Prolonged exposure to lung-derived cytokines is associated with inflammatory activation of microglia in patients with COVID-19 (preprint)

Neurological impairment is the most common finding in patients with post-acute sequelae of COVID-19. Furthermore, survivors of pneumonia from any cause have an elevated risk of dementia. Dysfunction in microglia, the primary immune cell in the brain, has been linked to cognitive impairment in murine models of dementia and in humans. Here, we report a transcriptional response in human microglia collected from patients who died following COVID-19 suggestive of their activation by TNF- and other circulating pro-inflammatory cytokines. Consistent with these findings, the levels of 55 alveolar and plasma cytokines were elevated in a cohort of 341 patients with respiratory failure, including 93 unvaccinated patients with COVID-19 and 203 patients with other causes of pneumonia. While peak levels of pro-inflammatory cytokines were similar in patients with pneumonia irrespective of etiology, cumulative cytokine exposure was higher in patients with COVID-19. Corticosteroid treatment, which has been shown to be beneficial in patients with COVID-19, was associated with lower levels of CXCL10, CCL8, and CCL2 - molecules that sustain inflammatory circuits between alveolar macrophages harboring SARS-CoV-2 and activated T cells. These findings suggest that corticosteroids may break this cycle and decrease systemic exposure to lung-derived cytokines and inflammatory activation of microglia in patients with COVID-19.

Examining the impact of a universal positive psychology program on mental health outcomes among Australian secondary students during the COVID-19 pandemic.

BACKGROUND: This study aimed to examine the impact of a web-based positive psychology program delivered universally to secondary school students during school closures caused by the COVID-19 pandemic in New South Wales, Australia. METHODS: Using a quasi-experimental design conducted in 2020, 438 students aged 12-15 years (73% male) from 4 secondary schools were invited to complete the 'Bite Back Mental Fitness Challenge'. This web-based program consisted of 7 self-directed modules that targeted 5 key domains of positive psychology. Self-reported symptoms of anxiety and depression and help-seeking intentions for mental health were assessed at baseline prior to school closures (February to March 2020) and at post-test after the return to school (July to August 2020). At post-test, students also reported on their perceived changes in mental health and help-seeking behavior for mental health during the pandemic. Completion of the program modules was recorded. RESULTS: A total of 445 students consented and 336 (75.5%) completed both assessments. On average, participants completed 2.31 modules (SD: 2.38, range: 0 to 7). There was no change in symptoms of anxiety and depression or help-seeking intentions between baseline and post-test, with no significant effects for gender and history of mental illness. Students who were symptomatic for anxiety and depression at baseline reported lower symptoms at post-test, but this change was not significant. Ninety-seven students (27.5%) reported that their mental health had worsened during the pandemic, and a significant increase in anxiety and depressive symptoms was found in this subsample at post-test. Only 7.7% of students reported a change in their help-seeking behavior, with increased mental health support sought from the Internet, parents, and friends. CONCLUSIONS: The universal delivery of a web-based positive psychology program during school closures did not appear to be associated with improved mental health symptoms; however, completion of the modules was low. Different effects may emerge when selectively delivered to students with mild or greater symptoms. The findings also suggest that broader measures of mental health and wellbeing, including perceived change, are key to the mental health surveillance of students during periods of remote learning.

"It was there when I came home": young adults and jail reentry in the context of COVID-19.

In this study, the authors explore how young adults navigated the dual challenges of the COVID-19 pandemic and jail reentry in a large urban environment. Fifteen young adults (aged 18-25) participated in up to nine monthly semi-structured interviews to discuss their experiences of reentry during the height of the COVID-19 pandemic (i.e., spring and summer 2020). Participants held mixed attitudes and beliefs about COVID-19. Several participants viewed the pandemic as a hoax, while others took the pandemic more seriously, particularly if their friends and family members had contracted the virus. Yet nearly all participants viewed the pandemic as having a relatively minimal impact on their lives compared to the weight of their reentry challenges and probation requirements. Young adults described COVID-19 stay-at-home orders as limiting their exposure to negative influences and facilitating compliance with probation requirements. However, resource closures due to COVID-19, including schools, employment programs, and social services presented barriers to reentry success. The authors draw upon these findings to pose implications for interventions supporting young adult reentry. Supplementary Information: The online version contains supplementary material available at 10.1007/s12103-022-09683-8.

