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The study investigated factors influencing tourists' adaptive behaviors and advocacy for domestic destinations during COVID-19 using a combination of integrated generalized structured component analysis (IGSCA) and fuzzy set qualitative comparative analysis (fsQCA). One thousand tourists from Thailand, South Korea, and China participated in the study. The results revealed that fsQCA's multiple configurations provided valuable insights into the antecedents affecting adaptive behavior and destination advocacy, which complemented IGSCA's symmetric results. The study affirmed the complexity of antecedents that impact outcomes and supported the notion of complexity theory in explaining tourists' destination supporting behavior. The study provided implications for future research in this area.
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Both enterprises and their employees have globally experienced remote work at an unprecedented scale since the outbreak of COVID-19. As the pandemic becomes less of a threat, some companies have called their employees back to a physical office, citing issues related to working remotely, but many employees have refused to return. Thus, working in the metaverse has gained much attention as an alternative that could complement the weaknesses of completely remote work or even offline work. However, we do not know yet what benefits and drawbacks the metaverse has as a legitimate workspace, because there are few real cases of 1) working in the metaverse and 2) working remotely at such an unprecedented scale. Thus, this paper aims to identify real challenges and opportunities the metaverse workspace presents when compared to remote work by conducting semi-structured interviews and participatory workshops with various employees and company stakeholders (e.g., HR managers and CEOs) who have experienced at least two of three work types: working in a physical office, remotely, or in the metaverse. Consequently, we identified 1) advantages and disadvantages of remote work and 2) opportunities and challenges of the metaverse. We further discuss design implications that may overcome the identified challenges of working in the metaverse. © 2023 Owner/Author.
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In this study, the components of microwave-assisted extracts obtained from Thuja orientalis leaves were analyzed, and the cytotoxicity, antibacterial and antiviral activities were evaluated. The predominant components from microwave-assisted extraction were catechin, leucopelargonidin, arecatannin, quinolone, and kaempferol derivatives, which are classified in the fla-vonoid and tannin groups. We observed that the 0.11 mg/mL of extract concentration did not show cytotoxicity in HaCaT cells. The antibacterial activities were tested according to the guidelines of methods for determining the bactericidal activity of antimicrobial agents. The extracts showed 99.9% antibacterial efficiency against gram-positive S. aureus, while the anti-bacterial effect on gram-negative E. coli was insignificant. When the extract concentration and contact time with bacteria were increased, 99.9% antibacterial efficiency was observed for E. coli as well as S. aureus. Following the standard to assess the activity of microbicides against viruses in suspension (ASTM-E1052-20), the antiviral efficiency was more than 99.99% for influenza A (H1N1) and SARS-CoV-2. These results suggest its potential use in antiviral disinfectants, surface coatings, personal protective equipment, and textiles. © 2023 The Korean Society of Industrial and Engineering Chemistry. All rights reserved.
