Exploring PM2.5 variations from calibrated low-cost sensor network in Greater Kampala, during COVID-19 imposed lockdown restrictions: Lessons for Policy

Air pollution is considered a major public health risk globally, and the global South including sub-Saharan Africa face particular health risks, but there is limited data to quantify the level of pollution for different air quality contexts. The COVID-19 lockdown measures led to reduced human activities, and provided a unique opportunity to explore the impacts of reduced activities on urban air quality. This paper utilises calibrated data from a low-cost sensor network to explore insights from the diverse ambient air quality profile for four urban locations in Greater Kampala, Uganda before and during lockdown from March 31 to May 5 2020, highlighting the uniqueness of air pollution profiles in a sub-Saran Africa context. All locations saw year to year improvements in 24-hour mean PM2.5 between 9 and 25µg/m3 (i.e. 17-50% reduction from the previous year) and correlated well with reduction in traffic (up to approx. 80%) and commercial activities. The greatest improvement was observed in locations close to major transport routes in densely populated residential areas between 8 pm and 5 am. This suggests that the reduction in localised pollution sources such as nocturnal polluting activities including traffic and outdoor combustion including street cooking characteristic of fast-growing cities in developing countries, coupled with meteorological effects led to amplified reductions that continued well into the night, although meteorological effects are more generalised. Blanket policy initiatives targeting peak pollution hours could be adopted across all locations, while transport sector regulation could be very effective for pollution management. Likewise, because of the clustered and diffuse nature of pollution, community driven initiatives could be feasible for long-term mitigation. © 2022

Prior sars-cov-2 infection is associated with subclinical changes in the cardiovascular morphology, function, energetics and exercise capacity

Background: COVID-19 has documented multisystem effects. Whether clinically significant cardiac involvement is related to severity of disease in a working age military population remains unknown, but has implications for occupational grading and ability to deploy. Aims: To determine in the military population 1) whether prior SARS-CoV-2 infection causes clinically significant cardiac disease and 2) whether changes are related to disease severity. Methods: 105 military personnel were recruited, 85 with prior SARS-CoV-2 infection (39±10 years, 87% male;50 mild (community), 35 severe (hospitalized) and 20 healthy volunteers (mean age 39 ±8.4 years, 90% male) underwent comprehensive cardiopulmonary investigations including;cardiopulmonary exercise test, exercise echocardiography, cardiac31MRI and P-MR spectroscopy (rest and dobutamine stress). Results: Prior SARS-CoV-2 infection was related to lower VO2max (110±18.2 vs 133±6.7% predicted, p<0.05), anaerobic threshold (45±10 vs 56±14% of peak VO2, p<0.05), VO2/HR (102±21 vs 128±24% predicted, p<0.05) and VE/VCO2 slope (28.3±5.0 vs 25.8±2.7, p<0.05) and an increase in average E/e' change from rest to exercise stress (+1.49±2.4 vs-0.16±3.6, p<0.05). Whilst resting myocardial energetics were similar, prior SARS-CoV-2 infection was associated with a fall in PCr/ATP during stress (by 8%, p=<0.01) which was not seen in healthy controls. When groups were ordered normal> mild> severe disease, RVEDVi, RV stroke volume, VO2peak, VO2pulse and VE/VCO slope were reduced (Jonckheere-Terpstra, all p<0.05). Conclusion: In a young military population, prior SARS-CoV-2 infection is associated with subclinical cardiovascular changes including;lower right ventricular volumes, reduced markers of exercise capacity and reduced myocardial energetics during stress.

