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Background: COVID-19 vaccine booster uptake remains low and preventable COVID-19 deaths continue to occur, making access to oral antivirals for those most at risk of severe COVID-19 outcomes essential. Method(s): We estimated age and gender adjusted prevalence ratios of oral nirmatrelvir-ritonavir (NMV/r) uptake by sociodemographics, clinical characteristics, and prescription eligibility (based on age, underlying medical conditions, body mass index, physical inactivity, pregnancy, or smokers), among participants in a large U.S. national prospective cohort who were infected with SARS-CoV-2 between December 2021 and October 2022. Among participants who reported NMV/r uptake, we also described the proportion who reported (1) taking NMV/r as directed and (2) NMV/r was helpful for reducing COVID-19 symptoms. Result(s): Among 1,594 participants with a SARS-CoV-2 infection as of October 2022, 1,356 were eligible for NMV/r prescription;of whom 209 (15.4% [95%CI:13.5-17.3]) reported receiving NMV/r. NMV/r uptake increased from 2.2% (95%CI:1.0-3.4) between December 2021 and March 2022 to 16.5% (95% CI:13.0-20.0) between April and July 2022 and 28.6% (95%CI:24.4-32.8) between August and October 2022, respectively. Participants >=65 years of age reported the highest uptake of NMV/r (30.2% [95%CI:22.2-38.2]). Black non-Hispanic participants (7.2% [95%CI:2.4-12.0]) and those in the lowest income group (10.6% [95%CI:7.3-13.8]) had lower uptake than white non-Hispanic (15.8% [95%CI:13.6-18.0]) and high-income individuals (18.4% [95%CI:15.2-21.7]), respectively. Participants with type 2 diabetes had greater uptake (28.8% [95%CI:20.4-37.3]), compared to those without it (12.4% [95%CI:4.8-20.0]). Among a subset of 278 participants who had a prior SARSCoV-2 infection, those who had a history of long COVID reported greater uptake (22.0% [95%CI:13.9-30.1]) for a subsequent SARS-CoV-2 infection than those without a history of long COVID (7.9% [95%CI:3.9-11.8]). Among all participants who were prescribed NMV/r (N=216), 89% (95%CI:85-93) reported that they took NMV/r as directed and 63% (95%CI:57-70) stated NMV/r was helpful for reducing COVID-19 symptoms. Conclusion(s): Uptake of NMV/r increased over time coinciding with national efforts to increase awareness and access. However, most individuals who were eligible for NMV/r did not receive it. Lower NMV/r uptake among racial/ethnic minorities and individuals with lower household income suggests a need to improve awareness and address barriers to uptake in these populations.
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Background: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are common and associated with respiratory function decline, increased morbidity and mortality. It is unclear how COVID19 has impacted AECOPD phenotype and if it is associated with worse outcomes compared to other infections in COPD patients. Aim(s): To explore changes in AECOPD clinical characteristics and outcomes during the COVID-19 pandemic. Method(s): A prospective cohort study of all adults >=18y admitted to either acute care hospital in Bristol UK, Aug 20- Jul 21. Patients presenting with signs/symptoms or a clinical/radiological diagnosis of acute respiratory disease were included. Result(s): 2557 hospitalisations with AECOPD were recorded (incidence 361 per 100000);13% had SARS-CoV-2 identified, 69% had another pathogen and 18% had no infectious aetiology identified. Patient characteristics and clinical features were similar for patients with and without COVID19. ICU admissions were more common with SARS-CoV-2 than other infections (4% v 1%, P<0.001). SARS-CoV-2 associated AECOPD had greater inpatient (25% v 9%, P<0.001) and 30-day mortality (25% v 12%, P<0.001) than AECOPD associated with other infections. Among all AECOPD patients who had received >=1 dose of any COVID vaccination, ICU admission rates were lower than for unvaccinated persons (4% v 0%, P<0.01). Discussion(s): SARS-CoV-2 infection was associated with worse outcomes among persons hospitalized with AECOPD. SARS-CoV-2 vaccination was effective in reducing disease severity and ICU admission. More data are needed about the effectiveness of COVID19 vaccines for modifying disease severity in COPD patients.
