Distinct Patterns of SARS-CoV-2 BA.2.87.1 and JN.1 Variants in Immune Evasion, Antigenicity and Cell-Cell Fusion (preprint)

The rapid evolution of SARS-CoV-2 variants presents a constant challenge to the global vaccination effort. In this study, we conducted a comprehensive investigation into two newly emerged variants, BA.2.87.1 and JN.1, focusing on their neutralization resistance, infectivity, antigenicity, cell-cell fusion, and spike processing. Neutralizing antibody (nAb) titers were assessed in diverse cohorts, including individuals who received a bivalent mRNA vaccine booster, patients infected during the BA.2.86/JN.1-wave, and hamsters vaccinated with XBB.1.5-monovalent vaccine. We found that BA.2.87.1 shows much less nAb escape from WT-BA.4/5 bivalent mRNA vaccination and JN.1-wave breakthrough infection sera compared to JN.1 and XBB.1.5. Interestingly. BA.2.87.1 is more resistant to neutralization by XBB.15-monovalent-vaccinated hamster sera than BA.2.86/JN.1 and XBB.1.5, but efficiently neutralized by a class III monoclonal antibody S309, which largely fails to neutralize BA.2.86/JN.1. Importantly, BA.2.87.1 exhibits higher levels of infectivity, cell-cell fusion activity, and furin cleavage efficiency than BA.2.86/JN.1. Antigenically, we found that BA.2.87.1 is closer to the ancestral BA.2 compared to other recently emerged Omicron subvariants including BA.2.86/JN.1 and XBB.1.5. Altogether, these results highlight immune escape properties as well as biology of new variants and underscore the importance of continuous surveillance and informed decision-making in the development of effective vaccines.

Synergistic Role of NK Cells and Monocytes in Promoting Atherogenesis in Severe COVID-19 Patients. (preprint)

Clinical data demonstrate an increased predisposition to cardiovascular disease (CVD) following severe COVID-19 infection. This may be driven by a dysregulated immune response associated with severe disease. Monocytes and vascular tissue resident macrophages play a critical role in atherosclerosis, the main pathology leading to ischemic CVD. Natural killer (NK) cells are a heterogenous group of cells that are critical during viral pathogenesis and are known to be dysregulated during severe COVID-19 infection. Their role in atherosclerotic cardiovascular disease has recently been described. However, the contribution of their altered phenotypes to atherogenesis following severe COVID-19 infection is unknown. We demonstrate for the first time that during and after severe COVID-19, circulating proinflammatory monocytes and activated NK cells act synergistically to increase uptake of oxidized low-density lipoprotein (Ox-LDL) into vascular tissue with subsequent foam cell generation leading to atherogenesis despite recovery from acute infection. Our data provide new insights, revealing the roles of monocytes/macrophages, and NK cells in COVID-19-related atherogenesis.

Immune Evasion, Infectivity, and Fusogenicity of SARS-CoV-2 Omicron BA.2.86 and FLip Variants (preprint)

Evolution of SARS-CoV-2 requires the reassessment of current vaccine measures. Here, we characterized BA.2.86 and the XBB-lineage variant FLip by investigating their neutralization alongside D614G, BA.1, BA.2, BA.4/5, XBB.1.5, and EG.5.1 by sera from 3-dose vaccinated and bivalent vaccinated healthcare workers, XBB.1.5-wave infected first responders, and monoclonal antibody (mAb) S309. We assessed the biology of the variant Spikes by measuring viral infectivity and membrane fusogenicity. BA.2.86 is less immune evasive compared to FLip and other XBB variants, consistent with antigenic distances. Importantly, distinct from XBB variants, mAb S309 was unable to neutralize BA.2.86, likely due to a D339H mutation based on modeling. BA.2.86 had relatively high fusogenicity and infectivity in CaLu-3 cells but low fusion and infectivity in 293T-ACE2 cells compared to some XBB variants, suggesting a potentially differences conformational stability of BA.2.86 Spike. Overall, our study underscores the importance of SARS-CoV-2 variant surveillance and the need for updated COVID-19 vaccines.

