PROLONGED SARS-CoV-2 VIRAL BURDEN IN SIV-SARS-CoV-2 COINFECTED MACAQUES

Background: Individuals living with HIV are at increased risk of morbidity and mortality from COVID-19. Furthermore, SARS-CoV-2 infection in immunocompromised HIV infected individuals poses a risk to prolonged infection and viral shedding and the emergence of new variants of concern (VOCs). Using the SIV macaque model for AIDS, we are investigating the hypothesis that immune dysfunction during HIV infection will prolong SARSCoV- 2 viral infection, promote enhanced COVID-19 disease, and accelerate viral evolution. Here, we report the impact of SIV-CoV-2 co-infection on immune responses and pathogenesis. Method(s): Eight female rhesus macaques (aged 7-15 years, 5.5-9.9kg) were infected with SIVmac251 via low dose intravaginal challenge and then inoculated with 6.5x105 TCID50/mL SARS-CoV-2 (WA-1) at 17-34 weeks post-SIV infection via combined intranasal and intratracheal routes. Blood, bronchoalveolar lavage (BAL), stool, and nasal, oral, and rectal swabs were collected pre-infection through 14 days post-infection (DPI) to measure immune responses and viremia. ELISAs, ELISPOT, qRT-PCR, lung pathology, cytokine multiplex, and virus neutralization assays were performed to measure viral loads, pathogenesis, and immune responses. Result(s): Three days post-SARS-CoV-2 infection, we observed a transient decrease in CD4 counts, but there were no changes in clinical symptoms or plasma SIV viral loads. However, SARS-CoV-2 replication persisted in the upper respiratory tract, but not the lower respiratory tract. In addition, SARS-CoV-2 IgG seroconversion was delayed and antigen-specific T-cell responses were dampened. Notably, viral RNA levels in nasal swabs were significantly higher 7-14 DPI in SIV+ compared to previously published results using the same SARS-CoV-2 challenge virus in SIV- rhesus (PMCID: PMC8462335, PMC8829873). In addition, SIV/CoV-2 co-infected animals exhibited elevated levels of myeloperoxidase (MPO), a marker of neutrophil activation and increased lung inflammation. Conclusion(s): Here we provide evidence for the utility of the rhesus macaque in modeling human HIV-SARS-CoV-2 co-infection. Our results suggest that immunosuppression during SIV infection impairs de novo generation of anti-SARS-CoV-2 immunity, that may contribute to prolonged SARS-CoV-2 viral shedding, increased transmission windows, altered disease pathogenesis, and lower protection against subsequent SARS-CoV-2 exposures. Studies in progress will determine if SARS-CoV-2 viral evolution is accelerated in SIV-infected macaques.

Recruitment of patients to the AVERT DOSE international trial - the Irish experience

Introduction: Mobility training is a complex intervention and recovery post-stroke is multidimensional. AVERT DOSE is the first trial to use an adaptive trial design in stroke rehabilitation and aims to define optimal early intervention regimens for people with mild to moderate ischaemic stroke. Seven Irish sites are participating. Method(s): AVERT DOSE (ACTRN:12619000557134) is a randomised trial that will recruit >2,500 patients internationally. Randomisation is to two groups according to stroke severity. Patients are then randomised to one of four mobility training regimens in each strata and the intervention is delivered for up to 14-days. Primary Outcome: Identification of the intervention regimen that results in higher proportion of favourable outcome at 3-months post-stroke. Seven Irish sites are participating. Result(s): In Ireland, 3 sites are recruiting (SJH, OLOLH, and MMUH) with 4 finalising contracts. Thirteen patients have been recruited to date in Ireland and 265 internationally. Trial set-up has proven complex and variable across Irish sites, with time to ethics approval ranging from 10-37-months. Given the COVID-19 pandemic and international nature of the trial, online training and meetings were necessitated for all Irish sites. Close communication, teamwork and shared responsibilities have supported this process. Flexibility was required with some blinded followup assessments using telehealth. Conclusion(s): Undertaking rehabilitation research requires a dynamic, problem-solving approach, particularly during a pandemic. Irish sites have embraced this opportunity to answer an important stroke research question. In Ireland, shared learning in trial governance should improve future rehabilitation trial readiness. Trial recruitment is expected to gain pace as more Irish and international sites are approved.

