The effect of the COVID-19 pandemic on severe asthma care in Europe - will care change for good?

Background The COVID-19 pandemic has put pressure on health-care services forcing the reorganization of traditional care pathways. Aim To investigate;(1) how physicians taking care of severe asthma patients in Europe reorganized care during the COVID-19 pandemic;(2) patient satisfaction with these changes;and (3) impact on future care. Methods In this European-wide cross-sectional study, patient surveys were sent to patients with a physiciandiagnosis of severe asthma, and physician surveys to severe asthma specialists (November 2020 - May 2021). Results 1101 patients and 268 physicians from 16 European countries contributed to the study. Common physicianreported changes in severe asthma care included use of video/phone consultations (46%) and change to home administered biologics (38%), which resulted in high satisfaction levels in most patients (Figure 1). Many physicians expect continued implementation of video/phone consultations (41%) and home administration of biologics (52%). Conclusions Change to video/phone consultations and home administration of biologics was common in severe asthma care during the COVID-19 pandemic, and was associated with high satisfaction levels in most but not all cases. Many physicians expect these changes to continue in future severe asthma care, though satisfaction levels may change after the pandemic. (Figure Presented).

Multimodal surveillance of SARS-CoV-2 at a university enables development of a robust outbreak response framework.

BACKGROUND: Universities are vulnerable to infectious disease outbreaks, making them ideal environments to study transmission dynamics and evaluate mitigation and surveillance measures. Here, we analyze multimodal COVID-19-associated data collected during the 2020-2021 academic year at Colorado Mesa University and introduce a SARS-CoV-2 surveillance and response framework. METHODS: We analyzed epidemiological and sociobehavioral data (demographics, contact tracing, and WiFi-based co-location data) alongside pathogen surveillance data (wastewater and diagnostic testing, and viral genomic sequencing of wastewater and clinical specimens) to characterize outbreak dynamics and inform policy. We applied relative risk, multiple linear regression, and social network assortativity to identify attributes or behaviors associated with contracting SARS-CoV-2. To characterize SARS-CoV-2 transmission, we used viral sequencing, phylogenomic tools, and functional assays. FINDINGS: Athletes, particularly those on high-contact teams, had the highest risk of testing positive. On average, individuals who tested positive had more contacts and longer interaction durations than individuals who never tested positive. The distribution of contacts per individual was overdispersed, although not as overdispersed as the distribution of phylogenomic descendants. Corroboration via technical replicates was essential for identification of wastewater mutations. CONCLUSIONS: Based on our findings, we formulate a framework that combines tools into an integrated disease surveillance program that can be implemented in other congregate settings with limited resources. FUNDING: This work was supported by the National Science Foundation, the Hertz Foundation, the National Institutes of Health, the Centers for Disease Control and Prevention, the Massachusetts Consortium on Pathogen Readiness, the Howard Hughes Medical Institute, the Flu Lab, and the Audacious Project.

NEUROPSYCHIATRIC DISORDERS AND PARENTAL STRESS DURING THE COVID-19 PANDEMIC: AN ITALIAN RETROSPECTIVE LONGITUDINAL STUDY

AIM: The objective of our study is to evaluate the impact that the COVID-19 emergency and the related measures adopted have had on the family management of minors with neuropsychiatric disorders. Another objective of this study is to carry out a first longitudinal evaluation of this impact on parental stress, comparing the data collected before the pandemic with those collected during the lockdown. METHODS: This is an observational study that involved 271 families of patients already treated at the Child Neuropsychiatry Unit of the Salerno University Hospital between 2 and 23 years (112 with Autism Spectrum Disorder, 86 with epilepsy and 73 with other disorders of neurodevelopment). All participants were given an ad hoc telephone interview and a standardized questionnaire (PSI - Parenting Stress Index-Short Form). The telephone interview showed that a significant percentage of parents reported an increase in their child's daily management difficulties during the lock-down and emotional / behavioral problems, in particular the externalizing disorder. Comparison of the mean scores of the PSI-SF questionnaires completed before and during the lockdown showed a statistically significant increase in scores in the Total Stress scale and in the Parental Distress subscales. RESULTS & CONCLUSION: The results of our study suggest that the confinement measures and changes in daily routine imposed by quarantine negatively affected the behavioral and emotional dimensions of both children and parents causing a significant increase in parental stress, which is mainly related to feelings of inadequacy in relation to their role in such a delicate situation, and concern for the future.

