COVID-19 associated severe mucocutaneous blistering eruptions: A case series

Introduction: Mucocutaneous eruptions are associated with many viral processes and present as erythema multiforme (EM), reactive infectious mucocutaneous eruption (RIME), Stevens Johnson syndrome (SJS) or toxic epidermal necrosis (TEN). Limited reports have described the association of COVID-19 and mucocutaneous eruptions in children and adults to date. Method(s): This was a multicenter descriptive case series performed at six tertiary medical centers. Inclusion required a clinical diagnosis of EM, RIME, SJS or TEN and a positive COVID-19 test (rapid antigen or PCR) less than 4 weeks prior to onset of dermatologic manifestation. Data was collected at time of each patient encounter. Result(s): A total of 7 patients met criteria and had a median age of 15 years for pediatric patients (<18 years of age) and 36 years for adult patients (>18 years of age). Patients were found to have a diagnosis of RIME in 85.7% of cases. Oral mucosal involvement was the most common clinical finding (100%), followed by ocular (57.1%), urogenital (57.1%) and skin (42.9%) involvement. 71.4% of cases required hospitalization for their cutaneous eruption. No patients died from their inflammatory condition. Discussion(s): This case series highlights the development of mucocutaneous eruptions in association with COVID-19 infection. Within our cohort, RIME was the most commonly identified COVID-associated eruption. These findings provide additional evidence that abnormalities in host immune response to viral pathogens play a role in severe mucocutaneous blistering conditions. Further investigation will aid our understanding of this disease to improve diagnostics and advance targeted treatments for patients in the future.

Returning to work: a qualitative study of the experiences of head and neck cancer survivors.

BACKGROUND: UK head and neck cancer incidence and prevalence in working-age people are increasing. Work is important for individuals and society. Head and neck cancer survivors return to work less than other cancer survivors. Treatment affects physical and psychological functioning long-term. Evidence is limited, with no UK qualitative studies. METHODS: A qualitative study was conducted, underpinned by a critical realism approach, involving semi-structured interviews with working head and neck cancer survivors. Interviews were conducted using the Microsoft Teams communication platform and interpreted using reflexive thematic analysis. RESULTS: Thirteen head and neck cancer survivors participated. Three themes were drawn from the data: changed meaning of work and identity, return-to-work experiences, and the impact of healthcare professionals on returning to work. Physical, speech and psychosocial changes affected workplace interactions, including stigmatising responses by work colleagues. CONCLUSION: Participants were challenged by returning to work. Work interactions and context influenced return-to-work success. Head and neck cancer survivors want return-to-work conversations within healthcare consultations, but perceived these as absent.

COVID-19 as the Great (un)Equalizer: The Framing of Women in Media Coverage in China, the Middle East, and the U.S

International news representations of the COVID-19 crisis are particularly salient in shaping public health responses. Therefore, women's differential experiences are important to highlight in order to develop gender-responsive programming and strategies to improve global health outcomes. Informed by work on feminist political economy, this content analysis investigates how women are discursively framed during the pandemic by analyzing digital reports from three major television news channels (based in China, Qatar, and the United States). The aim is to evaluate the extent to which international media coverage reinforces gender and other power differentials within and across countries and shapes public understanding of the direct and indirect effects of the disease on women. Study findings indicate women's limited visibility in COVID-19 news and differences in framing across and within sources. The need for international media to give voice to and consider in depth the way structurally reproduced inequalities facilitate public health crises as well as the disparate effects on the health of intersecting groups including but not limited to women, people of color, gender minorities, and those located in lower income countries is reinforced in this work. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

The Seventh Annual Academic International Medicine Virtual Congress and Scientific Forum, June 9-12, 2022: Building a Stronger Future

