Are COVID-19 systematic reviews up to date and can we tell? A cross-sectional study.

BACKGROUND: COVID-19 led to a rapid acceleration in the number of systematic reviews. Readers need to know how up to date evidence is when selecting reviews to inform decisions. This cross-sectional study aimed to evaluate how easily the currency of COVID-19 systematic reviews published early in the pandemic could be determined and how up to date these reviews were at the time of publication. METHODS: We searched for systematic reviews and meta-analyses relevant to COVID-19 added to PubMed in July 2020 and January 2021, including any that were first published as preprints. We extracted data on the date of search, number of included studies, and date first published online. For the search date, we noted the format of the date and where in the review this was reported. A sample of non-COVID-19 systematic reviews from November 2020 served as a comparator. RESULTS: We identified 246 systematic reviews on COVID-19. In the abstract of these reviews, just over half (57%) reported the search date (day/month/year or month/year) while 43% failed to report any date. When the full text was considered, the search date was missing from 6% of reviews. The median time from last search to publication online was 91 days (IQR 63-130). Time from search to publication was similar for the subset of 15 rapid or living reviews (92 days) but shorter for the 29 reviews published as preprints (37 days). The median number of studies or publications included per review was 23 (IQR 12-40). In the sample of 290 non-COVID SRs, around two-thirds (65%) reported the search date while a third (34%) did not include any date in the abstract. The median time from search to publication online was 253 days (IQR 153-381) and each review included a median of 12 studies (IQR 8-21). CONCLUSIONS: Despite the context of the pandemic and the need to easily ascertain the currency of systematic reviews, reporting of the search date information for COVID-19 reviews was inadequate. Adherence to reporting guidelines would improve the transparency and usefulness of systematic reviews to users.

Behavioral Medicine Research Council (BMRC) statement papers: A new approach to consensus building in behavioral medicine science.

The BMRC has initiated a new initiative, the Behavioral Medicine Research Council (BMRC) Scientific Statement papers. The statement papers will move the field forward by guiding efforts to improve the quality of behavioral medicine research and practice and facilitate the dissemination and translation of behavioral medicine research. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

New-onset urticaria and COVID-19 -A case report and literature review

Background: A variety of skin conditions are reported in association with COVID-19. Among these clinical patterns, urticarial lesions are described. We present a case of new-onset urticaria in an adult patient with mild COVID-19. In addition, we performed a comprehensive structured literature search to evaluate the temporal relationship between COVID-19 and urticarial manifestations and their duration. Method(s): This case report presents an adult patient with new-onset urticaria and confirmed diagnosis of COVID-19, assessed according to international guidelines. A systematic review was conducted for relevant studies published in Pubmed/Medline database, between January 2020 and January 2022, using specific keywords for clinical and temporal features of skin lesions. Result(s): A 28-year- old male with a 24-hour history of fever and headache presented new-onset urticarial lesions. In the context of COVID-19 pandemic, infection with SARS-CoV- 2 was suspected, and a PCR test detected viral RNA in a nasopharynx sample confirming the diagnosis in this patient. Other clinical manifestations and abnormal laboratory findings were not detected. A diagnosis of SARS-CoV- 2 infection-associated urticaria was established. The urticarial rash improved with oral new-generation H1 antihistamines and was remitted in 5 days. The outpatient treatment did not include systemic corticosteroid and antiviral therapy. Out of 3542 articles published in PubMed on cutaneous manifestations linked to COVID-19/ SARS-CoV- 2 infection, 53 met the criteria of assessing urticaria in these conditions. From these, 30 were case reports, 13 were case series and 10 were cohort studies. From 273 patients reported with urticaria, only 53 had a clear mention of a positive antigen or nucleic acid amplification viral test. Urticaria preceded the onset of respiratory/systemic COVID-19 symptoms in 12 patients, appeared at the same time in 81 patients, and as a late manifestation in 45 patients. For 135 patients, the timing was not specified. Urticarial lesions were remitted between several hours to 12 weeks, either spontaneously or with symptomatic treatment. Conclusion(s): Based on reported cases, urticaria may be associated with COVID-19. There is a need for more relevant studies regarding urticaria in these infectious conditions, with detailed data on clinical pattern, time of onset, duration, severity, need for specific treatment and prognosis.