Alcohol use during the COVID-19 pandemic: gender, parenthood, intimate partner violence, and stress.

Some preliminary work during the COVID-19 pandemic indicates that adult alcohol use increased, particularly for parents. This cross-sectional study examined the quantity and frequency of adults' alcohol use during the early stages of the pandemic. Additionally, the influences of gender, parenthood, COVID-19-related stressors and intimate partner violence (IPV) on alcohol consumption were examined. The sample consisted of 298 adults (98 parents) from across the United States who completed self-report surveys through Qualtrics at the beginning of the pandemic in May 2020. In the present study, all men reported higher levels of drinking compared to all women. Although stress levels did not impact alcohol consumption, findings indicate that increased IPV experiences were associated with higher levels of heavy drinking during the pandemic. Results also suggested that having children in the home particularly impacted drinking levels during the pandemic, above and beyond the influence of gender, IPV, and stress levels. These findings suggest that parenthood may have had a cascading influence on drinking experiences during the COVID-19 pandemic. Implications and recommendations for further research are discussed.

Care Narratives by Annie Ernaux and Michael Rosen in the Light of the Covid-19 Pandemic

The Covid-19 pandemic has highlighted both the importance of care and a global crisis in care. Since its beginnings in the US in the 1980s as a feminist theory within virtue ethics, care ethics has emerged from the margins of the domestic sphere in the West to become a species theory and a force for radical societal change. Influenced by Joan Tronto's work, Alexandre Gefen has integrated the approach into literary studies in France as an interventionist reading strategy, offering therapeutic benefits to the reader as well. In a new intersectional approach, I argue that reading literature through a care ethics model can improve lives. I compare literary testimonies on either side of the patient/carer divide, Annie Ernaux's pre-Covid-19 care home narrative and Michael Rosen's Covid-19 patient testimony, which, read together, expand the field of medical humanities to promote a relational reconception of society over individualist neoliberalism.

Pain Management in Older Adults before and during the First Year of Covid-19 Pandemic: Prevalence, Trends, and Correlates.

BACKGROUND: There is limited knowledge on whether and how healthcare access restrictions imposed by the Covid-19 pandemic have affected utilization of both opioid and non-pharmacological treatments among US older adults living with chronic pain. METHODS: We compared prevalence of chronic pain and high impact chronic pain (HICP; i.e., chronic pain limiting life or work activities on most days or every day in the past 6 months) between 2019 (pre-pandemic) and 2020 (first year of pandemic) and utilization of opioids and non-pharmacological pain treatments among adults aged ≥65 years enrolled in the National Health Interview Survey (NHIS), a nationally representative sample of non-institutionalized civilian US adults. RESULTS: Of 12,027 survey participants aged ≥65 (representing 32.6 million non-institutionalized older adults nationally), the prevalence of chronic pain was not significantly different from 2019 (30.8%; 95% confidence interval [CI], 29.7-32.0%) to 2020 (32.1%; 95% CI, 31.0-33.3%; p=0.06). Among older adults with chronic pain, the prevalence of HICP was also unchanged (38.3%; 95% CI, 36.1-40.6% in 2019 versus 37.8%; 95% CI, 34.9-40.8% in 2020; p=0.79). Use of any non-pharmacological interventions for pain management decreased significantly from 61.2% (95 CI, 58.8-63.5%) in 2019 to 42.1% (95% CI, 40.5-43.8%) in 2020 (p<0.001) among those with chronic pain, as did opioid use in the past 12 months from 20.2% (95% CI, 18.9-21.6%) in 2019 to 17.9% (95% CI, 16.7-19.1%) in 2020 (p=0.006). Predictors of treatment utilization were similar in both chronic pain and HICP. CONCLUSION: Use of pain treatments among older adults with chronic pain declined in the first year of Covid-19 pandemic. Future research is needed to assess long-term effects of Covid-19 pandemic on pain management in older adults.

COVID-19 severity scale for claims data research.

