The impact of passive smoking in infancy on respiratory morbidity during covid-19 pandemic: a birth-cohort study

Objective: To evaluate the role of passive smoking (PS) on the incidence of wheezing and overall respiratory morbidity in infants born during the first peak of the coronavirus (COVID-19) pandemic, compared to infants born during the preceding year. Method(s): We used data collected in our recently published retrospective birth cohort study of 588 infants, 294 in each group, born in February-March 2020 (COVID-19 group) compared to a control group born in February-March 2019 (pre-COVID-19 group), at one year of age, using parental, telephone questionnaires. The primary outcome of wheezing/bronchodilator were similarly decreased, in PS and in non-PS (NPS)1. We further, conducted a post-hoc subgroup analysis of the respiratory outcomes: recurrent wheezing, emergency-room (ER) visits, pneumonia and admissions due to lower-respiratory-tract-infections (LRTI), to account for PS exposure. Atopy, daycare attendance, breastmilk, cesarean-section, siblings and gestational age were included in logistic regression models. Result(s): Demographic, perinatal, and atopic characteristics were similar between the groups. In NPS, secondary outcomes, including wheezing (OR 0.43, 95%CI 0.24-0.76), LRTI admissions (OR 0.1, 95%CI 0.01-0.89), recurrent wheezing (OR 0.28, 95%CI 0.11-0.7), ER admissions (OR 0.32, 95%CI 0.13-0.8) and pneumonia (OR 0.16, 95%CI 0.04-0.57) showed significant decreases during the COVID-19 first year pandemic. However, in PS, we did not observe these decreases in the respiratory morbidities. Conclusion(s): This study uncovers the overwhelming hazard of PS in abolishing the effect of the first year of COVID19 pandemic lock-downs, on infant's major respiratory morbidities.

The Avon Longitudinal Study of Parents and Children - A resource for COVID-19 research: Antibody testing results, April - June 2021.

The Avon Longitudinal Study of Parents and Children (ALSPAC) is a prospective population-based cohort which recruited pregnant women in 1990-1992 and has followed these women, their partners (Generation 0; G0) and their offspring (Generation 1; G1) ever since. The study reacted rapidly and repeatedly to the coronavirus disease 2019 (COVID-19) pandemic, deploying multiple online questionnaires and a previous home-based antibody test in October 2020. A second antibody test, in collaboration with ten other longitudinal population studies, was completed by 4,622 ALSPAC participants between April and June 2021. Of 4,241 participants with a valid spike protein antibody test result (8.2% were void), indicating antibody response to either COVID-19 vaccination or natural infection, 3,172 were positive (74.8%). Generational differences were substantial, with 2,463/2,555 G0 participants classified positive (96.4%) compared to 709/1,686 G1 participants (42.1%). Of 4,199 participants with a valid nucleocapsid antibody test result (9.2% were void), suggesting potential and recent natural infection, 493 were positive (11.7%); 248/2,526 G0 participants (9.8%) and 245/1,673 G1 participants (14.6%) tested positive, respectively. We also compare results for this round of testing to that undertaken in October 2020. Future work will combine these test results with additional sources of data to identify participants' COVID-19 infection and vaccination status. These ALSPAC COVID-19 serology data are being complemented with linkage to health records and Public Health England pillar testing results as they become available, in addition to four previous questionnaire waves and a prior antibody test. Data have been released as an update to the previous COVID-19 datasets. These comprise: 1) a standard dataset containing all participant responses to all four previous questionnaires with key sociodemographic factors; and 2) individual participant-specific release files enabling bespoke research across all areas supported by the study. This data note describes the second ALSPAC antibody test and the data obtained from it.

Including the child's voice in research from a longitudinal birth cohort: insights from the ROLO young person's advisory group.