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Background & Aim: Immunological characteristics of COVID-19 show pathological hyperinflammation associated with lymphopenia and dysfunctional T cell responses. These features provide a rationale for restoring functional T cell immunity in COVID-19 patients by adoptive transfer of SARS-CoV-2 specific T cells. Methods, Results & Conclusion(s): To generate SARS-CoV-2 specific T cells, we isolated peripheral blood mononuclear cells from 7 COVID-19 recovered and 13 unexposed donors. Consequently, we stimulated cells with SARS-CoV-2 peptide mixtures covering spike, membrane and nucleocapsid proteins. Then, we culture expanded cells with IL-2 for 21 days. We assessed immunophenotypes, cytokine profiles, antigen specificity of the final cell products. Our results show that SARSCoV- 2 specific T cells could be expanded in both COVID-19 recovered and unexposed groups. Immunophenotypes were similar in both groups showing CD4+ T cell dominance, but CD8+ and CD3+CD56+ T cells were also present. Antigen specificity was determined by ELISPOT, intracellular cytokine assay, and cytotoxicity assays. One out of 14 individuals who were previously unexposed to SARS-CoV-2 failed to show antigen specificity. Moreover, ex-vivo expanded SARS-CoV-2 specific T cells mainly consisted of central and effector memory subsets with reduced alloreactivity against HLA-unmatched cells suggesting the possibility for the development of third-party partial HLA-matching products. In conclusion, our findings show that SARSCoV- 2 specific T cell can be readily expanded from both COVID-19 and unexposed individuals and can therefore be manufactured as a biopharmaceutical product to treat severe COVID-19 patients.Copyright © 2023 International Society for Cell & Gene Therapy
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A first-stage moderated mediation model consisting of general risk awareness of COVID-19, perceived risk of playing golf, and revisit intention was introduced to specify when and how political orientation influences an individual's decision to play golf again. Findings are discussed in the context of a dual process model of political identity, and the implications for practice as well as future research are presented. Consumers consciously or subconsciously conduct risk-benefit analysis for consumption choices, whether it is a careful piecemeal examination or a heuristic probe (Hespanhol et al., 2015). [...]golf was considered a safer recreational activity with relatively little risk of transmission than other activities where social distancing was either difficult or impossible (Robinson et al., 2021). [...]it is worth exploring the relationship between general risk awareness of the disease and domain-specific risk and how they influence individuals' decisions to play golf.
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Objectives: Efforts to combat COVID-19 have largely focused on vaccination and non-pharmaceutical interventions to decrease hospitalization and death and to reduce transmission. First generation COVID-19 direct-acting antivirals (DAAs) are only authorized for high-risk patients to reduce individual risk of disease progression. However, DAAs can also impact transmission by reducing viral load, thereby shortening the duration of infectivity. Next generation oral DAAs in development may have safety profiles that are amenable to broader eligibility and use. This analysis estimates the economic and clinical impact of increasing the utilization of DAAs to treat COVID-19. Method(s): A susceptible-infected-recovered-susceptible model was developed to estimate COVID-19-related outcomes based on DAA uptake. Cost-savings modeled included reduced healthcare utilization amongst individual patients and, importantly, potential savings attributable to reduced transmission. Cost inputs included treatment acquisition costs, adverse events, healthcare utilization, and productivity losses based on published literature. One million individuals were assessed with clinical and economic outcomes estimated for DAA adoption by risk level. Result(s): The model projects 402,330 new infections per 1 million individuals annually, leading to 6,000 hospitalizations and 107 deaths. By increasing DAA use by 10% in the high-risk population and 20% in the standard-risk population, infections decreased to 312,000, with 1,800 fewer hospitalizations and 34 fewer deaths. Decreases in medical encounters were driven by reduction in transmission (77% of the decrease) and reduction in severity amongst those treated (23% of the decrease). Among deaths averted, 72% were attributable to the reduction in transmission. Overall, costs decrease by 23.5% with increased treatment. Conclusion(s): This study is among the first to model the potential population-level impact of DAAs in reducing infectivity and transmission, a factor currently under-emphasized in the literature. New DAAs under development with potentially improved safety profiles may expand the uptake of treatment and substantially reduce the clinical and economic burden of COVID-19.Copyright © 2023
