Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 15 de 15
Filter
1.
Zhonghua Yu Fang Yi Xue Za Zhi ; 56(10): 1395-1400, 2022 Oct 06.
Article in Chinese | MEDLINE | ID: covidwho-2090421

ABSTRACT

In the context of the global pandemic of COVID-19, the epidemic intensity, epidemic characteristics and infection risk of influenza have presented new features. COVID-19 and influenza have simultaneously emerged in many regions of the world. COVID-19 and influenza are similar in terms of transmission mode, clinical symptoms and other aspects. There are also similarities in the mechanism of influenza virus and novel coronavirus on cells. At the same time, it is feasible and significant to do a good job in the prevention and control of COVID-19 and influenza. This paper discusses the relevant strategies and measures for the joint prevention and control of influenza and novel coronavirus from the aspects of influenza vaccination to prevent co-infection, simultaneous vaccination of influenza vaccine and novel coronavirus vaccine, etc., and puts forward corresponding thoughts and suggestions, in order to provide scientific support for the formulation of strategies on seasonal influenza vaccine and novel coronavirus vaccination.


Subject(s)
COVID-19 , Influenza Vaccines , Influenza, Human , Humans , Influenza, Human/prevention & control , Influenza, Human/epidemiology , COVID-19 Vaccines , COVID-19/prevention & control , Seasons , Vaccination , SARS-CoV-2
2.
International Journal of Radiation Oncology, Biology, Physics ; 114(3):e439-e440, 2022.
Article in English | Academic Search Complete | ID: covidwho-2036113

ABSTRACT

Radiation therapy has an increasing role in the management of patients with metastatic cancer. The integration of ablative versus palliative techniques with surgical and systemic approaches is complex, and inefficient care delivery can lead to prolonged hospitalizations that are inconsistent with palliative goals. A dedicated Inpatient Radiation Oncology Consult (IROC) service was created to provide rapid access to palliative radiotherapy. We previously reported the short-term impact of the IROC service in reducing hospital length of stay (LOS), and here we provide an update on long-term improvements in patient care, focusing on quality-of-care metrics including hospital LOS, use of hypofractionated approaches, and prognosis-appropriate care. We retrospectively compared inpatient radiation oncology consults placed in the 12 months preceding IROC (N = 1,507) to those placed during a 12-month period after IROC implementation (N = 1,509). The dates for calendar-matched cohorts were selected to minimize potential confounding from practice changes related to the first peak of the COVID-19 pandemic. We analyzed continuous variables using the Mann-Whitney test and categorical variables using the Fisher's exact test. The IROC service was associated with reduced hospital length of stay for all consults (mean difference 1.0 day, P = 0.045). IROC led to shorter inpatient radiotherapy courses (mean 5.8 vs. 5.0 days, P = 0.007, and this reduction was greatest for patients discharged to hospice (mean 5.2 vs. 3.7 days, P = 0.033). Compared to pre-IROC patients, IROC patients were more likely to receive hypofractionated treatment (≤ 5 fractions;pre-IROC, N = 405/551 (74%) vs. IROC, N = 433/528 (82%), P = 0.001). Notably, the trend toward fewer prescribed fractions was not due to increased uptake of inpatient stereotactic regimens (N = 84/551 (15%) vs. N = 87/528 (16%), pre-IROC vs. IROC, respectively, P = 0.560). Death within 60 days of inpatient radiation therapy decreased under IROC (pre-IROC, N = 227/551 (41%) vs. IROC, N = 184/528 (35%), P = 0.033). A dedicated inpatient radiation oncology consult (IROC) service was associated with long-term reductions in hospital length of stay. Prognosis-appropriate care was improved through shorter treatment courses and decreased delivery of radiation to patients discharged to hospice or with limited survival. Our findings demonstrate the value of a dedicated program addressing the appropriate delivery of radiotherapy to hospitalized patients and highlight opportunities to stratify patients appropriate for ablative versus palliative treatments. [ FROM AUTHOR] Copyright of International Journal of Radiation Oncology, Biology, Physics is the property of Pergamon Press - An Imprint of Elsevier Science 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 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 . (Copyright applies to all s.)

