of COVID-19 on outpatient services, inpatient care, elective surgery, and perioperative colorectal cancer care, a DElayed COloRectal cancer surgery (DECOR-19) survey was conducted in collaboration with numerous international colorectal societies with the objective of obtaining several learning points from the impact of the COVID-19 outbreak on our colorectal cancer patients which will assist us in the ongoing management of our colorectal cancer patients and to provide us safe oncological pathways for future outbreaks.
| 2346925 | ecrin-mdr-crc
Project description:The main objective of this study is to offer and evaluate an interim triage approach for patients waiting for surveillance colonoscopies. This will reduce the waiting period and the psychological stressors for our patients and from a scientific point of view allow us to compare the yield of findings for each approach.
| 2383510 | ecrin-mdr-crc
Project description:Measures to limit SARS-CoV-2 transmission in 2020 reduced other viral infections. Among 7 US children's hospitals, invasive pneumococcal disease cumulative incidence decreased by 46% in 2020 vs 2017-2019. Limited droplet transmission of pneumococci and preceding viral pathogens may be responsible.
| S-EPMC9384319 | biostudies-literature
Project description:The aim of this study was to assess the changes in the occurrence of prenatal and postnatal anxiety and depression symptoms, and to assess what factors significantly affect the appearance of symptoms of depression and anxiety in young mothers. The study group consisted of 130 women after childbirth. Due to the ongoing restrictions caused by the COVID-19 pandemic, the survey was prepared online. The questionnaire was fully anonymous, and it contained the authors' own questions and two standardized questionnaires: the Edinburgh Postnatal Depression Scale (EPDS) and Generalized Anxiety Disorders GAD-7. The conducted analysis clearly indicated that the level of postpartum depression, in as many as 52 of the mothers, had increased significantly compared to the time before delivery, when symptoms of depression were shown by 22 women (p = 0.009). However, there was no statistically significant change between prenatal and postnatal anxiety. There are many factors associated with postnatal depression. The strongest predictors turned out to be average socioeconomic status, history of anxiety disorders, past neurosis or depression, lack of or inadequate level of assistance from healthcare professionals, as well as lactation problems and postpartum pain.
| S-EPMC8304229 | biostudies-literature
Project description:Mucormycosis is a deadly opportunistic disease caused by a group of fungus named mucormycetes. Fungal spores are normally present in the environment and the immune system of the body prevents them from causing disease in a healthy immunocompetent individual. But when the defense mechanism of the body is compromised such as in the patients of diabetes mellites, neustropenia, organ transplantation recipients, and other immune-compromised states, these fungal spores invade our defense mechanism easily causing a severe systemic infection with approximately 45-80% of case fatality. In the present scenario, during the COVID-19 pandemic, patients are on immunosuppressive drugs, glucocorticoids, thus are at high risk of mucormycosis. Patients with diabetes mellitus are further getting a high chance of infection. Usually, the spores gain entry through our respiratory tract affecting the lungs and paranasal sinuses. Besides, they can also enter through damage into the skin or through the gastrointestinal route. This review article presents the current statistics, the causes of this infection in the human body, and its diagnosis with available recent therapies through recent databases collected from several clinics and agencies. The diagnosis and identification of the infection were made possible through various latest medical techniques such as computed tomography scans, direct microscopic observations, MALDI-TOF mass spectrometry, serology, molecular assay, and histopathology. Mucormycosis is so uncommon, no randomized controlled treatment studies have been conducted. The newer triazoles, posaconazole (POSA) and isavuconazole (ISAV) (the active component of the prodrug isavuconazonium sulfate) may be beneficial in patients who are refractory to or intolerant of Liposomal Amphotericin B. but due to lack of early diagnosis and aggressive surgical debridement or excision, the mortality rate remains high. In the course of COVID-19 treatments, there must be more vigilance and alertness are required from clinicians to evaluate these invasive fungal infections.