AN INTERNATIONAL REPORTING REGISTRY OF PATIENTS WITH CELIAC DISEASE AND COVID-19: INITIAL RESULTS FROM SECURE-CELIAC

Background: As the COVID-19 pandemic continues, there are questions about whether patients with celiac disease (CD) are at increased risk for severe outcomes. Prior studies have shown that patients with CD have a higher risk of developing zoster and complications from influenza and pneumococcal pneumonia, risks that persist after adoption of the gluten free diet. To study the outcomes of COVID-19 in patients with celiac disease, we created a secure, online, de-identified adult and pediatric reporting registry. Methods: The SECURECeliac registry (www.covidceliac.org) was established on March 31, 2020 and promoted via physician email lists, national societies, and word-of-mouth. Clinicians worldwide are encouraged to report all cases of COVID-19 in patients with celiac disease, regardless of severity. (Only confirmed cases of COVID-19, either through viral PCR swab or serology testing, are eligible to be reported in the registry.) Clinicians were counseled to report confirmed cases only after a minimum of 7 days and sufficient time had passed to observe the disease course through resolution of acute illness or death. A choropleth map to illustrate geographic differences in reported cases of COVID-19 in those with CD was created using QGIS and an interactive online website was created using ARCGIS to visualize current data by time, country, age, sex, hospitalizations, and deaths. Results: Between March 31, 2020 and November 20, 2020, there have been 84 cases of COVID-19 reported in patients with celiac disease. Countries across five continents are represented in the registry: Asia, Australia, Europe, North America and South America (Figure 1). 86% of patients (N = 72) did not require hospitalization for COVID-19 while 14% did (N = 12). 1% of patients (N = 1) required ICU-level care while 1% of patients (N = 1) died from COVID-19. Patients who were hospitalized tended to be older (45.8y vs 39.4y, p= 0.2) and have at least one comorbidity (50.0% vs 31.9%, p= 0.3). Patients who were hospitalized were also less likely to adhere to a strict gluten-free diet (41.7% vs 65.3%, p=0.2). Patients with gastrointestinal symptoms were more likely to be hospitalized (66.7% vs 31.9%, p = 0.03). An online dashboard with interactive map displaying the current global distribution of patients with CD and COVID-19 is found here: www.covidceliac.org/map Conclusions: Preliminary data from the SECURECeliac registry does not suggest increased risk of severe outcomes in patients with celiac disease who contract COVID-19. Gastrointestinal symptoms were associated with hospitalization for COVID-19. The registry remains open for clinicians to contribute to this reporting system so as to better define the impact of COVID-19 on patients with celiac disease and how factors such as age, comorbidities, and treatments impact COVID-19 outcomes.(Image Presented)(Table Presented)

Estimating visual difference between reproduction gamuts: Moving our pilot study from the lab to online delivery

Images reproduced for different output devices are known to be limited in the range of colours that can be reproduced. It is accepted that reproductions made with different print processes, and on different substrates, will not match, although the overall reproduction appearance can be optimized using an output rendering. However, the question remains: how different are they visually? This paper reports on a pilot study that tests whether visual difference can be reduced to a single dimensional scale using magnitude estimation. Subject to recent Covid restrictions, the experiment was moved from the lab to an online delivery. We compare the two methods of delivery: in-person under controlled viewing conditions, and online via a web-based interface where viewing conditions are unknown. © 2021 Society for Imaging Science and Technology.

Views of patients with inflammatory bowel disease on the safety of biologics and vaccination during the covid-19 pandemic

Introduction: The American Gastroenterological Association (AGA) guidelines recommend continuing the use of biologics in those who have not tested positive for COVID-19 and are asymptomatic. 1 This study evaluated the views of patients with IBD on biologics and COVID-19 vaccination during the COVID-19 pandemic. Methods: We surveyed 204 participants through Amazon Mechanical Turk that fulfilled the inclusion criteria of: >18 years old, diagnosed with IBD, and on a biologic. The study was approved by the institutional review board. A five-point Likert scale was used to gauge participants' level of understanding of the risks and benefits of biologics during the pandemic. Participants were also asked what they would do with their biologic if tested positive for COVID-19 and their willingness to accept the COVID-19 vaccine. Descriptive statistics were used to analyze data. Results: Majority of the participants were male (60.1%), under the age of 50 (95.1%), had at least a high school degree/GED (99%), and were insured (90.6%). Participants reported moderate understanding (mean±SD, 2.8±1.1) of the risks and benefits of biologic use for IBD during the COVID-19 pandemic. A remarkable number of participants, 43.6%, reported stopping their biologic due to fear of contracting COVID-19. Also, the majority of participants would “somewhat” agree to be vaccinated against COVID-19 vaccine if the vaccine is available to them (mean±SD, 2.0±1.1) and their attitude toward the vaccination did not change even if their gastroenterologists were to recommend the vaccine (Table 1). Conclusion: Despite recommendations from the AGA to continue one's biologic, a significant number of participants reported either decreasing their dose or stopping their biologic. The participants also reported only a “moderate understanding” of the risks and benefits of using biologics during the pandemic. Most striking, participants' attitude towards receiving a COVID-19 vaccine did not change even if a gastroenterologist were to recommend it. Thus, there is a need to evaluate each patient's biologic compliance and educate patients on the impact of COVID-19 on their treatment plan at their gastroenterology appointments. Further inquiry at appointments is also needed to understand vaccination hesitancy.

Age differences in the association of comorbid burden with adverse outcomes in SARS-CoV-2.

