Longitudinal Coronavirus Antibody Responses in Africa between 2013 and 2021

Background: Pre-existing coronavirus-specific antibody responses may affect SARS-CoV-2 responses. We evaluated longitudinal samples obtained before and during the pandemic in participants from Kenya, Nigeria, Tanzania and Uganda;90% were people living with HIV. Method(s): Serum samples were tested using a multiplex bead-based immunoassay to measure antibody binding against 22 antigens including Nucleocapsid (N) and Spike (S) proteins of the 7 human coronaviruses and one malaria antigen. Result(s): We tested 819 longitudinal samples from 80 participants collected between July 2013 and May 2021 (3-16 samples per participant). Using a signal to noise ratio (S/N) >10, 13, 1, and 5 participants showed at least one time point with IgG responses to S of SARS-CoV-2 (ancestral), SARS-CoV-1 and MERS-CoV respectively while 14, 8, and 11 participants showed responses to N before 2020. Across individuals, IgG binding to SARS-CoV-2 S subunit S2 was most frequently detected and it showed the highest within-host fluctuations over time. A few individuals had elevated responses that persisted over years towards multiple antigens, most frequently to different SARS-CoV-2 antigens and rarely to distinct viruses. One individual showed high RBD-specific IgG responses to distinct coronaviruses at a single time point before 2020. Responses against coronaviruses measured post-2020 generally correlated with responses measured before 2020, except for a subset of infected individuals whose responses against SARS-CoV-2 dramatically increased post-pandemic. IgG responses against the ancestral SARS-CoV-2 variant were most correlated with responses against Alpha and Gamma (then to Beta and Delta, rho >0.75) variants. Using an IgM S/N >10, 31 participants were Malaria positive and 22 showed concurrent elevated coronavirus IgM responses. However, about half of the malaria positive participants had no IgG responses against any coronavirus antigen and the rest presented limited and variable patterns of association between responses against coronaviruses and malaria. Conclusion(s): Our study confirmed that a small subset of individuals in Africa had long-lasting IgG coronavirus-specific antibodies before the pandemic. While there was an association between coronavirus IgM responses and responses against malaria, there was no correlation between IgG responses and malaria infection. Further analysis is needed to better understand the interactions between antigens in the development of antibody immunity to coronaviruses. (Table Presented).

Health Messaging and the Black Community: Analysis of Rhetoric in Michelle Obama's Social Media's Posts Announcing Her COVID-19 Vaccination Status

COVID-19 data reveal that the pandemic caused chaos for all, but the Black community repeatedly saw elevated rates of infection and high mortality rates. After COVID-19 vaccines were developed, dissemination and uptake within the Black community lacked. It was abundantly clear that the Black community's large distrust of the medical establishment was a barrier to successfully rolling out COVID-19 vaccines. Former First Lady Michelle Obama, received her vaccine and posted a captioned image across all of her social media platforms. Her posts functioned as a health promotion tool. Therefore, to grasp the importance of Blackness and Black culture as it relates to communication, we utilize the Culture-Centered Approach as a lens to analyze the rhetoric of Michelle Obama's vaccination posts. We argue that not only did Michelle Obama use her social position as former First Lady and a Black woman to connect with the Black community when she posted about receiving the vaccine, but we also highlight the unique communicative choices present in the posts that are rooted in Blackness. © 2023 Taylor & Francis Group, LLC.

Virtual Guest Speakers in Textile and Apparel Courses: Student Experiences and Expectations

This paper focuses on the findings related to the second part of a continuing study of student impressions of the industry guest speaker experience in college fashion courses: student perceptions of virtual guest speakers. Data from 130 participants who were enrolled in the researchers' textile and apparel classes at two United States universities were analyzed. Findings suggested that although there are disadvantages to the use of virtual industry guest visits, many students find them useful and enlightening. While respondents overall preferred in-person visits, student concern with technological issues seems to have lessened during the forced move to online coursework during the COVID-19 pandemic, and they have come to realize that the online medium, especially through the "chat” functionality found in videoconferencing platforms, can be an effective way to ask questions. Suggestions are made for instructors considering the use of the virtual medium for industry speaker visits. © 2022 ITAA.