OBJECTIVE: To create and validate a methodology to assign a severity level to an episode of COVID-19 for retrospective analysis in claims data. DATA SOURCE: Secondary data obtained by license agreement from Optum provided claims records nationally for 19,761,754 persons, of which, 692,094 persons had COVID-19 in 2020. STUDY DESIGN: The World Health Organization (WHO) COVID-19 Progression Scale was used as a model to identify endpoints as measures of episode severity within claims data. Endpoints used included symptoms, respiratory status, progression to levels of treatment and mortality. DATA COLLECTION/EXTRACTION METHODS: The strategy for identification of cases relied upon the February 2020 guidance from the Centers for Disease Control and Prevention (CDC). PRINCIPAL FINDINGS: A total of 709,846 persons (3.6%) met the criteria for one of the nine severity levels based on diagnosis codes with 692,094 having confirmatory diagnoses. The rates for each level varied considerably by age groups, with the older age groups reaching higher severity levels at a higher rate. Mean and median costs increased as severity level increased. Statistical validation of the severity scales revealed that the rates for each level varied considerably by age group, with the older ages reaching higher severity levels (p < 0.001). Other demographic factors such as race and ethnicity, geographic region, and comorbidity count had statistically significant associations with severity level of COVID-19. CONCLUSION: A standardized severity scale for use with claims data will allow researchers to evaluate episodes so that analyses can be conducted on the processes of intervention, effectiveness, efficiencies, costs and outcomes related to COVID-19.

Autonomous Synthesis of Functional, Permanently Phosphorylated Proteins for Defining the Interactome of Monomeric 14-3-3ζ.

14-3-3 proteins are dimeric hubs that bind hundreds of phosphorylated "clients" to regulate their function. Installing stable, functional mimics of phosphorylated amino acids into proteins offers a powerful strategy to study 14-3-3 function in cellular-like environments, but a previous genetic code expansion (GCE) system to translationally install nonhydrolyzable phosphoserine (nhpSer), with the γ-oxygen replaced with CH2, site-specifically into proteins has seen limited usage. Here, we achieve a 40-fold improvement in this system by engineering into Escherichia coli a six-step biosynthetic pathway that produces nhpSer from phosphoenolpyruvate. Using this autonomous "PermaPhos" expression system, we produce three biologically relevant proteins with nhpSer and confirm that nhpSer mimics the effects of phosphoserine for activating GSK3ß phosphorylation of the SARS-CoV-2 nucleocapsid protein, promoting 14-3-3/client complexation, and monomerizing 14-3-3 dimers. Then, to understand the biological function of these phosphorylated 14-3-3ζ monomers (containing nhpSer at Ser58), we isolate its interactome from HEK293T lysates and compare it with that of wild-type 14-3-3ζ. These data identify two new subsets of 14-3-3 client proteins: (i) those that selectively bind dimeric 14-3-3ζ and (ii) those that selectively bind monomeric 14-3-3ζ. We discover that monomeric-but not dimeric-14-3-3ζ interacts with cereblon, an E3 ubiquitin-ligase adaptor protein of pharmacological interest.

The effects of short messages encouraging prevention behaviors early in the COVID-19 pandemic.

Effectively addressing public health crises like the COVID-19 pandemic requires persuading the mass public to change their behavior in significant ways. Many efforts to encourage behavior change-such as public service announcements, social media posts, and billboards-involve short, persuasive appeals, yet the effectiveness of these messages is unclear. Early in the COVID-19 pandemic, we tested whether short messages could increase intentions to comply with public health guidelines. To identify promising messages, we conducted two pretests (n = 1,596) in which participants rated the persuasiveness of 56 unique messages: 31 based on the persuasion and social influence literatures and 25 drawn from a pool of crowdsourced messages generated by online respondents. The four top-rated messages emphasized: (1) civic responsibility to reciprocate the sacrifices of health care workers, (2) caring for the elderly and vulnerable, (3) a specific, sympathetic victim, and (4) limited health care system capacity. We then conducted three well-powered, pre-registered experiments (total n = 3,719) testing whether these four top-rated messages, and a standard public health message based on language from the CDC, increased intentions to comply with public health guidelines, such as masking in public spaces. In Study 1, we found the four messages and the standard public health message significantly outperformed a null control. In Studies 2 and 3, we compared the effects of persuasive messages to the standard public health message, finding that none consistently out-performed the standard message. This is in line with other research showing minimal persuasive effects of short messages after the very early stages of the pandemic. Across our studies, we found that (1) short messages can increase intentions to comply with public health guidelines, but (2) short messages featuring persuasive techniques from the social science literature did not substantially outperform standard public health messages.

