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1.
Public Health Nurs ; 2022 Oct 27.
Article in English | MEDLINE | ID: covidwho-2239128

ABSTRACT

OBJECTIVES: Vaccine hesitancy is one of the top 10 threats to world health. The ongoing pandemic highlighted this health threat. The COVID-19 vaccine hesitancy remains underreported in the Philippines. Thus, this study aimed to describe and analyze the comments of Filipinos in TikTok videos about COVID-19 vaccine hesitancy. DESIGN: Manifest content analysis. SAMPLE: A total of 25 TikTok videos and their comments (n = 4564) were analyzed. METHODS: We collected data between July 2021 and October 2021. Bengtsson's approach to content analysis was utilized to analyze the data. Data were validated using member-checking and intercoder reliability. RESULTS: This study afforded three themes of COVID-19 vaccine hesitancy: (a) fear and mistrust (subthemes: influence of Dengvaxia vaccine, the influence of people who refuse to be vaccinated, lack of trust in the government, lack of trust in healthcare workers, doubts on vaccines' effectiveness), (b) misinformation and disinformation (subthemes: misbeliefs, insufficient knowledge), and (c) adamant attitudes (subthemes: unwillingness to be vaccinated, picky on vaccine brand). CONCLUSION: Our study established Filipinos' diverse reasons for COVID-19 vaccine hesitancy. TikTok, as a social media platform, is used for COVID-19 vaccine discussions and the dissemination of misinformation. To prepare for the next pandemic or public health disaster, the government, HCWs, and the public must efficiently convey timely, accurate health information and dispel misinformation on social media platforms.

2.
JAMA Netw Open ; 6(2): e2255965, 2023 02 01.
Article in English | MEDLINE | ID: covidwho-2242423

ABSTRACT

This cohort study compares the risk of new-onset hypertension, hyperlipidemia, and diabetes before and after COVID-19 infection among patients who were vaccinated vs unvaccinated before infection.


Subject(s)
COVID-19 Vaccines , COVID-19 , Diabetes Mellitus , Humans , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Diabetes Mellitus/epidemiology , Vaccination
3.
J Infect Dis ; 227(4): 533-542, 2023 02 14.
Article in English | MEDLINE | ID: covidwho-2244138

ABSTRACT

BACKGROUND: Evidence is accumulating of coronavirus disease 2019 (COVID-19) vaccine effectiveness among persons with prior severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. METHODS: We evaluated the effect against incident SARS-CoV-2 infection of (1) prior infection without vaccination, (2) vaccination (2 doses of Pfizer-BioNTech COVID-19 vaccine) without prior infection, and (3) vaccination after prior infection, all compared with unvaccinated persons without prior infection. We included long-term care facility staff in New York City aged <65 years with weekly SARS-CoV-2 testing from 21 January to 5 June 2021. Test results were obtained from state-mandated laboratory reporting. Vaccination status was obtained from the Citywide Immunization Registry. Cox proportional hazards models adjusted for confounding with inverse probability of treatment weights. RESULTS: Compared with unvaccinated persons without prior infection, incident SARS-CoV-2 infection risk was lower in all groups: 54.6% (95% confidence interval, 38.0%-66.8%) lower among unvaccinated, previously infected persons; 80.0% (67.6%-87.7%) lower among fully vaccinated persons without prior infection; and 82.4% (70.8%-89.3%) lower among persons fully vaccinated after prior infection. CONCLUSIONS: Two doses of Pfizer-BioNTech COVID-19 vaccine reduced SARS-CoV-2 infection risk by ≥80% and, for those with prior infection, increased protection from prior infection alone. These findings support recommendations that all eligible persons, regardless of prior infection, be vaccinated against COVID-19.