3.
Radiotherapy and Oncology ; 170:S629, 2022.
Article in English | EMBASE | ID: covidwho-1967461

ABSTRACT

Purpose or Objective Radiation therapy has an expanding role in the management of patients with advanced cancers, including in the palliative and oligometastatic settings. We previously described an inpatient radiation oncology consult (IROC) service created to deliver rapid, specialized metastatic cancer care to hospitalized patients. Here we report an 18-month update on IROC patient outcomes to test the hypothesis that IROC decreased hospital length of stay (LOS) and led to more prognosis-appropriate care, including during the first peak of the COVID-19 pandemic. Materials and Methods The IROC service started in January 2020 and comprises faculty, advanced practice providers, nurses and resident trainees. Faculty are specialists in palliative and metastatic cancer care with certification in ablative radiation techniques. We compared inpatient radiation oncology consults placed from January to December 2019 (pre-IROC, N = 1,507) to those placed from June 2020 to June 2021 (IROC, N = 1,509). In a separate analysis, we examined consults during a non-overlapping period from March to June 2020 (N = 302) to assess changes in IROC practice patterns related to the peak of the COVID-19 pandemic in New York City. Statistical significance was assessed using the Mann-Whitney test. Results Hospital LOS decreased among all inpatient radiation oncology consult patients after implementation of IROC (N = 1,509 patients) by an average of 1.0 day compared to patients treated prior to IROC (N = 1,507 patients;P = 0.045). With IROC, consults were staffed an average of 0.6 days sooner (P < 0.001). Death within 60 days of inpatient RT decreased under IROC (35.4%, N = 187/528 patients) compared to prior (43.7%, N =241/551 patients, P = 0.005). Among patients discharged to hospice, inpatient treatment duration decreased after IROC (median 4 vs. 2 days, pre-IROC (N = 64 patients) vs. IROC (N = 82 patients), respectively, P = 0.033). The IROC service received consults for 21 patients infected with SARS-CoV-2, and 17 patients had active COVID-19 during treatment. Notably, hospital LOS for patients receiving inpatient RT under IROC was significantly shorter during the COVID-19 peak (median LOS 9 days, P < 0.001), when time to treatment decreased by an (Figure Presented) Conclusion A dedicated inpatient radiation oncology consult (IROC) service was associated reduced hospital LOS, faster care delivery, and more prognosis-appropriate care. It enabled rapid implementation of emergency RT guidelines, including abbreviated treatment durations, during the first COVID-19 peak in a pandemic hotspot

4.
Gastroenterology ; 162(7):S-675-S-676, 2022.
Article in English | EMBASE | ID: covidwho-1967359

ABSTRACT

Background: Vaccination against SARS-CoV-2 is a highly effective strategy to protect against infection, which is predominantly mediated by vaccine-induced antibodies. Postvaccination antibodies are robustly produced by those with inflammatory bowel disease (IBD) even on immune-modifying therapies but are blunted by anti-TNF therapy. In contrast, T-cell response which primarily determines long-term efficacy against disease progression, , is less well understood. We aimed to assess the post-vaccination T-cell response and its relationship to antibody responses in patients with inflammatory bowel disease (IBD) on immunemodifying therapies. Methods: We evaluated IBD patients who completed SARS-CoV-2 vaccination using samples collected at four time points (dose 1, dose 2, 2 weeks after dose 2, 8 weeks after dose 2). T-cell clonal analysis was performed by T-cell Receptor (TCR) immunosequencing. The breadth (number of unique sequences to a given protein) and depth (relative abundance of all the unique sequences to a given protein) of the T-cell clonal response were quantified using reference datasets and were compared to antibody responses. Results: Overall, 303 subjects were included (55% female;5% with prior COVID) (Table). 53% received BNT262b (Pfizer), 42% mRNA-1273 (Moderna) and 5% Ad26CoV2 (J&J). The Spike-specific clonal response peaked 2 weeks after completion of the vaccine regimen (3- and 5-fold for breadth and depth, respectively);no changes were seen for non-Spike clones, suggesting vaccine specificity. Reduced T-cell clonal depth was associated with chronologic age, male sex, and immunomodulator treatment, and was preserved by nonanti- TNF biologic therapies;augmented clonal depth was associated with anti-TNF treatment (Figure). TCR depth and breadth were associated with vaccine type;after adjusting for age and gender, Ad26CoV2 (J&J) exhibited weaker metrics than mRNA-1273 (Moderna) (p= 0.01 for each) or BNT262b (Pfizer) (p=0.056 for depth). Antibody and T-cell responses were only modestly correlated;while those with robust humoral responses also had robust TCR clonal expansion, a substantial fraction of patients with high antibody levels had only a minimal T-cell clonal response (Figure). Conclusion: Age, sex and select immunotherapies are associated with the T-cell clonal response to SARS-CoV-2 vaccines, and T-cell responses are low in many patients despite high antibody levels. These factors, as well as differences seen by vaccine type may help guide reimmunization vaccine strategy in immune-impaired populations. Further study of the effects of anti-TNF therapy on vaccine responses are warranted. (Table Presented)

