Browsing by Subject "COVID-19"
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Item 10 Tips for Maintaining a Healthy Lifestyle and Body Weight(Fairbanks School of Public Health, 2020-03-18) Song, Yiqing; Epidemiology, School of Public HealthAt this extreme moment, we began working from home, away from campus, and keeping social distance for as many people as possible. As we stay home and are stuck with the foods that have been in our fridge or pantry for a while, we are temporarily living a sedentary lifestyle with increased odds of physical inactivity, excessive eating and sitting, stress, anxiety, and depression. In particular, many of us will gain some weight during the pandemic and may keep the extra weight permanently, which may carry considerable health risks for type 2 diabetes, hypertension, heart attack, stroke, and other health problems. Here, I’d like to share some basic tips and resources for how to maintain your healthy lifestyle, body weight, and overall well-being while staying home and engaging in social distancing.Item 1137. What Do We Know? Teaching Medical Students to Deal with Uncertainty as a Pandemic Unfolds(Oxford, 2020-10) Bauer, Margaret E.; Trujillo, Daniel; Brown, Cameron; Gomez, Martiza; Davidson, Darrell; Relich, Ryan F.; Allen, Bradley L.; Microbiology and Immunology, School of MedicineBackground The global COVID-19 pandemic has had a major impact on medical student education. As the pandemic spread nationwide, numerous universities shut down with only days’ notice, and medical students were removed from all patient care settings and restricted from campuses. Yet, the need and curiosity of these future physicians to understand this new disease was great, including how to interpret and integrate rapidly evolving information on the underlying viral and immune mechanisms, pathophysiology, and epidemiology. Time students spent away from patient care settings presented an opportunity to rapidly develop and deliver new curriculum covering SARS-CoV-2 and COVID-19. Methods A team of students and faculty at Indiana University developed a Fundamentals of COVID-19 course that included up-to-date information on the virology, immunology, and pathophysiology of COVID-19. The course was delivered online, with both synchronous and asynchronous activities. Virology and immunology of the coronavirus family, including current knowledge to-date of SARS-CoV-2, were delivered using a series of readings and brief videos, followed by a small group exercise that required students to choose and present to their peers a paper from the scientific literature on COVID-19. A similar approach was used to deliver content about the pathophysiology of COVID-19. To place the COVID-19 experience in context of other pandemics, students researched and educated their small group cohort on another historical pandemic. Results To measure course effectiveness, we administered a pre-course survey gauging students’ self-confidence in their knowledge of these topics; the same survey was administered after completion of the course. Surveys from 645 (89% of enrolled) 3rd and 4th year medical students who completed both surveys were analyzed. Results showed that the course elicited a 57% increase (p< 0.001) in students’ confidence in their knowledge of COVID-19 virology and immunology and a 64% increase (p< 0.001) in knowledge of the pathophysiology. Conclusion Data showed that the asynchronous content and group activities were successful in engaging and educating the students on foundational knowledge of COVID-19 and were an effective approach to rapidly evolving information when faced with a novel disease.Item 153. AYA Subspecialty Patient and Parent Views on COVID-19 Vaccination(Elsevier, 2022) Hardman, Sara; Jacob, Seethal A.; Coven, Scott L.; Rahim, Mahvish Q.; Miller, Meagan E.; Zimet, Gregory D.; Meagher, Carolyn G.; Ott, Mary A.; Pediatrics, School of MedicinePurpose: Adolescents/young adults (AYA) with hematologic and oncologic (heme-onc) conditions are important targets for vaccine outreach because they are at increased risk for complications from COVID-19. AYA patients may also need additional support, as they are transitioning from parent to independent vaccine decision-making. AYA with sickle cell disease (SCD) are of particular concern because a high proportion are African American and experience structural racism in addition to their illness. Our objective was to examine AYA and parent attitudes regarding the COVID-19 vaccine among heme-onc populations. Methods: As part of a larger IRB-approved study, we recruited vaccine decision-makers in pediatric SCD and oncology survivor clinics, including parents of adolescents under 18 years (n=35), AYA patients 18-21 years old (n=21), and parents of AYA patients 18-21 years old (n=14). After informed consent, participants completed a demographic survey and a semi-structured interview regarding their vaccine decision-making process. Example questions included “What do you see as the benefits of the COVID-19 vaccine?” and “What are your concerns about the COVID-19 vaccine?”