Mental Health, Social Connectedness, and Fear During the COVID-19 Pandemic: A Qualitative Perspective from Older Women with HIV.

Older women with HIV (WWH) confront significant biopsychosocial challenges that may be exacerbated by the COVID-19 pandemic. Between May 2020 and April 2021, following a resiliency intervention conducted as part of a randomized parent trial, 24 cisgender WWH (M = 58 years old) completed quantitative assessments and qualitative interviews exploring the impact of COVID-19 on mental health. Qualitative data were analyzed via rapid analysis. Most participants were Black (62.5%) and non-Hispanic or Latina (87.5%). Emergent themes included (1) increased anxiety and depression; (2) a loss of social connectedness; (3) fear of unknown interactions among COVID-19, HIV, and other comorbidities; and (4) the use of largely adaptive strategies to cope with these issues. Findings suggest that older WWH face significant COVID-19-related mental health challenges, compounding existing stressors. As the pandemic persists, it will be important to assess the impact of these stressors on wellbeing, identify effective coping strategies, and provide increased support to mitigate COVID-19-related mental health issues over time. Trial Registration: ClinicalTrials.gov identifier: NCT03071887.

Type I IFN stimulates lymph node stromal cells from adult and old mice during a West Nile virus infection.

Advanced age is a significant risk factor during viral infection due to an age-associated decline in the immune response. Older individuals are especially susceptible to severe neuroinvasive disease after West Nile virus (WNV) infection. Previous studies have characterized age-associated defects in hematopoietic immune cells during WNV infection that culminate in diminished antiviral immunity. Situated amongst immune cells in the draining lymph node (DLN) are structural networks of nonhematopoietic lymph node stromal cells (LNSCs). LNSCs are comprised of numerous, diverse subsets, with critical roles in the coordination of robust immune responses. The contributions of LNSCs to WNV immunity and immune senescence are unclear. Here, we examine LNSC responses to WNV within adult and old DLNs. Acute WNV infection triggered cellular infiltration and LNSC expansion in adults. Comparatively, aged DLNs exhibited diminished leukocyte accumulation, delayed LNSC expansion, and altered fibroblast and endothelial cell subset composition, signified by fewer LECs. We established an ex vivo culture system to probe LNSC function. Adult and old LNSCs both recognized an ongoing viral infection primarily through type I IFN signaling. Gene expression signatures were similar between adult and old LNSCs. Aged LNSCs were found to constitutively upregulate immediate early response genes. Collectively, these data suggest LNSCs uniquely respond to WNV infection. We are the first to report age-associated differences in LNSCs on the population and gene expression level during WNV infection. These changes may compromise antiviral immunity, leading to increased WNV disease in older individuals.

Evaluating dry vs. wet disinfection in boot baths on detection of porcine epidemic diarrhea virus and porcine reproductive and respiratory virus RNA.