As the COVID-19 pandemic continued to fade, first glimpses of "post-pandemic normal " began to emerge in the late 2021 and early 2022. This new hope came with a positive new momentum - an opportunity to transform and reinvent. Yet given a high degree of uncertainty extending well into 2022, the American College of Academic International Medicine made a strategic decision in the late 2021 to move forward with Virtual 7th Annual Congress and Scientific Forum (AIM 2022). The theme of this year's meeting was "Building a Stronger Future " and reflected the early post-pandemic optimism. Primary organization of the meeting was facilitated by the Sarasota Memorial Health Care System, Sarasota, Florida, with substantial contributions provided by Northwell Health, Long Island, New York. The Scientific Forum once again took place virtually, enabling participants from around the globe to present their research. A summary of these efforts and outcomes is provided in this article. The following core competencies are addressed in this article: Interpersonal and communication skills, Professionalism, Practice-based learning and improvement, Systems based practice.

Pulmonary Complications and Mortality in Patients with SARS-CoV-2 Undergoing Elective and Emergent Hand Surgery

Background Patients acutely infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may have increased risk for postsurgical pulmonary complications and mortality, particularly with general anesthesia. Surgery is often delayed to mitigate risk;however, excessive delays may result in morbidity. Optimal criteria for delaying surgery in patients with or without symptoms are unknown. This study aimed to evaluate any complications following hand surgery in patients testing positive for SARS-CoV-2.Methods We retrospectively reviewed patients with a positive polymerase chain reaction test within 60 days before or after hand surgery between March 31, 2020 and March 31, 2021. Patients were telephoned also to supplement records. Type of surgery, type of anesthesia, comorbidities, timing of surgery, onset of symptoms, and complications were recorded.Results We identified 21 patients undergoing 26 procedures, of which 21 (81%) were emergency procedures and 5 (19%) were elective. Mean age was 37 years (range: 17-71). General anesthesia was used in 88% of cases, with mean duration of 110 minutes. SARS-CoV-2 was diagnosed on average 6 days preoperatively (range: 39 days preop-14 days postop). Positive tests were usually identified preoperatively (50%), versus day-of-surgery (25%) or postoperatively (25%). Patients were symptomatic in only 27% of cases, and completely asymptomatic in 73%. No asymptomatic patients developed complications. One patient suffered a fracture malunion after delayed surgery. Pulmonary complications were noted in 3 patients;all had prior pulmonary disease and underwent emergency surgeries under general anesthesia. Overall mortality rate was 0%.Conclusion Pulmonary complications and mortality are low following hand surgery in asymptomatic patients with a positive SARS-CoV-2 test.

Teaching professional skills during the pandemic: Does delivery mode matter?

This study explores how the transition to online course delivery during the pandemic impacted a professional skills course that incorporates in-class and out of class experiential learning activities. We compare student performance on a resume writing assignment, a LinkedIn profile creation assignment, a mock interview with members of local businesses, and overall class scores during Fall 2019 when the professional skills course was delivered face-to-face with student performance during Fall 2020 when the course was delivered online. We explore whether the effect of delivery mode varied as a function of student sex, race and first-generation college status. Our results indicate students performed better on the resume and LinkedIn assignments when the course was delivered online than when it was offered face-to-face, and there was no difference in mock interview or overall class performance. Despite concerns that women, racial minorities and first-generation students could suffer disproportionately in the online version of the course, the relationship between class delivery mode and student performance did not vary as a function of these student characteristics. This is encouraging for institutions interested in offering these courses, and underscores the importance of future research that expands our understanding of when different delivery modes are appropriate. © 2023

Increased Rates of Hospitalized Children with Type 1 and Type 2 Diabetes Mellitus in NYC Hospital During COVID19 Pandemic