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S38 Figure 1ConclusionsOmicron infection was associated with less severe illness compared to Delta infection across three separate measures of severity. COVID-19 vaccination was independently associated with lower in-hospital disease severity, regardless of variant. Lower severity of Omicron combined with the ability of vaccine to further reduce severity may result in reduced pressure on healthcare services;however, the increased transmissibility of Omicron and potential for higher numbers of infections, particularly in elderly patients, may mitigate these benefits.Please refer to page A208 for declarations of interest related to this .
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S41 Figure 1ConclusionsWhile SARS-CoV-2 infection was a large component of hospitalised aLRTD, non-SARS-CoV-2 infection caused 56% of respiratory infection hospitalisations overall. Measured incidences of non-SARS-CoV-2 pneumonia and NP-LRTI were higher than pre-pandemic UK estimates. Given public health interventions to reduce all infective aLRTD implemented during this year, these higher estimates likely reflect highly comprehensive surveillance although there may have been a true higher non-SARS-CoV-2 disease incidence. These results demonstrate the significant burden of acute respiratory infection on healthcare systems. Broader efforts to prevent and manage all forms of adult aLRTD should be prioritized in addition to current COVID-19 prevention efforts.Please refer to page A209 for declarations of interest related to this .
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Background: Acute Lower Respiratory Tract Disease (aLRTD) includes pneumonia, non-pneumonic lower respiratory tract infection (NP-LRTI), heart failure (HF) and chronic respiratory disease exacerbation (CRDE). COVID19 has affected aLRTD disease burden. Few studies estimate total aLRTD burden, and subgroup distribution may have changed. Aim(s): To describe the frequency of individual aLRTD components and determine the impact of COVID19 on aLRTD disease. Method(s): A prospective cohort study of all adults >=18y admitted to either acute care hospital in Bristol, UK, from Aug 20-Jul 21. Patients were included if presenting with signs/symptoms or a clinical/radiological diagnosis of aLRTD. Result(s): 9243 aLRTD hospitalisations occurred: 5161 pneumonia, 2636 NP-LRTI, 1990 HF, 4144 CRDE, and 198 undifferentiated aLRTD cases. Overlap was common (Fig1): 31% HF and 83% CRDE events occurred in association with pneumonia or NP-LRTI. Hospitalisation rates corresponded with COVID-19 incidence over time. 41% hospitalisations were associated with positive SARS-CoV-2 test. Non-COVID19 aLRTD hospitalisations showed less variation over time. Discussion(s): aLRTD is a complex matrix with significant overlap between CRDE, HF and pneumonia/NP-LRTI. COVID19 disease in hospitalised adults was a large component of total aLRTD during this pandemic year;however, non-COVID19 aLRTD caused considerable disease burden.
