Stroke hospitalisation during and after the COVID19 lockdowns;findings from ARCOS V

Background: In 2020, the COVID19 pandemic disrupted the health system and potentially affected the presentation and care of stroke patients. The Auckland Regional Community Stroke Study (ARCOS V) provided an opportunity to study the impact of the pandemic on stroke hospitalisation. Aim(s): To compare stroke hospitalisation and time from stroke onset to admission during COVID19 lockdowns with post-lockdown periods. Method(s): ARCOS V is a prospective, population-based, study of stroke and TIA incidence and outcomes in those aged >=15 years in the Greater Auckland region. Case ascertainment commenced on 1 March 2020 but was paused on 31 August 2020 (Phase 1) due to the observed impact of COVID19 on health service use. ARCOS V case ascertainment recommenced from 1 September 2020 for 12 months (Phase 2). We compared incidence of stroke, and time from onset to hospitalisation for two equivalent 6-month periods (March to August 2020 and 2021). Result(s): In Phase 1, 1144 stroke cases were hospitalised. The mean time to admission was 0.8 days [SD=3.9]. In Phase 2 (preliminary), 1250 stroke cases were hospitalised, and the mean time to admission was 1 day [SD=4.7]. In both Phases, males, younger [15-64 years] people, and Pacific people presented to hospital later. More detailed findings (analyses underway) including the comparative proportion of cases receiving neuroimaging, and revascularisation procedures by age, sex and ethnicity in the two phases will be presented. Conclusion(s): Fewer cases were admitted and time from stroke onset to admission was shorter during the peak of the pandemic in 2020, compared to 2021. Reduced time may be due to reduced traffic and fewer people in the emergency department during complete lockdown. The reasons for fewer people presenting to hospital during lockdown need to be explored further.

Supporting People Receiving Substance Use Treatment during COVID-19 through a Professional-Moderated Online Peer Support Group

The COVID-19 pandemic exacerbated the ongoing opioid crisis in the United States. Individuals with a substance use disorder are vulnerable to relapse during times of acute stress. Online peer support communities (OPSCs) have the potential to decrease social isolation and increase social support for participants. In September 2020, we launched a private, professional-moderated OPSC using the Facebook Group platform to study its effects on the mental health wellness of women undergoing substance use treatment. This study was particularly meaningful as the participants were not able to join in-person treatment sessions due to the COVID-19 pandemic. Preliminary findings indicate that study participants reported decreased loneliness and increased online social support three months after initiating the OPSC. They tended to interact with content initiated by a clinical professional more than those generated by peers. © 2022 ACM.

RELAPSES of IDIOPATHIC INFLAMMATORY MYOPATHIES after VACCINATION AGAINST COVID19: A REAL-LIFE ITALIAN STUDY

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination plays a crucial role as pivotal strategies to curb the coronavirus dis-ease-19 (COVID-19) pandemic. Despite the mass-scale vaccination, literature data about the incidence of disease fares in IIM patients are still not reported as well as the immunological condition. Objectives: The present study aimed to describe the clinical status of patients affected by IIM after vaccination against COVID19 in order to assess the number of relapses or immune-mediated reactions in a cohort of Italian patients with such disease. Methods: We included all patients affected by IIM and followed by Myositis Clinic, Rheumatology and Respiratory Diseases Units, Siena University Hospital, Bari University Hospital, Policlinico Umberto I, Sapienza University, Rome, and Policlinico Paolo Giaccone, Palermo. Inclusion criteria were a recent (<3 months) clinical and serological assessment before the survey and a defnite diagnosis of dermatomyosi-tis, polymyositis and anti-synthetase syndrome. All patients underwent a telephone survey in order to establish their clinical status and potential relapses after vaccination. Results: A total of 119 IIM patients (median, IQR 58 (47-66) years;32 males) were consecutively enrolled. Fifty had a diagnosis of DM, 39 had PM and 30 had ASS. The median months of disease duration was 79.62±83.98. According to number of organs involvement, forty-two had only one, 45 had two organs involvement, 20 had three, 11 had four and one had five. The majority of them received two doses of COVID-19 vaccine, except four patients who refused the vaccination: 94 (78.9%) Cominarty, 16 (13.4%) Moderna, 5 (0.04%) AZ. Seven (0.06%) patients had fare after vaccination, the majority of them were mild except one major with three organs involved and one life-threatening with systemic involvement. In order to understand or predict the effect of demographic and clinical features on the fare development after vaccination, a logistic regression analysis was performed. The goodness-of-ft statistics showed a Chi2 associated with the Log ratio (L.R.) of 0.045. From the probability associated with the Chi-square tests, the Type II analysis showed the variable that most influences the development of fare was the number of organs involved (p=0.047). Sixty-eight patients received the third dose of COVID-19 vaccination: 51 (75%) Cominarty and 17 (25%) Moderna. Only one (0.01%) patient (the same who had life-threatening fare with systemic involvement after two doses) had fare after third dose and eventually died. Conclusion: Vaccines against SARS-CoV2 have provided, both in registratory studies and in preliminary real-life evidence, an overall good efficacy and safety. Nevertheless, only scanty data are available for rheumatic patients in general and the ones affected by IIM in particular. To the best of our knowledge, ours represent the largest cohort of IIM patients in which immunogenicity of anti-SARS-CoV2 vaccine was assessed. In line with real-life data from other diseases, we found a non-statistically signifcant risk of relapse in our patients, which occurred seldom, usually mild and in patients with a more severe and aggressive course of disease.