Objectives There have been reports of increased new onset diabetes and severity of DKA for children with diabetes following COVID19 infection and during the pandemic worldwide. Our objective is to study whether there is a change in admission rates and severity of presentation for type 1 (T1DM) and type 2 diabetes mellitus (T2DM) in our center from 2018 to 2020. Methods This is an IRB approved retrospective chart review of children admitted to our two hospitals from 1/1/18 to 12/31/20. We included ICD9 and ICD10 codes for diabetic ketoacidosis (DKA), hyperglycemic hyperosmolar syndrome (HHS) and hyperglycemia for those with diabetes. SAS 9.4 was used for ANOVA, T-test, Poisson regression. Results We included 132 patients with 214 hospitalizations: 158 T1DM, 40 T2DM and 16 other (14 steroid induced, 2 MODY). Overall admissions increased from 3.4% in 2018, to 4.6% in 2019, and 6.4% in 2020 (p = 0.05). Overall T1DM admissions were similar across all 3 years, however T2DM rates increased from 0.4% to 0.8% to 2% (p=0.0064). Newly diagnosed T1DM rates increased from 0.4% to 0.3% to 1.7% (p=0.002), and new-onset T2DM rates also increased from 0.2% to 0.7% to 1.1% (p=0.0026). DKA increased from 2.5% to 3.5% to 4% (p=0.028). HHS increased from 0.1% to 0.2% to 0.6% (p=0.047). There was no difference in average A1c. Severity of DKA in newly diagnosed diabetes was unaffected (p=0.833). Only 3 patients tested positive for COVID 19 while everyone else was negative by COVID 19 PCR. Conclusions Our urban academic medical center is located in central Brooklyn and serves a majority who are Black (87%). As far as we know, this is the first study investigating pediatric diabetes cases admitted in central Brooklyn during the height of the pandemic. Overall, hospitalization rates in children with T2DM and in new onset T1DM and T2DM increased, despite overall admissions declining in 2020. Whether the shutdown affected patient's perception of their symptoms or another reason leading to delayed care, or change in access to care remains to be seen. Active COVID19 infection did not appear to affect patients who had been admitted for diabetes. More studies are needed to elucidate the reason for this observed increase hospitalization rates.

Early Combination Therapy with Immunoglobulin and Steroids Is Associated with Shorter Icu Length of Stay in Multisystem Inflammatory Syndrome in Children Associated with Covid19

BACKGROUND AND AIM: Suggested therapeutic options for Multisystem Inflammatory Syndrome in Children (MIS-C) include intravenous immunoglobulins (IVIG) and steroids. Prior studies have shown the benefit of combination therapy with both agents on fever control or the resolution of organ dysfunction. The objective of this study was to analyze the impact of IVIG and steroids on hospital and ICU length of stay (LOS). METHOD(S): This was a retrospective study on 356 hospitalized MIS-C patients from 03/20-9/21 (28 U.S. sites) in the SCCM Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS) COVID-19 Registry. The effect of IVIG and steroids initiated in the first two days of admission, alone or in combination, on LOS was analyzed using intention to treat analysis. Adjustment for confounders was made by multivariable mixed regression with a random intercept for the site. RESULT(S): Median age of the study population was 8.8 (IQR 4.0, 13) years. 247/356 (70%) patients required ICU admission during hospitalization. Of the total patients, 153 (43%) received IVIG and steroids, 33 (9%) received IVIG only, 43 (12%) received steroids only, and 127 (36%) received neither within first two days. After adjustment of confounders, only combination therapy showed a significant decrease of ICU LOS by 1.6 days compared to no therapy (exponentiated coefficient 0.71 [95% CI 0.51, 0.97, p=0.03]). No significant difference was observed in hospital LOS or the secondary outcome variables. CONCLUSION(S): Combination therapy with IVIG and steroids initiated in the first 2 days of admission favorably impacts ICU LOS in children with MIS-C.