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Background: COVID-19 causes significant morbidity and mortality, albeit with considerable heterogeneity among affected individuals. It remains unclear which host factors determine disease severity and survival. Given the propensity of clonal hematopoiesis (CH) to promote inflammation in healthy individuals, we investigated its effect on COVID-19 outcomes. Method(s): We performed a multi-omics interrogation of the genome, epigenome, transcriptome, and proteome of peripheral blood mononuclear cells from COVID-19 patients (n=227). We obtained clinical data, laboratory studies, and survival outcomes. We determined CH status and TET2-related DNA methylation. We performed single-cell proteogenomics to understand clonal composition in relation to cell phenotype. We interrogated single-cell gene expression in isolation and in conjunction with DNA accessibility. We integrated these multi-omics data to understand the effect of CH on clonal composition, gene expression, methylation of cis-regulatory elements, and lineage commitment in COVID-19 patients. We performed shRNA knockdowns to validate the effect of one candidate transcription factor in myeloid cell lines. Result(s): The presence of CH was strongly associated with COVID-19 severity and all-cause mortality, independent of age (HR 3.48, 95% CI 1.45-8.36, p=0.005). Differential methylation of promoters and enhancers was prevalent in TET2-mutant, but not DNMT3A-mutant CH. TET2- mutant CH was associated with enhanced classical/intermediate monocytosis and single-cell proteogenomics confirmed an enrichment of TET2 mutations in these cell types. We identified celltype specific gene expression changes associated with TET2 mutations in 102,072 single cells (n=34). Single-cell RNA-seq confirmed the skewing of hematopoiesis towards classical and intermediate monocytes and demonstrated the downregulation of EGR1 (a transcription factor important for monocyte differentiation) along with up-regulation of the lncRNA MALAT1 in monocytes. Combined scRNA-/scATAC-seq in 43,160 single cells (n=18) confirmed the skewing of hematopoiesis and up-regulation of MALAT1 in monocytes along with decreased accessibility of EGR1 motifs in known cis-regulatory elements. Using myeloid cell lines for functional validation, shRNA knockdowns of EGR1 confirmed the up-regulation of MALAT1 (in comparison to wildtype controls). Conclusion(s): CH is an independent prognostic factor in COVID-19 and skews hematopoiesis towards monocytosis. TET2-mutant CH is characterized by differential methylation and accessibility of enhancers binding myeloid transcriptions factors including EGR1. The ensuing loss of EGR1 expression in monocytes causes MALAT1 overexpression, a factor known to promote monocyte differentiation and inflammation. These data provide a mechanistic insight to the adverse prognostic impact of CH in COVID-19.
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Too often African knowledge systems are excluded from formal discussions surrounding public health, as they are often perceived traditional mechanisms that operate outside the sphere of mainstream science and medicine. Yet with the diffusion of COVID-19 across the globe, new conversations have emerged in relation to Africa's community-based successes in responding to the virus and its impacts. This chapter employs a geographical analysis of Senegal in order to highlight the ways in which Senegalese have approached the diffusion of COVID-19 and successfully controlled its spread. Using maps and qualitative data, this chapter underscores the ways in which global public health experts can draw from the expertise of African nations given the complex ways they have responded to both this pandemic and previous health emergencies. Findings indicate that science and community-based response systems are the key to Senegal's management of coronavirus. This chapter aims to subvert dominant discourses, which suggest that African states somehow stumbled upon their pandemic-related successes. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2023. All rights reserved.
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Since COVID-19 was declared a global pandemic, scholars and practitioners have put much effort into testing effective advertising strategies for COVID-19 vaccinations. Guided by humor theories, this study aimed to examine (1) the effect of humor on persuading COVID-19 vaccination and (2) the moderating role of trust in government for the unvaccinated population. Across two studies (college students and general adult populations), for lower trust in government individuals, through greater public service advertisement (PSA) processing depth and believability, there was a higher vaccination intention after the humor (non-humor) advertisement. For higher trust in government individuals, there was evidence that the vaccination intention was lowered after the humor (vs. non-humor) message through lowered PSA processing depth and believability. This study expands humor theory into testing COVID-19 vaccination messages while considering an individual psychological factor, trust in the government, that has emerged as an essential determinant to COVID-19 messaging. The contributions to COVID-19 vaccination advertising strategy and advertising to the unvaccinated population, in general, are discussed.