Duration of MERS - Coronavirus antibodies in a small closed dromedary camel herd in Dubai

This investigation shows that MERS-CoV ELISA antibodies remain in dromedary camels at least for 9 years, most probably lifelong. The viral infection was most likely acquired at a young age when maternal antibodies have receded between 4 to 8 month of age. Additionally, in the investigated herd, the 4 ELISA antibody negative dromedary camels remained negative also for 9 years, indicating, that no MERS-CoV was circulating in the herd. Until today, the specific source of MERS-CoV infection for young dromedaries remains unknown.

Joy at work and vocational identity during COVID-19: A structural equation model.

OBJECTIVE: This study aims to explore the interrelations between joy at work, vocational identity, and COVID-19-related latent variables. DESIGN: A cross-sectional design was adopted to survey 253 registered nurses through nursing organizations and social networking sites during the time of the COVID-19 pandemic. METHODS: Structural Equation Modeling through Partial Least Squares (SEM-PLS) was employed to accurately analyze and estimate relationships among joy at work, vocational identity, and COVID-19-related constructs in compliance with published standards and guidelines. RESULTS: Thirty-one items received convergent validity measures to represent the five study constructs related to joy at work, vocational identity, and Work life Impact of COVID-19 pandemic: Meaning, Engagement, and Growth (MEG), Compassion, Sensitivity, and Respect (CSR), Trust, Support, and Flexibility (TSF), Vocational Identity Questionnaire (VIQ), and Work life Impact of COVID-19 pandemic (CI). The generated model exhibited good model fit and consistent quality indices. The data fit statistically with the model: (Average Path Coefficient = 0.195, p < 0.000); Average R-Squared = 0.156, p < 0.003; Average Adjusted R-Squared = 0.151, p < 0.004; Average Variance Inflation Factor = 2.193 (within the ideal range); Average Full collinearity VIF = 2.388 (within the ideal range), and Tenenhaus Goodness of Fit (GoF) = 0.329. The perceived Work life Impact of COVID-19 pandemic (CI) was a significant predictor of joy at work constructs (MEG, CSR, and TSF) and VIQ with direct effects. It also exerted a negative influence over MEG and TSF, but positively on CSR and VIQ. Notably, joy at work constructs significantly mediated the effects of CI on VIQ. CONCLUSION: A structural model was developed that offers insights and a parsimonious explanation for the interrelations of COVID-19, joy at work, and vocational identity variables. The pandemic unquestionably influences the nurses' perceived joy, sense of calling, and meaning in life's work, and joy at work enhances nurses' work-life worth during challenging times. CLINICAL RELEVANCE: An increased understanding of nurses' joy at work during challenging times can potentially influence work culture, informs individual nurses, nurse leaders, and healthcare systems in all professional domains of practice and provides the foundational information to identify barriers to joy and strategies that enhance joy.

Hybrid optimized feature selection and deep learning based COVID-19 disease prediction.