Long-term effectiveness of COVID-19 vaccines against infections, hospitalisations, and mortality in adults: findings from a rapid living systematic evidence synthesis and meta-analysis up to December, 2022.

BACKGROUND: Synthesising evidence on the long-term vaccine effectiveness of COVID-19 vaccines (BNT162b2 [Pfizer-BioNTech], mRNA-1273 [Moderna], ChAdOx1 nCoV-19 [AZD1222; Oxford-AstraZeneca], and Ad26.COV2.S [Janssen]) against infections, hospitalisations, and mortality is crucial to making evidence-based pandemic policy decisions. METHODS: In this rapid living systematic evidence synthesis and meta-analysis, we searched EMBASE and the US National Institutes of Health's iSearch COVID-19 Portfolio, supplemented by manual searches of COVID-19-specific sources, until Dec 1, 2022, for studies that reported vaccine effectiveness immediately and at least 112 days after a primary vaccine series or at least 84 days after a booster dose. Single reviewers assessed titles, abstracts, and full-text articles, and extracted data, with a second reviewer verifying included studies. The primary outcomes were vaccine effectiveness against SARS-CoV-2 infections, hospitalisations, and mortality, which were assessed using three-level meta-analytic models. This study is registered with the National Collaborating Centre for Methods and Tools, review 473. FINDINGS: We screened 16 696 records at the title and abstract level, appraised 832 (5·0%) full texts, and initially included 73 (0·4%) studies. Of these, we excluded five (7%) studies because of critical risk of bias, leaving 68 (93%) studies that were extracted for analysis. For infections caused by any SARS-CoV-2 strain, vaccine effectiveness for the primary series reduced from 83% (95% CI 80-86) at baseline (14-42 days) to 62% (53-69) by 112-139 days. Vaccine effectiveness at baseline was 92% (88-94) for hospitalisations and 91% (85-95) for mortality, and reduced to 79% (65-87) at 224-251 days for hospitalisations and 86% (73-93) at 168-195 days for mortality. Estimated vaccine effectiveness was lower for the omicron variant for infections, hospitalisations, and mortality at baseline compared with that of other variants, but subsequent reductions occurred at a similar rate across variants. For booster doses, which covered mostly omicron studies, vaccine effectiveness at baseline was 70% (56-80) against infections and 89% (82-93) against hospitalisations, and reduced to 43% (14-62) against infections and 71% (51-83) against hospitalisations at 112 days or later. Not enough studies were available to report on booster vaccine effectiveness against mortality. INTERPRETATION: Our analyses indicate that vaccine effectiveness generally decreases over time against SARS-CoV-2 infections, hospitalisations, and mortality. The baseline vaccine effectiveness levels for the omicron variant were notably lower than for other variants. Therefore, other preventive measures (eg, face-mask wearing and physical distancing) might be necessary to manage the pandemic in the long term. FUNDING: Canadian Institutes of Health Research and the Public Health Agency of Canada.

COVID-19 Modeling To Support Decision Making In Brazil: A Scoping Review

Introduction. In the context of the COVID-19 pandemic, which required urgent responses from health systems, and ongoing decision making in a context of limited and evolving evidence, modeling played a significant role in supporting public policy making. Nonetheless, particularly in low and middle-income countries, modeling groups are scarce, and usually not routinely involved in supporting public health policy making. We aimed to appraise COVID-19 modeling work in Brazil during the pandemic. Methods. We performed a scoping review following PRISMA guidelines to identify groups conducting COVID-19 modeling to support health decision-making in Brazil. Search strategies were applied to MEDLINE, LILACS, Embase, ArXiv, and also included National data repositories and gray literature. We excluded reports of models without modeling results. Titles, s, data repository descriptions and full-text articles identified were read and selected by two reviewers. Data extracted included modeling questions, model characteristics (structure, type, and programming), epidemiologic data sources, main outcomes reported, and parameters. To further identify modeling groups that might have not yet published results, snowball sampling was performed, and a short survey was sent electronically. Investigators and policymakers were invited to an online interview, to obtain further information on how they interacted, communicated, and used modeling results. Results. We retrieved 1,061 references. After removing duplicates (127), 1,016 s and titles were screened. From an initial selection of 142 s, 133 research groups were identified, of which 67 didn't meet the eligibility criteria. Of these, 66 groups were invited for an interview, of which 24 were available, including 18 modeling groups from academic institutions, and four groups from State Health departments. Most models assessed the impact of mitigation measures in cases/hospitalization/deaths and healthcare service demand. Interaction and communication with decisionmakers were not well established in most groups. Conclusions. Despite a large number of modeling groups in Brazil, we observed a significant gap in modeling demand and communicating its results to support the decision-making process during the COVID-19 pandemic.