5.
Gastroenterology ; 162(7):S-279, 2022.
Article in English | EMBASE | ID: covidwho-1967266

ABSTRACT

BACKGROUND: In response to COVID-19 vaccination, cytotoxic and cytokine effector T cell immune responses are elicited in the T-cell compartment, based on recognition of epitopes presented by Class I or Class II MHC molecules, respectively. The levels of these distinct T-cell responses may have significant implications for immunization strategies and risk assessment. Knowledge of these two responses after vaccination is still largely unknown, especially in the context of immunomodulatory treatment regimens. METHODS: We performed T-cell receptor (TCR) immunosequencing (Adaptive Biotechnologies, Seattle WA) of IBD patients (N=303) and health care worker controls (HCW, N=224) at up to four time points (prior to dose 1, prior to dose 2, 2 weeks after dose 2, 8 weeks after dose 2). Two metrics of TCR response, breadth (# of unique antigen-specific sequences) and depth (expansion of antigen-specific sequences), were calculated for all sequences and Class I- and Class II-specific sequences, and compared to demographics, IBD treatment, and vaccine type. Subjects with exceptional Class I or Class II responses were calculated as significant residuals relative to the Class I vs. Class II regression line. Similar associations were observed for both breadth and depth: breadth is presented here for brevity. RESULTS: Both Class I- and Class II-specific T-cell responses peaked 2 weeks after dose 2, and significantly correlated with lower age, female gender, and mRNA vaccine type (mRNA-1273/Moderna and BNT262b/Pfizer, versus vector vaccine AD26CoV2/J&J) (FIGURE). Class II responses comprised ~85% of detected TCR response in both IBD and HCW subjects. Among IBD patients, there was a significant elevation of the class I response with anti-TNF treatment (p=0.04). This effect was most pronounced at later timepoints, suggesting that anti-TNF permitted a more persistent Class I-specific response. Among patients with exceptionally high or low Class I TCR response, there were significant differences in TCR metrics across vaccine types (p=0.0035). 21% of AD26CoV2 patients were highly Class I-biased (Zscore>1, 9.4% and 7.3% for BNT162 and mRNA-1273, respectively), and this was correlated with lower anti-spike serology 2 and 8 weeks after vaccination (p<1E-10). Conversely, mRNA- 1273 patients were Class I-deficient, representing 25.3% of patients but 44.1% of highly Class I-deficient patients (Zscore<1, 0% for AD26CoV2). CONCLUSION: The T-cell clonal response to SARS-CoV-2 vaccine is Class II-predominant, but the Class I-response is augmented by anti-TNF therapy and vector vaccine type. These factors may help guide reimmunization vaccine strategy in immune-impaired populations, and warrant further study of the effects of anti-TNF therapies on vaccine efficacy.(Figure Presented)Figure: TCR response time course (left);effect of anti-TNF (middle);effect of vaccine type (right). Breadth was predominantly Class II for most patients, with maximum response at 2 weeks after full vaccination (left). The balance of Class I vs. Class II response was significantly biased towards Class I at 8 weeks after full vaccination for patients receiving anti-TNF treatment for IBD (asterisk, p=0.036). Patients receiving AD26CoV2 vaccines were significantly increased in Class I responses, while patients receiving mRNA-1273 vaccines were significantly reduced for Class I responses (t-tests: p=0.0036 at 8 weeks [asterisk], p=0.051 at 2 weeks).