BACKGROUND: Public and patient involvement (PPI) through Young Person's Advisory Groups (YPAG) enables children to provide guidance and insight into research activities. PPI is an important characteristic of research, however, to date, most collaboration has been with adults. Also, few YPAGs have been established within the Irish setting. The ROLO (Randomised cOntrol trial of a LOw glycaemic index diet in pregnancy to prevent macrosomia) YPAG was established in July 2020 to identify the research priorities of a group of healthy Irish children who are part of a longitudinal birth cohort. We aimed to describe this process and the key insights to date. METHODS: The ROLO study is a longitudinal birth cohort which has followed-up mother-child dyads at multiple timepoints over 10 years. Mothers actively involved in the study were contacted by the research team to invite their ROLO child and older sibling to participate in the YPAG. Meetings were conducted virtually between July 2020 and February 2022. Researchers encouraged free expression of views amongst the children regarding their research interests. Meetings were recorded, transcribed verbatim and analysed for themes based on the topics most frequently discussed and considered important to participants. RESULTS: In all, seven ROLO children and six older siblings attended four ROLO YPAG meetings. Participants were aged between nine to fifteen years old. Four key themes were identified; study children viewed their identity as part of a longitudinal birth cohort as positive and unique; study children considered the fitness test and body measurements as fun aspects related to their participation; all children considered the impact and use of social media as an important form of communication; and all participants expressed interest in attaining new health-related information and learning opportunities. Children suggested topics such as mental health, future viruses, organ transplants, cancer, and the effect of technology and chemicals on the body were important for future research. CONCLUSION: The ROLO YPAG offers promising scope for continued collaboration. The themes identified from the meetings contribute to a gap in the literature which will guide future research activities, particularly with children, in view of study design, relevance, and by communication strategies. Trial Details: ISRCTN54392969 registered at www.isrctn.com .

The ROLO pregnancy study took place in the National Maternity Hospital in Dublin Ireland. It started in 2007 and ended in 2011. The researchers recorded what women were eating. They also measured the weight of the baby at birth. Since then, ROLO mothers and their children were invited to come back to the study. Now the children of the study are 9­11 years of age.The researchers invited members of the ROLO study to speak with them. They wanted to know what research was important to them. They set up a group called the ROLO Family Advisory Committee in 2017. This group of parents and researchers meet once a year. The group thought it was important to include children as well. They made a new group called the ROLO Young Person's Advisory Group in 2020. The group has 7 ROLO children and 6 older siblings. The members are aged between 9 and 15-years-old. The children and researchers have met four times so far.The researchers found four key themes. Study children saw their identity as being part of a longitudinal birth cohort as positive and unique. Study children liked the fitness test and body measurements. All children thought that social media was an important form of communication. All children were interested in learning new information on how their bodies worked.Involving this group of children is important. It will make our research more relevant. Other researchers who want to involve children can learn from our experience.

Examining virtual research recruitment and participant diversity in a multi-center birth cohort, Childhood Allergy and the NeOnatal Environment" (CANOE)

Rationale: Recruitment for a NIH/ECHO-supported multi-center birth cohort, "Childhood Allergy and the NeOnatal Environment” (CANOE) stopped due to the COVID-19 pandemic. Redesign of study procedures emphasized virtual and socially distanced activities. We hypothesized that "virtual” recruitment methods (social media, websites, email) would surpass "traditional” methods (in-clinic, telephone, flyers/print materials) and increase enrollment of families from diverse backgrounds and communities. Methods: Pregnant women (n=439, target 500) were recruited from four academic medical centers in Detroit MI, Madison WI, Nashville TN, and St. Louis MO. We collected demographic and social information by questionnaires and examined race, ethnicity, age, parity, and employment status in relation to recruitment method using chi-square tests. Results: In-clinic and telephone recruitment comprised 55% of enrollment, followed by print materials (17%), and social media and email (15%). The cohort includes families self-identifying as Caucasian/White (63%), African American/Black (27%), Hispanic/Latino (3.3%), Asian (3.5%), and mixed races (1.2%). This reflects site demographics for White and Black patients, while other populations are not as well recruited into this cohort. Recruitment method success did not vary by race, ethnicity, maternal age, or employment status (p=ns for each comparison). Most (63%) multigravida mothers (9.1% of participants) were recruited in clinic, while primigravida participants were recruited more evenly via all methods. Conclusions: "Virtual” recruitment methods comprised a smaller proportion of cohort enrollment than hypothesized and study recruitment method did not vary by race/ethnicity;however, consideration of combined, varied, and novel recruitment methods may add to the development of best practices for more representative research study recruitment.