Brazilian Collaborative Network For COVID-19 Modeling: Successful Experience Of Using Real-Time Science To Support Evidence-Based Decision-Making

Introduction. Modeling is important for guiding policy during epidemics. The objective of this work was to describe the experience of structuring a multidisciplinary collaborative network in Brazil for modeling coronavirus disease 2019 (COVID-19) to support decisionmaking throughout the pandemic. Methods. Responding to a national call in June 2020 for proposals on COVID-19 mitigation projects, we established a team of investigators from public universities located in various regions throughout Brazil. The team's main objective was to model severe acute respiratory syndrome coronavirus 2 transmission dynamics in various demographic and epidemiologic settings in Brazil using different types of models and mitigation interventions. The modeling results aimed to provide information to support policy making. This descriptive study outlines the processes, products, challenges, and lessons learned from this innovative experience. Results. The network included 18 researchers (epidemiologists, infectious diseases experts, statisticians, and modelers) from various backgrounds, including ecology, geography, physics, and mathematics. The criteria for joining the network were having a communication channel with public health decision-makers and being involved in generating evidence for public policy. During a 24-month period, the following sub-projects were established: (i) development of a susceptible-exposed-infected-recovered-like, individual-based metapopulation and Markov chain model;(ii) projection of COVID-19 transmission and impact over time with respect to cases, hospitalizations, and deaths;(iii) assessment of the impact of non-pharmacological interventions for COVID-19;(iv) evaluation of the impact of reopening schools;and (v) determining optimal strategies for COVID-19 vaccination. In addition, we mapped existing COVID-19 modeling groups nationwide and conducted a systematic review of relevant published research literature from Brazil. Conclusions. Infectious disease modeling for guiding public health policy requires interaction between epidemiologists, public health specialists, and modelers. Communicating modeling results in a nonacademic format is an additional challenge, so close interaction with policy makers is essential to ensure that the information is useful. Establishing a network of modeling groups will be useful for future disease outbreaks.

Prevalence and Motivators of Getting a COVID-19 Booster Vaccine in Canada: Results from the iCARE Study.

Studies have shown that the protection afforded by COVID-19 vaccines against hospitalization and death decreases slowly over time due to the emergence of new variants and waning immunity. Accordingly, booster doses remain critical to minimizing the health impacts of the pandemic. This study examined the prevalence rate, sociodemographic determinants, and motivators of getting a COVID-19 booster vaccine within the Canadian population. We recruited a representative sample of 3001 Canadians aged 18+ years as part of the iCARE study using an online polling form between 20 January and 2 February 2022. Participants self-reported their booster status and were dichotomized into two groups: those who did vs. did not receive at least one booster dose. A total of 67% of participants received a booster dose. Chi-square analyses revealed that older age (p < 0.001) and having a chronic disease diagnosis (p < 0.001) were associated with being more likely to get a booster. Boosted individuals reported motivators tied to efficacy and altruism, whereas non-boosted individuals reported motivators tied to efficacy and safety. Results suggest that messaging will require careful tailoring to address the identified behavioral motivators among non-boosted individuals who emphasize safety and efficacy of additional vaccine doses.

Incidence and Risk of Pulmonary Embolism in Pediatric Patients with Acute Covid-19 Infection