6.
Gastroenterology ; 162(7):S-160, 2022.
Article in English | EMBASE | ID: covidwho-1967250

ABSTRACT

Background: Vaccine-induced protection against SARS-CoV-2 infection is predominantly mediated by humoral immunity;protection against disease progression is primarily determined by cellular immunity. Patients with inflammatory bowel disease (IBD) have high rates of post-vaccination anti-Spike IgG [IgG(S)] seroconversion, but postvaccination immune responses relative to non-IBD controls have not been well described. We aimed to assess post-vaccination humoral (antibody) and cellular (T-cell) responses in IBD relative to healthcare worker (HCW) controls. Methods: We evaluated IBD patients enrolled in a US registry referred from 26 centers at 2, 8, and 16 weeks after completing 2 doses of SARSCoV- 2 mRNA vaccination and compared results to non-IBD non-immunosuppressed HCW participating in a parallel study. We analyzed plasma antibodies to the receptor binding domain of the viral spike protein using the SARS-CoV-2 IgG-II assay (Abbott Labs, Abbott Park, IL);IgG(S) > 50 AU/mL was defined as positive. Those with prior COVID were excluded. We also performed T-cell clonal analysis by T-cell receptor (TCR) immunosequencing at 8 weeks (Adaptive Biotechnologies, Seattle, WA). The breadth (number of unique sequences to a given protein) and depth (relative abundance of all the unique sequences to a given protein) of the T-cell clonal response were quantified using reference datasets. Analyses were adjusted for age, sex and vaccine type. Results: Overall, 1805 subjects were included (IBD n=1074 (65% Crohn's disease, 35% ulcerative colitis);HCW n=731). Age and sex were similar between both cohorts;Hispanic ethnicity and Asian race were less common among IBD than HCW (Table). Vaccine type included BNT162b2 (Pfizer) (75% of IBD, 98% of HCW) and the remainder mRNA-1274 (Moderna). IBD treatments included anti- TNF (46%), other biologics (33%), other immune suppressing therapy (9%), and no immune suppression (12%). Postvaccination antibody levels were lower among IBD than HCW both before and after adjusting for vaccine type (p<0.0001 each timepoint;Figure). After further restricting the IBD cohort to those on no immune-suppressive therapies, antibodies remained lower in IBD vs HCW at 2w (p=0.008) and 8w (p<0.0001), but not 16w (p=0.07). Among 321 subjects with available whole cell samples at 8 weeks (IBD n=163, HCW =158), Spikespecific TCR responses were similar between IBD and HCW for both clonal breadth and depth in both unadjusted and adjusted analyses;sub-analyses of those on biologics yielded similar results. Conclusion: Patients with IBD have dampened humoral responses, but similar cellular responses, after SARS-CoV-2 mRNA vaccination relative to HCW. These findings suggest a potentially greater risk of infection, but not of disease progression, among those with IBD, and should be considered to help guide booster dosing strategies for the IBD population. (Figure Presented) (Figure Presented) Figure: Post-vaccination immune responses: (A) Antibody responses are lower in IBD relative to non-IBD healthcare workers at 2, 8, and 16 weeks (p<0.0001 at each timepoint). In contrast, post-vaccination Spike-specific T-cell receptor clonal breadth (B1) and clonal depth (B2) at 8 weeks are similar in IBD compared to healthcare workers.

7.
University of Toronto Medical Journal ; 99(2):30-35, 2022.
Article in English | Scopus | ID: covidwho-1837449

ABSTRACT

The COVID-19 pandemic has produced massive procedural backlogs in many parts of the developed world, with a disproportionate impact on the elderly. Whereas it is well-known that such a backlog would cause undue morbidity and mortality in thousands of patients, it is still unclear how jurisdictions plan on catching up on their missed surgeries and screening tests. In this comparative review therefore, we examine existing literature to quantify the backlog and thereafter summarize the solutions that have been proposed to clear it. Searches were performed on Google, Google Scholar, PubMed, Ovid MEDLINE®, and Ovid Embase® to identify literature from Canada, the United Kingdom, and the United States of America. We report our findings with a focus on three representative types of procedures including cataract surgery, colorectal screening, and hip and knee replacement surgery. Common themes of potential solutions included leveraging more advanced technology, ensuring preventative care, training an appropriate allied health workforce, and innovating in the operating room to improve efficiency and surgical capacity. Although no single solution emerges to be universally applicable, a combination of proposed solutions can be considered after an individualized assessment of the hospital or clinic context, the type of surgery required, and the availability of equipment, facility, and staff. © 2022, University of Toronto. All rights reserved.

