The multifactorial complexities of autoimmune development in Pemphigus vulgaris: Critical evaluation of the role of environmental and lifestyle "exposome" factors.

Pemphigus vulgaris (PV) is a potentially life-threatening blistering disorder characterized by autoantibodies directed against cell-cell adhesion molecules that serves as an excellent model to study human autoimmune development. Numerous studies have identified specific Human Leukocyte Antigen (HLA) genes, in particular DRB1*0402 and DQB1*0503, that confer disease risk. Although HLA is required, it is not sufficient for the initiation of disease. As with all autoimmune diseases, the etio-pathogenesis of PV is complex, meaning it is multifactorial. Susceptibility is polygenic, and the search for non-HLA disease-linked genes continues. Moreover, twin studies across autoimmune conditions indicate that non-genetic environmental and lifestyle factors, which can be collectively grouped under the term "exposome", are also major contributors to disease development. The literature presents evidence for the potential role of multiple triggers such as medications, infections, stress, diet, immunizations, and sleep to influence the etiology, pathophysiology, and prognosis of PV. However, a clear understanding of the degree to which specific factors impact PV is lacking. In this investigation, we comprehensively review the environmental elements listed above and consider the strength of evidence for these factors. The overall goals of this work are to provide greater insights into the factors that influence disease susceptibility, disease development and disease course and ultimately help to better guide clinicians and inform patients in the management of PV.

Effect of physical activity on stress and the sense of community during the COVID-19 pandemic: The role of gender and age

Despite their effectiveness in minimizing the spread of infection, movement restrictions adopted during the Coronavirus disease 2019 (COVID-19) pandemic have not been without their health-related consequences, including decreases in physical activity and increases in sedentary behavior. This study aimed to investigate differences in stress and sense of community among Korean citizens in various age groups according to the degree of their participation in physical activity during the COVID-19 pandemic. We analyzed data collected during the Social Survey of Busan Metropolitan City 2020, the population of which included all household members over the age of 15. Data for a total of 33,082 participants (male = 15,129;female = 17,953) were extracted using a two-stage cluster sampling method. Age, stress level, and sense of community were analyzed using independent t-tests, while the frequency of participation in physical activity was analyzed using a Mann-Whitney U test. Differences in stress level and community consciousness according to the frequency of physical activity were examined via multivariate analysis of variance. Variables exhibiting significant differences were evaluated for differences between groups through Scheffe's post hoc analysis. First, stress levels were higher among female adolescents than male adolescents. Among adults and older adults, men exhibited higher overall stress levels than women, whereas sense of community was stronger in women than men. Second, male adolescents in the regular physical activity participation group showed lower levels in some factors of stress than those in the nonparticipating group. Finally, a higher frequency of participation in physical activity among adults and older adults was associated with lower stress and higher sense of community, regardless of gender. In conclusion, regular participation in physical activity should be considered when designing strategies for managing stress and promoting social relationships at the national and individual levels during COVID-19 and any similar pandemics in the future.Copyright ©2023 The Author(s). Published by MRE Press.

Impact of the COVID-19 pandemic on Swedish adults aged 77 years and older: Age differences in lifestyle changes.

AIMS: This study aimed to describe the impact of the COVID-19 pandemic on lifestyle and social activities among older adults in Sweden, with a special focus on differences between the 'younger old' (aged 77-84) and 'older old' (aged 85-109). METHODS: This study is based on a nationally representative sample of older adults (aged ⩾77 years) in Sweden (SWEOLD). Data were collected between May 2021 and April 2022, when many recommendations were removed but the virus was still classified as a public health disease. We studied occurrences and differences between the two age groups in several lifestyle factors and social activities. RESULTS: The younger old displayed larger changes in lifestyles because of the pandemic than the older old. Most changes were found in social interactions with family. CONCLUSIONS: Our results highlight the large heterogeneity within the Swedish population aged ⩾77 years, and that the younger old experienced a bigger lifestyle change than the older old. Previous activity levels might be important to consider in order to understand how regulations may affect the older population. Finally, our findings indicate large age differences in Internet use, which require attention to prevent digital exclusion of an already vulnerable group.