INTRODUCTION: Previous studies have reported an increased risk of procoagulant events such as pulmonary embolism (PE) in adult patients with Coronavirus Disease-19 (COVID-19). However, scant information exists within pediatric samples. This study aimed to investigate the effect of COVID-19 acute infections on the incidence of PE among pediatric patients. METHOD(S): Using Virtual Pediatric Systems (VPS), retrospective data was collected of patients age < 18 years old who were admitted to participating pediatric critical care units from 2018-2021. Patients with an ICD diagnosis of COVID-19 infection or PE were extracted for further analysis. Additional information regarding patient age, gender, race, BMI, comorbidities were also obtained. RESULT(S): In total, there were 488,298 admissions to PICUS participating in VPS from 2018 - 2021. In 2018 and 2019, prior to the COVID-19 pandemic, the incidence of PE among the pediatric population was 2.29 per 1000 patients (n=614). During the COVID-19 pandemic in 2020-2021, the incidence of PE increased to 3.11 per 1000 patients (n=686). Of the PE cases between 2020 to 2021, 12.1% (n=83) patients had an acute COVID-19 infection (53.0% female;42.0% BMI> 35;91.6% >12 years of age;92.8% survival). Patients with acute COVID-19 infection had 3.4 (95% CI, 2.7 - 4.2) times the risk of pulmonary embolism than patients from 2020 to 2021 without acute COVID-19 infection. CONCLUSION(S): In this study, we report an increased incidence of PE among pediatric patients during the COVID-19 pandemic when compared with the years prior to the pandemic. Additionally, we report a significantly increased relative risk of pulmonary embolism in patients with acute COVID-19 infection compared to patients without acute COVID-19 infection. Further analysis is planned to adjust for hypercoagulable states. Additional research is needed to identify risk factors for PE in pediatric patients with COVID-19.

Ten Minutes a Semester: Evaluation of a Short Wellness Intervention for Undergraduate Chemistry and Biology Courses

The COVID-19 pandemic has highlighted many challenges undergraduate students face including their ability to manage stress. Poor stress management can contribute to poor academic performance and health outcomes;better wellness habits and stress reduction go hand-in-hand, as improved wellness habits reduce overall stress and expand positive stress management strategies. This article describes the design of a short wellness intervention for STEM classes and its evaluation after implementation in five chemistry and biology courses that span the four years of a biochemistry degree. This intervention, composed of a short, in-class presentation and an associated supplemental resource handout, presents students with information on five wellness areas: sleep, nutrition, water intake, exercise, and meditation and mindfulness. Students were surveyed at three points (once preintervention and twice postintervention) in one semester and asked to report their perceived stress, current wellness habits, and overall perception of the intervention. Notably, the majority of students (89%) thought the intervention should be included in other courses. The importance of completing the intervention in class was underscored by the small number of students (19%) who reported accessing the additional resources provided outside of class. Student wellness habits did not dramatically shift postintervention, but this study garnered insights into the barriers students face when attempting to change their wellness behavior. Overwhelmingly students reported that academic workload was the dominant factor hindering positive wellness change. The intervention materials, including a suggested script, are shared, and data-supported recommendations for implementation in other courses and institutions are provided.

How well do covariates perform when adjusting for sampling bias in online COVID-19 research? Insights from multiverse analyses.

COVID-19 research has relied heavily on convenience-based samples, which-though often necessary-are susceptible to important sampling biases. We begin with a theoretical overview and introduction to the dynamics that underlie sampling bias. We then empirically examine sampling bias in online COVID-19 surveys and evaluate the degree to which common statistical adjustments for demographic covariates successfully attenuate such bias. This registered study analysed responses to identical questions from three convenience and three largely representative samples (total N = 13,731) collected online in Canada within the International COVID-19 Awareness and Responses Evaluation Study ( www.icarestudy.com ). We compared samples on 11 behavioural and psychological outcomes (e.g., adherence to COVID-19 prevention measures, vaccine intentions) across three time points and employed multiverse-style analyses to examine how 512 combinations of demographic covariates (e.g., sex, age, education, income, ethnicity) impacted sampling discrepancies on these outcomes. Significant discrepancies emerged between samples on 73% of outcomes. Participants in the convenience samples held more positive thoughts towards and engaged in more COVID-19 prevention behaviours. Covariates attenuated sampling differences in only 55% of cases and increased differences in 45%. No covariate performed reliably well. Our results suggest that online convenience samples may display more positive dispositions towards COVID-19 prevention behaviours being studied than would samples drawn using more representative means. Adjusting results for demographic covariates frequently increased rather than decreased bias, suggesting that researchers should be cautious when interpreting adjusted findings. Using multiverse-style analyses as extended sensitivity analyses is recommended.