| S-EPMC8881997 | biostudies-literature
Project description:BackgroundPregnant women's stress, mental and physical health, and health behaviours can have important implications for maternal and child health outcomes.AimTo examine pregnant women's levels of stress, mental and physical health, and health behaviours during the COVID-19 pandemic.MethodsA cross-sectional survey was conducted online, with recruitment and data collection occurring between 16/6/20 and 17/7/20. Participants were pregnant women recruited via online pregnancy/parenting communities. Participants self-reported their levels of general stress, pregnancy-specific stress and COVID-19 related stress, mental and physical health, general health behaviours, and COVID-19 related health behaviours.Findings573 pregnant women participated in the survey. Participants were most commonly resident in the United States (42.6%, n=243), Ireland (41.2%, n=235) or the United Kingdom (10%, n=57). The majority (80.0%, n=457) were married and educated to degree level or above (79.3, n=453). Pregnant women reported high levels of pregnancy-specific and COVID-19-related stress, and low levels of mental and physical health, during the pandemic. Encouragingly, pregnant women in this study generally reported high levels of adherence to public health advice and pregnancy health behaviours. Stress and general mental health outcomes were best predicted by well-being factors (including stress and social support). Health impairing behaviours (e.g. poor diet) were predicted by both well-being and demographic factors.DiscussionInterventions targeting pregnancy- and pandemic-specific stress at the population level will be essential to support mental health and minimise adverse outcomes for women and children during the pandemic.
| S-EPMC9051042 | biostudies-literature
Project description:BackgroundThe COVID-19 pandemic has caused substantially elevated distress in pregnant individuals, which has the potential to affect the developing infant brain. Our main objective was to understand how prenatal distress was related to infant brain structure and function and whether social support moderated the associations.MethodsThe Pregnancy during the COVID-19 Pandemic (PdP) cohort study collected Patient-Reported Outcomes Measurement Information System Anxiety scale, Edinburgh Postnatal Depression Scale, and Social Support Effectiveness Questionnaire data from a population-based sample of pregnant individuals living in Canada (N = 8602). For a subsample of participants, their infants (n = 75) underwent magnetic resonance imaging at 3 months of age to examine whether prenatal maternal distress was associated with infant brain architecture, including the role of social support as a potential protective factor.ResultsOverall, 33.4% of participants demonstrated clinically elevated depression symptoms and 47.1% of participants demonstrated clinically elevated anxiety symptoms. We identified lower social support as a significant predictor of clinically elevated prenatal maternal distress (t8598 = -22.3, p < .001). Fifty-eight diffusion image datasets (20 female/38 male, 92 ± 14 days old) and 41 functional datasets (13 female/28 male, 92 ± 14 days old) were included in our analysis after removal of poor-quality images and infants without postpartum maternal distress scores. We found significant relationships between prenatal maternal distress and infant amygdala-prefrontal microstructural and functional connectivity measures, and we demonstrate for the first time that social support moderates these relationships.ConclusionsOur findings suggest a potentially long-lasting impact of the COVID-19 pandemic on children and show that social support acts as a possible mediator not just for pregnant individuals but also developing infants. These findings provide timely evidence to inform clinical practice and policy surrounding the care of pregnant individuals and highlight the importance of social support.
| S-EPMC9110020 | biostudies-literature
Project description:The COVID-19 pandemic has been associated with a global increase in psychological distress in pregnant women. This study evaluated the effects of STEP-COVID, a six-session mentalization-based prenatal group program offered online during the COVID-19 pandemic. The 100 participants were allocated to STEP-COVID or to the natural trajectory of prenatal care. Pre- and post-intervention assessments included measures of psychological distress, post-traumatic symptoms and positive affectivity. Perception of change during pregnancy on resilience-promoting factors was also assessed at post-intervention. A significant decrease in psychological distress and post-traumatic symptoms and an increase in positive affectivity were observed in participants in the intervention condition, whereas only post-traumatic symptoms improved in the control condition. Women who participated in STEP-COVID also reported greater changes during pregnancy on resilience-promoting factors than women in the control condition. Results hold promise for buffering the effect of the pandemic on the mental health of pregnant women using brief online interventions. Clinical trial registration: NCT05419167 (15/06/2022).
| S-EPMC10116444 | biostudies-literature