This paper presents a review of literature about the topic of Integrating New Network Topologies with Appropriated Bandwidth Management as Professional Resources to Support the Quality of Research and Higher Education to Initiate the Covid-19 Effects in Mali. The consensus admitted by all is the indispensability of Internet data services in the sector of education and research especially in this period of a breakout due to the coronavirus pandemic. The current paper reviewed literature about the scope to support insights that will contribute to raising the quality of research and higher education through the integration of new network topologies and the appropriated Internet data as professional resources to initiate the Covid-19 effects in Mali. This research contributes to providing both teachers and students with access to the internet with a personal user account, to facilitate the adoption of blended learning through virtual learning platforms and other relevant materials to complement their degrees programs. Thanks to the integration of these technologies, Malian higher education staff will get facilities to multiply their cooperation with highly technology-integrated countries like Indonesia, Malesia, Australia, and Korea.

Rationale, aims and objectives: The purpose of this study is to describe the symptoms and clusters characteristics of COVID-19 patients in Taiwan. Method: The Central Epidemic Command Center (CECC) from Taiwan CDC daily press release publications were extracted for patient demographic information (age, gender, case type and cluster) and the symptoms exhibited by the patients before diagnosis were collected. Results: A total of 1030 COVID-19 cases were reported in Taiwan up until the end of March 2021, of which 1009 patients had symptoms available. Of available patient data, 633 patients (62.74%) were symptomatic and 376 patients (37.26%) were asymptomatic, as classified in our study based on the published list of potential symptoms of COVID-19 by WHO. The most prevalent symptoms of our patients were coughing (29.33%), fever (26.56%) and nasal symptoms (20.22%). Our regression analysis found when the first detected patient of the cluster had a subjective sensation of feeling feverish, the number of infected cases in the cluster increased by 4.59 cases. Similarly, patients who experienced a slightly elevated body temperature or fever were associated with an increase of 2.37 and 0.35 cases in each cluster, respectively. Furthermore, increasing one new COVID-19 test per thousand population reduces 7.22 cases per cluster. Conclusions: The majority of reported cases in Taiwan were symptomatic. Symptoms which had the greatest number of patients overall were cough, fever, and nasal symptoms. It is our hope to help physicians to better diagnose current Taiwan COVID-19 patients, while aiding the government in stopping the spread of new cases.

Objective To evaluate and characterize menstrual changes among COVID-19 vaccinated and infected women. Design A national survey. Setting An online nationwide questionnaire survey, querying about menstrual changes after COVID-19 vaccination or infection. Population Reproductive-age non-pregnant women. Methods The questionnaire was distributed via an online link through social media and directed the participants to an online anonymous Google questionnaire. Results In total, 10,319 women responded, of which 7,904 met the inclusion criteria. Changes in menstrual patterns following the BNT162b2 vaccine were reported by 3,689 (46.7%). Of these, 2,974 women, (80.6%) described excessive bleeding (heavy, prolonged, or intermenstrual) compared with 715 (19.4%) who reported scant bleeding (light, short, or prolonged intervals). Among women who experienced abnormal uterine bleeding (AUB), in most cases (61.1%) it occurred between the vaccination and the ensuing menstrual period. Menstrual disturbances were more common among accurately vaccinated women compared with inaccurately vaccinated by having received a single shot or having undergone a prolonged interval between shots (51% vs 36.6%, P < .001). Menstrual disturbances were similar in type and distribution among the vaccinated and infected women. Conclusions AUB emerged as a side effect of the BNT162b2 vaccine and a symptom of the COVID-19 infection. It was characterized mainly by excessive bleeding. Although the precise incidence could not be determined in this study, the type of bleeding disturbance, as well as the characterization of women at risk, were well defined. The incidence and the long-term consequences of the BNT162b2 vaccine on uterine bleeding warrant further investigation.