Interplay Between Sociodemographic Variables, Physical Activity, Sleep, Dietary Habits, and Immune Health Status: A Cross-Sectional Study From Saudi Arabia's Western Province.

BACKGROUND: In addition to developing effective therapeutic approaches, the maintenance of health also constitutes lifestyle and behavioral aspects related to being more resilient in the event of future illness. Reduced immune health has been linked to reports of more frequent and severe infections as well as a variety of non-communicable diseases, both of which may eventually place a significant burden on the healthcare system. Several lifestyles and behaviors can influence immune health, both positively and negatively. Accordingly, this study aimed to evaluate the immune health status and investigate its relationship with widely practiced lifestyle behaviors that are thought to affect immunological functioning. DESIGN AND METHOD: Saudi Arabian citizens and international residents of the Western Province were invited to participate in this cross-sectional web-based survey through an online advertisement. The integrated questionnaire on lifestyle (Arab Teens Lifestyle Study) and immune health status (Immune Status Questionnaire (ISQ)) was completed in November 2022 by 1230 participants. Descriptive analysis, Mann-Whitney U test, chi-square, or Fisher's exact test was utilized to investigate the relationships between study variables and immune health status groups. Spearman's or Pearson's correlation coefficients were used to determine correlations between the overall ISQ scores and study variables. RESULTS: Of the 925 study participants, 34.7% scored below 6 on the ISQ. Of the respondents, 50% had a body mass index of 25 or higher, and 46.3% reported sleeping less than four hours each night. Of the participants, 62-82% did not engage in any form of physical activity. The associations between the ISQ score and weight (p = 0.006), total sleep time per night (p = 0.001), duration of household activities (p < 0.001), and smoking status (p = 0.001) were statistically significant. CONCLUSIONS: According to the data presented here, reduced immune health as measured by ISQ < 6 was prevalent among residents of Saudi Arabia's Western Province and correlated significantly with obesity, sleep duration, and smoking status. Various measures to mitigate the negative impact of an unhealthy lifestyle on public health and to reverse the observed poor immune health and their economic consequences are highly required.

Assessing potential of the gain in the life expectancy of population using artificial neural networks

Introduction. At present it is especially vital to search for and test new analytical systems that can give a possibility to predict a medical and demographic situational lowing for multifactorial influence exerted by the environment. Our research goal was to establish regional peculiarities and predictive estimates of potential gain in such an important indicator as life expectancy at birth (LEB) depending on changes in socio-hygienic determinants potent of modifying it. To do that, we took data collected in a RF region where the current demographic situation was rather tense against the backdrop of stable economic conditions. Materials and methods. A potential of the gain in LEB was estimated by modelling cause-effects relations between environmental indicators and life-style related ones, or determinants that determined population health. Models were created by using artificial neural networks. Results. Our methodology was proven to be optimal and precise (differences are equal to 0.98%). It can be applied quite successfully to predict a potential gain in LEB at a regional level together with identifying what modifying factors should be considered priority ones. LEB on the analyzed territory (the Perm region) was established to likely grow by 661.6 days by 2024 and reach 73.12 years;by 855.7 days by 2030 and reach 73.65 years if the current trends related to changes in the analyzed determinants persisted and the achievement of target indicators of national projects and regional development programs. In case the relevant targets set within national projects and regional development programs were achieved, this indicator would grow by 661.6 days and reach 73.12 years. The most significant groups of factors that determine LEB on the analyzed territory against the backdrop of stable economic situation include sanitary-epidemiological welfare (working conditions et al.), public healthcare indicators (population provided with sufficient number of doctors), sociodemographic indicators (expenses on social policies), lifestyle factors (the proportion of the population involved in physical culture and sports;consumption of vegetables and fruits;retail sales of alcoholic beverages, etc.). Their contribution to the gain in LEB varies from 51.2 to 228.6 days. Limitations. Limitations of the study include the model being "stationary” due to its training relying on data collected in 2010–2019;use of a specific set of indicators;failure to consider the influence exerted by the current epidemiological processes (the COVID-19 pandemics). Conclusion. We analyzed data collected in an RF region with a rather tense demographic situation and established that by 2024 an adjusted target LEB value would be achieved there if the trend in changes in socio-hygienic determinants recovered to its pre-pandemic levels. Achievement of target LEB values by 2030 requires additional project activities that consider specific regional features and focus on managing priority determinants and reducing mortality among working age population. © 2022 Izdatel'stvo Meditsina. All rights reserved.

