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1.
Cell ; 185(5): 881-895.e20, 2022 03 03.
Article in English | MEDLINE | ID: covidwho-1649960

ABSTRACT

Post-acute sequelae of COVID-19 (PASC) represent an emerging global crisis. However, quantifiable risk factors for PASC and their biological associations are poorly resolved. We executed a deep multi-omic, longitudinal investigation of 309 COVID-19 patients from initial diagnosis to convalescence (2-3 months later), integrated with clinical data and patient-reported symptoms. We resolved four PASC-anticipating risk factors at the time of initial COVID-19 diagnosis: type 2 diabetes, SARS-CoV-2 RNAemia, Epstein-Barr virus viremia, and specific auto-antibodies. In patients with gastrointestinal PASC, SARS-CoV-2-specific and CMV-specific CD8+ T cells exhibited unique dynamics during recovery from COVID-19. Analysis of symptom-associated immunological signatures revealed coordinated immunity polarization into four endotypes, exhibiting divergent acute severity and PASC. We find that immunological associations between PASC factors diminish over time, leading to distinct convalescent immune states. Detectability of most PASC factors at COVID-19 diagnosis emphasizes the importance of early disease measurements for understanding emergent chronic conditions and suggests PASC treatment strategies.


Subject(s)
COVID-19/complications , COVID-19/diagnosis , Convalescence , Adaptive Immunity/genetics , Adolescent , Adult , Aged , Aged, 80 and over , Autoantibodies/blood , Biomarkers/metabolism , Blood Proteins/metabolism , CD8-Positive T-Lymphocytes/immunology , CD8-Positive T-Lymphocytes/metabolism , COVID-19/immunology , COVID-19/pathology , COVID-19/virology , Disease Progression , Female , Humans , Immunity, Innate/genetics , Longitudinal Studies , Male , Middle Aged , Risk Factors , SARS-CoV-2/isolation & purification , Transcriptome , Young Adult
2.
Prim Health Care Res Dev ; 22: e72, 2021 11 19.
Article in English | MEDLINE | ID: covidwho-1526035

ABSTRACT

BACKGROUND: Patient and public involvement (PPI) plays a crucial role in ensuring research is carried out in conjunction with the people that it will impact upon. In this article, we present our experiences and reflections from working collaboratively with patients and public through the lifetime of an National Institute for Health Research (NIHR) programme grant; the Chronic Headache Education and Self-management Study (CHESS) which took place between 2015 and 2020. PPI OVER THE COURSE OF CHESS: We worked closely with three leading UK migraine charities and a lay advisory group throughout the programme. We followed NIHR standards and used the Guidance for Reporting Involvement of Patients and the Public checklist. We consulted our PPI contacts using a variety of methods depending on the phase of the study and the nature of the request. This included emails, discussions, and face-to-face contact.PPI members contributed throughout the study in the programme development, in the grant application, ethics documentation, and trial oversight. During the feasibility study; in supporting the development of a classification interview for chronic headache by participating in a headache classification conference, assessing the relevance, and acceptability of patient-reported outcome measures by helping to analyse cognitive interview data, and testing the smartphone application making suggestions on how best to present the summary of data collected for participants. Due to PPI contribution, the content and duration of the study intervention were adapted and a Delphi study with consensus meeting developed a core outcome set for migraine studies. CONCLUSIONS: The involvement of the public and patients in CHESS has allowed us to shape its overall design, intervention development, and establish a core outcome set for future migraine studies. We have reflected on many learning points for the future application of PPI.


Subject(s)
Headache Disorders , Self-Management , Feasibility Studies , Humans , Patient Reported Outcome Measures , United Kingdom
3.
Hum Behav Emerg Technol ; 2021 Oct 28.
Article in English | MEDLINE | ID: covidwho-1487469

ABSTRACT

The impact of the Covid-19 pandemic and ensuing social restrictions has been profound, affecting the health, livelihoods, and wellbeing of populations worldwide. Studies have shown widespread effects on mental health, with an increase in stress, loneliness, and depression symptoms related to the pandemic. Media plays a critical role in containing and managing crises, by informing society and fostering positive behavior change. Social restrictions have led to a large increase in reliance on online media channels, and this can influence mental health and wellbeing. Anxiety levels, for instance, may be exacerbated by exposure to Covid-related content, contagion of negative sentiment among social networks, and "fake news." In some cases, this may trigger abstinence, leading to isolation and limited access to vital information. To be able to communicate distressing news during crises while protecting the wellbeing of individuals is not trivial; it requires a deeper understanding of people's emotional response to online and social media content. This paper selectively reviews research into consequences of social media usage and online news consumption for wellbeing and mental health, focusing on and discussing their effects in the context of the pandemic. Advances in Artificial Intelligence and Data Science, for example, Natural Language Processing, Sentiment Analysis, and Emotion Recognition, are discussed as useful methods for investigating effects on population mental health as the pandemic situation evolves. We present suggestions for future research, and for using these advances to assess large data sets of users' online content, to potentially inform strategies that enhance the mental health of social media users going forward.

