Global Impact of the COVID-19 Pandemic on Cerebral Venous Thrombosis and Mortality

Background and purpose: Recent studies suggested an increased incidence of cerebral venous thrombosis (CVT) during the coronavirus disease 2019 (COVID-19) pandemic. We evaluated the volume of CVT hospitalization and in-hospital mortality during the 1st year of the COVID-19 pandemic compared to the preceding year. Methods: We conducted a cross-sectional retrospective study of 171 stroke centers from 49 countries. We recorded COVID-19 admission volumes, CVT hospitalization, and CVT in-hospital mortality from January 1, 2019, to May 31, 2021. CVT diagnoses were identified by International Classification of Disease-10 (ICD-10) codes or stroke databases. We additionally sought to compare the same metrics in the first 5 months of 2021 compared to the corresponding months in 2019 and 2020 (ClinicalTrials.gov Identifier: NCT04934020). Results: There were 2,313 CVT admissions across the 1-year pre-pandemic (2019) and pandemic year (2020); no differences in CVT volume or CVT mortality were observed. During the first 5 months of 2021, there was an increase in CVT volumes compared to 2019 (27.5%; 95% confidence interval [CI], 24.2 to 32.0; P<0.0001) and 2020 (41.4%; 95% CI, 37.0 to 46.0; P<0.0001). A COVID-19 diagnosis was present in 7.6% (132/1,738) of CVT hospitalizations. CVT was present in 0.04% (103/292,080) of COVID-19 hospitalizations. During the first pandemic year, CVT mortality was higher in patients who were COVID positive compared to COVID negative patients (8/53 [15.0%] vs. 41/910 [4.5%], P=0.004). There was an increase in CVT mortality during the first 5 months of pandemic years 2020 and 2021 compared to the first 5 months of the pre-pandemic year 2019 (2019 vs. 2020: 2.26% vs. 4.74%, P=0.05; 2019 vs. 2021: 2.26% vs. 4.99%, P=0.03). In the first 5 months of 2021, there were 26 cases of vaccine-induced immune thrombotic thrombocytopenia (VITT), resulting in six deaths. Conclusions: During the 1st year of the COVID-19 pandemic, CVT hospitalization volume and CVT in-hospital mortality did not change compared to the prior year. COVID-19 diagnosis was associated with higher CVT in-hospital mortality. During the first 5 months of 2021, there was an increase in CVT hospitalization volume and increase in CVT-related mortality, partially attributable to VITT

Global Impact of the COVID-19 Pandemic on Cerebral Venous Thrombosis and Mortality.

BACKGROUND AND PURPOSE: Recent studies suggested an increased incidence of cerebral venous thrombosis (CVT) during the coronavirus disease 2019 (COVID-19) pandemic. We evaluated the volume of CVT hospitalization and in-hospital mortality during the 1st year of the COVID-19 pandemic compared to the preceding year. METHODS: We conducted a cross-sectional retrospective study of 171 stroke centers from 49 countries. We recorded COVID-19 admission volumes, CVT hospitalization, and CVT in-hospital mortality from January 1, 2019, to May 31, 2021. CVT diagnoses were identified by International Classification of Disease-10 (ICD-10) codes or stroke databases. We additionally sought to compare the same metrics in the first 5 months of 2021 compared to the corresponding months in 2019 and 2020 (ClinicalTrials.gov Identifier: NCT04934020). RESULTS: There were 2,313 CVT admissions across the 1-year pre-pandemic (2019) and pandemic year (2020); no differences in CVT volume or CVT mortality were observed. During the first 5 months of 2021, there was an increase in CVT volumes compared to 2019 (27.5%; 95% confidence interval [CI], 24.2 to 32.0; P<0.0001) and 2020 (41.4%; 95% CI, 37.0 to 46.0; P<0.0001). A COVID-19 diagnosis was present in 7.6% (132/1,738) of CVT hospitalizations. CVT was present in 0.04% (103/292,080) of COVID-19 hospitalizations. During the first pandemic year, CVT mortality was higher in patients who were COVID positive compared to COVID negative patients (8/53 [15.0%] vs. 41/910 [4.5%], P=0.004). There was an increase in CVT mortality during the first 5 months of pandemic years 2020 and 2021 compared to the first 5 months of the pre-pandemic year 2019 (2019 vs. 2020: 2.26% vs. 4.74%, P=0.05; 2019 vs. 2021: 2.26% vs. 4.99%, P=0.03). In the first 5 months of 2021, there were 26 cases of vaccine-induced immune thrombotic thrombocytopenia (VITT), resulting in six deaths. CONCLUSIONS: During the 1st year of the COVID-19 pandemic, CVT hospitalization volume and CVT in-hospital mortality did not change compared to the prior year. COVID-19 diagnosis was associated with higher CVT in-hospital mortality. During the first 5 months of 2021, there was an increase in CVT hospitalization volume and increase in CVT-related mortality, partially attributable to VITT

Richtlinien zur Verwendung von Desinfektionsmitteln: Vergleich zwischen Malaysia und anderen Ländern

