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1.
Early Intervention in Psychiatry ; 17(Supplement 1):26, 2023.
Article in English | EMBASE | ID: covidwho-20240524

ABSTRACT

Background: During the first months of the COVID-19 pandemic presentations to emergency psychiatric services sharply declined, despite no significant change in the incidence of psychosis. Aim(s): To investigate the impact of COVID-19 on the duration of untreated psychosis (DUP) in a first-episode service. Method(s): Data was collected by the specialized treatment early in psychosis (STEP) clinic to compare the DUP pre vs. early and late pandemic stages. The onset of the pandemic was defined as the 15th of March 2020, based on an analysis of case numbers and the advent of restrictions. Outcome measures were DUP total (the time elapsed between onset of psychosis and enrolment in the STEP clinic), DUP demand (the time from onset of psychosis to first antipsychotic prescription), and DUP supply (the time from first antipsychotic prescription to enrolment into STEP). Result(s): DUP total decreased significantly (p = .008) during the early pandemic compared with pre-pandemic from a median of 208 (IQR, 24-1020.0) to 55.5 days (IQR, 8.0-560.0). During the late pandemic stage, DUP total increased back to a median of 153.5 days (IQR, 1.0- 885.0). DUP demand decreased significantly (p = .001) during the early pandemic compared to pre-pandemic from a median of 117 (IQR, 17.0-714.0) to 35 days (IQR, 2.0-541.0) and then reduced further to 27.5 (IQR, 0.0-690.0) days during the late pandemic. No significant changes were found in DUP supply (p = .24) across the different stages of the pandemic. This is the first study to show a reduction in DUP associated with the pandemic.

2.
Journal of the Royal Statistical Society Series a-Statistics in Society ; 2022.
Article in English | Web of Science | ID: covidwho-2193229
3.
Journal of the Royal Statistical Society Series a-Statistics in Society ; 2022.
Article in English | Web of Science | ID: covidwho-2193219
4.
medrxiv; 2022.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2022.10.25.22281528

ABSTRACT

Recent case reports and epidemiological data suggest fungal infections represent an under-appreciated complication among people with severe COVID-19. However, the frequency of fungal colonization in patients with COVID-19 and associations with specific immune responses in the airways remain incompletely defined. We previously generated a single-cell RNA-sequencing (scRNA-seq) dataset characterizing the upper respiratory microenvironment during COVID-19, and mapped the relationship between disease severity and the local behavior of nasal epithelial cells and infiltrating immune cells. Our study, in agreement with findings from related human cohorts, demonstrated that a profound deficiency in host immunity, particularly in type I and type III interferon signaling in the upper respiratory tract, is associated with rapid progression to severe disease and worse clinical outcomes. We have now performed further analysis of this cohort and identified a subset of participants with severe COVID-19 and concurrent detection of Candida species-derived transcripts within samples collected from the nasopharynx and trachea. Here, we present the clinical characteristics of these individuals, including confirmatory diagnostic testing demonstrating elevated serum (1, 3)-{beta}-D-glucan and/or confirmed fungal culture of the predicted pathogen. Using matched single-cell transcriptomic profiles of these individuals' respiratory mucosa, we identify epithelial immune signatures suggestive of IL-17 stimulation and anti-fungal immunity. Further, we observe significant expression of anti-fungal inflammatory cascades in the nasal and tracheal epithelium of all participants who went on to develop severe COVID-19, even among participants without detectable genetic material from fungal pathogens. Together, our data suggests that IL-17 stimulation - in part driven by Candida colonization - and blunted type I/III interferon signaling represents a common feature of severe COVID-19 infection.


Subject(s)
Mycoses , Graft vs Host Disease , COVID-19 , Colorectal Neoplasms
5.
Ecological Solutions and Evidence ; 2(e12093), 2021.
Article in English | CAB Abstracts | ID: covidwho-1838123

ABSTRACT

Wildlife strongly alter behaviour in response to human disturbance;however, fundamental questions remain regarding the influence of human infrastructure and activity on animal movement. The Covid-19 pandemic created a natural experiment providing an opportunity to evaluate wildlife movement during a period of greatly reduced human activity. Speculation in scientific reviews and the media suggested that wildlife might be increasing movement and colonizing urban landscapes during pandemic slowdowns. However, theory predicts that animals should move and use space as efficiently as possible, suggesting that movement might actually be reduced relative to decreased human activity. The researchers quantified space use, movement, and resource-selection of 12 GPS-collared mountain lions (eight females, four males) occupying parklands in greater Los Angeles during the Spring 2020 California stay-at-home order when human activity was far below normal. The researchers also tested the hypothesis that reduced traffic on Los Angeles area roadways increased permeability of these barriers to animal movement. Contrary to expectations that wildlife roamed more widely during pandemic shutdowns, resident mountain lions used smaller areas and moved shorter distances relative to their historical behaviour in greater Los Angeles. They also relaxed avoidance of anthropogenic landscape features such as trails and development, which likely facilitated increased travelling efficiency. However, there was no detectable change in road-crossing, despite reduced traffic volume. Our results support the theoretical prediction that animals maximize movement efficiency and suggest that carnivores incur energetic costs while avoiding humans. While mountain lions may restrict movement at the landscape level relative to barriers, they appear to increase distances moved at finer scales when avoiding human activity - highlighting the scale-dependent nature of animal responses to human disturbance. Avoiding humans can reduce direct mortality of large carnivores and is often suggested to be an important mechanism promoting coexistence in shared landscapes. However, energetic costs incurred by increased movement and space-use while avoiding human activity may have important consequences for population viability, predator-prey interactions, community structure, and human-wildlife conflict. Management providing sufficient wild prey and education regarding best practices for protection of domestic animals are important for conserving large carnivores in human-dominated landscapes.