Analysis of National Surveillance Data to Support Case Definition Revisions for Multisystem Inflammatory Syndrome in Children (MIS-C), United States, February 2020-April 2022

Background. Classification of MIS-C, COVID-19, and other pediatric inflammatory conditions is challenged by phenotypic overlap and absence of diagnostic laboratory evidence. Due to public health need and based on limited data from early cases, CDC developed a necessarily broad MIS-C surveillance case definition in May 2020. Studies have since shown that some criteria do not distinguish between MIS-C and other conditions and may contribute to misclassification. To inform planned revision to the CDC definition, we evaluated the impact of narrowing these criteria on case inclusion in national MIS-C surveillance. Methods. Of state and local health-department reported cases meeting the current MIS-C case definition as of 04/14/2022, we describe the proportion that met revised criteria under consideration including fever duration, C-reactive protein (CRP) elevation using a defined cutoff, and organ involvement represented by specific criteria. We also evaluated cases identified using potential combinations of revised criteria. Results. Of 8,096 MIS-C cases fulfilling the original case definition, 6,332 (78%) had sufficient data for evaluation of criteria. Of these, 96% had fever for >=2 days and 94% had a CRP >= 3.0 mg/dL (Table 1). Cardiac involvement defined by key features of MIS-C was present in 84% of cases (62% if BNP/proBNP elevation was excluded);43% had shock. Dermatologic, gastrointestinal (GI) and hematologic involvement were present in 75%, 89% and 37% of cases, respectively. Neurologic (excluding headache), renal, and respiratory involvement were present in 16%, 20%, and 63% of cases, respectively. The number of cases with >= 2 of cardiac (without BNP/proBNP elevation), shock, dermatologic, GI, or hematologic involvement was 5,733 (91%). SARS-CoV-2 testing results are shown in Table 2. Conclusion. The CDC MIS-C case definition is intentionally broad. Using national surveillance data, we evaluated case inclusion under narrower criteria, prioritizing features of MIS-C that distinguish it from similar pediatric inflammatory conditions. A surveillance case definition may not capture all cases and is not intended to replace clinical judgment. We plan to assess additional criteria combinations, describe potentially excluded cases, and incorporate findings into a revised definition.

Multisystem Inflammatory Syndrome in Children (MIS-C) in Persons Fully Vaccinated with Two Doses of mRNA COVID-19 Vaccine Compared with Persons with Partial or No Vaccination Reported, U.S. National MIS-C Surveillance

Background. CDC began collecting COVID-19 vaccination status of persons with MIS-C as part of national surveillance inMay, 2021. We describe and compare MIS-C in fully vaccinated persons withMIS-C in persons with partial or no vaccination reported. Methods. We identified COVID-19 vaccine age-eligible persons meeting the CDC MIS-C case definition reported by health departments as of March 28, 2022 and divided theminto 3 groups for this analysis: 1) fully vaccinated (receipt of a 2-dosemRNAprimary vaccine series with MIS-C onset >=28 days after vaccine dose 2 to account for the delay between infection and MIS-C), 2) partially vaccinated (MIS-C onset after dose 1 or < 28 days from dose 2 or receipt of Janssen [Johnson & Johnson] vaccine and 3) no vaccination reported. We compared characteristics between the groups. Results. Of 7,880 MIS-C cases reported, 1,085 were vaccine eligible: 45 were fully vaccinated, 64 partially vaccinated, and 976 had no vaccine reported. Demographic characteristics were similar, although the Northeast had the lowest percentage of persons with vaccination not reported (Table). Though not statistically significant, fully vaccinated persons less frequently had severe cardiac involvement (67% vs 74%), shock (33% vs 44%), severe hematologic involvement (47% vs 54%), and mucocutaneous involvement (53% vs 63%) compared with those with no vaccine reported (Table). Forty-four percent of those fully vaccinated required ICU-level care vs 59% with no vaccine reported (p=0.053). Nineteen (2%) of those without vaccine reported died;no fully or partially vaccinated persons died. (Table Presented) Conclusion. Persons who acquire SARS-CoV-2 infection after being fully vaccinated can develop MIS-C, with similar clinical characteristics to those with no vaccination reported. A lower but not statistically significant percentage of fully vaccinated persons required ICU-level care compared with those without vaccination, and there were no deaths in the fully vaccinated group. These data do not account for trends in MIS-C over time, including the influence of circulating SARS-CoV-2 variants on MIS-C clinical manifestations. We will continue to evaluate these comparisons as the sample size of reported MIS-C cases increases.