Aim: Sanitation and cleanliness are essential factors in reducing the spread of pathogens and preventing healthcare-associated infections. Disinfectants are associated with better hygiene outcomes to reduce pathogen transmission risk and minimize risks to healthcare workers (HCWs) and patients. Methods: A literature search was undertaken using the electronic databases Scopus, Web of Science, Ovid and Google Scholar. The inclusion criteria for this study are observational and original research studies dating from the five-year period 2017-2021. Other inclusion criteria are full text, English language, qualitative or quantitative studies relevant to the research question. The exclusion criteria are animal studies, systematic reviews, conference proceedings, abstracts, projection modelling studies, in-vivo or in-vitro studies, and books. Results: Five study nations included the United States of America (USA), the United Kingdom (UK), China, India and South Korea, together with Malaysia. These nations have existing policies, regulations and guidelines regarding the use of disinfectants. HCWs should be aware of the national laws and guidelines that govern the purchase, distribution and use of disinfectants. They should also understand the different roles of the agencies involved, so the context for the guidance provided is clear. Coordination and collaboration across various stakeholders are required for creating solid policies. Conclusion: Product research and innovation are indispensable, as appropriate personal protective equipment and safety measures for HCWs and patients have top priority in every nation. Hence, clear guidelines for handling disinfectants, in addition to health education about scientific-evidence-based disinfectants, are required.Zielsetzung: Hygiene und Sauberkeit sind wesentliche Faktoren, um die Ausbreitung von Krankheitserregern zu unterbinden und Healthcare-assoziierte Infektionen (HAI) zu verhindern. Der Einsatz von Desinfektionsmitteln erfolgt mit dem Ziel, das Risiko der Übertragung von Krankheitserregern zu verringern und dadurch Infektionsrisiken für Beschäftigte im Gesundheitswesen und für Patienten zu minimieren. Methode: Es wurde eine Literaturrecherche in den elektronischen Datenbanken Scopus, Web of Science, Ovid und Google Scholar durchgeführt. Die Einschlusskriterien für die Studie sind Beobachtungs- und Originalstudien aus den letzten fünf Jahren (2017-2021). Weitere Einschlusskriterien sind englischsprachige, qualitative oder quantitative Studien im Volltext, die für die Forschungsfrage relevant sind. Ausschlusskriterien sind Tierstudien, systematische Übersichten, Konferenzberichte, Zusammenfassungen, Projektionsmodellierungsstudien, In-vivo- oder In-vitro-Studien und Bücher. Ergebnisse: Zu den fünf Studienländern gehören die Vereinigten Staaten von Amerika (USA), das Vereinigte Königreich (UK), China, Indien, Südkorea und Malaysia. In diesen Ländern gibt es Strategien, Vorschriften und Richtlinien zur Verwendung von Desinfektionsmitteln. Die Mitarbeiter des Gesundheitswesens sollten die nationalen Gesetze und Richtlinien kennen, die den Kauf, die Verteilung und die Verwendung von Desinfektionsmitteln regeln. Sie sollten auch die verschiedenen Rollen der beteiligten Stellen verstehen, damit der Kontext für die bereitgestellten Leitlinien klar ist. Für die Entwicklung solider Strategien sind Koordination und Zusammenarbeit zwischen den verschiedenen Interessengruppen erforderlich.Schlussfolgerung: Produktforschung und -innovation sind unentbehrlich, weil eine angemessene persönliche Schutzausrüstung und Sicherheitsmaßnahmen für das Gesundheitspersonal und die Patienten für jede Nation höchste Priorität haben. Daher sind klare Leitlinien für den Umgang mit Desinfektionsmitteln sowie eine wissenschaftlich fundierte Gesundheitsaufklärung über Desinfektionsmittel erforderlich

Knowledge and preventive behaviour among pregnant women with latent toxoplasmosis in Malaysia

Latent toxoplasmosis could induce various hormonal and behavioural perturbations in infected hosts. We aimed to study the latent seroprevalence of Toxoplasma gondii (T. gondii) and the relationship between infection, knowledge and behaviour among 400 pregnant mothers. Plasma samples were tested for the presence of T. gondii IgG antibodies while a structured questionnaire was used to record respondents’ socio-demographic characteristics, general information and knowledge on plausible risk factors, symptoms, timing of infection, and preventive knowledge and behaviour regarding toxoplasmosis. The seroprevalence of latent toxoplasmosis among respondents was at 31.8%. This study indicated that 69.5% of them had poor knowledge of toxoplasmosis but most of them (99.8%) practised preventive behaviours. Multiple logistic regression analysis showed that pregnant women with low education levels (aOR: 1.91, 95% CI 1.18, 3.10; p = 0.008) and past medical history (aOR: 2.32, 95% CI 1.32, 4.06; p = 0.003) were both twice as likely to have anti-T. gondii IgG seropositivity. Besides, women who were unsure regarding the transmission mode of the disease via blood transfusion were four times more likely (aOR: 3.93, 95% CI 1.54, 10.01; p = 0.004) to have chronic toxoplasmosis seroprevalence. Women who were unsure regarding the necessities of avoiding stray cats had aOR of 0.42 (95% CI 0.24, 0.71, p = 0.001) for chronic toxoplasmosis seroprevalence. Translating the knowledge on toxoplasmosis into the practice of preventive behaviour via a health education programme is crucial in reducing the risk of disease transmission especially among pregnant women