Metabolic Modeling Elucidates Phenformin and Atpenin A5 as Broad-Spectrum Antiviral Drugs (preprint)

Abstract: The SARS-CoV-2 pandemic has reemphasized the urgent need for broad-spectrum antiviral therapies. We developed a computational workflow using scRNA-Seq data to assess cellular metabolism during viral infection. With this workflow we predicted the capacity of cells to sustain SARS-CoV-2 virion production in patients and found a tissue-wide induction of metabolic pathways that support viral replication. Expanding our analysis to influenza A and dengue viruses, we identified metabolic targets and inhibitors for potential broad-45 spectrum antiviral treatment. These targets were highly enriched for known interaction partners of all analyzed viruses. Indeed, phenformin, an NADH:ubiquinone oxidoreductase inhibitor, suppressed SARS-CoV-2 and dengue virus replication. Atpenin A5, blocking succinate dehydrogenase, inhibited SARS-CoV-2, dengue virus, respiratory syncytial virus, and influenza A with high selectivity indices. In vivo, phenformin showed antiviral activity against SARS-CoV-2 in a Syrian hamster model. Our work establishes host metabolism as druggable for broad-spectrum antiviral strategies, providing invaluable tools for pandemic preparedness.

Mental health during the COVID-19 pandemic: Stress and strain profiles in the German population.

Clinical observations indicate that people frequently display stress-related behavior during the COVID-19 pandemic. Although numerous studies have been published concerning pandemic-related psychological distress, systematic data on the interrelationships between stress sensitivity, personality, and behavioral characteristics of people are still lacking. In the present cross-sectional online survey study, we applied a German version of the COVID Stress Scales (CSS) and standard psychological questionnaires to systematically identify the complex interplay between stress sensitivity, gender, and personality in the modulation of quality of life and mental health in the German population (N = 1774; age ≥ 16 years). A CSS-based cluster analysis revealed two clusters characterized by higher and lower stress levels. Study participants in each cluster differed significantly with respect to neuroticism, extraversion, agreeableness, quality of life, depression, and anxiety. Females were significantly overrepresented in the higher stress cluster, while there was an overrepresentation of males in the lower stress cluster. Neuroticism was identified as a risk factor and extraversion as a protective factor for enhanced pandemic-related stress responses. For the first time our data show a taxonomy of factors, which modulate pandemic-related stress sensitivity and warrant consideration as key indicators of quality of life and psychological distress during the COVID-19 pandemic. We suggest that our data may advise governmental regulation of pandemic-related public health measures, to optimize quality of life and psychological health in different groups of the population.

Study Conditions and University Students' Mental Health during the Pandemic: Results of the COVID-19 German Student Well-Being Study (C19 GSWS).

University students are generally vulnerable to mental health problems. This was exacerbated during the COVID-19 pandemic, when students experienced decisive changes and restrictions in their academic lives. Our study aimed at (a) analysing associations between study conditions and symptoms of depression and anxiety and (b) determining the extent of use and motivation to use student counselling services. The C19 GSWS is a cross-sectional study conducted at five universities in Germany (N = 7203). Descriptive analyses and linear regression models were performed to estimate the associations between study conditions and mental health outcomes. A total of 42.4% of the students felt down, depressed, or hopeless on several days over the past 14 days. Between a third and 44.1% of the students felt burdened by their study conditions. Worse perceived study conditions were associated with higher levels of depressive symptoms and anxiety. Only 7.1% indicated that they had utilised student counselling services, and female gender, enrolment in a bachelor's programme, and having more than 1 reason for utilisation were factors associated with use. The results of our research underline the need for universities to review their study conditions and to provide targeted intervention strategies and counselling services to promote students' mental well-being.

Perspectives of online anatomy teachers: A neglected study population struggles with the invisible student.

