In a recent study, researchers observed that more than one-third of children with a primary immunodeficiency disease died from COVID-19.
Children with certain immunodeficiency diseases have a higher mortality rate due to COVID-19, suggests new research out of the Karolinska Institutet published in the Journal of Allergy and Clinical Immunology.
Most children infected with COVID-19 are asymptomatic or have mild symptoms, but those with certain immunodeficiency diseasesalso called inborn errors of immunity (IEI)may have mutated genes that affect the immune system, preventing it from protecting itself against infections. This could lead to severe, or deadly, complications.
Mortalityis much higher among children with primary immunodeficiency diseases infected with SARS-CoV-2. Our results indicate that basic immunological examination and genetic analysis should be conducted in children with severe COVID-19 or multi-inflammatory syndrome (MIS-C). The clinicians will then be able to help these children with more precise therapies based on their genetic changes, said study leader Qiang Pan-Hammarstrm, professor at the Department of Biosciences and Nutrition, Karolinska Institutet, in a press release.
Among children with primary immunodeficiency diseases (examples include hereditary and congenital diseases of the immune system), certain individuals have mild or no symptoms after contracting infection from COVID-19, whereas others experience severe symptoms. There is controversial evidence explaining why the range of symptoms differs greatly, according to the authors of the current study.
Researchers at Karolinska Institutet set out to understand whether genetics play a role in the severity of some COVID-19 cases among children with primary immunodeficiency diseases. Between August 2020 and September 2020, researchers identified 31 unvaccinated children in Iran who had the same primary immunodeficiency disease. The participants, aged 5 months to 19 years, suffered from a severe or critical COVID-19 infection.
After performing genetic and immunological analyses, researchers found that 11 children died from SARS-CoV-2 complications. Among participants, 5 (16%) children were diagnosed with MIS-C.
The research suggests that patients with MIS-C differ from those without MIS-C because they cannot produce their own antiviral antibodies. Consequently they, would not have the full benefit of vaccination, said lead author Hassan Abolhassani, assistant professor at the Department of Biosciences and Nutrition, Karolinska Institutet, in the press release.
Further, the genetic analyses showed that more than 90% of children with primary immunodeficiency diseases had a mutation that affected proteins (interferons) that regulate the immune system during a viral infection. These mutated genes could explain why their immune defenses were not functioning properly.
The researchers performed an additional literature review of global reports that studied this population. The team identified the mortality rate from COVID-19 to be 8% among children with an IEI.
The study was limited to researching patients with severe COVID-19 cases, those infected with the original strain, and non-vaccinated children.
Our results clarify the molecular mechanism of these immune diseases, which opens up the possibility of developing a more targeted therapy. The knowledge acquired from the study also allows us to develop better strategies for the treatment and prevention of severe COVID-19 disease in these patients, Pan-Hammarstrm said in the press release.
Reference
Karolinska Institutet. Higher risk of serious COVID-19 complications in children with primary immunodeficiency. EurekAlert! September 16, 2022. Accessed on September 19, 2022. https://www.eurekalert.org/news-releases/964997
Covid-19 in children and teens appeared to raise the risk of developing diabetes in two studies that didnt settle the debate about whether the coronavirus can trigger the chronic condition.
Scientists from the Norwegian Institute of Public Health used national health registries to examine new diagnoses of type 1 diabetes over two years after the start of the pandemic. They found that youngsters who had tested positive for the coronavirus were about 60% more likely to develop type 1 diabetes.
By now, most people are aware of the risk of developing long COVID after having COVID-19. But new research suggests the virus can ramp up your risk of developing blood clotsand that risk stays higher than normal for a year afterward.
Thats the main takeaway from a large new study published in the journal Circulation. The study analyzed data from 48 million people registered in Great Britains National Health System from January 2020 until the day before COVID-19 vaccines were made available in December 2020. The researchers found 1.4 million diagnoses of COVID-19 and, among those, 10,500 patients that developed blood clot-related issues.
The researchers discovered that, in the first week after someone received a COVID-19 diagnosis, the risk of developing an arterial blood clot (which can lead to a heart attack or stroke by blocking blood flow to the heart or brain), was nearly 22 times higher than in someone who didnt have the virus. The risk dropped by the second week, but was still elevatedit was less than four times higher than in someone who didnt have the virus.