The COVID-19 virus has affected many people around the globe with several issues. Moreover, it causes a worldwide pandemic, and it makes more than one million deaths. Countries around the globe had to announce a complete lockdown when the corona virus causes the community to spread. In real-time, Polymerase Chain Reaction (RT-PCR) test is conducted to detect COVID-19, which is not effective and sensitive. Hence, this research presents the proposed Caviar-MFFO-assisted Deep LSTM scheme for COVID-19 detection. In this research, the COVID-19 cases data is utilized to process the COVID-19 detection. This method extracts the various technical indicators that improve the efficiency of COVID-19 detection. Moreover, the significant features fit for COVID-19 detection are selected using proposed mayfly with fruit fly optimization (MFFO). In addition, COVID-19 is detected by Deep Long Short Term Memory (Deep LSTM), and the Conditional Autoregressive Value at Risk MFFO (Caviar-MFFO) is modeled to train the weight of Deep LSTM. The experimental analysis reveals that the proposed Caviar-MFFO assisted Deep LSTM method provided efficient performance based on the Mean Squared Error (MSE) and Root Mean Squared Error (RMSE), and achieved the recovered cases with the minimal values of 1.438 and 1.199, whereas the developed model achieved the death cases with the values of 4.582 and 2.140 for MSE and RMSE. In addition, 6.127 and 2.475 are achieved by the developed model based on infected cases.

The impacts of COVID-19 measures on drug markets and drug use among a cohort of people who use methamphetamine in Victoria, Australia.

BACKGROUND AND AIMS: Few studies of the impacts of the coronavirus disease 2019 (COVID-19) public health measures on drug markets and drug use patterns have used longitudinal data. We aimed to examine whether COVID-19 measures were associated with increases in methamphetamine price, decreases in methamphetamine use frequency and subsequent changes in secondary outcomes of other drug use frequency in metropolitan Melbourne and regional Victoria. DESIGN: Longitudinal analysis framework was used from a longitudinal cohort of people who use methamphetamine. SETTING: Victoria state, Australia. PARTICIPANTS: One hundred eighty-five VMAX study participants who reported a methamphetamine purchase after the onset of the pandemic were used for the price paid analysis. Methamphetamine or other drug use frequency analysis was performed using 277 participants who used methamphetamine during the pandemic or in the year before the pandemic. MEASUREMENTS: Price paid per gram of methamphetamine derived from the most recent purchase price and most recent purchase quantity. Frequency of methamphetamine and other drug use measured as the average number of days per week used in the last month. FINDINGS: Compared with pre-COVID-19 period, methamphetamine prices increased by AUD351.63 (P value <0.001) and by AUD456.51 (P value <0.001) in Melbourne and regional Victoria, respectively, during the period in which the most intense public health measures were implemented in Victoria. Although prices decreased after harder restrictions were lifted (by AUD232.84, P value <0.001 and AUD263.68, P value <0.001, in Melbourne and regional Victoria, respectively), they remained higher than pre-COVID-19 levels. A complementary 76% decrease was observed in relation to methamphetamine use frequency in regional Victoria (P value = 0.006) that was not offset by any changes in the frequency of use of other drugs such as alcohol, tobacco or other illicit drugs. CONCLUSION: COVID-19 public health measures in Victoria state, Australia, appear to have been associated with major price changes in the methamphetamine market and decreased frequency of use of the drug.

A Randomized Trial of Behavioral Nudges Delivered Through Text Messages to Increase Influenza Vaccination Among Patients With an Upcoming Primary Care Visit.

PURPOSE: To evaluate if nudges delivered by text message prior to an upcoming primary care visit can increase influenza vaccination rates. DESIGN: Randomized, controlled trial. SETTING: Two health systems in the Northeastern US between September 2020 and March 2021. SUBJECTS: 74,811 adults. INTERVENTIONS: Patients in the 19 intervention arms received 1-2 text messages in the 3 days preceding their appointment that varied in their format, interactivity, and content. MEASURES: Influenza vaccination. ANALYSIS: Intention-to-treat. RESULTS: Participants had a mean (SD) age of 50.7 (16.2) years; 55.8% (41,771) were female, 70.6% (52,826) were White, and 19.0% (14,222) were Black. Among the interventions, 5 of 19 (26.3%) had a significantly greater vaccination rate than control. On average, the 19 interventions increased vaccination relative to control by 1.8 percentage points or 6.1% (P = .005). The top performing text message described the vaccine to the patient as "reserved for you" and led to a 3.1 percentage point increase (95% CI, 1.3 to 4.9; P < .001) in vaccination relative to control. Three of the top five performing messages described the vaccine as "reserved for you." None of the interventions performed worse than control. CONCLUSIONS: Text messages encouraging vaccination and delivered prior to an upcoming appointment significantly increased influenza vaccination rates and could be a scalable approach to increase vaccination more broadly.