Objective: to investigate a possible bi-directional association between gestational diabetes (GDM) and the SARS-CoV-2 infection during pregnancy. Design: case-control study with prospective data collection for the case group and 1:2 matching with historical controls Setting: University Hospital of Bern, Switzerland Population: 224 pregnant women: 75 cases with SARS-CoV-2 infection during pregnancy, matched 1:2 with controls based on parity, BMI and ethnicity. Methods: SARS-CoV-2 infection was diagnosed by RT-PCR. Screening for GDM was performed by 75mg oral glucose tolerance test at 26 weeks’ gestation in all women. Main Outcomes: Prevalence of GDM was calculated in both groups. Multivariate binary logistic regression analysis was performed to assess risk factors for GDM and inpatient COVID-19 management. Results: 34.6% of the patients in the case group suffered from GDM, vs. 16.1% in the control group (p=0.002). 35.7% patients were diagnosed with GDM after the SARS-CoV-2 infection, vs. 33.3% diagnosed before infection (OR(95%CI) 1.11(0.40-3.08), p=0.84), with no correlation between the time-point of infection and GDM diagnosis. SARS-CoV-2 (OR(95%CI) 2.79 (1.42, 5.47), p=0.003) and BMI (OR(95%CI) 1.12 (1.05, 1.19), p=0.001) were significant independent risk factors for GDM. Conclusions: The significantly higher rate of GDM among women with SARS-CoV-2 infection during pregnancy, as compared to matching controls, suggests that GDM increases the risk of infection. On the other hand, SARS-CoV-2 during pregnancy might increase the risk of developing GDM. Vaccination and caution in using protective measures should be recommended to pregnant women, particularly those with co-morbidities. Funding: none Keywords: SARS-CoV-2, gestational diabetes, COVID-19

Background. COVID-19 is usually less severe and has lower case fatality in children than in adults. We aimed to characterize the clinical and radiological features of children and adolescents hospitalized with laboratory-confirmed SARS-CoV-2 infection and to evaluate the risk factors for COVID-19-related severity in the pediatric Mexican population. Methods. We did an analysis of all patients younger than 18 years who had quantitative RT-PCR-confirmed COVID-19, admitted to the National Pediatrics Institute, and described their clinical characteristics with the radiological findings at admission, related to the severity and clinical outcome. Results. A total of 129 patients had available data showing laboratory-confirmed SARS-CoV-2 infection and were included in the sample. Among these patients the most common signs were fever (82.2%), tachypnea (72.1%) and cough (71.3%). The most frequent radiological pattern that stood out was the interstitial pattern (66.7%). History of oncologic pathology (25.6%) was the most frequent past medical history. ESR was the only laboratory value significantly associated with severity (27.82  23.83 mm/hr). NSAIDs (93%), antibiotics (57.4%), and steroids (40.3%) were the most common medication given. The average hospitalization stay was 14.2 days, 21.7% of the total patients required transfer to the intensive care unit. At discharge, 20.2% required oxygen on an outpatient basis, and unfortunately 7.0% of the patients who were admitted to the institute for COVID-19 died. Conclusions. COVID-19 in children was associated with mild symptoms and good prognosis; ESR was the only laboratory value significantly associated with severity. Patients with hematologic/oncologic co-morbidities had severe presentations.

Background: COVID-19, which occurred at the end of December 2019, has evolved into a global public health threat. COVID-19’s high infectivity and mortality prompt governments and scientific community to respond quickly to the outbreak of the pandemic. The application of personal protective equipment (PPE) is of great significance in overcoming the epidemic situation. Although there were many studies about PPE and COVID-19, there is no study about bibliometric analysis of these studies. This study aims to provide a general overview of studies on PPE and COVID-19. Methods: On October 07, 2021, the Web of Science (WOS) Core Collection database was used to identify documents on PPE and COVID-19. HistCite and VOSviewer softwares were used for citation analysis and visualization mapping. Results: A total of 1462 documents authored by 6993 authors and published in 750 journals were included in the final analysis. The most prolific author was Macintyre CR. The USA was the most productive country with 463 published documents. The leading journal was Plos One. Network visualization map showed that USA was the largest international collaboration network. The keyword “COVID-19” had the strongest total link strengths (TLS) and largest number of occurrences. The New England Journal of Medicine was the leading source with highest TLS. The University of Toronto had the highest number of links and the highest TLS. Conclusions: The bibliometric analysis of PPE and COVID-19 provides an overall perspective, and the appreciation and study of these influential publications are very useful for future research.