Impact of COVID-19 on health risk behaviors in northern California: A cross-sectional survey.

The COVID-19 pandemic has been disruptive, unevenly impacting health behaviors in different geographical regions and population groups. We examined how COVID-19 affected perceived changes in physical activity, sleep, and diet and the impact of socio-demographic variables on a calculated health risk behavior score. In this cross-sectional study, 505 residents of northern California completed a web-based survey from August to November of 2020. Chi-square and multivariable linear regression analyses examined the association between socio-demographic variables and the health risk behavior score. Approximately 84 % of respondents experienced at least one unfavorable behavior change after the pandemic, with 49.5 % indicating a reduction in physical activity, 29.7 % a decrease in sleep, 33.1 % an increase in sugary snack consumption, and 29.3 % a decrease in fruit and vegetable intake. Multivariate analyses indicated a higher health risk behavior score (less favorable) for females compared to males (male beta = -0.815, p < 0.0001) and Hispanics compared to Whites (Hispanics beta = 0.396, p = 0.033). The negative changes in health behavior observed in females could be attributed to a higher reduction in fruit and vegetable consumption, and a larger increase in sugary and salty snacks when compared to males. A higher reduction in exercise, sleep, and fruit and vegetable intake were the main drivers of the unfavorable results seen for Hispanics when compared to Whites. Findings highlight the detrimental behavioral changes during the COVID-19 pandemic and the disproportionate impact on Hispanics and women. These results are valuable to policymakers to identify ways to support those most affected by the pandemic and its potential long-term effects.

Associations between Demographic Characteristics, Lifestyle Factors and School-Related Conditions and Symptoms of Mental Health Problems in Norwegian Upper Secondary School Students.

BACKGROUND: The purpose of this study was to evaluate the associations between demographic characteristics, lifestyle factors and school-related conditions, and symptoms of mental health problems in Norwegian upper secondary school students following the COVID-19 pandemic. METHODS: In this cross-sectional study design we used a binary logistic regression model to evaluate potential associations between the predictors and dependent variable. RESULTS: The following six predictors had a statistically significant impact on symptoms of mental health problems; gender effect of being a girl (p < 0.001), self-perceived body image (p < 0.001), sleep problems (p < 0.001), dietary habits (p = 0.033), school satisfaction (p = 0.013), and satisfaction with physical education (PE) class participation (p = 0.025). CONCLUSIONS: Being a girl was associated with a 315% higher probability of reporting symptoms of mental health problems than boys, whereas one unit increase in sleep problems showed a 192% higher probability of symptoms of mental health problems. Furthermore, a one unit increase on the respective beneficial predictors' scales was associated with the following percentage having a lower probability of reporting symptoms of mental health problems; self-perceived body image (59%), dietary habits (58%), school satisfaction (82%), and satisfaction with PE class participation (68%).

Effect of the Coronavirus Disease 2019 Lockdown on Lifestyle Factors in Japanese Patients with Inflammatory Bowel Disease.