Maintaining biosecurity between swine barns is challenging, and boot baths are an easily implementable option some utilize to limit pathogen spread. However, there are concerns regarding their efficacy, especially when comparing wet or dry disinfectants. The objective of this study was to evaluate the efficacy of boot baths in reducing the quantity of detectable porcine epidemic diarrhea virus (PEDV) and porcine reproductive and respiratory syndrome virus (PRRSV) genetic material using wet or dry disinfectants. Treatments included 1) control, 2) dry chlorine powder (Traffic C.O.P., PSP, LLC, Rainsville, AL), and 3) wet quaternary ammonium/glutaraldehyde liquid (1:256 Synergize, Neogen, Lexington, KY). Prior to disinfection, rubber boots were inoculated with 1 mL of a co-inoculants of PRRSV (1 × 105 TCID50 per mL) and PEDV (1 × 105 TCID50 per mL) and dried for 15 min. After the drying period, a researcher placed the boot on the right foot and stepped directly on a stainless steel coupon (control). Alternatively, the researcher stepped first into a boot bath containing either the wet or dry sanitizer, stood for 3 s, and then stepped onto a steel coupon. After one minute, an environmental swab was then collected and processed from each boot and steel coupon. The procedure was replicated 12 times per disinfectant treatment. Samples were analyzed using a duplex qPCR at the Kansas State Veterinary Diagnostic Laboratory. Cycle threshold values were analyzed using SAS GLIMMIX v 9.4 (SAS, Inc., Cary, NC). There was no evidence of a disinfectant × surface × virus interaction (P > 0.10). An interaction between disinfectant × surface impacted (P < 0.05) the quantity of detectable viral RNA. As expected, the quantity of the viruses on the coupon was greatest in the control, indicating that a contaminated boot has the ability to transfer viruses from a contaminated surface to a clean surface. Comparatively, the dry disinfectant treatment resulted in no detectable viral RNA on either the boot or subsequent coupon. The wet disinfectant treatment had statistically similar (P > 0.05) viral contamination to the control on the boot, but less viral contamination compared to the control on the metal coupon. In this experiment, a boot bath with dry powder was the most efficacious in reducing the detectable viral RNA on both boots and subsequent surfaces.

The Effect of COVID-19 Shelter-in-Place Orders on Pediatric Craniofacial Trauma.

Objectives: To investigate the impacts of the shelter-in-place orders on the injury patterns among children with craniofacial trauma. Materials and Methods: Pediatric (<18 years old) craniofacial trauma cases presenting to a regional level I trauma center 1 year before and after the initiation of Washington's shelter-in-place order were retrospectively reviewed. Demographic and injury-related variables were recorded, and bivariate and logistic regression analyses were computed. Results: One hundred nineteen children were evaluated over 2-year period (46 pre- and 73 post-shelter-in-place and were comparable in age, gender, and ethnicity (p ≥ 0.17)). The distribution of injury mechanisms between pre- and post-shelter-in-place were significantly different (p = 0.02), with the largest proportional increase in falls (10.5%) and had higher rates of associated brain injury (p ≤ 0.02). After adjusting for effect modifiers and confounders, children presenting during the post-shelter-in-place period were more likely to have associated brain injuries (odds ratio 3.4, 95% confidence interval: 1.11-10.6, p = 0.03). Conclusions: Among pediatric craniofacial injury cases, the shelter-in-place order was associated with a higher likelihood of brain injury and significant changes in injury mechanisms, with a higher proportion of falls.

Post-traumatic growth in PhD students during the COVID-19 pandemic.

Throughout the COVID-19 pandemic, graduate students have faced increased risk of mental health challenges. Research suggests that experiencing adversity may induce positive psychological changes, called post-traumatic growth (PTG). These changes can include improved relationships with others, perceptions of oneself, and enjoyment of life. Few existing studies have explored this phenomenon among graduate students. This secondary data analysis of a survey conducted in November 2020 among graduate students at a private R1 University in the northeast United States examined graduate students' levels and correlates of PTG during the COVID-19 pandemic. Students had a low level of PTG, with a mean score of 10.31 out of 50. Linear regression models showed significant positive relationships between anxiety and PTG and between a measure of self-reported impact of the pandemic and PTG. Non-White minorities also had significantly greater PTG than White participants. Experiencing more negative impact due to the pandemic and ruminating about the pandemic were correlated with greater PTG. These findings advance research on the patterns of PTG during the COVID-19 pandemic and can inform future studies of graduate students' coping mechanisms and support efforts to promote pandemic recovery and resilience.

Transcriptional reprogramming from innate immune functions to a pro-thrombotic signature by monocytes in COVID-19.