Sentiment Analysis of Online Movie Reviews using Machine Learning

Many websites encourage their users to write reviews for a wide variety of products and services. In particular, movie reviews may influence the decisions of potential viewers. However, users face the arduous tasks of summarizing the information in multiple reviews and determining the useful and relevant reviews among a very large number of reviews. Therefore, we developed machine learning (ML) models to classify whether an online movie review has positive or negative sentiment. We utilized the Stanford Large Movie Review Dataset to build models using decision trees, random forests, and support vector machines (SVMs). Further, we compiled a new dataset comprising reviews from IMDb posted in 2019 and 2020 to assess whether sentiment changed owing to the coronavirus disease 2019 (COVID-19) pandemic. Our results show that the random forests and SVM models provide the best classification accuracies of 85.27% and 86.18%, respectively. Further, we find that movie reviews became more negative in 2020. However, statistical tests show that this change in sentiment cannot be discerned from our model predictions. © 2022,International Journal of Advanced Computer Science and Applications. All Rights Reserved.

Elevated angiotensin-converting enzyme 2 (ACE2) expression in cats with hypertrophic cardiomyopathy.

Angiotensin-converting enzyme 2 (ACE2) is an enzyme within the renin-angiotensin-aldosterone system that plays a role in regulating blood pressure. However, it is also a cellular receptor for infection with SARS coronaviruses. Although most cats develop subclinical or mild disease following infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) acquired from human patients, a previous study has suggested hypertrophic cardiomyopathy (HCM) is a potential risk factor for the development of severe disease in the cat. Herein we investigate the ACE2 protein expression in the lung, heart, and kidney from a small subset of cats with (n = 10) and without HCM (n = 10) by immunohistochemistry. The abundance and intensity of ACE2 expression is slightly elevated in alveoli (p = 0.09; 0.07, respectively) and bronchioles (p = 0.095; 0.37, respectively). However, statistically elevated abundance and intensity of ACE-2 expression was only evident in the heart of cats with HCM (p = 0.032; p = 0.011, respectively). Further investigation did not demonstrate a statistical correlation between the ACE2 expression in the heart in relation to the heart weight to body weight ratio, and the ventricular wall ratio. Current findings suggest an overexpression of ACE2 in HCM cases but follow up study is warranted to understand the pathophysiological process.

The impact of COVID-19 on the lives of Canadians with and without non-communicable chronic diseases: Results from the iCARE Study (preprint)

Background: The COVID-19 pandemic and its prevention policies have taken a toll on Canadians, and certain subgroups may have been disproportionately affected, including those with non-communicable disease (NCDs; e.g., heart and lung disease) due to their risk of COVID-19 complications. Aims/Objectives: We investigated the impacts of COVID-19 on mental health, lifestyle habits, and access to healthcare among Canadians with NCDs compared to those without, and the extent to which women with NCDs were disproportionately affected. Methods: As part of the iCARE study (www.icarestudy.com), data from seven Canadian representative samples (total n=24,028) was collected via online surveys between June 4, 2020 to February 2, 2022 and analyzed using general linear models. Results: A total of 45.6% (n=10,570) of survey respondents indicated having at least one physician-diagnosed NCD, the most common of which were hypertension (24.3%), chronic lung disease (13.3%) and diabetes (12.0%). In fully adjusted models, those with NCDs were 1.18-1.24 times more likely to reporting feeling lonely, irritable/frustrated, and angry ‘to a great extent’ compared to those without (p’s <.001). Similarly, those with NCDs were 1.22-1.24 times more likely to report worse eating and drinking habits and cancelling medical appointments/avoiding the emergency department compared to those without (p’s <.001). Moreover, although there were no sex differences in access to medical care, women with NCDs were more likely to report feeling anxious and depressed, and report drinking less alcohol, compared to men with NCDs (p’s <.01). Conclusion: Results suggest that people with NCDs and women have been disproportionately impacted by the pandemic, and that women with NCDs have suffered greater psychological distress compared to men, and men with NCDs have increased their alcohol consumption compared to women. Findings point to potential intervention targets among patients with NCDs.

Online Collaborative Learning in Urology.

