Airbnb vs hotel? Customer selection behaviors in upward and downward COVID-19 trends

Purpose: To provide a dynamic view on accommodation choice behaviors during the pandemic, this study aims to examine the impact of recent trends on prospective travelers' preferences for hotels and Airbnb. Design/methodology/approach: The paper adopts a mixed methods approach that incorporates three independent studies (experimental analysis, online search pattern analysis and an econometric event study) to understand customer decision-making behaviors. Findings: The findings indicate that travelers prefer Airbnb entire flats/apartments to hotels when the pandemic is trending upward. This result externally validates travelers' preference toward Airbnb during periods of high risk. Interestingly, when the trends go downward, however, the same behavioral pattern was not identified. Research limitations/implications: This study provides important empirical insights into how the evolution of health crises influence customer decision-making for hotels and Airbnb. Future research needs to consider the role of socio-demographic factors in accommodation selection behaviors and examine how travelers react to cleanliness levels between Airbnb and hotels. Originality/value: As one of initial studies that empirically examine Airbnb customers' decision-making behaviors in the context of the COVID-19 pandemic's trends, this study provides a dynamic view on how the evolution of the pandemic influences accommodation choice behaviors. © 2023, Emerald Publishing Limited.

Thyroid as a target of adjuvant autoimmunity/inflammatory syndrome due to mRNA-based SARS-CoV2 vaccination: from Graves' disease to silent thyroiditis.

BACKGROUND: As COVID-19 became a pandemic, the urgent need to find an effective treatment vaccine has been a major objective. Vaccines contain adjuvants which are not exempt from adverse effects and can trigger the autoimmune/inflammatory syndrome induced by adjuvants (ASIA). There is very little information about autoimmune endocrine disease and the ASIA after the use of mRNA-based SARS-CoV2 vaccination. CASE SERIES: We report three cases and also review the literature showing that the thyroid gland can be involved in the ASIA induced by the mRNA-based SARS-CoV2 vaccination. We present the first case to date of silent thyroiditis described in the context of SARS-CoV2 vaccination with Pfizer/BioNTech. Also, we discuss the first subacute thyroiditis in the context of SARS-CoV2 vaccination with the Moderna's vaccine. Finally, we provide another case to be added to existing evidence on Graves' disease occurring post-vaccination with the Pfizer/BioNTech vaccine. DISCUSSION: Adjuvants play an important role in vaccines. Their ability to increase the immunogenicity of the active ingredient is necessary to achieve the desired immune response. Both the Moderna and the Pfizer/BioNTech vaccines use mRNA coding for the SARS-CoV2 S protein enhanced by adjuvants. In addition, the cross-reactivity between SARS-CoV2 and thyroid antigens has been reported. This would explain, at least, some of the autoimmune/inflammatory reactions produced during and after SARS-CoV2 infection and vaccination. CONCLUSION: The autoimmune/inflammatory syndrome induced by adjuvants involving the thyroid could be an adverse effect of SARS-CoV2 vaccination and could be underdiagnosed.

The impact of hotel CSR for strategic philanthropy on booking behavior and hotel performance during the COVID-19 pandemic

During the novel coronavirus (COVID-19) pandemic, some hotels have engaged in corporate social responsibility (CSR) activities to help overcome the crisis. Given that most existing research examines the impact of hotel CSR on a single stakeholder, how hotel CSR activities in a crisis are perceived by multiple stakeholders is unknown. Drawing on the concept of strategic philanthropy, this study examines the impact of hotel CSR activities during the pandemic, such as providing accommodations to healthcare workers, on hotel firms' market value and prospective hotel customers' booking behavior. Adopting mixed-methods approach, this study finds negative impacts of hotel CSR for strategic philanthropy on firm market value and customer booking behavior. The study result indicates that the value of hotel CSR depends on the nature and environmental contexts of CSR. Specific theoretical and practical implications are provided.