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Background. Whether receipt of COVID-19 vaccine associates with receipt of other routinely-recommended adult vaccines such as, influenza and pneumococcal vaccines is not well described. We evaluated this relationship in a population of adults who were hospitalized for acute respiratory infection (ARI). *Odds ratio describing odds of receiving at least one COVID-19 vaccine (vs not) by influenza vaccination status adjusted for race, employment status, chronic cardiac diseases, cancer, solid organ transplant, and chronic kidney disease. **Odds ratio describing odds of receiving at least one COVID-19 vaccine (vs not) by pneumococcal vaccination status adjusted for race and chronic kidney disease. Methods. We enrolled adults (>= 18 years of age) who were hospitalized at Emory University Hospital and Emory University Hospital Midtown with symptoms consistent with ARI. Participants were interviewed and medical records ed to gather demographic information, including social behaviors during the pandemic, medical history, and prior vaccination history (i.e., COVID-19, influenza, and pneumococcal). Using two separate logistic regression analyses, we determined the association between i) receipt of influenza vaccine in the prior year among adults >= 18 years and ii) receipt of any pneumococcal vaccine in the prior 5 years among adults >= 65 years on the receipt of at least one COVID-19 vaccine>= 14 days prior to admission. Adjusted models included demographic information (e.g., age, sex, race/ethnicity, employment status), social behaviors, and history of chronic medical conditions. Results. Overall, 1056 participants were enrolled and had vaccination records available. Of whom, 509/1056 (48.2%) had received at least one dose of COVID-19 vaccine. Adults >= 18 years who received influenza vaccine were more likely to have received >=1 dose of COVID-19 vaccine compared to those who did not (267/373 [71.6%] vs 242/683 [35.4%] P=< .0001;adjusted odds ratio [OR]: 3.3 [95%CI: 2.4, 4.4]). Similarly, adults >=65 years who received pneumococcal vaccine were more likely to have received >= 1 dose of COVID-19 vaccine compared to those who did not (195/257 [75.9%] vs 41/84 [48.8%] P=< .0001;adjusted odds ratio [OR]: 3.0 [95% CI: 1.8, 5.1]). Conclusion. In this study of adults hospitalized for ARI, receipt of influenza and pneumococcal vaccination strongly correlated with receipt of COVID-19 vaccination. Continued efforts are needed to reach adults who remain hesitant to not only receive COVID-19 vaccines, but also other vaccines that lessen the burden of respiratory illness.
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Background. During the COVID-19 pandemic, social interventions such as social distancing and mask wearing have been encouraged. Social risk factors for SARS-CoV-2 infection and subsequent hospitalization remain uncertain. Methods. Adult patients were eligible if admitted to Emory University Hospital or Emory University Hospital Midtown with acute respiratory infection (ARI) symptoms (<= 14 days) or an admitting ARI diagnosis from May 2021 - Feb 2022. After enrollment, an in-depth interview identified demographic and social factors (e.g., employment status, smoking history, alcohol use), household characteristics, and pandemic social behaviors. All patients were tested for SARS-CoV-2 using PCR. We evaluated whether these demographic and social factors were related to a positive SARS-CoV-2 test upon admission to hospital with ARI using a logistic regression model. Results. 1141 subjects were enrolled and had SARS-CoV-2 PCR results available (700 positive and 441 negative). The median age was greater in the SARS-CoV-2 negative cohort than in the positive cohort (60 and 53 years, respectively;P< .0001). Those who tested positive were more likely to have had at least some college education compared to those who tested negative (64.3% vs 52.3%, P< .0001;adjusted odds ratio [aOR]: 1.4 [95%CI: 1.1, 2.0]). Compared to those who tested negative, those who were SARS-CoV-2 positive were also more likely to be employed (48.9% vs 26.5%, P< .0001;aOR: 1.7 [95%CI: 1.1, 2.3]), have children 5-17 yo at home (27.6% vs 17.9%, P=.0002;aOR: 1.5 [95%CI: 1.1, 2.1]). Those with COVID-19 were less likely to receive home healthcare (6.2% vs 13.3%, P< .0001;aOR: 0.5 [95%CI: 0.4, 0.9]) and to be a current or previous smoker (7.6% vs 17.7%, P< .0001;aOR: 0.3 [95%CI: 0.2, 0.5]). Conclusion. Among adults admitted to the hospital for ARI, those who tested positive for SARS-CoV-2 were typically younger, more likely to care for school-aged children, more likely to work outside the home, but were less likely to receive home healthcare or smoke. Personal and public health strategies to mitigate COVID-19 should take into consideration modifiable social risk factors.
