Immune Response to COVID-19 Vaccination in Frail Patients (preprint)

Objective This study sought to examine the immune response to COVID-19 vaccination in frail patients and the associated role of inflammatory factors in immune response to COVID-19 vaccination.Methods A prospective cohort study design was used to assess the effects of the COVID-19 vaccine in non-frail and frail elderly individuals following a frailty assessment. The immune response between the two elderly populations were compared using Poisson regression modeling. A nested case-control study in an elderly population was also performed, differentiating the case group from the control group based on COVID-19 vaccine efficacy. A logistic regression analysis was employed to examine the correlation between frailty-related inflammatory factors and COVID-19 vaccine efficacy.Results A total of 920 individuals participated in the study, with 598 (65%) belonging to the non-frail group and 322 (35%) to the frail group. The frail group exhibited a lower seropositivity rate than the non-frail group after adjusting for age, amount of vaccination shots, and vaccination type using modified Poisson regression (RR = 0.929, 95% CI: 0.891 − 0.968; P < 0.05). The Logistic regression analysis revealed that the positive group had lower levels of CXCL10 (OR = 0.951; CI: 0.907 − 0.997; P < 0.05) after correcting for covariate weakening.Conclusion The present findings indicate that frailty may have a negative impact on COVID-19 vaccine efficacy. The concentration of CXCL10 may affect COVID-19 vaccine efficacy by altering the inflammatory levels in elderly frail patients.

Alcohol consumption, alcohol expectancies, and drinking contexts in young Argentinean college students before and during the COVID-19 pandemic: a one-year follow-up study.

Background: The COVID-19 pandemic and lockdowns are known to affect alcohol consumption. This study examines drinking expectancies and contexts upon alcohol consumption of Argentinean students.Objectives: To assess within-person changes in alcohol consumption in Argentinean college students (aged 18-24), from August 2019 with a one-year follow-up during the COVID-19 lockdown, considering alcohol expectancies, drinking contexts, and main socio-demographic variables. To validate the stability of these predictors, we discuss the effects on the alcohol consumption across dependent and independent measures.Methods: We assessed one longitudinal (N = 300, 70% female) and one cross-sectional (N = 165, 78% female) sample via online surveys and applied multilevel analysis and regressions, respectively.Results: Alcohol consumption significantly increased during lockdown compared to one-year before (mean: 6.91 and 8.26 alcohol units, correspondingly). In the longitudinal sample, social facilitation (medium effect sizes [ES]: 0.21, 0.22) and parental presence (medium ES: 0.12, 0.21) significantly and stable (through time) predicted increasing effects on consumption. In the cross-sectional sample, stress control (high ES: 0.78) and parental presence (high ES: 0.42) were associated with higher consumption during lockdown.Conclusion: College students increased their alcohol consumption during lockdown, suggesting that restrictive sanitary measures may negatively affect consumption. Literature is not conclusive as both decreases and increases in alcohol consumption in students from developed countries were reported. Before and during COVID-19 lockdown, parental presence is a stable predictor of increased alcohol consumption, though unusual according to the literature. Health policies aimed at modifying the behavior of parents who promote/share alcohol consumption with their offspring may help reduce drinking in college students.

A full genome tiling array enhanced the inspection and quarantine of SARS-CoV-2.

As the worldwide spreading epidemic of SARS-CoV-2, quick inspection and quarantine of passengers for SARS-CoV-2 infection are essential for controlling the spread of SARS-CoV-2, especially the cross-border transmission. This study reports a SARS-CoV-2 genome sequencing method based on a re-sequencing tiling array successfully used in border inspection and quarantine. The tiling array chip has four cores, with one core of 240,000 probes dedicated to the whole genome sequencing of the SAR-CoV-2 genome. The assay protocol has been improved to reduce the detection time to within one day and can detect 96 samples in parallel. The detection accuracy has been validated. This fast and simple procedure is also of low cost and high accuracy, and it is particularly suitable for the rapid tracking of viral genetic variants in custom inspection applications. Combining these properties means this method has significant application potential in the clinical investigation and quarantine of SARS-CoV-2. We used this SARS-CoV-2 genome re-sequencing tiling array to inspect and quarantine China's entry and exit ports in the Zhejiang Province. From November 2020 to January 2022, we observed the gradual shift of SARS-CoV-2 variants from the D614G type to the Delta Variant, and then to the dominance of the Omicron variant recently, consistently with the global emergency pattern of the new SARS-CoV-2 variant.

Health Communication in Games at the Early Stage of COVID-19 Epidemic: A Grounded Theory Study Based on Plague, Inc.