Outbreak of SARS-CoV-2 in a teenage discotheque in Northern Ireland-November 2021.

OBJECTIVES: To report key findings associated with an outbreak of SARS-CoV-2 following a teenage disco in Northern Ireland. STUDY DESIGN: Observational case series. METHODS: A case was defined as an individual who attended the event with a positive SARS-CoV-2 result between 6th and 20th November 2021. Demographic and clinical information, including symptom status, date of onset and school attended, were recorded during contact tracing. Vaccination status was derived from the COVID-19 Vaccine Management System. Forty-five samples associated with the outbreak were sequenced as part of the NI Whole Genome Sequencing (WGS) programme. RESULTS: Only 2.4% (5/205) of cases received a COVID-19 vaccine more than 14 days before the event. 84.9% (174/205) had received no vaccine at the time of the event and 12.7% (26/205) had been vaccinated within 14 days, offering only limited disease protection. The AY4.2.2 lineage of two cases who attended the event after symptom onset was found in 69% of sequenced outbreak cases. CONCLUSIONS: This study demonstrates extensive COVID-19 transmission in largely unvaccinated teenagers in an indoor venue with limited social distancing, close social contact and mixing, limited ventilation and singing and shouting. Public Health authorities developing COVID-19 entertainment regulations should consider congregations of teenagers in these settings, especially if vaccination rates are low in this group or they are not eligible for vaccination at that time. Public communications should be developed to ensure young people with COVID-19 symptoms follow public guidance regarding self-isolation and in particular avoid indoor events with larger numbers.

Higher ACE2 expression in the brains of individuals with Alzheimer's disease

BACKGROUND: The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a major cause of death, particularly in the elderly. The geriatric population in which cognitive decline due to Alzheimer's disease (AD) is frequent is disproportionately affected by the pandemic. In addition, central nervous system (CNS) manifestations have been reported in a significant subset of SARS-CoV-2 infected patients. METHOD: Since the principal entry receptor utilized by SARS-COV-2 is Angiotensin-Converting Enzyme 2 (ACE2), we examined whether ACE2 protein and mRNA levels were altered postmortem in parietal cortex samples from two different AD cohorts, totalling 142 cases. RESULTS: Both immunoblot and RT-qPCR analysis revealed higher concentrations of ACE2 protein and mRNA in persons with a neuropathological diagnosis of AD, compared to age-matched controls. Brain levels of ACE2 were inversely correlated with antemortem cognitive scores. We found that ACE2 protein was highly enriched in microvessels of mice compared to brain parenchyma, but not in humans. Detachment of ACE2 from brain cell membranes was strongly associated with pericytes loss. No significant change of ACE2 protein was detected in the parietal cortex from the 3xTg-AD mouse model of AD neuropathology. CONCLUSION: Our data suggest that cognitive impairment is associated with higher levels of ACE2 in the brain, which might contribute the higher risk of CNS SARS-CoV-2 infection in cognitively impaired individuals and AD patients. © 2021 the Alzheimer's Association.

