Racing with the industry: an interview on motorsports, esports, livestreaming and the COVID-19 pandemic

The following interview discusses two paradigmatic media sports cases during live sports lockdown in 2020. Producing online tournament responses to the COVID-19 cancellations of live events, the IndyCar First Responders 175 race and the W Series esports league both turned to esports livestreaming. Under this transition, themes of safety, gender equity, risk, and rules emerged as key topics surrounding the current and future state of esports within media sports ecosystems. As discussed by Garth Midgley (founder of GOATi Entertainment and lead developer of 22-Racing Series), Abe Stein (senior strategist with the Sports Innovation Lab), Gina Miller and Jo Diamond (Communications executives, W Series), and Emma Witkowski (senior lecturer and esports academic), these cases exemplify ascending issues in sports quick transition to online esports and networked livestreaming solutions, shoring up media sports under lockdown.

Resilient Regions in Brazil: Unfolding the Effects of COVID-19 From a Socioeconomic Perspective

At the beginning of 2020, the world was left in an unprecedented state of shock by the COVID-19 pandemic. Brazil quickly became the epicenter of new cases of contamination, where the propagation of the virus was unrestrained, despite boasting one of the strongest Universal health coverage systems in Latin America. This paper has at least three empirical contributions to the literature about economic resilience and the COVID-19 pandemic. Firstly it is a critical issue regarding the "economics versus life" trade-off, which is an essential question for developing countries, given that policymakers must decide between policies to reduce the number of COVID-19 infections without damaging the economy. Secondly, our findings suggest that the early adoption of isolation measures applied in 2020, such as the financial aid and the vaccination have been effective in controlling the effects of the pandemic, especially in vulnerable microregions. Furthermore, it was verified that the Emergency financial aid was a fundamental policy in minimizing the economic impacts of the pandemic and allowing people to practice social distancing, contributing positively to the Employment Resilience Index and negatively related to the growth rate of deaths due to COVID-19. The contribution of our study is to measure an inverted U-shaped curve to demonstrate that policymakers must achieve a minimum of families to decrease the COVID-19 deaths. These contributions are essential and straightforward findings to lead policymakers' decisions in developing countries facing financial constraints in the public budget and population reticence about physical distancing, self-quarantine and vaccination.

Perception of body image, food consumption, sedentary behavior and physical activity in a Brazilian academic population during the lockdown due to the COVID-19 pandemic

The study evaluates the perception of body image associated with food consumption, sedentary behavior, and practice of physical activity responses during the COVID-19 lockdown in the academic population of a Brazilian University. Four hundred fifteen students answered an online survey during 1-31 May/2020. Frequencies were used to describe the outcomes, and the Chi-square test (p< 0.05) to determine associations. A negative perception of change in body image was found in both females and males (e.g., 73% and 55%, respectively), significantly associated with a perception of an increase in food consumption, watching TV and social media (more than 2 hours), not practicing physical activity in females, and with an increase in food consumption in males. The results presented a general picture of behavioral responses during the COVID-19 pandemic of students in Brazil, suggesting that a negative perception of body image changing has been associated with health-related behaviors, especially in females © Copyright 2018: Servicio de Publicaciones de la Universidad de Murcia

Pediatric Multi-System Inflammatory Syndrome With Fatal Cerebral Edema in a Patient With COVID-19

INTRODUCTION: There are increasing reports of a pediatric multisystem inflammatory syndrome associated with coronavirus disease 2019 (COVID-19) that presents with varying clinical features, but includes features of Kawasaki disease or toxic shock syndrome. Symptoms include fever, rash, abdominal pain, vomiting, and diarrhea. Many patients present without any respiratory symptoms and testing for SARS-CoV-2 is often negative. METHODS: A retrospective chart review was performed. RESULTS: A 7-year-old previously healthy male presented with 3 days of fevers up to 102.4F, headaches, abdominal pain, and intractable vomiting. Both parents had tested positive for SARS-CoV-2 four weeks prior. Nasopharyngeal swab tested positive for SARS-CoV-2 RNA. Echocardiogram was normal. CT venogram of his head was negative for any pathology. He developed severe neck pain and persistent headache during his hospitalization. Soon after receiving hydroxychloroquine, he developed a facial rash and altered mental status with episodes of aphasia, agitation, and pinpoint pupils. He then became unresponsive with left gaze deviation. A non-contrast head CT and CT angiography were negative. He was given levetiracetam and cefazolin and transferred to the pediatric intensive care unit. An electroencephalogram (EEG) showed no epileptiform activity. Over the following 7 hours, the EEG demonstrated left frontotemporal slowing, which progressed into a loss of fast activity over the right hemisphere with increased delta activity in the left hemisphere, then abruptly changed to generalized voltage attenuation.He rapidly lost brainstem reflexes, developing fixed and dilated pupils. Repeat CT scan revealed diffuse cerebral edema with loss of gray-white differentiation. Lab results then were consistent with severe inflammation. An intracranial pressure monitor revealed pressures greater than 76 mmHg. His exam soon became consistent with brain death. Pathologic evaluation showed diffuse cerebral edema with perivascular mononuclear infiltrates. CONCLUSION: The cause of this pediatric multi-system inflammatory syndrome is unclear and the mechanism by which SARS-CoV-2 affects the nervous system is unknown. Pediatric patients with COVID-19 and neurologic symptoms should be closely monitored as they can rapidly decline due to fulminant cerebral edema.

