Investigation of Post-Pandemic Patient Perception toward Clinical Trials

Background/Objective: The objective of this poster was to understand patient perception about clinical trial participation after the onset of the COVID-19 pandemic. Many believe that the widely publicized production of vaccines has influenced patient perception, and we aimed to understand any other factors that impact whether patients go through with a clinical trial after prescreening. Using the patient database at Princeton Medical Institute, we emailed a survey to 689 patients who screened for either psychiatric or neurologic trials. Design(s): We designed three surveys: one for patients with neurologic disorders, one for neurologic caregivers, and one for patients with psychiatric disorders, namely major depressive disorder (MDD), posttraumatic stress disorder (PTSD), binge eating disorder (BED), social anxiety disorder, and smoking cessation. For data analysis, we received 55 complete responses that we analyzed to understand patient impressions about trusting medications on the market compared to study drugs, willingness to join trials after hearing about the pandemic, and telehealth appointments. Result(s): One result that stood out was that 85.5 percent of all respondents reported that increased awareness of COVID-19 vaccine development did not change their willingness to join our trials. Additionally, we learned that younger patients in the psychiatric population preferred telehealth appointments (82%) over older patients in the neurologic population (40%). Conclusion(s): The main reason for these results is the convenience that telehealth provides by eliminating challenging factors, such as transportation and scheduling. Future research can build on these findings by using a stronger sample size that captures all patient viewpoints on participating in clinical trials.

Implications of face mask use on body composition assessment by air-displacement plethysmography.

BACKGROUND & AIMS: The BOD POD (COSMED USA Inc., Concord, CA) is a common instrument used to assess body composition by employing air displacement plethysmography and whole-body densitometry to determine body volume. This instrument requires isothermal conditions during testing; therefore, the introduction of outside isothermal air can impact testing results. With the COVID-19 pandemic introducing face mask mandates, it is unknown whether the use of a face mask during BOD POD testing may lead to erroneous measurement by introducing isothermal air. Thus, the purpose of this cross-sectional study was to investigate the impact of wearing a surgical face mask compared to not wearing a surgical face mask on body composition assessment among adults. METHODS: During testing, female subjects were required to wear a swimsuit or form-fitting lycra shorts and a sports bra and male subjects were required to wear form-fitting lycra shorts. American Society for Testing and Materials (ASTM) level one surgical face masks (bacterial and particulate filtration efficiency of 95%) and standard swim caps were provided by researchers. Variables of interest included percent body fat, body fat, percent lean body mass, and lean body mass. Participants (n = 33) completed one test wearing a mask and one test without a mask back-to-back with conditions held constant. Dependent-sample sign tests, Bland-Altman Plots, and Passing-Bablok regression analyses were used to test mask-on versus mask-off differences and agreement between variables of interest. RESULTS: There were no significant median differences in any body composition results between face mask use and non-face mask use using dependent-sample sign tests. Bland-Altman Plots demonstrated acceptable agreement between mask usage and non-mask usage. No significant differences were seen in the slopes of the variables using Passing-Bablok regression. CONCLUSIONS: Results suggest that wearing a face mask does not appreciably impact body composition results. Therefore, ASTM level 1 disposable surgical face mask does not introduce a significant amount of isothermal air during BOD POD testing.

Host-pathogen interactions of highly pathogenic coronaviruses reveal drug targets

Background: The novel coronavirus SARS-CoV-2, the causative agent of COVID-19, has caused worldwide social and economic disruption. Initial efforts to treat SARS-CoV-2 were hampered by limited knowledge of the molecular details of SARS-CoV-2 infection. To identify molecular targets for SARS-CoV-2 therapeutics, we mapped the host-pathogen protein interactions of SARS-CoV- 2, and investigated host dependency pathways that are required for SARS-CoV-2 infection using drug, knockdown and knockout screens. Concerns regarding the mutagenic potential of SARS-CoV-2 also led us to inquire whether a conserved set of human host factors may be required for infection by all highly pathogenic coronaviruses, thus representing pan-coronavirus drug targets. Therefore, we also mapped the host protein interactions of SARS-CoV-1 and MERS-CoV. Methods: We cloned, tagged and expressed proteins encoded by SARS-CoV-2, SARS-CoV-1, and MERS-CoV in HEK-293T cells, which are permissive to infection by all three viruses. Cells expressing individual proteins were harvested, affinity purifications performed in 96-well format, and protein mass spectrometry was utilized to identify physical interaction partners of each viral protein. Drug treatments, RNAi knockdowns and CRISPR/Cas9 knockouts were tested for SARS-CoV-2 viral phenotypes in Vero, Caco2 or A549-ACE2 cells. Results: We report 389 high-confidence interactors of SARS-CoV-2, 366 interactions for SARS-CoV-1, and 296 interactions for MERS-CoV. Among the SARS-CoV-2 interactors, we identified at least 66 druggable human proteins or host factors, and screening small molecules targeting these pathways using multiple viral assays have identified at least four sets of pharmacological agents that demonstrate antiviral activity against SARS-CoV-2. Comparison of the host-pathogen interactomes of SARS-CoV-2 with the other highly pathogenic coronaviruses SARS-CoV-1 and MERS highlights shared host interactions which may represent pan-coronavirus drug targets. Conclusion: We successfully utilized systematic protein interaction mapping to identify drug targets for SARS-CoV-2, leading to several Covid-19 clinical studies investigating the efficacy of drugs perturbing these pathways. Furthermore, comparative proteomics of the related coronaviruses SARS-CoV-1 and MERS-CoV identified shared host interactions which may represent pan-coronavirus drug targets. For a full list of contributing authors see: Gordon, D. E. et al. Nature 583, 459-468 (2020);Gordon, D. E. et al. Science 370 (2020).