Online teachers are an under-researched population, but their perspectives are crucial to the successful implementation of online education. A fully online section of an established face-to-face (F2F) two-semester undergraduate anatomy course with a prosection laboratory commenced in 2012 at The University of Western Ontario, Canada. Professors' lectures for F2F students were broadcast in live and archived format to online students using Blackboard Collaborate (BBC) video conferencing software. Teaching assistants (TAs) delivered online laboratories using BBC and three-dimensional (3D) anatomical computer models. This study explored the common experiences and issues faced by the course teachers from 2012 to 2014. Transcripts from open-ended, individual interviews with professors (n = 4) and TAs (n = 5) were coded and analyzed thematically. The teachers' concern for their inability to see the students during sessions to assess class engagement and their teaching effectiveness, and to develop social relationships, was the main finding. However, video conferencing software and email were sufficient communication methods for the students' questions and the teachers' answers. The TAs noted usability challenges and anatomical inaccuracies in the 3D models compared to cadavers. Due to limitations of BBC's screen sharing function, live manipulation for the 3D computer models was not possible; however, the TAs found pedagogical value in using screen captures of the models for drawing activities with the students. Overall, preparation time for teaching online was longer than for F2F. The study's findings provide science educators with issues to consider when preparing for online teaching and recommendations to optimize the teaching experience.

Proteomics reveals antiviral host response and NETosis during acute COVID-19 in high-risk patients.

SARS-CoV-2 remains an acute threat to human health, endangering hospital capacities worldwide. Previous studies have aimed at informing pathophysiologic understanding and identification of disease indicators for risk assessment, monitoring, and therapeutic guidance. While findings start to emerge in the general population, observations in high-risk patients with complex pre-existing conditions are limited. We addressed the gap of existing knowledge with regard to a differentiated understanding of disease dynamics in SARS-CoV-2 infection while specifically considering disease stage and severity. We biomedically characterized quantitative proteomics in a hospitalized cohort of COVID-19 patients with mild to severe symptoms suffering from different (co)-morbidities in comparison to both healthy individuals and patients with non-COVID related inflammation. Deep clinical phenotyping enabled the identification of individual disease trajectories in COVID-19 patients. By the use of the individualized disease phase assignment, proteome analysis revealed a severity dependent general type-2-centered host response side-by-side with a disease specific antiviral immune reaction in early disease. The identification of phenomena such as neutrophil extracellular trap (NET) formation and a pro-coagulatory response characterizing severe disease was successfully validated in a second cohort. Together with the regulation of proteins related to SARS-CoV-2-specific symptoms identified by proteome screening, we not only confirmed results from previous studies but provide novel information for biomarker and therapy development.

COVID-19 stress syndrome in the German general population: Validation of a German version of the COVID Stress Scales.

The COVID Stress Scales (CSS) are a new self-report instrument for multidimensional assessment of psychological stress in the context of the pandemic. The CSS have now been translated and validated in over 20 languages, but a validated German version has not yet been available. Therefore, the aim was to develop a German version of the CSS, to test its factor structure, reliability, and validity, and to compare it with international studies. In an online survey (08/2020-06/2021), N = 1774 individuals from the German general population (71.5% female; Mage = 41.2 years, SD = 14.2) completed the CSS as well as questionnaires on related constructs and psychopathology. After eight weeks, participants were asked to participate again for the purpose of calculating retest reliability (N = 806). For the German version, the 6-factor structure with good model fit (Root Mean Square Error of Approximation, RMSEA = 0.06) was confirmed, with the six subscales: Danger, Socio-Economic Consequences, Xenophobia, Contamination, Traumatic Stress, and Compulsive Checking. Internal consistencies ranged from ω = .82-.94 (except Compulsive Checking ω = .70), and retest reliability from rtt = .62-.82. Convergent and discriminant validity were confirmed for the German version. Related constructs such as health anxiety, general xenophobia, obsessive-compulsive behavior, and posttraumatic stress disorder symptoms correlated moderately with the respective subscale and lower with the other scales. With anxiety and depression, Traumatic Stress showed the strongest correlation. Overall, there was a high degree of agreement in an international comparison. The CSS can help to identify pandemic-related psychological stress and to derive appropriate interventions.

