Interventions on Socioeconomic and Racial Inequities in Respiratory Pandemics: a Rapid Systematic Review.

Purpose of Review: Racial and socioeconomic inequities in respiratory pandemics have been consistently documented, but little official guidance exists on effective action to prevent these. We systematically reviewed quantitative evaluations of (real or simulated) interventions targeting racial and socioeconomic inequities in respiratory pandemic outcomes. Recent Findings: Our systematic search returned 10,208 records, of which 5 met inclusion criteria, including observational (n = 1), randomized trial (n = 1), and simulation (n = 3) studies. Interventions studied included vaccination parity, antiviral distribution, school closure, disinfection, personal protective equipment, and paid sick leave, with a focus on Black (n = 3) and/or Latinx (n = 4) or low-SES (n = 2) communities. Results are suggestive that these interventions might be effective at reducing racial and/or SES disparities in pandemics. Summary: There is a dearth of research on strategies to reduce pandemic disparities. We provide theory-driven, concrete suggestions for incorporating equity into intervention research for pandemic preparedness, including a focus on social and economic policies.

Moderating role of healthcare disruptions on friend and family pandemic-related negative life events predicting latines' anxiety and alcohol use over time

The Latine community has experienced a disproportionate amount of pandemic-related negative life events during the COVID-19 pandemic. The current study, therefore, adopted a contextual and environmental lens to understand the moderating role of healthcare disruptions on friend and family pandemic-related negative life events (e.g., PRNLE) predicting anxiety and alcohol use over time. The current study was part of a more extensive longitudinal study on students' genetic and environmental experiences. Findings indicated that among Latines who experienced more significant healthcare disruptions, increased family PRNLE predicted greater alcohol use but not anxiety over time. Additionally, friend PRNLE did not significantly predict alcohol or anxiety with high or low healthcare disruptions present. Our findings suggest that Latines may rely on the family to navigate their concerns and mitigate the PRNLE when experiencing healthcare disruptions. Therefore, clinical and policy implications are discussed to reduce alcohol-related inequalities during the ongoing global pandemic. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

The causal effect of education and cognitive performance on risk for suicide attempt: A combined instrumental variable and co-relative approach in a Swedish national cohort.

BACKGROUND: The aim of this study was to clarify the possible causal associations between education phenotypes and non-fatal suicide attempts. In particular, we evaluated the roles of academic achievement (school grades), cognitive performance (IQ), and educational attainment (education level). METHODS: Based on longitudinal Swedish registry data, we included 2,335,763 individuals (48.7% female) with available school grades, 1,448,438 men with IQ measures, and 4,352,989 individuals (48.4% female) with available data on education level. We combined two different approaches to aid in causal inference: 1) instrumental variables analysis, using month of birth as an instrument related to education but not suicide attempt, to control for measured and unmeasured confounders, and 2) co-relative analysis, comparing pairs of different genetic relatedness (cousins, half, and full siblings) to control for genetic and environmental influences. RESULTS: High education was associated with reduced risk of suicide attempt. Instrumental variable analysis indicated evidence of a likely causal association between higher school grades and lower risk of suicide attempts (HR = 0.71). Co-relative analyses supported the causality between the three predictors and suicide attempt risk (school grades, HR = 0.80, IQ, HR = 0.83, education level, HR = 0.76). Finally, we examined the specificity of education phenotypes and found that both cognitive (IQ) and non-cognitive (school grades, education level) processes were involved in suicide attempt risk. LIMITATIONS: IQ was only available in men, limiting the generalizability of this analysis in women. CONCLUSIONS: Efforts to support causal associations in psychiatric research are needed to offer better intervention. Programs improving education during adolescence would decrease suicide attempt risk.

Patient Satisfaction in Neurodevelopmental Pediatrics: In-Person vs Telemedicine.

BACKGROUND: As a result of the COVID-19 pandemic, medical practices for children with neurodevelopmental disorders urgently adopted telehealth, despite limited data regarding patient satisfaction. OBJECTIVE: To compare patient satisfaction survey scores for neurodevelopmental pediatric appointments completed in-person to appointments completed via telemedicine. METHODS: Using routinely collected Press Ganey survey results, the proportion of Top Box scores (the percentage of responses in the highest possible category [ie, the percentage of "very good" or "always" responses]) for an in-person only group was compared to the proportion in a telemedicine-only group using Fisher's exact test. RESULTS: Most respondents gave Top-Box scores in response to all of the questions for both in-person and telemedicine visits. There were no statistically significant differences in any domain of the Press Ganey surveys in Top Box percentages for in-person vs telemedicine visits. CONCLUSION: This study provides preliminary evidence that telehealth may be an acceptable modality for families seeking care for their children with neurodevelopmental concerns.