For clots that happen in the veins, like deep vein thrombosis and pulmonary embolism, the risk in the first week after being diagnosed with COVID-19 was 33 times higher. After three to four weeks after a person had been diagnosed, it was about eight times higher. The risk was still 1.8 times higher between 27 and 49 weeks later when compared to people who had never had COVID-19.
The risks were there regardless of how severe a persons COVID-19 was, but they were higher in those who were hospitalized with the virus. The clot risks were also higher in Black and Asian patients.
Overall, the clots were rare. The overall risk of developing an arterial clot in the 49 weeks after being diagnosed with COVID-19 was 0.5% and it was 0.25% for a venous clot in that time period. (To translate that into real-world health issues, it led to about 7,200 additional heart attacks or strokes and 3,500 additional cases of pulmonary embolism, deep vein thrombosis, or other vein-related health issues.)
This raises a lot of questions about safety after having COVID-19, including why this might happen and what you should be on the lookout for. Heres what you need to know.
The study didnt explore thisit simply found an associationbut there are some theories on why this link might exist.
A big one is that the virus can cause inflammation in your body. COVID provokes an inflammatory response that can enhance blood clotting and damage vascular structures, says infectious disease expert Amesh A. Adalja, M.D., a senior scholar at the Johns Hopkins Center for Health Security. As a result, he says, a heightened risk of clotting can persist.
Its also possible that an increased risk of blood clots is simply how the virus works, says Thomas Russo, M.D., professor and chief of infectious disease at the University at Buffalo in New York. It seems to be part of the pathophysiology of this virus, he says.
Dr. Russo says that doctors have known from the beginning of this pandemic that when you get infected with COVID, you have a greater tendency to form blood clots. Early on, we were seeing these terrible situations of people with black fingers and toes, and damage to a variety of organs because of blood clots, he says.
Doctors say that other infections can cause a higher-than-usual risk of blood clots. Dr. Adalja points out that the link is well described with shingles, causing an increased risk of heart attacks.
These clots have also been described with flu, Dr. Russo says. However, theyre more common with COVID.
Its normal for blood to clot under certain circumstances, like when you have a cut. But blood clots can be an issue when they form and create a blockage or travel to other areas of the body, like your lungs or brain, according to Medline Plus. Symptoms of dangerous clots depend on where theyre located in the body. Per Medline Plus, they can include:
Dr. Adalja stresses that this risk is rare. However, Dr. Russo says its still a good idea to at least be aware of the risk for blood clots and what symptoms can look like.
Its also a good idea to get your full COVID-19 vaccination series, including boosters youre eligible for, whether youve had COVID or not, Dr. Russo says. This is yet another reason to try to protect yourself from getting COVID, he says.
Korin Miller is a freelance writer specializing in general wellness, sexual health and relationships, and lifestyle trends, with work appearing in Mens Health, Womens Health, Self, Glamour, and more. She has a masters degree from American University, lives by the beach, and hopes to own a teacup pig and taco truck one day.
Illustration by CDC
COVID-19 continues to trend downward in Alabama and this week is averaging about 90% fewer average daily cases and hospitalizations than when the state hit its all-time peak in January.
According to the Alabama Department of Public Health, the state averaged 201 new cases a day this week and an average of 323 COVID-positive hospitalized patients. The states positivity rate was 8.1%, down from more than 24% a month ago.
Jefferson County reported a positivity rate of 7.5% this week, with 39 cases.
Currently, the Centers for Disease Control and Prevention ranks four Alabama counties as having high community levels of COVID: Limestone, Dallas, Butler and Escambia. Last week, 15 counties were classified as having high COVID community levels, including Jefferson County, which this week is classified as having low community levels of the virus.
Cases and deaths have been greatest among white residents during the past four weeks, making up 50.4% of total cases and 70.6% of deaths, respectively, according to ADPH.
As usual, the highest rate of deaths, 54.6%, have been among those 75 and older during the past month.
The largest group of people being diagnosed with the disease in that time period, however, is the 25-49 age group, making up 29.6% of cases.