An intersectional and social determinants of health framework for understanding Latinx psychological distress in 2020: Disentangling the effects of immigration policy and practices, the Trump Administration, and COVID-19-specific factors

The COVID-19 pandemic has disproportionately impacted U.S. communities of color, such as the Latino/x population. The pandemic coincides with other major contemporary structural factors affecting Latinxs, including the effects of U.S. immigration policies and President Trump's xenophobic rhetoric and priorities. Yet, the independent and simultaneous implications of the larger sociopolitical climate and specific COVID-19 concerns for Latinx mental health remain less clear. The present study uses an intersectional and social determinants of health framework to examine these relationships. Multivariable regression models were estimated with three waves of population-based panel data from the Pew American Trends Study (collected between 2019 and 2020) with Latinx adults (n = 1,132). We simultaneously examined how worries regarding deportation, respondents' citizenship and legal status, perceptions regarding the Trump Administration, anti-Hispanic discrimination, and pandemic-related concerns predicted variation in Latinx self-reported psychological distress, after adjusting for other important covariates. We also conducted analyses separately by gender. The results indicated that worrying about a family member or a friend being deported, perceiving higher anti-Hispanic discrimination, and viewing coronavirus as a threat to respondents' personal health and finances were significantly associated with higher levels of psychological distress. Stratified analyses revealed that gender filters the ways that some of these stressors affect the mental health of Latinas, such as perceived threats about deportation, compared to Latinos. Taken together, this work demonstrates the diverse social determinants shaping Latinx mental health in intersectional ways early in the pandemic. (PsycInfo Database Record (c) 2023 APA, all rights reserved) (Spanish) La pandemia de COVID-19 ha afectado de manera desproporcionada en EE. UU. a las comunidades de color, tales como la poblacion latina. La pandemia coincide con otros importantes factores estructurales contemporaneos que afectan a los latinos, incluidos los efectos de las politicas de inmigracion de EE. UU. y las prioridades y la retorica xenofoba del expresidente Trump. Sin embargo, siguen siendo menos claras las consecuencias independientes y simultaneas del clima sociopolitico mas amplio y las inquietudes especificas a la COVID-19 respecto a la salud mental de los latinos. El presente estudio utiliza los determinantes sociales transversales del marco de salud para examinar estas relaciones. Se estimaron los modelos de regresion entre variables multiples con datos basados en tres olas poblacionales del estudio Pew American Trends Study (reunidos entre 2019 y 2020) con adultos latinos (n = 1,132). De manera simultanea, se examino la manera en que las preocupaciones respecto a la deportacion, el estado legal y de ciudadania de los encuestados, las percepciones relacionadas con el gobierno de Trump, las discriminacion contra los hispanos y las inquietudes relacionadas con la pandemia predijeron una variacion en como los latinos informaron sobre su angustia psicologica, despues de adaptarse a otras covariables. Tambien se realizaron por separado los analisis segun el genero. Los resultados indicaron que preocuparse por un familiar o amigo que fuera deportado, percibir una mayor discriminacion contra los hispanos y ver al coronavirus como una amenaza a la salud y la economia personal de los encuestados estaban relacionados de manera significativa a niveles mas elevados de angustia psicologica. Los analisis estratificados revelaron que el genero filtra las maneras en que algunos de estos factores estresantes, tales como la percepcion de amenazas de deportacion, afectan la salud mental de las mujeres latinas, en comparacion con la de los hombres latinos. En su conjunto, este trabajo demuestra las variadas determinantes sociales de la salud que dieron forma a la salud mental de los latinos de maneras trasversales a principios de la pandemia. (PsycInfo Database Record (c) 2023 APA, all rights reserved) Impact Statement This study finds that worries about deportation, perceptions of anti-Hispanic discrimination, and having higher levels of COVID-19-related financial and health concerns were significantly associated with increased psychological distress among Latinxs in Spring 2020, net of other covariates. Gender-stratified analyses reveal that worries about deportation, legal and citizenship status, and pandemic-related effects on personal lives and health increased distress among Latinas but not Latinos. This highlights the array of gendered impacts and social determinants of health affecting Latinx psychological well-being during the pandemic. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Autistic characteristics and mental health symptoms in autistic youth during the first COVID-19 wave in Canada.