Objectives: This study aimed to assess the impact of COVID-19 on the prevalence of respiratory pathogens among hospitalized children with lower respiratory tract infections (LTRIs) in Shanghai. Methods: Respiratory specimens were collected from children with LTRIs in Children’s Hospital of Fudan University from February 2019 to January 2021 and common respiratory pathogens were detected using multiplex PCR. The data of 13 respiratory pathogens were analyzed and compared between the year of 2020 (from February 2020 to January 2021) and 2019 (from February 2019 to January 2020). Results: A total of 1049 patients were enrolled, including 417 patients in 2019 and 632 patients in 2020. In 2020, 27.53% of patients were tested positive for at least one pathogens, which was significantly lower than that in 2019 (78.66%). The top three pathogens were Mp, ADV and RV in 2019, whereas RV, RSV and PIV were the predominant ones in 2020. The positive rates of Mp, ADV, RV, PIV, InfB, H3N2 and H1N1 were significantly decreased in 2020. RV was the most detectable respiratory pathogen in 2020, and become the most frequent pathogen in all five age groups. PIV had a high prevalence from October to December 2020 which was even higher than that in 2019. InfA was not detected in 2020. Co-infection was significantly less frequent in 2020. Conclusions: The public health interventions aiming to eliminate COVID-19 have great impact on the prevalence of common respiratory pathogens. The prevalence of RV and PIV reminds us a possible resurgence of some pathogens.

Abstract Rationale, aims and objectives During the COVID-19 pandemic, in order to keep schools open and reduce SARS-CoV spreading, it is necessary to identify and isolate early SARS-CoV-2 positive paediatric patients (PP). The aim of this study was to describe the appropriateness of school hot spot (HS) setting for SARS-CoV 2 testing based on open access of PP. Method A cross-sectional study was performed between September 2020 and March 2021 among a sample of 13,283 PP in four different hospital settings. We collected: date of swab execution, type of swab, execution setting of the swab, result of the swab, information about community spread of the virus in the 14 days prior to the swab execution, sex and age. Results In Our sample, females were 45.8%. The swabs executed in all the hospital settings had a lower likelihood of resulting positive compared with the school HS setting. New-borns below 3 months and patients aged between 11 and 13 years old reported a higher probability of a swab tested positive compared to adolescents. Instead, children aged between 3 months and 2 years and aged between 3 years and 5 years were less likely to result positive. Conclusion We found a high prevalence of PP positive to the test for the detection of SARS-CoV-2 at the school hot spot compared with other settings. The open access modality to the nasopharyngeal swab was effective in identifying PP with COVID-19. Public health authorities should implement these testing modality in order to reduce SARS-CoV-2 infections in school settings.

KEY POINTS: 1. COVID19 has mandated many changes to secondary care since declaration of the pandemic in 2019. Reducing the exposure of the hospital setting to patients to a minimum is therefore not only in the best interests of individual patients but also the public. 2. A steady increase in the percentage of same-day discharges of hemithyroidectomy cases has been observed over the past 3 years, with very few post-operative complications. 3. The inferences made from this communication propose that hemithyroidectomy operations can be carried out safely as day case procedures under otolaryngology departments in a district general setting. 4. Patients no longer require a drain inserted at the end of a hemithyroidectomy procedure provided adequate haemostasis has been achieved. 5. Hemithyroidectomy procedures should be prioritised as earlier on the operating list to ensure adequate time for observation in recovery and ample time for the discharge process to be completed to achieve same-day discharge.