Using diverse community feedback to inform inclusive community action: Insights from the Louisiana Community Engagement Alliance

Purpose of Study: Clinical trial participation remains low among US minority groups, who account for <1/10 of trial participants.1,2 Diverse, equitable and inclusive participation is needed to lessen disparities in health status and clinical outcomes.3 Community-based participatory research (CBPR) strategies identify salient community issues, and may be useful for understanding and addressing participation barriers among minority groups.4,5 The Louisiana Community Engagement Alliance Against COVID-19 Disparities (LA-CEAL) - a partnership of universities, community pharmacies, faith-based organizations (FBOs), and federally qualified health centers (FQHCs) - aims to strengthen and leverage community relationships to address barriers to uptake of preventive/therapeutic strategies in underserved populations. This study examines the utility of LA-CEAL's CBPR approach in facilitating inclusive participation in clinical trials. Methods Used: Listening forums were held with a diverse group of LA community stakeholders, including healthcare providers, community pharmacists, FBO leaders and other trusted community members, to gather views on the need for and challenges to inclusive trial participation. Ongoing discussions between community representatives and leaders, academics and program staff facilitated outreach and guided development of informational strategies targeting minority groups. Summary of Results: Listening forums (N = 4;20 participants) revealed limited awareness, mistrust and fear stemming from historical and present injustices, and difficulty accessing opportunities as key themes underlying barriers to participation. To address identified barriers, 8 video testimonials featuring participants, investigators, and health advocates (62.5% Black;12.5% Hispanic;50% female) were developed to educate on expectations and experiences, motivations to participate, human subject protections, and the importance of diversity. Two animated videos featuring trusted community leaders and cultural ambassadors (e. g., New Orleans cultural icon, Irma Thomas) were created to explain trial processes, discuss participation benefits, and address the history of racism in medicine. Finally, connections between the Tulane Clinical Translational Unit and rural FQHCs enabled clinical trial study buses to visit and recruit in diverse LA communities. Conclusion(s): Via LA community stakeholder discussions, targeted strategies to address barriers to minority participation in clinical trials were developed and applied. Use of CBPR strategies was critical to developing intentional action reflective of LA community needs. Copyright © 2023 Southern Society for Clinical Investigation.

An understanding of discordant SARS-CoV-2 test results: An examination of the data from a central Auckland laboratory

AIM: The diagnostic sensitivity of the SARS-CoV-2 real time reverse transcription polymerase chain reaction (RT-PCR) test has not been determined. This has led to a degree of uncertainty in the interpretation of results, particularly in patients tested repeatedly. The aim of this study was to explore the characteristics of patients who initially tested negative, and subsequently tested positive for SARS-CoV-2. METHOD(S): This retrospective observational study utilised data from the LabPlus Virology laboratory, Auckland City Hospital, to identify cases (hospital and community) with initial negative and subsequent positive SARS-CoV-2 RT-PCR results. Their clinical and laboratory characteristics were summarised. RESULT(S): From 1 February to 13 April a total of 20,089 samples were received for SARS-CoV-2 testing. Of 2,011 samples from patients with multiple tests, 25 samples were positive. Nine samples were from patients who initially tested negative then tested positive. Reasons for the initial negative test results, which were all from upper respiratory tract samples, included pre-symptomatic presentation or late presentation. All patients had significant risk factors and ongoing or evolving symptoms, which warranted repeat testing. CONCLUSION(S): Few patients had discordant test results for SARS-CoV-2 RT-PCR. For patients who have a significant risk factor and a negative test result, repeat testing should be performed. Copyright © 2020 New Zealand Medical Association. All rights reserved.

Association between vitamin D deficiency and extended duration of COVID-19 symptoms

