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Background: The 2021 EAACI Biological Guidelines note safety of omalizumab use during rhinovirus infections, but data on initiation of this biologic therapy for patients with resistant chronic spontaneous urticaria (rCSU) during the SARS-CoV- 2 pandemic and uptake of COVID-19 vaccination are scarce. This study evaluated: 1) safety of omalizumab initiation and continuation during the pandemic;2) rate of COVID-19 positivity in patients on omalizumab therapy and 3) COVID-19 vaccine uptake among patients on biologic therapy. Method(s): A department-held database identified patients who started omalizumab for rCSU between 1 March 2020 and 31 December 2021, and those who contracted COVID-19 infection and their vaccination status. Result(s): Forty-one patients (median age 42 years, 85% females) with rCSU (baseline UAS7 > 28) were started on omalizumab therapy (300mg subcutaneous once every 28 days, 6 doses/cycle), and 17 (41%) were transferred to home care. A total of 316 doses were used with no anaphylaxis events. Nineteen patients had excellent response (UAS < 6) and remained on treatment (53% patients on 2nd cycle), including two patients now on 4th cycle having required almost continuous biologic therapy. A total of 22 patients had stopped omalizumab, 14 having responded to therapy (12 patients had complete response in cycle 1 and two patients in cycle 2) while 8 patients were non-responders (20% overall non-responders;7 patients within cycle 1 and one in cycle 2). Seven patients (17%) tested positive for SARS-CoV- 2 (PCR) whilst on omalizumab therapy, but none had severe illness or required hospitalisation. 90% of patients had at least 1 dose of COVID-19 vaccine, while 27 patients (66%) had 3 doses (2 primary and 1 booster). All patients deferred omalizumab for a week after COVID-19 vaccination. Ninety-eight vaccine doses were given including 64 doses of BNT162b2 mRNA (Pfizer-BioNTech) vaccine, followed by AstraZeneca at 33 doses and 1 dose of Moderna vaccine. One patient had worsening of severe urticaria after first dose of AZ vaccine, and refused further vaccines, subsequently contracted SARS-CoV- 2 whilst on omalizumab therapy. Yet another patient who was never vaccinated having stopped omalizumab after complete response (2nd cycle), subsequently tested positive for SARS-CoV- 2 but did not report relapse of urticaria. Conclusion(s): Omalizumab therapy was safe and effective in rCSU and none of the patients who contracted SARS-CoV- 2 on the biological therapy developed severe illness. (Table Presented).
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In the past, it was believed that investors may generate abnormal returns (AR) for trading stocks by employing technical trading rules. However, since the COVID-19 pandemic broke out, stock markets around the world seem to suffer a serious impact. Therefore, whether investors can beat the markets by applying technical trading rules during the period of COVID-19 pandemic becomes an important issue for market participants. The purpose of this study is to examine the profitability of trading stocks with the use of technical trading rules under the COVID-19 pandemic. By trading the constituent stocks of DJ 30 and NASDAQ 100, we find that almost all of the trading rules employed in this study fail to beat the market during the COVID-19 pandemic period, which is different from the results in 2019. The revealed findings of this study may shed light on that investors should adopt technical trading with care when stock markets are seriously affected by black swan events like COVID-19. © 2023 World Scientific Publishing Company.