Subject(s)
COVID-19 Vaccines , COVID-19 , Humans , COVID-19/epidemiology , COVID-19/prevention & control , BNT162 Vaccine , COVID-19 Testing , Long-Term Care , New York City/epidemiology , SARS-CoV-2 , Nursing Homes
4.
J Med Virol ; 2022 Sep 29.
Article in English | MEDLINE | ID: covidwho-2237294

ABSTRACT

The COVID-19 pandemic has had a detrimental impact on the healthcare system. Our study armed to assess the extent and the disparity in excess acute myocardial infarction (AMI)-associated mortality during the pandemic, through the recent Omicron outbreak. Using data from the CDC's National Vital Statistics System, we identified 1 522 669 AMI-associated deaths occurring between 4/1/2012 and 3/31/2022. Accounting for seasonality, we compared age-standardized mortality rate (ASMR) for AMI-associated deaths between prepandemic and pandemic periods, including observed versus predicted ASMR, and examined temporal trends by demographic groups and region. Before the pandemic, AMI-associated mortality rates decreased across all subgroups. These trends reversed during the pandemic, with significant rises seen for the youngest-aged females and males even through the most recent period of the Omicron surge (10/2021-3/2022). The SAPC in the youngest and middle-age group in AMI-associated mortality increased by 5.3% (95% confidence interval [CI]: 1.6%-9.1%) and 3.4% (95% CI: 0.1%-6.8%), respectively. The excess death, defined as the difference between the observed and the predicted mortality rates, was most pronounced for the youngest (25-44 years) aged decedents, ranging from 23% to 34% for the youngest compared to 13%-18% for the oldest age groups. The trend of mortality suggests that age and sex disparities have persisted even through the recent Omicron surge, with excess AMI-associated mortality being most pronounced in younger-aged adults.

5.
Teach Learn Nurs ; 2022 Aug 19.
Article in English | MEDLINE | ID: covidwho-2228075

ABSTRACT

Introduction: : This study examined Filipino nursing students' use of household materials as low-cost simulators and how they aid in online return demonstrations. Methods: : Summative content analysis guided this study. We collected uploaded YouTube videos (n=14) depicting Filipino nursing students using low-cost simulators in their skills demonstration. We used Bengtsson's approach to content analysis to analyze the data. Findings: : Four themes of low-cost simulators were identified: home and hardware, health and beauty, creative articles, and entertainment. The categories under home and hardware were tools, containers, furniture, and packaging. Health and beauty low-cost simulators were toiletries and medical supplies. Creative articles included fabrics, clothing accessories, and stationeries. Entertainment low-cost-simulators had toys and computer accessories. Discussion: : During the COVID-19 pandemic, our research uncovered home equipment employed as low-cost simulators to help nursing students' online simulation of skills demonstration. We recommend further investigation of whether students learned using low-cost simulators.

6.
Int J Environ Res Public Health ; 20(4)2023 Feb 08.
Article in English | MEDLINE | ID: covidwho-2234113

ABSTRACT

Frontline clinicians responding to the COVID-19 pandemic are at increased risk of burnout, but less is known about the trajectory of clinician burnout as caseloads increase and decrease. Personal and professional resources, including self-efficacy and hospital support, can attenuate the risk of burnout. Yet, empirical data documenting how burnout and resources changed as the pandemic waxed and waned are limited. This intensive longitudinal prospective study employed ecological momentary assessment methods to examine trajectories of burnout and resources over the pandemic's first year in a New York City hospital. A 10-item survey was emailed every 5 days to frontline clinicians (physicians, nurses, and physician assistants). The primary outcome was a single-item validated measure of burnout; predictors included daily hospital COVID-19-related caseloads and personal and professional resources. Clinicians (n = 398) completed the initial survey and an average of 12 surveys over the year. Initially, 45.3% of staff reported burnout; over the year, 58.7% reported burnout. Following the initial COVID peak, caseloads declined, and burnout levels declined. During the second wave of COVID, as caseloads increased and remained elevated and personal and professional resource levels decreased, burnout increased. This novel application of intensive longitudinal assessment enabled ongoing surveillance of burnout and permitted us to evaluate how fluctuations in caseload intensity and personal and professional resources related to burnout over time. The surveillance data support the need for intensified resource allocation during prolonged pandemics.


