Lateral flow assays for COVID-19

Rapid tests are essential tools for monitoring and containing the COVID-19 pandemic. Lateral flow assays (LFAs) have been introduced for the point-of-care COVID-19 diagnosis, using paper-based devices, and widely used for detecting antigen or antibody related to COVID-19. This book chapter includes a brief overview of the LFAs for rapid test of COVID-19, with focus on nanomaterials for bioconjugation, material selection, human sampling, antibody and antigen tests, viral nucleic acid detection, advantages, limitations, and future perspective. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2023. All rights reserved.

Association between Receipt of COVID-19, Influenza, and Pneumococcal Vaccination

Background. Whether receipt of COVID-19 vaccine associates with receipt of other routinely-recommended adult vaccines such as, influenza and pneumococcal vaccines is not well described. We evaluated this relationship in a population of adults who were hospitalized for acute respiratory infection (ARI). *Odds ratio describing odds of receiving at least one COVID-19 vaccine (vs not) by influenza vaccination status adjusted for race, employment status, chronic cardiac diseases, cancer, solid organ transplant, and chronic kidney disease. **Odds ratio describing odds of receiving at least one COVID-19 vaccine (vs not) by pneumococcal vaccination status adjusted for race and chronic kidney disease. Methods. We enrolled adults (>= 18 years of age) who were hospitalized at Emory University Hospital and Emory University Hospital Midtown with symptoms consistent with ARI. Participants were interviewed and medical records ed to gather demographic information, including social behaviors during the pandemic, medical history, and prior vaccination history (i.e., COVID-19, influenza, and pneumococcal). Using two separate logistic regression analyses, we determined the association between i) receipt of influenza vaccine in the prior year among adults >= 18 years and ii) receipt of any pneumococcal vaccine in the prior 5 years among adults >= 65 years on the receipt of at least one COVID-19 vaccine>= 14 days prior to admission. Adjusted models included demographic information (e.g., age, sex, race/ethnicity, employment status), social behaviors, and history of chronic medical conditions. Results. Overall, 1056 participants were enrolled and had vaccination records available. Of whom, 509/1056 (48.2%) had received at least one dose of COVID-19 vaccine. Adults >= 18 years who received influenza vaccine were more likely to have received >=1 dose of COVID-19 vaccine compared to those who did not (267/373 [71.6%] vs 242/683 [35.4%] P=< .0001;adjusted odds ratio [OR]: 3.3 [95%CI: 2.4, 4.4]). Similarly, adults >=65 years who received pneumococcal vaccine were more likely to have received >= 1 dose of COVID-19 vaccine compared to those who did not (195/257 [75.9%] vs 41/84 [48.8%] P=< .0001;adjusted odds ratio [OR]: 3.0 [95% CI: 1.8, 5.1]). Conclusion. In this study of adults hospitalized for ARI, receipt of influenza and pneumococcal vaccination strongly correlated with receipt of COVID-19 vaccination. Continued efforts are needed to reach adults who remain hesitant to not only receive COVID-19 vaccines, but also other vaccines that lessen the burden of respiratory illness.