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Background: COVID-19 vaccines are safe & effective, though patients with rheumatic diseases like idiopathic inflammatory myositis (IIMs), and those with multiple comorbidities continue to be hesitant. Adverse events after vaccination are not extensively studied in those with multiple coexisting autoimmune diseases. Patients with IIM often have multiple autoimmune rheumatic and autoimmune non-rheumatic comorbidities (IIM-AIDs), with potentially increased risk of AEs. The COVAD study aimed to assess COVID-19 vaccination-related AEs till 7 days post-vaccination in IIM-AIDs compared to IIMs and healthy controls (HCs) group. Method(s): T he C OVAD s tudy g roup c omprised > 110 c ollaborators across 94 countries. The study was conducted from March-December 2021. A survey monkey platform-based self-reported online survey captured data related to COVID-19 vaccination-related AEs in IIMs, AIDs, and HCs. We compared COVID-19 vaccination-related AEs among IIM-AID patients and IIM alone and HCs, adjusting for age, gender, ethnicity, vaccine type, immunosuppression, and numbers of AIDs, using binary logistic regression. Statistically significant results following multivariate regression are reported. Result(s): Among 6099 participants, 1387 (22.7%) IIM, 4712 (77.2%) HC, 66.3% females, were included from 18 882 respondents: 573 (41.0%) people with IIM-AIDs;814 (59.0%) with IIM without other AIDs;and 4712 HCs. People with IIM were older [median 54 (45-66) IIM-AIDs, 64 (50-73) IIM, 34 (26-47) HC years, P < 0.001]. BNT162b2 (Pfizer) (37.5%) and ChAdOx1nCoV-19 (Oxford) (11.1%) were the most common vaccines. When compared to IIM alone, IIM-AID patients reported higher overall AEs [OR 1.5 (1.1-2.1)], minor AE [OR 1.5 (1.1-2.1)] &major AE [OR 3 (1.5-5.8)]. IIM-AIDs patients also reported higher body ache, nausea, headache, & fatigue (OR ranging 1.3-2.3). After adjusting for the number of AIDs, the major AEs equalized but overall AEs, & minor AEs, such as fatigue remained higher. When compared to HCs, IIM-AIDs patients reported similar overall AEs, minor AEs but higher major AEs [OR 2 (1.2-3.3)] nausea/ vomiting [OR 1.4 (1.01-2)], headache [OR 1.2 (1.01-1.6)], and fatigue [OR 1.3 (1.03-1.6)]. Dermatomyositis with AIDs (n = 183) reported higher major AEs [OR 4.3 (1.5-12)] compared to DM alone (n = 293). Active IIM with AIDs (n = 482) reported higher overall AEs [OR 1.5 (1.1-2.2)], minor AEs [OR 1.5 (1.1-2.2)] and major AEs [OR 2.6 (1.2-5.2)] compared to active IIM alone (n = 643). Conclusion(s): COVID-19 vaccination is safe with minimal to no risks of short-term AEs in patients with IIM without other concomitant autoimmune diseases. The presence of autoimmune multimorbidity conferred higher self-reported short-term risks of overall, major, and minor COVID-19 vaccination-related AEs 7 days post-vaccination, particularly in those with active IIM.
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P73 Table 1Results from questionnaires. Median values reported.*only assessed in CFQ-R for subjects over 14 years of age (n=12)Type Domain Pre Post P value Median CFQ-R (n=16) Physical 87.5 95.83 0.116 Emotion 68.75 80 0.124 Eat 100 100 0.57 Treatment 72.17 66.67 0.346 Social 66.67 71.83 0.532 Body 88.89 88.89 0.811 Respiratory 83.33 93.06 0.006 Digestive 83.34 94.45 0.107 Role* 83.33 91.67 0.084 Weight* 83.34 100 0.131 Vitality* 58.33 66.67 0.833 Health* 66.67 83.34 0.082 Median PEI-Q(n=16) Abdominal symptom score (A) 0.93 0.71 0.38 Bowel movement score (B) 0.25 0 0.119 Total symptom score 0.58 0.405 0.018 Impacts (C) 0 0 0.564 Total summary score 0.375 0.27 0.02 Median WEMWBS(n=16) 50 51 0.895 ConclusionThe assessment tools used in this study usefully identified improvements in gastrointestinal and respiratory symptoms. The lack of change in indices of mental well-being is probably a result of relatively good mental health in this age group prior to CFTR modulator treatment and may have been influenced by the impact of the COVID pandemic during which this study was conducted.