An Earth-mass planet in a time of COVID-19: KMT-2020-BLG-0414Lb

We report the discovery of KMT-2020-BLG-0414Lb, with a planet-to-host mass ratio q (2) = 0.9-1.2 x 10(-5) = 3-4 circle plus at 1 sigma, which is the lowest mass-ratio microlensing planet to date. Together with two other recent discoveries (4 less than or similar to q/q (circle plus) less than or similar to 6), it fills out the previous empty sector at the bottom of the triangular (log s, log q) diagram, where s is the planet-host separation in units of the angular Einstein radius theta E. Hence, these discoveries call into question the existence, or at least the strength, of the break in the mass-ratio function that was previously suggested to account for the paucity of very low-q planets. Due to the extreme magnification of the event, A (max) similar to 1450 for the underlying single-lens event, its light curve revealed a second companion with q (3) similar to 0.05 and ;log s (3);similar to 1, i.e., a factor similar to 10 closer to or farther from the host in projection. The measurements of the microlens parallax pi (E) and the angular Einstein radius theta E allow estimates of the host, planet and second companion masses, (M (1), M (2), M (3)) similar to (0.3 M (circle dot), 1.0 M (circle plus), 17 M-J ), the planet and second companion projected separations, (a (perpendicular to,2), a (perpendicular to,3)) similar to (1.5, 0.15 or 15) au, and system distance D (L) similar to 1 kpc. The lens could account for most or all of the blended light (I similar to 19.3) and so can be studied immediately with high-resolution photometric and spectroscopic observations that can further clarify the nature of the system. The planet was found as part of a new program of high-cadence follow-up observations of high-magnification events. The detection of this planet, despite the considerable difficulties imposed by COVID-19 (two KMT sites and OGLE were shut down), illustrates the potential utility of this program.

Prognostic bioindicators in severe COVID-19 patients.

BACKGROUND: Severe acute respiratory syndrome caused by novel coronavirus 2 (SARS-CoV-2) emerged in Wuhan (China) in December 2019. Here we evaluated a panel of biomarkers to phenotype patients and to define the role of immuno-inflammatory mediators as biomarkers of severity. MATERIALS AND METHODS: Serum samples were obtained from 24 COVID-19 patients on admission to hospital, before any treatment or infusion of intravenous steroids or invasive ventilation. KL-6 IL-6 and C-peptide were measured by chemiluminescent enzyme immunoassay. IL-6 assay was validated for accuracy and precision. The validity of variables used to distinguish severe from mild-to-moderate patients was assessed by areas under curves (AUC) of the receiver operating characteristic (ROC) and logistic regression was performed to combine parameters of the two groups. RESULTS: In the severe group, IL-6, CRP and KL-6 concentrations were significantly higher than in mild-to-moderate patients. KL-6, IL-6 and CRP concentrations were directly correlated with each other. ROC curve analysis of the logistic regression model including IL-6, KL-6 and CRP showed the best performance with an AUC of 0.95. CONCLUSIONS: Besides corroborating previous reports of over-expression of IL-6 in severe COVID-19 patients requiring mechanical ventilation, analytical determination of other mediators showed that IL-6 concentrations were correlated with those of KL-6 and CRP. The combination of these three prognostic bioindicators made it possible to distinguish severe COVID-19 patients with poor prognosis from mild-to-moderate patients.

Pedagogies for employability: understanding the needs of STEM students through a new approach to employability development

Labour market trends and the economic impacts of COVID-19 are elevating the importance of knowledge as a factor of production whilst concurrently eroding traditional forms of employment. Mindful of the implications for higher education, this study approached employability development as ‘the ability to find, create and sustain meaningful work across the career lifespan’. The study was grounded in social cognitive theory and adopted a metacognitive approach to employability. Data were generated through an online self-assessment completed by 12,576 students enrolled with Australian universities. Data from science, technology, engineering and mathematics (STEM) students were compared with those from students in non-STEM fields. STEM students differed in several key employability traits. The paper highlights the need to promote more nuanced occupational literacy about the future of work alongside awareness that STEM skills and capabilities are valued across multiple sectors and roles. Opportunities and challenges for embedding a pedagogy for employability are discussed. © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.