Comparison of attitudes toward routine maternal vaccines and COVID-19 vaccines among pregnant patients in an urban safety-net setting.

OBJECTIVE: To explore attitudes toward tetanus-diphtheria-acellular pertussis (Tdap), influenza, and COVID vaccines among English- and Spanish- speaking pregnant individuals in a safety net setting. METHODS: Pregnant people aged 18 years or older were recruited from outpatient clinics between August 2020 and June 2021. Interviews were conducted via phone in English or Spanish, recorded, transcribed, and translated verbatim. Data were qualitatively analyzed using modified grounded theory and content analysis. RESULTS: 42 patients participated (22 English-speaking, 20 Spanish-speaking). Most participants expressed positive attitudes towards both routine prenatal vaccinations and COVID-19 vaccines, endorsing the belief that vaccines promote health and considering vaccines a social norm. Positive attitudes were similar for the three vaccines, and among Spanish- and English-speaking individuals. Participants trusted their healthcare provider's recommendations and felt comfortable receiving booster doses of vaccines they had received successfully in the past. Vaccine concerns differed by each vaccine. Despite limited knowledge, few participants expressed concerns about Tdap vaccines. Concerns around influenza vaccines often stemmed from personal experience and centered around ineffectiveness and increased risk of flu-like illnesses. Participants expressed the most concerns related to COVID vaccinations, including misinformation about serious side effects and distrust around accelerated approval of the vaccines. Many participants wished to know more about the side effects and safety of vaccinating during pregnancy, especially regarding the fetus's health. CONCLUSIONS: Most participants supported routine prenatal vaccinations, including COVID vaccines. Clinicians are trusted information sources and can help reinforce positive attitudes and social norms of receiving vaccinations in pregnancy while addressing vaccine-specific concerns. FUNDING: This work was supported by Suzanne Cutler Vaccination Education & Research Fund at the Boston University Chobanian and Avedisian School of Medicine for funding and support.

Satisfaction with telerheumatology care: Patient and clinician perspectives

Use of telerheumatology has increased significantly due to the circumstances surrounding the COVID-19 pandemic. This period of widespread adoption of telerheumatology represents an opportunity to improve access to care in the future by leveraging the newfound experience with and acceptance of telerheumatology achieved during this time. In order to optimize telerheumatology use and efficacy moving forward, the experience of patients and providers with the current state of technology must be considered. In this chapter, we summarize the available evidence describing patient and provider experience with telerheumatology across its lifespan. Patients generally have reported high satisfaction with their telerheumatology visits, citing increased convenience and improved access to care as the primary benefits. Noted barriers included apprehension and nervousness about the process, technologic barriers, and concerns regarding the quality of care. Physicians' opinions were more mixed but overall reported being satisfied with delivering care via telerheumatology. Perceived benefits included shorter waiting times, whereas barriers included impaired communication, inaccurate diagnosis, and possibility for delay in care. Patient and physician attitudes regarding telerheumatology have changed positively in the setting of the COVID-19 pandemic. Future studies should assess whether this positive attitude is temporary or whether it continues in future years. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022. All rights reserved.