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The Deepwater Horizon oil spill, the largest in U.S. history, has impacted communities and residents, near and far, in numerous ways. This study proposed and tested a conceptual framework to examine the extent to which (a) information factors (sufficiency, repertoires, similarity, and sensitivity) and attitudes (feeling efficacious in seeking information and willingness/motivation to accept information) are associated with uncertainties in communities during the oil spill and (b) uncertainties, in turn, lead to symptoms of posttraumatic stress disorder (PTSD) after the spill. A cross-sectional survey study (N = 240) was conducted in the Houston Ship Channel area. Structural equation modeling was used to test the hypothesized conceptual model. Information sufficiency, information similarity, willingness to accept information, and efficacy in information seeking were significant predictors of uncertainty. These predictors explained 30.4% variances of uncertainty. Uncertainty was, in turn, a significant predictor of symptoms of PTSD. Current findings signify the importance of information factors and residents' attitudes in reducing uncertainty and symptoms of PTSD developed during crisis situations, including the current COVID-19 pandemic.
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In this paper, we propose a path control framework for guiding and simulating the patient's path of travel to speed up virus testing in pandemic situations, such as COVID-19. We use geographic information and hospital state information to construct graphs to yield optimal travel paths. Pathfinding algorithms A* and Navigation mesh, which have been widely used, are efficient when applied to control agents in a virtual environment. However, they are not suitable for real-time changing cases such as the COVID-19 environment because they guide only predetermined static routes. In order to receive a virus infection test quickly, there are many factors to consider, such as road traffic conditions, hospital size, number of patient movements, and patient processing time, in addition to guiding the shortest distance. In this paper, we propose a framework for digitally twinning various situations by modeling optimization functions considering various environmental factors in real-world urban maps to handle viral infection tests quickly and efficiently.
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Intro: Ritonavir-boosted nirmatrelvir has shown efficacy in reducing the rate of hospitalisation and 28-day mortality among unvaccinated populations with COVID-19. The role of Ritonavir-boosted nirmatrelvir among high risk hospitalised COVID-19 patients remained uncertain. Our study aimed to assess the efficacy of Ritonavir-boosted nirmatrelvir in reducing disease progression among high-risk hospitalised COVID-19 patients. Method(s): This is a retrospective case-control study (ratio 1:1) among hospitalised COVID-19 patients with mild-moderate severity, within 5 days of illness, and had at least one risk factor for severe disease. Treatment group (case) received Nirmatrelvir and Ritonavir twice daily for 5 days. Historical controls before the introduction of Ritonavir-boosted nirmatrelvir were obtained in the same hospital. Both groups received standard of care. The primary outcome was rate of clinical progression from non-hypoxia to hypoxia. Finding(s): 200 patients from January to July 2022 were included in the analysis, where 108 (54%) were male, mean age of 63.7 (SD 17.1), 95% completed primary COVID-19 vaccination and 91 (45.5%) had evidence of pneumonia (moderate severity). Most common comorbids were hypertension(65%), diabetes mellitus(40%) and overweight(36%). Clinical progression to hypoxia was significantly lower in the treatment group (4%) compared to the control group (18%) (OR=0.190, 95% CI: 0.0618 - 0.583). Comparing case to control, the rates of ICU admission were 1% vs 3%, mechanical ventilation 0% vs 2% and inpatient mortality 2% vs 2%. 97% patients completed Ritonavir-boosted nirmatrelvir in the treatment group. Conclusion(s): Among high-risk hospitalised COVID-19 patients who received ritonavir-boosted nirmatrevir, they were 81% less likely to experience desaturation. Ritonavir-boosted Nirmatrelvir remains beneficial among highly vaccinated populations during the Omicron wave in COVID-19 pandemic.Copyright © 2023
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In this study, the components of microwave-assisted extracts obtained from Thuja orientalis leaves were analyzed, and the cytotoxicity, antibacterial and antiviral activities were evaluated. The predominant components from microwave-assisted extraction were catechin, leucopelargonidin, arecatannin, quinolone, and kaempferol derivatives, which are classified in the fla-vonoid and tannin groups. We observed that the 0.11 mg/mL of extract concentration did not show cytotoxicity in HaCaT cells. The antibacterial activities were tested according to the guidelines of methods for determining the bactericidal activity of antimicrobial agents. The extracts showed 99.9% antibacterial efficiency against gram-positive S. aureus, while the anti-bacterial effect on gram-negative E. coli was insignificant. When the extract concentration and contact time with bacteria were increased, 99.9% antibacterial efficiency was observed for E. coli as well as S. aureus. Following the standard to assess the activity of microbicides against viruses in suspension (ASTM-E1052-20), the antiviral efficiency was more than 99.99% for influenza A (H1N1) and SARS-CoV-2. These results suggest its potential use in antiviral disinfectants, surface coatings, personal protective equipment, and textiles. © 2023 The Korean Society of Industrial and Engineering Chemistry. All rights reserved.
