First Case of COVID-19 Treated with Monoclonal Anti-Spike Antibodies in a Patient with Cystic Fibrosis in Romania

Patients with chronic lung conditions, including cystic fibrosis, may be prone to severe COVID-19. Therefore, therapeutic intervention should be prompt and tailored to all associated comorbidities. We report the case of a 17-year-old male adolescent with cystic fibrosis and multiple chronic conditions (bronchiectasis, exocrine pancreatic insufficiency, chronic multidrug resistant Pseudomonas aeruginosa colonization, nasal polyposis, chronic sinusitis, ventricular extrasystoles and multiple drug allergies), who presented with an acute episode of productive cough, and was confirmed with moderate COVID-19 based on positive RT-PCR for SARS-CoV-2 and lung imaging showing isolated foci of interstitial pneumonia. Intravenous treatment with the monoclonal antibody cocktail casirivimab and imdevimab was administered. The evolution was favorable, with rapid remission of the inflammatory syndrome and gradual decrease of cough, without progression to severe or critical COVID-19, but with complications such as repeated hemoptysis, which was due to the patient’s underlying conditions, and which required close monitoring for timely adjustment of the patient’s chronic treatment.

Transitional Care Nurses’ Self-Reported Characteristics of Work Areas, Job Satisfaction, Competencies and Need for Further Training: A Cross-Sectional Study

Introduction: Transitional care for older people with multiple chronic conditions is complex, and it is essential to identify the competencies of the nurses who provide such care. Aim: This study aimed to describe and compare the self-reported characteristics of transitional care nurses to their work areas, job satisfaction, competencies, and need for further training. Methods: A cross-sectional study design was used, and STROBE was followed for reporting. The total population of transitional care nurses (n=28) in Denmark was invited to participate. Data were collected through a questionnaire covering work areas, job satisfaction, competencies, and the need for further training. Results: Respondents reported high confidence in competencies related to direct clinical practice, cooperation and consultation, caregiver involvement, and use of electronic communication, and a limited need for further training. Expert transitional care nurses have high confidence in their work competencies related to patients and administrative tasks and increased job satisfaction.

Changes in Eating Habits and Sedentary Behavior During the COVID-19 Pandemic in Adolescents With Chronic Conditions

Introduction: Among healthy adolescents, school closures and home confinement were shown to increase unhealthier eating habits and sedentary behavior. It remains unknown to which extent the pandemic has impacted the lifestyle of adolescents with chronic conditions. Thus, the aim of this study is to report on the impact of the COVID-19 outbreak on eating habits and sedentary behavior among adolescents with multiple chronic conditions (n = 347) from a tertiary, referral hospital vs. healthy peers.Methods: This observational study was conducted in São Paulo (Brazil) between July and October 2020, period in which a set of social distancing measures to contain the pandemic.Results: The main findings of this study were that adolescents with chronic conditions and health peers showed important changes in eating habits (e.g., more often cooking and eating in front of television than before quarantine). Also, 86.8% of adolescents with chronic conditions and 91.6% of healthy adolescents reported increasing screen time during pandemic. No major differences were observed between patients and controls.Conclusions: Adolescents with chronic conditions and healthy peers exposed to pandemic showed substantial changes in lifestyle, stressing the need for specific care to mitigate poor eating habits and excessive sedentary behavior for patients and healthy adolescents.

Patients with Multiple Illnesses

Approximately one-third of all individuals have multiple chronic conditions (MCCs) worldwide. Certain disorders tend to cluster together often, with correlations, such as depression and stroke, Alzheimer’s illness and infectious diseases such as HIV/AIDS and tuberculosis coupled and diabetes and cardiovascular diseases. The prevalence of MCC is highly variable according to the definition used and the number of conditions included in the study. In the United States, it was reported to be 23.1%. While other studies report MCC as high as 80% among elder population. The patient hardship encompasses a decline in standards of living, costly expenditures, adherence to multiple medications, incapacity to work, symptoms management, and a significant financial load on caregivers. This significant load from MCCs is expected to rise further. At the current time, the presence of more than one disease causes the patients to take multiple drugs, further prescribing may be indicated for the side effects of the used drugs. Furthermore, new conditions can be misdiagnosed and mistaken as side effects of the drugs the patients is taking. Strategies for treatments include establishing agreement on MCC taxonomy, putting more emphasis on MCC research, focusing on primary prevention to reduce morbidity, and shifting healthcare institutions and policies to a multiple-condition paradigm.

The Intersecting Consequences of Race-Gender Health Disparities on Workforce Engagement for Older Workers: An Examination of Physical and Mental Health

The dramatic growth of older adults’ labor participation over the past 25 years, including women and people of color, is reshaping the American labor force. The current study contributes new knowledge concerning why individuals over age 50 years may be working longer despite negative impacts of deteriorating physical and mental health associated with aging. Inquiries regarding who continues to work and why can be answered, in part, by addressing how workforce engagement and health are shaped by notable social inequities along the dimensions of age, race, and gender. Guided by cumulative advantage/disadvantage and intersectionality frameworks, we examine whether having multiple chronic conditions (MCC)—two or more physical conditions—and depression affect workforce participation. Using multinomial logistic regression models, we analyze the 2014–2016 waves of the Health and Retirement Study ( N = 4250). Findings reveal that having multiple chronic illnesses increase the likelihood of labor force exit, especially among workers who also have depression. We also discover intersectional nuances which illuminate complex race-gender dynamics related to health and work processes in later life. We conclude with recommendations for workplace policy that promote the retention of older workers with chronic illness and depression and aim to decrease disparities in older workers’ work engagement.

Virtual Geriatric Education Preferences of Rural Social Workers

Older adults in rural communities need access to comprehensive healthcare services provided by practitioners equipped with geriatric knowledge and skills. The Geriatric Rural Extension of Expertise through Telegeriatric Service (GREETS) project goal is to use telemedicine and telehealth to expand geriatric service options to underserved Michigan regions. GREETS educational programs train health practitioners to provide geriatric care for vulnerable older adults. To determine gaps in geriatric competencies, the team conducted an online survey of health professionals including behavioral health practitioners. Respondents identified educational topics and preferred virtual delivery methods. Demographic information included respondent’s professional position, practice setting, and county. The respondents were asked to indicate level of educational need using a scale ranging from a low, medium, or high need. Fifty (47%) of 106 total responses were from social workers. We compared the percent of social workers to other practitioners’ responses in our analysis. Four topics emerged for both groups as medium or high educational needs: 1) transitional care when changing residential settings or post-hospitalization; 2) assisting family caregivers cope with caregiving responsibilities; 3) incorporating community-based services into care plans; and 4) and managing frail older adults. Social workers noted higher need than the other respondents for: 1) managing chronic pain; 2) managing care of patients with multiple chronic conditions; 3) having serious illness conversations; 4) diagnosing dementia; and 5) discussing advance care planning. Both social worker and other respondents indicated interactive case-based webinars; published tools, toolkits, tip sheets; and didactic webinars as their top three learning formats.