ABSTRACT
The SARS-CoV-2 outbreak has impacted different socioeconomic aspects of our societies and represents a global health problem. The different rates of infection are heavily influenced by host genetic factors such as the variability in the HLA region. The aim of our study was to evaluate the role of specific HLA alleles in the Bulgarian population that contribute to COVID-19 progression. 76 Bulgarian patients (median age 59.4;range 25-84) with COVID-19, separated into 3 groups based on the severity of the infection, were included in the study. All patients were typed at allele level for HLA-A, -B, -C, -DRB1, -DQB1, and -DPB1. Data from a representative Bulgarian population control group of young individuals (n = 540;median age 28,5;range 18-38) with unknown infectious status was used for comparison. Among the patient group, HLA-A*23:01 (OR = 3.16;p = 0.016), and DQB1*05:03 (OR = 3.1;p = 0.0009) showed positive association with moderate course of COVID-19, whereas DRB1*07:01 (OR = 2.54;p = 0.018) was associated with more severe disease. We found that A*01:01 (OR = 1.82;p = 0.018), B*35:03 (OR = 2.22;p = 0.011), B*40:06 (OR = 23.59;p = 0.0001), and DRB1*14:01 (OR = 3.37;p = 0.015) strongly correlate with the disease progression and could be considered as high-risk alleles. Furthermore, A*02:01 (OR = 0.4;p = 0.02), and DQB1*03:01 (OR = 0.47;p = 0.025) were predominantly found in asymptomatic patients and controls and probably exert a protective effect. Population-based and intra-individual variability of the HLA complex could partially explain the different courses of COVID-19. Despite some limitations, our preliminary data shows that some HLA alleles may be associated with a more severe course of the SARS-Cov infection, while others could possibly be considered protective. This work was supported by grant KP06DK1/13, 2021, Ministry of Education and Science, Bulgaria.
ABSTRACT
Background: Chronic urticaria (CU) is a common chronic inflammatory disease. Vaccination against viral infections including COVID-19 can induce increased CU disease activity. As of now, it is unclear how often CU exacerbations occur after COVID-19 vaccination. Method(s): COVAC-CU is an international, multicenter, observational, cross-sectional study of the global network of urticaria centers of reference and excellence (UCAREs). COVAC-CU evaluates the effects of COVID-19 vaccination in patients with CU including rates and risk factors of CU exacerbation. Here, we analyzed 1857 patients with CU who had received at least one COVID-19 vaccination. Data were collected via a questionnaire and retrieved from patient charts. Result(s): Of 1857 patients with CU (median age: 42 years;range: 18-91 years), 72.1% were female and 71.2%, 14.4% and 14.4% had chronic spontaneous urticaria, chronic inducible urticaria, or both, respectively. Most patients had received two doses of COVID-19 vaccine (79.1%), compared to one (9.7%), three (11%), or four (0.3%). Vaccine type included: BTN162b2 (58.4%;BioNTech/Pfizer), ChAdOx1 nCOV-19 (13.8%;AstraZeneca), BBIBP-CorV (8.2%;Sinopharm), Gam-COVID- Vac (8%;Sputnik), mRNA-1273 (5.3%;Moderna), and Ad26.COV 2.5 (4.7%;Janssen/J&J). Less than 10% of patients used premedication, and less than half of patients (44.4%) reported one or more adverse reactions after vaccination. The most common adverse reactions were local injection site reactions (29.6%), fatigue (19.7%), fever (19%), muscle pain (17.9%), headache (14%), and exacerbation of CU (15%). Severe allergic reactions/anaphylaxis were reported by 0.4% of CU patients. In almost all patients who experienced exacerbation of their CU, this occurred within one week after receiving the vaccine, i.e. after 1 to 12 hours (25.8 %), after 12 hours to 48 hours (31.1%) or after 2-7 days (37.9%). Conclusion(s): Most CU patients tolerate COVID-19 vaccination well;severe allergic reaction (anaphylaxis) rates were similar or lower than the self-reported rates reported in the general population. Exacerbation of urticaria was reported in one in five patients, mostly in a week after receiving the vaccine.
ABSTRACT
The research aims to define the model and the role of motivation to learn in the online classrooms. As online courses become prevalent during the present pandemic caused by COVID-19, it is very important to search for the answers to the following questions: How can instructors design their online courses to optimize student motivation? And how can students identify and take advantage of motivational strengths in online courses? The modified version of the Motivation to Learn Online Questionnaire (MLOQ) was used to assess college students' motivation to learn during online classes. The MLOQ is adapted, in part, from the Motivated Strategies for Learning Questionnaire (MSLQ) and it was designed to assess the following dimensions: intrinsic and extrinsic goal orientation, self-efficacy and task value. These factors are based on a general cognitive view of motivation and are well-documented as influencing the quality of instruction in a traditional classroom, but they might function differently in online learning environments. Two other constructs: instructor support and social engagement are part of the MLOQ since they are relevant to the motivation to learn online. The sample consists of 184 university students recruited from 30 different online courses taught at two private universities in Skopje, the International Balkan University and University American College Skopje. Results from the confirmatory factor analysis show that the hypothesized 6-factor model has an acceptable fit to the data from this research and it can be considered when determining the optimal approach to online learning.
ABSTRACT
Background: Our multicentric study explores the potential relationship between time perception, level of distress and fear of infection with COVID-19 in cancer patients undergoing chemotherapy. Methods: Perception of time was assessed in 300 cancer patients with solid tumors by evaluating each subjects’ prospective estimation of how fast one minute passed compared to the actual time. The median value (25 sec) of time perception was used to group cases into two categories of fast and slow perception of time. The National Comprehensive Cancer Network Distress Thermometer was used to evaluate levels of distress on a scale from 0 to 10. Patients scoring 4 or above were 173 (57.7%) and were regarded as having high levels of distress. Analogical thermometer was created for the fear of COVID-19 infection. Results: Significantly more patients were distressed in the presence of COVID-19 than historically controls. Patients with lung, breast and colon cancer were most distressed and worried about possible COVID-19 infection. Median value of both thermometers was 5. The pattern of the time perception distributions significantly changed over levels of distress and fear of COVID-19 infection (both p<0.05). There were significant negative correlations between time perception and values of Distress and COVID-19 thermometers (rho=-0.341 and rho=-0.169) and positive correlation between values of both thermometers (rho=0.601). Patients with a fast perception of time had significantly higher levels of distress (5.4±3.1) and fear from COVID-19 (5.3±3.3) infection than patients with a slow perception of time (3.2±2.8 and 4.2±3.2;respectively, both p<0.05). Moreover, in a multivariate analysis of covariance, time estimation, was significantly related to the reported values of both thermometers (V = 0.13, F (2, 297) = 21.2, p <0.001). Conclusions: Significantly more patients with cancer disease experienced distress in the presence of possible COVID-19 infection. Perception of time is a novel potent indicator for high levels of distress and fear of COVID-19 infection in cancer patients. Legal entity responsible for the study: Medical University of Varna. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.