Determinants of vaccination behavior among university students 20 months after the COVID-19 outbreak: Results of the COVID-19 German Student Well-being Study (C19 GSWS).

Evidence indicates a higher COVID-19 vaccine hesitancy among university students due to their age and a lower risk of COVID-19 related complications compared to the general population in Germany. However, little is known about the other determinants of COVID-19 vaccination behavior for the population of German university students. This study aimed to investigate determinants of vaccination behavior in this population. The cross-sectional COVID-19 German Student Well-being Study was conducted at five German universities from October 27th to November 14th, 2021, via an online survey (n=7,267). Multiple logistic regressions were calculated to examine associations of psychological antecedents of vaccination (5Cs: confidence, complacency, constraints, calculation, collective responsibility), Critical Health Literacy in a Pandemic (CHL-P), and additional determinants (previous infection, trust in the health care system, feeling informed about the COVID-19 vaccine) and vaccination status (not vaccinated vs. fully vaccinated). All 5Cs were associated with reporting to be vaccinated, except for complacency. Regarding the CHL-P, students who felt that the current scientific knowledge about COVID-19 in terms of the policy decisions on pandemic measures was very complex had higher odds for reporting being vaccinated (OR=3.02; 95% CI: 2.26-4.04). Students who felt well informed about the COVID-19 vaccines were also more likely to report being fully vaccinated (OR=2.20; 95% CI: 1.51-3.21). Due to our finding that the 5Cs are associated with vaccination status among university students, we recommend that the different components of the 5Cs should be considered in future vaccination campaigns implemented in the university context.

Early Adverse Effects of Behavioural Preventive Strategies During the COVID-19 Pandemic in Germany: An Online General Population Survey.

Background: Quarantine and physical distancing represent the two most important non-pharmaceutical actions to contain the COVID-19 pandemic. Comparatively little is known about possible adverse consequences of these behavioural measures in Germany. This study aimed at investigating potential early adverse effects associated with quarantine and physical distancing at the beginning of the countrywide lockdown in Germany in March 2020. Method: Using a cross-sectional online survey (N = 4,268), adverse consequences attributed to physical distancing, symptoms of psychopathology, and sociodemographic variables were explored in the total sample as well as in high-risk groups (i.e., people with a physical or mental condition). Results: The most frequently reported adverse effects were impairment of spare time activities, job-related impairment, and adverse emotional effects (e.g., worries, sadness). Participants with a mental disorder reported the highest levels of adverse consequences (across all domains) compared to participants with a physical disease or participants without any mental or physical condition. No significant association between the duration of the behavioural protective measures and the severity of adverse mental health effects was observed. Conclusion: Results showed that non-pharmaceutical actions were associated with adverse effects, particularly in people with mental disorders. The findings are of relevance for tailoring support to special at-risk groups in times of behavioural preventive strategies.

Simultaneous quantification of nirmatrelvir and ritonavir by LC-MS/MS in patients treated for COVID-19.

Nirmatrelvir is an antiviral agent active against SARS-CoV-2, the virus causing the pandemic disease COVID-19. It is administrated in combination with the protease inhibitor ritonavir, which acts in case of COVID-19 mainly as enzyme blocking agent preventing the premature metabolic elimination of nirmatrelvir. The combination of the two drugs in separate tablets is marketed under the brand name Paxlovid® and shows good effectivity in preventing the progression of COVID-19 to severe disease state. In this work, we described a LC-MS/MS method for the simultaneous quantification of nirmatrelvir and ritonavir in human plasma of patients treated for COVID-19 with Paxlovid®. After addition of D6-ritonavir as internal standard, plasma proteins were precipitated by the addition of methanol. The analytes were separated by gradient elution on a C18-column and were detected by tandem mass spectrometry. Calibration functions were linear in the ranges of 10 - 10000 ng/mL for nirmatrelvir and 2 - 2000 ng/mL for ritonavir. Inter-day and intra-day precision and accuracy was better than 15 % in the quality control samples and better than 20 % at the LLOQ. The method was successfully applied on samples of hospitalized patients treated for COVID-19 and proved to be capable in supporting therapeutic drug monitoring (TDM).

