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1.
Viruses ; 14(6)2022 06 18.
Article in English | MEDLINE | ID: covidwho-1964108

ABSTRACT

The global spread of SARS-CoV-2 and its variants poses a serious threat to human health worldwide. Recently, the emergence of Omicron has presented a new challenge to the prevention and control of the COVID-19 pandemic. A convenient and reliable in vitro neutralization assay is an important method for validating the efficiency of antibodies, vaccines, and other potential drugs. Here, we established an effective assay based on a pseudovirus carrying a full-length spike (S) protein of SARS-CoV-2 variants in the HIV-1 backbone, with a luciferase reporter gene inserted into the non-replicate pseudovirus genome. The key parameters for packaging the pseudovirus were optimized, including the ratio of the S protein expression plasmids to the HIV backbone plasmids and the collection time for the Alpha, Beta, Gamma, Kappa, and Omicron pseudovirus particles. The pseudovirus neutralization assay was validated using several approved or developed monoclonal antibodies, underscoring that Omicron can escape some neutralizing antibodies, such as REGN10987 and REGN10933, while S309 and ADG-2 still function with reduced neutralization capability. The neutralizing capacity of convalescent plasma from COVID-19 convalescent patients in Wuhan was tested against these pseudoviruses, revealing the immune evasion of Omicron. Our work established a practical pseudovirus-based neutralization assay for SARS-CoV-2 variants, which can be conducted safely under biosafety level-2 (BSL-2) conditions, and this assay will be a promising tool for studying and characterizing vaccines and therapeutic candidates against Omicron-included SARS-CoV-2 variants.


Subject(s)
COVID-19 , SARS-CoV-2 , Antibodies, Neutralizing , Antibodies, Viral , COVID-19/therapy , Humans , Immunization, Passive , Neutralization Tests/methods , Pandemics , SARS-CoV-2/genetics , Spike Glycoprotein, Coronavirus
2.
Children (Basel) ; 9(7)2022 Jul 14.
Article in English | MEDLINE | ID: covidwho-1928491

ABSTRACT

The emergence of the Omicron variant was accompanied by an acute increase in COVID-19 cases and hospitalizations in New York City. An increased incidence of COVID-19-associated croup in children during the Omicron wave has been recognized, suggesting that there may be other changes in clinical symptoms and severity. To better understand clinical outcomes and health care utilization in children infected with SARS-CoV-2 during the Omicron wave, we performed a cross-sectional study in pediatric patients aged ≤18 years who were tested for SARS-CoV-2 in pediatric emergency departments within a large medical system in New York City from 2 December 2021 to 23 January 2022. We described the clinical characteristics and outcomes of pediatric patients who presented to the pediatric emergency department and were hospitalized with SARS-CoV-2 infection during the Omicron wave in New York City. There were 2515 children tested in the ED for SARS-CoV-2 of whom 794 (31.6%) tested positive. Fifty-eight children were hospitalized for a COVID-19-related indication, representing 7.3% of all COVID-19-positive children and 72% of hospitalized COVID-19-positive children. Most (64%) children hospitalized for a COVID-19-related indication were less than 5 years old. Indications for hospitalization included respiratory symptoms, clinical monitoring of patients with comorbid conditions, and exacerbations of underlying disease. Eleven (19%) hospitalized children were admitted to the ICU and six (10%) required mechanical ventilation. Children infected with COVID-19 during the Omicron wave, particularly those less than 5 years old, were at risk for hospitalization. A majority of hospitalizations were directly related to COVID-19 infection although clinical indications varied with less than a half being admitted for respiratory diseases including croup. Our findings underscore the need for an effective COVID-19 vaccine in those less than 5 years old, continued monitoring for changes in clinical outcomes and health care utilization in children as more SARS-CoV-2 variants emerge, and understanding that children are often admitted for non-respiratory diseases with COVID-19.