8.
Chinese Journal of Disease Control and Prevention ; 26(2):188-192 and 217, 2022.
Article in Chinese | EMBASE | ID: covidwho-1822638

ABSTRACT

Objective To describe the social support, anxiety, and sleep quality of residents in the District of Shanghai during the COVID-19 and to analyze the to correlation of these factors. Methods A structured questionnaire was used to investigate residents' social support, anxiety, and sleep quality. The questionnaire consisted of social support rate scale, the self-rating anxiety scale (SAS) and Pittsburgh sleep quality index (PSQI), investigated the social support, anxiety, and sleep quality of residents in the District of Shanghai under the COVID-19 epidemic and analyzed their potential influencing factors. Structural equation model was constructed to understand the relationship among these factors. Results A total of 258 questionnaires were collected, with 237 being eligible for analyzing. The results showed that there were statistically significant differences in sleep quality (P =0.004) and social support (P =0.009) among residents with different highest education levels. The structural equation model-fitting indices were CFI =0.929, NFI =0.891, IFI =0.930, NNFI =0.907, RMSEA =0.082, χ 2/df =2.599. It indicated that the fitting degree was good. The results showed that the social support of residents could affect their anxiety degree to some extent (r=-0.15). The higher the social support, the lower the anxiety degree they had. Moreover, the degree of anxiety could affect the sleep quality (r =0.72), and the higher the degree of anxiety, the worse the sleep quality they had. Conclusion During the epidemic of COVID-19, residents' social support is related to their anxiety level, and the anxiety level is related to their sleep quality. By improving residents' support, their degree of anxiety could be reduced to improve their sleep quality.

9.
PubMed; 2021.
Preprint in English | PubMed | ID: ppcovidwho-333803

ABSTRACT

Global deployment of vaccines that can provide protection across several age groups is still urgently needed to end the COVID-19 pandemic especially for low- and middle-income countries. While vaccines against SARS-CoV-2 based on mRNA and adenoviral-vector technologies have been rapidly developed, additional practical and scalable SARS-CoV-2 vaccines are needed to meet global demand. In this context, protein subunit vaccines formulated with appropriate adjuvants represent a promising approach to address this urgent need. Receptor-binding domain (RBD) is a key target of neutralizing antibodies (Abs) but is poorly immunogenic. We therefore compared pattern recognition receptor (PRR) agonists, including those activating STING, TLR3, TLR4 and TLR9, alone or formulated with aluminum hydroxide (AH), and benchmarked them to AS01B and AS03-like emulsion-based adjuvants for their potential to enhance RBD immunogenicity in young and aged mice. We found that the AH and CpG adjuvant formulation (AH:CpG) demonstrated the highest enhancement of anti-RBD neutralizing Ab titers in both age groups (~80-fold over AH), and protected aged mice from the SARS-CoV-2 challenge. Notably, AH:CpG-adjuvanted RBD vaccine elicited neutralizing Abs against both wild-type SARS-CoV-2 and B.1.351 variant at serum concentrations comparable to those induced by the authorized mRNA BNT162b2 vaccine. AH:CpG induced similar cytokine and chemokine gene enrichment patterns in the draining lymph nodes of both young adult and aged mice and synergistically enhanced cytokine and chemokine production in human young adult and elderly mononuclear cells. These data support further development of AH:CpG-adjuvanted RBD as an affordable vaccine that may be effective across multiple age groups. ONE SENTENCE SUMMARY: Alum and CpG enhance SARS-CoV-2 RBD protective immunity, variant neutralization in aged mice and Th1-polarizing cytokine production by human elder leukocytes.