Social Risk Factors for COVID-19-Related Hospitalizations in Adults

Background. During the COVID-19 pandemic, social interventions such as social distancing and mask wearing have been encouraged. Social risk factors for SARS-CoV-2 infection and subsequent hospitalization remain uncertain. Methods. Adult patients were eligible if admitted to Emory University Hospital or Emory University Hospital Midtown with acute respiratory infection (ARI) symptoms (<= 14 days) or an admitting ARI diagnosis from May 2021 - Feb 2022. After enrollment, an in-depth interview identified demographic and social factors (e.g., employment status, smoking history, alcohol use), household characteristics, and pandemic social behaviors. All patients were tested for SARS-CoV-2 using PCR. We evaluated whether these demographic and social factors were related to a positive SARS-CoV-2 test upon admission to hospital with ARI using a logistic regression model. Results. 1141 subjects were enrolled and had SARS-CoV-2 PCR results available (700 positive and 441 negative). The median age was greater in the SARS-CoV-2 negative cohort than in the positive cohort (60 and 53 years, respectively;P< .0001). Those who tested positive were more likely to have had at least some college education compared to those who tested negative (64.3% vs 52.3%, P< .0001;adjusted odds ratio [aOR]: 1.4 [95%CI: 1.1, 2.0]). Compared to those who tested negative, those who were SARS-CoV-2 positive were also more likely to be employed (48.9% vs 26.5%, P< .0001;aOR: 1.7 [95%CI: 1.1, 2.3]), have children 5-17 yo at home (27.6% vs 17.9%, P=.0002;aOR: 1.5 [95%CI: 1.1, 2.1]). Those with COVID-19 were less likely to receive home healthcare (6.2% vs 13.3%, P< .0001;aOR: 0.5 [95%CI: 0.4, 0.9]) and to be a current or previous smoker (7.6% vs 17.7%, P< .0001;aOR: 0.3 [95%CI: 0.2, 0.5]). Conclusion. Among adults admitted to the hospital for ARI, those who tested positive for SARS-CoV-2 were typically younger, more likely to care for school-aged children, more likely to work outside the home, but were less likely to receive home healthcare or smoke. Personal and public health strategies to mitigate COVID-19 should take into consideration modifiable social risk factors.

Prior SARS-CoV-2 infection and risk of subsequent COVID-19-related hospitalization: a test negative design

Background. Studies show that past SARS-CoV-2 infection provides a protective immune response against subsequent COVID-19, but the degree of protection from prior infection has not been determined. History of previous SARS-COV-2 Infection and Current SARS-COV-2 Infection Status at Admission. *Adjusted for chronic respiratory disease and prior COVID-19 vaccination Methods. From May 2021 through Feb 2022, adults (>= 18 years of age) hospitalized at Emory University Hospital and Emory University Hospital Midtown with acute respiratory infection (ARI) symptoms, who were PCR tested for SARS-CoV-2 were enrolled. A prior history of SARS-CoV-2 infection was obtained from patient interview and medical record review. Previous infection was defined as a self-reported prior SARS-CoV-2 infection or previous evidence of a positive SARS-CoV-2 PCR test >= 90 days before ARI hospital admission. We performed a test negative design to evaluate the protection provided by prior SARS-CoV-2 infection against subsequent COVID-19-related hospitalization. Effectiveness was determined using logistic regression analysis adjusted for patient sociodemographic and clinical characteristics and COVID-19 vaccination status. Results. Of 1152 adults hospitalized for ARI, 704/1152 (61%) were SARS-CoV-2 positive. 96/1152 (8%) had a prior SARS-CoV-2 infection before hospital admission. Patients with a previous history of SARS-CoV-2 infection were less likely to test positive for SARS-CoV-2 upon admission for ARI compared to those who did not have evidence of prior infection (31/96 [32%] vs 673/1056 [64%];adjustedOR: 0.25 [0.15, 0.41] (Table). Conclusion. Reinfections represented a small proportion (< 10%) of COVID-19-related hospitalizations. Prior SARS-CoV-2 infection provided meaningful protection against subsequent COVID-19-related hospitalization. The durability of this infection-induced immunity, variant-specific estimates, and the additive impact of vaccination are needed to further elucidate these findings.

33rd meeting of the international task force for disease eradication, 14-15 March 2022

These proceedings contain articles that discuss setting the stage: the current state of the TB epidemic and COVID-19 effects, recap of events after the UN high-level conference in 2018, and direction for the UN high-level meeting in 2023. The ITFDE last discussed tuberculosis (TB) in 2010 and identified the following objectives: accelerated improvement and expansion of laboratory services for diagnosis and treatment, including assessment of drug resistance;increased support for better control and research;improved access to care and coverage of the most vulnerable populations;and political advocacy for TB control by potential allies inside and outside the health sector.