ISOLATION OF PAN-SARBECOVIRUS mABs THAT NEUTRALIZE SARS-CoV-1 AND SARS-CoV-2 VARIANTS

Background: The continued emergence of severe acute respiratory syndrome coronaviruses (SARS-CoVs) and recent explosion of the SARS-CoV-2 pandemic highlights the need for broad and potent antibody recognition and understanding the contexts in which they may develop. Antibodies with cross reactivity across SARS lineages may be of particular value in preparing for future outbreaks of new sarbecoviruses. Method(s): We isolated monoclonal antibodies (mAbs) from an individual 60-days post-vaccination, 30-days post Delta-infection. Reconstructed antibodies were screened for binding to a panel of prefusion-stabilized Spike trimers from SARS-CoV-2 and other beta-coronaviruses using enzyme-linked immunosorbent assay (ELISA). Neutralization potency and breadth was assessed using a spike-pseudotyped lentivirus neutralization assay. Additionally, epitope and escape mutant profiling was conducted by deep mutational scanning (DMS) to identify mutations that affect antibody binding. Lastly, binding breadth was further evaluated using a yeast display library of RBDs from SARS-CoV-2 variants and related sarbecoviruses. Result(s): We identified several SARS-CoV-2-specific mAbs that neutralized SARS-CoV-2 variants of concern (VOCs) and SARS-CoV-1. Notably, two of these mAbs (C68.61 and C68.185) neutralized SARS-CoV-1 with an IC50 = 307 and 139 ng/mL (respectively) that is similar to or better than the potency of S309 (IC50 = 206 ng/mL) and CR3022 (IC50 = 981 ng/mL), which are mAbs isolated from individuals with SARS-CoV-1 infections. C68.61 also neutralized all Omicron VOCs tested and retained neutralization activity against currently circulating variants BQ1.1 (IC50=790 ng/ml) and XBB (IC50=590 ng/ml). Key C68.61 mAbescape mutations identified by DMS in the Omicron BA.2 background yeast display library included sites K462, E465, R466, and I468, which are conserved sites across all VOCs and SARS-CoV-1. The isolated mAbs displayed crossreactive binding to RBDs from diverse SARS-CoV-1-related CoVs and African and European sarbecovirus isolates as well as SARS-CoV-2 VOCs. Conclusion(s): Here we describe mAbs from a SARS-CoV-2-infected individual that bound and neutralized both SARS-CoV-2 and SARS-CoV-1, including one that showed breadth across recent VOCs. Given their breadth, these SARS-CoV-2 cross-reactive mAbs may be robust to viral escape and thus could contribute to therapeutic efforts. In addition, these mAbs displayed broad cross-reactive activity across sarbecoviruses and may be beneficial against future spillover events.

An integrated approach: The use of both methylprednisolone and dexamethasone in the management of COVID-19 acute respiratory distress syndrome (ARDS) in Trinidad and Tobago

Case report Background: With the continued rise of COVID-19 hospitalizations due to variants, breakthrough infections and vaccine hesitancy, current treatment regimens must be evaluated. Corticosteroids (CS) have been shown to decrease mortality in patients who require oxygen, especially those on invasive mechanical ventilation [Pinzo et al. 2021]. Steroids also lower intubation rates and transfer to intensive care units [Ahmad et al. 2021]. Methylprednisolone (MP) and dexamethasone (DEX) have been used for the treatment of COVID-19 patients with varied data on outcomes. Having obtained the patient's consent, the case below aims to highlight the use of both MP and DEX in the management of COVID-19 ARDS. Case: A 61-year- old male with a history of prostate cancer in remission presented with fever for 2 weeks and cough and dyspnoea for 2 days. He denied any gastrointestinal or neurological symptoms. He was unvaccinated to COVID-19 and reported recent exposure. On examination his oxygen saturation was 89% on room air and on auscultation, decreased air entry and crepitations were noted bilaterally. COVID-19 infection was confirmed by a positive nasopharyngeal swab. Lab investigations revealed an elevated C-Reactive Protein (CRP) of 26 mg/L, with a normal leukocyte count and renal function. Chest radiograph showed scattered consolidations bilaterally. A diagnosis of ARDS was made and non-invasive ventilation via dual oxygen therapy was initiated. He was later admitted to the High Dependency Unit (HDU) for continuous positive airway pressure ventilation. A tapering dose of MP was administered starting with a loading dose of 1g intravenously (IV) followed by 250 mg IV daily for 3 days and then 1 mg/kg twice daily until discharged from the HDU. MP was then switched to DEX 8mg IV daily and continued until supplemental oxygen was no longer needed. Serial blood draws noted a gradual decline in the CRP value. He was subsequently discharged and followed up in an outpatient setting. Conclusion(s): Current guidelines recommend fixed dosing regimens of CS in COVID-19 ARDS. This case demonstrates the effectiveness of using tapered MP followed by DEX in the management of COVID-19 ARDS. As such CS should not be a fixed dose regimen but rather tailored to the patient's requirements with dose adjustments guided by supplemental oxygen demand and CRP values. Further research is required on CS potency and dosing in COVID-19 associated pulmonary disease.