REASON FOR REVIEW: A recent shift towards use of telehealth and remote learning has significant implications on resident and fellow education in urology. Implementation of multi-institutional online didactic programs, spurred on by the COVID epidemic, has changed the traditional resident teaching paradigm from individual institutional silos of knowledge and expertise to a shared nationwide database of learning.  RECENT FINDINGS: In this article, we explore the current trend towards virtual education and its progress to date, lessons learned on the optimization of this teaching modality, and future direction and sustainability of collaborated, standardized and accessible didactic education in urology. Multi-institutional collaborative remote video didactics has emerged as a critical part of resident education. These lectures have been overwhelmingly successful and have persisted beyond the pandemic to become a part of the urologic training curricula. This collaborative and standardized approach to resident education provides access to national and international experts, encourages cross-institutional collaboration and discussion, and builds a repository of lectures with easy access for learners. Utilization of this teaching modality will continue to be impactful in urologic training and will require ongoing efforts and input from both collaborating intuitions and professional societies to continue to improve on and engage in this important learning tool.

Early Isolates of SARS-CoV-2 Result in Different Pathogenesis in the Transduced Mouse Model of COVID-19.

A transduced mouse model of SARS-CoV-2 infection was established using Balb/c mice. This was achieved through the adenovirus-vectored delivery of the hACE2 gene, to render the mice transiently susceptible to the virus. The model was characterised in terms of the dissemination of hACE2 receptor expression, the dissemination of three SARS-CoV-2 virus variants in vivo up to 10 days following challenge, the resulting histopathology and the clinical signs induced in the mice. In transduced mice, the infection was short-term, with a rapid loss in body weight starting at day 2 with maximum weight loss at day 4, followed by subsequent recovery until day 10. The induced expression of the hACE2 receptor was evident in the lungs, but, upon challenge, the SARS-CoV-2 virus disseminated beyond the lungs to spleen, liver and kidney, peaking at day 2 post infection. However, by day 10 post infection, the virus was undetectable. The lung histopathology was characterised by bronchial and alveolar inflammation, which was still present at day 10 post infection. Transduced mice had differential responses to viral variants ranking CVR-Glasgow 1 > Victoria-1 > England-2 isolates in terms of body weight loss. The transduced mouse model provides a consistent and manipulatable model of SARS-CoV-2 infection to screen viral variants for their relative virulence and possible interventions.

Patterns of Internet Use, and Associations with Loneliness, amongst Middle-Aged and Older Adults during the COVID-19 Pandemic.

Loneliness among older adults is a major societal problem with consequences for health and wellbeing; this has been exacerbated by the coronavirus pandemic. The present study investigated associations between internet use, including frequency and type of use, and loneliness in a large UK sample of middle-aged and older adults, aged 55-75 (n = 3500) from the English Longitudinal Study of Ageing (ELSA) cohort study. Our findings indicated a clear relationship between the frequency of internet use and subjective loneliness. Those who used the internet more than once a day reported feeling less lonely than those who used the internet once a week or less. We also found that those who used the internet for e-mail communication were less lonely. However, individuals indicated higher levels of loneliness when the internet was used for information searches about health. Regarding sociodemographic factors underlying internet usage, less frequent use was seen amongst individuals who lived alone, people who were not employed, who had lower education levels, and lower sociodemographic status. Additionally, gender differences were found in the type of internet use: males report using the internet for e-mail communication more than females, while females' internet use for health-related information searches was higher than in males. In sum, findings suggest that intervention strategies that promote internet access amongst middle-aged and older people could be useful for tackling loneliness and point to the groups within society that should be the focus of such interventions.

Impact of biological sex and gender-related factors on public engagement in protective health behaviours during the COVID-19 pandemic: cross-sectional analyses from a global survey.