. Saturation was reached. Interviews were audio recorded, transcribed, and analyzed using thematic analysis. Codes were developed from the literature and early interviews. Examples included “attitudes against vaccine,” “medical mistrust,” “hesitancy,” “vaccine side effects,” and “vaccine interactions with disease process.” Fisher exact statistical tests were performed to analyze quantitative data. Results: In SCD clinic, we recruited 31 index patients (mean age: 15.1±3.5 years; 30 African American and 1 Other or Mixed), yielding 11 AYA and 26 parent interviews. In survivor clinic, we recruited 26 index patients (mean age: 16.0±3.4 years; 20 White, 2 Hispanic or Latinx; 2 Other or Mixed, 1 African American, and 1 Asian), yielding 10 AYA and 23 parent interviews. Out of the total index patients, 8 had already received the vaccine, 13 were planning to receive it, 27 were considering it, and 9 had declined it. There was no clear relationship between patients’ diagnosis (SCD or cancer) and their vaccine decisions nor between the index patient’s age (under or over 18) and their vaccine decisions. A high proportion of participants saw benefits to vaccination, such as lowering personal risk, community benefits of preventing the spread of COVID-19, and a possible return to “normal.” However, many AYA and parent participants also had concerns toward the vaccine, including concerns about short-term side effects and the potential for unknown, long-term effects. Concerns were also voiced about how rapidly the vaccine was developed and misconceptions about the vaccine were common, namely the vaccine causing infertility or increasing one’s susceptibility to contracting COVID-19. Medical mistrust toward either the vaccine or providers was explicitly stated by several participants, the majority of whom were from minoritized groups. Conclusions: COVID-19 vaccines have the potential to protect medically and socially vulnerable AYA, however patient and parent concerns, misconceptions, and mistrust are still prevalent. These data provide insights into the design and implementation of vaccine counseling interviews for AYA subspecialty patients and families.Item 2020 Year in Review: Pharmacologic Treatments for COVID-19(2021-04) Saunders, Jessica L.; Davis, Michael D.; Pediatrics, School of MedicineCOVID-19, caused by SARS-CoV-2 infection, has led to a pandemic of acute respiratory illness. Pharmacologic treatments for COVID-19 have included treatments targeting infection prevention, prevention of viral replication, reducing inflammation and managing symptoms of respiratory failure caused by the disease. This is a review of key pharmacologic treatments for COVID-19 based on peer-reviewed articles from 2020.Item 241: Malignant Catatonia Possibly Precipitated by SARS-CoV-2 Infection(Wolters Kluwer, 2021) Johnson, Sean; Kapoor, Rajat; Kim, Yo Sup; Medicine, School of MedicineItem 247 Identifying Factors that Contribute to Joy and Gratitude for Emergency Medicine Healthcare Workers Amidst the COVID-19 Pandemic(Elsevier, 2021-10) Kelker, H.; Cushman, E.; Munson, C.; Yoder, K.; Musey, P.; Reed, K.; Henderson, B.; Vynas, P.; Johnson, O.; Welch, J.; Emergency Medicine, School of MedicineStudy Objective: During COVID-19, emergency medicine (EM) providers have labored to protect the health of their patients, often at the expense of their own well-being. Increased demands imposed on providers without intentional efforts to evaluate and improve wellness can lead to burnout, attrition, and compromise patient care. Practices that promote mindfulness, reflection and gratitude have been shown to reduce burnout. The Institute for Healthcare Improvement (IHI) Framework for Improving Joy In Work provides an approach to restore joy and engagement by first identifying elements that "matter most” to healthcare workers. The objective of this study was to identify common themes and associations that contribute to EM provider and staff (1) joy in work, (2) gratitude, and (3) personal wellness. Methods: This descriptive study used an electronic survey tool with open-ended questions adapted from the IHI framework to assess what matters most. Q1: What brings you joy in your work? Q2: Thinking back to what matters most, what are you grateful for? Q3: What do you do to maintain your personal wellness? In Nov. 2020, email listservs were used to recruit a voluntary sample of emergency physicians, advanced practice providers (APPs), residents, fellows, nurses and staff from 10 academic and community hospitals. Data were managed in Qualtrics and Excel. Qualitative analysis used inductive thematic coding by two authors independently, with verification by a third. Information redundancy signaled saturation for common themes. Pivot tables examined themes across demographics, and