Magnifying inequality: How black women found safety in the midst of dual pandemics

In 2020, COVID-19 in tandem with racial tensions spurred by various occurrences throughout the nation proved detrimental to minoritized persons. Black women, who are often the heads of households, familial and communal caregivers, and organizers, were tasked with protecting themselves, their families, and their communities from racialized violence and infection. This article explores the idea of safety and the responsibilities of Black women to ensure, secure, and maintain safety. The intersection of these two forces creates dual inequities. Whether sacrificing safety for the sake of racial equality or experiencing medical racism while seeking treatment for COVID-19, the duality of Being black and a woman during two prevalent threats exacerbate existing inequities. Using symbolic interactionism to illustrate the function of structures and roles in defining Black women's positionality and intersectionality to examine the policies and systems that act on the lives of these women, we discuss the ways in which Black women created safety for themselves and their families at the intersection of both threats emphasizing the inequity in home, health, and financial outcomes among Black women. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

SITUATED COGNITION 360degree EDITOR 2021: A SOLUTION FOR INTERACTIVE MEDICAL TRAINING DURING THE COVID-19 PANDEMIC PERIOD

Imagine entering an operating theatre or developing clinical skills in empathy and communication through Virtual Reality. To enhance the experience of learning novel methods using VR have been researched and simulated for clinicians. This is because some aspects of clinical training, like conducting procedures and effective team communication focus on 'learning by doing' which is difficult to recreate remotely. Here we present a proof-of-concept prototype of a 360degree-video editor that augments 360degree videos with media to create a mixed reality learning experience. Method An editor was built inside Unity to augment 360degree- videos of real-world scenarios in healthcare with interactive data. Unity is a cross-platform games engine used to create two-dimension three-dimension virtual reality and augmented reality games as well as video players to play panoramic 360degree-videos. The video player is attached to a Render Texture and a Skybox material that provides the spherical surface for the 360degree-video achieving an immersive experience. Results The editor comprises two software packages one for the trainer another for the learner. As a unique feature we introduce clickable Hotspots. This enables users to annotate the 360degree film by tagging specific artefacts in the environment and create a place-based interaction. These Hotspots are anchored to a position and can display text and images and form part of a novel branched timeline of nested data. The intention being the trainer would create the film and annotate the environment with interactive media. This would then be available to the learner who would use the player to view a bespoke teaching package. Conclusion Situated Cognition 360 Editor 2021 envisages trainers creating interactive 360degree-video learning experiences using real life scenarios in healthcare. Future steps involve user experience evaluations co-design and development of new learner interactions that deliver low cost remote and easily deployed healthcare education through immersive learning environments.