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Much uncertainty remains about effective messaging to boost public support for COVID-19 mitigation efforts, especially among people of color. We investigate the relationship between interview language and expressed support for COVID-19 public health protocols among Latinos: America's largest ethnic group. Prior work establishes that interview language shapes opinions by cognitively structuring which considerations people use to express attitudes. Yet other work suggests interview language shapes opinions by activating specific cultural norms associated with a tongue. We predicted that interviewing in Spanish (versus English) would boost support for COVID-19 protocols by activating pro-social norms known to be strongly associated with that language. We uncover null support for this prediction in a pre-registered experiment on bilingual Latino adults (N = 1645). Instead, we find that Latinos assigned to interview in Spanish report weaker support for COVID-19 protocols, regardless of which cultural norms are primed. We discuss implications for COVID-19 attitudes in linguistically diverse polities.
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Background: High titer COVID-19 convalescent plasma (CCP) reduces hospitalizations among immunocompetent outpatients. This study evaluated recipient post-transfusion S receptor binding domain (S-RBD) IgG antibody levels and the association of progressing to hospitalization among unvaccinated outpatients with COVID-19 treated with CCP or control plasma. Method(s): This analysis focused on participants from a multicenter doubleblind, randomized, controlled trial comparing treatment of outpatients with COVID-19 convalescent plasma (CCP) or control plasma without SARS-CoV-2 antibodies. Participants with confirmed SARS-CoV-2 infection were transfused within 9-days of symptom onset between June 2020 and October 2021 (n=110 vaccinated control;n=105 vaccinated CCP;n=464 unvaccinated control;n=472 unvaccinated CCP;total n=574 control and n=577 CCP recipients). All subjects had specimens collected the day prior to transfusion (D-1), within 30 minutes after transfusion (D0), 14 (D14), 28 (D28), and 90 (D90) days post-transfusion. Ancestral SARS-CoV-2 S-RBD was measured by an in-house validated ELISA. All 54 COVID-19-related hospitalizations occurred within 2 weeks of transfusion. Result(s): Post-transfusion anti-S-RBD IgG levels on D0 were significantly greater for CCP (median=4 titer,log3) compared to control (median=2 titer,log3;p< 0.001) recipients. Neither sex nor age impacted antibody levels following CCP treatment at D14, D28, and D90. Vaccinated recipients had greater titers than unvaccinated recipients prior to transfusion with little change in titers post-transfusion. Unvaccinated recipients had low antibody titers on D-1 with CCP recipients exhibiting a significant increase in titer from D-1 to D0 compared to controls (mean fold change=1.89;p< 0.001). Among unvaccinated recipients, those who received CCP transfusion late ( >5 days after symptom onset) and had low D0 antibody levels (< 4.24 titer, log3) had the greatest proportion of hospitalizations (5.5%). In contrast, those who received CCP transfusion early (< 5 days after symptom onset) with high D0 antibody levels ( >4.24 titer, log3) had no hospitalizations. Unvaccinated CCP recipient anti-S-RBD IgG antibody levels on D0 correlated with donor anti-S-RBD IgG antibody levels (r=0.30, p< 0.001). Conclusion(s): Among unvaccinated outpatients with COVID-19, CCP recipient antibody dilutional titers after transfusion over 540 titer correlated with protection against hospitalization when transfusion occurred within 5 days of symptom onset. (Figure Presented).