Objective To examine the effect of the coronavirus disease 2019 (COVID-19) lockdown on lifestyle factors and psychological stress in patients with inflammatory bowel disease (IBD). Methods A retrospective study was conducted on patients with IBD in Japan 2 months after the initiation of the first state of emergency (June 16 to August 21, 2020). A self-reported questionnaire was used to collect data, and lifestyle factors and psychological stress levels before and after the state of emergency were compared. Patients Patients with IBD who were followed up regularly at Osaka City University Hospital from June 16 to August 21, 2020, were included and were classified into elderly (≥65 years old) and non-elderly groups (<65 years old). Results The study sample comprised 451 responders (241, ulcerative colitis; 210, Crohn's disease; 0, COVID-19). The sleep duration increased, whereas the exercise, working, and walking durations decreased during the COVID-19 lockdown. The proportion of patients with psychological stress due to COVID-19, those with an inability to exercise, and those staying indoors increased significantly during COVID-19 lockdown. Lifestyle factors changed more markedly in non-elderly patients, those who were more stressed due to COVID-19, those with the inability to exercise, and those staying indoors during COVID-19 lockdown. Among elderly patients, no significant changes were identified in stress-causing factors. Conclusion The COVID-19 lockdown affected lifestyle factors and psychological stress in patients with IBD, particularly non-elderly patients. These findings may be helpful in suggesting favorable lifestyle changes for patients with IBD.

Impact of the COVID-19 Pandemic on Korean Adolescents' Mental Health and Lifestyle Factors.

PURPOSE: The coronavirus disease 2019 (COVID-19) pandemic has caused changes in the daily lives of Korean adolescents and affected their emotional well-being. This study compared lifestyle factors and the mental health status of adolescents before and during the COVID-19 pandemic. METHODS: We conducted a secondary analysis using data from a national cross-sectional cohort (Korean Youth Risk Behavior Web-based Survey, KYRBS) collected in 2019 before the COVID-19 outbreak and in 2020 during the pandemic. This study included 57,303 students from the 2019 KYRBS and 54,948 from the 2020 KYRBS. Lifestyle factors such as dietary habits, physical activity levels, time spent studying, duration of Internet use, and mental health status, including perceived stress, experience of depressive mood, and suicidal ideation and attempts, were included in the analyses. RESULTS: The perceived stress levels, self-reported depressive mood, and suicidal thoughts and attempts were lower in the students surveyed in 2020 during the COVID-19 pandemic than in the students surveyed in 2019 before the COVID-19 outbreak. The time spent studying and sleep duration decreased compared to before the pandemic, and sleep satisfaction increased during the COVID-19 pandemic. DISCUSSION: Our results showed an improvement in mental health status in Korean adolescents during the pandemic, but caution is needed when interpreting these results. Future research is needed to determine the effects of a long-lasting pandemic on mental health and lifestyle factors in adolescents.

Identification of Factors Influencing Cholesterol Changes in Elementary-School Children: A Longitudinal Study.

Changes in serum cholesterol levels during childhood may affect the risk of cardiovascular disease in adulthood. However, cholesterol level changes in Japanese children and adolescents and the factors that influence them have not been completely elucidated. This study aimed to determine whether cholesterol levels changed due to the effects of growth and identify factors. This cohort study included elementary-school children in the fourth grade (9-10-year-old) who underwent assessments of cholesterol levels and demographic and lifestyle characteristics. The participants were followed up in their first year of junior high school with the same laboratory, demographic, and lifestyle assessments. From the fourth year of elementary school to the first year of junior high school, children's cholesterol levels decreased (p < 0.0001). Regarding bowel movements, cholesterol level reduction was significant in individuals with regular bowel movements but not significant in those with infrequent bowel movements. Weight was the factor that most strongly negatively predicted cholesterol level reduction (p < 0.001). The study demonstrated the significance of lifestyle factors for growth-related changes of total cholesterol levels and identified weight as the factor that most strongly influenced total cholesterol level changes. Guidance regarding lifestyle improvements should be imparted to children from the fourth grade of elementary school.

Impact of the COVID-19 pandemic on therapy compliance and lifestyle factors of patients with growth hormone deficiency.