Improved outcomes with use of the LenusCOPD digital service in the DYNAMIC-SCOT study

Introduction: LenusCOPD patient and clinician apps include prompted daily patient-reported outcomes (PROs), self-management resources, structured clinical summary, wearable and home NIV data with asynchronous patientclinician messaging. To support patients with severe COPD during the COVID-19 pandemic we paused recruitment to the RECEIVER trial (NCT04240353) in March 2021 and provided LenusCOPD as routine care in the 'DYNAMICSCOT' service scale-up. Method(s): Data was censored on 31st August 2021 when 83 RECEIVER trial participants and 140 scale-up patients had completed minimum 1 year follow up. Outcomes including app usage, service workload, hospital admissions and mortality vs matched control cohort were determined from web analytic and de-identified EHR data. Result(s): Sustained patient app utilisation (avg 3.5 interactions/patient/week) was noted in both cohorts. Service management required 1 session of clinician time 5 days/week. There was a significant reduction in respiratory related admissions and occupied bed days comparing the 12 months pre- and post-onboarding and comparing RECEIVER & scale-up vs control patients. Figure 1 shows improved time to admission and death for the RECEIVER and scaleup cohorts of LenusCOPD users. PRO data showed stable quality of life scores across the cohorts. Conclusion(s): The DYNAMIC-SCOT project confirms the feasibility and benefits of scaling a digital service model for co-management of COPD.

Effects of Social Media Use on Adolescent Connectivity and Emotions During Pandemic-Induced School Closures: A Qualitative Analysis.

BACKGROUND: The recent and ongoing COVID-19 pandemic provides a unique opportunity to examine social media and technology use during a time in which technology served as adolescents' primary form of socialization. The literature is mixed regarding how increased screen time during this period affected adolescent mental health and well-being. The mechanisms by which screen time use affected adolescent psychosocial outcomes is also unknown. OBJECTIVE: To deepen our understanding of how social media and technology use, social connectivity, and emotional well-being intersected during pandemic-related school closures. METHODS: English-speaking adolescents ages 13-17 were recruited on Instagram for a brief screening survey; 39 participants were purposefully selected to complete a semi-structured interview regarding their social media/technology use during the pandemic. Interview summaries were abstracted from recordings and deductive codes were created for the primary question stems. These codes were subsequently reviewed for main themes. RESULTS: Main themes were 1) Adolescent social media and technology use during school closures usually allowed for more and easier social connectivity, but the amount and relative ease of connectivity differed according to purpose and type of use. 2) Emotions, particularly those of stress and happiness, were connected to whether adolescents actively or passive engaged with social media and technology. CONCLUSIONS: Our results suggest a nuanced relationship between social media and technology use and adolescent social support and emotional well-being, including during the pandemic. Specifically, how adolescents use and/or engage with online platforms greatly influences their ability to connect with others as well as feelings of stress and happiness. In the context of the ongoing pandemic and as technology in general remains at the core of the adolescent experience, future research should continue to examine how adolescents navigate and utilize online spaces, in beneficial and harmful ways. This will inform education and interventions that foster healthy social media and technology habits.

Responsive, adaptive, and future-centred leadership in response to crisis: findings from Australia, Fiji, and New Zealand

The COVID-19 pandemic has caused major disruption to education and highlighted the importance of effective leadership during times of crisis. This paper considers the impact of the pandemic on school leaders in Australia, Fiji, and New Zealand. A secondary analysis of data from five interpretivist, qualitative studies was conducted. The aim of the study was to investigate the similarities and differences between the leaders' experiences across school settings, states/provinces, and countries. Our findings place renewed importance on understanding the role of schools within the community and the vital role school leaders play in helping schools respond to volatile and dynamic circumstances. The findings show how leaders' roles and responsibilities adapted to respond quickly and effectively to the urgency of the crisis, regardless of the context. Furthermore, common practices such as attending to wellbeing and providing clear and timely communication were revealed. The analysis also revealed some interesting nuances in the leaders' responses because of the duration of the crisis, the particular needs of the community, and government requirements. Papers like this provide insights into what leaders do and how schools and systems might prepare and support leaders to lead during times of crisis. © 2023 Informa UK Limited, trading as Taylor & Francis Group.