4.
BJPsych Open ; 7(5): e161, 2021 Sep 02.
Article in English | MEDLINE | ID: covidwho-1394499

ABSTRACT

BACKGROUND: The COVID-19 pandemic and resultant social restrictions have had widespread psychological ramifications, including a rise in depression prevalence. However, longitudinal studies on sociodemographic risk factors are lacking. AIMS: To quantify longitudinal changes in depression symptoms during the pandemic compared with a pre-pandemic baseline, in middle-aged and older adults, and identify the risk factors contributing to this. METHOD: A total of 5331 participants aged ≥50 years were drawn from the English Longitudinal Study of Ageing. Self-reported depression symptoms in June/July 2020 were compared with baseline data from 2-3 years prior. Regression models investigated sociodemographic and lifestyle variables that could explain variance in change in depression. RESULTS: Within-participant depression scores increased significantly from pre-pandemic levels: 14% met the criteria for clinical depression at baseline, compared with 26% during the pandemic. Younger age, female gender, higher depression scores at baseline, living alone and having a long-standing illness were significant risk factors. Gender-stratified regression models indicated that older age was protective for women only, whereas urban living increased risk among women only. Being an alcohol consumer was a protective factor among men only. CONCLUSIONS: Depression in UK adults aged ≥50 years increased significantly during the pandemic. Being female, living alone and having a long-standing illness were prominent risk factors. Younger women living in urban areas were at particularly high risk, suggesting such individuals should be prioritised for support. Findings are also informative for future risk stratification and intervention strategies, particularly if social restrictions are reimposed as the COVID-19 crisis continues to unfold.

5.
Sci Rep ; 11(1): 16193, 2021 08 10.
Article in English | MEDLINE | ID: covidwho-1351975

ABSTRACT

We have optimised a reverse transcription-loop-mediated isothermal amplification (RT-LAMP) assay for the detection of SARS-CoV-2 from extracted RNA for clinical application. We improved the stability and reliability of the RT-LAMP assay by the addition of a temperature-dependent switch oligonucleotide to reduce self- or off-target amplification. We then developed freeze-dried master mix for single step RT-LAMP reaction, simplifying the operation for end users and improving long-term storage and transportation. The assay can detect as low as 13 copies of SARS-CoV2 RNA per reaction (25-µL). Cross reactivity with other human coronaviruses was not observed. We have applied the new RT-LAMP assay for testing clinical extracted RNA samples extracted from swabs of 72 patients in the UK and 126 samples from Greece and demonstrated the overall sensitivity of 90.2% (95% CI 83.8-94.7%) and specificity of 92.4% (95% CI 83.2-97.5%). Among 115 positive samples which Ct values were less than 34, the RT-LAMP assay was able to detect 110 of them with 95.6% sensitivity. The specificity was 100% when RNA elution used RNase-free water. The outcome of RT-LAMP can be reported by both colorimetric detection and quantifiable fluorescent reading. Objective measures with a digitized reading data flow would allow for the sharing of results for local or national surveillance.


Subject(s)
COVID-19 Nucleic Acid Testing/methods , Molecular Diagnostic Techniques/methods , Nucleic Acid Amplification Techniques/methods , COVID-19 Nucleic Acid Testing/standards , Humans , Molecular Diagnostic Techniques/standards , Nucleic Acid Amplification Techniques/standards , Sensitivity and Specificity
6.
Healthcare (Basel) ; 9(4)2021 Apr 01.
Article in English | MEDLINE | ID: covidwho-1167476

ABSTRACT

Concerns have been raised regarding middle-aged and older adults' mental health during the coronavirus outbreak. The aim of the current study was to characterise associations between internet use (frequency and purpose), depression symptoms and Quality of Life (QoL) during the pandemic, in individuals aged 55-75. Data (N = 3491) were drawn from the English longitudinal study of ageing (ELSA) cohort study collected in June/July 2020 (while social distancing measures were in place). Associations with frequency of use were tested using analysis of covariance (ANCOVAS), controlling for covariates such as wealth and education. Type of internet use (for communication, information search) was also analysed amongst frequent users. Significant effects of frequency of use were observed (p = 0.01 for depression, p < 0.001 for QoL), with lower depression symptoms and higher QoL scores amongst more frequent users. Regarding purpose of use, those who reported using the internet for communication purposes had higher QoL. However, use for health-related or Government services information searching was associated with more depression symptoms. Results provide important information regarding the potential benefits of internet use for middle-aged and older people, suggesting that strategies to increase internet usage (particularly for communication) might benefit middle-aged and older adults' mental health and counter isolation as the coronavirus crisis continues to evolve.

7.
Psychiatry Res ; 298: 113819, 2021 04.
Article in English | MEDLINE | ID: covidwho-1096207

ABSTRACT

The COVID-19 pandemic and the consequent restrictions imposed by governments worldwide have had profound social and psychological effects, particularly for young adults. This study used longitudinal data to characterise effects on mental health and behaviour in a UK student sample, measuring sleep quality and diurnal preference, depression and anxiety symptoms, wellbeing and loneliness, and alcohol use. Self-report data was collected from 254 undergraduates (219 females) at a UK university at two-time points: autumn 2019 (baseline, pre-pandemic) and April/May 2020 (under 'lockdown' conditions).  Longitudinal analyses showed a significant rise in depression symptoms and a reduction in wellbeing at lockdown. Over a third of the sample could be classed as clinically depressed at lockdown compared to 15% at baseline. Sleep quality was not affected across the sample as a whole. The increase in depression symptoms was highly correlated with worsened sleep quality. A reduction in alcohol use, and a significant shift towards an 'evening' diurnal preference, were also observed. Levels of worry surrounding contracting COVID-19 were high. Results highlight the urgent need for strategies to support young people's mental health: alleviating worries around contracting COVID, and supporting good sleep quality, could benefit young adults' mental health as the COVID-19 crisis unfolds.


Subject(s)
Alcohol Drinking , Anxiety , COVID-19 , Communicable Disease Control , Depression , Loneliness , Sleep Wake Disorders , Students , Adolescent , Adult , Alcohol Drinking/epidemiology , Anxiety/epidemiology , Anxiety/etiology , Depression/epidemiology , Depression/etiology , Female , Humans , Longitudinal Studies , Male , Sleep Wake Disorders/epidemiology , Sleep Wake Disorders/etiology , Students/psychology , Students/statistics & numerical data , United Kingdom/epidemiology , Young Adult
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