Although alterations in myeloid cells have been observed in COVID-19, the specific underlying mechanisms are not completely understood. Here, we examine the function of classical CD14+ monocytes in patients with mild and moderate COVID-19 during the acute phase of infection and in healthy individuals. Monocytes from COVID-19 patients display altered expression of cell surface receptors and a dysfunctional metabolic profile that distinguish them from healthy monocytes. Secondary pathogen sensing ex vivo leads to defects in pro-inflammatory cytokine and type-I IFN production in moderate COVID-19 cases, together with defects in glycolysis. COVID-19 monocytes switch their gene expression profile from canonical innate immune to pro-thrombotic signatures and are functionally pro-thrombotic, both at baseline and following ex vivo stimulation with SARS-CoV-2. Transcriptionally, COVID-19 monocytes are characterized by enrichment of pathways involved in hemostasis, immunothrombosis, platelet aggregation and other accessory pathways to platelet activation and clot formation. These results identify a potential mechanism by which monocyte dysfunction may contribute to COVID-19 pathology.

Teacher leadership and science instructional practice: Teaching elementary science in a time of crisis

This study explores the challenges that elementary science educators face when teaching science in a time of crisis, as well as how to best provide elementary teachers with ongoing support for their science teaching during the novel COVID-19 pandemic. Using a phenomenological approach, this research focuses on elementary science teachers, educators, and formal and informal leaders to understand their experiences during the pandemic and how to best support them during remote and in-person science teaching. Using data collected from questionnaires, semi-structured interviews, and focus group discussions, findings discuss the specific experiences and challenges faced by elementary science first-year teachers, early career teachers, and leaders. Following the transactional model of stress and coping (Lazarus & Folkman, 1984) and the buffering effect of social support (Cohen & McKay, 1984), first-year and early career elementary science teachers used multiple coping mechanisms to handle the stress of science teaching during the pandemic, including problem solving and collaborating with other educators. From a distributed leadership perspective (Spillane, Halverson, & Diamond, 2001b), district-level elementary science curriculum specialists and coaches act as leaders in science education. When faced with constraints and challenges due to the pandemic, these district-level leaders used this opportunity to reimagine what their leadership work could look like, including rethinking what supports they can offer classroom teachers when they cannot easily access classrooms, how to design effective science curricula for remote teaching, and how to collaborate with other educators in new ways. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Eviction, post-traumatic stress, and emergency department use among low-income individuals in New Haven, CT.

We sought to examine whether and how landlord-related forced moves (inclusive of, but not limited to, legal eviction) were associated with emergency department (ED) use over time. We used survey data collected between 2017 and 2019 among 283 low-income participants in New Haven, CT to examine whether experiencing a legal eviction or other landlord-related forced move (T0) was associated with increased odds of ED use 6 months (T1) and 12 months (T2) later. We conducted bootstrapped mediation analyses to examine indirect effects of post-traumatic stress symptoms. One-fifth of participants (n = 61) reported a recent forced move at baseline (T0); half of these were legally evicted. Landlord-related forced moves were associated with ED use at T1 (AOR = 2.06, 95 % CI: 1.04-4.06) and T2 (AOR = 3.05, 95 % CI: 1.59-5.88). After adjustment for sociodemographic factors and other health-related confounders, legal eviction was not significantly associated with ED use at T1 (AOR = 1.61, 95 % CI: 0.68-3.81), but was significantly associated with ED use at T2 (AOR = 3.58, 95 % CI: 1.58-8.10). Post-traumatic stress symptoms accounted for 15.1% of forced moves' association with ED use (p <.05). Landlord-related forced moves are positively associated with subsequent ED use, and post-traumatic stress symptoms are one factor that may help explain this association. Structural interventions that promote housing stability are needed to advance health equity, and they may also help to reduce preventable ED use. Such interventions are imperative in the context of the COVID-19 pandemic, which has strained health system capacity and exacerbated housing instability for many low-income renters. Results underscore the relevance of trauma-informed care and integrated care management to clinical practice in emergency settings.