Hepatitis C Care Cascade Before and After Lifted Insurance Restrictions In Birth Cohort and Non-Birth Cohort Patients

Background. In 2016, the MetroHealth System implemented a system-wide hepatitis C (HCV) screening initiative in novel settings. We previously showed that those born 1945-1965 (birth cohort, BC) had higher rates of linkage to care (LTC) and sustained virologic response (SVR) rates compared to non-BC (not born 1945-1965). Since 2019, restrictions on fibrosis, sobriety and prescriber have been loosened. We hypothesized that gaps in care cascade between BC and non-BC patients (including LTC rates) would lessen in those diagnosed after 2019. Methods. We compared the HCV LTC rates and care cascade in patients diagnosed from Jan 1, 2016 to June 30 2017 (early group) to those diagnosed July 1, 2019 to Dec 31, 2020 (late group) as well between BC and non-BC patients. We performed logistic regression to evaluate the impact of race, gender, known prior HCV positivity, site of HCV diagnosis, HIV, insurance, active injection drug use (IDU), remote IDU, psychiatric disorder, BC status and early/late diagnosis on LTC. Results. The study population comprised 2103 HCV+ patients (1349 non-BC, 754 BC). There were 1026 patients in the early group and 1077 patients in the late group. 1353 patients were HCV RNA+. Of those, 914 (67.6%) were white, 306 (22.6%) African American;872 (64.4%) male;990 (74.5%) Medicaid;822 (60.7%) outpatient diagnosis. On multivariable analysis, factors affecting. LTC were: BC (aOR 1.71, 95%CI 1.19-2.45, p=0.003);diagnosed inpatient (aOR 0.45 (0.32-0.66), p< 0.0001), emergency department (aOR 0.55, (0.35-0.89), p=0.0142) or jail (aOR 0.23, (0.13-0.4), p=0.23);active IDU (aOR 0.22, (0.14-0.35), p< 0.0001);remote IDU (aOR 0.60, (0.4-0.89)p=0.01);and diagnosis in the late group (aOR 0.67, (0.51-0.8), p=0.005). The care cascade improved in the late group, but gaps remained in non-BC vs BC (Table). Conclusion. The non-BC continued to have lower rates of LTC compared to BC in the late group.Overall LTC was decreased in the late group for both non-BC and BC likely due to COVID-19. However, improvement in medication approval was shown in the late group, and most patients who were prescribed treatment completed it. Active IDU remained a barrier to non-LTC, but did not fully explain the differences between BC and non-BC patients. (Table Presented).

Prolonged respiratory viral infection associated with presence of coinfections in an urban birth cohort

Background. Prolonged infection by respiratory viruses has been reported, especially in hospitalized or immunocompromised children. However, little is known of factors contributing to prolonged respiratory viral infection, particularly in asymptomatic and less severe infections. We examined characteristics associated with prolonged viral infection in a community-based birth cohort. Methods. The PREVAIL cohort is a CDC-sponsored two-year birth cohort in Cincinnati, Ohio conducted during 4/2017 to 8/2020. Mid-turbinate nasal swabs were collected weekly from children and tested using the Luminex Respiratory Pathogen Panel. The primary outcome was prolonged viral infection, which was defined as a viral nucleic acid detection lasting 4 or more weeks. Proportions of prolonged viral infections were compared using Fisher's exact test with Holms corrections. Adjusted odds ratios (aOR) and 95% confidence intervals were calculated using a mixed effects logistic regression model while controlling for within-subject clustering, viral species, child age, child sex, symptom status, and coinfection. This analysis was limited to subjects who provided at least 70% of weekly samples. Results. Among 101 children, providing 7871 child-weeks of follow-up, we identified 780 viral infections. The median duration of infection across all respiratory viruses was 1 week, except for bocavirus and coronavirus NL63, each with 2 weeks;40% of bocavirus and >10% of adenovirus, coronavirus NL63, RSV A, human metapneumovirus, and parainfluenza 1 infections were associated with prolonged infection (>4 weeks). No prolonged infections were detected for influenza A or B, coronavirus 229E or HKU1, or parainfluenza 2 or 4 infections. Viral coinfection (aOR=3.1, 95% CI 1.9, 5.0) and female sex (aOR 1.8, 95%CI 1.1, 2.9) were significantly associated with prolonged infection, while symptom status and child age were not. Conclusion. In the PREVAIL cohort, detection of respiratory viruses lasting 4 weeks or longer was common for certain respiratory pathogens and was especially prolonged for bocavirus. Biological factors such as the presence of additional viral infections or child sex may affect the likelihood of prolonged infection. (Figure Presented).