Introduction and ObjectivesVitamin D (VD) is involved in immunity and inflammation through mechanisms such as renin inhibition and inflammatory cytokine reduction. There is already evidence to suggest that VDD may increase COVID-19 infection susceptibility, however research assessing the impact of VDD on COVID-19 symptom duration is limited. The aim of this research was to determine whether VDD is a significant independent risk factor for extended durations of COVID-19 symptoms.MethodsThe study included 392 healthcare workers who isolated due to COVID-19 symptoms during the first wave of the pandemic (12th to 22nd May 2020) as part of the convalescent immunity (COCO) study. Data on 8 symptom types and duration of symptoms were collected, including patients’ demographics and co-morbidities. Anti-SARS-Cov-2 antibodies were measured using a combined IgG, IgA and IgM ELISA (The Binding Site). Vitamin D status was determined by measurement of serum 25(OH)D3 using the AB SCIEX Triple Quad 4500 mass spectrometry system. VDD was defined as serum 25(OH)D3 <30 nmol/L.ResultsThrough univariate analysis of VDD and non-VDD staff, we initially showed VDD to be significantly associated with longer durations of body aches (median 7 days, IQR 5–14 vs. median 5 days, IQR 3–7.5;p=0.0075) and fatigue (median 12 days, IQR 7–14 vs. median 7 days, IQR 4–14;p=0.0127). VDD did not influence the duration of the other 6 symptoms analysed, such as cough and fever. Using binary logistic regression models, we confirm that VDD is a significant independent risk factor for extended durations of fatigue (OR 2.089, 95% CI 1.087–4.011;p=0.027) and body aches (OR 3.069, 95% CI 1.538–6.124;p=0.001). Additionally, VDD staff experienced a significantly greater quantity of symptoms compared to non-VDD staff (median 5, IQR 4–7 versus median 4, IQR 3–6;p=0.0030).ConclusionsThis is one of the first studies to investigate the influence of VDD on COVID-19 symptom duration. Our results indicate that VDD is a significant independent risk factor for a longer duration of body aches and fatigue. Larger studies are required to confirm these results and determine if VD supplementation could shorten symptoms.

The Impact of COVID-19 on People with Parkinson's: Insights from Wearable Sensors

Objective: To describe changes in daily activity measured by wearable sensors in participants with Parkinson's disease (PD) following the COVID-19 pandemic. Background: Digital tools provide objective, frequent and sensitive data collection in real-world settings. In a natural history study of PD, participants used wearable sensors before and after COVID-19 shutdowns. Design/Methods: At research visits throughout this two-year study at the University of Rochester Medical Center, participants wore sensors with accelerometer and gyroscopic capabilities and completed questionnaires. Following each visit, participants wore sensors remotely for 7 days during waking hours. Participant position and activity from days 1-6 of wear was classified from sensor data. Results: Prior to March 14 2020, when COVID-19 shutdowns began in Monroe County, NY, 17 participants with PD (70.4 (6.3) years) and 13 controls (61.1 (13.5) years) completed a baseline visit. All 30 later completed a month 12 visit after COVID-19 shutdowns. Sensor wear was comparable at baseline (13.9 (1.4) hours/day) and month 12 (13.74 (2.1) hours/day). At month 12, PD participants walked an average of 1709 (1457) steps/day, approximately 17% less than at baseline (2048 (1416) steps/day), with considerable individual variation. PD participants spent approximately 20% more time lying while awake at month 12 (112.7 (149.9) min) than at baseline (93.6 (103.1) min). Daytime sleep did not increase from baseline (39.6 (39.3) min) to month 12 (39.2 (32.8) min). PD and control participants reported greater anxiety and depression at month 12. From baseline to month 12, controls had similar activity trends as participants with PD, but walked more, spent less time lying, had less daytime sleep, and reported less depression and anxiety at both time points. Conclusions: Following the emergence of COVID-19, participants with PD walked less and spent more time resting. These data provide an objective measure of the pandemic's impact on a small cohort of individuals with PD.