Cellular immune responses to SARS-CoV-2 mRNA vaccination in patients with multiple sclerosis: an Israeli multi-center experience following 3 vaccine doses

Objectives/Aims: Disease modifying therapies (DMTs) affect immune responses to SARS-CoV-2 exposure or vaccination in patients withmultiple sclerosis(PwMS).Humoral responses were shown to be significantly compromised inPwMStreated with anti- CD20 therapies and S1P inhibitors.We evaluated the effect of DMTs(and specifically anti-CD20)on cell-mediated immune responses to 2 and 3 SARS-CoV-2 vaccinations in PwMS. Method(s): 522 PwMS and 68 healthy controls vaccinated with BNT162b2-Pfizer mRNA vaccine against SARS-CoV-2, were recruited in a nation-wide multi-center study. Blood was collected at 3 time-points: 2-16 weeks and ~6 months post 2nd vaccination and 1-16 weeks following 3rd vaccination.The cellular responseswere evaluatedby quantifying IFNgamma secretion in blood incubated with COVID-19 spike-antigen. Result(s): 75% PwMS were seropositive post 2nd or 3rd vaccination. IgG levels decreased by 82% within 6 months from vaccination (p<0.0001), but were boosted 10.3 fold by the 3rd vaccination (p<0.0001), and 1.8 fold compared to <=3m post 2nd vaccination (p=0.025). Patients treated with most DMTs were seropositive post 2nd and 3rd vaccinations,with the exception ofocrelizumaband fingolimod-treated patients(antibody positivity between38%to 56%). A time interval of >=5 months between ocrelizumab infusion and vaccination was associated with higher IgG levels (p=0.039 post-2nd vaccination;p=0.036 post-3rd vaccination), and with higher proportions of seropositive patients.Anti-spike proteinT-cell responses were detected in96% of PwMStreated with ocrelizumabpost 2nd and 3rd vaccination.The mortality rates and the proportion of patients with severe COVID-infection, were at similar levels in patients treated with ocrelizumab and those under other DMDs. Conclusion(s): PwMS treated with most DMTs developedeffectivehumoralresponses in general. In patients treated with anti-CD20 therapies, who had reduced antibodies following repeated vaccinations, strongT-cell responseswere mounted and provided a good level of protection against severe disease or death from COVID.

Capturing qualitative follow up data in a "real-world" study to assess disease modifying therapy use in the multiple sclerosis population before the pandemic and after: an update from the OPTIMISE:MS pharmacovigilance study

Introduction: Therapeutic disease modifying therapy options in the Multiple Sclerosis population have increased rapidly, but qualitative "real-world" follow up data is limited across many clinical trials being conducted. The OPTIMISE:MS pharmacovigilance study follows patients up for 7 years. Aim(s): "Real-world" observational data was collected from 14 participating sites located in the UK and Scotland. Participating study centres aimed to recruit all patients who are able and willing to provide consent to the inclusion criteria of the study. We wanted to determine what proportion of patients had completed follow up visits and had their data entered onto the study database pre and post the COVID-19 pandemic to date. Method(s): OPTIMISE:MS is a "real-world" longitudinal 7 year observational study recruiting 4000 patients with Multiple Sclerosis nationally from the UK and Scotland.All patients enrolled as of 30th April 2022 completed their baseline (n=2507) and at least 1 follow up visit (n=1254) for the study. Result(s): 1852 (73%) participants in OPTIMISE:MS are female with age range 18-82 (mean 43.8, SD 10.96) and 671 (27%) participants were male. The majority are of White ethnicity (1970, 78%), with a substantial minority from other ethnic groups. 2346 (94%) have RRMS with a mean time since diagnosis 8.5 years (SD 7.62). The DMT class history at baseline for all patients enrolled onto the study showed that 1130 (45%) were on second generation DMTs when compared to 807 (32%) of patients with no currently taking a DMT. The time (years) since the diagnosis of MS was <5 years in n=1029 (41%) patients. The highest prescribed DMTs documented at the first follow up visit of patients between 2019 and 2022 was Natalizumab (Tysabri) (n=10385) and Dimethyl fumarate (Tecfidera) (n=5406) that was the second highest.When assessing the lowest prescribed DMT for the same time period, Siponimod (n=6) and Interferon beta-1b (Betaferon (n=35) were documented. Conclusion(s): The results showed the frequency of follow up visits that had been carried out on the OPTIMISE:MS study for patients recruited to date.The data showed that more work has to be done to ensure that participating sites consistently update the follow up records of their patient cohorts in a timely manner.The OPTIMISE:MS study remained open throughout the pandemic and it was encouraging to see that the DMT prescribing methods for MS patients remained consistently high before, during and after the pandemic.