BACKGROUND: Older age and comorbid burden are both associated with adverse outcomes in SARS-CoV-2, but it is not known whether the association between comorbid burden and adverse outcomes differs in older and younger adults. OBJECTIVE: To compare the relationship between comorbid burden and adverse outcomes in adults with SARS-CoV-2 of different ages (18-64, 65-79 and ≥ 80 years). DESIGN, SETTING, AND PARTICIPANTS: Observational longitudinal cohort study of 170,528 patients who tested positive for SARS-CoV-2 in the US Department of Veterans Affairs (VA) Health Care System between 2/28/20 and 12/31/2020 who were followed through 01/31/2021. MEASUREMENTS: Charlson Comorbidity Index (CCI); Incidence of hospitalization, intensive care unit (ICU) admission, mechanical ventilation, and death within 30 days of a positive SARS-CoV-2 test. RESULTS: The cumulative 30-day incidence of death was 0.8% in cohort members < 65 years, 7.1% in those aged 65-79 years and 20.6% in those aged ≥80 years. The respective 30-day incidences of hospitalization were 8.2, 21.7 and 29.5%, of ICU admission were 2.7, 8.6, and 11% and of mechanical ventilation were 1, 3.9 and 3.2%. Median CCI (interquartile range) ranged from 0.0 (0.0, 2.0) in the youngest, to 4 (2.0, 7.0) in the oldest age group. The adjusted association of CCI with all outcomes was attenuated at older ages such that the threshold level of CCI above which the risk for each outcome exceeded the reference group (1st quartile) was lower in younger than in older cohort members (p < 0.001 for all age group interactions). LIMITATIONS: The CCI is calculated based on diagnostic codes, which may not provide an accurate assessment of comorbid burden. CONCLUSIONS: Age differences in the distribution and prognostic significance of overall comorbid burden could inform clinical management, vaccination prioritization and population health during the pandemic and argue for more work to understand the role of age and comorbidity in shaping the care of hospitalized patients with SARS-CoV-2.

Risk of adverse outcomes in hospitalized patients with autoimmune disease and covid-19: A matched cohort study from new york city

Objective: To examine the impact of autoimmune disease on the composite outcome of intensive care unit admission, intubation, or death, from COVID-19 in hospitalized patients. Methods: Retrospective cohort study of 186 patients hospitalized with COVID-19 between March 1st-April 15th, 2020 at New York-Presbyterian Hospital/Columbia University Irving Medical Center. The cohort included 62 patients with autoimmune disease and 124 age-and sex-matched controls. The primary outcome was a composite of intensive care unit admission, intubation, and death, with secondary outcome assessing time to in-hospital death. Baseline demographics, comorbidities, medications, vital signs, and laboratory values were collected. Conditional logistic regression and Cox proportional hazards regression were used to assess the association between autoimmune disease and clinical outcomes. Results: Patients with autoimmune disease were more likely to have at least one comorbidity (25.8% vs. 12.9%, p=0.03), take chronic immunosuppressive medications (66.1% vs. 4.0%, p<0.01), and have had a solid organ transplant (16.1% vs. 1.6%, p<0.01). There were no significant differences in intensive care unit admission (14.2% vs. 19.4%, p=0.44), intubation (14.2% vs. 17.7%, p=0.62) or death (17.5% vs. 14.5%, p=0.77). On multivariable analysis, patients with autoimmune disease were not at an increased risk for a composite outcome of intensive care unit admission, intubation, or death (adjOR 0.79, 95%CI 0.37-1.67). On Cox regression, autoimmune disease was not associated with in-hospital mortality (adjHR 0.73, 95%CI 0.33-1.63). Conclusion: Among patients hospitalized with COVID-19, individuals with autoimmune disease did not have an increased risk of a composite outcome of intensive care unit admission, intubation, or death.

Dealing With Isolation Using Online Morning Huddles for University Lecturers During Physical Distancing by COVID-19: Field Notes

Isolation can affect our well-being negatively. To prevent the spread of the infection COVID-19, many workers, including university lecturers, are required to work from home. In order to maintain high levels of well-being and team cohesion, academics at the University of Derby Online Learning initiated a virtual huddle to briefly socialise and check on their colleagues' well-being every morning. This piece of field notes reports the context (COVID-19 in the United Kingdom), the details of this morning socialization, the first-hand experience of attending this huddle, and possible applications. Perceived positive impacts of our huddles include better well-being, cultivating compassion in team culture, and enhanced team cohesion. These advantages can be also useful in student supervision, wider socialization with colleagues to counter the silo mentality, and other occupational sectors. Our field notes will be helpful for lecturers and other types of employees who work collaboratively yet in isolation during this uncertain and challenging time of crisis.