ABSTRACT
Introduction: COVID-19 was declared a global pandemic in March 2020 and drastically changed daily life with ensuing stay-at-home orders. Studies have shown that adherence to healthy diet and exercise declined during this time. Internet search query data has been used to understand public interest in health-related behaviors such as smoking cessation. Therefore, the aim of this study was to examine whether internet searches for weight loss and bariatric interventions increased at the height of the pandemic. Methods: Google Ads Keyword Planner, a publicly available online tool, was used to obtain the search volumes for the keywords “weight loss,” “bariatric surgery,” “endoscopic weight loss procedure,” “gastric balloon,” and “endoscopic sleeve gastroplasty” per month from November 2017- October 2021. Search volumes were identified globally and by country (US, France, Spain, and Italy). Results: Globally, Google searches for “weight loss” peaked to 1,830,000 queries in April 2020, a 122% increase from April 2019 (Fig. 1a). By country, “weight loss” searches increased in April 2020 by 83% (1.8-fold) in the US, 311% (4-fold) in France, 679% (7.8- fold) in Spain, and 236% (3.4-fold) in Italy compared to the year prior (Fig. 1b,1c). Globally, average searches per month for “weight loss” from Mar 2020-Sep 2021 compared to prepandemic searches increased by 58% (Fig 1a). In the US, average monthly searches from Jul 2020-Sep 2021 increased by 43% for “bariatric surgery,” 16% for “gastric balloon,” 116% for “endoscopic sleeve gastroplasty,” and 309% for “endoscopic weight loss procedure” compared to Nov 2017-Jun 2020 averages (Fig. 2). Discussion: The COVID-19 pandemic heightened public interest in weight loss and endoscopic interventions. Several studies have shown that even one month into national lockdowns, people were reporting decreased physical activity, increased snack and alcohol consumption, and weight gain. This may have led to a rise in weight loss Google searches to combat these. Concurrently, research linking obesity with severe COVID-19 was publicized which may have contributed to an interest in weight loss. Elective procedures resumed in most hospitals in the US in summer 2020, possibly explaining the relative peaks in searches for bariatric procedures in July. Notably, interest in both weight loss and bariatric procedures not only increased during the height but have also remained elevated in 2021 as the planet slowly returns to a new normal. Furthermore, while total search volume is higher for ""bariatric surgery,"" there is clearly a rapidly rising interest in endoscopic procedures especially after July 2020. These data present an opportunity for gastroenterologists to provide continued patient education on optimal weight loss strategies varying from lifestyle modification, pharmacologic therapy, endobariatric therapy, and bariatric surgery. (Figure Presented) Figure 1. Google search volumes by month for the search query “weight loss” globally (1a), in the United States (1b), and in Europe (1c) from November 2017-September 2021 (Figure Presented) Figure 2. Google search volume by month for the search queries “bariatric surgery,” “endoscopic weight loss procedure,” “gastric balloon,” and “endscopic sleeve gastroplasty” in the United States from November 2017-September 2021
ABSTRACT
Background. Sharp declines in influenza and respiratory syncytial virus (RSV) circulation across the U.S. have been described during the pandemic in temporal association with community mitigation for control of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We aimed to determine relative frequencies of rhinovirus/ enterovirus (RV/EV) and other respiratory viruses in children presenting to emergency departments or hospitalized with acute respiratory illness (ARI) prior to and during the COVID-19 pandemic. Methods. We conducted a multi-center active prospective ARI surveillance study in children as part of the New Vaccine Surveillance Network (NVSN) from December 2016 through January 2021. Molecular testing for RV/EV, RSV, influenza, and other respiratory viruses [i.e., human metapneumovirus, parainfluenza virus (Types 1-4), and