In total, Alabama has reported 1,517,904 cases of COVID since the pandemic began in March 2020 and 20,395 deaths. Of the states 5.08 million residents, 2.4 million have completed a series of vaccinations against the virus.
Critically acclaimed singer-songwriterAndy Grammer is known for his uplifting catchy songs. From Keep Your Head Up to Honey, Im Good even his song titles spread a message of positivity.
But Grammer wants the world to know that despite his outward persona, he too sometimes struggles with mental health challenges. During the pandemic, he turned to therapy and self-work to manage his mental well-being.
[When] it got completely quiet and I was not allowed to leave my house and not allowed to be around thousands of people and not allowed, honestly, to just be distracted, I was forced to sit with myself, and that was not super fun, Grammer told Healthline. [I] realized, oh, I got a lot of work inside, invisible work to do here that I dont think I would have done as soon if it hadnt been for the pandemic.
To raise awareness about mental health and well-being, he is headlining the fundraiser Beyond the SidelinesFriday September 23.Proceeds from the event will benefit Kicking The Stigma, an initiative led by the Indianapolis Colts and Irsay family, which aims to raise awareness about mental health disorders and remove the stigma associated with them.
Its been really cool to align with different organizations that are doing really good work to break the stigma, said Grammer. [I] want to be really open about it and say that I struggled a lot and its totally normal and okay to take care of yourselfWere all pretty clear that if you break your leg, you need to go to PT and get a cast and do the whole thing, but its a little more invisible and vaguer when it comes to mental health, but it doesnt need to be.
Below, Grammer shared more with Healthline about mental health, music, and what keeps him motivated and inspired.
Healthline: While the pandemic negatively impacted your mental health, it sounds like it forced you to pay attention to it. Is that right?Grammer: In hindsight, Im grateful for it. Im currently outside of a building right now. Were filming a podcast called Man Enough, which is all about masculinity, and we were getting into, yesterday, an episode about what it is about guys that we feel like going to therapy is weak or something. It almost sounds clich to talk about. Its a point thats been brought up plenty; theres nothing new about it. What is interesting is that for me, I had to be completely destroyed to say, ok, fine, Ill go to therapy. Why does it have to be that way? Why do I have to be so clearly not capable of going about my day to then say, ok, I think I need some help. Rather than just being like I dont feel so great, which is all the time, not all the time consistently, but throughout the day, youre like Im sad or Im anxious or Im these things.
How did therapy help you?Therapy has helped me a lot. Id love to help do anything to help someone not to get so low before they can turn to it. Ultimately, its like are you creating space in your life to work through your own stuff? and I know for me, I was not, and thats what the pandemic did for me. It kind of forced it upon me, which Im in hindsight grateful for, but it was not super fun to go through.
Was that your first time going to therapy?I went to therapy one time in high school. My mom sent me because I thought I was supposed to start on the varsity basketball team. I worked on it since I was in like 4th grade, and I didnt start. I came off the bench as sixth man and it really threw my identity and my [self-worth] off and so then I went and talked to a therapist about four times and it was pretty helpful.
I think I was afraid to own the darker sides of myself. So, therefore, its just a little bit scary to acknowledge that to even yourself that youre not perfect and everybodys got crap. But if youre never willing to look at that stuff or deal with the stuff inside yourself, then youre not being a complete version of yourself, and there is a place where youre okay, and totally enough, and totally loveable, and shitty sometimes.
Your songs are so positive and uplifting, but they also address deep serious feelings. Do you think people often think that people who are happy, positive, and optimistic cant have dark days?I cant speak for everybody else, just for myself. I know for my own art, if youre going to be someone who is dealing in the world of optimism and joy and uplifting yourself and others, even the word uplift means that you are low.
I wrote my first song, Keep Your Head Up, after my mom died, so its all grounded in pain. I think that hope can be really rebellious in a dark time, but if its not, thats the kind of optimism and hope that I try to sing about, that I can really get behindI think that joy or happiness in the face of darkness is so much more interesting, and thats usually the place that Im writing from.
Has singing and writing been healing for you?Yeah. On the last tour, I started my show with a poem, and it leads into a song called Damn it Feels Good to Me. I think it takes a lot of courage to own all the pieces of yourself. Theres a real freedom in it, but it is undeniably a courageous act to in your art or in your life or with people you trust, to share all of yourself.