3.
Viruses ; 14(6):1332, 2022.
Article in English | MDPI | ID: covidwho-1894259

ABSTRACT

The global spread of SARS-CoV-2 and its variants poses a serious threat to human health worldwide. Recently, the emergence of Omicron has presented a new challenge to the prevention and control of the COVID-19 pandemic. A convenient and reliable in vitro neutralization assay is an important method for validating the efficiency of antibodies, vaccines, and other potential drugs. Here, we established an effective assay based on a pseudovirus carrying a full-length spike (S) protein of SARS-CoV-2 variants in the HIV-1 backbone, with a luciferase reporter gene inserted into the non-replicate pseudovirus genome. The key parameters for packaging the pseudovirus were optimized, including the ratio of the S protein expression plasmids to the HIV backbone plasmids and the collection time for the Alpha, Beta, Gamma, Kappa, and Omicron pseudovirus particles. The pseudovirus neutralization assay was validated using several approved or developed monoclonal antibodies, underscoring that Omicron can escape some neutralizing antibodies, such as REGN10987 and REGN10933, while S309 and ADG-2 still function with reduced neutralization capability. The neutralizing capacity of convalescent plasma from COVID-19 convalescent patients in Wuhan was tested against these pseudoviruses, revealing the immune evasion of Omicron. Our work established a practical pseudovirus-based neutralization assay for SARS-CoV-2 variants, which can be conducted safely under biosafety level-2 (BSL-2) conditions, and this assay will be a promising tool for studying and characterizing vaccines and therapeutic candidates against Omicron-included SARS-CoV-2 variants.

4.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-337852

ABSTRACT

Background: The public experienced loss of resources, including their health and property during the COVID-19 pandemic. The Conservation of Resources (COR) Theory is a useful tool to explain the effect of resource loss on mental health. This paper examines the effect of resource loss on depression and peritraumatic distress considering the situational and social context of the COVID-19 pandemic, applying COR theory. Methods: : An online survey was conducted for Gyeonggi residents over eight days (5 October to 13 October 2020) when the second wave of the COVID-19 in South Korea declined;2,548 subjects were included in the hierarchical linear regression analysis. Results: : COVID-19 related experiences (infection /isolation /quarantine), resource losses (e.g., financial burden, deterioration of health, and decline of self-esteem), and fear of stigma were related to elevated levels of peritraumatic distress and depression. A higher level of risk perception was associated with higher peritraumatic distress, and people with reduced income or job loss showed a higher level of depression. Social support was a protective factor for mental health. Conclusions: : This study indicates that COVID-19-related experiences and loss of daily resources require attention when considering mental health parameters during COVID-19. Moreover, it is important to monitor the mental health of medically and socially vulnerable groups and those who have lost resources due to the pandemic and to provide these individuals with social support or financial compensation.

5.
Signal Transduct Target Ther ; 7(1): 139, 2022 04 27.
Article in English | MEDLINE | ID: covidwho-1815514

ABSTRACT

The SARS-CoV-2 Omicron variant shows substantial resistance to neutralization by infection- and vaccination-induced antibodies, highlighting the demands for research on the continuing discovery of broadly neutralizing antibodies (bnAbs). Here, we developed a panel of bnAbs against Omicron and other variants of concern (VOCs) elicited by vaccination of adenovirus-vectored COVID-19 vaccine (Ad5-nCoV). We also investigated the human longitudinal antibody responses following vaccination and demonstrated how the bnAbs evolved over time. A monoclonal antibody (mAb), named ZWD12, exhibited potent and broad neutralization against SARS-CoV-2 variants Alpha, Beta, Gamma, Kappa, Delta, and Omicron by blocking the spike protein binding to the angiotensin-converting enzyme 2 (ACE2) and provided complete protection in the challenged prophylactic and therapeutic K18-hACE2 transgenic mouse model. We defined the ZWD12 epitope by determining its structure in complex with the spike (S) protein via cryo-electron microscopy. This study affords the potential to develop broadly therapeutic mAb drugs and suggests that the RBD epitope bound by ZWD12 is a rational target for the design of a broad spectrum of vaccines.