adenovirus] were performed on specimens collected from children enrolled children. Cumulative percent positivity of each virus type during March 2020-January 2021 was compared from March-January in the prior seasons (2017-2018, 2018-2019, 2019-2020) using Pearson's chi-squared. Data are provisional. Results. Among 69,403 eligible children, 37,676 (54%) were enrolled and tested for respiratory viruses. The number of both eligible and enrolled children declined in early 2020 (Figure 1), but 4,691 children (52% of eligible) were enrolled and tested during March 2020-January 2021. From March 2020-January 2021, the overall percentage of enrolled children with respiratory testing who had detectable RV/EV was similar compared to the same time period in 2017-2018 and 2019-2020 (Figure 1, Table 1). In contrast, the percent positivity of RSV, influenza, and other respiratory viruses combined declined compared to prior years, (p< 0.001, Figure 1, Table 1). Figure 1. Percentage of Viral Detection Among Enrolled Children Who Received Respiratory Testing, New Vaccine Surveillance Network (NVSN), United States, December 2016 - January 2021 Table 1. Percent of Respiratory Viruses Circulating in March 2020- January 2021, compared to March-January in Prior Years, New Vaccine Surveillance Network (NVSN), United States, March 2017 - January 2021 Conclusion. During 2020, RV/EV continued to circulate among children receiving care for ARI despite abrupt declines in other respiratory viruses within this population. These findings warrant further studies to understand virologic, behavioral, biological, and/or environmental factors associated with this continued RV/EV circulation.
ABSTRACT
Background. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with increased morbidity and mortality in immunocompromised individuals, including solid organ transplant recipients (SOTR). Despite being excluded from phase 1-3 SARS-CoV-2 vaccine clinical trials, SOTR were identified as high-risk populations and prioritized for vaccination in public health guidelines. We aimed to evaluate the antibody response to two doses of the BNT162b2 (Pfizer-BioNTech) vaccine in SOTR as compared to healthy controls (HC). Methods. SOTR and HC scheduled to receive two doses of BNT162b2 vaccine and able to complete required follow-up visits were enrolled. Blood specimens were collected from participants before receiving the first and second doses and 21-42 days after the second dose. Enzyme-linked immunosorbent assay (ELISA) was used to detect immunoglobulin G (IgG) to the SARS-CoV-2 spike receptor-binding domain (RBD). Generalized estimating equations with a working independence correlation structure were used to compare anti-RBD IgG levels between SOTR and HC at each study visit and within each group over time. All models were adjusted for age, sex, and pre-vaccination seroreactivity in the ELISA. Results. A total of 54 SOTR and 26 HC were enrolled, with mean (SD) ages of 72 (3.6) and 62 (6.7) years, 61% and 35% were male, and 91% and 88% were white, respectively. The most common organ transplant types were kidney (41%) and liver (37%). All SOTR were receiving calcineurin inhibitors. The median time post-transplantation was 7 years. SOTR had markedly lower mean anti-RBD IgG levels when compared to HC with adjusted mean differences of -0.76 (95%CI: [-1.04, -0.47];p < 0.001) ELISA units (EU) and -1.35 (95%CI [-1.68, -1.01];p < 0.001) EU after the first and second doses, respectively (Figure 1). Both groups had a significant increase in anti-SARS-CoV-2 IgG levels after the second dose. However, the magnitude was lower in SOTR, 0.49 (95%CI [0.31, 0.69];p < 0.001) EU than in HCs, 1.08 (95% CI [0.91, 1.24];p < 0.001) EU. Figure 1. Anti-SARS-CoV-2 RBD IgG levels in solid organ transplant recipients and healthy controls before receiving the BNT162b2 vaccine (baseline), post-vaccine dose 1, and post-vaccine dose 2. Conclusion. Our study showed SOTR mounted weaker humoral immune responses than HC to SARS-CoV-2 vaccines. Given a lower response, SOTR should continue to practice social distancing and masking until data on vaccine efficacy are available in this vulnerable population.