Barriers to access and utilisation of perinatal mental healthcare in the UK

Background Lack of access to mental health services during the perinatal period is a significant public health concern in the UK. Barriers to accessing services may occur at multiple points in the care pathway. However, no previous reviews have investigated multilevel system barriers or how they might interact to prevent women from accessing services. Aims and Objectives To explore: 1) the barriers affecting women's access to PMH care at different points in the care pathway, 2) how women's access to and experience of PMH care has been affected by the COVID-19 pandemic. Methods Findings from two studies will be presented: 1) A systematic review of women, their family members', and healthcare providers' perspectives of barriers to accessing PMH care in the UK;2) A qualitative study with women's (n = 18) experiences of accessing PMH services during the COVID-19 pandemic, in an ethnically diverse population in South East London. Results The systematic review identified several key barriers that affected help seeking and treatment during the perinatal period. Barriers were identified at four levels: Individual (e.g. stigma, poor awareness), organisational (e.g. resource inadequacies, service fragmentation), sociocultural (e.g. language, cultural barriers) and structural (e.g. unclear policy). Interviews with women highlighted that pandemic restrictions and social distancing created additional difficulties and disruptions to accessing PMH care, and increased feelings of anxiety and isolation. Women expressed mixed feelings about remote delivery of PMH. Interpretation/Discussion Complex interlinked barriers to accessing PMH care exist within the UK and services have been further disrupted by the COVID-19 pandemic. To improve access to mental healthcare for women during the perinatal period, multilevel strategies are recommended which address individual, organisational, sociocultural and structural-level barriers at different stages of the care pathway. Conclusions To address barriers and reduce inequity in access to care, multilevel national strategies combined with targeted approaches to identifying and responding to local population needs are required.

A simple intervention improved compliance with the COVID-19 swabbing policy for patients receiving chemotherapy in the Royal Bolton Hospital haematology department

Preventing coronavirus (COVID-19) transmission has become a significant priority in the management of haematology patients. Some patients are more vulnerable not only because of their haematological condition but also because of the intensive medication they are prescribed. Swabbing patients for COVID-19 within 72 h prior to chemotherapy has been recognized as an important safety measure to reduce the risk of serious complications from the virus as a result of immunosuppression from this treatment. Poor compliance with swabbing guidelines was recognized as a target for improvement within the Bolton Haematology department, in order to improve patient safety and protect the most vulnerable. The aims of this project were (1) to ascertain baseline compliance to the policy of swabbing haematology patients for COVID-19 within 72 h of chemotherapy, (2) to trial a series of simple interventions to increase swabbing compliance over four months and (3) to identify barriers to achieving compliance. An audit was conducted to assess baseline compliance. Eligible patients were identified using iQEMO and their swab results and clinic appointments were reviewed to assess whether they had been swabbed or seen in clinic within 72 h of chemotherapy, other barriers to swabbing were documented throughout. Three rounds of interventions were trialled using the PDSA model. Intervention 1 was an education session targeted at clinicians to highlight the importance of swabbing as well as the current protocol and compliance. Intervention 2 was adjusting the protocol to exclude those on oral chemotherapy, which was based on guidelines from local hospitals. Intervention 3 was a redesign of the ward checklist to include a reminder to swab inpatients. Interventions were either adopted, adjusted or abandoned based on the outcome, process and balancing measures. Results were distributed among the department at local meetings. Baseline compliance with the swabbing policy was 55%. Following intervention 1, compliance decreased to 49%. Following intervention 2, compliance increased to 88%. Following intervention 3, compliance with inpatient swabbing increased from 50% to 100% but there was no overall effect on compliance. Following three rounds of interventions, overall compliance increased from 55% to 88%. Barriers to swabbing included;not having a clinic appointment within 72 h, human error, that is, forgetting to swab and rescheduled clinic appointments. As far as we are aware, this is the first UK-based project to review compliance with COVID-19 swabbing protocols within a haematology department. This project has highlighted multiple factors involved in achieving compliance with swabbing protocols and demonstrated the potential of excluding patients receiving oral chemotherapy from swabbing policies to drastically improve this outcome. This project is relevant to all healthcare professionals who are involved with swabbing and has the potential to improve patient safety across departments..

Age-related differences in SARS-CoV-2 testing in the Northern Region of New Zealand

AIM: There is concern the low incidence of coronavirus disease 2019 (COVID-19) in children reflects undertesting in this population. This study sought to describe the age-distribution of SARS-CoV-2 testing in the Northern Region of New Zealand. METHODS: A retrospective single-centre review of all SARS-CoV-2 tests performed at LabPLUS, Auckland City Hospital, between 12 February and 18 April 2020. RESULTS: A total of 22,333 tests were performed, with 313 (1.40%) positive results. The age-adjusted SARS-CoV-2 testing rate was three times higher in adults than in children. The overall proportion of positive tests was lower in children (0.86%) than adults (1.45%). However, within the paediatric population the proportion of tests positive differed significantly between those <10 years old (0.08%) and those 10-14 years old (2.6%). CONCLUSION: The lower proportion of tests positive in children <10 years of age suggests they are appropriately tested relative to their rates of disease. A large high school-associated cluster makes the higher proportion of tests positive in children 10-14 years old difficult to interpret. Older children may have a higher risk of infection and increasing testing in intermediate and high school aged children may be indicated. © 2020 New Zealand Medical Association. All rights reserved.