Objectives: An empirical study is carried out based on Plague, Inc. to explore whether the game has raised awareness of public health and urged players to make a better choice about health. Materials and Methods: Twenty-six college students from 24 cities in 11 provinces of China were investigated for a week-long survey. According to grounded theory principles, we coded original records from 69 diary reports using qualitative analysis tools. Results: We constructed nine core categories from participants' journals and drew the mechanism chart of the game as a means of health communication. The results showed that participants had experienced (1) an iterative learning process based on the authenticity and multiperspective features of the game and obtained specific learning outcomes; (2) deep thinking through the association between the game and the real world. And we extracted variables that are highly predictive of behavior change, including cognition of seriousness, cognition of susceptibility, action clue, and self-efficacy. Furthermore, noncore categories (including emotions and gameplay) directly and indirectly impacted players' learning and behavior change. Conclusion: The study shows Plague, Inc. has played a positive role in health communication (mainly reflected in the improvement of players' cognitive level, the establishment of health belief, and behavior changes). Moreover, it is concluded that reflection plays an important role in health communication interventions. However, careful consideration should be given to the use of this game as a means of health intervention due to its limitations and certain deficiencies.

General Mental Health State Indicators in Argentinean Women During Quarantine of up to 80-Day Duration for COVID-19 Pandemic.

Introduction: Argentinean quarantine during the COVID-19 pandemic is one of the most long-lasting worldwide. We focused on the first 80-days of this quarantine on Argentinean women. Our aims were to analyze differences in general mental health state (MHS) indicators, by the (1) sites of residence with different prevalence of COVID-19 cases, and (2) quarantine duration; (3) to assess multiple relationships between each general MHS indicator and potentially affecting factors. Methods: We used a cross-sectional design with convenience successive sampling (N = 5,013). The online survey included a socio-demographic questionnaire (elaborated ad hoc) with standardized and validated self-reported questionnaires (General Health Questionnaire, Kessler Psychological Distress Scale) measuring the MHS indicators: self-perceived health, psychological discomfort, social functioning and coping, and psychological distress. Results: Worse self-perceived health and higher psychological discomfort affected significantly more women residing in sites with high prevalence of COVID-19 cases, compared to those residing in sites with intermediate prevalence, but effect sizes were small. Mean scores of all general MHS indicators were significantly worse for longer quarantine sub-periods (up to 53, 68, and 80-day duration) than for shorter sub-periods (up to seven, 13, and 25-day duration). Being a younger age, having mental disorder history, and longer quarantine durations were associated to worsening MHS, while the lack of previous suicide attempt has a protective effect. Discussion: Our findings show that a worse MHS during quarantine may not be attributed to the objective risk of contagion (measured greater or less), and under quarantine, women MHS-as indicated by group central tendency measures-got worse as time went by. This strongly suggests that special attention needs to be paid to younger women and to women with history of mental disorder. Along with physical health, mental health must be a priority for the Government during and after quarantine and the COVID-19 pandemic.

Changes in Healthcare Workers' Anxiety During Two Time Points of the COVID-19 Pandemic: Evidence From a Longitudinal Study.

Evidence on the within-person changes of healthcare workers' mental health across waves of COVID-19 cases during this pandemic is absent. The aim of this study is to examine the within-person changes of anxiety in Argentinean healthcare workers, adjusting for main demographic factors, region of residence, mental disorder history, and COVID-19 contagion, during the COVID-19 pandemic. A longitudinal web survey (N = 305) was conducted during two time points of the pandemic, one of which was an infection peak. Anxiety significantly increased across time. However, there were significant interaction effects modulating anxiety levels. The largest anxiety increases occurred in healthcare workers who were not sure if they had contracted COVID-19 while symptomatic. Irrespective of the time point, anxiety was the highest in healthcare workers from a region inside the country who were not sure if they had contracted COVID-19, either asymptomatic or symptomatic. An interaction effect between the mental disorder history and the COVID-19 contagion suggested that the anxiety outcomes were mainly due to the concern about the COVID-19 contagion, rather than due to pre-existing mental health vulnerabilities. Regardless of the starting point in anxiety levels, an increasing anxiety outcome may be expected among healthcare workers as the pandemic progresses. The uncertainty regarding COVID-19 contagion is a preventable and modifiable interacting factor to produce the worst anxiety outcomes among healthcare workers.

Suicidal risk and impulsivity-related traits among young Argentinean college students during a quarantine of up to 103-day duration: Longitudinal evidence from the COVID-19 pandemic.