Autistic youth are at heightened risk for mental health issues, and pandemic-related stressors may exacerbate this risk. This study (1) described caregiver-reported youth mental health prior to and during the pandemic; and (2) explored individual, caregiver, and environmental factors associated with changes in autistic characteristics, social-emotional symptoms, and overall mental health. 582 caregivers of autistic children (2-18 years old) completed an online survey between June and July 2020 in which they provided demographic information, their child's pre-COVID and current mental health, autistic characteristics, and social-emotional symptoms. Caregivers also rated their own perceived stress, and COVID-related household and service disruption. According to caregivers, youth experienced more autistic characteristics and social-emotional concerns during the pandemic. Autistic youth were also reported to experience poorer overall mental health during the pandemic than before the pandemic. Older youth whose caregiver's indicated higher perceived stress and greater household disruption were reported to experience more autistic traits during pandemic. Caregiver-reported increases in youth social-emotional symptoms (i.e., behavior problems, anxiety, and low mood) was associated with being older, the presence of a pre-existing mental health condition, higher caregiver stress, and greater household and service disruption. Finally, experiencing less household financial hardship prior to COVID-19, absence of a pre-existing psychiatric condition, less caregiver stress, and less service disruption were associated with better youth pandemic mental health. Strategies to support the autistic community during and following the pandemic need to be developed. The developmental-ecological factors identified in this study could help target support strategies to those autistic youth who are most vulnerable to mental health problems.

The Choice between Plasma-Based Common Coagulation Tests and Cell-Based Viscoelastic Tests in Monitoring Hemostatic Competence: Not an either-or Proposition.

There has been a significant interest in the last decade in the use of viscoelastic tests (VETs) to determine the hemostatic competence of bleeding patients. Previously, common coagulation tests (CCTs) such as the prothrombin time (PT) and partial thromboplastin time (PTT) were used to assist in the guidance of blood component and hemostatic adjunctive therapy for these patients. However, the experience of decades of VET use in liver failure with transplantation, cardiac surgery, and trauma has now spread to obstetrical hemorrhage and congenital and acquired coagulopathies. Since CCTs measure only 5 to 10% of the lifespan of a clot, these assays have been found to be of limited use for acute surgical and medical conditions, whereby rapid results are required. However, there are medical indications for the PT/PTT that cannot be supplanted by VETs. Therefore, the choice of whether to use a CCT or a VET to guide blood component therapy or hemostatic adjunctive therapy may often require consideration of both methodologies. In this review, we provide examples of the relative indications for CCTs and VETs in monitoring hemostatic competence of bleeding patients.

Supporting radiography clinical placements in Ireland during the COVID-19 pandemic: The practice educators perspective.

INTRODUCTION: The COVID-19 pandemic has significantly impacted healthcare services and the clinical learning environment. Several studies have investigated radiography students' experiences of clinical placement during the pandemic; however, few have investigated the Clinical Practice Educator's (CPEs) perspective. CPEs play a pivotal role in supporting clinical education. METHOD: A qualitative study was conducted using a purposeful sample of twenty-two CPEs, each working in a different Irish hospital. Four semi-structured focus groups were used to gather data. To maintain reasonable homogeneity, CPEs who were new to the role (n = 8) were assigned a separate focus group from experienced CPEs (n = 14). Inductive thematic analysis was applied. RESULTS: CPEs experienced role expansion, particularly in managerial and administrative aspects of the role. They described arranging COVID-19 vaccinations locally for radiography students and the complexities of student rostering during the pandemic. CPEs perceived the pandemic to have impacted students' emotional wellbeing with 'high anxiety levels' and 'loneliness' being reported. They also perceived issues with clinical readiness and the student transition to clinical practice. Many challenges were faced by CPEs including arranging clinical recovery time for numerous students when sites were already at full capacity, fewer learning opportunities due to decreased patient throughput and range of imaging examinations, social distancing constraints, resistance from staff to student placements, and a shortage of staff for student supervision. Flexibility, communication, and multi-level support helped CPEs to fulfil their role. CONCLUSION: The results provide insight into how CPEs supported radiography clinical placements during the pandemic and into the challenges faced by CPEs in their role. CPEs supported student placement through multi-level communication, teamwork, flexibility, and student advocacy. IMPLICATIONS FOR PRACTICE: This will aid understanding of the support mechanisms needed by CPEs to provide quality clinical placements.