TROMBOCITOPENIA IMUNE ASSOCIADA À INFECÇÃO POR SARS-COV-2

Introducao: A doenca causada pelo coronavirus (COVID-19) foi caracterizada pela Organizacao Mundial de Saude como pandemia em marco de 2020. Os sintomas de tosse, dispneia progressiva, febre e mialgia estao comumente presentes. No entanto, o espectro clinico abrange acometimento de diversos orgaos e sistemas. As alteracoes hematologicas tem sido descritas na infeccao pelo SARS-Cov2. Estudos retrospectivos identificaram leucopenia em 25% dos pacientes, linfopenia em 63% dos casos e trombocitopenia em 33%, sendo que niveis plaquetarios inferiores a 100.000/mm3 sao observados em menos de 5% dos casos. Relato de casos: A.P.C, feminino, 38 anos, profissional de saude, sem comorbidades previas. Internada por sintomas respiratorios concomitante a menorragia. HB: 14,8 g/dL HT: 41%, leucocitos: 1890/mm3 e plaquetas: 7000/mm3, sem alteracao nos testes de coagulacao (TAP/TTPA). Infeccao por SARS-CoV-2 confirmada em RT-PCR por swab de nasofaringe. Tomografia de torax com opacidades em vidro fosco e consolidacoes predominante em periferia com acometimento maior de 50% do parenquima pulmonar. Sorologias nao reagentes para HIV e hepatite C e B;Fator antinuclear e fator reumatoide negativos;ausencia de disfuncao renal ou hepatica. Instituido tratamento com azitromicina e ceftriaxona. Apresentou reducao em valores hematimetricos e contagem plaquetaria de 1.000/mm3. Realizados concentrados de plaquetas 7 U/dia por 2 dias, introduzido prednisona 1 mg/kg. Evolui favoravelmente apos introducao de corticosteroide, marcado incremento plaquetario para 21.000/mm3 no segundo dia de terapia. Alta hospitalar apos onze dias de internacao com normalizacao plaquetaria - 151.000/mm3. Discussao e conclusao: Em paciente com COVID-19, a contagem plaquetaria inferior a 20.000/mm3 ou queda aguda maior que 50%, pode indicar etiologia imune. O primeiro caso de purpura trombocitopenia imune (PTI) relacionado ao COVID-19 foi publicado em abril de 2020, e atualmente sao descritos 38 casos de trombocitopenia grave com valores inferiores a 20.000/mm3. A fisiopatologia da plaquetopenia associada a infeccao pelo SARS-CoV-2 e pouco elucidada. Alguns mecanismos estao interrelacionados, como a diminuicao da producao plaquetaria causada por citocinas ou agressao direta as celulas progenitoras hematopoieticas e o aumento do consumo plaquetario associado a lesao pulmonar. No entanto, o mecanismo mais relevante e o mimetismo molecular entre componente viral e glicoproteinas plaquetarias com producao de anticorpos, reagindo de maneira cruzada com destruicao de plaquetas. A terapeutica com imunossupressores e indicada para tratamento, sendo o corticosteroide como primeira-linha. A imunoglobulina humana pode ser instituida em casos refratarios ou necessidade de rapido aumento plaquetario;e a transfusao de concentrados de plaquetas sao reservados apenas em situacao de sangramentos graves. Em resumo, a trombocitopenia grave associada ao virus SARS-CoV-2 e uma condicao rara. A introducao da terapeutica adequada nao deve ser retardada, visando aumento plaquetario e reducao do risco de complicacoes hemorragicas relacionadas.Copyright © 2020

Virtual Outpatient Heart Failure Care - Lessons From the Covid-19 Era

Background: The COVID-19 pandemic disrupted the way care is delivered to patients with chronic conditions such as heart failure (HF). Many outpatient encounters are now conducted virtually via telehealth. Whether virtual visit for HF results in similar type of interventions as when the patient is seen in person is not known. Methods: Starting on March 15, 2020, all non-time sensitive outpatient in-person appointments at our institution were cancelled and transitioned to virtual appointments where possible. We included all patients seen in a tertiary care HF clinic from February 18 to March 13 (pre-Covid) and from March 16 to May 15 (post-COVID). We examined the volume of in-person and virtual visits and compared medication titration rates pre- and post-COVID. Results: The study cohort included 745 patients, mean age 60.7+/-15.3 years, 65.2% male, 80.9% Caucasian, 7.7% Hispanic/Latino. Of these, 227 patients were seen pre-COVID and 518 post-COVID. All appointments were in-person pre-COVID. After the change, only 18% of appointments were in-person while 82% were virtual. Outpatient volume decreased after March 15, but gradually increased, eventually to volumes that exceeded pre-COVID (Figure). Detailed results on medication titration are shown in Table. Diuretic titration took place in 33/227 (14.5%) of patients pre-COVID and 83/518 (16.0%) post-COVID (p=NS). Among 567 patients with HF with reduced ejection fraction (HFrEF), titration of guideline-directed medical therapy (GDMT) took place in 86/172 (50.0%) of patients pre-COVID and 159/395 (40.2%) post-COVID (p=0.03). Among the 395 HFrEF patients seen post-COVID, GDMT was titrated in 33/68 (48.5%) patients seen in person and 126/327 (38.5%) seen virtually - p=0.13. Barriers to medication titration in virtual visits were lack of blood pressure readings and lack of recent laboratory results. Conclusion: Telehealth has become an essential method of outpatient care delivery for chronic HF. Once implemented, it offered efficiencies including improved access to the HF clinic thanks to higher throughput capacity compared to physical clinic space. However, we identified that GDMT titration took place less frequently than during in-person visits. Since it is anticipated that telehealth use will continue into the future, approaches to maximize GDMT in the absence of traditional direct physical contact with HF patients are needed.