OBJECTIVE: Given the role of sociocultural gender in shaping human behaviours, the main objective of this study was to examine whether sex and gender-related factors were associated with the public's adherence to COVID-19-recommended protective health behaviours. DESIGN: This was a retrospective analysis of the survey that captured data on people's awareness, attitudes and behaviours as they relate to the COVID-19 policies. SETTING: Data from the International COVID-19 Awareness and Responses Evaluation survey collected between March 2020 and February 2021 from 175 countries. PARTICIPANTS: Convenience sample around the world. MAIN OUTCOME MEASURES: We examined the role of sex and gender-related factors in relation to non-adherence of protective health behaviours including: (1) hand washing; (2) mask wearing; and (3) physical distancing. Multivariable logistic regression was conducted to determine the factors associated with non-adherence to behaviours. RESULTS: Among 48 668 respondents (mean age: 43 years; 71% female), 98.3% adopted hand washing, 68.5% mask wearing and 76.9% physical distancing. Compared with males, females were more likely to adopt hand washing (OR=1.97, 95% CI: 1.71 to 2.28) and maintain physical distancing (OR=1.28, 95% CI: 1.22 to 1.34). However, in multivariable sex-stratified models, females in countries with higher Gender Inequality Indexes (GII) were less likely to report hand washing (adjusted OR (aOR)=0.47, 95% CI: 0.21 to 1.05). Females who reported being employed (aOR=0.22, 95% CI: 0.10 to 0.48) and in countries with low/medium GIIs (aOR=0.18, 95% CI 0.06 to 0.51) were less likely to report mask wearing. Females who reported being employed were less likely to report physical distancing (aOR=0.39, 95% CI: 0.32 to 0.49). CONCLUSION: While females showed greater adherence to COVID-19 protective health behaviours, gender-related factors, including employment status and high country-wide gender inequality, were independently associated with non-adherence. These findings may inform public health and vaccination policies in current as well as future pandemics.

Are COVID-19 systematic reviews up to date and can we tell? A cross-sectional study (preprint)

BackgroundCOVID-19 led to a rapid acceleration in the number of systematic reviews. Readers need to know how up to date evidence is when selecting reviews to inform decisions. This cross-sectional study aimed to evaluate how easily the currency of COVID-19 systematic reviews published early in the pandemic could be determined and how up to date these reviews were at the time of publication.MethodsWe searched for systematic reviews and meta-analyses relevant to COVID-19 added to PubMed in July 2020 and January 2021, including any that were first published as preprints. We extracted data on the date of search, number of included studies, and date first published online. For the search date, we noted the format of the date and where in the review this was reported. A sample of non-COVID-19 systematic reviews from November 2020 served as a comparator.ResultsWe identified 246 systematic reviews on COVID-19. In the abstract of these reviews, around half (48%) reported the complete search date (day/month/year) and 43% failed to report any date. In the full text, the complete date and no date were reported in 82% and 6% of reviews, respectively. The median time from last search to publication online was 91 days (IQR 63–130). Time from search to publication was similar for the subset of 15 rapid or living reviews (92 days) but shorter for the 29 reviews published as preprints (37 days). The median number of studies or publications included per review was 23 (IQR 12–40). In the sample of 290 non-COVID SRs, around a quarter (27%) reported the complete search date and a third (34%) did not include any date in the abstract. The median time from search to publication online was 253 days (IQR 153–381) and each review included a median of 12 studies (IQR 8–21).ConclusionsDespite the context of the pandemic and the need to easily ascertain the currency of systematic reviews, reporting of the search date information for COVID-19 reviews was suboptimal. Reviews were conducted and published more quickly than non-COVID reviews but potentially at the expense of adequate reporting.

Evaluation of the Educational Impact of the Urology Collaborative Online Video Didactics Lecture Series.

OBJECTIVE: To assess the impact of the Urology Collaborative Online Video Didactic (COViD) lecture series series on resident knowledge as a supplement to resident education during the coronavirus disease 2019 pandemic. METHODS: One hundred thirty-nine urology residents were voluntarily recruited from 8 institutions. A 20-question test, based on 5 COViD lectures, was administered before and after watching the lectures. Pre- and posttest scores (percent correct) and score changes (posttest minus pretest score) were assessed considering demographic data and number of lectures watched. Multiple linear regression determined predictors of improved scores. RESULTS: Of residents recruited, 95 and 71 took the pre- and posttests. Median number of lectures watched was 3. There was an overall increase in correct scores from pretest to posttest (45% vs 57%, P < .01). Watching any lectures vs none led to higher posttest scores (60% vs 44%, P < .01) and score changes (+16% vs +1%, P < .01). There was an increase in baseline pretest scores by post-graduate year (PGY) (P < .01); however there were no significant differences in posttest or score changes by PGY. When accounting for lectures watched, PGY, and time between lecture and posttest, being a PGY6 (P = .01) and watching 3-5 lectures (P < .01) had higher overall correct posttest scores. Watching 3-5 lectures led to greater score changes (P < .001-.04). Over 65% of residents stated the COViD lectures had a large or very large impact on their education. CONCLUSIONS: COViD lectures improved overall correct posttest scores and increased knowledge base for all resident levels. Furthermore, lectures largely impacted resident education during the coronavirus disease 2019 pandemic.