A qualitative analysis of radiography students' reflective essays regarding their experience of clinical placement during the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic significantly impacted healthcare services and clinical placement for healthcare students. There is a paucity of qualitative research into radiography students' experiences of clinical placement during the pandemic. METHOD: Students in stages three and four of a 4-year BSc Radiography degree in Ireland wrote reflective essays regarding their experience of clinical placement during the COVID-19 healthcare crisis. Permission was granted by 108 radiography students and recent graduates for their reflections to be analysed as part of this study. A thematic approach to data analysis was used, allowing themes to emerge from the reflective essays. Two researchers independently coded each reflective essay using the Braun and Clarke model. RESULTS: Four themes were highlighted; 1) Challenges associated with undertaking clinical placement during the pandemic, such as reduced patient throughput and PPE-related communication barriers; 2) Benefits of clinical placement during the pandemic, in terms of personal and professional development and completing degree requirements to graduate without delay; 3) Emotional impact and 4) Supporting students in clinical practice. Students recognised their resilience and felt proud of their contribution during this healthcare crisis but feared transmitting COVID-19 to family. Educational and emotional support provided by tutors, clinical staff and the university was deemed essential by students during this placement. CONCLUSIONS: Despite the pressure hospitals were under during the pandemic, students had positive clinical placement experiences and perceived these experiences to have contributed to their professional and personal growth. IMPLICATIONS FOR PRACTICE: This study supports the argument for clinical placements to continue throughout healthcare crisis periods, albeit with additional learning and emotional support in place. Clinical placement experiences during the pandemic prompted a deep sense of pride amongst radiography students in their profession and contributed to the development of professional identity.

Reply to Bareille et al. Are Viscoelastometric Assays of Old Generation Ready for Disposal? Comment on "Volod et al. Viscoelastic Hemostatic Assays: A Primer on Legacy and New Generation Devices. J. Clin. Med. 2022, 11, 860".

We are pleased to see that Bareille et al. have written a Commentary: "Are viscoelastometric assays of old generation ready for disposal?" [...].

COVID-associated non-vasculitic thrombotic retiform purpura of the face and extremities: A case report.

SARS-CoV-2 infection can manifest many rashes. However, thrombotic retiform purpura rarely occurs during COVID-19 illness. Aggressive anti-COVID-19 therapy with a high-dose steroid regimen led to rapid recovery. This immunothrombotic phenomenon likely represents a poor type 1 interferon response and complement activation on the endothelial surface in response to acute infection.

An intersectional and social determinants of health framework for understanding Latinx psychological distress in 2020: Disentangling the effects of immigration policy and practices, the Trump Administration, and COVID-19-specific factors