Subject(s)
COVID-19 , SARS-CoV-2 , Animals , Antibodies, Monoclonal/genetics , Antibodies, Viral , Broadly Neutralizing Antibodies , COVID-19/prevention & control , COVID-19 Vaccines/genetics , Cryoelectron Microscopy , Epitopes , Humans , Mice , SARS-CoV-2/genetics , Spike Glycoprotein, Coronavirus/genetics , Vaccination , Viral Envelope Proteins
6.
BMC Public Health ; 22(1): 860, 2022 04 29.
Article in English | MEDLINE | ID: covidwho-1813314

ABSTRACT

BACKGROUND: Social distancing policies work in different ways and at different levels. In addition, various forms of monitoring systems have been implemented in different countries. However, there is an almost complete lack of specific monitoring system in Republic of Korea to effectively monitor social distancing measures compliance and outcome. This study aims to develop a monitoring system for social distancing measures compliance and outcome in Korea to evaluate and improve the implemented policy. METHODS: A draft monitoring system was developed after reviewing Korea's social distancing measures (central and local government briefings) and checking available data about social distancing behavior. The modified Delphi process was used to evaluate the draft of the social distancing monitoring system. In total, 27 experts participated in the evaluation. The round 1 evaluation includes (1) commenting on the composition of the monitoring fields (open response), (2) monitoring indicators for each monitoring field (10-point Likert scale), and (3) commenting on the source of data used to develop the monitoring system (open response). In the round 2 evaluation, 55 indicators, excepting open responses, were re-evaluated. RESULTS: The response rate for the Delphi survey was 100% in both the first and second rounds. Of the 55 indicators, 1 indicator, which did not satisfy the quantitative criteria, was excluded. According to the experts' open response comments, 15 indicators were excluded, as these indicators overlapped with other indicators or had little relevance to social distancing. Instead, 23 new indicators were added. Finally, 62 indicators were included with 12 available data sources. The monitoring system domain was divided into 'social distancing measures state, social distancing measures compliance, social distancing outcome'. CONCLUSIONS: This study is significant in that it is the first in Korea to develop a comprehensive monitoring system for checking if social distancing measures are being followed well, and is applicable to estimates utilizing data that are immediately available for each indicator. Furthermore, the developed monitoring system could be a reference for other countries that require the development of such systems to monitor social distancing.


Subject(s)
Physical Distancing , Humans , Republic of Korea
7.
Influenza Other Respir Viruses ; 16(4): 680-689, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1764954

ABSTRACT

BACKGROUND: We sought to assess whether persistent COVID-19 symptoms beyond 6 months (Long-COVID) among patients with mild COVID-19 is associated with poorer health status, quality of life, and psychological distress. METHODS: This was a multicenter prospective cohort study that included adult outpatients with acute COVID-19 from eight sites during 2-week sampling periods from April 1 and July 28, 2020. Participants were contacted 6-11 months after their first positive SARS-CoV-2 to complete a survey, which collected information on the severity of eight COVID-19 symptoms using a 4-point scale ranging from 0 (not present) to 3 (severe) at 1 month before COVID-19 (pre-illness) and at follow-up; the difference for each was calculated as an attributable persistent symptom severity score. A total attributable persistent COVID-19 symptom burden score was calculated by summing the attributable persistent severity scores for all eight symptoms. Outcomes measured at long-term follow-up comprised overall health status (EuroQol visual analogue scale), quality of life (EQ-5D-5L), and psychological distress (Patient Health Questionnaire-4). The association between the total attributable persistent COVID-19 burden score and each outcome was analyzed using multivariable proportional odds regression. RESULTS: Of the 2092 outpatients with COVID-19, 436 (21%) responded to the survey. The median (IQR) attributable persistent COVID-19 symptom burden score was 2 (0, 4); higher scores were associated with lower overall health status (aOR 0.63; 95% CI: 0.57-0.69), lower quality of life (aOR: 0.65; 95%CI: 0.59-0.72), and higher psychological distress (aOR: 1.40; 95%CI, 1.28-1.54) after adjusting for age, race, ethnicity, education, and income. CONCLUSIONS: In participants with mild acute COVID-19, the burden of persistent symptoms was significantly associated with poorer long-term health status, poorer quality of life, and psychological distress.