10.
INFORMS International Conference on Service Science, ICSS 2020 ; : 255-260, 2022.
Article in English | Scopus | ID: covidwho-1750467

ABSTRACT

Since December 2019, the COVID-19 outbreak has spread in over 100 countries and regions at a stunning pace. To prevent humanitarian health hazards such as COVID-19, people are strongly suggested to purchase and use Personal Protective Equipments (PPEs) for self-protection. However, the fraction of the population who refused to comply with the PPEs is high (and also much higher in some regions than others). In this paper, we focus on an empirically tested behavioral explanation for the compliance obstacle (a lack of self-control) based on the present-bias effect, which means the trend to give a higher valuation to a present reward but a lower valuation to a future reward (O’Donoghue & Rabin, 2006). Since the utility of PPEs is realized in the future, a consumer may postpone his purchase decision but finally abandon his purchase plan in the future period due to this present-bias effect. The key take-away we focus on is that advance selling can be beneficial to the consumers as a commitment device (Bryan et al., 2010). However, the effect of advance selling may be limited, especially for consumers with low valuation, and can only encourage a part of consumers to purchase PPEs. Advance selling alone cannot fully address the compliance obstacles in PPEs. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

11.
Zhonghua Yu Fang Yi Xue Za Zhi ; 56(2): 103-107, 2022 Feb 06.
Article in Chinese | MEDLINE | ID: covidwho-1600048

ABSTRACT

Influenza is an infectious respiratory disease caused by the influenza viruses. Older people, infants and people with underlying medical conditions could have a higher risk of severe influenza symptoms and complications. The co-infection of Coronavirus Diseases 2019 (COVID-19) with influenza viruses could lead to the complication of prevention, diagnosis, control, treatment, and recovery of COVID-19. Influenza vaccine and COVID-19 vaccine overlapped in target populations, vaccination time, and inoculation units. Although there was insufficient evidence on the immunogenicity and safety of co-administration of influenza vaccine and COVID-19 vaccine, World Health Organization and some countries recommended co-administration of inactivated influenza vaccine and COVID-19 vaccine. This review summarized domestic and international vaccination policies and research progress, and put forward corresponding suggestions in order to provide scientific support for the formulation of vaccination strategy on seasonal influenza vaccine and COVID-19 vaccine.


Subject(s)
COVID-19 , Influenza Vaccines , Influenza, Human , Aged , COVID-19 Vaccines , China , Humans , Infant , Influenza, Human/epidemiology , Influenza, Human/prevention & control , Pandemics/prevention & control , SARS-CoV-2 , Seasons , Vaccination
12.
PubMed; 2021.
Preprint in English | PubMed | ID: ppcovidwho-296797

ABSTRACT

Background: Vaccination against SARS-CoV-2 is a highly effective strategy to protect against infection, which is predominantly mediated by vaccine-induced antibodies. Postvaccination antibodies are robustly produced by those with inflammatory bowel disease (IBD) even on immune-modifying therapies but are blunted by anti-TNF therapy. In contrast, T-cell response which primarily determines long-term efficacy against disease progression,, is less well understood. We aimed to assess the post-vaccination T-cell response and its relationship to antibody responses in patients with inflammatory bowel disease (IBD) on immune-modifying therapies. Methods: We evaluated IBD patients who completed SARS-CoV-2 vaccination using samples collected at four time points (dose 1, dose 2, 2 weeks after dose 2, 8 weeks after dose 2). T-cell clonal analysis was performed by T-cell Receptor (TCR) immunosequencing. The breadth (number of unique sequences to a given protein) and depth (relative abundance of all the unique sequences to a given protein) of the T-cell clonal response were quantified using reference datasets and were compared to antibody responses. Results: Overall, 303 subjects were included (55% female;5% with prior COVID) (Table). 53% received BNT262b (Pfizer), 42% mRNA-1273 (Moderna) and 5% Ad26CoV2 (J&J). The Spike-specific clonal response peaked 2 weeks after completion of the vaccine regimen (3- and 5-fold for breadth and depth, respectively);no changes were seen for non-Spike clones, suggesting vaccine specificity. Reduced T-cell clonal depth was associated with chronologic age, male sex, and immunomodulator treatment. It was preserved by non-anti-TNF biologic therapies, and augmented clonal depth was associated with anti-TNF treatment. TCR depth and breadth were associated with vaccine type;after adjusting for age and gender, Ad26CoV2 (J&J) exhibited weaker metrics than mRNA-1273 (Moderna) (p=0.01 for each) or BNT262b (Pfizer) (p=0.056 for depth). Antibody and T-cell responses were only modestly correlated. While those with robust humoral responses also had robust TCR clonal expansion, a substantial fraction of patients with high antibody levels had only a minimal T-cell clonal response. Conclusion: Age, sex and select immunotherapies are associated with the T-cell clonal response to SARS-CoV-2 vaccines, and T-cell responses are low in many patients despite high antibody levels. These factors, as well as differences seen by vaccine type may help guide reimmunization vaccine strategy in immune-impaired populations. Further study of the effects of anti-TNF therapy on vaccine responses are warranted.