Social Determinants of Health Screening During COVID-19: A Comparison Between an Urban Academic Emergency Department Fast Track and Adult Primary Care Clinic

Study Objectives: Social determinants of health (SDOH) impact patients’ health outcomes, yet screening methods in emergency departments (EDs) are inconsistent. Patients who seek care in EDs may be at greater risk for adverse SDOH than those seen by their primary care physician (PCP), but little comparable data is available. The authors sought to identify SDOH among ED Fast Track patients during the COVID-19 pandemic at an urban, safety-net hospital, measure preferred methods of resource referrals and barriers to accessing resources, and compare the prevalence of adverse SDOH among of ED Fast Track patients to that of adult PCP clinic patients. Methods: ED Fast Track patients were screened using a validated SDOH screener, and asked about the impact of COVID-19 on their SDOH. This was a convenience sample conducted from 1/15/21 to 4/13/21 and determined to be exempt by the IRB. Trained study staff completed screening and provided a printed resource guide. A two-week follow-up telephone survey assessed for barriers to resource connection. ED Fast Track patient data was then compared to concurrent SDOH data for adult PCP clinic patients, which collected the same validated SDOH screening data but was self-reported. Results: Among 414 adult ED Fast Track patients, 296 (71.5%) screened positive for at least one adverse SDOH, most commonly education (38.41%), food (35.0%), and housing insecurity (20.5%). Most (56.8%) endorsed COVID-19 affecting their SDOH. Fewer patients (36/156, 23.1%) reported attempting to connect with a resource. Barriers to accessing resources included having no time to call or visit the resource (59%), not recalling being given the resource guide (41%) or having lost it (28%). When compared to adult PCP clinic patients (Table 1), ED Fast Track patients were 10 times more likely to report at least one adverse SDOH (OR 10.0, 95% CI 6.9-14.4), 13 times more likely to report housing needs (OR 13.1, 95% CI 5.2-32.7), 8 times more likely to have food insecurity (OR 8.2, 95% CI 4.7-14.1) and 11 times more likely to have employment difficulty (OR 11.1, 95% CI 5.7-21.6). Conclusion: Most ED Fast Track patients reported at least one adverse SDOH negatively impacted by the COVID-19 pandemic. Providing printed resource guides at ED discharge may be insufficient for linking patients to resources. ED Fast Track patients were far more likely to report adverse SDOH than adult PCP clinic patients based on the unadjusted odds ratio analyses. This finding, however, is limited by the negative impact of COVID-19 on ambulatory SDOH screening rate, and a potential selection bias as patients with adverse SDOH may have experienced difficulty accessing their PCP clinics. This finding further emphasizes the need to standardize and expand SDOH screening and strengthen further resources from EDs. [Formula presented]