Public Significance Statement This study finds that worries about deportation, perceptions of anti-Hispanic discrimination, and having higher levels of COVID-19-related financial and health concerns were significantly associated with increased psychological distress among Latinxs in Spring 2020, net of other covariates. Gender-stratified analyses reveal that worries about deportation, legal and citizenship status, and pandemic-related effects on personal lives and health increased distress among Latinas but not Latinos. This highlights the array of gendered impacts and social determinants of health affecting Latinx psychological well-being during the pandemic. The COVID-19 pandemic has disproportionately impacted U.S. communities of color, such as the Latino/x population. The pandemic coincides with other major contemporary structural factors affecting Latinxs, including the effects of U.S. immigration policies and President Trump's xenophobic rhetoric and priorities. Yet, the independent and simultaneous implications of the larger sociopolitical climate and specific COVID-19 concerns for Latinx mental health remain less clear. The present study uses an intersectional and social determinants of health framework to examine these relationships. Multivariable regression models were estimated with three waves of population-based panel data from the Pew American Trends Study (collected between 2019 and 2020) with Latinx adults (n = 1,132). We simultaneously examined how worries regarding deportation, respondents' citizenship and legal status, perceptions regarding the Trump Administration, anti-Hispanic discrimination, and pandemic-related concerns predicted variation in Latinx self-reported psychological distress, after adjusting for other important covariates. We also conducted analyses separately by gender. The results indicated that worrying about a family member or a friend being deported, perceiving higher anti-Hispanic discrimination, and viewing coronavirus as a threat to respondents' personal health and finances were significantly associated with higher levels of psychological distress. Stratified analyses revealed that gender filters the ways that some of these stressors affect the mental health of Latinas, such as perceived threats about deportation, compared to Latinos. Taken together, this work demonstrates the diverse social determinants shaping Latinx mental health in intersectional ways early in the pandemic.

Traumatic Proximal Femoral Fractures during COVID-19 Pandemic in the US: An ACS NSQIP® Analysis.

In order to determine the impact of COVID-19 on the treatment and outcomes in patients with proximal femoral fracture's (PFF), we analyzed a national US sample. This is a retrospective review of American College of Surgery's (ACS) National Surgical Quality Improvement Program (NSQIP) for patients with proximal femoral fractures. A total of 26,830 and 26,300 patients sustaining PFF and undergoing surgical treatment were sampled during 2019 and 2020, respectively. On multivariable logistic regression, patients were less likely to have 'presence of non-healing wound' (p < 0.001), functional status 'independent' (p = 0.012), undergo surgical procedures of 'hemiarthroplasty'(p = 0.002) and 'ORIF IT, Peritroch, Subtroch with plates and screws' (p < 0.001) and to be 'alive at 30-days post-op' (p = 0.001) in 2020 as compared to 2019. Patients were more likely to have a case status 'emergent', 'loss of ≥10% body weight', discharge destination of 'home' (p < 0.001 for each) or 'leaving against medical advice' (p = 0.026), postoperative 'acute renal failure (ARF)' (p = 0.011), 'myocardial infarction (MI)' (p = 0.006), 'pulmonary embolism (PE)' (p = 0.047), and 'deep venous thrombosis (DVT)' (p = 0.049) in 2020 as compared to 2019. Patients sustaining PFF and undergoing surgical treatment during pandemic year 2020 differed significantly in preoperative characteristics and 30-day postoperative complications when compared to patients from the previous year.

BENEFITS OF POST-OPERATIVE SPECIALIST GERIATRIC CARE FOR OLDER PATIENTS UNDERGOING ELECTIVE ORTHOPAEDIC SURGERY

Background: The Covid-19 pandemic changed work practices across many different healthcare institutions. The difficulties with cross-site transfers created an opportunity in our institution to provide on-site post-operative rehabilitation for older patients undergoing elective orthopaedic surgery. The aim of this study is to assess the impact of post-operative specialist geriatric care on older patients. Methods: This is a single-centre, retrospective study that received approval from the local hospital ethics committee. Data were collected on all patients admitted to the on-site specialist rehabilitation unit post-elective orthopaedic surgery between 1st May 2020 and 31st December 2021. Two patients in this group were excluded as they had not attended a pre-operative assessment clinic. Data were collected from hospital Information Technology platform, Bluespiers. Results: 76 patients, 18 males and 58 females, were included in this study. The median age was 80 years. In the specialist rehabilitation unit, evidence of cognitive impairment was established in 40.79% of cases, there were 3 cases of newly diagnosed dementia, a history of falls was identified in 32.89% of patients and 13.16% of patients were found to have sarcopaenia. The median length of stay in the rehabilitation unit was 25 days. 51.32% of patients were discharged home independently, 23.68% of patients went home with a new Home-Care Package (HCP), 15.79% of patients were discharged home with an existing HCP, 6.58% of patients were transferred for further treatment and 2.63% patients were discharged to residential care units. Conclusion: This data demonstrates a clear role for specialist geriatric care in elective rehabilitation, with a significant proportion of patients being discharged home independently. The benefits of a comprehensive geriatric assessment in the peri-operative setting include increased identification of cognitive impairment allowing appropriate implementation of brain health as well as identification of a history of falls, enabling falls risk assessment and management including bone health assessment.