Trauma-Informed Public Management: A Step Toward Addressing Hidden Inequalities and Improving Employee Wellbeing

Public management practices that take a holistic approach are increasingly necessary;trauma-informed care, when embedded within public service, recognizes histories, experiences, and emotions of individuals. Many public servants experience vicarious trauma, by the very nature of their work, and there is a need to recognize this reality and use tools and techniques that are appropriately trauma-informed. Many organizations utilize trauma-informed care principles to engage with clients or citizens in arenas like social work, mental health, or addiction care, yet fewer organizations take a trauma-informed approach with their own employees to provide a safe and supportive workplace. Trauma-informed public management, conceptualized as embedding the six principles of trauma-informed practices into an organizational ethos, represents an opportunity to center the affective needs of public and nonprofit employees and managers who often bring their own traumatic experiences with them to their role and/or experience vicarious trauma in their jobs. The authors use applied examples from public sector responses to the COVID-19 pandemic--a prolonged and traumatic experience shared by public servants and citizens alike--to demonstrate these six principles and outline how trauma-informed techniques can be implemented now to benefit the public sector workforce. © 2021 SPAEF.

Academic Integrity during the COVID-19 Pandemic

An online learning environment can be effective but presents additional challenges with regard to academic integrity compared to in-person education. The onset of the COVID-19 pandemic forced many institutions to an online learning environment with less than two weeks' notice. Even before migrating to the online learning environment, violations of academic integrity have been shown to be alarmingly prevalent in United States institutions. In an online environment where students have unfettered access to online resources, “availability” would be expected to be a substantial factor making cheating easier and, thus, more prevalent. The goal of this research is to analyze student perceptions of adherence to academic integrity rules before and after the initial COVID-19 response in Spring 2020, where classes were forced to an online learning environment. Due to the COVID-19 pandemic, our university made a sudden shift from fully in-person instruction to entirely remote online learning with less than two weeks' notice to both students and faculty. This sudden shift left faculty scrambling to convert in-person lectures, which relied heavily on chalkboards and document cameras as the interface to communicate to students in the classroom, to an entirely online format using only computers from home. The faculty decided to survey the students to obtain their perspective to determine if students felt that they and their peers would adhere to academic integrity rules during this change to an online learning environment. Student surveys were administered during the first and last week of the change from in-person to online instruction for 12 engineering classes at an undergraduate institution, including civil, mechanical, electrical, and general engineering classes. Paired t-tests were performed to determine if students initially felt others would, and afterward did, adhere to academic integrity rules. Results indicate that while students had a positive perception of themselves adhering to academic integrity rules they did not feel that their peers would - with a statistically significant difference. These results are concerning since students may be more predisposed to cheat if they feel they are at a disadvantage because others are cheating. Also, grades are not an adequate assessment of learning objectives being met if students are not adhering to academic integrity requirements. © American Society for Engineering Education, 2022.