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Background. Studies show that past SARS-CoV-2 infection provides a protective immune response against subsequent COVID-19, but the degree of protection from prior infection has not been determined. History of previous SARS-COV-2 Infection and Current SARS-COV-2 Infection Status at Admission. *Adjusted for chronic respiratory disease and prior COVID-19 vaccination Methods. From May 2021 through Feb 2022, adults (>= 18 years of age) hospitalized at Emory University Hospital and Emory University Hospital Midtown with acute respiratory infection (ARI) symptoms, who were PCR tested for SARS-CoV-2 were enrolled. A prior history of SARS-CoV-2 infection was obtained from patient interview and medical record review. Previous infection was defined as a self-reported prior SARS-CoV-2 infection or previous evidence of a positive SARS-CoV-2 PCR test >= 90 days before ARI hospital admission. We performed a test negative design to evaluate the protection provided by prior SARS-CoV-2 infection against subsequent COVID-19-related hospitalization. Effectiveness was determined using logistic regression analysis adjusted for patient sociodemographic and clinical characteristics and COVID-19 vaccination status. Results. Of 1152 adults hospitalized for ARI, 704/1152 (61%) were SARS-CoV-2 positive. 96/1152 (8%) had a prior SARS-CoV-2 infection before hospital admission. Patients with a previous history of SARS-CoV-2 infection were less likely to test positive for SARS-CoV-2 upon admission for ARI compared to those who did not have evidence of prior infection (31/96 [32%] vs 673/1056 [64%];adjustedOR: 0.25 [0.15, 0.41] (Table). Conclusion. Reinfections represented a small proportion (< 10%) of COVID-19-related hospitalizations. Prior SARS-CoV-2 infection provided meaningful protection against subsequent COVID-19-related hospitalization. The durability of this infection-induced immunity, variant-specific estimates, and the additive impact of vaccination are needed to further elucidate these findings.
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The coronavirus pandemic has indelibly impacted society over the past two years. This qualitative study explores how working female caregivers, in particular, experienced the pandemic and how the workplace supported them during this time. Findings from interviews with 29 working female caregivers revealed that many caregivers were unable to set boundaries around caregiving during the pandemic. Caregivers frequently found themselves on their own in providing care. This meant that caregivers had little time to themselves to rest and recharge. Whereas prior to the pandemic, caregivers may have had help with caregiving through services like respite and adult daycare, these services were no longer options. This reduced level of external support and care influenced caregivers' socioemotional wellbeing. Workplace policies, such as the ability to work remotely and working flexible hours, helped to ease caregiver burden. These findings have implications for both caregivers and workplaces during future crises and disasters.
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There is evidence that it may be possible to detect viruses and viral infection optically using techniques such as Raman and infra-red (IR) spectroscopy and hence open the possibility of rapid identification of infected patients. However, high-resolution Raman and IR spectroscopy instruments are laboratory-based and require skilled operators. The use of low-cost portable or field-deployable instruments employing similar optical approaches would be highly advantageous. In this work, we use chemometrics applied to low-resolution near-infrared (NIR) reflectance/absorbance spectra to investigate the potential for simple low-cost virus detection suitable for widespread societal deployment. We present the combination of near-infrared spectroscopy and chemometrics to distinguish two respiratory viruses, respiratory syncytial virus (RSV), the principal cause of severe lower respiratory tract infections in infants worldwide, and Sendai virus (SeV), a prototypic paramyxovirus. Using a low-cost and portable spectrometer, three sets of RSV and SeV spectra, dispersed in phosphate-buffered saline (PBS) medium or Dulbecco’s modified eagle medium (DMEM), were collected in long-term and short-term experiments. The spectra were pre-processed, and analysed by partial least squares discriminant analysis (PLS-DA) for virus type and concentration classification. Moreover, the virus type/concentration separability was visualized in a low-dimensional space through data projection. The highest virus type classification accuracy obtained in PBS and DMEM is 85.8% and 99.7%, respectively. The results demonstrate the feasibility of using portable NIR spectroscopy as a valuable tool for rapid, on-site and low-cost virus pre-screening for RSV and SeV with the further possibility of extending this to other respiratory viruses such as SARS-CoV-2. IEEE