Preliminary results of the FILO phase 2 trial for untreated fit patients with intermediate risk chronic lymphocytic leukemia comparing ibrutinib plus venetoclax (IV) vs. FCR

With the emergence of targeted therapies, defining the best strategy for the treatment of previously untreated CLL patients remains challenging. The aim of this phase 2 study was to compare the efficacy of an association with ibrutinib and venetoclax (IV) to the standard FCR regimen in fit patients with intermediate-risk CLL defined by either unmutated IGHV status, 11q deletion, or complex karyotype in the absence of TP53 abnormality. Patients were randomized 1:1 between two treatment arms, i.e. FCR 6 cycles or IV. After a lead-in phase of ibrutinib as a single agent from the month (M)1 to M3, the total duration of treatment with IV was based on the response achieved at M9;if bone marrow (BM) MRD was <0.01% using flow cytometry, the treatment was continued for 6 additional months until M15 and then stopped;if BM MRD at M9 was ≥0.01%, the treatment with IV was continued for 18 additional months until M27. The primary endpoint was the percentage of patients with BM MRD <0.01% at M27 in both arms. We present here the preliminary results on the first evaluation done at M9 including CT-scan, BM biopsy, and MRD assessment in PB and BM after the inclusion of all the 120 patients as initially planned. One hundred and twenty patients were enrolled from September 2019 to February 2021. The median age was 59 [34-72] and 61 [34-74] years in the FCR and IV arms, respectively. The characteristics of the patients were well-balanced between the 2 arms in terms of gender (male 72% FCR, 74% IV), PS ECOG 0-1 (59% FCR, 68% IV), and Binet stage (A, B, and C 15, 64, 21% for FCR;8.5, 59, and 32% for IV). No major difference in terms of cytogenetic features was noted, all patients but one had unmutated IGHV. At the time of data cut-off for this interim analysis, the median follow-up for all cohort was 12.7 [4.5.9-21.4] months. The frequency of patients presenting all grades adverse events (AE) so far was 90% (grade ≥3: 45%) in the FCR arm and 80% (grade ≥3: 45%) in the IV arm. The rate of infusion-related reactions (IRR) in the FCR arm was 35% on cycle 1-day 1 (14% grade 3-4);for the IV arm, 5% of patients experienced tumor lysis syndrome (TLS) (grade 3 for 1 patient). Ibrutinib doses were reduced for seven patients (four permanently stopped and three resumed at a lower dose because of toxicities (digestive, hepatic, or hematological). Venetoclax was permanently discontinued before M9 in four patients (digestive toxicities and grade 4 neutropenia). Fifty-two serious adverse events were reported of which 22 were in the IV arm (among them one sudden death, one ischemic stroke, one acute coronary syndrome, two atrial fibrillations, two TLS, two acute renal failures, one hepatitis, one neutropenia, two COVID pneumonitis, and one osteoporotic fracture) and 30 in the FCR arm (among them five febrile neutropenia, one hemolytic anemia, one thrombocytopenia, three IRR, three TLS, three COVID pneumonitis, one acute myeloid leukemia, one myelodysplasic syndrome). All patients with COVID pneumonitis had a favorable evolution with the need for intensive care and convalescent plasma for three of them. The first 85 patients included in the study have reached M9 and among them, nine prematurely discontinued the study, (one active hemolysis, one ischemic stroke, one TLS, one hepatitis, and one sudden death in the IV arm;three hematologic toxicities and one early progression in the FCR arm). In the evaluated patients (n=74), 69% of patients in the FCR arm and 43% of patients in the IV arm achieved bone BM MRD <0.01%. The complete (CR, CRi) and partial response rates were 56 and 44% in the FCR arm and 74 and 26% in the IV arm, respectively. In conclusion, preliminary results show a lower BM MRD rate in the IV arm compared to the FCR arm at M9, with toxicity that remains significant and relatively similar between the two arms. However, BM MRD rate may improve after longer exposure to the IV combination and the analysis of the primary endpoint at M27 will be decisive in determining the best therapeutic strategy.