Predicting the potential for zoonotic transmission and host associations for novel viruses.

Host-virus associations have co-evolved under ecological and evolutionary selection pressures that shape cross-species transmission and spillover to humans. Observed virus-host associations provide relevant context for newly discovered wildlife viruses to assess knowledge gaps in host-range and estimate pathways for potential human infection. Using models to predict virus-host networks, we predicted the likelihood of humans as hosts for 513 newly discovered viruses detected by large-scale wildlife surveillance at high-risk animal-human interfaces in Africa, Asia, and Latin America. Predictions indicated that novel coronaviruses are likely to infect a greater number of host species than viruses from other families. Our models further characterize novel viruses through prioritization scores and directly inform surveillance targets to identify host ranges for newly discovered viruses.

Active coping strategies and less pre-pandemic alcohol use relate to college student mental health during the COVID-19 pandemic

Objective To further delineate risk and resilience factors contributing to trajectories of mental health symptoms experienced by college students through the pandemic. Participants n = 183 college students (67.2% female). Methods Linear mixed models examined time effects on depression and anxiety. Propensity-matched subgroups exhibiting “increased” versus “low and stable” depression symptoms from before to after the pandemic-onset were compared on pre-pandemic demographic and psychological factors and COVID-related experiences and coping strategies. Results Students experienced worsening of mental health symptoms throughout the pandemic, particularly during Fall 2020 compared with Fall 2019 (Depression scale d = −0.43 [95% CI: −0.65 to −0.21]). The propensity-matched subgroup exhibiting relative resilience (“low and stable” symptoms) reported less alcohol use prior to the pandemic, greater use of active coping strategies, and less of an impact on their college progress. Conclusions Results point to several potential targets of screening and intervention to decrease residual impacts of the pandemic.

The mental health impact of contact with COVID-19 patients on healthcare workers in the United States.

This study assessed the relationship between contact with COVID-19 patients and the mental health of healthcare workers (HCWs) in the United States (US). In a convenience sample of 957 HCWs who completed an anonymous online survey between April-May 2020, HCWs who provided direct care to confirmed or suspected COVID-19 patients reported increased depressive and posttraumatic symptoms compared to HCWs with no COVID-19 patient contact. Additionally, more frequent contact was associated with higher distress. More data drawn from diverse samples that better represent US HCWs are needed to fully assess the scope of this association.

Analyzing changes to U.S. municipal heat response plans during the COVID-19 pandemic.

Extreme heat events are the deadliest weather-related event in the United States. Cities throughout the United States have worked to develop heat adaptation strategies to limit the impact of extreme heat on vulnerable populations. However, the COVID-19 pandemic presented unprecedented challenges to local governments. This paper provides a preliminary review of strategies and interventions used to manage compound COVID-19-extreme heat events in the 25 most populous cities of the United States. Heat adaptation strategies employed prior to the COVID-19 pandemic were not adequate to meet during the co-occurring compound hazard of COVID-19-EHE. Long-term climate-adaptation strategies will require leveraging physical, financial, and community resources across multiple city departments to meet the needs of compound hazards, such as COVID-19 and extreme heat.

A Program to Improve Digital Access and Literacy Among Community Stakeholders: Cohort Study.

BACKGROUND: For many research teams, the role of community stakeholders is critical. However, community stakeholders, especially those in low-income settings, are at risk of being excluded from research and community engagement initiatives during and after the COVID-19 pandemic because of the rapid transition to digital operations. OBJECTIVE: We aimed to describe the implementation and feasibility of a program called Addressing the Digital Divide to Improve Patient-Centered Outcomes Research, which was designed to address barriers to technology use, and to examine changes in participants' perceived comfort with digital technology before and after the program. METHODS: To promote full engagement, we worked with 20 existing community leaders to cocreate a training course on using digital technology. We assessed the frequency of technology use and comfort with technology through an adapted 8-item version of the Functional Assessment of Comfort Employing Technology Scale and used the Wilcoxon signed-rank test for survey analysis. We also conducted a focus group session with 10 participants and then performed reflective journaling and content analysis to determine emergent themes. RESULTS: We found that the program was feasible to implement and worthwhile for participants (15/16, 94%). After the program, the participants perceived an increase in the frequency of technology use (z=2.76, P=.006). The participants reported that the program was successful because of the technology training program, but recommended that the program have a slower pace and include a helpline number that they could call with questions. CONCLUSIONS: Future programs should consider that populations with low literacy view technology training as a core element to decreasing technology disparity. This study demonstrates that through low-cost input, community members can be provided the resources and training needed to virtually participate in research studies or community engagement initiatives.