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BACKGROUND: Postdoctoral trainees play a vital role in securing grant funding, building alliances, and mentoring graduate students under the guidance of a mentor who can help develop their intellectual independence. However, the experiences of postdoctoral trainees, particularly within health professions schools, is largely unexplored. The purpose of this study was to investigate the experiences of postdoctoral trainees and faculty advisors at a public four-year school of pharmacy and identify areas of opportunity to improve postdoctoral training. METHODS: Focus groups and interviews were conducted to elicit participants' experiences, perceptions, and suggestions for improvement. Stakeholder groups included postdoctoral trainees and faculty who serve as postdoctoral advisors. Thematic coding was used to identify semantic themes, and summaries of participant perceptions were generated. Results were mapped to the identity-trajectory framework. RESULTS: Participants described various experiences related to intellectual growth, networking opportunities, and institutional support. In addition, participant agency was critical for developing career goals and navigating transitions. COVID-19 introduced unique challenges associated with transitioning to remote work and managing goals/motivation. Areas of opportunity were identified, such as improving infrastructure, enhancing mentoring, and enhancing communication. CONCLUSION: Postdoctoral trainees play a critical role in the success of academic institutions. Scholarly endeavors that explore postdoctoral experiences, specifically those utilizing qualitative methods, can help pharmacy education better understand and meet the needs of postdoctoral trainees and faculty advisors. This study provides insight into the experiences of postdoctoral scholars and provides evidence for improving these training programs in schools of pharmacy.
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COVID-19 , Pharmacy , Faculty , Humans , Mentors , Research Personnel/educationABSTRACT
Introduction: The AbC-19™ lateral flow immunoassay (LFIA) performance was evaluated on plasma samples from a SARS-CoV-2 vaccination cohort, WHO international standards for anti-SARS-CoV-2 IgG (human), individuals ≥2 weeks from infection of RT-PCR confirmed SARS-CoV-2 genetic variants, as well as microorganism serology. Methods: Pre-vaccination to three weeks post-booster samples were collected from a cohort of 111 patients (including clinically extremely vulnerable patients) from Northern Ireland. All patients received Oxford-AstraZeneca COVID-19 vaccination for the first and second dose, and Pfizer-BioNTech for the third (first booster). WHO international standards, 15 samples from 2 variants of concern (Delta and Omicron) and cross-reactivity with plasma samples from other microorganism infections were also assessed on AbC-19™. Results: All 80 (100%) participants sampled post-booster had high positive IgG responses, compared to 38/95 (40%) participants at 6 months post-first vaccination. WHO standard results correlated with information from corresponding biological data sheets, and antibodies to all genetic variants were detected by LFIA. No cross-reactivity was found with exception of one (of five) Dengue virus samples. Conclusion: These findings suggest BNT162b2 booster vaccination enhanced humoral immunity to SARS-CoV-2 from pre-booster levels, and that this antibody response was detectable by the LFIA. In combination with cross-reactivity, standards and genetic variant results would suggest LFIA may be a cost-effective measure to assess SARS-CoV-2 antibody status.
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In this work, we present the combination of near-infrared spectroscopy and chemometrics to distinguish respiratory syncytial virus (RSV) and Sendai virus (SeV), the first study of its kind. Using a low-cost and portable spectrometer, a total of 440 virus spectra were collected over four separate sessions. The spectra were pre-processed by normalisation and baseline removal, and variable elimination was conducted based on the standard deviation. Partial least squares discrimination analysis was used to model the relationship between the spectra and the virus categories, resulting in the accuracy of 0.825 and 0.855 for validation and prediction, respectively. Since the portable spectrometer has simple operation and can provide analytical results in real time, it can be used as a viable tool for rapid, on-site and low-cost virus screening for RSV, SeV and possibly other similar viruses such as SARS-CoV-2.