Environmental Impacts on Infectious Disease: A Literature View of Epidemiological Evidence.

Background: This article summarises a session from the recent Pacific Basin Consortium for Environment and Health Focus meeting on Environmental Impacts on Infectious Disease. Objective: To provide an overview of the literature underpinning the presentations from this session. Methods: References used in developing the presentations were obtained from the presenters. Additional references were obtained from PubMed using key words from the presentations. Findings and Conclusions: The Hokkaido longitudinal children's study has found that exposure to chemicals in early life, such as persistent organic pollutants and per/polyfluorinated compounds, is associated with a range of immunological outcomes such as decreased cord blood IgE, otitis media, wheeze, increased risk of infections and higher risk of food allergy.Epidemiological evidence links exposure to poor air quality to increased severity and mortality of Covid-19 in many parts of the world. Most studies suggest that long-term exposure has a more marked effect than acute exposure.Components of air pollution, such as a newly described combustion product known as environmentally persistent free radicals, induce oxidative stress in exposed individuals. Individuals with genetic variations predisposing them to oxidative stress are at increased risk of adverse health effects from poor air quality.

The effect of home confinements on myopic risk profile in European adolescents: The Generation R Study

Purpose : To battle the spreading of the COVID-19 virus, all over the world measures like home confinement and nation-wide lockdowns have been implemented at regular intervals. These measures have shown an increase in myopic incidence particularly in China, which applied a very strict lockdown and home confinement. The Netherlands used a so called “intelligent lockdown” which allowed children to go outside. We evaluated the association between COVID restrictions and myopia risk factors in an European cohort of adolescents. Methods : A total of 1101 participants (mean age 16.3 ± 3.65 yrs) of the population-based prospective birth-cohort study Generation R filled in a questionnaire about their behavior before, during, and after lockdown in the Netherlands. These participants had undergone cycloplegic refractive error measurement at 13 years of age. We evaluated time spent outdoors, time spent online (handheld or other devices), time spent on near work (education and non-educational) from March-October 2020 in myopic (spherical equivalent <-0.5D) and non-myopic children. We used a repeated measures ANOVA to compare differences between these time periods, and logistic regression corrected for age, gender, and ethnicity to evaluate differences between myopic and non myopic children. Results : During and after lockdown the children spent signicantly more time online (+113 and +59min/day) on both hand held (+64 and +10 min/day) and other devices (+49 and +7 min/day), and on educational nearwork (+73 and +63min/day). Non-educational near work increased only significantly during lockdown (+176 min/day). Time spent outside did not change significantly and was ±2 hours/day. Children of non-European descent spent more time online (235min/day vs 260 min/day, P= 0.004) and on non-educational near work (452 min/day vs 559 min/day, p=0.0002). We found no significant difference in behavior between myopic and non-myopic children. Conclusions : The Dutch lockdown for COVID increased digitized near work in adolescents, but did not affect outdoor exposure. Children without myopia did not do better than those already myopic. Based on these results, we expect that the COVID pandemic will also lead to an increase in myopia prevalence and progression in European children, but to a lesser extent than in Asia.

Family income loss and child health inequality during the COVID-19 pandemic in Taiwan