Anxiety and depressive symptoms of German university students 20 months after the COVID-19 outbreak - A cross-sectional study.

BACKGROUND: Given the long duration of the COVID-19 pandemic, monitoring mental health remains important. This study aimed to determine (1) the prevalence of anxiety and depressive symptoms among university students 20 months after the first COVID-19 restrictions and (2) which factors were associated with these outcomes. METHODS: The cross-sectional COVID-19 German Student Well-being Study (C19 GSWS) collected data of 7025 students at five German universities. Associations between anxiety and depressive symptoms with sociodemographic and other factors were analysed using multivariable logistic regression models. RESULTS: The mean age of the participants was 23.9 years (SD = 4.9), 67 % were female and 31 % male. The prevalence for depressive symptoms was 29 % (PHQ-2) and 12 % (CES-D 8) and 32 % for anxiety. A complicated relationship status, the lack of a trusted person, and financial difficulties were associated with anxiety and depressive symptoms. University students who were worried about (re-) infection with COVID-19 had a 1.37-times higher chance for reporting anxiety (GAD-2: OR, 95 % CI: 1.09-1.71). Those with pre-existing cardiovascular health conditions had an up to 3.21-times higher chance for reporting depressive symptoms (OR, CESD-D 8, 95 % CI: 1.44-7.14). LIMITATIONS: The study design is cross-sectional and uses self-reported outcomes. CONCLUSIONS: Concepts for prevention and counselling to tackle mental health problems in students are needed and programmes should take specific stressors related to the pandemic into account.

COVID-19 related disruption in higher education students' health and wellbeing: Implications for university action

The COVID 19 pandemic has led to substantial disruptions in the lives of students in higher education. Partial or full closures of institutions for face-to-face teaching or consultations over a long-lasting period of time in many countries have had significant consequences on the psychosocial health and wellbeing of many students. This perspectives article summarizes the implications on mental, social, and behavioral aspects of students' wellbeing. Moreover, the need for health promoting und supportive services, programmes, structures, and policies is outlined with recommendations for institutional actions on the level of teaching practice, counseling services, and health monitoring, and with the call to re-affirm the wider policy-oriented approach of the Health Promoting University.