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Digital technologies have been widely utilized to assist with disease detection and management throughout the Covid-19 pandemic. The prevalence of smartphone usage amongst populations has assisted the provision of mobile applications that citizens can use to manage their health. Covid-19 symptom checker smartphone apps enable users to enter their health characteristics and receive validated advice related to self-isolation, testing and whether to seek clinical care. Moreover, the collection of symptom data can assist healthcare providers with disease surveillance and resource allocation. However, the adoption of symptom checker apps can be influenced by several factors including the functionality of the app, and data privacy and protection policies. In this study, we reviewed nine symptom checker apps that were available on the Android and iOS platforms. We analyzed characteristics related to the functionality and accessibility of the apps, and factors that related to privacy, transparency and trust. We found that most of the apps were multifunctional and several (n = 4) combined contact tracing and symptom checking functionalities. Moreover, there was variation in the quantity of personal data collected and symptom checking questions. For all the apps reviewed information related to privacy and data protection was available, however, there was variability in the content and readability of this material. Information regarding the technical profile of the apps was also inconsistent. For several of the apps, access to the symptom checking functionality was restricted by location. This review suggests that symptom checker apps provide an effective tool for public health management during the Covid-19 pandemic. © 2021, Springer Nature Switzerland AG.
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This paper explores the Indigenous Food Circle's (IFC) response to the COVID-19 pandemic in Northwestern Ontario, Canada. Established in 2016, the IFC is an informal collaborative network of Indigenous-led and Indigenous-serving organizations that aims to support and develop the capacity of Indigenous Peoples to collaboratively address challenges and opportunities facing food systems and to ensure that food-related programming and policy meets the needs of the all communities. Its primary goals are to reduce Indigenous food insecurity, increase food self-determination, and establish meaningful relationships with the settler population through food. This community case study introduces the IFC and shares the strategies and initiatives that were used during the COVID-19 pandemic in 2020 to address immediate needs and maintain a broader focus on Indigenous food sovereignty. The food related impacts of the COVID-19 pandemic on Indigenous People and determining solutions cannot be understood in isolation from settler colonialism and the capitalist food system. Reflecting on the scholarly literature and the experiential learnings that emerged from these efforts, we argue that meaningful and impacting initiatives that aim to address Indigenous food insecurity during an emergency situation must be rooted in a decolonizing framework that centers meaningful relationships and Indigenous leadership.
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Food systems are significant sources of global greenhouse gas emissions (GHGE). Since emission intensity varies greatly between different foods, changing food choices towards those with lower GHGE could make an important contribution to mitigating climate change. Public engagement events offer an opportunity to communicate these multifaceted issues and raise awareness about the climate change impact of food choices. An interdisciplinary team of researchers was preparing food and climate change educational activities for summer 2020. However, the COVID-19 pandemic and lockdown disrupted these plans. In this paper, we report on shifting these events online over the month of June 2020. We discuss what we did and the reception to our online programme. We then reflect on and highlight issues that arose. These relate to: (1) the power dynamics of children, diet and climate change; (2) mental health, diet and COVID-19; (3) engaging the wider science, agriculture and food communities; (4) the benefits of being unfunded and the homemade nature of this programme; (5) the food system, STEAM (science, technology, engineering, arts and mathematics) and diversity; and (6) how our work fits into our ongoing journey of food and climate change education.
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Environmental issues are of especially great importance to younger individuals, such as university students. Course-based Undergraduate Research Experiences (CUREs) are a proven methodology for transforming short-term study abroad to yield higher impact and quality student outcomes, especially as they relate to teaching environmental sustainability. This paper offers a review of tested pedagogical frameworks, provides evidence to substantiate this statement from assessment data, and offers insights on how to develop and implement an international CURE. It also shares how embedding CUREs into innovative and high-quality short-term study abroad experiences can work to positively transform the post COVID-19 era of short-term study abroad. Several case studies are presented that document how students’ hands-on involvement in developing questions about real-world sustainability issues, devising and carrying out group research, and presenting their findings affect their acquisition of scientific skills and a sustainability-oriented mindset. © 2020 by the author. Licensee MDPI, Basel, Switzerland.