6.
Wellcome Open Research ; 6(12), 2021.
Article in English | CAB Abstracts | ID: covidwho-1780278

ABSTRACT

Background: Lateral flow immunoassays (LFIAs) are able to achieve affordable, large scale antibody testing and provide rapid results without the support of central laboratories. As part of the development of the REACT programme extensive evaluation of LFIA performance was undertaken with individuals following natural infection. Here we assess the performance of the selected LFIA to detect antibody responses in individuals who have received at least one dose of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine.

7.
Journal of Policy Analysis and Management ; : 46, 2022.
Article in English | Web of Science | ID: covidwho-1653325

ABSTRACT

Economic crises like the Great Recession and the COVID pandemic prompt government intervention to stabilize homeowners and housing markets. During the Great Recession, the primary intervention was permanent loan modifications, with mixed evidence of success. The COVID pandemic spurred a more targeted but temporary intervention-mortgage payment relief for unemployed homeowners. Little is known about the long-term effectiveness of temporary mortgage assistance for homeowner outcomes. This paper leverages data on the U.S. Department of the Treasury's Hardest Hit Fund (HHF) program to analyze the longer-term effects of temporary mortgage payment subsidies on mortgage default. Our first research design exploits the fact that some states were not eligible to offer an HHF program and that certain Metropolitan Statistical Areas (MSAs) encompass jurisdictions in both HHF and non-HHF states. In a second research design, we model selection into the HHF program directly, exploiting lender variation in program participation as an instrument. Our results indicate that receipt of HHF assistance leads to a 40 percent reduction in the probability of mortgage default and foreclosure through four years post assistance. We estimate heterogeneous effects for different at-risk populations and discuss implications for policy.

8.
Wellcome Open Research ; 5, 2021.
Article in English | Scopus | ID: covidwho-1471171

ABSTRACT

Background: As of August 2021, every region of the world has been affected by the COVID-19 pandemic, with more than 196,000,000 cases worldwide. Methods: We analysed COVID-19 cases among travellers from mainland China to different regions and countries, comparing the region- and country-specific rates of detected and confirmed cases per flight volume to estimate the relative sensitivity of surveillance in different regions and countries. Results: Although travel restrictions from Wuhan City and other cities across China may have reduced the absolute number of travellers to and from China, we estimated that up to 70% (95% CI: 54% - 80%) of imported cases could remain undetected relative to the sensitivity of surveillance in Singapore. The percentage of undetected imported cases rises to 75% (95% CI 66% - 82%) when comparing to the surveillance sensitivity in multiple countries. Conclusions: Our analysis shows that a large number of COVID-19 cases remain undetected across the world. These undetected cases potentially resulted in multiple chains of human-to-human transmission outside mainland China. © 2021 Bhatia S et al.

9.
Wellcome Open Research ; 5:143, 2020.
Article in English | MEDLINE | ID: covidwho-1464042

ABSTRACT

Background: Since the start of the COVID-19 epidemic in late 2019, there have been more than 152 affected regions and countries with over 110,000 confirmed cases outside mainland China.

10.
International Journal of Infectious Diseases ; 101:269-269, 2020.
Article in English | Academic Search Complete | ID: covidwho-1452250

ABSTRACT

B Background: b The epidemics of severe acute respiratory syndrome (SARS) in Hong Kong generates the need to evaluate the effectiveness of control measures. B Methods and materials: b An individual-based mathematical model was developed alongside a resource-constrained contact tracing process for SARS outbreak. B Conclusion: b An improved understanding of the transmission dynamics of the SARS outbreak under different scenarios of contact tracing approach helps design the optimal control strategies with the given resources to control new emerging disease in the future. [Extracted from the article] Copyright of International Journal of Infectious Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