Subject(s)
Burnout, Professional , COVID-19 , Humans , Pandemics , Prospective Studies , Burnout, Psychological , Ecological Momentary Assessment , Surveys and Questionnaires
7.
JCI Insight ; 8(3)2023 02 08.
Article in English | MEDLINE | ID: covidwho-2229935

ABSTRACT

The widespread presence of autoantibodies in acute infection with SARS-CoV-2 is increasingly recognized, but the prevalence of autoantibodies in non-SARS-CoV-2 infections and critical illness has not yet been reported. We profiled IgG autoantibodies in 267 patients from 5 independent cohorts with non-SARS-CoV-2 viral, bacterial, and noninfectious critical illness. Serum samples were screened using Luminex arrays that included 58 cytokines and 55 autoantigens, many of which are associated with connective tissue diseases (CTDs). Samples positive for anti-cytokine antibodies were tested for receptor blocking activity using cell-based functional assays. Anti-cytokine antibodies were identified in > 50% of patients across all 5 acutely ill cohorts. In critically ill patients, anti-cytokine antibodies were far more common in infected versus uninfected patients. In cell-based functional assays, 11 of 39 samples positive for select anti-cytokine antibodies displayed receptor blocking activity against surface receptors for Type I IFN, GM-CSF, and IL-6. Autoantibodies against CTD-associated autoantigens were also commonly observed, including newly detected antibodies that emerged in longitudinal samples. These findings demonstrate that anti-cytokine and autoantibodies are common across different viral and nonviral infections and range in severity of illness.


Subject(s)
Autoantibodies , COVID-19 , Humans , Autoantigens , Critical Illness , Cytokines , SARS-CoV-2
8.
J Am Med Dir Assoc ; 2022 Dec 22.
Article in English | MEDLINE | ID: covidwho-2210648

ABSTRACT

OBJECTIVES: To examine the prevalence of coping behaviors during the first 2 waves of the COVID-19 pandemic among caregivers of assisted living residents and variation in these behaviors by caregiver gender and mental health. DESIGN: Cross-sectional and longitudinal survey. SETTING AND PARTICIPANTS: Family/friend caregivers of assisted living residents in Alberta and British Columbia. METHODS: A web-based survey, conducted twice (October 28, 2020 to March 31, 2021 and July 12, 2021 to September 7, 2021) on the same cohort obtained data on caregiver sociodemographic characteristics, anxiety and depressive symptoms, and coping behaviors [seeking counselling, starting a psychotropic drug (sedative, anxiolytic, antidepressant), starting or increasing alcohol, tobacco and/or cannabis consumption] during pandemic waves 1 and 2. Descriptive analyses and multivariable (modified) Poisson regression models identified caregiver correlates of each coping behavior. RESULTS: Among the 673 caregivers surveyed at baseline, most were women (77%), White (90%) and age ≥55 years (81%). Alcohol (16.5%) and psychotropic drug (13.3%) use were the most prevalent coping behaviors reported during the initial wave, followed by smoking and/or cannabis use (8.0%), and counseling (7.4%). Among the longitudinal sample (n = 386), only alcohol use showed a significantly lower prevalence during the second wave (11.7% vs 15.1%, P = .02). During both waves, coping behaviors did not vary significantly by gender, however, psychotropic drug and substance use were significantly more prevalent among caregivers with baseline anxiety and depressive symptoms, including in models adjusted for confounders [eg, anxiety: adjusted risk ratio = 3.87 (95% CI 2.50-6.00] for psychotropic use, 1.87 (1.28-2.73) for alcohol use, 2.21 (1.26-3.88) for smoking/cannabis use). CONCLUSIONS AND IMPLICATIONS: Assisted living caregivers experiencing anxiety or depressive symptoms during the pandemic were more likely to engage in drug and substance use, potentially maladaptive responses. Public health and assisted living home initiatives that identify caregiver mental health needs and provide targeted support during crises are required to mitigate declines in their health.