Subject(s)
COVID-19 , Psychological Distress , Adult , COVID-19/complications , COVID-19/epidemiology , Health Status , Humans , Prospective Studies , Quality of Life/psychology , SARS-CoV-2
8.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-313221

ABSTRACT

Background: To evaluate the current status of emotional exhaustion and peritraumatic distress of healthcare workers (HCWs) in the COVID-19 pandemic, and identify factors associated with their mental health status. Methods An online survey involving 1,068 HCWs that included nurses, physicians, and public health officers was conducted. Descriptive statistics and multivariate regression analyses were performed on the collected data. Results Although no significant difference in peritraumatic distress was observed among the surveyed HCWs, the workers’ experience of emotional exhaustion varied according to work characteristics. Respondents who were female, older, living with a spouse, and/or full-time workers reported higher levels of emotional exhaustion. Public health officers and other medical personnel who did not have direct contact with confirmed patients and full-time workers had a higher level of peritraumatic distress. Forced involvement in work related to COVID-19, worry about stigma, worry about becoming infected, and perceived sufficiency of organizational support negatively predict emotional exhaustion and peritraumatic distress. Conclusions Job-related and emotional stress of HCWs should not be neglected. Evidence-based interventions and supports are required to protect HCWs from mental illness and to promote mental health of those involved in the response to the COVID-19 pandemic.

9.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-321069

ABSTRACT

Background: Since the COVID-19 pandemic is an ongoing situation in most countries worldwide, a “social distancing” policy as a non-pharmaceutical intervention has been implemented for several months in many countries including Korea. Social distancing policies work in different ways and at different levels. In addition, various forms of surveillance systems have been implemented in different countries. However, there is an almost complete lack of specific surveillance system in Korea to effectively monitor social distancing policy. This study aims to develop a monitoring system for social distancing measures in Korea to evaluate and improve the implemented policy. Methods: A draft monitoring system was developed after reviewing Korea's social distancing measures (central and local government briefings) and checking available data for applications. The modified Delphi process was used to evaluate the draft of the monitoring system. In total, 27 experts participated in the evaluation. The round 1 evaluation includes (1) commenting on the composition of the monitoring fields (open response), (2) monitoring indicators for each monitoring field (10-point Likert scale), and (3) commenting on the source of data used to develop the monitoring system (open response). In the round 2 evaluation, 55 indicators, excepting open responses, were re-evaluated. Results: The response rate for the Delphi survey was 100% in both the first and second rounds. Of the 55 indicators, 14 were excluded according to experts’ open response comments, as these indicators did not satisfy the quantitative criteria. Finally, 41 indicators were included with 12 available data sources. The monitoring system domain was divided into input, process/output, and result. Conclusions: This study is significant in that it is the first in Korea to develop a comprehensive monitoring system for social distancing policy, and is applicable to estimates utilizing data that are immediately available for each indicator. Furthermore, the developed monitoring system could be a reference for other countries that require the development of such systems to monitor social distancing measures.