This study presents a 57-year-old male patient with COVID-19 who had had no lung disease before COVID-19 pneumonia. However, after COVID-19 pneumonia with sequels and treatments that include corticosteroids and IL-6 receptor antagonists, an invasive pulmonary aspergillus (IPA) cavity occurred immediately.

Background: Placebos being prescribed with full honesty and disclosure (i.e., open-label placebo = OLP) have been shown to reduce symptom burden in a variety of conditions. With regard to allergic rhinits, previous research provided inconclusive evidence for the effects of OLP, possibly related to a separate focus on either symptom severity or symptom frequency. Overcoming this limitation of previous research, the present study aimed to examine the effects of OLP on both the severity and frequency of allergic symptoms. Methods: In a randomized-controlled trial, patients with allergic rhinits ( N=74) were randomized to OLP or treatment as usual (TAU). Due to the COVID-19 pandemic, OLP was administered remotely in a virtual clinical encounter. Participants took placebo tablets for 14 days. The primary outcomes were the severity and frequency of allergic symptoms. The secondary endpoint was allergy-related impairment. Results: OLP did not significantly improve symptom severity over TAU, F(1, 71) = 3.280, p = .074, ɳ² p = .044, but did reduce symptom frequency, F(1, 71) = 7.272, p = .009, ɳ² p = .093, and allergy-related impairment more than TAU, F(1, 71) = 6.445, p = .013, ɳ² p = .083, reflecting medium to large effects. The use of other anti-allergic medication did not influence the results. Conclusions: While OLP was able to lower the frequency of allergic symptoms and allergy-related impairment substantially, its effects on symptom severity were weaker. The remote provision of OLP suggests that physical contact between patients and providers might not be necessary for OLP to work.

General methods to quantize reference frame transformations, to a “superposition of coordinate transformations” have been previously introduced on an array of recent observations developed through gravitational amplification of primeval density fluctuations generated in the exceedingly early phase of cosmic evolution. In this paper, we strongly combine machine learning characteristics to Quantum Kerr- (A) dS-Myers–Perry black microBlackHole-Inspired Gravitational for both Euclidean and Lorentzian signatures in Practice. I provide algorithms by means of mean percentile free energy ranking, in a new recall-based evaluation metric for the generation of an anti-COVID-19 small molecule combination of RoccuffirnaTM, RoccuttirnaTM, and EplerotiffirnaTM anti- (nCoV-19) ligands. In this paper, I show that the notion of entanglement and superposition are observer-dependent features in quantum circuit reference frames including Galilean trans formation, and near-horizon symmetries ranging from supergravity theories to Lorentzian cryptographic signatures to enhance the RoccuffirnaTM’s gravity to trap the SARS-COV-2 viruses in practice.

Background: COVID-19 vaccines are safe and effective at preventing severe disease. Among the rare complications that may compromise vaccine acceptance are allergic reactions. This study aimed at comparing the incidence and potential triggers of the most commonly reported allergic reactions related to licensed COVID-19 vaccines in Europe and the United States (US) based on data of the two of the world’s largest vaccine adverse event reporting systems, EudraVigilance and VAERS. Methods: Data pertaining to allergic reactions post COVID-19 vaccination reported from week 52/2020 to week 39/2021 were collected from EudraVigilance and VAERS databases and analyzed. Incidence rates were calculated using the corresponding administered vaccine doses as denominators for all licensed vaccines and both platform types (mRNA or vectored). The composition of the novel mRNA and vectored vaccines was examined to identify potential allergic triggers. Results: Anaphylactic reactions and anaphylactic shock were the most common allergic reactions, predominantly reported by females, at estimated incidence rates of 9.91/million and 1.36/million vaccine doses, respectively. A 2- to 5-fold higher incidence of both allergic reactions was found in Europe compared to the US for both vaccine platforms. Most cases were benign. Fatalities were extremely rare and associated with vectored rather than mRNA vaccines. Conclusions: The precise mechanism(s) for allergic reactions after vaccination with COVID-19 vaccines are not fully known. Plausible explanations include exposure to components of the final pharmaceutical product and cross-reactivity to ingredients or unintentional impurities in the final formula. Additional research is warranted to further improve vaccine safety.