Objectives: This study aimed to examine the relationship between family income loss and child health during the COVID-19 pandemic. Methods: Data for the analysis were obtained from the Taiwan Birth Cohort Study, a nationally representative sample of babies born in 2005, and 18, 024 caregivers participated in the survey as their children aged 15. In analysis, we first conducted descriptive analyses to test the correlation between socioeconomic variables and family income loss. We next assessed whether there was a gradient relationship between family income loss and child health using Cochran-Armitage trend test. Finally, multiple logistic regression was used to estimate the relationship between family income loss and child health. Results: Our findings indicated that (1) lower socioeconomic families were at a greater risk of suffering income loss during COVID-19;(2) children in the families experiencing a more severe loss of income had worse health, but the gradient relationship was not significant for those in higher income families;and (3) significantly higher risk of fair/poor health of children was found in the severe (OR: 1.3, 95% CI 1.2-1.5) and mild (OR: 1.2, 95% CI 1.1-1.3) income loss groups than in the no income loss group after adjustment for socioeconomic variables. Conclusions: Family income loss due to COVID-19 was significantly associated with child health inequality. To avoid widening the health gap, children in families experiencing financial impacts during the COVID-19 pandemic should be protected and supported, particularly those in lower socioeconomic groups. © 2022 Chinese Public Health Association of Taiwan. All rights reserved.

THE COVID-19 PANDEMIC AND MENTAL HEALTH: EFFECTS OF SOCIAL SUPPORT AND SELF-REGULATION

Social support has been widely associated with various morbidity and mortality. How does social support availability help youths cope with the global pandemic of Covid-19 and maintain their mental well-being? Utilizing data from a UK national birth cohort, namely the Millennium Cohort Study, this research investigated the joint role of social support availability and self-regulation against such major life stressors, inclusding G × E mechanisms. Results from 4095 cohort members (399 males (47.20%) and 2602 females (63.54%), others refused to report) suggested that social support availability at the outburst of Covid-19 pandemic, as well as age 7 emotional self-regulation (rated by cohort members' parents) contributes to youths' better mental health (viz., mental well-being and non-specific psychological distress) shortly after the outburst of Covid-19 (;B;s > 0.072, ps < .018). Most importantly, age 7 cognitive self-regulation and social support availability jointly predicted better their well-being 4 months later after the local outbursts of pandemic (for mental well-being, B = 0.309, p = .017, 95% CI = [0.056, 0.562];and for non-specific psychological distress, B =-0.299, p = .043, 95% CI = [-0.587,-0.011]). Johnson-Neyman plots (false discovery rate limited) suggested that it was those high but not low in cognitive self-regulation that benefited more from the perceived social support availability. Within the ranges of significance (81.19% for mental well-being and 80.94% for non-specific psychological well-being), social support availability positively predicted mental health and such effect increased gradually as the increase of age 7 cognitive self-regulation. Findings filled in the research gap such that social support and self-regulation have been investigated separately as two coping mechanisms, by revealing that self-regulation (i.e., internal resources) determines the utility of social support availability (i.e., external resources). Findings here inspired new research questions for the field, such as whether relevant developmental trajectories of self-regulation and social support might intertwin to cast on health trajectories, and whether these processes are subject to potential G × E interactions such as the exposure to childhood adversity or relevant genetic risks. Models to examine these hypotheses will be discussed.

Coronavirus Disease 2019 (COVID-19) Lockdown: Morbidity, Perception, Behaviors, and Attitudes in French Families From the PARIS Birth Cohort.

Background: Few studies have examined the overall experience of adolescents and their families during COVID-19 lockdowns. This study describes COVID-19-related morbidity in the PARIS birth cohort families during the first lockdown in France and identifies family profiles in terms of morbidity, perception, behaviors, and attitudes. Methods: Online questionnaires were sent to adolescents of the PARIS birth cohort and their parents. Possible COVID-19 was defined by symptoms using the ECDC definition. Household transmission was estimated by calculating the observed clinical secondary attack rates. Perception, behaviors and attitudes were assessed by levels of stress, degree of satisfaction regarding levels of information about COVID-19, degree of agreement with the lockdown and preventive measures. COVID-19 morbidity in adolescents and parents was compared using chi-squared or Student's t-tests. Within each family, perception, behaviors, and attitudes were compared between adolescents and parents using matched-pairs tests. To identify contrasting family profiles, a K-means cluster analysis was implemented. Results: Of 1,549 families contacted, 1,051 (68%) participated. Adolescents were less affected by possible COVID-19 than their parents (138.7 vs. 192.7 per 1,00,000 person-days). Household transmission of possible COVID-19 was higher when possible COVID-19 came from adults than from adolescents. Most families implemented preventive measures. Adolescents and parents generally shared the same attitudes, but adolescents were less compliant with restrictive measures. Four family profiles were identified which differed mainly regarding family stress, COVID-19 in the household, and compliance with preventive measures. Conclusion: Improving information dissemination to parents and adolescents, including dedicated adolescent messages, would increase adherence to preventive measures.