O EMPREGO DE TESTES RÁPIDOS DE HEPATITES VIRAIS NA CASCATA DA LINHA DE CUIDADOS DE PESSOAS EM SITUAÇÃO DE RUA: UM ESTUDO TRANSVERSAL

Introdução: O emprego de Testes Rápidos (TR) para Hepatites Virais (HV) é uma estratégia oportuna para iniciar a cascata da linha de cuidados, especialmente em populações-chave, como as Pessoas em Situação de Rua (PSR). Porto Alegre-RS está no topo do ranking nacional da morbimortalidade das HV, entretanto a vigilância epidemiológica pode ser um desafio nas PSR, pois não há um campo específico para essa vulnerabilidade na notificação compulsória. O referido trabalho objetiva avaliar fatores associados à adesão na cascata da linha de cuidados da PSR com TR reagentes para HV tipo C na vigência das medidas de isolamento pelo SARS-CoV-2. Métodos: Estudo transversal, com dados do monitoramento clínico da equipe do Consultório na Rua de Porto Alegre_RS durante a pandemia pelo COVID-19. A equipe possui 5332 PSR cadastradas e realiza os TR na unidade base, e de modo “extra-muros”, como em abordagens de rua e locais de oferta de serviços sociais. Resultados: Foram analisados 498 TR para HV tipo C, ao longo do monitoramento, 39(7,8%) apresentaram TR reagente, sendo que 15(41,6%) realizaram carga viral e 11(30,5%) tiveram detecção quantitativa, com valores entre 15.451 e 7.851.465 UI/ml. Seguindo o protocolo, destas esperava-se que 11(30,5%) fossem encaminhadas, entretanto apenas 8(22,2%) o aceitaram. Entre estes, 4(11,1%) compareceram a consulta e 2(5,5%) tiveram tratamento indicado. Sobre o perfil epidemiológico observa-se que: 33(91,6%) homens cis, 3 mulheres cis (8,3%), 17(47,2%) idade igual ou maior que 50 anos, 3(8,3%) apresentam co-infecção com HIV, 7(19,4%) com tuberculose e 8(22,2%) apresentaram TR reagente para sífilis. Entre os TR reagentes, 11(30,5%) já tinham o diagnóstico prévio de HV tipo C. A replicação do TR está relacionada as abordagens “extra-muros” que dificulta a checagem dos prontuários. Ainda, 11(30,5%) perderam o vínculo no início do cuidado, ao não coletar o exame de quantificação de carga viral e 3(8,3%) por não comparecer ao especialista. Infere-se, em parte, o absenteísmo às dificuldades pela falta de documentos de identificação, a localização descentralizada dos 2 laboratórios municipais e fatores comportamentais, como 12(33,3%) uso de álcool e outras drogas. Conclusões: O monitoramento clínico, por meio da tabela Excel, permite à equipe de assistência multiprofissional a organização da gestão dos cuidados, através de buscas ativas e continuidade do seguimento do ponto em que a PSR parou, não necessitando reiniciar a cascata.