AIM: This study aimed to examine longitudinal changes on suicidal risk levels, adjusting for impulsivity-related traits, quarantine duration, main demographic factors, mental disorder history, and loneliness, in young Argentinean college students with (ideation; attempt) and without suicidal behavior history, during a quarantine of up to 103-day duration of the COVID-19 pandemic. METHODS: A longitudinal design with two-repeated measures was used (N = 1202). Follow-up was a month later from the first measurement. Three groups were analyzed: with suicidal ideation history, with suicide attempt history, and without suicidal behavior history. RESULTS: Percentages of college students with high or moderate suicidal risk were alarming (accumulated: 62.23% first measurement, 57.65% second measurement). Multilevel analysis on the three groups showed that suicidal risk diminished from the first measurement to the follow-up, having mental disorder history predicted higher suicidal risk, and negative urgency had the largest increasing effects on suicidal risk which persisted over time. CONCLUSIONS: Suicidal risk widely affects college students during lengthy quarantines of the COVID-19 pandemic and it should be tracked in those having pre-existing vulnerabilities, but also in those without. Education on managing negative emotions may help decrease suicide risk in college students during the COVID-19 pandemic.

A Longitudinal Study on the Changes in Mental Health of Healthcare Workers during the COVID-19 Pandemic.

Objective: This study examines Argentinean health care workers in order to 1) test self-perceived job performance levels and the presence of psychological symptoms compatible with common mental disorders, and 2) examine within-person changes in general discomfort and psychological distress, adjusting for demographic factors, region, and health-related factors during two time points of the COVID-19 pandemic.Method: This longitudinal study comprised 305 healthcare workers who completed a survey at two time points approximately 4 months apart. We used the General Health Questionnaire and the Kessler Psychological Distress Scale to measure mental health outcomes. To address the first aim we calculated differences (Student's t test for paired samples) and correlations (Pearson's r coefficient). To address the second aim we used fixed effects model by means of a multilevel approach, a linear model that considers dependency in the data.Results: Self-perceived job performance deteriorated across time. From the first measurement to the four-month follow-up, more health care workers presented common mental disorders (40% vs 45.57%), depression, and/or anxiety (52.46% vs 62.62%). A meaningful worsening of mental health was observed in healthcare workers who expressed concern about being infected with COVID-19, whether asymptomatic (greater general discomfort and psychological distress) or symptomatic (greater general discomfort). Likewise, there were significant interactions between a history of mental disorder and concern about COVID-19 infection.Conclusions: Among healthcare workers, the uncertainty about the COVID-19 infection may have larger negative mental health impacts than actually being infected.

A longitudinal study on depression and anxiety in college students during the first 106-days of the lengthy Argentinean quarantine for the COVID-19 pandemic.

BACKGROUND: The Argentinean quarantine is among the strictest and longest quarantines in the world. To determine if a worsening pattern on mental health would emerge with a prolonged quarantine duration, a longitudinal analysis pertaining to the lengthy mandatory Argentinean quarantine was conducted. AIM: To examine depression and anxiety changes in college students, as a function of quarantine duration, demographic and health-related factors, during successive time cuts of the lengthy mandatory quarantine in Argentina. METHODS: We used a longitudinal design, N = 1492 college students. For the first measurement, successive samplings were carried out across quarantine sub-periods of up to 106-days duration. The follow-up was one month later. RESULTS: Particularly women, young, and having a history of mental disorder and suicidal behavior, were more depressed and anxious under mandatory restrictive quarantine conditions. Repeated measures of both depression and anxiety scores remained constantly high during the more restrictive quarantine sub-periods of up to 13 and 53-days duration, and decreased during the less restrictive quarantine sub-period of up to 106-days duration, but with small effect sizes (0.10-0.08). CONCLUSIONS: Restrictive quarantine has negative effects on mental health outcomes. Partial spontaneous remissions of depression and anxiety symptoms may be expected with further quarantine relaxations.

Longitudinal evidence on mental health changes of college students with and without mental disorder background during the Argentina's lengthy mandatory quarantine.