11.
J Opioid Manag ; 18(6): 523-528, 2022.
Article in English | MEDLINE | ID: covidwho-2202522

ABSTRACT

BACKGROUND: There are limited studies regarding the effects of COVID-19 in patients with a concurrent diagnosis of opioid use disorder (OUD). Due to the rapidly developing nature and consequences of this disease, it is important to identify patients at an increased risk for serious illness. The aim of this study was to identify whether COVID-19 patients with OUD are at an increased risk of hospitalization and other adverse outcomes. METHODS: This retrospective chart review compared clinical parameters from patients with positive COVID-19 status as identified by a positive SARS-CoV-2 PCR test and diagnosed OUD at the University of Utah Health. The primary outcome variables were hospitalization for COVID-19, length of hospital stay, and the presence of comorbidities in the OUD patient population. Descriptive statistics and prevalence ratios (PRs) were generated. Log binomial models generated PRs adjusted by age, sex, and race, and comorbidities of asthma, pneumonia, hypertension, cardiovascular disease, and diabetes. RESULTS: COVID-19 patients with OUD were significantly more likely than patients without OUD to have asthma (p < 0.01), diabetes (p < 0.01), hypertension (p < 0.01), cardiovascular disease (p < 0.01), and chronic pneumonia (p < 0.01), and to be hospitalized (27.9 percent vs 3.6 percent; p < 0.01), admitted to the intensive care unit (11.5 percent vs 1.5 percent; p < 0.01), and receive mechanical ventilation (30.5 percent vs 0.1 percent; p < 0.01). After adjusting for age, sex, race, asthma, pneumonia, cardiovascular disease, hypertension, and diabetes, patients with OUD continued to be at increased risk for inpatient hospitalization (aPR = 4.27, 95 percent confidence interval [CI] = 1.66-10.94). Patients with OUD also averaged longer stays in the hospital than those without OUD (9.53 days vs 0.70 days, p < 0.001). CONCLUSION: Patients with a diagnosis of OUD in the presence of COVID-19 are more likely to be hospitalized, have underlying health issues, and have longer hospital inpatient stays compared to patients without OUD.


Subject(s)
Asthma , COVID-19 , Cardiovascular Diseases , Diabetes Mellitus , Hypertension , Opioid-Related Disorders , Humans , SARS-CoV-2 , Retrospective Studies , Analgesics, Opioid/adverse effects , Opioid-Related Disorders/diagnosis , Opioid-Related Disorders/epidemiology , Opioid-Related Disorders/therapy , Hospitalization , Diabetes Mellitus/epidemiology , Hypertension/epidemiology
13.
Clin Immunol ; 246: 109209, 2023 01.
Article in English | MEDLINE | ID: covidwho-2158591

ABSTRACT

Children infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) develop less severe coronavirus disease 2019 (COVID-19) than adults. The mechanisms for the age-specific differences and the implications for infection-induced immunity are beginning to be uncovered. We show by longitudinal multimodal analysis that SARS-CoV-2 leaves a small footprint in the circulating T cell compartment in children with mild/asymptomatic COVID-19 compared to adult household contacts with the same disease severity who had more evidence of systemic T cell interferon activation, cytotoxicity and exhaustion. Children harbored diverse polyclonal SARS-CoV-2-specific naïve T cells whereas adults harbored clonally expanded SARS-CoV-2-specific memory T cells. A novel population of naïve interferon-activated T cells is expanded in acute COVID-19 and is recruited into the memory compartment during convalescence in adults but not children. This was associated with the development of robust CD4+ memory T cell responses in adults but not children. These data suggest that rapid clearance of SARS-CoV-2 in children may compromise their cellular immunity and ability to resist reinfection.


Subject(s)
COVID-19 , Humans , Adult , SARS-CoV-2 , CD4-Positive T-Lymphocytes , Immunity, Cellular , Lymphocyte Activation , Antibodies, Viral
14.
Nat Commun ; 13(1): 7762, 2022 12 15.
Article in English | MEDLINE | ID: covidwho-2160212

ABSTRACT

Type-III CRISPR-Cas systems have recently been adopted for sequence-specific detection of SARS-CoV-2. Here, we repurpose the type III-A CRISPR complex from Thermus thermophilus (TtCsm) for programmable capture and concentration of specific RNAs from complex mixtures. The target bound TtCsm complex generates two cyclic oligoadenylates (i.e., cA3 and cA4) that allosterically activate ancillary nucleases. We show that both Can1 and Can2 nucleases cleave single-stranded RNA, single-stranded DNA, and double-stranded DNA in the presence of cA4. We integrate the Can2 nuclease with type III-A RNA capture and concentration for direct detection of SARS-CoV-2 RNA in nasopharyngeal swabs with 15 fM sensitivity. Collectively, this work demonstrates how type-III CRISPR-based RNA capture and concentration simultaneously increases sensitivity, limits time to result, lowers cost of the assay, eliminates solvents used for RNA extraction, and reduces sample handling.