Evaluation of the Effects on Uninfected Pregnant Women and Their Pregnancy Outcomes During the COVID-19 Pandemic in Beijing, China.

Background: People's lifestyles may have changed during the COVID-19 pandemic, which may have a profound impact on pregnant women and newborns. This study aims to assess the effects of the COVID-19 pandemic on uninfected pregnant women and their newborns, including potential environmental factors. Methods: We retrospectively analyzed the pregnancy complications of 802 cases in the pandemic group and 802 controls in the pre-pandemic group in a matched nested case-control study, and evaluated the association with sociodemographic features, lifestyles, and other factors in 311 pregnant women with adverse pregnancy outcomes. Results: Compared to the pre-pandemic group, the rates of anemia, vaginitis, shoulder dystocia, and adverse pregnancy outcomes such as preterm birth were increased in the pandemic group. After controlling for the covariates, we observed a higher risk of adverse pregnancy outcomes in the pandemic group. Pregnant women with adverse pregnancy outcomes had an increased rate of anemia and vaginal candidiasis. Conclusion: COVID-19 pandemic has profound effects on adverse pregnancy outcomes, suggesting the importance of ensuring regular prenatal checkups and keeping a healthy lifestyle.

TV, computer, tablet and smartphone use and autism spectrum disorder risk in early childhood: a nationally-representative study.

BACKGROUND: Screen media use in early childhood has largely increased in recent years, even more so during the COVID-19 epidemic, and there is much discussion regarding its influence on neurodevelopment, including Autism Spectrum Disorder (ASD). METHODS: We examined the relationship between use of TV, computer, tablet and smartphone at age 2 years and risk of ASD assessed in telephone-based questionnaires among 12,950 children participating in the nationally representative ELFE ('Etude Longitudinale Française sur les Enfants') birth cohort study in France. RESULTS: In inverse-probability weighted (IPW) multinomial regression analyses, children's weekly or daily screen media use was associated with an increased likelihood of an intermediate risk of ASD (IPW-controlled OR for weekly use:1.07, 95% CI 1.02-1.12; IPW-controlled OR for daily use:1.05, 95% CI 1.02-1.08) but inversely associated with a high risk (IPW-controlled OR for weekly use: 0.60, 95% CI 0.50-0.73; IPW-controlled OR for daily use: 0.75, 95% CI 0.62-0.91), as ascertained by the M-CHAT. This was confirmed when studying TV as well as computer/tablet exposure separately. CONCLUSIONS: Overall, our nationally-representative study conducted among a large sample of 2-year-old children, indicates a complex relationship between screen exposure and ASD risk.

FEASIBILITY AND ACCEPTABILITY OF BABY1000 - LESSONS FROM CONDUCTING A NOVEL EARLY BIRTH COHORT STUDY DURING THE COVID-19 PANDEMIC

Background: Few birth cohort studies begin prospective data collection in very early pregnancy. The BABY1000 pilot study aims to assess the feasibility and acceptability of biological sample collection, health indicator measurement and questionnaire administration through early pregnancy and the first 2000 days of life. Methods: The feasibility and acceptability of BABY1000 were evaluated using mixed methods. Participants were invited to complete an online survey with an additional offer to a virtual focus group discussion. Quantitative feedback was analysed descriptively. Qualitative responses were analysed using discourse analysis to examine the beliefs, values, and practices of participants. Results: From September to November 2021, 87 mothers completed the survey (mean age 33.5 years [SD 3.7], 60% born in Australia). From this, 22 parents participated in one of five focus groups. Main reported benefits of study participation were the ability to have children assessed physically, access additional scans, and ask researchers questions face-to-face. Protocol changes introduced due to COVID-19, including at-home data collection, affected participants' perceptions of the benefits of involvement and represented the highest number of comments received (27% of comments from survey and focus group feedback). Most participants reported feeling comfortable with sample collection (>95%), though less reported feeling comfortable or neutral about taking their own stool sample (80%). Conclusions: It is feasible to collect a range of biological samples, questionnaire, and health indicator data from early pregnancy up to two years of age with moderately high acceptability. Unsurpisingly, protocol changes due to the COVID-19 pandemic affected participants' perceptions of study involvement.