In a recent Instagram post of yours, you mentioned that you originally wrote songs for yourself, but realized how much they impacted other people. Is that rewarding?Its super rewarding. When you do deeper work on yourselfwhen youre courageous and you share the whole version of yourself in your art or in your life, it gives permission for other people to do that in their lives and that is such a sweet thing that by kind of healing yourself and then sharing whatever you found, youre creating spaces for other people to do the same. That is an awesome, awesome life. I want to do as much of that as possible.
When you need a mental boost, do you ever listen to your own songs?I dont turn on my own songs. I have my own people that I go to. Thats why its the biggest compliment in the world when someone tells me that Ive been that for them because I know how important it can be. Music is incredible. I always say music is like a spiritual chiropractor. If youre feeling funky, it can go inside of you and give you a little crack to get you back on track.
I had a day the other day where I woke up, and I hadnt slept very long, and I was getting ready to leave my hotel out on tour, not in my best headspace. I was like: Am I going to work out? Am I going to go eat some crappy thing? Where am I at? And someone had just text me a song as I was leaving, and the song was incredible, and it changed my day. It made me choose better versions of myself that day, and that is really important and powerful.
What self-care methods or coping strategies do you turn to during difficult times?Its definitely very personal, and I want to make sure that people dont think theres some one-size-fits-all. I think it comes down to self-knowledge and understanding what it is that actually works for you. For me, Im not always the best at it, but Im pretty clear that if I get a workout in, that helps a lot with my mental health.
And then something spiritual like respecting my own depth. Something that will go deeper and take me out of the day-to-day. If I do that as well as workout really hard and get a good sweat in, its kind of like you have to trust because you dont want to do those things you have to trust that by the end of it, you will be a better version of yourself. And over time, that has been made clear for me.
Is it rewarding to use your music to draw attention to mental health?The best thing that I love about what I do, and if youve ever been to shows, is that you are in a specific place where youre open to hearing some things that you might not always be. You know? Like, it creates space for you to go a little deeper into yourself when youre surrounded by all these people, and music has this effect, so it can be a really special time to go deep with people.
Do you have a particular song that really does that with your audience?Its so unique to people. When I start different songs, I can see that different people have taken certain songs [to heart]. I have a song right now called Saved My Life, which is about people showing up for you, and a lot of times, Ill start that song and see a mother and a daughter just hugging and crying. I have a song, Dont Give Up on Me, which I think does some of that. Keep Your Head Up has been a song that people use almost like an aspirin when theyre not feeling good.
Whether a new coronavirus variant takes hold in the coming weeks could determine if Michigan will undergo another seasonal COVID surge or enjoy its first quiet winter in three years.
Modeling from The COVID-19 Scenario Modeling Hub offer projections for the next six months, with a handful of different scenarios based on vaccine uptake and the emergence of hypothetical new variants. Health officials have looked to these models throughout the pandemic to help estimate upcoming trends.
The latest models suggest Michigan could see COVID cases and hospitalizations continue to plateau or even decline this fall if there are no new immune-escaping variants of coronavirus that gain traction through the end of the year.
On the other hand, a new variant with the ability to evade existing immunity could open the door to another rise in infections, hospitalizations and deaths this winter, much like omicron caused in 2021.
Its the kind of situation where I would love it if we got a pleasant surprise and we ended up not having a winter spike, but I think we probably should prepare for one, said Marisa Eisenberg, an associate professor of epidemiology at the University of Michigan who assists the state with infectious disease modeling. History has shown that usually we do get one.
The difference between Scenario Hubs most pessimistic scenario (new variant, low booster uptake), and its most optimistic scenario (no new variant, high booster uptake early on), is about 600,000 hospitalizations and 70,000 deaths nationwide.
The group estimates early booster availability and uptake would avert 6-12% of cases, 10-16% of hospitalizations, and 12-15% of deaths.
Related: COVID questions: Are the new vaccine boosters still free? Whos eligible?
Omicron subvariants BA.4 and BA.5 continue to make up more than 95% of sequenced samples in the U.S. Another omicron subvariant known as BA.2.75, originally identified in India, made up 1.3% of sequenced U.S. cases last week and is being monitored by the World Health Organization.