A remote OASIS: Implementing clinical guidelines over a virtual platform

Keywords: OASIS;Clinical guidelines;Virtual Purpose: The OsteoArthritis Self-management & Independent-living Support Group (OASIS Group) was set up in response to NICE Guidance CG177 in 2014, to create a cost effective yet high quality and efficient treatment pathway for people living with hip and knee osteoarthritis (Roberts & Busby 2020). The world was then changed dramatically with the appearance of the COVID-19 pandemic, which forced significant changes to ways of professional working. After the closure of non-essential services, the OASIS team were forced to revisit the NICE Guidelines in order to develop a virtual service for people with osteoarthritis (OA). Methods: During the restoration of services, the OASIS group was developed into a virtual programme to focus on the core treatment of enhancing understanding OA and its management, alongside a home exercise plan and weight loss advice. Converting to a virtual platform still required safeguards to be in place to protect patient's information and maintain confidentiality. The following documents needed to be created to ensure Information Governance principles were observed and were approved by Health & Safety and Legal teams within the trust: • Standard Operating Procedures (SOP) for managing unwell patients • SOP for using Microsoft Teams for group consultations • Risk assessment • User-agreement • Safe-home checklist • Screening tool Patient educational material from the OASIS group was converted to a virtual format to be presented to patients at each session. Patients have also been involved in the co-creation of an educational guidebook alongside the team to develop appropriate tools to aid self management. Digital versions of outcome measures, working within licencing restrictions, were also created to monitor the effectiveness of the programme. Results: The move to a virtual platform for the delivery of the OASIS programme has allowed the most vulnerable patients to access services safely. In a time when they are shielding to protect their health, the remote OASIS group provides them with a tailored treatment programme to educate and empower them to self manage their long-term condition. Conclusion(s): Moving forwards, the virtual platform is now a viable option even with the return of face-face appointments, for those people who struggle to access the service. It remains a sustainable and cost effective service to tackle the ever-growing problem of OA. Patient satisfaction and feedback will be collected after each group to ensure high quality care that meets the needs of its users. Following pilot groups, outcomes will be collected and analysed to monitor the effectiveness of the programme and compare to the original OASIS group. Impact: Development of the remote OASIS group removes the restraints of location and facility availability allowing access from a wider proportion of the population. It maintains group interactions and provides a service that keeps people safe whilst still addressing their health care needs. The foundation of processes and documents that have been developed for use with the remote OASIS programme have formed a template for future groups to be based upon. Work is underway with Keele University to develop a lower back pain virtual group, using the experiences and expertise of OASIS at its core. Funding acknowledgements: This work was not funded.

Weight loss approaches in rural and urban u.s. adults in the international weight control registry

Background: Individuals living in rural areas have higher obesity and obesity related co-morbidities than their urban counterparts. Understanding rural-urban differences associated with weight management may inform the development of effective weight management interventions for adults living in rural areas. Methods: The International Weight Control Registry (IWCR) is an online registry designed to assess factors contributing to successes and challenges with weight loss and weight loss maintenance across the world. We examined demographics, weight history and weight management strategies in a sample of urban and rural residents in the Midwestern U.S. (IA, IL, IN, KS, MI, MN, MO, ND, NE, OH, SD, WI). Participants were classified as rural or urban by the Rural-Urban Commuting Area Code. Analyses included Chi-square tests for proportions and independent t-test and Wilcoxon rank sum test for continuous variables. Results: The sample was 45% rural (n = 78 of a total N = 174) with a mean age of 50.3 years. Rural residents were more likely to be white, non-college graduates, and have lower family income compared with urban areas (p < 0.05). Rural and urban residents reported similar weight histories and strategies for weight management. Work-related physical activity was higher and weekday sitting time was lower in rural compared to urban residents (p < 0.01). These data could potentially be impacted by the relative number of residents working from home during COVID-19 (Urban: 59% vs. Rural: 37%, p < 0.05). Rural residents were more likely to report a lack of neighborhood walkability (p < 0.01) and healthy food availability (p < 0.05) compared with urban residents. Conclusions: These data suggest rural-urban differences in demographic characteristics, opportunity for leisure time physical activity, and the availability of heathy foods should be considered in the development of weight management interventions. The consistency of the observed findings will be evaluated at the regional, national and international levels as the size of the available sample in the IWCR increases.

Response to COVID-19 Vaccines in Patients Receiving Intensified Post-ASCT Therapy with Daratumumab, Lenalidomide, Bortezomib (Dara-VR) Due to Ultra-High Risk (UHiR) Newly Diagnosed Myeloma (NDMM) or Primary Plasma Cell Leukemia (pPCL): Exploratory Analysis of the UK Optimum/Muknine Trial

