Sex and age affect acute and persisting COVID-19 illness.

Long COVID is associated with neurological and neuropsychiatric manifestations. We conducted an observational study on 97 patients with prior SARS-CoV-2 infection and persisting cognitive complaints that presented to the University Health Network Memory Clinic between October 2020 and December 2021. We assessed the main effects of sex, age, and their interaction on COVID-19 symptoms and outcomes. We also examined the relative contribution of demographics and acute COVID-19 presentation (assessed retrospectively) on persistent neurological symptoms and cognition. Among our cohort, males had higher hospitalization rates than females during the acute COVID-19 illness (18/35 (51%) vs. 15/62 (24%); P = .009). Abnormal scores on cognitive assessments post-COVID were associated with older age (AOR = 0.84; 95% CI 0.74-0.93) and brain fog during initial illness (AOR = 8.80; 95% CI 1.76-65.13). Female sex (ARR = 1.42; 95% CI 1.09-1.87) and acute shortness of breath (ARR = 1.41; 95% CI 1.09-1.84) were associated with a higher risk of experiencing more persistent short-term memory symptoms. Female sex was the only predictor associated with persistent executive dysfunction (ARR = 1.39; 95% CI 1.12-1.76) and neurological symptoms (ARR = 1.66; 95% CI 1.19-2.36). Sex differences were evident in presentations and cognitive outcomes in patients with long COVID.

COVID-19 vaccines: Considering sex differences in efficacy and safety.

The development of SARS-CoV-2 vaccines represents a significant breakthrough for managing the COVID-19 pandemic. However, their approval process has exposed a crucial limitation in clinical trial reports-that is, a disregard for sex differences in response to vaccines. Historically, males and females have shown different reactions to vaccines of many kinds, which have become apparent with the arrival of COVID-19 vaccines in late-2020. In this article, we review regulatory data from Phase III vaccine trials as well as peer-reviewed reports from vaccines administered to the general population, many of which failed to stratify results by sex. We also discuss the exclusion of pregnant and lactating persons in drug development and the regulatory guidelines for use of COVID-19 vaccines in such populations. We conclude by proposing some questions to stimulate discussion with the intent of advancing the field toward precision medicine.

Qualitative study of frontotemporal lobar degeneration caregivers' coping strategies and concerns during COVID-19

Background The coronavirus (COVID-19) pandemic has been particularly arduous on those living with dementia and their caregivers as they depend on in-person support and programs. High rates of depression and anxiety were reported in Alzheimer's disease during the COVID-19 pandemic (El Haj, 2020). In patients with frontotemporal lobar degeneration (FTLD) there are additional challenges as these patients have motor, language, behavior disorders and cognitive deficits. We examined the impact of COVID-19 on FTLD caregivers. Method From March 2020-June 2020, we carried out a qualitative study with FTLD caregivers to determine the impact of COVID-19 on their continued ability to care for the person with dementia. We examined the following: patient?s age, relationship to primary caregiver, number of people in household, access to virtual telecommunication, access to exercise, caregivers? greatest supports, their identified needs and fears. Result We included 52 FTLD patient-caregiver dyads (5 behavioral variant (bvFTD), 17 primary progressive aphasia (PPA), 19 Corticobasal Syndrome (CBS), and 11 Progressive Supranuclear Palsy (PSP)). Mean age of patients was 67.9+/-8.76. 57% of caregivers were female. 60% of patients lived alone with spouse, 23% lived with spouse and a child, 2 patients lived in LTC, 3 with a family member (not spouse) or friend, 1 was in hospital, and 2 lived alone. 75% had access to virtual telecommunication. 44% were engaged in physical activity (mostly walking). 16 caregivers (25%) reported their greatest needs were reinstating or increasing Personal Support Worker hours, 8 (15%) needed access to other health care providers and for 7 (13%) they wanted Adult Day Programs to reopen. 31 caregivers (60%) reported their greatest support was family;8 (15%) were grateful for community supports. 22 caregivers (42%) were concerned about ongoing decline whilst only 11 (21%) feared COVID. Conclusion We provide some qualitative data on FTLD caregivers? experience during COVID. The most frequent concern was ongoing decline. Over 50% of caregivers reported their greatest need was access to services and their greatest support was family network. Enabling easily accessible and safe in-home care is important to support people living at home with FTLD during the pandemic. REFERENCES: El Haj, M. Psychiatry Research, (2020).