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Background: People with HIV (PWH) on antiretroviral therapy (ART) appear to be at higher risk for worse COVID-19 outcomes, but the underlying mechanisms-including effects of COVID-19 and host factors on the broader humoral immune repertoire-are poorly understood. Method(s): REPRIEVE enrolled a global cohort of ART-treated PWH ages 40-75. COVID+ was defined by positive receptor binding domain IgG or IgA from annual visits 5/2020-2/2021. Antibody isotype, subclass, and Fc receptor Luminex arrays to SARS-CoV-2, CMV, EBV, HSV, HIV, influenza, pneumococcus, and RSV were assessed. Report of COVID diagnosis (collected every 4 months) was defined as mild, moderate, or severe (asymptomatic if no clinical diagnosis but IgG/ IgA+). FDR-corrected regression was used to assess effects of 1) COVID+ on non- SARS-CoV-2 repertoire in full cohort and 2) host factors on non-SARS-CoV-2 and SARS-CoV-2 repertoire in COVID- and COVID+ cohorts, respectively, adjusted for age, sex, region, nadir CD4, and HIV VL at entry. Result(s): Of 2,464 unvaccinated participants, 283 (11%) were COVID+;260 (92%) were asymptomatic. Median age was 53, 35% were women, 50% had nadir CD4 < 200, median current CD4 was 649, and 97% had HIV VL < 400. In the full cohort, COVID+ was associated with higher CMV PP65 IgG3 and FcgammaRIIA (P< 0.05);COVID severity was not associated with the non-SARS-CoV-2 repertoire. Among COVID-, older age, female sex, and lower nadir CD4 were associated with higher EBV and CMV responses;IgG1 levels were higher in women for all non-SARS-CoV-2 antigens assessed (P< 0.05). Among COVID+, higher BMI was associated with amplified SARS-CoV-2 IgG, IgA, IgM, and FcgammaRIIA responses (P< 0.05). Lower nadir CD4 was associated with a SARSCoV- 2 repertoire shift toward IgM and FcgammaRIIB (P< 0.05). Age and sex were not associated with SARS-CoV-2-related repertoire changes in COVID+. Conclusion(s): Our analysis presents a comprehensive view of host factors associated with the humoral immune repertoire among a global cohort of ART-treated PWH. COVID's association with higher CMV responses may suggest increased susceptibility to or a consequence of persistent inflammation after infection. The striking amplification of SARS-CoV-2 responses with higher BMI suggests an excessive inflammatory response. Lower nadir CD4 was related to uncontrolled extra-follicular and inhibitory SARS-CoV-2 responses, which are unlikely to be protective. These findings may suggest mechanisms underlying factors associated with worse COVID-19 outcomes among PWH. (Figure Presented).
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Introduction: Virtual communication has become common practice during the COVID-19 pandemic due to visitation restriction. We aimed to evaluate overall family satisfaction in intensive care unit (FS-ICU) with virtual communication strategies during the COVID-19 pandemic period. Method(s): In this prospective multi-centre study involving three metropolitan hospitals in Melbourne, Australia, the next of kin (NOK) of all the eligible ICU patients between 07/01/2022 and 10/31/2020 were required to complete an adopted version of FS-ICU 24-Questionnaire. Group comparisons were analysed for family satisfaction scores: ICU/ care (satisfaction with care), FS-ICU/dm (satisfaction with information/ decision-making) and FS-ICU total (overall satisfaction with the ICU) were calculated. The essential predictors that influence family satisfaction were identified using quantitative and qualitative analyses. Result(s): Seventy-three out of the 227 patients' NOK who initially agreed, completed the FS-ICU questionnaire (response rate 32.2%). The mean (SD) FS-ICU/total was 63.9 (30.8). The mean score for satisfaction with FS-ICU/dm was lower than the FS-ICU/care (62.1 [30.30 vs. 65.4 [31.4];p 0.001) (Fig. 1). There was no difference in mean FS-ICU/ total scores between survivors (n = 65;89%) and non-survivors (n = 8, 11%). Higher patient APACHE-III score, female NOK and the patient dying in ICU were independent predictors for FS-ICU/total score while a telephone call at least once a day by an ICU doctor was related to higher family satisfaction for FS-ICU/dm. Conclusion(s): There was low overall family satisfaction with ICU care and virtual communication strategies adopted during the COVID-19 pandemic. Effort should be targeted for improving factors with virtual communication that cause low family satisfaction during the COVID-19 pandemic.
