ABSTRACT
Introduction: COVID-related lockdown led to a radical modification of daily activities and routines which are known to affect sleep. Compared to the general population, participants with autism may be particularly vulnerable to the repercussions of lockdown on sleep, given their intrinsic inflexible adherence to routines and the high overall prevalence of sleep disturbances in this population. Method(s): The study is a French nation-wide online survey assessing sleep-wake rhythms and behaviours known to affect sleep (daily screen time, daylight exposure, physical activity), before and during COVID-related lockdown. Respondents were 207 adults with autism (56% female) and 1652 adults of the general population (77% female), with a mean age 35.3 years (SD 11.3). Between group comparison (before, during and difference between before and during lockdown) were conducted using logistic regressions adjusted on age and sex. Within group comparison (comparing before and during lockdown) were conducted using paired analyses (Mantel-Haenszel or Wilcoxon rank test accordingly). Result(s): Before lockdown, the adults with autism displayed on average later chronotype, lower sleep quality, more evening screen time, less exposure to daylight and less exercise (all p < 0.01). Lockdown affected all studied measures of sleep and related exposures in a similar way in both groups: Poorer self-rated sleep quality as well as a less regular and delayed sleep-wake rhythm, longer screen time in the evening and less exposure to daylight (all p < 0.001). However, modification in sleep duration was not linear, with an increase of extremes (less than 6 h and more than 10 h) in both groups. Conclusion(s): Adults with autism displayed significantly higher levels of sleep and circadian rhythm disturbances and less favourable daily routines known to regulate sleep. While the effect of confinement on sleep and sleep related behaviours was similar in both groups, the results highlight that the pre-existing shift in circadian rhythms and lifestyles in adults with ASD further deteriorated during lockdown.
ABSTRACT
Background: Thymic epithelial tumors (TETs) are rare malignancies associated with dysregulation of the immune system with humoral and cell mediated immunity abnormalities. Anti-syndrome coronavirus type 2 (SARSCoV- 2) vaccine is effective at preventing COVID-19 morbidity and mortality. No published data are available regarding the post-vaccine immunization in TET patients (pts). The aim of our study was to evaluate the immunization in TET pts, who received the third mRNA vaccine dose and who did not achieve seroconversion after the previous two doses. Method(s): Starting from November 2021 to March 2022, 23 consecutive TET patients (pts) found to be serologically negative after two doses of SARS-Cov-2 mRNA vaccine (BNT162b2 by Pfizer-BioNTech) were enrolled at the Rare Tumors Coordinating Center of Campania Region (CRCTR-Naples, Italy). SARS-CoV-2 spike-binding IgG antibody serological levels were centrally analyzed by chemiluminescent immunoassay (CLIA) at two different time-points: T0 (before the third dose) and T1 (one month after the third dose). Cut-off for Ab titers positivity was >25 AU/mL. Result(s): Among the 23 enrolled pts, 10 (43,5%) were female and 13 (56,5%) males;17 pts had thymoma and 6 thymic carcinoma. Autoimmune disorders were detected in 20 TET pts (87%), of whom 3 (15%) suffered from Myasthenia Gravis, 8 (40%) from Good's Syndrome, 7 (35%) from both diseases, and 2 (10%) from other autoimmune disorders. By the time of third vaccine dose 2 pts had died, 2 pts were lost to follow up, 5 pts had suffered from SARS-CoV-2 infection. Of the remaining 14 pts, 7 achieved seroconversion whereas 7 maintained negative serological antibody titers. Two of these 7 pts had SARSCoV- 2 infection after the third dose. Interestingly, among these 7 pts who did not develop positive antibody titers, 6 had active cancer disease and only one was diseasefree. Moreover, 6 out of these 7 pts suffered from Good's Syndrome. On the other hand, among the 7 pts who developed positive antibody titers, only 3 had active disease. Conclusion(s): Our preliminary results showed that TET pts who did not achieve seroconversion even after the third SARS-Cov-2 vaccine dose in most cases had active cancer disease. If confirmed on larger cohorts of patients, these data may have important clinical implications and may help to better identify fragile pts who could benefit the most from prophylactic therapy with monoclonal antibodies.
ABSTRACT
OBJECTIVES: Explore the evolution of sleep during the SARS-CoV-2 quarantine period and define associated factors. METHODS: An online survey of patients in quarantine. Questions targeted the conditions of quarantine, sleep related behaviours and exposure to factors known to affect sleep and circadian rhythms (light exposure and sport). RESULTS: In all, 1777 participants were included: 77% women and 72% aged 25-54 years. Quarantine conditions were most frequently in couples with children (36%) and in a house with a garden (51%). Forty-seven percent of participants reported a decrease in sleep quality during quarantine. Factors associated with a reduction in sleep quality by logistic regression were sleep reduction (OR 15.52 P<0.001), going to bed later (OR 1.72 P<0.001), getting up earlier (2.18 P=0.01), an increase in sleep-wake irregularity (OR 2.29 P<0.001), reduced exposure to daylight (OR 1.46 P=0.01) and increased screen use in the evenings (OR 1.33 P=0.04). CONCLUSION: Sleep quality tended to reduce during quarantine and this was associated with changes in sleep behaviours and light exposure, especially in the evening. In order to optimise sleep during quarantine, regular sleep and wake times, at least 1hour exposure to daylight and a reduction of screen use in the evenings are suggested.