10.
Nanomaterials (Basel) ; 11(12)2021 Dec 17.
Article in English | MEDLINE | ID: covidwho-1613912

ABSTRACT

The rapid purification of biomaterials such as DNA, RNA, and antibodies has attracted extensive attention, and research interest has increased further with the COVID-19 pandemic. In particular, core-shell-structured superparamagnetic nanoparticles have been continuously studied for their application as biopurification materials. It has been reported that Fe3O4@SiO2 nanoparticles are one of the most promising candidates for separating nucleic acids via a simple and rapid process. This study proposed a fabrication method for dual-layered Fe3O4@SiO2 nanoparticles, in which the density of the SiO2 shell was controlled using an intermediate surfactant during the SiO2 coating. After the fabrication of dual-layered Fe3O4@SiO2 nanoparticles, structural, morphological, and magnetic analyses were conducted. The results showed that the Fe3O4 nanoparticles were surrounded by a dense layer 15.6~27.9 nm thick and a porous layer 24.2~44.4 nm thick, and had superparamagnetic properties with high saturated magnetization at room temperature (86.9 emu/g). Then, the optimal conditions for the biopurification material were suggested based on analysis of the selective separation of plasmid DNA.

11.
BMC Public Health ; 21(1): 2075, 2021 11 12.
Article in English | MEDLINE | ID: covidwho-1574638

ABSTRACT

BACKGROUND: To evaluate the current status of emotional exhaustion and peritraumatic distress of healthcare workers (HCWs) in the COVID-19 pandemic, and identify factors associated with their mental health status. METHODS: An online survey involving 1068 of consented HCWs that included nurses, physicians, and public health officers was conducted in May 2020. Descriptive statistics and multivariate regression analyses were performed on the collected data. RESULTS: Although no significant difference in peritraumatic distress was observed among the surveyed HCWs, the workers' experience of emotional exhaustion varied according to work characteristics. Respondents who were female, older, living with a spouse, and/or full-time workers reported higher levels of emotional exhaustion. Public health officers and other medical personnel who did not have direct contact with confirmed patients and full-time workers had a higher level of peritraumatic distress. Forced involvement in work related to COVID-19, worry about stigma, worry about becoming infected, and perceived sufficiency of organizational support negatively predict emotional exhaustion and peritraumatic distress. CONCLUSIONS: Job-related and emotional stress of HCWs should not be neglected. Evidence-based interventions and supports are required to protect HCWs from mental illness and to promote mental health of those involved in the response to the COVID-19 pandemic.


Subject(s)
COVID-19 , Pandemics , Burnout, Psychological , Cross-Sectional Studies , Female , Health Personnel , Humans , SARS-CoV-2
12.
Children (Basel) ; 8(5)2021 May 17.
Article in English | MEDLINE | ID: covidwho-1234673

ABSTRACT

BACKGROUND: Children experience seasonal variations in growth whereby height increases most in spring and least in autumn, and weight increases least in spring and most in autumn. We hypothesized that activity restriction caused by efforts to contain the spread of coronavirus disease 2019 (COVID-19) would result in increased body mass index (BMI) in children, differing from conventional seasonal growth variations. METHODS: We included 169 children who visited endocrine clinics of three hospitals in Korea at regular intervals under the same conditions for two years. Visit dates were D1 (January, 2019), D2 (July, 2019), D3 (January, 2020) before the COVID-19 outbreak, and D4 (July, 2020) during the pandemic. Differences in the z-score for height (HT), weight (WT), and BMI among time points and between spring seasons (i.e., S1-S3) were compared. RESULTS: There were significant differences in BMIz among time points, which decreased from D1-D2 and increased from D2-D3 and D3-D4. WTz significantly increased from D2-D3 and D3-D4. BMIz values of S1 (spring 2019) and S3 (spring 2020) were -0.05 and 0.16, respectively, showing significant differences. WTz values between S1 and S3 were significantly different (-0.02 vs. 0.13). CONCLUSIONS: In 2019, there were conventional seasonal variations in BMIz, which declined in spring and increased in autumn, while in 2020, BMIz increased even in spring. The COVID-19 pandemic may have affected seasonal variations in the growth of children attending endocrine clinics.