OBJECTIVES: To recognize and assess treatment compliance in children and adolescents with growth hormone deficiency during the cronavirus disease-2019 (COVID-19) pandemic along with other lifestyle factors that might have been affected by the pandemic, such as diet, physical activity, sleep pattern, and screen time. METHODS: This descriptive, cross-sectional study was carried out between March 2020-2021 at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Data were collected through clinical interview questions. RESULTS: The total sample size was 130 patients, 54 (41.5%) of whom were males and 76 (58.5%) were females. The mean age of the patients was 12.56±3.44 years. Comparisons of before and during the COVID-19 pandemic revealed significant changes in growth hormone therapy compliance (p=0.007), dietary changes (p=0.002) with an increase in vegetables and fruit consumption, a significant decrease in physical activity time (p<0.001), an increase in sleep time (p<0.001), and screen time (p<0.001). CONCLUSION: The COVID-19 crisis had an impact on growth hormone therapy compliance, with a significant impact on other lifestyle factors such as dietary habits, physical activity, sleep time, and leisure screen time.

COVID-19 Vaccination Hesitancy or Acceptance and Its Associated Factors: Findings from Post-Vaccination Cross-Sectional Survey from Punjab Pakistan.

COVID-19 has posed massive challenges related to health, economy, and the social fabric of the entire human population. To curb the spread of the virus, the Government of Pakistan initiated a vaccination campaign against COVID-19. The objective of this research was to assess the factors associated with COVID-19 vaccine acceptance or hesitancy. The data were collected telephonically using a cross-sectional survey design through a close-ended structured questionnaire from a sample of 1325 vaccinated and non-vaccinated individuals with a response rate of 38%. SPSS v. 26 was used to analyze the data. The study revealed that 73% of the respondents were male, half in the 40-49 age group, 78% living in urban areas, and 45% had a monthly income between 20,001-50,000 Pakistani rupees. People felt reluctant to get vaccinated because of myths and misinformation related to it. The socio-demographic factors including male, age 60-69, middle or higher level of education, marital status, currently employed, from middle socio-economic status, living in urban areas, high access to mass media, history of influenza vaccination, physical activity, and perceived good health status were significantly associated with COVID-19 vaccination uptake. Concerted efforts are needed to achieve vaccine targets for the broader population through understanding and identifying barriers to vaccination.

[Lifestyle factors and medical activity of patients with COVID-19 treated on an outpatient basis using telemedicine technologies].

The aim of the study was to study the factorial conditionality of the state of health and the features of medical activity (MA) of patients with COVID-19 who were treated on an outpatient basis using telemedicine technologies. MATERIAL AND METHODS: The study of lifestyle factors (LS) and MA was conducted by an anonymous survey of 7,743 patients with COVID-19. The patients' health was assessed based on the study of the course of the underlying disease and the presence of concomitant diseases, which were detected in 24.3% of COVID-19 patients according to the data of copying information from medical records. RESULTS: It was revealed that the prevalence of tobacco smoking was 33.25 cases per 100 respondents, 45.4% of respondents were overweight, 75.6% of patients had a low level of physical activity, 68.2% and 53.8% of patients had low medical literacy and MA, respectively. It is established that the greatest impact on the health status of the patients interviewed was provided by the bio-social activity (Smoking) (h = 0.702; m = 0.0063; p = 0.0022), physical activity (h = 0.624; m = 0.0026; p < 0.001, health behavior (h = 0.527; m = 0.0030; p < 0.001) and health literacy (h = 0.532; m = 0.0028; p < 0.001). CONCLUSION: The studied risk factors affecting the health status of COVID-19 patients, most of which are manageable, should be taken into account when forming therapeutic and preventive measures.

Association between Psychological Stress and Neck Pain among College Students during the Coronavirus Disease of 2019 Pandemic: A Questionnaire-Based Cross-Sectional Study.