A Modified PINN Approach for Identifiable Compartmental Models in Epidemiology with Application to COVID-19.

Many approaches using compartmental models have been used to study the COVID-19 pandemic, with machine learning methods applied to these models having particularly notable success. We consider the Susceptible-Infected-Confirmed-Recovered-Deceased (SICRD) compartmental model, with the goal of estimating the unknown infected compartment I, and several unknown parameters. We apply a variation of a "Physics Informed Neural Network" (PINN), which uses knowledge of the system to aid learning. First, we ensure estimation is possible by verifying the model's identifiability. Then, we propose a wavelet transform to process data for the network training. Finally, our central result is a novel modification of the PINN's loss function to reduce the number of simultaneously considered unknowns. We find that our modified network is capable of stable, efficient, and accurate estimation, while the unmodified network consistently yields incorrect values. The modified network is also shown to be efficient enough to be applied to a model with time-varying parameters. We present an application of our model results for ranking states by their estimated relative testing efficiency. Our findings suggest the effectiveness of our modified PINN network, especially in the case of multiple unknown variables.

High burnout among the South African orthopaedic community: a cross-sectional study

Background Burnout is epidemic among physicians, with the orthopaedic speciality displaying one of the highest rates of burnout in international studies. The burnout rate of the South African orthopaedic community is unknown. This study aimed to determine the prevalence and causes of burnout, as well as the coping mechanisms and associations with burnout, in South African orthopaedic surgeons and trainees. Methods We conducted a cross-sectional, secure, online survey of members of the South African Orthopaedic Association. The survey assessed demographic characteristics, workload, professional fulfilment and burnout (utilising the Stanford Professional Fulfilment Index), associated workplace distress conditions, causes of and coping strategies for burnout. A response was not compulsory for any question. Statistical analysis was performed to assess for independent associations with burnout. Results One hundred and fifty-six respondents, with a median age of 46.5 years (interquartile range [IQR] 37–58) participated. Ninety per cent (139 of 155) of respondents were male. Registrars accounted for 17% (27 of 155), while 83% (128 of 155) were qualified specialists. Respondents were in orthopaedic practice for a median of 17 years (IQR 9–28). Sixty per cent (76 of 127) practise in private, 17% (22 of 127) in public and 23% (29 of 127) in both sectors. The overall burnout rate was 72% (113 of 156). Burnout was associated with being the parent of young children and having fewer hours of sleep on call. Registrars were more likely to have burnout than consultants (OR 5.68, 95% CI 1.3–25.2). Gender, practice setting and subspeciality were not associated with burnout. Self-reported causes of burnout that were found to be associated with actual burnout were: ‘hours at work’, ‘lack of free time’ and ‘work–life imbalance’. No self-reported coping mechanisms were found to be protective in this cohort, but the use of alcohol as a coping mechanism was associated with an increased likelihood of burnout (OR 3.9, 95% CI 1.4–10.7). Respondents felt that the concurrent experience of the COVID pandemic at the time of running the survey reduced their experience of burnout. Conclusion The burnout rate in the South African orthopaedic community is 72%. Trainees were found to be particularly vulnerable. There appears to be a need to develop, assess and implement effective system-related initiatives aimed at reducing the burnout rate among orthopaedic surgeons and trainees in South Africa. Level of evidence: Level 4. © 2022 O’Connor M.