Management of dermatologic toxicities related to EGFR inhibitor therapy: Preliminary results from a survey of physicians in Germany

Introduction: Epidermal growth factor receptor inhibitors (EGFRi) significantly improve outcomes in metastatic colorectal cancer (mCRC) but are associated with skin toxicities that occur in ≥90% of patients and can reduce quality of life. Skin toxicities range from localised erythema to generalised acne-like rash and are severe (grade 3/4) in approximately 10% of patients. This study investigated how physicians in Germany manage EGFRi-associated skin toxicities. Methods: In this cross-sectional study, initiated in April 2020, physicians who had treated ≥5 patients with mCRC and who spent ≥60% of their time in clinical practice were invited to participate in an online survey of 37 questions. The study aimed to recruit 150 physicians, but recruitment was limited during the COVID-19 pandemic. Cut-off for the interim analysis was 18 February 2021, cut-off for final analysis was 18 April 2021. Results: At interim analysis, 53 physicians from 12 federal states had participated. The majority were male (74%), aged 50-59 years (47%), oncology specialists (83%) and had been practicing medicine for ≥10 years (89%). Most physicians (98%) discuss skin toxicity with patients. Physicians reported that they usually start managing skin toxicity before (19%) or at the time of EGFRi initiation (42%);however, 40% wait until the appearance of a rash. Most physicians (85%) would not discontinue EGFRi unless the rash was grade 4, and grade 1-3 rash was most commonly managed by dose reduction or delay. Before or at the time of EGFRi initiation, 91% of physicians recommend moisturiser, 89% sunscreen, 47% oral antibiotics, 11% topical steroids and 9% topical antibiotics. Nurses often educate patients about skin toxicity (reported by 60% of physicians) and advise on management before therapy (70%) and when rash occurs (89%). Most physicians consult a dermatologist about skin toxicity 'occasionally' (55%) or 'rarely' (34%). Current management strategies (AWMF/STEPP) are followed by 75% of physicians. Conclusion: This study found that most physicians follow available guidelines for the management of skin toxicities but was limited by sample size. Additional research may lead to an improved understanding of real-world treatment practices and identify opportunities for increasing physician awareness for optimal management of skin toxicities. Further analyses will be conducted after the final data cut-off to explore correlations between physician characteristics and management practices.

Use of Monoclonal Antibody Therapy in Hematologic Patients with Mild-to-Moderate COVID-19: A Retrospective Single-Center Experience