Objectives. Compared with the general population, childhood cancer survivors (CCS) could be at greater risk of psychological distress following the emergence of the COVID-19 pandemic. This cross-sectional study assessed the psychological consequences of COVID-19 on the mental health of CCS. Methods. In December 2020, we interviewed through an online self-report questionnaire 580 5-year CCS participating in the French Childhood Cancer Survivor Study (FCCSS) cohort. We first compared the mental health score of CCS with that observed in the French general population of the same age and gender. Subsequently, combining clinical and patient-reported outcomes, we studied predictors of the mental health score of CCS. Results. External comparisons revealed that the mental health score of CCS was similar to that observed in the general population. Among CCS, almost 42% stated that their psychological state had been worse during the lockdown. Predictors of poorer mental health included, among others, female gender, reporting a change of his/her occupational situation, having a relative who had been hospitalized or had died following COVID-19, and a greater perceived infection risk. Conclusion. Given the pre-existing vulnerability of some CCS to mental distress, the additional psychological consequences of COVID-19 in vulnerable survivors should receive attention from health care providers.

We perform all-atom molecular dynamics simulations to study the effects of the N-linked glycans on the stability of the spike glycoprotein in SARS-CoV-2. After a 100 ns of simulation on the spike proteins without and with the N-linked glycans, we found that the presence of glycans increases the local stability in their vicinity; even though their effect on the full structure is negligible.

We reported the 5 th published case of COVID-19 vaccine inducing SS and the first case to be induced by an inactivated SARS-CoV-2 vaccine « CoronaVac ». The short latency time strongly supports the pathogenic role of the vaccine as a cause of SS in our case.

Background: SARS-Cov2 already has over than 215 million people and more than 4.5 million fatalities. The beginning of the pandemic condition has led the health authorities in several countries to adopt no-pharmacological preventive measures, such as schools closures. The return took place at a time when the country had the highest rates of infection and mortality. In particular because of the circulation of the gamma variant (P.1) and the vaccination program were beginning in the country. Therefore, we aimed to investigate the prevalence of SARS-CoV2 in daycares after the return of educational activities. Methods The study involved seven childcare facilities. Swab samples from the nasopharynx and region were collected from each participant. This study was carried out between March 16 and September 3, 2021. Viral RNA was extracted using Invitrogen’s RNA purification kit. Viral diagnosis was obtained using RT-PCR, through the TaqMan system. Viral detection was performed with Seegene panel, Allplex TM 2019-nCoV Assay kit. Results and Conclusion: The study population included 201 participants among daycare workers and children. Only one sample (0,5%) was tested positive for the presence of SARS-CoV-2, which was an asymptomatic childcare worker, and no secondary cases were detected. Considering that the return to day care activities occurred in a period with high number of cases of deaths and lack of vaccines throughout the country, it is believed that the several preventive measures used by the day care center could be an indication of effectiveness in preventing transmission of SARS-CoV2.

Impact of COVID-19 Lockdown on Stress and Antireflux Diet Adherence of Patients with Laryngopharyngeal Reflux: Our Experience on 32 patients.