Impact of Covid-19 on students in high schools located in rural communities in México

The educational process shifted from schools to the home for Mexicans as a result of COVID-19. The objective was to analyze the economic, family and academic impact of COVID-19 among students from rural communities attending high school in Sinaloa. The methodology used for the study was the quantitative. The statistical sample size was 222 students from the Universidad Autónoma de Sinaloa, in México, who respond to an online questionnaire. The data was analyzed using descriptive statistics and correlational analysis. The results showed three types of problems: economic issues due to lack of income to buy the technological items required for online learning;family problems, specifically the lack of support provided by parents to help children with distance education;and academic difficulties, because there was little training provided to students on the use of technology. The authors concluded that COVID-19 caused difficulties and highlighted the existence of a digital divide, social inequality and educational lag. © Revista Latinoamericana de Ciencias Sociales. All rights reserved.

Prospective Analysis of the Impact of Impella 5.5 Devices on HLA Antibody Development in Transplant Recipients

Purpose: Little is known about the development of Human Leukocyte Antigen antibodies with the use of the new Impella 5.5 temporary mechanical circulatory assist device. Method(s): The prevalence and strength of HLA Class I and II antibodies were assessed prospectively from 6 patients with the Impella 5.5 and 10 control patients with no device support. Single antigen beads (One Lambda) were used to detect HLA antibodies in serum samples pre- and post-implantation of the device up to the time of heart transplantation. 6-month analysis for de novo HLA antibodies, rejection, rehospitalization and deaths were analyzed. Result(s): Baseline characteristics are shown in table 1A. 3/10 and 2/6 patients had pre-transplant HLA antibodies in the control and Impella groups, respectively. Additionally cross match results are shown in Table 1B. There was no increase in the prevalence of HLA antibodies detected post-transplant. None of the patients were admitted for concern of rejection, nor required outpatient optimization of immunosuppression. In the control group, 3 patients were hospitalized within 6 months post-transplant for non-rejection (COVID infection, pericardial effusion and right ventricular failure). There were no re-admissions within the Impella group. There was one death in the Impella group prior to discharge at index admission for transplant due to CMV viremia and stenotophomonas maltophilia infection post-transplant. There were no deaths in the control group. (Table 1C). Conclusion(s): The use of the new Impella 5.5 MCS assist device does not appear to increase the risk of development of de novo HLA antibodies nor appear to increase the risk of allograft rejection. Larger studies are needed to validate these preliminary findings.

Impact of the COVID-19 Pandemic on Antimicrobial Use and Resistance in the United States and the Dominican Republic

Background. The disease caused by SARS-CoV-2, COVID-19, has caused a global public health crisis. Lower respiratory tract infections (LRTIs) caused by COVID-19 has led to an increase in hospitalizations. Disease severity and concerns for bacterial co-infections can increase antimicrobial pressure. Our aim is to define and compare the impact of COVID-19 on antimicrobial use (AU) and antimicrobial resistance (AMR) in the Dominican Republic (DR) and the United States (US). Methods. We performed a retrospective review of AU and antimicrobial susceptibility patterns from 2019-20 at a hospital in the US (H-US) and the DR (H-DR). Our sites are community teaching hospitals with 151 beds in H-US and 295 beds in H-DR. After AU was tabulated, percent changes between 2019-20 were calculated. Resistance patterns for extended-spectrum beta-lactamase producing (ESBL) E coli, ESBL Klebsiella pneumoniae (ESBL-Kp), carbapenem resistant Pseudomonas aeruginosa (CR-PSAR) and Klebsiella pneumoniae (CR-Kp) were tabulated and percent changes between 2019-20 were calculated. Results. AU increased by 10% in H-US and 25% in H-DR, with carbapenem use increasing by 268% and 144% respectively. Ceftriaxone use increased by 30% in H-US and 33% in H-DR. Azithromycin increased 54% in H-US and 338% in the H-DR. Resistance increased from 10% to 28% for ESBL-Kp and from 10% to 12% for ESBL E coli at H-US. CR-PSAR decreased from 20% to 12%, while cefepime and piperacillin resistance increased from 5% to 20% and 3% to 16% respectively (Figure 1). At H-DR, ESBL-Kp resistance decreased from 68% to 64% and increased from 58% to 59% for ESBL E coli. CR-PSAR and cefepime resistance increased from 5% to 19% and from 9% to 29% respectively (Figure 2). Conclusion. COVID-19 had a major impact on antimicrobial consumption and resistance in the US and DR. A greater impact was seen on ESBL rates in the US whilst a greater impact on carbapenem resistance was seen in the DR. The rise in carbapenem use in H-US reflected a rise in ESBL rates. In the DR, ESBL producing organisms were common prior to COVID-19 and carbapenem use was more widespread. The impact of the COVID-19 pandemic on AU may accelerate AMR worldwide. The scale up of antimicrobial stewardship across the globe is urgently needed to curb AMR.