This study examined the changes in the mental health state of college students with and without mental disorder background, during successive time cuts of the Argentina's lengthy mandatory quarantine, while adjusting for quarantine duration, sex, age, suicidal behavior history, loneliness, and region of residence. We used a longitudinal design (N = 1615, 26% with mental disorder history). Successive samplings were performed from three days before quarantine start and across quarantine phases of up to 103-days duration. Follow-up was one month later. Sex (woman) and age (younger) were significant predictors of worse mental health only in college students without mental disorder background. Having any suicidal behavior background significantly predicted worse mental health in college students both with and without mental disorder history. Loneliness and region of residence were not statistically significant. In the between-groups comparisons, college students having mental disorder background had worse mental health than those without such a background. However, in the within-subject comparisons, no statistically significant changes occurred across time in the mental health of college students having mental disorder history. Conversely, significant changes occurred in those without such a background, but only when the interaction between time and quarantine duration was considered. Worsening mental health occurred during the most heavily restrictive quarantine phases, while some of the remissions occurred during the longest, but less restrictive ones.

Mental Health Impacts in Argentinean College Students During COVID-19 Quarantine.

Background: We aimed to: (1) analyze differences in both general (in terms of psychological well-being/discomfort, social functioning and coping, and psychological distress) and specific (depression, trait-anxiety, negative alcohol-related consequences, and suicidal risk) mental health state (MHS) in college students, residing in four different Argentinean regions (center, north, south, and the most populated) exposed to different spread-rates of the COVID-19; (2) analyze between-group differences in both general and specific MHS indicators at four quarantine sub-periods (twice prior, and twice following the first quarantine extension). Methods: We used a cross-sectional design with a convenience sample including 2,687 college students. Data was collected online during the Argentinean quarantine. We calculated one-way between-groups ANOVA with Tukey's post hoc test. Results: Regionally, the center and the most populated area differed in psychological well-being/discomfort and negative alcohol-related consequences, but not in the remaining MHS indicators. According to the quarantine sub-periods, there were differences in psychological well-being/discomfort, social functioning and coping, psychological distress, and negative alcohol-related consequences. Negative alcohol-related consequences were the only MHS indicator improving over time. For all of the remaining MHS indicators, we found a similar deterioration pattern in the course of time, with mean scores decreasing from the first to the 2nd week of the quarantine pre-extensions, then increasing toward the 1st week of the quarantine post-extension (with some MHS indicators reaching mean scores worse than the start), and then continued to increase. Conclusion: A worsened mean MHS during quarantine suggests that quarantine and its extensions contribute to negative mental health impacts.

Levels and predictors of depression, anxiety, and suicidal risk during COVID-19 pandemic in Argentina: the impacts of quarantine extensions on mental health state.

This research is aimed to: analyze differences in mental health state (MHS) indicators (depression, state-anxiety, trait-anxiety, and suicidal risk), during three quarantine sub-periods (starting since the first quarantine extension); assess multiple relationships between each MHS indicator and potentially affecting factors. We used a cross-sectional design with a convenience sample including 1100 participants. Data were collected online. Depression revealed a worsening pattern as quarantine sub-periods went by. Anxiety (both state and trait), just like suicidal risk, partially follow such a pattern, with mean scores increasing from the first to the second/third quarantine extensions, but then maintaining to the fourth extension. Predictors having protective effects on almost all the MHS indicators were: availability of current economic income (except for state-anxiety, without significant effect) and absence of suicide attempt history. Conversely, sex (woman), younger age, and mental disorder history had an increasing risk effect on all the MHS indicators. Overall, our findings indicate that quarantine have negative mental health impacts and that quarantine duration is a relevant aspect to be taken into account when measuring such an impact. More attention needs to be paid to vulnerable groups such as the young, women, and people with history of mental disorder.

Changes in healthcare workers’ anxiety during two time points of the COVID-19 pandemic: Evidence from a longitudinal study (preprint)

Evidence on the within-person changes of healthcare workers’ mental health during the COVID-19 pandemic is absent. This study aimed to examine the within-person changes of anxiety in Argentinean healthcare workers during this pandemic, adjusting for main demographic factors, region, mental disorder history, and COVID-19 contagion. A longitudinal web survey (N = 305) was conducted during two time points of the pandemic, one of which was an infection peak. Anxiety significantly increased across time. However, there were significant interaction effects modulating anxiety levels. The largest anxiety increases occurred in healthcare workers who were wondering if they had contracted COVID-19 while symptomatic. Irrespective of the time point, anxiety was the highest in healthcare workers from a region inside the country who were wondering if they had contracted COVID-19, either asymptomatic or symptomatic. An interaction effect between the mental disorder history and the COVID-19 contagion suggested that the anxiety outcomes were mainly due to the concern about the COVID-19 contagion, rather than due to pre-existing mental health vulnerabilities. An increasing anxiety outcome may be expected among healthcare workers as the pandemic progresses. The uncertainty regarding COVID-19 contagion is a preventable and modifiable interacting factor to produce the worst anxiety outcomes among healthcare workers.