13.
J Korean Med Sci ; 36(19): e134, 2021 May 17.
Article in English | MEDLINE | ID: covidwho-1232535

ABSTRACT

During the three the coronavirus disease 2019 (COVID-19) surges in South Korea, there was a shortage of hospital beds for COVID-19 patients, and as a result, there were cases of death while waiting for hospitalization. To minimize the risk of death and to allow those confirmed with COVID-19 to safely wait for hospitalization at home, the local government of Gyeonggi-do in South Korea developed a novel home management system (HMS). The HMS team, comprised of doctors and nurses, was organized to operate HMS. HMS provided a two-way channel for the taskforce and patients to monitor the severity of patient's condition and to provide healthcare counseling as needed. In addition, the HMS team cooperated with a triage/bed assignment team to expedite the response in case of an emergency, and managed a database of severity for real-time monitoring of patients. The HMS became operational for the first time in August 2020, initially managing only 181 patients; it currently manages a total of 3,707 patients. The HMS supplemented the government's COVID-19 confirmed case management framework by managing patients waiting at home for hospitalization due to lack of hospital and residential treatment center beds. HMS also could contribute a sense of psychological stability in patients and prevented the situation from worsening by efficient management of hospital beds and reduction of workloads on public healthcare centers. To stabilize and improve the management of COVID-19 confirmed cases, governments should organically develop self-treatment and HMS, and implement a decisive division of roles within the local governments.


Subject(s)
COVID-19/therapy , Home Care Services/organization & administration , Home Nursing/organization & administration , Local Government , Pandemics , SARS-CoV-2 , COVID-19/epidemiology , Counseling , Database Management Systems , Databases, Factual , Health Services Needs and Demand , Home Care Services/statistics & numerical data , Home Nursing/statistics & numerical data , Hospital Bed Capacity , Humans , Patient Care Team , Republic of Korea/epidemiology , Self Care , Waiting Lists
14.
Blood Adv ; 5(1): 207-215, 2021 01 12.
Article in English | MEDLINE | ID: covidwho-1035171

ABSTRACT

We aimed to identify predictors of outcomes and survival in patients living in 4 major metropolitan areas who had sickle cell disease (SCD) and COVID-19 to inform best approaches to prevention and care. Data were collected at baseline and during the clinical course in SCD patients diagnosed with COVID-19 in four COVID-19 epicenters. Patients were followed up posthospital discharge for up to 3 months. Of sixty-six SCD patients with COVID-19, fifty patients (75%) required hospitalization, and seven died (10.6%). Patients with preexisting kidney disease (chronic kidney disease) were more likely to be hospitalized. The most common presenting symptom was vaso-occlusive pain. Acute chest syndrome occurred in 30 (60%) of the 50 hospitalized patients and in all who died. Older age and histories of pulmonary hypertension, congestive heart failure, chronic kidney disease, and stroke were more prevalent in patients who died, as were higher creatinine, lactate dehydrogenase, and D-dimer levels. Anticoagulation use while inpatient was twice less common in patients who died. All deaths occurred in individuals not taking hydroxyurea or any other SCD-modifying therapy. Patients with SCD and COVID-19 exhibited a broad range of disease severity. We cannot definitively state that the overall mortality is higher in patients with SCD, although our case fatality rate was ∼10% compared with ∼3% in the general population, despite a median age of 34 years. Individuals with SCD aged >50 years, with preexisting cardiopulmonary, renal disease, and/or stroke not receiving hydroxyurea, who present with high serum creatinine, lactate dehydrogenase, and D-dimer levels, are at higher risk of death, irrespective of genotype or sex.