11.
Cell ; 184(18): 4713-4733.e22, 2021 09 02.
Article in English | MEDLINE | ID: covidwho-1343153

ABSTRACT

SARS-CoV-2 infection can cause severe respiratory COVID-19. However, many individuals present with isolated upper respiratory symptoms, suggesting potential to constrain viral pathology to the nasopharynx. Which cells SARS-CoV-2 primarily targets and how infection influences the respiratory epithelium remains incompletely understood. We performed scRNA-seq on nasopharyngeal swabs from 58 healthy and COVID-19 participants. During COVID-19, we observe expansion of secretory, loss of ciliated, and epithelial cell repopulation via deuterosomal cell expansion. In mild and moderate COVID-19, epithelial cells express anti-viral/interferon-responsive genes, while cells in severe COVID-19 have muted anti-viral responses despite equivalent viral loads. SARS-CoV-2 RNA+ host-target cells are highly heterogenous, including developing ciliated, interferon-responsive ciliated, AZGP1high goblet, and KRT13+ "hillock"-like cells, and we identify genes associated with susceptibility, resistance, or infection response. Our study defines protective and detrimental responses to SARS-CoV-2, the direct viral targets of infection, and suggests that failed nasal epithelial anti-viral immunity may underlie and precede severe COVID-19.


Subject(s)
COVID-19/immunology , COVID-19/virology , Immunity , SARS-CoV-2/physiology , Severity of Illness Index , Adult , Aged , Bystander Effect , COVID-19/genetics , Cohort Studies , Female , Humans , Male , Middle Aged , Nasopharynx/pathology , Nasopharynx/virology , RNA, Viral/analysis , RNA, Viral/genetics , Respiratory Mucosa/pathology , Respiratory Mucosa/virology , Transcription, Genetic , Viral Load
13.
Journal of Cardiac Failure ; 26(10):S162, 2020.
Article in English | EMBASE | ID: covidwho-871802

ABSTRACT

Background: The COVID-19 pandemic has necessitated significant alterations in ambulatory heart failure (HF) care, primarily with the introduction of telemedicine. We describe our initial experience caring for patients in the COVID-19 era in the Johns Hopkins Heart Failure Bridge Clinic (JHHFBC), an ambulatory disease management and diuresis clinic aimed at preventing hospitalizations. Methods: The JHHFBC sees about 2500 patients per year with 25% of those patients needing intravenous diuretics in the clinic. Starting March 16, 2020, we implemented a COVID-specific workflow incorporating telemedicine, which the clinic had previously not been utilizing. Patient visit outcomes were adjudicated, including change in diuretic dosing, intravenous diuretic administration, and need for hospitalization. Results: From March 16, 2020 to April 24, 2020 we had 116 patients seen 164 times (Figure 1). The average age of patients was 61 ± 14 years, 50% female, and 70% Black. Average left ventricular ejection fraction was 25 ± 21% with 45% nonischemic cardiomyopathy, 14% ischemic cardiomyopathy, 6% amyloid, 35% had heart failure with preserved ejection fraction. The majority of patients were New York Heart Association (NYHA) class II or III (109, 94%). Reasons for clinic referral included an equal frequency of post hospital discharge, worsening HF symptoms and routine follow up. Of the 96 telemedicine visits, 23% resulted in oral diuretic dose adjustment and 6 patients were referred for in-person visits. Of the 68 in-person visits, 34 (50%) resulted in intravenous diuretic administration in clinic, with 8 referrals to the emergency department or for direct admission. There were 2 referrals for cardioversion and 3 referrals to hospice by the clinic. Two of 16 clinic patients that were tested for Covid 19 were positive. Conclusion: We found that HF patients could be effectively managed via telemedicine, however a subset still benefit from in-person assessment and access to ambulatory intravenous diuresis to avoid hospitalization. We hope these initial experiences will lend insights to optimization of future outpatient HF care, including the use of telemedicine, even after the current global health emergency.

14.
Computational and Structural Biotechnology Journal ; (2001-0370 (Electronic))2020.
Article in English | PMC | ID: covidwho-849196

ABSTRACT

The emergence and reemergence of coronavirus epidemics sparked renewed concerns from global epidemiology researchers and public health administrators. Mathematical models that represented how contact tracing and follow-up may control Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS) transmissions were developed for evaluating different infection control interventions, estimating likely number of infections as well as facilitating understanding of their likely epidemiology. We reviewed mathematical models for contact tracing and follow-up control measures of SARS and MERS transmission. Model characteristics, epidemiological parameters and intervention parameters used in the mathematical models from seven studies were summarized. A major concern identified in future epidemics is whether public health administrators can collect all the required data for building epidemiological models in a short period of time during the early phase of an outbreak. Also, currently available models do not explicitly model constrained resources. We urge for closed-loop communication between public health administrators and modelling researchers to come up with guidelines to delineate the collection of the required data in the midst of an outbreak and the inclusion of additional logistical details in future similar models. FAU - Kwok, Kin On

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