NORTH TO THE FUTURE: A NEW ASYNCHRONOUS DELIVERY OF THE CLASSIC "FLORA CLASS" AT THE UNIVERSITY OF ALASKA FAIRBANKS

Alaska is relatively isolated from the rest of the United States, due to its distance, size and widespread population. Online course delivery is a valuable alternative to on-campus enrollment for many of the rural students in our state. Introduction to the Flora of Alaska and Systematic Botany are now being offered as fully online courses with a lab component. These courses taught both online, and in the classroom (COVID-19 depending), are versions of the first author's own experiences taking these same classes taught by Don Pinkava at Arizona State University. His legacy as an intrepid botanist and inspiring educator influenced how I (Steffi Ickert-Bond) approached developing my own teaching style. The course design presented reflects some of Don Pinkava's rigorous detailed and challenging course content and innovative labs. The devoted teacher he was, Dr. Pinkava left for us a comprehensive statement outlining his teaching principles he had acquired over many years (Appendix 1). As a student of Don's, I have applied those teaching principles to my own courses. To create a lab experience like Don's classes, I have carefully chosen technology that will allow students from all over the state (and even outside Alaska) to have a hands-on learning experience. Using cutting-edge virtual herbaria they collect data, and perform plant dissections within the flora's native environment. Instead of traditional course materials like textbooks, students use an inexpensive wide-angle macro lens to take high-resolution, detailed photos of flora on the go. The technology not only lets students mimic lab spaces in their own areas but also expands their digital networks through the submission of images to iNaturalist, enabling them to share and collaborate with enthusiasts around the world. Students must get outside, touch with their hands and share what they discover. In combining traditional methods with modern technologies such as virtual, streaming dissections students develop skills and confidence with the microscope and dissection techniques just as much as I did in Don's in person Flora of Arizona class in 1993. Today the Introduction to the Flora of Alaska (BIOL190), and Systematic Botany (BIOL331) are both exciting intersections highlighting a curiosity for wild plants, an exploration of Alaska's plant communities as well as a great introduction to the science of botany. Don's Flora of Arizona took us students to those same crossroads. Together with my colleague Dr. Ute Kaden who teaches STEM methodology at the School of Education, UAF we describe effective course design elements for online delivery of a biology course and the challenges that come with it. Some student feedback after the first semester running will be presented here as well. (English) [ FROM AUTHOR] Alaska está relativamente aislada del resto de los Estados Unidos, debido a su distancia, tamaño y población extendida. La entrega de cursos en línea es una alternativa valiosa a la inscripción en el campus para muchos de los estudiantes rurales de nuestro estado. Introducción a la Flora de Alaska y Botánica Sistemática ahora se ofrecen como cursos completamente en línea con un componente de laboratorio. Estos cursos impartidos tanto en línea como en el aula (dependiendo de COVID-19), son versiones de las propias experiencias del primer autor al tomar estas mismas clases impartidas por Don Pinkava en la Universidad Estatal de Arizona. Su legado como botánico intrépido y educador inspirador influyó en cómo yo (Steffi Ickert-Bond) abordé el desarrollo de mi propio estilo de enseñanza. El diseño del curso presentado refleja algunos de los contenidos rigurosos, detallados y desafiantes del curso y los laboratorios innovadores de Don Pinkava. El devoto maestro que fue, el Dr. Pinkava nos dejó una declaración completa que describe los principios de enseñanza que había adquirido durante muchos años (Apéndice 1). Como estudiante de Don, he aplicado esos principios de enseñanza a mis propios cursos. Para crear una experiencia de laboratorio como las clases de Don, he elegido cuidadosamente la tecnología que permitirá a los estudiantes de todo el estado (e incluso fuera de Alaska) tener una experiencia de aprendizaje práctica. Utilizando herbarios virtuales de última generación, recopilan datos y realizan disecciones de plantas dentro del entorno nativo de la flora. En lugar de los materiales tradicionales del curso, como los libros de texto, los estudiantes usan una lente macro gran angular económica para tomar fotografías detalladas de alta resolución de la flora sobre la marcha. La tecnología no solo permite a los estudiantes imitar espacios de laboratorio en sus propias áreas, sino que también expande sus redes digitales mediante el envío de imágenes a iNaturalist, lo que les permite compartir y colaborar con entusiastas de todo el mundo. Los estudiantes deben salir, tocar con las manos y compartir lo que descubren. Al combinar métodos tradicionales con tecnologías modernas, como disecciones virtuales, los estudiantes desarrollan habilidades y confianza con el microscopio y las técnicas de disección tanto como lo hice en la clase presencial de Flora de Arizona de Don en 1993. Hoy en día, la Introducción a la Flora de Alaska (BIOL190) y Systematic Botany (BIOL331) son interesantes intersecciones que destacan la curiosidad por las plantas silvestres, una exploración de las comunidades de plantas de Alaska y una gran introducción a la ciencia de la botánica. Don's Flora of Arizona nos llevó a los estudiantes a esa misma encrucijada. Junto con mi colega, la Dra. Ute Kaden, quien enseña metodología STEM en la Facultad de Educación de la UAF, describimos elementos de diseño de cursos efectivos para la entrega en línea de un curso de biología y los desafíos que conlleva. Aquí también se presentarán algunos comentarios de los estudiantes después del primer semestre. (Spanish) [ FROM AUTHOR] Copyright of Journal of the Botanical Research Institute of Texas is the property of Journal of the Botanical Research Institute of Texas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Interdisciplinary diagnosis and therapy of anterograde hyposmia after previousSARS Cov-2 infection