Background: Successful vaccination against SARS-CoV2 is highly effective in preventing serious COVID-19 illness and is particularly recommended for at risk populations including patients with multiple myeloma (MM). However, there is uncertainty to which extent modern intensified therapies targeting plasma cell features might attenuate vaccination responses;some early vaccination recommendations for MM have proposed extended treatment breaks of several weeks to maximise vaccination success. Such an approach can be challenging in UHiR MM and pPCL, where maintaining treatment intensity is hallmark for preventing rapid relapse of the aggressive tumor. To address this uncertainty, we measured post-vaccination serological responses in patients treated uniformly with intensified Dara-VR consolidation and Dara-R maintenance post-ASCT for UHiR NDMM or pPCL in the UK OPTIMUM/MUKnine trial (NCT03188172). Methods: Between Sep 2017 and Jul 2019, 107 patients with UHiR NDMM or pPCL were recruited to OPTIMUM and received intensified post-ASCT consolidation with Dara-VR(d) for 18 cycles followed by maintenance with Dara-R until progression. In an exploratory analysis, centrally stored serum samples available for patients with a completed and documented vaccination history of two doses of an anti-SARS-CoV2 vaccine were analyzed for serological vaccine responses Total IgG/IgA/IgM Anti-SARS-CoV-2 spike glycoprotein was measured by ELISA (MK654;The Binding Site). As per UK national guidance and local availability, patients received two vaccine doses 12 weeks apart of either tozinameran (Pfizer/Biontech) or vaxzevria (AstraZeneca);serum taken at least 3 weeks after patients received their second dose was analyzed. Results were correlated with baseline characteristics and annotated with treatment and response data. Patient with available matched serological and vaccination status data at time of data cut-off (09 JUL 2021) were included. Collection of vaccination status data is ongoing and updated results comprising additional patients enrolled in OPTIMUM, as well as antigen levels, will be presented. Data will also comprise longitudinal antibody level measurements for patient with available sequential material. Results: Serological vaccine response data was available for 40 OPTIMUM patients with documented completed double vaccination status. Median patient age was 58.5 years (range 39-70) and clinical and molecular tumor features were similar to the overall trial safety population. All patients had received their second dose before June 2021. Of the 40 patients, 42.5% had received tozinameran and 57.5% vaxzevria. Baseline characteristics of the two groups were comparable. At time of second vaccine dose, 55% of patients were receiving Dara-VR consolidation treatment and 45% Dara-R maintenance. There was no recommendation to pause trial treatment for purposes of vaccination and no extended times off treatment for this reason were reported. Overall, 72.5% of patients had a positive vaccine antibody level as per manufacturer cut-point for high specificity evidence of antigen exposure (infection or vaccine). The response rate was nominally higher for vaxzevria (91.3%) than for tozinameran (47.1%), a dysbalance that will be further investigated with ongoing extension of the cohort. Of note, 90% of patients analyzed had reached a complete response (CR) of their MM prior to being vaccinated, and the majority of patients not in CR had a positive vaccine response. Response rates were nominally slightly higher in patients in receipt of Dara-R maintenance at time of second dose with 77.8% compared to Dara-VR consolidation with 68.2%. Conclusions: These results show a high serological response rate to COVID-19 vaccination in UHiR MM patients receiving intensified post-ASCT consolidation and maintenance therapy in remission. Findings suggest that continuation of intensified post-ASCT therapy for patients with aggressive tumors and a high risk of relapse are compatible with serological responses to commonly used COVID-19 vaccines. Disclosures: Jen er: Janssen: Consultancy, Honoraria, Speakers Bureau;BMS/Celgene: Consultancy, Honoraria, Speakers Bureau;Takeda: Consultancy;Pfizer: Consultancy. Hall: BMS/Celgene: Research Funding;Janssen: Research Funding. Garg: University Hospital Leicester: Current Employment;Takeda Janssen Novartis Sanofi: Other: Travel Accommodations, Expenses;Amgen Janssen Novartis Sanofi Takeda: Honoraria. Jackson: J and J: Consultancy, Honoraria, Speakers Bureau;GSK: Consultancy, Honoraria, Speakers Bureau;takeda: Consultancy, Honoraria, Research Funding, Speakers Bureau;amgen: Consultancy, Honoraria, Speakers Bureau;celgene BMS: Consultancy, Honoraria, Research Funding, Speakers Bureau;oncopeptides: Consultancy;Sanofi: Honoraria, Speakers Bureau. Pratt: Binding Site: Consultancy;BMS/Celgene: Consultancy;Gilead: Consultancy;Janssen: Consultancy;Takeda: Consultancy;Amgen: Consultancy. Cook: Karyopharm: Consultancy;Sanofi: Consultancy;Takeda: Consultancy, Research Funding;Janssen: Consultancy, Research Funding;BMS/Celgene: Consultancy, Research Funding;Amgen: Consultancy. Drayson: Abingdon Health: Current holder of individual stocks in a privately-held company. Kaiser: BMS/Celgene: Consultancy, Other: Travel support, Research Funding;Janssen: Consultancy, Other: Educational support, Research Funding;GSK: Consultancy;Karyopharm: Consultancy, Research Funding;Pfizer: Consultancy;Amgen: Honoraria;Seattle Genetics: Consultancy;Takeda: Consultancy, Other: Educational support;AbbVie: Consultancy.