Predicting what the actual new variant is going to be and when it might emerge is a really tough problem, Eisenberg said. It depends so much on transmission happening not just in Michigan but all around the world, and other variables.
There are a lot of different variants that (the World Health Organization) and others are keeping track of. Whether any one of those is likely to kind of emerge and become the next dominant variant is tough to say.
Michigans COVID-19 trends have been consistent from week to week throughout the summer, with steady increases over the last three months. During the last week, the state reported an average of 1,849 cases and 17 deaths per day -- up from 1,588 cases and eight deaths per day three months ago.
Similarly, hospitals were treating 1,174 COVID patients as of Tuesday, Sept. 20, compared to 777 such patients on June 21.
The latest numbers arent far off from mid-September 2021, when the state was reporting about 2,772 cases and 21 deaths per day. Case counts were likely more accurate then, due to less availability of at-home testing.
In the months that followed, a more infectious variant known as omicron took over delta as the dominant strain in the U.S., resulting in spikes in case, death and hospitalization rates. By mid-January, there were more than 17,500 cases being reported per day in Michigan, and hospitalizations neared 5,000 COVID patients as health systems begged for residents to exercise caution.
The models from Scenario Hub show potential for another spike near the end of the year. They also leave the door open for rates to continue plateauing even despite a hypothetical new variant, as its difficult to predict the infectiousness of a hypothetical new variant.
Another big factor at play will be how much of the population will get the new bivalent vaccines. The updated booster shots, which became available to Michiganders earlier this month, were made to offer protection against the original coronavirus strain from the start of the pandemic, as well as omicron BA.4 and BA.5.
Absent of a new variant, the models project early boosters could prevent 2.4 million cases, 137,000 hospitalizations, and 9,700 deaths from COVID.
The bivalent booster will help fight the omicron subvariants, including BA.4 and 5, said Dr. Natasha Bagdasarian, Michigans chief medical executive, in a prepared statement. COVID-19 vaccines remain our best defense against the virus, and we recommend all Michiganders stay up to date.
About 63% of Michiganders got an initial dose of the original vaccines. Of them, about 59% got an initial booster dose. The state hadnt published any data on bivalent booster uptake as of Wednesday, Sept. 21.
Scenario Hub notes that even the best models of emerging infections struggle to give accurate forecasts greater than a few weeks out due to unpredictable variables like changing policy environment, behavior change, development of new control measures, and random events.
Eisenberg said its getting harder to make these models, because the picture of existing immunity and re-infection is getting increasingly complicated with the evolving coronavirus variants. Still, they remain useful.
Theyre not trying to project whats going to happen, she said. Theyre saying if we get a new variant, heres what it might look like. If we dont, heres what it might look like.
To find a vaccine near you, visit the online vaccine finder tool and enter your ZIP code. If youre looking for a bivalent booster, select one or both of the bivalent shots from Pfizer and Moderna.
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Introduction: The 2019 coronavirus (COVID-19) rapidly spread throughout the world, with diverse negative consequences in all fields, including the continuity of treatment for patients with other diseases. The public hospital for high-complexity procedures affiliated with the So Jos do Rio Preto School of Medicine, So Paulo, Brazil, normally has a high annual quantity of outpatient appointments. However, the consequences of COVID-19 led to a reduction in the number of appointments, exams, and outpatient procedures. The aim of the present study was to evaluate the impact of the pandemic on outpatient care for individuals with urological conditions at a university hospital.
Patients and Methods: A retrospective, descriptive, cross-sectional study was conducted involving the analysis of all outpatient appointments for individuals with urological conditions at the Urology Clinic of the So Jos do Rio Preto Hospital, So Paulo, Brazil,between January 2019 (pre-pandemic period) and December 2020 (after the first year of COVID-19). The variables of interest were sex, age, and affected organs of the genitourinary system.
Results: Among the 4,972 outpatient appointments involving patients with urological conditions in 2019, 70.7% involved males and the largest portion of patients were in the seventh decade of life (40.02%). Among the 4,584 outpatient appointments in 2020, 69.9% involved males and the largest portion were in the seventh decade of life (47.07%). Significant differences were found in the number of outpatient appointments between 2019 and 2020 in all age groups (p < 0.0001). The most affected organs of the genitourinary system in both 2019 and 2020 were the prostate (46.07% and 56.31%, respectively), bladder (30.56% and 22.48%, respectively), and kidney/ureter (22.85% and 19.68%, respectively), with no significant differences between the two years.