Evaluation of Pediatric Facial Fracture Patients during the COVID-19 Pandemic

Background:The COVID-19 pandemic has significantly impacted the provision of health care, including the suspension of elective and nonessential surgeries. This study presents an early effect of the COVID-19 pandemic on the surgical care of pediatric patients with facial fractures.Methods:This study presents a retrospective cohort study of pediatric patients with facial fractures who presented to a pediatric level I trauma center before and during the pandemic. Patients were included regardless of treating specialty, treatment modality, or inpatient status.Results:One hundred nine patients met the inclusion criteria. There were 70 patients in the pre-pandemic cohort and 39 in the pandemic cohort. Mean age in the pre-pandemic cohort was 11.6?±?4.5?years old and 11.1?±?4.7 in the pandemic cohort (P?=?.623). Majority of patients during the pandemic were female (59%), compared to the predominantly male pre-pandemic cohort (25.7%). Motor vehicle accidents were the most common cause of injury during the pandemic (n?=?16, 41.0%), compared to sports in pre-pandemic (n?=?21, 30.0%). The most common fracture during the pandemic was nasal fracture (n?=?26, 66.7%), which was also the most common fracture in pre-pandemic cohort (n?=?59, 84.3%). There were significantly more skull fractures (17.9%, P?=?.02) and orbital fractures (23.1%, P?=?.02) during the pandemic, as well as more hospital (33.0%, P?=?.004) and ICU admissions (17.9%, P?=?.018). There was no difference in operative rate during the pandemic (41.0%) compared to pre-pandemic (48.6%, P?=?.449).Conclusions:The COVID-19 pandemic caused a global stoppage of sports and outdoor activities. As a result, more of the fractures that presented to the hospital were due to motor vehicle accidents during the pandemic, leading to proportionally greater rates of admissions and neurological associated injuries.

The feasibility and promise of Dialectical Behavior Therapy Skills Training with teachers and school personnel in high‐poverty schools

This study examined the feasibility and promise of using virtual Dialectical Behavior Therapy Skills Training (DBT‐ST) with educators. DBT‐ST was offered to 39 educators (89% female, mean age 46.45) in one high‐poverty school district during the COVID‐19 pandemic using a pre–post design. Educators attended five of eight groups (Mode = 8) and there were statistically significant decreases in stress (p = .001, rrb = −.51) and dysfunctional coping (p = .000, rrb = −.57), and increases in DBT skill use (p = .016, rrb = .44). Ratings on anxiety and depression were unchanged. The χ2 analyses indicated a significant relationship between stress and attendance with the high stress group more likely to attend the groups than the low stress group, χ2(1) = 4.88, p = .027. DBT‐ST may be feasible for teachers but future considerations regarding the role of mental health personnel in delivering teacher health and wellness interventions is warranted. [ FROM AUTHOR] Copyright of Psychology in the Schools is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Transcriptional reprogramming from innate immune functions to a pro-thrombotic signature upon SARS-CoV-2 sensing by monocytes in COVID-19 (preprint)

Alterations in the myeloid immune compartment have been observed in COVID-19, but the specific mechanisms underlying these impairments are not completely understood. Here we examined the functionality of classical CD14+ monocytes as a main myeloid cell component in well-defined cohorts of patients with mild and moderate COVID-19 during the acute phase of infection and compared them to that of healthy individuals. We found that ex vivo isolated CD14+ monocytes from mild and moderate COVID-19 patients display specific patterns of costimulatory and inhibitory receptors that clearly distinguish them from healthy monocytes, as well as altered expression of histone marks and a dysfunctional metabolic profile. Decreased NFkB activation in COVID-19 monocytes ex vivo is accompanied by an intact type I IFN antiviral response. Subsequent pathogen sensing ex vivo led to a state of functional unresponsiveness characterized by a defect in pro-inflammatory cytokine expression, NFkB-driven cytokine responses and defective type I IFN response in moderate COVID-19 monocytes. Transcriptionally, COVID-19 monocytes switched their gene expression signature from canonical innate immune functions to a pro-thrombotic phenotype characterized by increased expression of pathways involved in hemostasis and immunothrombosis. In response to SARS-CoV-2 or other viral or bacterial components, monocytes displayed defects in the epigenetic remodelling and metabolic reprogramming that usually occurs upon pathogen sensing in innate immune cells. These results provide a potential mechanism by which innate immune dysfunction in COVID-19 may contribute to disease pathology.

