Psychological distress and symptom-related burnout in asthma during the COVID-19 pandemic.

People with asthma may be particularly vulnerable to pandemic-related psychological distress, and research is needed to understand the impact of the coronavirus disease 19 (COVID-19) pandemic on their health and well-being. We sought to study the well-being of people with asthma relative to non-asthmatic controls during the COVID-19 pandemic. We also investigated asthma symptoms and COVID-19-related anxiety as potential mediators of distress. Participants completed self-report measures of psychological functioning, including anxiety, depression, stress, and burnout. Controlling for potential confounds, multiple-regression analyses examined differences in psychological health between people with and without asthma. Mediator analyses investigated the role of asthma symptoms and COVID-19-related anxiety in this relationship. 234 adults (111 with asthma, 123 without) participated in an online survey from July to November 2020. During this time, people with asthma reported higher levels of anxiety, perceived stress, and burnout symptoms compared to controls. Elevations in burnout symptoms were found beyond general anxiety and depression (sr2 = .03, p < .001). Reported symptoms typical in both asthma and COVID-19 partially mediated this relationship (Pm = .42, p < .05). People with asthma reported unique psychological challenges during the COVID-19 pandemic including elevated burnout symptoms. Experience of asthma symptoms played a key role in vulnerability to emotional exhaustion. Clinical implications include increased attention to asthma symptom burden within the context of heightened environmental stress and restricted healthcare access.

CONSOLIDATION OF ERN-EUROBLOODNET: THE EUROPEAN REFERENCE NETWORK ON RARE HEMATOLOGICAL DISEASES FIRST 5 YEARS OF IMPLEMENTATION

Background: ERN-EuroBloodNet was established in 2017 as the European Reference Network on Rare Hematological Disorders (RHDs) bringing together nationally recognized centres of excellence with the goal of promoting EU best health care in RHDs. ERN-EuroBloodNet has been recently enlarged integrating 103 HCP from 24 EU-MS. Aims: ERN-EuroBloodNet was conceived to contribute to innovative, efficient and sustainable health systems and facilitate access to better and safer healthcare for EU citizens while decreasing the cross-border health barriers. Methods: Since 2017, ERN-EuroBloodNet established the state-of-the art of RHD allowing the implementation of transversal and disease-specific strategies, where actions on very rare RHD were prioritized. Results: Profile. 182 expert profiles were created freely accessible. Expert centers follow 65,000 RHD patients and treat 5,000 new patients per year, while 24 patients requested support for cross-border health assistance. Expertise. The need to improve access to next-generation sequencing for non-oncological RHD and bone marrow transplantation for sickle cell disease (SCD) was identified. Also, significant disparities in the clinical practice of primary vitreoretinal lymphoma were found and we demonstrated that less than 30% of children with SCD benefit from adequate annual stroke risk monitoring. Guidelines. A repository of 68 Clinical Practice Guidelines (CPG) classified on quality of evidence and consensus approach was created. Recommendations for diagnosis and treatment of methemoglobinemia was published in collaboration with EHA. A CPG on Adult Burkitt Lymphoma is under development. Next topics focus long-term complications in hemoglobinopathies and patients' pathways&summary. Education. ERN-EuroBloodNet Webinars were launched for professionals with 26 Thursdays Webinars and 3 EBAH accredited Topic on Focus on Cutaneous Lymphoma, Thrombotic Microangiopathies, and Bone Marrow Failures. A collaboration was established for EHA & ERN-EuroBloodNet Spotlight on Castleman Disease. For patients, 3 Topic on Focus were launched for Myelodysplastic syndromes, SCD, and Cutaneous lymphoma. Past webinars are available at EuroBloodNet EDU Youtube channel. Preceptorships on SCD will be launched soon. Telemedicine. 43 complex cases have been inter-professionally discussed in the Clinical Patient Management System with 21 outcome reports delivered. Registries. 184 Registries were identified through the European Rare Blood Diseases Platform (ENROL), endorsed by the EHA. The ENROL project, which includes rare anemias, dendritic cell leukemia and von Villebrand's disease pilots, aims to collect exhaustive and therefore epidemiological data for RHDs. The final objective is a possibility of EU health planningl and the promotion of research by identifying cohorts of patients. ERNEuroBloodNet launched the collaborative platform on patients with red blood cells and COVID-19 containing so far 373 patients. Collaborations. collaborative research projects were encouraged like EC-funded projects i.e., genomics and personalized medicine in hematological diseases (GenoMed4All) and the properties and viability of erythrocytes (EVIDENCE), or the International Hemoglobinopathy Research Network (INHERENT) for genomic and phenotypic correlations. Summary/Conclusion: The implementation of well-defined strategies but above all adapted to the specific and not yet covered needs of RHD has led to the realization of concrete projects. This has laid the foundations to strengthen health systems in the field of RHD and allow them to flourish under the new EU4Health programme.