Associations between sedentary behavior and negative emotions in adolescents during home confinement: Mediating role of social support and sleep quality

Background: Prolonged periods of sedentary behaviour, for instance, engendered by home confinement in Shenzhen city, has led to negative mental health consequences, especially in adolescents. Previous research suggests, in general, that sedentary behavior can increase negative emotions. However, the specific mechanism driving the relationship between sedentary behavior and negative emotions is still relatively unclear. Social support and sleep quality might partly explain the effect of sedentary behavior on negative emotions. Thus, the current study aimed to examine the associations between sedentary behavior and negative emotions, and to investigate if social support and sleep quality mediate such a relationship. Method: During home confinement due to the COVID-19 Omicron variant outbreak, 1179 middle and high school students in Shenzhen were invited to voluntarily complete an e-questionnaire, including the 21-item Depression Anxiety Stress Scale (DASS-21), the short form of the International Physical Activity Questionnaire (IPAQ-SF), the Social Support Rating Scale (SSRS) and the Pittsburgh Sleep Quality Index (PSQI). Data from 1065 participants were included in the analysis. Results: We observed significant sex-related and demografic-related differences in emotional (e.g., anxiety, stress and social support) and other outcome variables (e.g., sitting duration and PSQI score). Furthermore, sedentary behavior, social support, and sleep quality were associated with negative emotions (p < .01), even after controlling for sex, age, only-child case, body mass index, and metabolic equivalent level. In addition, social support and sleep quality partially mediated the association between sedentary behavior and negative emotions. Conclusion: The findings of the current study suggest that social support and sleep quality partially mediate the relationship between sedentary behavior and negative emotions in middle and high school students during home confinement in Shenzhen city. © 2022 The Author(s)

Vasculitis post COVID-19 vaccinations in an infection naive population: A temporal association?

Background/Purpose: To date, isolated cases of vasculitis linked to COVID-19 vaccinations have been reported. Western Australia (WA), a state of 2.8 million habitants, had largely been shielded initially from COVID-19 infections with only 3.7 cases/1,000 people identified prior to March 2022. In addition, there were only 3.4 cases/1,000 people detected between July 2021 and March 2022(1). Vaccination rates during this period were high with an adult double vaccination rate recorded at over 95%(2). The combination of these has led to a unique study population. We describe a case-series of patients who developed a medium or large vessel vasculitis post-COVID- 19 vaccination. Method(s): Patients who developed a medium or large vessel vasculitis with symptom onset within four weeks of a COVID-19 vaccine were identified from public and private Rheumatology departments in WA between July 2021 and March 2022. Result(s): The clinical features and diagnosis of 10 identified patients are presented in Table 1. Ages ranged between 41-83 and a various subtypes of vasculitis were observed. Nine patients had symptom onset within two weeks post vaccine. All patients received high dose corticosteroids and seven received steroid-sparing therapies with initial good outcomes. Conclusion(s): The link between vaccinations and induction of autoimmunity remains disputed. It must be emphasised that COVID-19 vaccinations have been critical in this pandemic. The reporting of such cases serves to expand the literature base and generate discussion. Biases (recall and observer) and coincidence could account for these observations. However, the time interval between symptom onset and characteristic features of certain cases in an infection naive population should raise further questions. (Table Presented).

Inhaled modified angiotensin converting enzyme 2 (ACE2) as a decoy to mitigate SARS-CoV-2 infection

COVID-19 is a new zoonotic disease caused by the SARS-CoV-2 virus. Since its emergence in Wuhan City, China, the virus has rapidly spread across the globe causing calamitous health, economic and societal consequences. It causes disproportionately severe disease in the elderly and those with co-morbidities, such as hypertension and diabetes. There is currently no proven treatment for COVID-19 and a safe and effective vaccine is at least a year away. The virus gains access to the respiratory epithelium through cell surface angiotensin converting enzyme 2 (ACE2). The receptor binding domain (RBD) of the virus is unlikely to mutate without loss of pathogenicity and thus represents an attractive target for antiviral treatment. Inhaled modified recombinant human ACE2, may bind SARS-CoV-2 and mitigate lung damage. This decoy strategy is unlikely to provoke an adverse immune response and may reduce morbidity and mortality in high-risk groups. Copyright © 2020 New Zealand Medical Association. All rights reserved.