Longitudinal Plasma Cytokine Profiles Differentiating COVID-19 Severity Groups

Background. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19), an infection with widely varying clinical severity. Severe COVID-19 was initially proposed to be secondary to cytokine storm syndrome (CSS). However, studies since showed that patients with severe COVID-19 rarely display CSS cytokine phenotypes, and may have more limited inflammatory responses instead. Methods. Prospective cohorts, aged 0-90 years of age who tested positive by polymerase chain reaction (PCR) for SARS-CoV-2 were enrolled from inpatient hospitals and outpatient testing centers in Memphis, TN from May 2020-January 2021. Longitudinal blood samples were obtained including acute, sub-acute and convalescent timepoints. Severity scores of asymptomatic, mild, moderate, and severe COVID-19 were assigned at time of convalescent assessment. Plasma was analyzed with a quantitative human magnetic 38-plex cytokine assay. Results. : 169 participants were enrolled, including 8 asymptomatic, 117 mild, 22 moderate and 17 severe cases, and 5 children with post-COVID-19 multisystem inflammatory syndrome in children (MIS-C). All moderate and severe patients were hospitalized and received treatment (39%). Clear distinctions were seen between asymptomatic-mild cases and moderate-severe cases at acute timepoints and during disease progression for GCSF, IL-8, IL-10, IL-15, IL-1Ra, IP-10, MIP-1a, MIP-1β, and TGFα. There was a significant difference between participants who did and did not require hospitalization for acute timepoint levels of IL-10, IL-15, MIP-1 β and TGFα (p< 0.01). Only 4 participants with active COVID-19 were found to meet criteria for CSS (2%), only 3 of which were severe. MIS-C participants showed nearly universally elevated cytokine levels compared to those with active COVID-19. Conclusion. Moderate and severe acute COVID-19 has a distinct cytokine profile from asymptomatic and mild cases, as detected from acute, subacute and convalescent plasma.

Hantavirus Disease and COVID-19.

OBJECTIVES: Navajo Nation is disproportionately affected by hantavirus cardiopulmonary syndrome (HCPS), a severe respiratory disease that can quickly progress to respiratory failure and cardiogenic shock. The initial signs and symptoms of HCPS are indistinguishable from coronavirus disease 2019 (COVID-19). However, this distinction is critical, as the disease course differs greatly, with most patients with COVID-19 experiencing mild to moderate illness. We set out to determine if the evaluation of peripheral blood smears for five hematopathologic criteria previously identified as hallmarks of hantavirus infection, or "the hantavirus 5-point screen," could distinguish between COVID-19 and HCPS. METHODS: The hantavirus 5-point screen was performed on peripheral blood smears from 139 patients positive for COVID-19 seeking treatment from Tséhootsooí Medical Center and two Emory University hospitals. RESULTS: Of these 139 individuals, 136 (98%) received a score of 3/5 or below, indicating low suspicion for HCPS. While thrombocytopenia, one of the key signs of HCPS, was seen in the patients with COVID-19, it was generally mild and remained stable on repeat specimens collected 12 to 24 hours later. CONCLUSIONS: Given these findings, the 5-point screen remains a useful rapid screening tool for potential HCPS cases and may be useful to distinguish early HCPS from COVID-19 in HCPS endemic regions.