Boosting nitric oxide in stress and respiratory infection: Potential relevance for asthma and COVID-19.

Nitric oxide (NO) is a ubiquitous signaling molecule that is critical for supporting a plethora of processes in biological organisms. Among these, its role in the innate immune system as a first line of defense against pathogens has received less attention. In asthma, levels of exhaled NO have been utilized as a window into airway inflammation caused by allergic processes. However, respiratory infections count among the most important triggers of disease exacerbations. Among the multitude of factors that affect NO levels are psychological processes. In particular, longer lasting states of psychological stress and depression have been shown to attenuate NO production. The novel SARS-CoV-2 virus, which has caused a pandemic, and with that, sustained levels of psychological stress globally, also adversely affects NO signaling. We review evidence on the role of NO in respiratory infection, including COVID-19, and stress, and argue that boosting NO bioavailability may be beneficial in protection from infections, thus benefitting individuals who suffer from stress in asthma or SARS-CoV-2 infection.

A Review on Mode of Delivery during COVID-19 between December 2019 and April 2020.

OBJECTIVE: This study aims to review the published literature to determine mode of delivery in pregnant women with coronavirus disease 2019 (COVID-19) and the indications reported for cesarean section early in the pandemic to add information to the current narrative and raise awareness of trends discovered. STUDY DESIGN: A systematic review was conducted by searching PubMed, Scopus, and ScienceDirect databases for articles published between December 2019 and April 29, 2020 using a combination of the keywords such as COVID-19, coronavirus 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), pregnancy, vaginal delivery, cesarean section, vertical transmission, management, and guidelines. Peer-reviewed case studies with confirmed SARS-CoV-2 women who delivered were included to determine mode of delivery, indications for cesarean section, and maternal and neonatal characteristics. RESULTS: A review of 36 total articles revealed deliveries in 203 SARS-CoV-2 positive pregnant women. A comparable severity of disease in pregnant versus nonpregnant women was noted, as previously determined. Overall, 68.9% of women delivered via cesarean section, with COVID-19 status alone being a common indication. Maternal COVID-19 may also be associated with increased risk of preterm labor, although neonatal outcomes were generally favorable. Despite eight of 206 newborns testing positive for SARS-CoV-2, there remains no definitive evidence of vertical transmission. CONCLUSION: COVID-19 status alone became a common indication for cesarean delivery early in the pandemic, despite lack of evidence for vertical transmission. The increase in cesarean rate in this data may reflect obstetricians attempting to serve their patients in the best way possible given the current climate of constantly evolving guidelines on safest mode of delivery for the mother, infant, and provider. Upholding current recommendations from trusted organizations as new data are published, while also providing individualized support to expecting mothers on most appropriate mode of delivery, will reduce the amount of unnecessary, unplanned cesarean sections and could lessen the psychological impact of delivering during the COVID-19 pandemic. KEY POINTS: · COVID-19 may result in an increased rate of cesarean delivery for SARS-CoV-2 positive pregnant women.. · COVID-19 is a commonly reported indication for cesarean section, despite management guidelines urging against this.. · Although eight neonates tested positive for SARS-CoV-2, all additional fluid and tissue samples tested negative..

Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act: Division B--Revenue Provisions [May 15, 2020]

From the Document: Congress continues to consider proposals intended to alleviate the economic effects associated with the Coronavirus Disease 2019, or COVID-19, pandemic. One such proposal, the Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act (H.R. 6800), was introduced in the House on May 12, 2020. Division B of the HEROES Act, or the COVID-19 Tax Relief Act of 2020, contains a number of individual and business tax provisions, including [1] a one-time direct payment for eligible individuals, and an expansion of eligibility for the direct payments provided in the CARES [Coronavirus Aid, Relief, and Economic Security] Act;[2] enhanced benefits and/or expanded eligibility for the earned income tax credit (EITC), child tax credit, and child and dependent care tax credit, and suspension of the limitation on the deduction for state and local taxes paid;[3] expansions of tax credits for paid sick leave and paid family leave;[4] tax credits for employers and employees in businesses susceptible to COVID-19- related interruptions;[5] expanded utilization options for certain employee health and dependent care benefits;and [6] a permanent limitation on using noncorporate business losses to offset nonbusiness income, and reduced ability to carry back recent net operating losses.COVID-19 (Disease);Economic assistance

