Real world effectiveness of tixagevimab/cilgavimab (Evusheld) in the Omicron era.

BACKGROUND: Pre-exposure prophylaxis for COVID-19 with tixagevimab/cilgavimab (T/C) received Emergency Use Authorization (EUA) based on results of a clinical trial conducted prior to the emergence of the Omicron variant. The clinical effectiveness of T/C has not been well described in the Omicron era. We examined the incidence of symptomatic illness and hospitalizations among T/C recipients when Omicron accounted for virtually all local cases. METHODS: Through retrospective electronic medical record chart review, we identified patients who received T/C between January 1 -July 31, 2022 within our quaternary referral health system. We determined the incidence of symptomatic COVID-19 infections and hospitalizations due to or presumed to be caused by early Omicron variants before and after receiving T/C (pre-T/C and post-T/C). Chi square and Mann-Whitney Wilcoxon two-sample tests were used to examine differences between the characteristics of those who got COVID-19 before or after T/C prophylaxis, and rate ratios (RR) and 95% confidence intervals (CI) were calculated to assess differences in hospitalization rates for the two groups. RESULTS: Of 1295 T/C recipients, 105 (8.1%) developed symptomatic COVID-19 infection before receiving T/C, and 102 (7.9%) developed symptomatic disease after receiving it. Of the 105 patients who developed symptomatic infection pre-T/C, 26 (24.8%) were hospitalized, compared with six of the 102 patients (5.9%) who were diagnosed with COVID-19 post-T/C (RR = 0.24; 95% CI = 0.10-0.55; p = 0.0002). Seven of the 105 (6.7%) patients infected pre-T/C, but none of the 102 infected post-T/C required ICU care. No COVID-related deaths occurred in either group. The majority of COVID-19 cases among those infected pre-T/C treatment occurred during the Omicron BA.1 surge, while the majority of post-T/C cases occurred when Omicron BA.5 was predominant. In both groups, having at least one dose of vaccine strongly protected against hospitalization (pre-T/C group RR = 0.31, 95% CI = 0.17-0.57, p = 0.02; post-T/C group RR = 0.15; 95% CI = 0.03-0.94; p = 0.04). CONCLUSION: We identified COVID-19 infections after T/C prophylaxis. Among patients who received T/C at our institution, COVID-19 Omicron cases occurring after T/C were one-fourth as likely to require hospitalization compared to those with Omicron prior to T/C. However, due to the presence of changing vaccine coverage, multiple therapies, and changing variants, the effectiveness of T/C in the Omicron era remains difficult to assess.

Understanding protective and risk factors affecting adolescents' well-being during the COVID-19 pandemic.

This study investigated the factors affecting adolescents' well-being during the COVID-19 pandemic from the perspectives of their participation in digital activities, emotional regulation, self-regulated learning, and parental involvement. Using self-reported data from 932 pairs of adolescents and their parents, we performed multiple-group structural equation modeling, which revealed that self-efficacy in online learning during school suspension was a key factor influencing adolescents' perceived worries after schools resumed. During school suspension, boys' cognitive-emotional regulation played a protective role in their well-being, helping them to avoid cyberbullying incidents, while girls' participation in leisure-oriented digital activities compromised their self-efficacy in online learning and led to cyberbullying incidents. Furthermore, improvement in parent-child relationships during school suspension encouraged adolescents to use more positive emotional regulation strategies, enhanced their self-efficacy in online learning, and reduced their leisure-time digital activities. The findings indicate that the effective regulation of adolescents' online behaviors, emotions, and self-efficacy, especially when combined with an emotionally secure family relationship, can ensure adolescents' well-being.

Evolution of Clinical Care in COVID-Infected Solid Organ Transplant Recipients.