Subject(s)
Anemia, Sickle Cell/complications , COVID-19/complications , Acute Chest Syndrome/blood , Acute Chest Syndrome/complications , Acute Chest Syndrome/mortality , Acute Chest Syndrome/therapy , Adult , Anemia, Sickle Cell/blood , Anemia, Sickle Cell/mortality , Anemia, Sickle Cell/therapy , Antisickling Agents/therapeutic use , COVID-19/blood , COVID-19/mortality , COVID-19/therapy , Disease Progression , Female , Fibrin Fibrinogen Degradation Products/analysis , Humans , Hydroxyurea/therapeutic use , Male , Risk Factors , SARS-CoV-2/isolation & purification , Young Adult
15.
Int J Equity Health ; 19(1): 198, 2020 11 06.
Article in English | MEDLINE | ID: covidwho-914048

ABSTRACT

While the coronavirus disease 2019 (COVID-19) pandemic is an ongoing worldwide, including South Korea (hereinafter Korea), it is impossible to predict the duration of the pandemic. To stop the spread of COVID-19, "social distancing," which included mandatory lockdown, and attention to personal hygiene are being adopted globally as non-pharmaceutical preventive strategies. In Korea, after maintaining strong social distancing rules for a while, the government transitioned to implementing "distancing in daily life" since May 6, 2020. The distancing in daily life was combined with infection prevention activities to stop the COVID-19 pandemic, while guaranteeing one's daily life and economic activities.In this regard, the Ministry of Health and Welfare in Korea disclosed key rules for personal quarantine. The five key rules for individual infection control are as follows: to stay at home for 3-4 days if you feel unwell, keep a distance of two arms' length from others, to wash your hands for 30 s and cough or sneeze into your sleeves, ventilate at least twice a day and disinfect regularly, and stay connected while physically distancing. However, for vulnerable populations, it is very difficult to follow such rules.Thus, we attempted to recommend how the society could support such vulnerable populations who may face difficulties in following these individual infection control rules. Through our recommendations for the weakest part of our society, we expect to strengthen the overall social structure.


Subject(s)
Coronavirus Infections/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Vulnerable Populations , COVID-19 , Coronavirus Infections/epidemiology , Government , Humans , Hygiene , Pneumonia, Viral/epidemiology , Psychological Distance , Quarantine/legislation & jurisprudence , Republic of Korea/epidemiology
16.
JMIR Res Protoc ; 9(10): e23655, 2020 Oct 27.
Article in English | MEDLINE | ID: covidwho-892417

ABSTRACT

BACKGROUND: Self-help smartphone apps offer a new opportunity to address youth suicide prevention by improving access to support and by providing potentially high fidelity and cost-effective treatment. However, there have been very few smartphone apps providing evidence-based support for suicide prevention in this population. To address this gap, we developed the LifeBuoy app, a self-help smartphone app informed by dialectical behavior therapy (DBT), to help young people manage suicidal thoughts in their daily life. OBJECTIVE: This study describes the protocol for a randomized controlled trial to evaluate the efficacy of the LifeBuoy app for reducing suicidal thoughts and behaviors, depression, anxiety, and psychological distress, and improving general mental well-being in young adults aged 18 to 25 years. METHODS: This is a randomized controlled trial recruiting 378 young adults aged between 18 and 25 years and comparing the LifeBuoy app with a matched attention control (a placebo app with the same display but no DBT components). The primary outcome is suicidal thoughts measured by the Suicidal Ideation Attributes Scale (SIDAS). The secondary outcomes are suicidal behavior, depression, anxiety, psychological distress, and general mental well-being. The changes in the levels of insomnia, rumination, suicide cognitions, distress tolerance, loneliness, and help seeking before and after using the app are evaluated in this study. The study also addresses risk factors and responses to the intervention. A series of items assessing COVID-19 experiences is included in the trial to capture the potential impact of the pandemic on this study. Assessments will occur on the following three occasions: baseline, postintervention, and follow-up at 3 months postintervention. A qualitative interview about user experience with the LifeBuoy app will take place within 4 weeks of the final assessment. Using linear mixed models, the primary analysis will compare the changes in suicidal thoughts in the intervention condition relative to the control condition. To minimize risks, participants will receive a call from the team clinical psychologist by clicking a help button in the app or responding to an automated email sent by the system when they are assessed with elevated suicide risks at the baseline, postintervention, and 3-month follow-up surveys. RESULTS: The trial recruitment started in May 2020. Data collection is currently ongoing. CONCLUSIONS: This is the first trial examining the efficacy of a DBT-informed smartphone app delivered to community-living young adults reporting suicidal thoughts. This trial will extend knowledge about the efficacy and acceptability of app-based support for suicidal thoughts in young people. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12619001671156; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378366. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/23655.