Effects of ASU 2016-13 and COVID-19 on banks' loan loss allowances

Accounting Standards Update (ASU) 2016–13 substantially changed the FASB's previous accounting guidance in SFAS 114 for credit loss estimation with the objective of making recognition more timely. We examine the effect of the initial adoption of ASU 2016–13 on January 1, 2020, on banks' loan loss allowances and its subsequent effect on banks' provision accruals over the first three quarters of 2020 during the COVID-19 pandemic when economic conditions changed rapidly. After controlling for bank size and other factors previously found to be associated with provisions, we find that banks adopting ASU 2016–13 made significantly larger provisions than SFAS 114 banks in Quarter 1 but not in Quarter 2. However, as economic conditions improved markedly in Quarter 3, we find a reversal in that the ASU 2016–13 banks reported significantly smaller mean provisions than the SFAS 114 banks. These results provide preliminary evidence that ASU 2016–13 has achieved its objective of making allowances more sensitive to changing economic conditions.

Baseline procalcitonin as a predictor of bacterial infection and clinical outcomes in COVID-19: A case-control study.

PURPOSE: Coronavirus disease-2019 (COVID-19) is associated with a wide spectrum of clinical symptoms including acute respiratory failure. Biomarkers that can predict outcomes in patients with COVID-19 can assist with patient management. The aim of this study is to evaluate whether procalcitonin (PCT) can predict clinical outcome and bacterial superinfection in patients infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). METHODS: Adult patients diagnosed with SARS-CoV-2 by nasopharyngeal PCR who were admitted to a tertiary care center in Boston, MA with SARS-CoV-2 infection between March 17 and April 30, 2020 with a baseline PCT value were studied. Patients who were presumed positive for SARS-CoV-2, who lacked PCT levels, or who had a positive urinalysis with negative cultures were excluded. Demographics, clinical and laboratory data were extracted from the electronic medical records. RESULTS: 324 patient charts were reviewed and grouped by clinical and microbiologic outcomes by day 28. Baseline PCT levels were significantly higher for patients who were treated for true bacteremia (p = 0.0005) and bacterial pneumonia (p = 0.00077) compared with the non-bacterial infection group. Baseline PCT positively correlated with the NIAID ordinal scale and survival over time. When compared to other inflammatory biomarkers, PCT showed superiority in predicting bacteremia. CONCLUSIONS: Baseline PCT levels are associated with outcome and bacterial superinfection in patients hospitalized with SARS-CoV-2.

Changes to eating and activity behaviors during the COVID-19 pandemic in persons with food addiction

Background: Prior studies have demonstrated the effects of the COVID-19 pandemic on weight management and lifestyle behaviors, though identification of who may be at greatest risk for negative consequences has not been fully explored. Addictive-like eating behavior, or food addiction, has been associated with an array of problematic eating behaviors, which may suggest heightened susceptibility to poorer outcomes. Methods: Participants (n = 288) in this online, cross-sectional study completed questionnaires in February, 2021 assessing food addiction and reported changes to their weight, eating, and physical activity before and during the COVID-19 pandemic. Results: Individuals with food addiction gained an average of 12.42 lb (5.63 kg) since March 2020, compared to an average weight gain of 2.14 lb (.97 kg) for those without food addiction (p < .001). Linear regression analyses controlling for age and body mass index (BMI) showed that food addiction was independently associated with higher weight gain (B = 9.28, t = 4.97, p < .001), greater intake of ultra-processed foods before and during COVID-19 (B = 1.08, t = 5.71, p < .001;B = 1.18, t = 6.42, p < .001, respectively), greater attribution of their overall current eating behaviors to COVID-19 circumstances (B = 23.19, t = 4.62, p < .001), and higher distress about their overall current eating behaviors (B = -22.12, t = -2.50, p = .01). Interaction effects demonstrated that individuals with food addiction who are older may be at particularly high risk for weight gain and distress. Conclusions: The present research suggests that food addiction is a uniquely meaningful phenotype, beyond the effects of BMI, to identify risk for the negative consequences of the COVID-19 pandemic. Individuals with food addiction, particularly those who are older, may benefit from support with weight management and addictive-like eating as the COVID-19 pandemic persists and resolves.