Introduction Olfactory dysfunction is a commonly described symptom in the setting of SARS-Cov-2 virus infection. The prevalence is reported to be 40-60 %. Spontaneous remission often occurs during the course, but many patients suffer from longer-term olfactory impairment. This study tests possible improvement of long-term impairment with intra-nasal reflex therapy (INRT). Methods Patients with > 6 weeks of persistent olfactory dysfunction after symptomatic covid-19 infection were included in the 28-day intervention study. INRT applications were performed on 6 dates over 14 days. Intranasal stimula- tion was performed endonasally bilaterally at 3 different sites. An ENT assessment was performed at the start and end points of the study. Quality of life was assessed bilaterally using SF36. An objective olfactory test (SniffinSticks) was performed trilaterally. Results A total of 15 patients, 9 women and 6 men (22-67 years) with disease onset between 03/2020 and 03/2021 were included. None of the study participants showed anatomical abnormalities, and the interventions (INRT) were well tolerated. Subjectively, there was a small to significant decrease in hyposmia in most patients in both groups, and objectively, some patients also showed improvement in their findings. Discussion The results suggest a promising approach as a complementary therapeutic option for hyposmia post covid-. To increase validity, an increase in the number of cases and the establishment of a control group is planned.

Programmed cell death: the pathways to severe COVID-19?

Two years after the emergence of SARS-CoV-2, our understanding of COVID-19 disease pathogenesis is still incomplete. Despite unprecedented global collaborative scientific efforts and rapid vaccine development, an uneven vaccine roll-out and the emergence of novel variants of concern such as omicron underscore the critical importance of identifying the mechanisms that contribute to this disease. Overt inflammation and cell death have been proposed to be central drivers of severe pathology in COVID-19 patients and their pathways and molecular components therefore present promising targets for host-directed therapeutics. In our review, we summarize the current knowledge on the role and impact of diverse programmed cell death (PCD) pathways on COVID-19 disease. We dissect the complex connection of cell death and inflammatory signaling at the cellular and molecular level and identify a number of critical questions that remain to be addressed. We provide rationale for targeting of cell death as potential COVID-19 treatment and provide an overview of current therapeutics that could potentially enter clinical trials in the near future.

Proteome reveals antiviral host response and NETosis during acute COVID-19 in high-risk patients (preprint)

SARS-CoV-2 remains an acute threat to human health, endangering hospital capacities worldwide. Many studies have aimed at informing pathophysiologic understanding and identification of disease indicators for risk assessment, monitoring, and therapeutic guidance. While findings start to emerge in the general population, observations in high-risk patients with complex pre-existing conditions are limited. To this end, we biomedically characterized quantitative proteomics in a hospitalized cohort of COVID-19 patients with mild to severe symptoms suffering from different (co)-morbidities in comparison to both healthy individuals and patients with non-COVID related inflammation. Deep clinical phenotyping enabled the identification of individual disease trajectories in COVID-19 patients. By the use of this specific disease phase assignment, proteome analysis revealed a severity dependent general type-2 centered host response side-by-side with a disease specific antiviral immune reaction in early disease. The identification of phenomena such as neutrophil extracellular trap (NET) formation and a pro-coagulatory response together with the regulation of proteins related to SARS-CoV-2-specific symptoms by unbiased proteome screening both confirms results from targeted approaches and provides novel information for biomarker and therapy development. Graphical AbstractSars-CoV-2 remains a challenging threat to our health care system with many pathophysiological mechanisms not fully understood, especially in high-risk patients. Therefore, we characterized a cohort of hospitalized COVID-19 patients with multiple comorbidities by quantitative plasma proteomics and deep clinical phenotyping. The individual patients disease progression was determined and the subsequently assigned proteome profiles compared with a healthy and a chronically inflamed control cohort. The identified disease phase and severity specific protein profiles revealed an antiviral immune response together with coagulation activation indicating the formation of NETosis side-by-side with tissue remodeling related to the inflammatory signature. O_FIG O_LINKSMALLFIG WIDTH=197 HEIGHT=200 SRC="FIGDIR/small/22271106v1_ufig1.gif" ALT="Figure 1"> View larger version (50K): org.highwire.dtl.DTLVardef@bab525org.highwire.dtl.DTLVardef@1cac7e7org.highwire.dtl.DTLVardef@a3ab1org.highwire.dtl.DTLVardef@19375fb_HPS_FORMAT_FIGEXP M_FIG C_FIG