Home Blood Pressure Monitoring in Women with Severe Hypertension Utilizing Audio-Only and In-Person Postpartum Encounters

Objective: Prompt postpartum follow-up for women with hypertension is recommended. We hypothesized that use of home blood pressure monitoring may be beneficial to improve engagement. Our aim was to utilize home blood pressure monitoring with in-person and audio-only virtual visits in women with severe hypertension. Study Design: From March 2020 – September 2020 women with severe hypertension requiring oral antihypertensive therapy postpartum were provided a blood pressure cuff at time of hospital discharge and taught to take home measurements twice daily. Follow-up was scheduled within 10 days. Due to the COVID pandemic, audio-only virtual visits were prioritized, but left to the discretion of the discharge provider. Home blood pressure logs were reviewed at each encounter and documented in the medical record. Severe hypertension was defined as 160/110 mmHg or greater. Subsequent in-person or virtual visits were determined by the provider. Follow-up data and blood pressure values up to 6 weeks postpartum were retrospectively obtained. Statistical analysis included χ2 and McNemar’s test, with a P value <.05 considered significant. Results: Blood pressure cuffs were given to 206 women. Ten (5%) women on antihypertensive therapy represented to the hospital for hypertension. Ten women were lost to follow up after discharge from the hospital, leaving 196 women (95%) who presented for at least 1 postpartum visit. Systolic and diastolic values at the first visit were significantly lower at the last postpartum visit when compared to the first. Additionally, by the last postpartum visit, women were are on less blood pressure medications than at time of discharge from the hospital (P=.048). Composite blood pressure ranges above 140/90, 150/100, and 160/110 mmHg were significantly lower at the last visit when compared to the first, except for severe diastolic values (Figure 1). Conclusion: Use of audio-only virtual visits with in person follow-up for women with severe hypertension allowed for decreased oral antihypertensive medications and a reduction in blood pressure 140/90mmHg or greater. [Formula presented] [Formula presented]

Postpartum Audio-Only Virtual Visits Versus In-Person Follow-up in Women with Severe Hypertension

Objective: Postpartum follow-up within 10 days is currently recommended for women with hypertension, though many women do not complete this visit. Methods beyond in-person visits may be necessary to achieve this. Our goal was to explore the use of home blood pressure monitoring with audio-only virtual visits and in-person postpartum visits for women with severe hypertension. Study Design: From March 2020 – September 2020 women with severe hypertension requiring oral antihypertensive therapy postpartum were provided a blood pressure cuff at time of hospital discharge and taught to take home measurements twice daily. Follow-up was scheduled within 10 days. Due to the COVID pandemic, audio-only virtual visits were prioritized, but left to the discretion of the discharge provider. Demographic and follow-up data up to six weeks postpartum were compiled retrospectively from the medical record. Severe hypertension was defined as blood pressure 160/110 mmHg or greater. Statistical analysis included χ2 and Student-t test, with P value <.05 considered significant. Results: Blood pressure cuffs were given to 206 women: 181 women with severe hypertension in the immediate postpartum period, and 25 who were re-admitted to the hospital with delayed-onset hypertension. Table 1 shows their demographics. Sixty-seven (32%) had pre-existing hypertension. There were 196 (95%) who had one postpartum visit, 165 (80%) had two visits. Average number of days to completion of follow-up appointment was 9 ± 6 days, with 146 (71%) following up at 10 days or less. Ten (5%) women did not return after discharge. Sixty-nine women had their first visit in-person, and 137 women had a virtual encounter. Virtual visits were more likely to be completed within 10 days (118/137 (86%) v 28/69 (41%), p<.001), and had less loss to follow-up after discharge (2/137 (1%) v 8/69 (12%), p<.001). Conclusion: In women with severe hypertension, follow-up within 10 days was more likely with audio-only virtual visits compared to clinic visits, offering an appropriate point of access to postpartum care. [Formula presented] [Formula presented]