Arrhythmia is an irregular hertbeat which leads to severe heart complications and it is the most common action of Cardio Vascular Diseases. India represents 31% of global deaths and need for accurate diagnosis and monitoring of Arrhythmia has not been addressed. In view, we developed a novel device Vigo Holter (VSH) that is connected to cloud and IoT based platform designed as an easy wearable for the patient. It records continuous ECG and HR to predict the changes in the heart. Compared a Vigo Holter against the traditional holter monitoring in 51 volunteers for 24 hrs with asymptomatic and symptomatic subjects. We evaluated patient compliance, analyzable signal time interval to arrhythmia detection, and diagnostic yield. In total 51 participants we found 46 reports with equivalent result where as the conditions (Second Degree Mobitz Type I block, First Degree AV block, IVCD and SVT episodes) identified by VSH . Importantly, ECG wave quality in reports with differences is same in both recordings and the total diagnostic yield was 39%. Total Noise in Traditional Holter was 1301 minutes whereas in Vigo Holter was 990 minutes. Total Analyzable time in Vigo Holter was 99.3% whereas in Traditional Holter was 90.22%. VSH reports clearly explained that no lead detachments and noise resultant from the wire entanglements leading to low noise and highly analyzable time. We demonstrated that VSH is very much needed and useful for people and doctors to detect arrythmia with highest accuracy and to avoid physical interaction with the patient during COVID-19

Background: The emergence of the coronavirus disease in late 2019 (COVID-19) has become one of the greatest health problems of the 21st century. Many aspects of this viral disease are still hidden. The current study is conducted to investigate COVID-19’s clinical manifestation, mortality factors, and their association with each other in the COVID-19 pandemic in Razavi-Khorasan province, Iran. Methods & Materials: This retrospective epidemiological population-based study was conducted from January 21, 2020, to March 20, 2021. The data including demographic characteristics and clinical presentations of the patients were extracted from the Medical Care Monitoring System (MCMC), disease management portal in the deputy of health and Hospital Information System (HIS). Results: A total of 80499 patients were admitted to all hospitals of Khorasan-Razavi University of Medical Sciences with laboratory/clinical COVID-19 confirmed disease, between January 2020 and March 2021. The male-to-female ratio was 1.10:1 and the mean age of our COVID-19 individuals was 55.67 ± 23.27. The most frequently reported presenting symptoms at admission were respiratory distress (58.2%), fever (36.7%), and cough (34.9%), and alternation in smell/taste (0.9%) was the less frequent. Being male, aging older than 60 years and having comorbidities were significantly associated with higher mortality rates. Conclusion: Due to the genetic mutations in the virus and the emergence of the new variants of the virus, clinical presentations, and mortality rates of the COVID-19 have been shifted through three reviewed waves. Further studies are needed to determine the impact of the new variants of the virus on individuals.

Abstract Background: Lung ultrasound (LUS) has become an important tool in diagnosing and following an adult patient with COVID-19; however, the literature for the pediatric age group is limited. Herein, we reviewed the up-to-date literatures on ultrasound use for COVID-19 pediatric patients for better management of COVID-19 in children. Methods and Objectives: The search terms “COVID-19,” “SARS-CoV2,” “coronavirus,” “2019-nCoV,” “lung ultrasound,” “sonography,” “adolescents” “children,” “childhood” and “newborn” were searched on the online databases PubMed, Embase and Medline. Articles meeting the inclusion criteria were included in the analysis and review. Results: We identified only fifteen studies to date using LUS to diagnose SARS-CoV-2 infection in children. These studies involved a total of 334 newborns, children and adolescents. Regarding the use of chest X-ray (CXR) and LUS in pediatric patients with COVID-19, we identified six studies with a total of 162 participants, with the following results: 33patients(14.11%) with lung abnormalities on lung US had a normal CXR; however, no patients with normal lung US had abnormalities on the CXR. In addition, regarding the use of computed tomography (CT) and LUS in pediatric patients with COVID-19 infection, we identified five studies with a total of 50 participants and 3 patients(6%) with lung abnormalities on chest LUS had a normal CT. Conclusion: Our findings suggest that LUS is a useful tool in the diagnosis of children and reduction in chest CT assessments may be possible when LUS is used in early diagnosis and follow-up monitoring of COVID-19 pneumonia in the children.