associations were analyzed with 2x2 contingency tables using chi-square, Fisher’s exact tests, and odds ratios (95% CI). Results: Of 254 respondents, 63% were female and 89% identified as White. Roles were 32% physicians, 8% APPs, 16% residents/fellows, and 44% nurses/staff. Response rates were 39-54% for providers. Common themes for joy in work were patient care (47%) and teamwork/camaraderie (43%), followed by feeling valued/appreciated (13%), making a difference (13%), and teaching/mentoring (9%). EM providers at academic sites were more likely to find joy in teaching/mentoring than those in the community (p=0.01; OR 10.5, 95% CI 1.3-82.6). For gratitude, themes were teamwork/ camaraderie (13%), family (12%), health (7%), and supportive work environment (7%). Themes for maintaining personal wellness were physical exercise (46%), time with family and friends (32%), hobbies (15%), and self-care (13%). Conclusions: Results of this study reveal common themes for EM providers and staff surrounding joy, gratitude, and wellness. By identifying elements that matter most, systems can take the next steps in the IHI framework to support and rejuvenate their healthcare team. Implications from our findings suggest that practices and future research to remove barriers and encourage meaningful provider-patient interactions, team camaraderie, teaching/mentoring, physical activity, and time with family/friends could increase joy and fulfillment for frontline healthcare workers.Item 274: Corticosteroid Use in Severely Hypoxemic COVID-19 Patients(Wolters Kluwer, 2021) Rahman, Omar; Trigonis, Russell; Craft, Mitchell; Kruer, Rachel; Miller, Emily; Terry, Colin; Persaud, Sarah; Kapoor, Rajat; Medicine, School of MedicineItem 5 ways that colleges and universities are pitching in to deal with the coronavirus pandemic(The Conversation US, Inc., 2020-04-21) Shaker, Genevieve; Plater, William; Lilly Family School of PhilanthropyItem 5-OR: Health Disparities in People with and without Diabetes during the COVID-19 Pandemic(American Diabetes Association, 2021-06-01) Myers, Barbara A.; Klingensmith, Rachel; de Groot, Mary; Medicine, School of MedicinePurpose: To characterize the psychosocial experiences of adults with (PWD) and without diabetes (ND) during the COVID-19 pandemic. US adults (2176) completed a web-based survey in May-June, 2020 and November-December, 2020, including demographics, COVID-19 exposure, diabetes-related distress (DDS-17), depressive symptoms (PHQ-8) and anxiety (GAD-7). At baseline, mean age was 49.6 years (S.D. = 16.9), 80% female, 88.3% White, with an annual household income of ≥ $60,000 (57.6%), type 2 diabetes (T2D; 301,13.9%), 145 prediabetes (145, 6.6%) and type 1 (T1D, 100, 4.6%). One-third (29.7%) reported decreased income due to the pandemic. T2Ds had more medical comorbidities and COVID risk factors than T1Ds and NDs (all p < 0.01). Mean PHQ-8 scores were 7.1 (S.D. = 5.8; mild), with the T2Ds (M = 7.7; S.D. = 5.9) exceeding NDs (M = 6.9; S.D. = 5.7; p<.001). Mean DDS-17 and GAD-7 scores were comparable for T1Ds and T2Ds (moderate level; p=NS). At 6 months (6MFU), 1,345 (62.6%) completed follow up surveys. Completers were more likely to be older, male, White, married, with higher education levels, and homeowners, with a greater proportion of medical comorbidities and lower A1cs at baseline than non-completers (all p<.05). 6MFU completers had lower baseline depressive symptoms and diabetes distress, lower household COVID-19 rates and less difficulty paying bills than non-completers (all p<.05). At 6MFU for all groups, depressive symptoms decreased (p<.0001) and financial strain improved (p<.001), while COVID exposure increased (personal and household, p<.001). Diabetes distress remained at a moderate level for T1Ds and T2Ds. T1Ds and T2Ds showed comparable levels of depressive symptoms to NDs but were more likely to report financial hardship (p<.05) and difficulty paying bills than NDs (p<.001). Health outcomes were worse for PWDs compared to NDs during the COVID-19 pandemic despite high SES protective factors. Persistent financial strain and diabetes distress increase the risk for future poor health outcomes.Item 547. A Retrospective Cohort Study of Treatment Patterns and Clinical Outcomes in Patients with COVID-19(Oxford, 2020-10) Pritchard, Haley; Hiles, Jon; Teresa, Batteiger; Desai, Armisha; Wrin, Justin E; Hlavaty, Ariel; Agard, Amanda; Hinton, Bradley; Lucky, Christine W; Fleming, Elizabeth; Khan, Humaira; Bomkamp, John P; Derringer, Jon; Schneider, Jack; Ryder, Jonathan; Russ, Jason D; Khan, Haseeba; Kleyman, Svetlana; Enane, Leslie A; Stack, Matthew; Kussin, Michelle L; Myers, Courtney; Nagy, Allysa; Richardson, Noah; Elsheikh, Omar; Rahman, Omar; Kruer, Rachel; Trigonis, Russell; Butt, Saira; Bhumbra, Samina; Kapil, Sasha; Abi-Mansour, Tanya; Howe, Zachary; Abdallah, Wassim; Gupta, Samir; Wools-Kaloustian, Kara; Medicine, School of Medicine