Changes in Adiposity as Measured by Modified BMI Z-scores Associated with the COVID-19 Pandemic Among Well Children and Adolescents Within a Large Urban Health System

Background: To control the spread of COVID-19 in NYC, a stay-at-home order was issued for March 22, 2020-June 13, 2020 followed by ongoing restrictions and only partial school reopening. The health impacts of these unprecedented restrictions on children are not yet known. Our objective was to examine whether BMI change during the COVID-19 period differed from the prior year among healthy children. Methods: This is a multicenter retrospective observational study of children aged five to eighteen years who received care within the NYC public hospital system between 2018 and 2020 encompassing all the five boroughs of the city. Using the system's electronic medical records, we identified patients who had a well-child visit between June 13, 2020 and December 31, 2020. Patients were included if they had annual well-child visits in the two previous years with anthropometric data recorded at all three visits. Patients with diagnoses that may affect adiposity (e.g. hypothyroidism) were excluded. We collected sociodemographic and anthropometric data for each year and calculated a modified body mass index z-score (mBMIz), which is a measure of relative BMI adjusted for age and sex. We compared change in mBMIz/month between the 2019 and 2020 visits (which included the pandemic) with the change in mBMIz/month between the 2018 and 2019 visits using generalized estimating equations (GEE). We examined whether the mBMIz/month change differed between the two periods and whether 2018 BMI category (underweight (5%), normal (5-85%), overweight (85-95%), obese (95-99%), extremely obese(>99%))modified this effect. Analyses were conducted using STATA software. Results: Of 23,458 patients seen between June 13, 2020 and December 31, 2020, 7,575 (32.3%) met our inclusion and exclusion criteria. The mean mBMIz was 0.68 in 2018, 0.69 in 2019 and 0.90 in 2020. (Table 1). In GEE analysis, the change in mBMIz/month was statistically significantly higher in 2019-2020 than in 2018-2019 (mean difference in mBMIz/month change=0.0152, p < 0.0001). While the change in mBMIz/month in 2019-2020 was lowest in patients in the extremely obese category, the difference in mBMIz/month between the two periods was greatest in this group (interaction effect of period and 2018 baseline category p < 0.0001). (Table 2). Conclusion: Our study suggests that the activity restrictions due to the COVID-19 outbreak are associated with greater excess weight gain in a diverse NYC population of healthy children as measured by mBMIz relative to the year prior to the outbreak. These findings correspond to the mean BMI percentile of our population changing from approximately 75th to the 82nd. These findings require further monitoring to better understand the specific reasons for the observed patterns across children in different BMI categories, assessment of longer-term health impact on this population and interventions to modify or reverse these worrisome trends. (Table Presented).

COMMUNITY ENGAGEMENT IN THE VIRTUAL AGE: A CROWDSOURCING OPEN CONTEST TO DESIGN A LATINOSPECIFIC COVID-19 CAMPAIGN

BACKGROUND: Latinos are among the most heavily impacted populations by the COVID-19 pandemic in the United States due to intersectional barriers to care. Crowdsourcing open contests can be an effective means of community engagement but have not been well studied in Latino populations nor in addressing the COVID-19 pandemic. The objectives of this study were to implement a crowdsourcing open contest to solicit a name for a social marketing campaign addressing COVID-19 for Latinos in Maryland, and evaluate the contest through mixed-methods analysis. METHODS: We conducted descriptive statistics of entries and votes, and demographics of participants. Submitted text was analyzed through inductive thematic analysis to understand community attitudes towards the COVID-19 pandemic. RESULTS: We received 74 entries within a brief 2-week period, limited by the urgency COVID-19 pandemic. The top 10 entries were chosen by a panel of community judges and the winner was decided by popular votes. We received 383 votes within 1 week. The most common themes were collective efficacy, self-efficacy, and perceived benefits of COVID-19 testing. We subsequently incorporated these themes into campaign advertisements, and these ended up being the highest performing ads. CONCLUSIONS: Crowdsourcing is an effective means of community engagement and an agile tool for guiding interventions to address COVID-19, including in populations impacted by healthcare disparities such as Latino communities.