The coronavirus disease of 2019 (COVID-19) greatly affected people's lifestyles. We used an online, cross-sectional survey during a COVID-19-related lockdown in Israel, with the aim of investigating the effects of such lockdowns on students' self-perceived stress and neck pain (NP). College students (N = 295) completed questions on sociodemographic characteristics, the Neck Disability Index (NDI), the Perceived Stress Scale, the Visual Analogue Scale (VAS), and NP frequency (four-point scale). Logistic regression models were calculated with the NDI as the dependent variable. In total, 35.6% of students experienced at least moderate NP-related disability (NDI ≥ 15), more during than before the lockdown. NP increased gradually, from a lifetime mean of 1.80 to a lockdown mean of 3.07 (χ2 = 316.72; p < 0.001). Students' self-perceived stress was moderate, and 59.3% reported experiencing study-related stress. Higher levels of self-perceived stress, study-related stress, sitting >3 h/day, and a higher VAS score were associated with a higher risk of an NDI ≥ 15 (Nagelkerke's R2 = 0.513, p < 0.001). The transition from on-campus to online learning seems to have exacerbated students' NP, which was correlated to their study stress and lifestyles. These findings advocate for the need to promote the physical and mental health of students via e.g., mental health services and occupational and ergonomic consulting services.

The COVID-19 and lifestyle nexus: settling the debate.

A recent debate that has gained our attention is that of coronavirus disease 2019 (COVID-19) being referred to as a lifestyle disease by the Royal College of General Practitioners (in the title of an online event) for which they later apologized and withdrew the reference. In this commentary, we demystify diseases related to 'lifestyle' and put this in the context of the age-old public health way of classifying diseases as communicable and non-communicable (NCDs). Evidence indicates that unhealthy lifestyles, in addition to causing NCDs, can also result in reduced immunity and/or cause injury to organs predisposing individuals to diseases, and their severity, traditionally defined as 'communicable' such as COVID-19. COVID-19 has demonstrated the nexus between communicable and NCDs as never before in no uncertain terms. Two important messages that have emerged from the pandemic are: (1) there is close proximity of communicable diseases to NCDs; and (2) individual personal hygiene-related lifestyles can influence the occurrence, severity and prevention of communicable diseases such as COVID-19.

Lifestyle Factors and Sleep Health across the Lifespan.

Sleep health, operationalized as a multidimensional construct consisting of sleep regularity, satisfaction, alertness, timing, efficiency, and duration, is an emerging concept in the field of sleep medicine which warrants further investigation. The purpose of the present study was to: (1) compare sleep health across the lifespan, (2) determine lifestyle factors associated with sleep health, and (3) examine whether lifestyle factors associated with sleep health varied between and within age groups. Participants consisted of 3284 individuals (Mean age = 42.70; 45% male) who participated in a cross-sectional online survey of sleep and health. Sleep health was measured using the RU-SATED scale, while demographic and lifestyle factors (e.g., daily social media use, sedentary activity, fast food consumption, etc.) were all self-reported. Sleep health was the highest among older adults (M = 8.09) followed by middle-aged (M = 7.65) and younger adults (M = 7.16). Across age groups, fast-food consumption, daily regularity, and daily TV, social media, or internet use were all negatively correlated with sleep health (ps < 0.05). Few differences in the association between lifestyle factors and sleep health across age groups were found. Overall, these findings may help to inform sleep health promotion efforts by targeting the most pertinent lifestyle factors for promoting sleep health.

Modifiable lifestyle factors and severe COVID-19 risk: a Mendelian randomisation study.