The effects of COVID‐19 on self‐management behaviours and service experiences in type 2 diabetes mellitus

This study explored the impact of COVID‐19 on adults with type 2 diabetes mellitus (T2DM) self‐management behaviours and service experiences within an ethnically diverse UK sample.A cross‐sectional survey design was employed. An 18‐item survey was administered to suitable patients attending the Lambeth Diabetes Intermediate Care Team (South East London, UK) via text message (n=993) or post (n=62).A total of 150 participants completed the survey, which revealed that 30% had changed their diabetes medication taking behaviour since the start of the COVID‐19 pandemic for a number of reasons. Negative changes in physical activity levels and dietary behaviours were also reported. Of those who received a telephone consultation, high satisfaction levels were reported but a clear preference for face‐to‐face consultations was still present.Our findings suggest that the COVID‐19 pandemic is having a negative impact on individuals with T2DM physical activity levels and dietary behaviours. Additionally, the findings indicate that although telephone consultations were highly accepted, many would prefer to receive a face‐to‐face consultation in future. Copyright © 2021 John Wiley & Sons.

The Post-Acute Phase of SARS-CoV-2 Infection in Two Macaque Species Is Associated with Signs of Ongoing Virus Replication and Pathology in Pulmonary and Extrapulmonary Tissues.

The post-acute phase of SARS-CoV-2 infection was investigated in rhesus (Macaca mulatta) and cynomolgus macaques (Macaca fascicularis). During the acute phase of infection, SARS-CoV-2 was shed via the nose and throat, and viral RNA was occasionally detected in feces. This phase coincided with a transient change in systemic immune activation. Even after the alleged resolution of the infection, computed tomography (CT) and positron emission tomography (PET)-CT revealed pulmonary lesions and activated tracheobronchial lymph nodes in all animals. Post-mortem histological examination of the lung tissue revealed mostly marginal or resolving minimal lesions that were indicative of SARS-CoV-2 infection. Evidence for SARS-CoV-2-induced histopathology was also found in extrapulmonary tissue samples, such as conjunctiva, cervical, and mesenteric lymph nodes. However, 5-6 weeks after SARS-CoV-2 exposure, upon necropsy, viral RNA was still detectable in a wide range of tissue samples in 50% of the macaques and included amongst others the heart, the respiratory tract and surrounding lymph nodes, salivary gland, and conjunctiva. Subgenomic messenger RNA was detected in the lungs and tracheobronchial lymph nodes, indicative of ongoing virus replication during the post-acute phase. These results could be relevant for understanding the long-term consequences of COVID-19 in humans.

Emergent transformation of cancer center tissue biobank to a COVID-19 biospecimen processing facility: Creation of shared institutional resource

Introduction: Establishment of a COVID19 Biospecimen Processing Facility (BPF) was undertaken, leveraging an existing Northwell Health Biospecimen Repository (NHBR). The purpose was to support COVID19 clinical trials and create a resource of biospecimens with clinical metadata. This institutional resource is envisioned to have impact on scientific inquiry, including innovation in clinical care and investigation of disease mechanisms. We present our experience, challenges, and scientific opportunities. Materials/Methods: NHBR pivoted from a cancer focus to COVID19, by establishing a dedicated BPF, redeploying existing personnel, recruiting additional volunteer health care workers, and building the IT infrastructure to support clinical trials and establish a COVID19 repository. Results: COVID19 biospecimens were obtained from three tertiary care facilities within Northwell Health;with inpatient COVID19 admission peak of 550, 711 & 304. NHBR staff of 6 Research Coordinators and 4 Pathologists' Assistants was supplemented by 22 volunteers. The Regeneron-Sanofi clinical trial to evaluate the efficacy of IL-6 inhibition with Sarilumab laid the framework for biospecimen processing. Additional COVID19 clinical trials continue to be supported by the BPF/NHBR. For biospecimen accrual, system data warehouse records were mined to identify biospecimens from COVID19 inpatients. A committee consisting of clinicians and clinical researchers provided guidance in developing the COVID19 BPF. The NHBRs preexisting global IRB-approved collection protocol obviated the need for an additional COVID19 biospecimen IRB protocol, which allowed for rapid activation of sample procurement. Accrual of 40,400 aliquots (serum, plasma, and whole blood) from 3,815 unique patients, including 366 COVID19 decedents. Viral Transport Medium (VTM) remnant specimens from more than 40,000 positive patients were retained. Conclusions: A database of remnant/discarded VTMs was established secondary to the patient care. Having a robust institutional research infrastructure is critical for preparedness and rapid response to the large-scale public health threat. Our call to action, rapid deployment and repurposing of existing assets enabled our health system to establish valuable resource that may enable us to further advance COVID19 related research. Limitations in our effort were: suspension of COVID19 biospecimen operations due to a shortage of human capital and a 4- month delay in procuring funding.