Subject(s)
COVID-19 , CRISPR-Cas Systems , RNA, Viral , Humans , COVID-19/diagnosis , DNA , Endonucleases/metabolism , RNA, Viral/isolation & purification , SARS-CoV-2 , Thermus thermophilus
15.
Nurs Health Sci ; 2022 Nov 29.
Article in English | MEDLINE | ID: covidwho-2137124

ABSTRACT

This study investigated the compliance and adherence of nurses, midwives, and nursing assistants to standard precautions (SPs). A cross-sectional design while adhering to STROBE guidelines was used for this study. Nursing staff (nurses, nursing assistants, and midwives) from a government tertiary hospital (n=515) were recruited and completed the Compliance with Standard Precautions Scale (CSPS) and Factors Influencing Adherence to Standard Precautions Scale (FIASPS). Analysis of variance (ANOVA), Pearson correlation, and linear regression analysis were used to analyze the data. The overall average compliance with the SPs of the nursing staff was suboptimal, and the disposal of sharps domain had the lowest compliance. Nurses are more compliant with sharps disposal than nursing assistants with waste disposal. Contextual cues were the most influential aspect of participants' adherence to SPs. All CSPS domains were significantly correlated with the contextual cues factor of FIASPS. Finally, service years and educational attainment were significant predictors of SPs adherence. The findings underscore the organization's critical responsibility to actively enforce policies using monitoring systems and contextual cues in the workplace to ensure staff compliance and adherence with SPs.

16.
American Politics Research ; : 1, 2022.
Article in English | Academic Search Complete | ID: covidwho-2112995

ABSTRACT

Conspiracy theories and misinformation (CTM) became a salient feature of the Trump era. However, traditional explanations of political attitudes and behaviors inadequately account for beliefs in CTM or the deleterious behaviors they are associated with. Here, we integrate disparate literatures to explain beliefs in CTM regarding COVID-19, QAnon, and voter fraud. We aim to provide a more holistic accounting, and to determine which political, psychological, and social factors are most associated with such beliefs. Using a unique national survey, we find that anti-social personality traits, anti-establishment orientations, and support for Donald Trump are more strongly related to beliefs in CTM than traditional left-right orientations or other frequently posited factors, such as education, science literacy, and social media use. Our findings encourage researchers to move beyond the traditional correlates of political behavior when examining beliefs that express anti-social tendencies or a deep skepticism of social and political institutions. [ FROM AUTHOR]

17.
Am J Respir Crit Care Med ; 205(12): 1403-1418, 2022 06 15.
Article in English | MEDLINE | ID: covidwho-2098104

ABSTRACT

Rationale: Lymphopenia is common in severe coronavirus disease (COVID-19), yet the immune mechanisms are poorly understood. As inflammatory cytokines are increased in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, we hypothesized a role in contributing to reduced T-cell numbers. Objectives: We sought to characterize the functional SARS-CoV-2 T-cell responses in patients with severe versus recovered, mild COVID-19 to determine whether differences were detectable. Methods: Using flow cytometry and single-cell RNA sequence analyses, we assessed SARS-CoV-2-specific responses in our cohort. Measurements and Main Results: In 148 patients with severe COVID-19, we found lymphopenia was associated with worse survival. CD4+ lymphopenia predominated, with lower CD4+/CD8+ ratios in severe COVID-19 compared with patients with mild disease (P < 0.0001). In severe disease, immunodominant CD4+ T-cell responses to Spike-1 (S1) produced increased in vitro TNF-α (tumor necrosis factor-α) but demonstrated impaired S1-specific proliferation and increased susceptibility to activation-induced cell death after antigen exposure. CD4+TNF-α+ T-cell responses inversely correlated with absolute CD4+ counts from patients with severe COVID-19 (n = 76; R = -0.797; P < 0.0001). In vitro TNF-α blockade, including infliximab or anti-TNF receptor 1 antibodies, strikingly rescued S1-specific CD4+ T-cell proliferation and abrogated S1-specific activation-induced cell death in peripheral blood mononuclear cells from patients with severe COVID-19 (P < 0.001). Single-cell RNA sequencing demonstrated marked downregulation of type-1 cytokines and NFκB signaling in S1-stimulated CD4+ cells with infliximab treatment. We also evaluated BAL and lung explant CD4+ T cells recovered from patients with severe COVID-19 and observed that lung T cells produced higher TNF-α compared with peripheral blood mononuclear cells. Conclusions: Together, our findings show CD4+ dysfunction in severe COVID-19 is TNF-α/TNF receptor 1-dependent through immune mechanisms that may contribute to lymphopenia. TNF-α blockade may be beneficial in severe COVID-19.


