ABSTRACT
Introduction: Personal social networks impact the quality of life of people living with multiple sclerosis (pwMS). Objective / Aims: To evaluate the dynamic associations between personal network features and neurological function in pwMS and control participants during the COVID-19 pandemic and compare with the pre-pandemic period. Method(s): We first analyzed data collected from 8 cohorts of pwMS and control participants during the COVID-19 pandemic from March-December 2020. We then leveraged data collected between 2017-2019 in 3 of the 8 cohorts for longitudinal comparison. Participants completed a personal network questionnaire, which quantified the structure and composition of each person's personal network, including the health behaviors of network members. Neurological disability was quantified by three interrelated patient-reported outcomes: Patient Determined Disease Steps (PDDS), Multiple Sclerosis Rating Scale-Revised (MSRS-R), and Patient Reported Outcomes Measurement Information System (PROMIS)-Physical Function. We identified the network features associated with neurologic disability using paired t-tests and covariate-adjusted regressions. Result(s): In the cross-sectional analysis of the pandemic data from 1130 pwMS and 1250 control participants, percentage of network members perceived to have a negative health influence was associated with greater neurological symptom burden in pwMS (MSRS-R: Beta[95% CI]=2.181[1.082, 3.279], p<.001) and worse physical function in control participants (PROMIS-Physical Function: Beta[95% CI]=-5.707[-7.405, -4.010], p<.001). In the longitudinal analysis of 230 pwMS and 136 control participants, the percentage of people contacted weekly or less (p<.001) decreased during the COVID-19 pandemic for both pwMS (0.30+/-0.26 v. 0.19+/-0.22) and controls (0.23+/-0.25 v. 0.15+/-0.21) when compared to the pre-pandemic period. PwMS further experienced a greater reduction in network size (p<.001), increase in constraint (a measure of close ties of the network, p<.001) and decrease in maximum degree (highest number of ties of a network member, p<.001) than controls during the COVID-19 pandemic. These changes in network features were not associated with worsening neurological disability. Conclusion(s): Our findings suggest that negative health influences in personal networks are associated with worse disability in all participants and COVID-19 pandemic led to contraction of personal networks to a greater extent for pwMS than controls.
ABSTRACT
During a global pandemic, mitigating the impact of the disease and coordinating efforts to manage not only the medical but also the logistical and administrative aspects of such an all-encompassing phenomenon are of paramount importance. An extremely important but less publicised issue in this context is laboratory management and safety in analytical laboratories. In times of high capacity utilisation, as is the case during a pandemic or endemic outbreak of disease, other routine processes have to be abbreviated or are cancelled altogether due to lack of planning owing to the rapid emergence of the outbreak. In order to achieve high level of cleanliness in laboratories of all shapes and sizes and with different requirements, a universal solution seems unimaginable. Our experiments show a promising, automated approach of disinfection of various spaces. Within a short timeframe of 1 h – 3 h it is possible to disinfect any desired room to achieve a laboratory grade hygiene status. This was proven by employing biological indicators validated for this procedure. The tested technology reduced the indicator germs by a concentration of the mathematical log 6 reduction. Achieving this high level of cleanliness is possible by assigning a single person to the task for the set-up at the scene. Steering and monitoring of the process can be done remotely. While the machine used in our experiments is not a completely new concept, our experiments in a real-life setting such as laboratories and clinics alike, show that the applied hydrogen peroxide vapour distributed by a specialized fogger, disinfects even hard to reach spots within closed-off spaces. This program can be performed while automated (PCR) machines are running and highly trained personnel can apply their expertise elsewhere. Moreover, while the program is running real-time data is available and the process can be remotely monitored and steered digitally. It is of major concern to ensure maintainability of infrastructure e.g. COVID labs, ambulances, laboratories or veterinary practitioners to ensure treatment of directly and indirectly related health issues within a crisis. We concentrated on evaluating the usability of the disinfection technology presented in real-life settings. © 2022 IDIMT. All rights reserved.
ABSTRACT
Introduction: Vaccine hesitancy is a major barrier to achieving herd immunity against COVID-19. This is especially apparent in patients with autoimmune diseases, such as multiple sclerosis (MS), who were largely excluded from seminal vaccine trials. Objectives/Aims: To assess COVID-19 vaccine hesitancy and early safety/tolerability in patients with MS and related disorders. Methods: Participants were recruited from multiple academic centers as part of the MS Resilience to COVID-19 (MSReCOV) Study Consortium. Statistical analysis was performed on responses to vaccine-specific questionnaires completed between February 24th and April 28th, 2021. Results: 1761 participants completed the vaccine questionnaire, including 1081(62%) with MS or another neuroinflammatory disease (NID), and 657(38%) controls. By survey completion, 1150(65%) participants had been vaccinated against SARS-CoV-2 with Pfizer(n=526, 54%), Moderna(n=415, 43%), Johnson & Johnson(n=22, 2%), AstraZeneca(n=2, 0.2%), or unknown(n=3, 0.3%). 82%(n=568) of MS/NID were on disease modifying therapy at the time of vaccination. Hesitancy rates were similar between MS/NID and controls(p=0.39), with 32% of unvaccinated participants(n=597, 34%) either unsure or not planning to be vaccinated. The most common reasons for hesitancy in patients with MS/NID pertained to vaccines being understudied in the autoimmune population(n=35, 54%), triggering a demyelinating event(n=30, 46%), or being too new(n=24, 37%). Of the MS/NID participants vaccinated with mRNA vaccines, 42%(n=240) and 45%(n=178) reported side effects(SE) after the first and second doses, respectively. Higher rates of SEs were noted in the MS/NID group after the second dose (67% vs. 45%;p<0.0001;RR 1.5, 95%CI:1.3 - 1.7). Most common SEs in the MS/NID groups were arm soreness(n=278, 85%), flu-like symptoms(n=139, 42%), and headache(n=23, 7%). Only 1 MS/ NID patient (vs. 3 controls) reported a neurologic SE other than headache, described as transient numbness. When comparing vaccinated and unvaccinated MS/NID patients, there was no difference in rates of recurrent neurologic symptoms(p=0.45), new neurologic symptoms(p=0.65) or new/ active lesions detected on MRI(p=0.35). Conclusions: Reasons for vaccine hesitancy in MS/NID population include lack of study in autoimmune population and fear of relapse. In this early analysis we found a higher rate of expected SEs after second mRNA dose but no evidence of worsening neurologic disease.