Conclusion: The COVID-19 pandemic exerted an impact on outpatient care for individuals with urological conditions at a university hospital, leading to a reduction in the number of appointments. No change was found with regard to the sex of the patient. In contrast, an increase was found in the number of patients 60 years of age or older during the year of the pandemic. The most affected organs of the genitourinary system were the prostate, bladder, and kidney/ureter in both years analyzed.
The 2019 coronavirus (COVID-19) that emerged in Wuhan, China [1] spread rapidly throughout the world [2,3]. Diverse negative consequences were felt in all fields, including the continuity of treatment for patients with other diseases. Changes occurred in the understanding of priorities in the health field, as human resources (medical and paramedical staff), materials, drugs and hospital beds in wards and intensive care units were prioritized to provide care for patients infected with COVID-19. Social distancing also contributed to the reduction in appointments, exams, and treatment for patients with other conditions.
Routine urological care was impacted and discussions were necessary on how to provide care for these patients [4]. One initiative in Brazil was Law n 13.989/2020, which addressed the use of telemedicine during the crisis caused by SARS-CoV-2[5]. Throughout the world, guidelines were formulated to assist in the determination of which outpatient procedures should be performed and which should be suspended [6-8].
Moreover, residents in urology may have had their education compromised due to the reduction in the number of outpatient appointments, despite the use of telemedicine. Indeed, the changes imposed by the COVID-19 pandemic led to a reduction in the participation of residents in urological activities [9,10].
The university hospital affiliated with the So Jos do Rio Preto School of Medicine,So Paulo, Brazil, is a high-complexity institution with a large number of annual outpatient appointments. The consequence of COVID-19 led to a reduction in the number of appointments, exams, and outpatient procedures. In this context, investigating the impact of the pandemic on urological outpatient care is justified. Despite the risk of contamination, patients with urological conditions should be seen, provided that safety guidelines and protocols are respected since such patients run the risk of the aggravation of certain clinical conditions.
The aim of the present study was to evaluate the impact of the pandemic on outpatient care for individuals with urological conditions at a university hospital considering possible associations with sex, age, and affected organs of the genitourinary system.
A retrospective, descriptive, cross-sectional study was conducted involving the analysis of all outpatient appointments for individuals (irrespective of ethnicity) with urological conditions at the Urology Clinic of the So Jos do Rio Preto Hospital, So Paulo, Brazil,between January 2019 (pre-pandemic period) and December 2020 (after first year of COVID-19). This study received approval from the Human Research Ethics Committee of the So Jos do Rio Preto School of Medicine (certificate number: 47083921.0.0000.5415).
Data were collected from the computational system of the hospital. The variables of interest were sex, age, and affected organs of the genitourinary system in patients with urological conditions in 2019 and 2020 (first year of the pandemic).
The data were entered into spreadsheets in the Excel program. Descriptive analysis involved the calculation of frequencies as well as central tendency and dispersion measures. Pearsons chi-squared test was used for the comparison of frequencies. The IBM SPSS Statistics for Windows, Version 23.0 (Released 2014; IBM Corp., Armonk, New York, United States)and GraphPad InStat 3.10 (Dotmatics, Boston, United States) programs were used for all analyses, with a p-value 0.05 considered indicative of statistical significance.
Among the 4,972 outpatient appointments involving patients with urological conditions in 2019, 70.7% involved males and the largest portion of patients were in the seventh decade of life (40.02%). Among the 4,584 outpatient appointments in 2020, 69.9% involved males and the largest portion were in the seventh decade of life (47.07%).
No significant difference was found in the comparison of the sex of the patients with urological conditions in outpatient care between 2019 and 2020 (p = 0.7727, chi-squared test). In contrast, significant differences were found in the number of outpatient appointments between 2019 and 2020 in all age groups (p < 0.0001) (Table 1).