MACROSCOPIC FINDINGS IN MICROSCOPIC COLITIS PREDICT MORE SEVERE DISEASE

Introduction Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) poses a special challenge for patients with inflammatory bowel disease (IBD) on biologics. In an effort to limit possible exposure to SARS-CoV-2, patients were transitioned from hospital infusion centers to home infusions (HI). The objective of this study is to assess patient experience with HI compared to infusions in the infusion center. Methods A 31-question survey was developed to assess patient experience with the transition to home infusions during the coronavirus disease 2019 (COVID-19) pandemic. All patients with IBD over the age of 18 years who received at least one dose of infliximab (or biosimilar) or vedolizumab infusion at our infusion center followed by at least one HI between 03/01/ 2020 to 10/30/2020 were included in the study. Consent was obtained over the phone and survey links were emailed to patients via REDCap. Binomial test was used to test if the percentage of patients choosing an option for a survey question was significantly different than 50% of the study population. A p-value of less than 0.05 was considered significant. Results Of the 112 patients who met inclusion criteria, 48 patients completed the survey. Forty-one patients (85.4%) aged 60 or younger and 27 patients (56.3%) were female. Twenty-eight patients (58.3%) had Crohn’s disease, and the majority (37/48) were receiving infliximab or biosimilar. Twenty-seven patients (56.3%) were receiving their current biologic medication for more than 12 months prior to the transition to HI. The majority of patients perceived that HI was equally or more safe than receiving infusions at the infusion center (81.2%, p-value < 0.0001) and preferred HI during the COVID-19 pandemic (70.1%, pvalue = 0.004). Nurses from the HI companies were found to be equally or more competent than the nurses at the infusion centers. The percentage of patients who perceived that comfort and ease of scheduling were better with HI was not significantly different from 50%. Thirty-eight patients (79.2%, p-value < 0.0001) wanted to continue/are considering continuing HI in the future. The median score for satisfaction with HI was 7 (Interquartile range: 2) on a scale of 0-10. Conclusion Patient experience with the transition to HI during the COVID-19 pandemic seems to be favorable in terms of safety, comfort, satisfaction, and nurses’ competency. Most patients preferred to receive HI during the pandemic and show interest in continuing HI in the future. Further research into the clinical outcomes and cost-effectiveness of the transition to HI will help us make more informed decisions about which patients are most appropriate for HI.

Impact of COVID19 epidemic and public health response on pediatric IBD presentation in selected NYC institutions