14.
Journal of Renewable and Sustainable Energy ; 13(2), 2021.
Article in English | Scopus | ID: covidwho-1220093

ABSTRACT

The COVID-19 pandemic has had a significant negative influence on energy consumption in 2020. On April 7, 2020, in response to the rapid spread of the infection, the Japanese government imposed a state of emergency. This action impacted energy consumption, energy production, and electricity prices. This study compares the impact of a reduction in load demand on renewable energy in the Japan public power grid under a state of emergency declaration (April to May 2020). Using publicly available data, comparisons are made for Kyushu, Tokyo, Kansai, and Hokkaido and assessed in relation to epidemic severity and geographical distribution. The results can be summarized as follows. (1) The consumption profiles and amounts of power consumption reduction are different in different areas. Tokyo shows the largest share of reduced load, followed by Kansai, Kyushu, and Hokkaido. The load reduction was mainly seen during the day, which reflects the differences in people's activities relative to the same period in 2019. (2) Different means of power dispatch, including power generators, energy storage systems, and transmission lines are used and compared in terms of responses to the changes in electricity consumption profile. (3) The overall fall in total load demand and the change in load sequence affected the integration and curtailment of photovoltaic power generation and consequentially caused the electricity price to drop. This paper clarifies the effects of COVID-19 on the public power grids of Japan. Further, it establishes the impact on policymakers in relation to the development of renewable energy. © 2021 Author(s).

15.
Journal of the American Geriatrics Society ; 69(SUPPL 1):S50, 2021.
Article in English | EMBASE | ID: covidwho-1214877

ABSTRACT

Background: During the COVID-19 pandemic, older adults are missing routine care appointments despite increasing availability of telehealth video visits. We conducted a needs assessment of two Residential Care Facilities for the Elderly (RCFE) in Northern California as a first step to improving access to telehealth visits for older community dwelling individuals. Methods: We conducted voluntary surveys of the independent community dwelling adults of two RCFEs. Site A houses residents who are mostly Caucasian and middle and upper middle class. Site B provides subsidized senior housing and serves a large group of residents who are non-English speakers. Surveys ascertained residents' preferred devices as well as comfort level, support, and barriers regarding telephonic and video visits. Results: Of the 700 surveys distributed, 249 surveys were completed and returned (36%). The average age of participants was 84.6 (SD = 6.6) and 77% were female. At site A, 89% of participants had a bachelor's degree or beyond and 99% listed English as their preferred language. At Site B, 43% had a bachelor's degree or beyond, and 13% preferred English while 73% preferred Mandarin. Regarding remote visits, 37% of all participants felt comfortable connecting with their healthcare team through video visits with computer being the most preferred device (23%) followed by smartphone (19%) and iPad/tablet (11%). Regarding perceived barriers, there were substantial differences depending on the site. Participants at Site A reported not knowing how to connect to the platform (24%), not being familiar with the technology (22%), and difficulty hearing (14%) as the top three barriers, whereas for the participants at Site B, the top three barriers were not being able to speak English well (55%), lack of interest in seeing provider outside of clinic (35%), and not knowing how to connect to the platform (35%). Conclusions: Significant barriers exist for older adults in RCFEs with telehealth visits with their care team. The largest barriers include difficulty with technology or using the video visit platform, language barriers, and lack of desire to see provider outside of clinic. Due to site specific differences in reported telemedicine barriers, any intervention to improve access should be tailored to the specific needs of that site.

SELECTION OF CITATIONS
SEARCH DETAIL