QUALIFICAÇÃO DO PLASMA CONVALESCENTE SARS-CoV-2 EM DOADORES DE SANGUE

Introducao: A pandemia relacionada ao novo coronavirus (SARS-CoV-2), com sua alta morbi-mortalidade, tem impulsionado um movimento de busca de tratamentos seguros e eficazes. Dentro deste contexto, a utilizacao de imunizacao passiva tem ganhado importancia. O Plasma imune ou "convalescente" (PC), refere-se ao plasma que e coletado de individuos apos a resolucao da infeccao e desenvolvimento de anticorpos. Alem de ja ter sido utilizado nas epidemias de Ebola e H1N1, a administracao de PC para os pacientes enfermos por SARS-CoV-2, tem sido relatado em alguns estudos, com ocorrencia de melhora de parametros clinicos e laboratoriais. A nao padronizacao deste produto e o conhecimento incipiente sobre este agente, traz uma seria de obstaculos que devem ser suplantados. O recrutamento, a elegibilidade do doador e a pesquisa e quantificacao dos anticorpos, sao alguns deles. Nao se sabe ate o momento qual a concentracao de anticorpos necessarias no PC, para que possa ser minimamente efetivo. O Food and Drugs Administration (FDA), preconiza que seja realizada pesquisa de anticorpos contra SARS-CoV-2 e sugere utilizacao de doadores que tenham titulo de anticorpos neutralizantes acima de 1/80. A pesquisa de anticorpos neutralizantes e um teste de pouco acesso na praticas clinica. Estudos tem sido feitos para correlacionar resultados de Elisa e/ou Quimioluminescencia com a presenca e titulos de anticorpos neutralizantes. Neste estudo, descrevemos a experiencia utilizando o teste de pesquisa de anticorpos SARS-CoV-2 (Abbott) com leitura de densidade optica correlacionada com titulos acima de 1/80 de anticorpos neutralizantes. Objetivo: Realizar a qualificacao de doadores quanto a existencia e intensidade de anticorpo SARS-CoV-2 IgG em doadores de sangue, a fim de fornecer terapeutica potencialmente eficaz de PC para o tratamento da COVID-19. Materiais e metodos: Foram realizados 459 testes de titulacao SARS-CoV-2 IgG em doadores de sangue do grupo H.Hemo. Os doadores testados eram homens ou mulheres nuligestas, que atendiam aos criterios para doacao de sangue, com exame confirmatorio da SARS- CoV-2 e no minimo 30 dias de resolucao dos sinais e sintomas da doenca. As amostras foram coletadas em duas situacoes: coleta somente de exames para pesquisa e qualificacao do doador para posterior doacao de plasma convalescente por aferese, ou coleta de doacao de sangue total e amostras para titulacao do plasma fresco congelado. Resultados: Dos 459 testes realizados, 333 (73%) apresentaram resultados positivos para IgG. Destes, 222 (66%) foram considerados qualificados para doacao de plasma convalescente, pois apresentaram leitura de densidade optica maior ou igual a 3,5. Este numero representa somente 47% do total de exames realizados. Conclusao: O desenvolvimento da doenca COVID-19 isoladamente nao representa um criterio seguro para qualificacao de doadores de plasma convalescente, uma vez que foram identificados pacientes com titulos baixos e ate negativos de anticorpo no plasma de doadores em mais de 50% dos candidatos.Copyright © 2020

Pivoting in Context: Using the Forging Alliances in Interdisciplinary Rehabilitation Research Model to Collaborate During COVID-19.

ABSTRACT: With the onset of the COVID-19 pandemic, researchers have been faced with challenges in maintaining interdisciplinary research collaborations. The purpose of this article is to apply and expand a previously introduced model to sustaining new interdisciplinary research collaborations: Forging Alliances in Interdisciplinary Rehabilitation Research (FAIRR). FAIRR is a logic model that can be used as a guide to create interdisciplinary rehabilitation research teams. In this article, the authors propose expanding FAIRR by including strategies for sustaining interdisciplinary rehabilitation research collaborations: modifying inputs (resources needed to assemble a team and to conduct research activities), shifting activities (steps taken to move the interdisciplinary collaboration forward), and examining what impacts the fit between inputs and activities. Two examples are used to highlight the application of the FAIRR model to interdisciplinary collaborations during COVID-19.