Clinical and epidemiologic features of SARS-CoV-2 in dogs and cats compiled through national surveillance in the United States.

OBJECTIVE: To characterize clinical and epidemiologic features of SARS-CoV-2 in companion animals detected through both passive and active surveillance in the US. ANIMALS: 204 companion animals (109 cats, 95 dogs) across 33 states with confirmed SARS-CoV-2 infections between March 2020 and December 2021. PROCEDURES: Public health officials, animal health officials, and academic researchers investigating zoonotic SARS-CoV-2 transmission events reported clinical, laboratory, and epidemiologic information through a standardized One Health surveillance process developed by the CDC and partners. RESULTS: Among dogs and cats identified through passive surveillance, 94% (n = 87) had reported exposure to a person with COVID-19 before infection. Clinical signs of illness were present in 74% of pets identified through passive surveillance and 27% of pets identified through active surveillance. Duration of illness in pets averaged 15 days in cats and 12 days in dogs. The average time between human and pet onset of illness was 10 days. Viral nucleic acid was first detected at 3 days after exposure in both cats and dogs. Antibodies were detected starting 5 days after exposure, and titers were highest at 9 days in cats and 14 days in dogs. CLINICAL RELEVANCE: Results of the present study supported that cats and dogs primarily become infected with SARS-CoV-2 following exposure to a person with COVID-19, most often their owners. Case investigation and surveillance that include both people and animals are necessary to understand transmission dynamics and viral evolution of zoonotic diseases like SARS-CoV-2.

Increased Susceptibility and 9-Fold Increased Mortality From COVID- 19 in Patients With ADTKD-MUC1

Background: Patients with autosomal dominant tubulointerstitial kidney disease due to MUC1 mutations (ADTKD-MUC1) have a frameshift mutation on one allele of the MUC1 genotype, resulting in production an abnormal MUC1frameshift protein on on allele and normal MUC1 on the other allele. The C variant of the rs4072037 SNP increases production of MUC1 or MUC1fs if it is contained in the corresponding promoter. In addition to the kidneys, MUC1 is expressed in the nose and lungs. ADTKD-UMOD has a very similar clinical presentation, but UMOD is expressed only in the kidney. Method(s): We conducted a survey (after emergence of the delta variant) using the REDCAP database of 957 individuals in our ADTKD cohort to determine if COVID-19 infection was more severe in ADTKD-MUC1 patients. Result(s): There were 89 ADTKD-MUC1 and 132 ADTKD-UMOD respondents, with similar age, body mass index, transplant rates, vaccination rates,. 25/89(28%) ADTKDMUC1 individuals developed COVID-19 vs. 21/132(16%) ADTKD-UMOD individuals (odds ratio 2.35(1.6-3.1) (p=0.028). 10/41 (24%) ADTKD-MUC1 individuals died of COVID-19 vs. 1/30 (3%) ADTKD-UMOD individuals (p=0.013), with an odds ratio of 9.4 (7.2-11.5). The mean plasma mucin1 level in 13 infected and 23 uninfected ADTKDMUC1 individuals was 6.40+/-3.4 vs.10.89+/-3.82 U/mL (p=0.0012). Of ADTKD-MUC1 individuals who developed COVID-19, only 19% had the CC phenotype (associated with increased MUC1 production) vs. 51% of the ADTKD-MUC1 individuals who did not develop COVID-19 (p=0.01). There was no difference in rs4073037 genotype frequencies in the ADTKD-UMOD group. Of the 10 ADTKD-MUC1 patients who died, 8 were transplanted, with only 3 greater than 60 years of age. 50 percent had received 2 COVID-19 vaccines. Conclusion(s): Patients with ADTKD-MUC1 have a 2-fold increased odds of developing COVID-19 and a 9-fold increased mortality from COVID-19. Among ADTKD-MUC1 patients, those producing less MUC1 were more likely to develop COVID-19.