Inhibiting the Deubiquitinase UCHL1 Reduces SARS-CoV-2 Viral Uptake by ACE2.

Coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), remains a significant public health burden with limited treatment options. Many ß-coronaviruses, including SARS-CoV-2, gain entry to host cells through the interaction of SARS-CoV-2 spike protein with membrane-bound ACE2 (angiotensin-converting enzyme 2). Given its necessity for SARS-CoV-2 infection, ACE2 represents a potential therapeutic target in COVID-19. However, early attempts focusing on ACE2 in COVID-19 have not validated it as a druggable target nor identified other ACE2-related novel proteins for therapeutic intervention. Here, we identify a mechanism for ACE2 protein modulation by the deubiquitinase (DUB) enzyme UCHL1 (ubiquitin carboxyl-terminal hydrolase isozyme L1). ACE2 is constitutively ubiquitinated and degraded by the proteasome in lung epithelia. SARS-CoV-2 spike protein cellular internalization increased ACE2 protein abundance by decreasing its degradation. Using an siRNA library targeting 96 human DUBs, we identified UCHL1 as a putative regulator of ACE2 function as a viral receptor. Overexpressed UCHL1 preserved ACE2 protein abundance, whereas silencing of the DUB in cells destabilized ACE2 through increased polyubiquitination. A commercially available small molecule inhibitor of UCHL1 DUB activity decreased ACE2 protein concentrations coupled with inhibition of SARS-CoV-2 infection in epithelial cells. These findings describe a unique pathway of ACE2 regulation uncovering UCHL1 as a potential therapeutic target to modulate COVID-19 viral entry as a platform for future small molecule design and testing.

Prognostic value of procalcitonin in cancer patients with coronavirus disease 2019.

OBJECTIVES: Many biomarkers have been studied to assist in the risk stratification and prognostication of patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Procalcitonin (PCT), a circulating precursor of the hormone calcitonin, has been studied with mixed results as a predictor of severe coronavirus disease 2019 (COVID-19) in the general population; however, to date, no studies have focused on the utility of PCT in predicting disease severity and death from COVID-19 in the cancer population. METHODS: We conducted a retrospective study of cancer patients hospitalized with COVID-19 at a comprehensive cancer center over a 10-month period who had PCT recorded on admission. We assessed associations between variables of clinical interest and the primary outcomes of progression of COVID-19 and death during or within 30 days of hospitalization using univariable and multivariable logistic regression. RESULTS: The study included 209 unique patients. In the univariate analysis, elevated PCT on admission was associated with higher odds of progression of COVID-19 or death (Odds ratio [OR] 1.40, 95% CI 1.08-1.93) and mortality alone (OR 1.53, 95% CI 1.17-2.11). In multivariate regression, PCT remained significantly associated with progression or death after holding chronic kidney disease (CKD) status constant (OR 1.40, 95% CI: 1.08, 1.93, p=0.003). Similarly, the association of PCT and death remained significant after adjusting for age (OR 1.54, 95% CI: 1.17-2.15). CONCLUSIONS: In hospitalized COVID-19 patients with underlying cancer, initial PCT levels on admission may be associated with prognosis, involving higher odds of progression of COVID-19 and/or mortality.