Is Lower Trust in COVID-19 Regulations Associated with Academic Frustration? A Comparison between Danish and German University Students.

Despite the proximity of both countries, Danes and Germans differ in the level of trust in their government. This may play a role with respect to the disruptive impact of the COVID-19 pandemic on university students. This study investigated the association between trust in governmental regulations, trust in university regulations, risk perceptions, and academic frustration among Danish and German students. As part of the COVID-19 International Student Well-being Study, an online survey was distributed among university students in participating European and non-European universities. In Denmark, 2945 students and Germany, 8725 students responded to the questionnaire between May and July 2020. Students from both countries reported approximately the same level of academic frustration concerning their progress and quality of education. However, German students perceived a higher risk of contracting SARS-CoV-2 compared to Danish respondents. Danish students showed higher trust in their government's COVID-19 regulations than German students. Lower trust in government and university COVID-19 regulations and higher risk perception were associated with higher academic frustration. These results indicate that the level of trust in COVID-19 regulations might have an impact the overall frustration of students regarding their study conditions.

Fear of Infection and Depressive Symptoms among German University Students during the COVID-19 Pandemic: Results of COVID-19 International Student Well-Being Study.

The COVID-19 pandemic has a significant psychological impact at the population level and fear of infection is one of the stressors involved. The study aimed to examine fear of infection and associations with university students' depressive symptoms, substance use, and social contacts during the COVID-19 outbreak in Germany in May 2020. A cross-sectional online survey was conducted at four German universities (n = 5.021, 69% female, mean age: 24 years) as part of the COVID-19 International Student Well-being Study. Fear of infection was assessed using self-generated items, depressive symptoms were assessed using the Center of Epidemiologic Studies Scale (CES-D-8). Associations between fear of infection and depressive symptoms were analyzed with linear regressions, controlling for sociodemographic variables. A total of 34% of the participants reported feeling worried about getting infected themselves, 75% were worried about someone from their personal network getting infected, and 78% feared that individuals close to them would get severely ill after infection. Sixteen percent of the variance of depressive symptoms could be explained by fear of infection (p ≤ 0.001). Students' fear of infection should be considered in student communication and counseling to prevent worsening of mental health in this population.

Worsened Financial Situation During the COVID-19 Pandemic Was Associated With Depressive Symptomatology Among University Students in Germany: Results of the COVID-19 International Student Well-Being Study.