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INTRODUCTION: Major progress has been made in treatment of patients with hemophilia over the last 30 or 40 years. Factor replacement, eliminating HIV and hepatitis C transmission, and more recently, longer-acting coagulation factors and immune treatments play a role in allowing patients with hemophilia to experience a longer and healthier life. Previous studies show that invasive procedures like colonoscopies, bronchoscopies or biopsies can safely be performed in patients with hemophilia if an appropriate factor replacement is given. However, because of their risk of bleeding, patients with hemophilia may be reluctant to undergo such invasive procedures or get recommended health maintenance, and these fears may have been worsened by the outbreak of COVID19. Therefore, we wondered if older patients with hemophilia have been impacted by the COVID19 pandemic and have received the recommended vaccinations and cancer screenings. METHODS: The data for this study originates in the hemophilia clinics of two academic centers in Kentucky (University of Louisville and University of Kentucky). IRB approval was obtained in both institutions. Surveys were mailed or emailed to patients 50 years of age or older in our database. Follow-up phone calls were made to patients who did not respond. The surveys had 17 health related questions focusing on general well-being, pain, smoking, cancer screening, vaccinations and COVID19. The original survey was performed between 11/2020 and 3/2021 and COVID19 vaccination status was updated in 7/2021. Overall, 50 patients in our database met the study criteria (hemophilia and age 50 years or older) and 36 responded (72%). Some patients did not answer all questions. Patient details are given in Table 1. Median age was 61 years, most patients had mild to moderate hemophilia, three patients were positive for HIV (all with a negative viral load), and 12 had been infected with hepatitis C. Questions related to the impact of COVID19 explored anxiety of leaving the house, meeting with other people, availability of medical appointments, and getting necessary medications. Patients were asked if they received an influenza vaccination and, if older than 60 years, if they had received a pneumonia vaccination. RESULTS: Overall, most patients reported a good quality of life (Table 2). Nevertheless, most were often or always in pain. About half of the patients were on opioid pain medication. A minority took only over the counter pain medication or no pain medication. 57% of respondents had received both vaccinations for COVID19, two-thirds of the unvaccinated planned to get it. 55% of respondents had undergone a colonoscopy in the previous 5 years. Only 18% identified themselves as current smokers. Few men had undergone screening for prostate cancer. Finally, 5 of 32 patients reported a previous diagnosis of cancer (3 patients with localized skin cancer, 2 patients with head and neck cancers). CONCLUSIONS: Quality of life in patients with hemophilia is self-reported as good or excellent in most older patients. However, chronic pain problems persist and are not always sufficiently controlled. One reason may be that many of our patients did not have consistent factor replacements early in their life. Only a minority of patients reported a psychological or physical impact of the COVID19 lockdown. Most patients as of June or July 2021 have been vaccinated against COVID19, however this is probably lower than in an age-matched group. Mayo Clinic's vaccine tracker reported a vaccination rate of 92.3% for the 65 and older age group in Kentucky (as of July 31 st of 2021). The rate of influenza vaccination is probably comparable to rates in other rural communities. The same applies to cancer screening by colonoscopy and PSA screening. The rate of smoking of 18% is relatively low but may suffer from under-reporting. Overall, health maintenance in older patients with hemophilia appears acceptable but can certainly be improved. Limitations of our study are small sample size and that most patients have mild to moderate hemo hilia. We plan to expand our study to other centers to get more insight into health issues in older patients with hemophilia. [Formula presented] Disclosures: No relevant conflicts of interest to declare.
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We evaluated the impact of the current COVID-19 pandemic and systemic racism on Underrepresented Minority (URM) students pursuing higher education in the STEM fields. Given the ongoing pandemic and the wave of protests in response to a series of police brutalities and systemic racism, URM students were thrown into uncharted territory. We reached out to a group of Black and Latino students who were already engaged in STEM. We began surveys and interviews by asking participants how they were and how their family and communities were doing. Next, participants answered questions about academic progress, challenges, and what support would be helpful. Our framework was based on a mixed-methods approach that draws on the work of Michael Patton (Qualitative Research & Evaluation Methods: Integrating Theory and Practice, 2014) and Veronica Thomas (American Journal of Evaluation, 2016, 38 (1), 7–28). Qualitative data from interviews were collected to capture perceptions, experiences, and recommendations of the study participants. Survey data were collected to reach as many students as possible and to provide numerical self-assessments of student experience, progression, and obstacles. All qualitative data were coded thematically using Atlas. ti, with the goal of illuminating emerging themes, and quantitative data were reviewed using descriptive statistics. Themes emerging from both data sets were compared, contrasted, and integrated in order to develop consistent findings that would enhance URM student perseverance and persistence in the face of confounding adversities. This study shows that ILSAMP COVID-19 Study participants maintained a commitment to pursuing a career in STEM. The findings of this study also indicate that the participants are stressed by their immediate circumstances and by the ongoing racism of U.S. society. These students ask for additional financial, academic, and networking support during the disruptions caused by the pandemic. More specifically, students request continued advising and connection with STEM professionals who can help them envision and enact a pathway to their own careers in STEM during this tumultuous period. The study validates the importance of key elements of the national LSAMP model as reported by Clewell et al. (Revitalizing the Nation’s Talent Pool in STEM, 2006). These are: academic integration, social integration, and professional integration. In addition, it identifies several other factors that are key to student success, including interventions that directly address racial trauma and economic hardship. © Copyright © 2021 Botanga, Blanc, Jones, Day and Charles.