Increased Rates of Hospitalized Children with Type 1 and Type 2 Diabetes Mellitus in NYC Hospital During COVID19 Pandemic

Objectives There have been reports of increased new onset diabetes and severity of DKA for children with diabetes following COVID19 infection and during the pandemic worldwide. Our objective is to study whether there is a change in admission rates and severity of presentation for type 1 (T1DM) and type 2 diabetes mellitus (T2DM) in our center from 2018 to 2020. Methods This is an IRB approved retrospective chart review of children admitted to our two hospitals from 1/1/18 to 12/31/20. We included ICD9 and ICD10 codes for diabetic ketoacidosis (DKA), hyperglycemic hyperosmolar syndrome (HHS) and hyperglycemia for those with diabetes. SAS 9.4 was used for ANOVA, T-test, Poisson regression. Results We included 132 patients with 214 hospitalizations: 158 T1DM, 40 T2DM and 16 other (14 steroid induced, 2 MODY). Overall admissions increased from 3.4% in 2018, to 4.6% in 2019, and 6.4% in 2020 (p = 0.05). Overall T1DM admissions were similar across all 3 years, however T2DM rates increased from 0.4% to 0.8% to 2% (p=0.0064). Newly diagnosed T1DM rates increased from 0.4% to 0.3% to 1.7% (p=0.002), and new-onset T2DM rates also increased from 0.2% to 0.7% to 1.1% (p=0.0026). DKA increased from 2.5% to 3.5% to 4% (p=0.028). HHS increased from 0.1% to 0.2% to 0.6% (p=0.047). There was no difference in average A1c. Severity of DKA in newly diagnosed diabetes was unaffected (p=0.833). Only 3 patients tested positive for COVID 19 while everyone else was negative by COVID 19 PCR. Conclusions Our urban academic medical center is located in central Brooklyn and serves a majority who are Black (87%). As far as we know, this is the first study investigating pediatric diabetes cases admitted in central Brooklyn during the height of the pandemic. Overall, hospitalization rates in children with T2DM and in new onset T1DM and T2DM increased, despite overall admissions declining in 2020. Whether the shutdown affected patient's perception of their symptoms or another reason leading to delayed care, or change in access to care remains to be seen. Active COVID19 infection did not appear to affect patients who had been admitted for diabetes. More studies are needed to elucidate the reason for this observed increase hospitalization rates.

Increased prevalence of blister aneurysm formation during the COVID-19 pandemic.

BACKGROUND: Intracranial blister aneurysms are a rare and an historically difficult to treat subset of aneurysms. They are distinct from typical saccular aneurysms with different pathophysiology and treatment options. METHODS: A prospectively maintained database of subarachnoid hemorrhage patients was queried for those presenting prior to the pandemic (2017-2019), and those presenting during the height of the pandemic in our locality (2021). Aneurysm characteristics and patient demographics associated with rupture risk/formation were collected. RESULTS: 334 aneurysmal subarachnoid hemorrhage patients were reviewed. 86 of these patients presented in 2021, with a statistically significant increase in the proportion of ruptured ICA blister aneurysms as compared to 2017-2019 (7/86, 8% vs 5/248, p = .02). Mean patient age, presenting grade, other aneurysm location proportions, aneurysm size, and incidence of delayed cerebral ischemia were not different between the groups. CONCLUSIONS: Patients presenting with SAH during the height of the SARS-CoV-2 pandemic in 2021 were more likely to have ICA blister type aneurysms.

Transformation leadership and work performance: mediating role of faculty engagement in higher educational institutions during COVID-19 pandemic

The purpose of this study is to examine the effect of Transformation Leadership (TL) on Work Performance (WP) and mediating role of teaching Faculty Engagement (FE) in Higher Educational Institutions (HEI) in India during the COVID-19 pandemic. The survey method of data collection using Google forms was circulated among teaching faculty working in HEI across major cities in India. We were able to gather 568 valid responses after screening the invalid responses. The outcome of the research indicates that the structural model confirms the positive association between TL and WP. Further, the results confirmed that EE positively mediates the association between TL and WP of teaching faculty in HEI. Thus, transformational leaders in HEI develop the engagement of teaching faculty, which enhances their WP even in the virtual work environment during the COVID-19 pandemic. Copyright © 2022 Inderscience Enterprises Ltd.