Background: Previous findings suggest that university students are at an elevated risk to experience financial hardship and to suffer from depressive symptoms. This vulnerability may have substantially increased during the coronavirus disease 19 (COVID-19) pandemic which might have affected students' socio-economic situation but possibly also their mental well-being. We examined whether the financial situation changed during the COVID-19 pandemic among German university students, and whether changes were associated with mental well-being. Methods: We conducted a cross-sectional online survey in May and July 2020 at five German universities. Participants were asked, if they had sufficient financial resources to cover monthly expenses before and during the pandemic. The answer options were dichotomized into worsened and no change/better financial situation compared to before the COVID-19 pandemic. Depressive symptoms were assessed using the CES-D 8 scale. For examining associations between sociodemographic, study-related, and financial factors and "worsened financial situation," we ran a generalized linear mixed model. To assess associations between depressive symptoms and worsened financial situation, we performed a linear mixed model. Results: We included 7,199 participants in the analyses (69% female, 30% male, 1% diverse, mean age: 24 years, standard deviation: 4.7). Overall, 25% of the participants reported to have a worsened financial situation at the time of the survey than in the time before COVID-19. Factors associated with a worsened financial situation were migration background, parents not being academics, not being able to borrow money, and payment of tuition fee by student and loan [odds ratios (OR) ranging from 1.20 to 2.35]. Factors associated with lower odds were: being single, living with others, studying a health-related field, being enrolled in a doctoral/Ph.D. or state exam program, and publicly funded tuition/tuition paid with a scholarship (OR ranging from 0.42 to 0.80). A worsened financial situation was associated with 1.02 points more on the CES-D 8 scale (95% CI: 0.80-1.24). Conclusion: Our results suggest that the pandemic put a number of students under financial strain with detrimental consequences for their mental well-being. Renewed attention must be paid to this vulnerable group to prevent the potentially damaging effects on their mental health.

Do patients with pathological health anxiety fear COVID-19? A time-course analysis of 12 single cases during the "first wave" of the COVID-19 pandemic in Germany.

OBJECTIVE: Pre-existing health anxiety is associated with an intensified affective response to the novel COVID-19 pandemic in the general population. Still, results on the reaction of people with a diagnosis of pathological health anxiety (i.e., hypochondriasis) are scarce. METHODS: In the present study, we investigated the course of (health) anxiety related to SARS-CoV-2/COVID-19 in comparison to (health) anxiety related to other severe diseases (e.g., cancer) in a sample of 12 patients with the diagnosis of pathological health anxiety during the "first wave" of the COVID-19 pandemic in Germany. Both SARS-CoV-2 related anxiety and anxiety related to other severe diseases were assessed weekly over 16 measurement points (30.03.-19.07.2020) and primarily analyzed with fixed effects regression analyses. RESULTS: Unexpectedly, SARS-CoV-2 related anxiety was on average significantly lower than anxiety related to other severe diseases (d = -0.54, p < .001) and not significantly associated with anxiety related to other severe diseases or pre-COVID-19 health anxiety. CONCLUSION: It therefore appears premature to assume that SARS-CoV-2 related anxiety and other health worries are necessarily strongly interrelated and comparably high in people with pathological health anxiety.

An analysis of anatomy education before and during Covid-19: August-December 2020.

Coronavirus disease-2019 (Covid-19) disrupted the in-person teaching format of anatomy. To study changes in gross anatomy education that occurred during August-December, 2020 compared to before the pandemic, an online survey was distributed to anatomy educators. The 191 responses received were analyzed in total and by academic program, geographic region, and institution type. Cadaver use decreased overall (before: 74.1 ± 34.1%, during: 50.3 ± 43.0%, P < 0.0001), as well as across allopathic and osteopathic medicine, therapy, undergraduate, and veterinary programs (P < 0.05), but remained unchanged for other programs (P > 0.05). Cadaver use decreased internationally and in the US (P < 0.0001), at public and private (P < 0.0001) institutions, and among allopathic medical programs in Northeastern, Central, and Southern (P < 0.05), but not Western, US geographical regions. Laboratories during Covid-19 were delivered through synchronous (59%), asynchronous (4%), or mixed (37%) formats (P < 0.0001) and utilized digital resources (47%), dissection (32%), and/or prosection (21%) (P < 0.0001). The practical laboratory examination persisted during Covid-19 (P = 0.419); however, the setting and materials shifted to computer-based (P < 0.0001) and image-based (P < 0.0001), respectively. In-person lecture decreased during Covid-19 (before: 88%, during: 24%, P = 0.003). When anatomy digital resources were categorized, dissection media, interactive software, and open-access content increased (P ≤ 0.008), with specific increases in BlueLink, Acland's Videos, and Complete Anatomy (P < 0.05). This study provided evidence of how gross anatomy educators continued to adapt their courses past the early stages of the pandemic.