Noncitizens and Eligibility for the 2020 Recovery Rebates [May 1, 2020]

From the Document: Some policymakers have expressed concern that certain individuals, including some immigrants (referred to as noncitizens, foreign nationals, or aliens in law and throughout this Insight), are ineligible for direct payments under the Coronavirus Aid, Relief, and Economic Security Act (CARES Act;P.L. 116-136). The statute refers to these payments as 2020 recovery rebates. The Internal Revenue Service (IRS) refers to these payments issued in 2020 as Economic Impact Payments. [...] There are three main categories of individuals who are ineligible for these payments (not necessarily mutually exclusive): 1. children over 16 years old and adult dependents;2. certain noncitizens who have individual taxpayer identification numbers (ITINs) or are nonresident aliens;and 3. higher-income taxpayers (generally with income over $99,000 if single, $198,000 if married, with higher thresholds for those with qualifying children). Generally, receipt of these payments in 2020 will be based on individuals' eligibility using information from 2019 (or, if unavailable, 2018). This Insight provides an overview of one category of individuals who are ineligible for the 2020 recovery rebates--certain noncitizens who have ITINs or are nonresident aliens.Tax rebates;Aliens;COVID-19 (Disease);Coronavirus Aid, Relief, and Economic Security (CARES) Act

How Would the HEROES Act (HR 6800) Modify the Direct Payments Enacted in the CARES Act (PL 116-136)? [May 19, 2020]

From the Document: The Coronavirus Aid, Relief, and Economic Security Act (CARES Act;P.L. 116-136), signed into law on March 27, 2020, included direct payments to individuals--referred to in the law as '2020 recovery rebates.' The Internal Revenue Service (IRS) refers to the payments issued in 2020 as economic impact payments (EIPs), whereas some media reports call them 'stimulus payments.' The recovery rebates are tax credits administered by the IRS. [...] The Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act (H.R. 6800), as passed by the House on May 15, 2020, would modify the direct payments provided in the CARES Act. Additionally, the HEROES Act would create a second round of direct payments. This Insight summarizes the proposed modifications, first describing the current-law treatment and then summarizing the HEROES Act changes.COVID-19 (Disease);Economic assistance, Domestic;Coronavirus Aid, Relief, and Economic Security (CARES) Act

COVID-19: Summary of the Direct Payments Proposed in the Heroes Act (HR 6800) [May 19, 2020]

From the Document: The Health and Economic Recovery Omnibus Emergency Solutions Act (HEROES Act;H.R. 6800), as passed by the House on May 15, 2020, proposes new direct payments to individuals, which the bill text refers to as 'additional recovery rebates to individuals.' Direct payments were included in the Coronavirus Aid, Relief, and Economic Security Act (CARES Act;P.L. 116-136), which was signed into law on March 27, 2020. This Insight provides a brief overview of the additional direct payments included in the HEROES Act. (The HEROES Act would also modify the direct payments in the CARES Act. These changes are summarized in a companion Insight).COVID-19 (Disease);Economic assistance;Coronavirus Aid, Relief, and Economic Security (CARES) Act

COVID-19: Child Care Tax Provisions in H.R. 7327 [July 24, 2020]

From the Document: The Coronavirus Disease (COVID-19) pandemic has broadly impacted child care in the United States. Surveys conducted in April of both working families with young children and child care providers found that the majority of child care providers had fully closed or reduced their enrollment. Data from the Bureau of Labor Statistics suggest that the number of child care workers decreased by about one-third between March and April [...] and about one-quarter between March and June, with the latter number potentially reflecting the effects of states partially reopening. Parents and providers have questions about if and when child care facilities will be able to reopen safely. The COVID-19 pandemic has also amplified concerns about child care affordability. As Congress continues to debate whether more needs to be done to address child care at the federal level, the House Rules Committee recently reported a resolution that would allow the House to consider two bills related to child care. One of those bills, the Child Care for Economic Recovery Act (H.R. 7327), includes several tax provisions, as summarized in this Insight.Child care--Taxation;Economics;Disaster recovery