The impact of withholding Entonox in labor during the COVID-19 pandemic on maternal and neonatal outcomes

Background: Entonox (Nitrous oxide in 50% oxygen) is commonly used for labor analgesia in obstetric units. During the pandemic uncertainties around the risk of aerosol generation and virus transmission led to withholding Entonox for women in labor for a 3-week period at our institution. We aimed to determine if withdrawing Entonox for labor analgesia impacted primarily on epidural rates, opioid analgesia use and several other secondary outcomes. Methods: The audit population included all women laboring during March 9-28 (the Entonox group), and March 29-April 16, 2020 (the COVID group). Women who delivered prior to, or within 30 mins of arriving on the birthing unit;as well as women with an intrauterine foetal death and those with incomplete clinical records were excluded. Binary outcomes were analysed using logistic regression and skewed continuous outcomes were logtransformed and analysed by linear regression. Models were adjusted for maternal and clinical risk factors, such as primiparity and induction of labor. Results: There were 122 and 121 women in the Entonox and COVID groups, respectively. Maternal demographics were similar between the groups (Table 1). Epidural requests were similar. Opioid use was significantly higher when Entonox was not available, but there were no significant differences in any maternal and neonatal outcomes (Table 2). Conclusion: Results from our study suggest that withholding Entonox in labor did not result in higher epidural rates. Opioid analgesia requirements were significantly increased. Withholding Entonox appeared safe and did not impact on any maternal and neonatal outcomes. (Figure Presented).

The impact of routine intraoperative cell salvage use for lower segment cesarean section during the Covid-19 Pandemic

Background: Blood services have been challenged to maintain their inventory during COVID-19. An expert group issued a 'Call to Action' to all stakeholders to implement practical, multimodal principles of Patient Blood Management (PBM). Intraoperative cell salvage (IOCS) is central to PBM also for lower segment cesarean section (LSCS). Prior to April 2020, we initiated IOCS during LSCS based on risk assessment for hemorrhage and patient factors. As the pandemic broadened, we mandated IOCS to reduce blood product usage. We examined the impact of routine IOCS on the incidence and degree of post-partum anemia, transfusion, and other maternal outcomes. Methods: We conducted a single-centre before-and-after study of obstetric patients undergoing LSCS in the 2 months prior to change in practice ('usual care', n=203) and the 2 months following ('mandated IOCS', n=228). Recovered blood was processed when a minimal autologous reinfusion volume of 100 ml was expected. Data were analysed using t-tests for normally distributed continuous data (else Mann Whitney U-tests) and Chi Squared test for frequency data. Post-operative iron infusion and length of stay (log-transformed) were modelled using logistic and linear regression, with inverse probability weighting to account for potential confounders. Results: Maternal demographics were similar between groups. (Table 1). More emergency LSCSs occurred in the usual care group. Compared to the Usual Care group, post-operative Hb was higher, and anemia cases, frequency of IV iron and length of stay were all lower in the Mandated IOCS group (Table 2). After statistical modelling, rates of post-partum iron infusion were significantly lower in the Mandated IOCS group but there was no difference in length of stay. Conclusion: Routine cell salvage provision during LSCS resulted in increased post-partum Hb and reduced anemia prevalence. This translated into a reduction in post-partum iron infusions. IOCS for LCSC may contribute to an avoidance of limited blood service products. (Table Presented) .

The Impact of COVID-19 on Adolescent Mental Health: Preliminary Findings From a Longitudinal Sample of Healthy and At-Risk Adolescents.

Background: The COVID-19 pandemic has brought on far-reaching consequences for adolescents. Adolescents with early life stress (ELS) may be at particular risk. We sought to examine how COVID-19 impacted psychological functioning in a sample of healthy and ELS-exposed adolescents during the pandemic. Methods: A total of 24 adolescents (15 healthy, nine ELS) completed self-report measures prior to and during the COVID-19 pandemic. The effect of COVID-19 on symptoms of depression and anxiety were explored using linear mixed-effect analyses. Results: With the onset of the pandemic, healthy but not ELS-exposed adolescents evidenced increased symptoms of depression and anxiety (ps < 0.05). Coping by talking with friends and prioritizing sleep had a protective effect against anxiety for healthy adolescents (t = -3.76, p = 0.002). Conclusions: On average, this study demonstrated large increases in depression and anxiety in adolescents who were healthy prior to the COVID-19 pandemic, while ELS-exposed adolescents evidenced high but stable symptoms over time.

Innocence in the shadow of COVID-19: Plea decision making during a pandemic.

Over 95% of criminal convictions in the United States are the result of guilty pleas. Consequently, it is critical that we ensure the process of pleading guilty is as free of coercion as possible. Yet, research has indicated that incarcerating defendants to await trial could have an undue influence on their decision to plead guilty. The current research employed a novel computer simulation to examine the impact of the COVID-19 pandemic on plea decision making among the innocent and the guilty when faced with potential pretrial detention. While presenting COVID-related information to participants increased both true and false guilty pleas, further analyses indicated that concerns about COVID-19 weighed more heavily on the innocent than the guilty. These findings illustrate the negative impact a pandemic could have in combination with a system of pleas that often allows prosecutors to provide defendants with just one guaranteed respite from jail-a guilty plea. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Metabolic stroke-like episode in a child with FARS2 mutation and SARS-CoV-2 positive cerebrospinal fluid.

The novel SARS-CoV-2 has infected over 48 million persons around the world. Children have been spared with regards to symptoms and sequelae of this highly infectious virus and in those with neurologic issues, the virus has not been present in the cerebrospinal fluid. Here, the authors present the first case of metabolic stroke-like episode with SARS-CoV-2 present in the cerebrospinal fluid in a child with a FARS2 deficiency. This report suggests a possible association of SARS-COV-2 infection and metabolic stroke-like episode, even in the absence of a phenotype classically associated with metabolic stroke-like episodes.