19.
Lancet Child Adolesc Health ; 4(10): 721-727, 2020 10.
Article in English | MEDLINE | ID: covidwho-665359

ABSTRACT

BACKGROUND: The risk of vertical and perinatal transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, which causes COVID-19), the most appropriate management, and the neonate's risk of developing COVID-19 during the perinatal period are unknown. Therefore, we aimed to elucidate best practices regarding infection control in mother-newborn dyads, and identify potential risk factors associated with transmission. METHODS: In this observational cohort study, we identified all neonates born between March 22 and May 17, 2020, at three New York Presbyterian Hospitals in New York City (NY, USA) to mothers positive for SARS-CoV-2 at delivery. Mothers could practice skin-to-skin care and breastfeed in the delivery room, but had to wear a surgical mask when near their neonate and practice proper hand hygiene before skin-to-skin contact, breastfeeding, and routine care. Unless medically required, neonates were kept in a closed Giraffe isolette in the same room as their mothers, and were held by mothers for feeding after appropriate hand hygiene, breast cleansing, and placement of a surgical mask. Neonates were tested for SARS-CoV-2 by use of real-time PCR on nasopharyngeal swabs taken at 24 h, 5-7 days, and 14 days of life, and were clinically evaluated by telemedicine at 1 month of age. We recorded demographics, neonatal, and maternal clinical presentation, as well as infection control practices in the hospital and at home. FINDINGS: Of 1481 deliveries, 116 (8%) mothers tested positive for SARS-CoV-2; 120 neonates were identified. All neonates were tested at 24 h of life and none were positive for SARS-CoV-2. 82 (68%) neonates completed follow-up at day 5-7 of life. Of the 82 neonates, 68 (83%) roomed in with the mothers. All mothers were allowed to breastfeed; at 5-7 days of life, 64 (78%) were still breastfeeding. 79 (96%) of 82 neonates had a repeat PCR at 5-7 days of life, which was negative in all; 72 (88%) neonates were also tested at 14 days of life and none were positive. None of the neonates had symptoms of COVID-19. INTERPRETATION: Our data suggest that perinatal transmission of COVID-19 is unlikely to occur if correct hygiene precautions are undertaken, and that allowing neonates to room in with their mothers and direct breastfeeding are safe procedures when paired with effective parental education of infant protective strategies. FUNDING: None.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Infectious Disease Transmission, Vertical/prevention & control , Pandemics , Pneumonia, Viral/epidemiology , Pregnancy Complications, Infectious/epidemiology , COVID-19 , Coronavirus Infections/transmission , Female , Follow-Up Studies , Humans , Infant, Newborn , Male , Pneumonia, Viral/transmission , Pregnancy , SARS-CoV-2 , United States/epidemiology
20.
Emerg Infect Dis ; 26(10): 2499-2501, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-635163

ABSTRACT

At least 246 cases of coronavirus disease (COVID-19) have been linked to nightclubs in Seoul, South Korea. During the April 30-May 5 holiday, young adults from across the country who visited nightclubs in Seoul contracted COVID-19 and spread it nationally. Nightclubs were temporarily closed to limit COVID-19 spread.


Subject(s)
Contact Tracing/methods , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Betacoronavirus , COVID-19 , Coronavirus Infections/diagnosis , Female , Humans , Incidence , Leisure Activities , Male , Pandemics , Pneumonia, Viral/diagnosis , Prevalence , Republic of Korea/epidemiology , SARS-CoV-2 , Young Adult
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