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Introduction: During the COVID-19 pandemic, various virus variants evolved worldwide. COVID-19 omicron (CO) was associated with a decrease in length of hospital stay, ICU admission and death [1] as compared to COVID-19 delta (CD). To estimate impact of CO on ICUs worldwide, we investigated characteristics, disease course and outcome of critically ill CO patients. Method(s): Of 8562 critically ill COVID-19 patients included in the prospective international multicenter RISC-19-ICU registry [2,3], characteristics and outcome were compared for 1890 CD and 272 CO patients admitted to ICU between 1-2021 and 9-2022. Mixed model analysis corrected for individual center effects and adjusted for age, sex, vaccination status, use of steroids and anticoagulants was used. Result(s): There was no difference in age, sex and BMI between groups. CO patients had more comorbidities [mean difference (MD) 0.7, 95% CI (0.5-1.0), p = 0.02], especially arterial hypertension, and higher SAPS II score [MD 0.0 (0-0.1), p < 0.001], SOFA score [MD 0.1 (0.1-0.3), p < 0.0001]. CO patients presented with higher cardiovascular system SOFA subscore, but better PF-ratio at ICU admission and smaller risk for intubation and mechanical ventilation throughout their ICU stay [OR 0.5 (0.3-0.8)]. There was no difference in ECMO treatments, ICU length of stay [MD 0.6 (0-11.4), p = 0.72] or ICU survival [HR 1 (0.7-1.5), p = 0.88] between the two groups. Conclusion(s): We show that critically ill CO patients present with more comorbidities, less severe respiratory disease but more severe hemodynamic instability at ICU admission as compared to CD patients, although the ICU length of stay and mortality was similar. These differences could be explained by differences in disease characteristics caused by CO, or by the increasing prevalence of CO as co-factor to preexisting disease. Continued monitoring of critically ill CO patients in ICUs worldwide is warranted.
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The proceedings contain 47 papers. The topics discussed include: increased humoral immune response after vaccination with mRNA-1273 vs BNT162b2 in patients with inflammatory rheumatic diseases;comparison of anti-fracture effectiveness of denosumab versus bisphosphonates in a registry-based, real-world cohort study;comparison of drug retention of TNF inhibitors, other biologics and JAK inhibitors in patients with rheumatoid arthritis who discontinued JAK inhibitor therapy;BRD3 regulates the inflammatory and stress response in rheumatoid arthritis synovial fibroblasts;effect of methotrexate and folic acid co-administration in arthritis;early anti-S antibody levels predict anti-SARS-CoV-2 neutralizing activity over 24 weeks in RA patients after SARS-CoV-2 mRNA vaccination;effect of zoledronate on bone mineral density and bone turnover markers after long-term denosumab therapy: observations in a real-world setting;and developing a screening tool for the detection of interstitial lung disease in systemic sclerosis: the ILD-RISC score.
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Background: The psychological well-being of older adults may have been negatively affected by the outbreak of the COVID- 19 epidemic due to the presence of comorbidity, increased risk of complications, mortality, and difficulty in adapting to mhealth and social isolation. The study aimed to investigate the anxiety level of community older adults during the COVID-19 epidemic and explore its associated factors, so that there can be more evidence-based advice to improve the mental health status for the older adults. Methods: Online questionnaires and face to face communication were used to investigate 320 community older adults, who were selected randomly. The questionnaires were used to investigate the sociodemographic characteristics, anxiety and resilience level of the participants. One-way ANOVA, correlation and regression analysis were performed to explore the factors associated with the anxiety among the older adults. Results: The mean of the anxiety among the all participants is 44.03±10.89 and 128 persons (40%) suffer from the anxiety (mild anxiety: 84.38%, moderate anxiety: 14.06%, severe anxiety: 14.06%). The mean of resilience is 56.68±18.26, and the three dimensions of CD-RISC is negative correlation with the anxiety. The SAS can be influenced by the chronic disease history (P=0.045), physical health conditions (P=0.024), economic income (P=0.026), the health education of the COVID-19 epidemic (P<0.001) and the level of resilience (P=0.002). Conclusions: The morbidity and score of the anxiety among the community older adults are higher during the COVID-19 epidemic than the usual. While the score of the CD-RISC is lower than the previous studies. Anxiety emerged as a prominent issue for community- dwelling older adults during the COVID-19 epidemic. Interventions that targeted resilience may have the potential to reduce anxiety level and improve the psychological well-being of the older adults.
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Background: The COVID-19 pandemic is an ongoing stressor that has resulted in millions of deaths and worsening of psychiatric health worldwide. However, we lack knowledge regarding the influence of specific behavioral and neural factors that may alleviate the impact of the pandemic on mental health. Thus, we assessed whether pre-pandemic resilient coping strategy engagement and frontolimbic circuitry influence depression and anxiety symptoms during the pandemic. Methods: In 72 young adults (72.2% female, mean age 24 years), we assessed depression and anxiety symptoms (BDI and SCARED-A), resilient coping strategies (CD-RISC), and resting-state functional connectivity (FC) of frontolimbic circuitry using fMRI. We conducted general linear models to test preregistered hypotheses that 1) less resilient coping pre-pandemic and 2) weaker frontolimbic FC pre-pandemic would predict more severe symptoms during the pandemic;and 3) coping would interact with FC to predict symptoms during the pandemic. Results: Anxiety symptoms worsened during the pandemic as compared to pre-pandemic, while depression symptoms improved (ps<0.001). Less resilient coping predicted more severe depression symptoms during the pandemic (p=0.023). Weaker frontolimbic FC pre-pandemic predicted more severe obsessive-compulsive (p=0.015) and separation anxiety symptoms (p=0.040) during the pandemic. Resilient coping interacted with frontolimbic FC to predict depression (p<0.001), obsessive-compulsive (p=0.041), panic (p=0.017), and generalized anxiety (p=0.027) symptoms during the pandemic. Conclusions: Less coping strategy engagement and weaker frontolimbic FC may represent risk factors for poor psychiatric health during the pandemic. This research may inform efforts to ameliorate the adverse psychological effects of the COVID-19 pandemic, as well as subsequent global stressful events. Supported By: This work was supported by the National Institutes of Health (NIH) Director’s Early Independence Award (DP5OD021370) to DGG;Brain and Behavior Research Foundation (National Alliance for Research on Schizophrenia and Depression;NARSAD) Young Investigator Award to DGG;and National Science Foundation Graduate Research Fellowship Program Award to BHG and JCF. Keywords: Depression, Anxiety, Brain Imaging, fMRI, Coping Strategies, COVID-19 Pandemic
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Mucociliary clearance, mediated by a coordinated function of cilia bathing in the airway surface liquid (ASL) on the surface of airway epithelium, protects the host from inhaled pathogens and is an essential component of the innate immunity. ASL is composed of the superficial mucus layer and the deeper periciliary liquid. Ion channels, transporters, and pumps coordinate the transcellular and paracellular movement of ions and water to maintain the ASL volume and mucus hydration. microRNA (miRNA) is a class of non-coding, short single-stranded RNA regulating gene expression by post-transcriptional mechanisms. miRNAs have been increasingly recognized as essential regulators of ion channels and transporters responsible for ASL homeostasis. miRNAs also influence the airway host defense. We summarize the most up-to-date information on the role of miRNAs in ASL homeostasis and host-pathogen interactions in the airway and discuss concepts for miRNA-directed therapy.