Purpose of Review: In this review, we aim to summarize the evolution of care for the solid organ transplant recipient (SOTR) with COVID-19 disease, based on the current published guidelines and our center's experience. Recent Findings: Oral antiviral medications and monoclonal antibodies are now used with the goal to prevent severe disease. Immunomodulating drugs in addition to antivirals have been used in the treatment of severe COVID-19. Summary: With the ongoing pandemic and unique challenges posed by the SOTR, understanding the risk and advancing management and treatment of COVID-19 infections are imperative to the successful care of a transplant recipient. There are many ongoing clinical trials being conducted in hopes of developing novel therapeutics towards COVID-19.

Parental Home Monitoring and Support and Students' Online Learning and Socioemotional Well-Being During COVID-19 School Suspension in Hong Kong.

Contextualized in the prolonged period of COVID-19-related school suspension in Hong Kong, the present study unravels relationships among socioeconomic status (SES), parental involvement, and learning outcomes for a matched sample of 186 primary and 932 secondary school students and their parents who participated in the eCitizen Education 360 survey. Three-step latent profile analysis (LPA) revealed different types of parental involvement at home and in school. For the primary school sample, students' SES did not predict membership in the parental involvement typology, but students whose parents provided more home monitoring and support had the highest level of online self-efficacy. As for the secondary student sample, students whose parents provided more home monitoring and support tended to have access to more home learning resources. Students whose parents provided home monitoring and support had the highest levels of online self-efficacy, acquisition of digital skills, and cognitive-emotional regulation, and were the least worried about school resumption. The study underscores complex patterns of parental involvement and identifies effective parental involvement practices that contribute to students' home online learning during the school suspension.

Measuring Digital Literacy during the COVID-19 Pandemic: Experiences with Remote Assessment in Hong Kong

Hong Kong was one of the first places hit with the COVID-19 outbreak in January 2020 and has since responded with several periods of full or partial school suspension, during which teaching and learning often occurred remotely using digital means. During this time, collecting research data and testing students have become more difficult than before. In this article, we report on a large-scale digital literacy (DL) performance assessment in Hong Kong that had to be conducted in a mix of modes?onsite, online supported, and online self-directed?during the pandemic. We discuss the administrative and methodological challenges of assessing DL, and explore preliminary data on the associations between student performance and the assessment mode adopted. We further discuss potential implications, including for high-stakes testing, and make recommendations for assessing DL remotely.

Patient-reportedimpact of myasthenia gravis in the real world: protocol for a digital observational study (MyRealWorld MG).

INTRODUCTION: Myasthenia gravis (MG) is a rare, chronic, autoimmune disease, mediated by immunoglobulin G antibodies, which causes debilitating muscle weakness. As with most rare diseases, there is little patient-reported data with which to understand and address patient needs. This study explores the impact of MG in the real world from the patient perspective. METHODS AND ANALYSIS: This is a 2-year prospective, observational, digital, longitudinal study of adults with MG, resident in the following countries: the USA, Japan, Germany, France, the UK, Italy, Spain, Canada and Belgium. The planned sample size is 2000. Recruitment will be community based, via patient advocacy groups, social media and word of mouth. Participants will use a smartphone application (app) to check eligibility, provide consent and contribute data. Planned data entry is as follows: (1) personal profile on enrollment-covering demographics, MG characteristics and previous care; (2) monthly event tracker-current treatments, healthcare visits, treatment-related adverse events, productivity losses; (3) monthly selection of validated generic and disease-specific patient-reported outcomes instruments: EQ-5D-5L, Myasthenia Gravis Activities of Daily Living, Myasthenia Gravis Quality of Life 15-item revised scale, Hospital Anxiety and Depression Scale and Health Utilities Index III. Analyses are planned for when the study has been running in most countries for approximately 6, 12, 18 and 24 months. ETHICS AND DISSEMINATION: The study protocol has been reviewed and granted ethics approval by Salus IRB for participants resident in the following countries: Germany, the UK and the US. Local ethics approval is being sought for the following study countries: Belgium, Canada, France, Italy, Japan and Spain. Study results will be communicated to the public and participants via conference presentations and journal publications, as well as regular email, social media and in-application communication. TRIAL REGISTRATION NUMBER: NCT04176211.