Relative Hypercoagulopathy of the SARS-CoV-2 Beta and Delta Variants when Compared to the Less Severe Omicron Variants Is Related to TEG Parameters, the Extent of Fibrin Amyloid Microclots, and the Severity of Clinical Illness.

Earlier variants of SARS-CoV-2 have been associated with hypercoagulability and an extensive formation of fibrin amyloid microclots, which are considered to contribute to the pathology of the coronavirus 2019 disease (COVID-19). The newer omicron variants appear to be far more transmissible, but less virulent, even when taking immunity acquired from previous infections or vaccination into account. We here show that while the clotting parameters associated with omicron variants are significantly raised over those of healthy, matched controls, they are raised to levels significantly lower than those seen with more severe variants such as beta and delta. We also observed that individuals infected with omicron variants manifested less extensive microclot formation in platelet-poor plasma compared with those harboring the more virulent variants. The measurement of clotting effects between the different variants acts as a kind of "internal control" that demonstrates the relationship between the extent of coagulopathies and the virulence of the variant of interest. This adds to the evidence that microclots may play an important role in reflecting the severity of symptoms observed in COVID-19.

BEREAVEMENT IN THE COVID-19 PANDEMIC: THE GRIEF EXPERIENCE OF AFRICAN AMERICAN & LATINO COMMUNITIES

Background: The COVID-19 pandemic death rate for African American and Latinx communities is twice as high as White Americans, leaving more loved ones to cope with the difficulties of bereavement. With already existing challenges, the COVID-19 pandemic has emphasized the need to understand the disproportionate struggles of people of color. Methods: To study the impact, we conducted the Survey of Bereavement After Covid-Related Death. In the current study, 267 participants answered online surveys, measuring loss characteristics, demographics, depression, grief, and an option for open-ended comments. Results: Grief and depression scores were predicted by kinship relationship, participant age, and time since loss, but were not predicted by gender, race, or ethnicity in regression analyses (grief: F = 6.38, p < .001;depression: F = 5.30, p < .001). However, the sample was not representative of the current population, with fewer African Americans and Hispanic/Latinx individuals than in the community. Conclusion: Pandemic grief severity and depression following bereavement is predicted by factors seen in pre-pandemic grief research. However, the study revealed that there are still significant challenges among recruiting underrepresented populations in academic research, indicating that further research is necessary.

GRIEF AND LOSS DURING THE COVID-19 PANDEMIC: EXPLORING PERCEIVED PHYSICAL HEALTH AS A PREDICTOR FOR RUMINATION

Background: Ruminative thought predicts complicated grief and hinders the adjustment to loss by acting as a cognitive avoidance strategy. Not only is the process linked to psychological issues, rumination is also associated with negative health consequences, such as poor sleep quality, impaired immune functioning, and cardiovascular disease. Understanding how bereaved people adjust to the death of a loved one, and the associated physical and psychological health outcomes, can offer meaningful direction for interventions. Self-reported physical health has been shown to be indicative of documented physical health. Very few studies have investigated the potential relationship between self-reported physical health and rumination, especially in the bereaved population. Methods: Arizonans who experienced the death of a partner, child, sibling, parent, grandparent, other family member, non-biological family, or close friend in the past year were recruited for a semi- structured phone interview, during which they reported their grief severity, depressive symptoms, grief-specific rumination, and perceived physical health. Results: In the present study (N = 51), we tested whether perceived physical health acts as a predictor for grief-specific rumination in bereaved individuals who experienced the death of a loved one during the COVID-19 pandemic. Participants (74.5% White, 80.4% non-Hispanic) had an average age of 51 (SD = 15.9) and were mostly female (76.5%). Linear regression analyses showed that self-reported physical health predicted grief rumination outcomes (F = 4.0, p = 0.005). Notably, self-reported physical health also predicted grief severity (F = 4.0, p < 0.005) and depression (F = 5.2, p < 0.001). Conclusion: These results are consistent with previous findings that engagement in ruminative thought is associated with poorer health. Using self-report measures to assess physical health may offer accessible insights related to psychological health outcomes-especially in a time of social distancing.