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Introduction/Aim: Self-management is considered important in people with pulmonary fibrosis (PF);however, components of self-management that are relevant to PF are not well defined. This study aimed to identify the common self-management components used in PF. Method(s): A scoping review was conducted according to the Joanna Briggs Institute Manual for Evidence Synthesis. The protocol was registered with Open Science Framework database (doi: https://doi.org/10.17605/OSF.IO/EUZ6S). A systematic search was conducted on August 16, 2022, using five electronic databases (Medline, Embase, PsychInfo, CINAHL and the Cochrane central register of controlled trials). Search results were screened and studies were included if they (i) described any educational, behavioural and support components that aimed at facilitating self-management;(ii) involved adults with PF;and (iii) employed quantitative, qualitative or mixed methods. Two researchers performed record screening and data extraction independently followed by discussions of discrepancies. Result(s): Of the 27081 records screened, 87 studies were included (39% observational studies, 26% randomised controlled trials). The most common self-management components were patient education (78%), information or support for managing physical symptoms (66%) and enhancing psychosocial wellbeing (54%). Majority of the included studies (71%) were rehabilitation programs with evidence of self-management training such as home exercise program and breathing training. Other studies included palliative care programs consisting of components such as patient education and care goal setting (12%), support programs for managing medication (4%), home-based self-monitoring training (4%), disease management programs (4%), mindfulness-focused stress reduction program (1%), telemedicine service delivered during the COVID-19 outbreak that included strategies to prevent infections and self-monitoring of clinical parameters (1%) and PF-specific educational and support website (1%). Over half of the interventions were provided by a multidisciplinary team. Conclusion(s): This review identified the common components used to promote self-management in PF. These findings help to guide the development of optimal interventions to support self-management in PF.
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Background: Immunocompromised patients with COVID-19 tend to shed viable virus for a prolonged period. Therefore, for moderately or severely immunocompromised patients with COVID-19, CDC recommends an isolation period of at least 20 days and ending isolation in conjunction with serial testing and consultation with an infectious disease specialist. However, data on viral kinetics and risk factors for prolonged viral shedding in these patients are limited. Method(s): From February 1, 2022 to April 1, 2022, we collected weekly saliva samples from immunocompromised patients with COVID-19 admitted to a tertiary hospital in Seoul, South Korea. Genomic and subgenomic RNAs were measured, and virus culture was performed. Result(s): A total of 41 patients were enrolled;29 (70%) were receiving chemotherapy against hematologic malignancies and the remaining 12 (30%) had undergone solid organ transplantation. Of the 41 patients, 14 (34%) had received 3 doses or more of COVID-19 vaccines. Real-time RT-PCR revealed that 7 (17%) were infected with Omicron BA.1, and 33 (80%) with Omicron BA.2. The median duration of viable virus shedding was 4 weeks (IQR 3-6). Patients undergoing B-cell depleting therapy shed viable virus for longer than the comparator (p=0.01). Multivariable analysis showed that 3-dose or more vaccination (HR 0.33, 95% CI 0.12 - 0.93, p = 0.04) and B-cell depleting therapy (HR 12.50, 95% CI 2.44 - 100.00, p = 0.003) independently affected viable virus shedding of SARS-CoV-2. Conclusion(s): Immunocompromised patients with COVID-19 shed viable virus for median 4 weeks. B-cell depleting therapy increases the risk of prolonged viable viral shedding, while completion of a primary vaccine series reduces this risk. Overall distribution of samples according to genomic viral copy number and culture positivity. Red dot indicates positive culture results, whereas blue dot indicated negative culture results. (Figure Presented).