BACKGROUND: Lifestyle factors including obesity and smoking are suggested to be correlated with increased risk of COVID-19 severe illness or related death. However, whether these relationships are causal is not well known; neither for the relationships between COVID-19 severe illness and other common lifestyle factors, such as physical activity and alcohol consumption. METHODS: Genome-wide significant genetic variants associated with body mass index (BMI), lifetime smoking, physical activity and alcohol consumption identified by large-scale genome-wide association studies (GWAS) of up to 941,280 individuals were selected as instrumental variables. Summary statistics of the genetic variants on severe illness of COVID-19 were obtained from GWAS analyses of up to 6492 cases and 1,012,809 controls. Two-sample Mendelian randomisation analyses were conducted. RESULTS: Both per-standard deviation (SD) increase in genetically predicted BMI and lifetime smoking were associated with about two-fold increased risks of severe respiratory COVID-19 and COVID-19 hospitalization (all P < 0.05). Per-SD increase in genetically predicted physical activity was associated with decreased risks of severe respiratory COVID-19 (odds ratio [OR] = 0.19; 95% confidence interval [CI], 0.05, 0.74; P = 0.02), but not with COVID-19 hospitalization (OR = 0.44; 95% CI 0.18, 1.07; P = 0.07). No evidence of association was found for genetically predicted alcohol consumption. Similar results were found across robust Mendelian randomisation methods. CONCLUSIONS: Evidence is found that BMI and smoking causally increase and physical activity might causally decrease the risk of COVID-19 severe illness. This study highlights the importance of maintaining a healthy lifestyle in protecting from COVID-19 severe illness and its public health value in fighting against COVID-19 pandemic.

The mental health and lifestyle impacts of COVID-19 on bipolar disorder.

BACKGROUND: It is unclear how those with bipolar disorder (BD) have been affected by the coronavirus (COVID-19) pandemic. This study aimed to obtain a more detailed understanding of the current mental health needs of these individuals, which is important for both the development of intervention strategies to better manage patient distress and to better prepare for similar circumstances in future. METHODS: The sample comprised 43 individuals with a verified diagnosis of BD and 24 healthy controls. Data about pandemic-related mental health support use, socio-demographics, mood, lifestyle, social rhythm and subjective cognitive dysfunction data were collected and compared between groups. Inter-relationships between scores were also examined. RESULTS: No between-group differences were found in terms of age, sex, living situation, job loss or reduced work hours due to COVID-19. Most patients with BD reported a history of ongoing formal psychological support (68.3%), with most continuing this support throughout the pandemic (82.1%). A large, statistically significant pandemic-related increase in subjective cognitive dysfunction was evident in the BD group. Subjective cognitive dysfunction was significantly associated with negative symptomology, suicidal thoughts, and quality of life ratings. LIMITATIONS: Data was collected in self-report format in an online survey and objective symptom measures were not used at this time CONCLUSION: The absenceof substantial differences between patients and controls in terms of mood symptoms, COVID-19 fear or lifestyle factors and social rhythms suggests a degree of resilience in BD patients; despite large pandemic related increases in subjective cognitive dysfunction.

The social and clinical impact of the COVID-19 epidemic on the Strasbourg lung transplant cohort: A single-center retrospective cohort study.

The clinical and social impacts of the COVID-19 epidemic on lung transplant (LTx) recipients remain poorly known. We aimed to evaluate its social, clinical, and behavioral consequences on the LTx patients followed in Strasbourg university hospital. A questionnaire was used to collect details concerning patients' lifestyles, their protection methods used to avoid COVID-19 contamination, and clinical infection-related information for March 2020. A specific score was created to quantify patients' contacts and the associated risk of infectious contagion. Data were collected from 322 patients (91.2%). A majority reported a higher application than usual of social distancing and barrier measures. 43.8% described infectious-related symptoms and 15.8% needed an anti-infective treatment. There was no difference in symptom onset according to age, native lung disease, diabetes, or obesity. Nineteen patients were tested for COVID-19, and four were diagnosed positive, all with a favorable outcome. The infection risk contact score was higher for symptomatic patients (p: 0.007), those needing extra-medical appointments (p < .001), and those receiving anti-infective treatments (p = .02). LTx patients reported a careful lifestyle and did not seem at higher risk for COVID-19. Our score showed encouraging preliminary results and could become a useful tool for the usual infection-related follow-up of the LTx patients.