The most affected organs of the genitourinary system in 2019 were the prostate (46.07%), bladder (30.56%) and kidney/ureter (22.85%). No significant reduction or increase occurred in 2020; the most affected organs were also the prostate (56.31%), bladder (22.48%), and kidney/ureter (19.68%) (Table 2).
The results of the present study show a reduction in the quantity of outpatient appointments of individuals with urological conditions at a university hospital during the pandemic. The male sex predominated in both the year before and the first year of the pandemic. A reduction occurred in the number of appointments for all age groups, except individuals 60 years of age or older, for whom an increase was found in 2020. Individuals less than 20 years of age accounted for the least number of appointments in the period studied.
In the analysis of the main organs of the genitourinary system, the prostate, bladder and kidney/ureter were the most affected in both years. Patients with prostate conditions accounted for the most appointments, irrespective of the pandemic, possibly due to the fact that such conditions are more prevalent among patients 60 years of age or older [11]. Moreover, the guidelines recommend not interrupting therapy in cases of prostate diseases without medical approval, which justifies appointments of patients in this age group even during the pandemic.
Conditions that affect the bladder require medical care, as symptoms such as hematuria, micturition pain, and urinary retention should be prioritized [12]. In the present study, the quantity of outpatient appointments diminished in the first year of the pandemic, which may be related to patients visiting emergency rooms for care.
Analyzing the quantity of outpatient appointments in patients with conditions of the kidneys and/or ureter, a slight increase was found in 2020, suggesting that these patients maintained clinical follow-up irrespective of the pandemic. Situations such as compromised renal function, fear of invasive procedures or aggravated pain due to a lack of medical follow-up may explain this finding [13,14].
A reduction of approximately 10% was found in the quantity of outpatient appointments for individuals with urological conditions in the first year of the pandemic compared to the previous year. However, some patients may also have been seen at the emergency service of this tertiary university hospital, which is a regional reference center for a population of approximately two million residents (Instituto Brasileiro de Geografia e Estatstica, Conjuntura Econmica, 2021).
In the scenario of the pandemic, outpatient appointments for patients with urological conditions should be maintained at tertiary centers that have the necessary infrastructure to deal with complications related to COVID-19 and provide safe specialized care for patients [15]. Moreover, outpatient follow-up of these patients is necessary, since some conditions, such as prostate cancer, may progress due to the situation of the pandemic [15].
The COVID-19 pandemic exerted an impact on outpatient care for individuals with urological conditions at a university hospital, leading to a reduction in the number of appointments. No change was found with regard to the sex of the patients. In contrast, an increase was found in the number of patients 60 years of age or older during the year of the pandemic. The most affected organs of the genitourinary system were the prostate, bladder, and kidney/ureter in both years analyzed.
Updated Sept. 22, 2022 3:38 pm ET
Health authorities encouraging retooled Covid-19 boosters are facing resistance from an unlikely corner: people who had embraced vaccines earlier in the pandemic.
The authorities have expressed hope that sluggish booster rates would pick up as people seek the reformulated shots, which target the latest versions of Omicron.
Under a tentative deal Washington state employees would get $1,000 bonuses for receiving a COVID-19 booster shot.
The agreement between the state and the Washington Federation of State Employees also includes 4% pay raises in 2023, 3% pay raises in 2024 and a $1,000 retention bonus, The Seattle Times reported.
Gov. Jay Inslee announced this month that all pandemic emergency orders will end by Oct. 31, including state vaccine mandates for health care and education workers. But he has said a vaccine mandate will continue to be in effect for workers at most state agencies.
Most employees were required to have their initial series of vaccination by October of last year or be fired. New state employees have had to be vaccinated before their official start date.
We want to have healthy people so people dont miss work, Inslee said earlier this month. The vaccine still remains a very important thing.
The Washington Federation of State Employees represents nearly 47,000 workers with roughly 35,000 state employees impacted by the tentative deal. The union said it would help address widespread staffing shortages and workplace safety issues.
The union called the deal, which still must be approved by both sides, the highest compensation package in the unions history.
Inslees office declined to speak to the specifics of the tentative agreement announced by the union.
Offering incentives for boosters reflects the feedback and recommendations we heard from employees and labor partners, Jaime Smith, an Inslee spokesperson, said.
