ABSTRACT
"COVID-toes" are chilblains that occurred in patients who may have been exposed to SARS-CoV-2, but without COVID-19 symptoms and/or with negative PCR or serology. The literature suggests that chilblains are an unexpected consequence of a strong interferon-mediated antiviral response, but the underlying molecular mechanisms remain poorly understood. We thus sought to explore the physiopathology of COVID-related chilblains by using spatially and temporally resolved transcriptomics. We included 19 patients with COVID-toes, and performed a complete virological assessment to exclude SARS-CoV-2 infection including skin viral metagenomics. Some patients had clinical symptoms evoking viral infection, but none had COVID-19. Apart from low levels of non-conventional antiphospholipid antibodies, biological tests were unremarkable. We performed spatially resolved transcriptomics (Visium, 10X Genomics) in 3 patients at different timepoints and compared them with 1 vaccination-related chilblain. We observed a different transcriptional profile in COVID-toes compared with COVID-19 vaccine-related chilblains. IRF1, CXCL10, ISG15 and STAT1 were highly expressed in COVID-toes and their expression decreased over time, confirming an activation of interferon and JAK/STAT pathways that was absent in vaccine-related chilblains. The proportion of inflammatory cell types obtained by spatial deconvolution varied over time in COVID-toes. Migratory dendritic cells were present at early stages, while T lymphocytes populations increased later. Overall, this work explores the mechanisms of COVID-19-related chilblains using spatially and temporally resolved transcriptomics.Copyright © 2023
ABSTRACT
Work continuity is one of the most critical issues that have emerged due to the COVID-19 pandemic. The different public and private sectors have suffered from the consequent disruption, leading to numerous cases of work discontinuity. The pandemic experience is an example of a national crisis where sustaining work and duties comprise a serious challenge, but it has also introduced the concept of remote and hybrid working. This paper explores sustaining work continuity through hybrid work environments by analyzing the different challenges and threats that would lead to work discontinuities, including culture, technology, geography, focusing on the public sector experience in the Kingdom of Bahrain. It mainly questions the efficiency and quality of services provided by public sector institutions during the pandemic in addition to employees' satisfaction with the continuity of remote work as a permanent alternative to the traditional ways of in-person attendance. In order to deduce feasible and pragmatic solutions, the adopted methodology integrates two approaches to analyze data, which substantially relies on the Institute of Public Administration in Bahrain (BIPA) and other academic resources. First, the collected data is analyzed through the Design Thinking approach, and then the addressed problems and possible solutions are validated through two Delphi Protocol rounds. In terms of building hybrid environments, a model has been adopted based on looking into employee and customer satisfaction by extracting a number of indicators related to the sustainability of work continuity. The paper concludes with recommendations that would improve work continuity during and after crises through hybrid work systems and policies that would assure smooth work performance and effective internal and external communication. © 2021 IEEE.