Subject(s)
COVID-19 , Lymphopenia , CD4-Positive T-Lymphocytes , CD8-Positive T-Lymphocytes , Cytokines , Humans , Infliximab , Leukocytes, Mononuclear , Receptors, Tumor Necrosis Factor , SARS-CoV-2 , Tumor Necrosis Factor Inhibitors , Tumor Necrosis Factor-alpha
18.
Economía ; 45(89):52-72, 2022.
Article in English | ProQuest Central | ID: covidwho-2091243

ABSTRACT

This paper finds strong support for a Phillips curve that becomes nonlinear when inflation is "low"-which our baseline model defines as less than 3 percent. The nonlinear curve is steep when output is above potential (slack is negative) but flat when output is below potential (slack is positive) so that further increases in economic slack have little effect on inflation. This finding is consistent with evidence of downward nominal wage and price rigidity. When inflation is high, the Phillips curve is linear and relatively steep. These results are robust to placing the threshold between the high and low inflation regimes at 2, 3, or 4 percent inflation or for a threshold based on country-specific medians of inflation. In this nonlinear model, international factors play a large role in explaining headline inflation (albeit less so for core inflation), a role that has been increasing since the global financial crisis. These results provide evidence of channels which could boost inflation in the future, even if they were dormant before the Covid pandemic.

19.
Biol Methods Protoc ; 7(1): bpac022, 2022.
Article in English | MEDLINE | ID: covidwho-2051304

ABSTRACT

Building realistically complex models of infectious disease transmission that are relevant for informing public health is conceptually challenging and requires knowledge of coding architecture that can implement key modeling conventions. For example, many of the models built to understand COVID-19 dynamics have included stochasticity, transmission dynamics that change throughout the epidemic due to changes in host behavior or public health interventions, and spatial structures that account for important spatio-temporal heterogeneities. Here we introduce an R package, SPARSEMODr, that allows users to simulate disease models that are stochastic and spatially explicit, including a model for COVID-19 that was useful in the early phases of the epidemic. SPARSEMOD stands for SPAtial Resolution-SEnsitive Models of Outbreak Dynamics, and our goal is to demonstrate particular conventions for rapidly simulating the dynamics of more complex, spatial models of infectious disease. In this report, we outline the features and workflows of our software package that allow for user-customized simulations. We believe the example models provided in our package will be useful in educational settings, as the coding conventions are adaptable, and will help new modelers to better understand important assumptions that were built into sophisticated COVID-19 models.

20.
iScience ; 25(10): 105209, 2022 Oct 21.
Article in English | MEDLINE | ID: covidwho-2041845

ABSTRACT

SARS-CoV-2 vaccines have unquestionably blunted the overall impact of the COVID-19 pandemic, but host factors such as age, sex, obesity, and other co-morbidities can affect vaccine efficacy. We identified individuals in a relatively healthy population of healthcare workers (CORALE study cohort) who had unexpectedly low peak anti-spike receptor binding domain (S-RBD) antibody levels after receiving the BNT162b2 vaccine. Compared to matched controls, "low responders" had fewer spike-specific antibody-producing B cells after the second and third/booster doses. Moreover, their spike-specific T cell receptor (TCR) repertoire had less depth and their CD4+ and CD8+T cell responses to spike peptide stimulation were less robust. Single cell transcriptomic evaluation of peripheral blood mononuclear cells revealed activation of aging pathways in low responder B and CD4+T cells that could underlie their attenuated anti-S-RBD antibody production. Premature lymphocyte aging may therefore contribute to a less effective humoral response and could reduce vaccination efficacy.

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