Randomized clinical trial of a brief, scalable intervention for mental health sequelae in college students during the COVID-19 pandemic.

This randomized clinical trial aimed to determine feasibility, acceptability, and initial efficacy of brief Dialectical Behavior Therapy (DBT) skills videos in reducing psychological distress among college students during the COVID-19 pandemic. Over six weeks, 153 undergraduates at a large, public American university completed pre-assessment, intervention, and post-assessment periods. During the intervention, participants were randomized to receive animated DBT skills videos for 14 successive days (n = 99) or continue assessment (n = 54). All participants received 4x daily ecological momentary assessments on affect, self-efficacy of managing emotions, and unbearableness of emotions. The study was feasible and the intervention was acceptable, as demonstrated by moderate to high compliance rates and video ratings. There were significant pre-post video reductions in negative affect and increases in positive affect. There was a significant time × condition interaction on unbearableness of emotions; control participants rated their emotions as more unbearable in the last four vs. first two weeks, whereas the intervention participants did not rate their emotions as any more unbearable. Main effects of condition on negative affect and self-efficacy were not significant. DBT skills videos may help college students avoid worsening mental health. This brief, highly scalable intervention could extend the reach of mental health treatment.

Impact of the COVID-19 pandemic on school-aged children with disabilities: Changes in therapy service delivery and functioning

Background and Objective(s): Children with physical or developmental disabilities often receive in-person physical therapy (PT), occupational therapy (OT), speech language therapy (SLT), and/or applied behavioral analysis (ABA) services. Stay-at-home orders early in the COVID-19 pandemic caused widespread therapy service disruptions. We used an online survey to: (1) describe changes in therapy service delivery in the early months of the pandemic (March-June 2020);(2) describe the impact of these changes on children's functioning;and (3) identify factors predicting loss of in-person services and receipt of teletherapy services. Study Design: Cross-sectional study. Study Participants & Setting: Four hundred and six participants completed the online survey. Participants were English-speaking parents of children with physical or developmental disabilities between the ages of 5 and 18 years, living in the US. Participants were recruited using convenience sampling through a variety of media platforms. Most children were aged 5 to 9 (57%) years. Reported diagnoses included developmental delay (36%), autism (31%), cerebral palsy (20%), and/or other disabilities (48%). Materials/Methods: We distributed an online survey over a 6-week period in June and July 2020. The survey was feasibility-tested prior to administration. Response options included multiple choice and Likert scales. Descriptive statistics summarized pre-during pandemic changes in therapy service delivery and in children's functioning. Logistic regressions explored individual and contextual factors predictive of loss of therapy services or receipt of teletherapy services. Results: For children receiving the service pre-pandemic, 65% lost access to PT, 58% to OT, 47% to SLT, and 55% to ABA between March and June of 2020. 42% of children lost access to all therapy services. 34% of children received at least one therapy service via telehealth (PT=18%, OT=25%, SLT=32%, ABA=26%) during this time. Over 50% of parents attributed some or significant declines in their child's behavior and social skills to changes in therapy services, and over 40% reported declines in their child's communication skills and endurance. Logistic regression models showed that children who received at least one therapy outside of school pre-pandemic were significantly less likely to lose all therapy services (B=-0.43 [0.22], z=-1.96, p=0.05, odds ratio=0.65) and significantly more likely to receive teletherapy (B=0.48 [0.23], z=2.1, p=0.04, odds ratio=1.6) compared to children who previously received therapy only in school. No other factors predicted service loss or format change. Conclusions/Significance: School-aged children with disabilities in the US experienced a dramatic loss of in-person therapy services and resulting declines in functioning early in the COVID-19 pandemic. Non-school services were more likely to provide teletherapy. Findings will inform efforts to improve access to teletherapy and address children's needs as the pandemic continues.