Children with SARS-CoV-2 infection have been consistently described with milder clinical outcomes compared to adults. However, data pertaining to the clinical evolution of SARS-CoV-2 infection in children with cancer remain scarce. In this descriptive cohort study, we report the clinical characteristics and outcomes of 31 pediatric oncology patients with SARS-CoV-2 infection in the province of Quebec, Canada. Most patients were asymptomatic or had mild symptoms, with only 2 COVID-19-related hospitalizations and no COVID-19-related deaths. The favorable outcomes in our cohort may be explained by Quebec's universal access to health care and regionalization of pediatric oncology care in tertiary centers exclusively.

Objective: To explore maternal humoral immune responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the rate of vertical transmission. Design: A prospective cohort study. Setting: Two university-affiliated medical centers in Israel. Population: Women positive for SARS-CoV-2 reverse-transcription-polymerase-chain-reaction (RT-PCR) test, during pregnancy were enrolled just prior to delivery. Methods: Levels of anti-SARS-CoV-2 spike-IgM, spike-IgG and nucleocapsid-IgG were tested in maternal and cord blood at delivery, and neonatal nasopharyngeal swabs were subjected to PCR testing. Main outcomes measures: The primary endpoint was the rate of vertical transmission, defined as either positive neonatal IgM, positive neonatal IgG with sero-negative mother or positive neonatal PCR. Results: Among 72 women, 36 (50%), 39 (54%) and 30 (42%) were positive for anti-spike-IgM, anti-spike-IgG and anti-nucleocapsid-IgG, respectively (p<0.0001 for IgG antibodies-comparison). At least 8/72 (11%) neonates were infected in utero; one had a positive PCR result and seven had positive IgG antibodies while their mothers were seronegative for the same IgG. IgM was not detected in cord blood. Anti-nucleocapsid-IgG and anti-spike-IgG were detected in 83% and 85% of neonates of seropositive mothers, respectively (Pearson coefficient correlation 0.8, p<0.001). The highest rate of positive maternal serology tests was 8-12 weeks post-infection (89% anti-spike IgG, 78% anti-spike-IgM and 67% anti-nucleocapsid-IgG). Thereafter, the rate of positive serology tests declined gradually; at 20 weeks post-infection, only anti-spike-IgG was detected in 33-50%. Conclusions: The rate of vertical transmission was at least 11%. Vaccination should be considered 3 months post-infection in pregnant women due to a decline in antibody levels.

Introduction: Hydroxychloroquine, with or without Azithromycin, was used as a treatment strategy for COVID-19 in March and April 2020. The use of Hydroxychloroquine (HCQ), with or without Azithromycin, may increase the risk of QT prolongation. This study was performed to assess the incidence and degree of QT prolongation in hospitalised COVID-19 patients treated with HCQ, and the association with morbidity and mortality. Methods and Results: Single centre retrospective observational study. Baseline corrected QT interval (QTc), peak QTc and change in QTc (∆QTc) were calculated for all patients. Known or suspected risk factors for QT prolongation were assessed. All patients were followed up for QT prolongation, length of stay, incidence of ICU admission and 30 day all-cause mortality. Sixty-two patients were included (mean age 67 years; 33.9% female). QT prolongation occurred in 62.9% of patients given HCQ, with ∆QTc ≥60msec or acquired QTc ≥500msec in 14.5% of patients. The mean ∆QTc was 28.4msec. QT prolongation was associated with increased mortality (OR 11.0; 95% CI 1.3 – 90.9; P=0.03). Conclusions: There was a high incidence of QT prolongation in patients who received HCQ as part of a COVID-19 treatment regimen. We observed an increased risk of death in patients with QT prolongation, as well as an increased incidence of ICU admission and longer length of stay in hospital. We recommend particular attention be paid to the risk of QT prolongation with novel treatment strategies for COVID-19. Further research is warranted on the effect of QT prolongation on clinical outcomes in COVID-19.