Challenges in Feeding Children Posed by the COVID-19 Pandemic: a Systematic Review of Changes in Dietary Intake Combined with a Dietitian's Perspective.

PURPOSE OF REVIEW: To examine the evidence that the dietary quality of children changed between the period preceding the COVID-19 pandemic and the first year during the pandemic. RECENT FINDINGS: A systematic review of the evidence for dietary changes occurring as a result of the pandemic-related restrictions, in Part I of this article, yielded 38 original research articles. These articles had conflicting results, some describing improvements in overall quality and some describing deteriorations. As a whole the studies were characterized by a low study quality, and children were poorly represented. Taken together, these studies do not provide enough evidence to draw conclusions about whether dietary habits changed or not as a result of the pandemic. However, in a wider, narrative review of the psychosocial changes occurring as a result of the COVID-19 pandemic, and the known associations of these factors with a dietary intake in Part II, we conclude that there is a reason to expect that the dietary quality of children might have been adversely affected by the COVID-19 pandemic. One the one hand, the literature fails to provide conclusive evidence on changes in the dietary quality of children resulting from the COVID-19 pandemic. On the other hand, the broader literature supports the hypothesis that children's dietary quality will have declined during the pandemic. Taken together, we urgently need more high-quality research on children's changes in dietary intake occurring over the pandemic. This will provide important information on whether any potential long-term consequences of such changes, if they exist, need to be examined and ameliorated.

Comparison of SARS-CoV-2 infection in two non-human primate species: rhesus and cynomolgus macaques (preprint)

SARS-CoV-2 is a coronavirus that sparked the current COVID-19 pandemic. To stop the shattering effect of COVID-19, effective and safe vaccines, and antiviral therapies are urgently needed. To facilitate the preclinical evaluation of intervention approaches, relevant animal models need to be developed and validated. Rhesus macaques (Macaca mulatta) and cynomolgus macaques (Macaca fascicularis) are widely used in biomedical research and serve as models for SARS-CoV-2 infection. However, differences in study design make it difficult to compare and understand potential species-related differences. Here, we directly compared the course of SARS-CoV-2 infection in the two genetically closely-related macaque species. After inoculation with a low passage SARS-CoV-2 isolate, clinical, virological, and immunological characteristics were monitored. Both species showed slightly elevated body temperatures in the first days after exposure while a decrease in physical activity was only observed in the rhesus macaques and not in cynomolgus macaques. The virus was quantified in tracheal, nasal, and anal swabs, and in blood samples by qRT-PCR, and showed high similarity between the two species. Immunoglobulins were detected by various enzyme-linked immunosorbent assays (ELISAs) and showed seroconversion in all animals by day 10 post-infection. The cytokine responses were highly comparable between species and computed tomography (CT) imaging revealed pulmonary lesions in all animals. Consequently, we concluded that both rhesus and cynomolgus macaques represent valid models for evaluation of COVID-19 vaccine and antiviral candidates in a preclinical setting.

Seasonal coronavirus protective immunity is short-lasting.

A key unsolved question in the current coronavirus disease 2019 (COVID-19) pandemic is the duration of acquired immunity. Insights from infections with the four seasonal human coronaviruses might reveal common characteristics applicable to all human coronaviruses. We monitored healthy individuals for more than 35 years and determined that reinfection with the same seasonal coronavirus occurred frequently at 12 months after infection.

Two serological approaches for detection of antibodies to SARS-CoV-2 in different scenarios: a screening tool and a point-of-care test.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has infected more than 8 million people worldwide, becoming a pandemic. Detecting antibodies against SARS-CoV-2 is of utmost importance and a good indicator of exposure and circulation of the virus within the general population. Two serological tools based on a double recognition assay [enzyme-linked immunosorbent assay (DR-ELISA) and lateral flow assay (DR-LFA)] to detect total antibodies to SARS-CoV-2 have been developed based on the recombinant nucleocapsid protein. A total of 1065 serum samples, including positive for COVID-19 and negative samples from healthy donors or infected with other respiratory pathogens, were analyzed. The results showed values of sensitivity between 91.2% and 100%, and specificity of 100% and 98.2% for DR-LFA and DR-ELISA, respectively. No cross-reactivity against seasonal coronavirus (HCoV-NL63, HCoV-229E, HCoV-HKU1, HCoV-OC43) was found. These results demonstrate the importance of serology as a complementary tool to polymerase chain reaction for follow-up of recovered patients and identification of asymptomatic individuals.