Background: COVID-19 has presented the global medical establishment with innumerable problems in the last year. The disease has a varied presentation, including severe pneumonia, acute respiratory distress syndrome, flu-like symptoms, gastrointestinal disease, and multiorgan failure. Concerning for the field of pediatric gastroenterology is the significant capacity of COVID-19 to generate an immune response which may increase risk of downstream autoimmune disease (Saad et al, 2020, Ehrenfeld et al 2020). Recent case studies have noted new onset UC associated with recent COVID infection (Aydin et al 2020). Interestingly, non-pharmaceutical interventions to prevent COVID-19 have massively decreased the incidence of infectious illnesses (Sullivan et al, 2020) which, if anything, would be expected to drive a decreased incidence of IBD. We have formed a consortium of New York City pediatric institutions aimed at characterizing this change, and here report early findings from three of our member institutions, SUNY Downstate Health Sciences University, Maimonides Medical Center, and New York University. Methods: New IBD diagnoses were identified between 2013-2019, as well as new diagnoses documented between 3/2020 and 3/2021. Data was examined using a direct comparison of new diagnostic rate 3/20-3/21 to mean diagnostic rate from 2013-2019, as well as using a mixed effects epidemiologic model to assess significance of any change. Results: An overall secular increase in IBD diagnostic rate of approximately 5% was noted, consistent with prior findings demonstrating increased incidence of IBD annually (Ye et al, 2020). Direct comparison with mean diagnostic rate over the preceding 7 years noted comparable IBD diagnostic rates in the pandemic year in comparison to pre-pandemic (50 new diagnoses vs. avg 43). Mixed effects modeling suggests a 1/3rd decrease in expected IBD diagnostic rate, although this did not meet the standard for significance. Discussion: Our initial results from three institutions suggest a maintenance of IBD diagnostic rates, despite surveillance data from NYC DOH demonstrating almost nonexistent pediatric influenza-like-illness and a significant decrease in overall pediatric gastroenterology visits. There are many possible confounding factors in this initial work, but this data is suggestive of a possible capacity for COVID19 (which per NYC records infected approximately 5% of the pediatric cohort in the city) to generate new onset IBD. Next steps will include expanding data collection to additional NYC institutions, subgroup analysis by disease type, gender, age of presentation, more detailed analysis of biomarkers, and analysis by borough given geographic variations in COVID19 infection density.

The experiences of basic education teachers of rio grande do sul among public education students in times of remote education and pandemic

After a year of Covid-19 pandemic, the subjects that make up basic education, the teachers, students and families, still try to adapt to this new reality. Thus, in this article, it is proposed to analyze the effects of the pandemic in view of the current work situation of teachers of public basic education of Rio Grande do Sul state. For this purpose, a structured interview was carried out with the professionals who volunteered to participate in the research. The questions were developed in order to respond to our objectives, which are: To understand the experiences of teachers in face of remote teaching during Covid-19 pandemic and to analyze the experiences of teachers while tensioning teacher formation and the curriculum. For this purpose, we use Cultural Studies as tools for analyzing teaching practices and knowledge in times of pandemic and also the tensioning of the school curriculum in the face of the current situation experienced by society. The results demonstrate that the curriculum, and its way of controlling space and time, no longer has the same scope in the school space and among students, showing an incompatibility between remote education and the traditional school curriculum. Thus, there is an urgent need to rethink the form and relations of teaching and learning in Brazilian education. © 2021 UNIVERSIDADE FEEVALE . All Rights Reserved.

Anti-SARS-CoV-2 IgG antibodies pre-and post-vaccination behavior in health workers from a Guatemalan cancer center

Introduction: The study of anti-SARS-CoV-2 IgG antibodies allows asymptomatic individuals with COVID-19 to be identified, and post-infection and post-vaccination immunity status to be evaluated. Objective: To know the behavior of anti-SARS-CoV-2 IgG antibodies before and after vaccination in workers of a cancer center. Methods: Prior to the application of the vaccine, the presence of anti-SARS-CoV-2 IgG antibodies (n = 171) was analyzed by evaluating anti-N IgG antibodies;post-vaccination, after receiving the second dose, anti-S IgG antibodies were evaluated (n = 60). Results: Prior to vaccination, IgG antibodies were present in 18.71% of participants;they were detected in 65.22% of those with prior history of COVID-19 diagnosis and in 11.49% of those without it. The positions with the highest prevalence were nurses (28.26%), paramedics (27.59%) and administrative workers (27.78%), p < 0.01. Anosmia, ageusia and chest tightness were associated with the presence of IgG (p < 0.05). Post-vaccination, all participants developed IgG antibodies;people with a previous COVID-19 diagnosis had higher titers: 10,277 vs. 6,819 AU/mL, p < 0.001. Conclusions: The study of anti-SARS-CoV-2 IgG allowed asymptomatic health workers to be identified. A high percentage of participants with prior COVID-19 diagnosis had antibodies. All participants developed IgG after vaccination, with higher titers being identified in those with previous infection.