Background: In November 2020, the U.S. Food and Drug Administration (FDA) issued emergency use authorization (EUA) for monoclonal antibody (mAb) therapy in patients with mild to moderate COVID-19 who are at high risk for disease progression. These mAbs reduce the risk of hospitalization in the general population. However, its efficacy and safety in immunocompromised hematology patients are not known. Methods: From November 9th, 2020, until February 28th, 2021, all adult hematology patients with mild to moderate COVID-19 disease who received monoclonal antibodies within 10 days of symptoms onset were included. Patients who were asymptomatic, had severe or critical COVID-19 disease, or were hospitalized at the time of COVID-19 diagnosis were excluded. Baseline demographic, clinical outcomes, and hematologic-related data were extracted. All statistical analysis was performed using SAS statistical software. Results: Thirty-eight hematology patients with mild to moderate COVID-19 disease who received mAb therapy under EUA were included in this study. Thirty (79%) patients received bamlanivimab and 8 (21%) casirivimab-imdevimab. Baseline characteristics prior to mAB administration include: 53% female, median age of 51 years (range: 21-80), with 18% above 65 years old. Twenty-eight (74%) patients received cellular therapy: 18 (47%) had undergone allogeneic hematopoietic cell transplantation (HCT), 9 (24%) autologous HCT, and 1 (3%) chimeric antigen receptor T-cell (CAR T) therapy. Among the 17 patients who had COVID-19 disease after HCT, the median time to COVID-19 diagnosis was 22.8 months (range: 2.6-274.4) from HCT to COVID-19 diagnosis. Twelve out of 17 (71%) alloHCT patients were being managed for active graft-vs-host disease (GvHD) at the time of COVID-19 diagnosis (chronic GVHD: n=11 [mild: 4, moderate: 4, severe: 3], acute GVHD (grade 2): n=1). Ten (59%) alloHCT patients were on immunosuppressant therapy at the time of COVID-19 diagnosis. Fifteen (39%) patients were on active treatment for their hematologic malignancy (HM) at the time of COVID-19 diagnosis with a mean of 3 previous lines of treatment (range: 1-6). Additional patient characteristics are shown in Table 1. mAb therapy under EUA was well tolerated in this patient population with only 1 (3%) patient having experienced an adverse reaction characterized as headache. Four (11%) patients were hospitalized due to COVID-19, and 2 (5%) progressed to severe disease. All four patients had received bamlanivimab. The median time for hospitalization from diagnosis of COVID-19 to admission date was 8 days (range: 1-20) while median time from mAB infusion to hospitalization was 7.5 days (range: 0-17). One patient (3%) died within 30 days of COVID-19 diagnosis;the cause of death was COVID-19 disease. Most patients (n=34, 89%) ultimately tested negative for SARS-CoV-2 by PCR after mAb infusion. 34% of patients (n=13) cleared the virus within 2 weeks of receiving mAb infsuion. The median time to clearance of viral shedding was 25.5 days (range: 7-138). After mAb infusion, most patients (10/15;67%) who were previously on active treatment for HM prior to diagnosis of COVID-19 resumed therapy for their HM with a median delay of 21.5 days (range: 12-42). We observed a significant difference in hospitalization was amongst patients who received a HCT vs. non-HCT (0%, 0/26 and 36%, 4/11 respectively;p<0.01). None of the other patient characteristics, which included: gender, ethnicity, age, BMI, smoking, obesity, chronic kidney disease, diabetes mellitus, hypertension, coronary vascular disease, and lung disease, were associated with significantly increased rate of hospitalization. Conclusion: This study demonstrates that SARS-COV2 specific mAb use in malignant hematology patients under EUA was safe and may reduce hospitalization as reported in the literature amongst those at high risk for disease progression. Thus, the access to SARS-COV2 mAb in this population who is at increased risk for complications from SARS-COV2 infection is critical in reducing progression to severe COVID-19 disease and hospitalization. [Formula presented] Disclosures: Ali: Incyte: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;CTI BioPharma: Membership on an entity's Board of Directors or advisory committees;BMS: Speakers Bureau. Aribi: Seagen: Consultancy. Artz: Radiology Partners: Other: Spouse has equity interest in Radiology Partners, a private radiology physician practice. Koller: Novartis: Consultancy. Nikolaenko: Rafael Pharmaceuticals: Research Funding;Pfizer: Research Funding. Shouse: Beigene: Honoraria;Kite Pharma: Speakers Bureau. Stein: Amgen: Consultancy, Speakers Bureau;Celgene: Speakers Bureau;Stemline: Speakers Bureau. Marcucci: Abbvie: Other: Speaker and advisory scientific board meetings;Novartis: Other: Speaker and advisory scientific board meetings;Agios: Other: Speaker and advisory scientific board meetings. Forman: Mustang Bio: Consultancy, Current holder of individual stocks in a privately-held company;Lixte Biotechnology: Consultancy, Current holder of individual stocks in a privately-held company;Allogene: Consultancy. Dadwal: AlloVir: Research Funding;Merck: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau;Astellas: Speakers Bureau;Shire/Takeda: Research Funding;Aseptiscope: Consultancy;Janssen: Other: Investigator;Karius: Other: Investigator. Al Malki: CareDx: Consultancy;Rigel Pharma: Consultancy;Jazz Pharmaceuticals, Inc.: Consultancy;Neximmune: Consultancy;Hansa Biopharma: Consultancy.

Evaluating the serological status of COVID-19 patients using an indirect immunofluorescent assay, France.

An indirect in-house immunofluorescent assay was developed in order to assess the serological status of COVID-19 patients in Marseille, France. Performance of IFA was compared to a commercial ELISA IgG kit. We tested 888 RT-qPCR-confirmed COVID-19 patients (1302 serum samples) and 350 controls including 200 sera collected before the pandemic, 64 sera known to be associated with nonspecific serological interference, 36 sera from non-coronavirus pneumonia and 50 sera from patient with other common coronavirus to elicit false-positive serology. Incorporating an inactivated clinical SARS-CoV-2 isolate as the antigen, the specificity of the assay was measured as 100% for IgA titre ≥ 1:200, 98.6% for IgM titre ≥ 1:200 and 96.3% for IgG titre ≥ 1:100 after testing a series of negative controls. IFA presented substantial agreement (86%) with ELISA EUROIMMUN SARS-CoV-2 IgG kit (Cohen's Kappa = 0.61). The presence of antibodies was then measured at 3% before a 5-day evolution up to 47% after more than 15 days of evolution. We observed that the rates of seropositivity as well as the titre of specific antibodies were both significantly higher in patients with a poor clinical outcome than in patients with a favourable evolution. These data, which have to be integrated into the ongoing understanding of the immunological phase of the infection, suggest that detection anti-SARS-CoV-2 antibodies is useful as a marker associated with COVID-19 severity. The IFA assay reported here is useful for monitoring SARS-CoV-2 exposure at the individual and population levels.