ABSTRACT
Background: Various respiratory molecular assays are available, each with different characteristics and advantages that make them uniquely valuable. The objective of this study was to compare rates of viral detection using singleplex and multiplex platforms in a research setting. Methods: A prospective viral surveillance study was conducted in Davidson County, TN. Infants under one year who presented with fever and/or respiratory symptoms were enrolled from the outpatient, emergency department and inpatient settings. Nasal swabs were collected and tested for influenza A (FluA), influenza B (FluB), human metapneumovirus (MPV), respiratory syncytial virus A and B (RSVA and RSVB), human adenovirus (AdV), parainfluenza 1, 2, 3, and 4 (PIV1-4) and SARS-2-CoV by both singleplex qPCR and the Luminex NxTAG Respiratory Pathogen and NxTAG CoV Extended panels. The rhinovirus/enterovirus, human bocavirus, Chlamydophila pneumoniae, Mycoplasma pneumoniae and coronavirus HKU1, NL63, 229E and OC43 results from the Luminex panel were excluded because singleplex qPCR was not performed on those targets. For singleplex qPCR results, cycle threshold (Ct) values were used as a surrogate for viral load, with a higher Ct value indicating a lower viral load. Results: A total of 112 nasal specimens were tested by both singleplex qPCR and Luminex, of which 65 were positive for at least one virus by either platform and 56 had a virus detected on both platforms (Figure 1). Seven specimens were positive by singleplex qPCR only and two were positive by Luminex only (Figure 1). The targets positive by singleplex qPCR only included FluB, RSVA, AdV and PIV2 and those positive by Luminex only included FluA H1N1 and RSVB (Figure 2). Specimens that were positive only on the singleplex assay had a higher average Ct value than those that were positive on both assays, indicating a lower viral load (Figure 3). Figure 1 Figure 2 Figure 3 Conclusion: The multiplex assay identified 89% of the total viruses detected while singleplex qPCR identified 97% of the total viruses detected. Lower viral loads may contribute to false negative results on the multiplex platforms. Future studies with larger sample sizes are needed in order validate our findings.
ABSTRACT
Background: One day after the pandemic was announced, Tennessee declared a state of emergency on March 12, 2020 with implementation of a stay-at-home order on March 23, 2020. Data regarding the routes and patterns of community transmission of SARS-CoV-2 are limited. We initiated an investigation after clusters of confirmed COVID-19 cases attended a large social gathering. Methods: We were notified of clinical providers who attended a “Silent School Auction” on March 7, 2020, of which several confirmed-cases were identified as targeted participants. To derive a standardized REDCap web-survey, we conducted a hypothesis-generating interview with three confirmed attendees to collect event details. Once finalized, enrollment included collecting sociodemographic, epidemiologic, and clinical data. Attendees were classified as: 1) confirmed if they had a positive SARS-CoV-2 test;2) suspected if they developed symptoms 21-days before or after the auction;and 3) asymptomatic if no symptoms were noted. Results: From March 20-June 16, 100/166 (60%) of attendees were enrolled, with a median age of 41 years, 54% female, and 99% white. Of those, 34 and 32 were confirmed- and suspect-cases, respectively. Table 1 compares sociodemographic behaviors of all attendees, with the majority of confirmed-cases eating late in the evening. From March 6 to March 8, 58 participants reported attending other social events, of which three (i.e., church service, women's retreat, and a birthday party) were common among 43 attendees and five individuals reported onset of mild respiratory symptoms prior to the event (Figure 1). Confirmed-cases were more likely to report having shortness of breath, chest tightness, loss of taste, loss of smell, and fever compared to suspect-cases (Figure 2) and no one required hospitalization. Dining tables from the school auction depicted a clustering of cases occurring at each table, with some individuals visiting more than one table during the event (Figure 3). Conclusion: We identified several COVID-19 cases from a single event that occurred prior to social mitigation strategies. Our investigation highlights the importance of staying home when sick and the significance of social distancing to halt transmission of COVID-19. (Table Presented).