Out of the shadows: Impact of SARS experience on Chinese netizens' willingness to donate for COVID-19 pandemic prevention and control.

While charitable donations help to raise funds and contribute to pandemic prevention and control, there are many unanswered questions about how people make such donation decisions, especially in countries like China where charitable donations have played an increasing role in recent years. This study contributes to the literature by assessing the potential impacts of Chinese netizens' experience with the 2002 severe acute respiratory syndrome (SARS) epidemic on their willingness to donate for COVID-19 pandemic prevention and control. Specifically, this study applies a difference-in-differences (DID) model to a dataset collected from a nationwide survey to examine how individuals' exposure to the SARS epidemic affects their willingness to donate to alleviate the COVID-19 pandemic. The results suggest that individuals' SARS epidemic experiences in their early lives, especially during the "childhood-adolescence" period, had a lasting and far-reaching impact on their willingness to donate toward COVID-19 pandemic prevention and control. Also, the impacts were likely heterogeneous by such sociodemographic factors as educational background, health status, and income level. The empirical findings highlight the importance of considering early-life experiences in developing and implementing epidemic prevention and control policies. While the SARS experience likely affected Chinese netizens' willingness to donate toward COVID-19 pandemic prevention and control, lessons learned from both the SARS epidemic and COVID-19 pandemic could be used to develop more effective public health education and prevention programs as well as to increase public donations for future pandemic prevention and control.

The Avon Longitudinal Study of Parents and Children - A resource for COVID-19 research: Home-based antibody testing results, October 2020. An emphasis on self-screening at a population level.

The Avon Longitudinal Study of Parents and Children (ALSPAC) is a prospective population-based cohort study which recruited pregnant women in 1990-1992 and has followed these women, their partners (Generation 0; G0) and offspring (Generation 1; G1) ever since. The study reacted rapidly to the COVID-19 pandemic, deploying online questionnaires in March and May 2020. Home-based antibody tests and a further questionnaire were sent to 5220 participants during a two-week period of October 2020.  4.2% (n=201) of participants reported a positive antibody test (3.2% G0s [n=81]; 5.6% G1s [n=120]). 43 reported an invalid test, 7 did not complete and 3 did not report their result. Participants uploaded a photo of their test to enable validation: all positive tests, those where the participant could not interpret the result and a 5% random sample were manually checked against photos. We report 92% agreement (kappa=0.853). Positive tests were compared to additional COVID-19 status information: 58 (1.2%) participants reported a previous positive test, 73 (1.5%) reported that COVID-19 was suspected by a doctor, but not tested and 980 (20.4%) believed they had COVID-19 due to their own suspicions.  Of those reporting a positive result on our antibody test, 55 reported that they did not think they had had COVID-19. Results from antibody testing and questionnaire data will be complemented by health record linkage and results of other biological testing- uniting Pillar testing data with home testing and self-report. Data have been released as an update to the original datasets released in July 2020. It comprises: 1) a standard dataset containing all participant responses to all three questionnaires with key sociodemographic factors and 2) as individual participant-specific release files enabling bespoke research across all areas supported by the study. This data note describes the antibody testing, associated questionnaire and the data obtained from it.

Estimating changes in physical behavior during lockdowns using accelerometry-based simulations in a large UK cohort.

To contain the recent COVID-19 outbreak, restrictions have been imposed, which has limited outdoor activity. These physical behavior changes can have serious health implications, but there is little objective information quantifying these changes. This study aimed to estimate the change in physical behavior levels during full lockdown conditions using objective data collected from a thigh-worn activity monitor. Data used were from 6492 individuals in the 1970 British Cohort Study, collected between 2016 and 2018. Using walking bout characteristics, days were classified as either "indoor only" (n = 861), "indoor and exercise" (n = 167), and "outdoor active" (n = 31 934). When compared to "outdoor active" days, "indoor only" days had 6590 fewer steps per day (2320 vs 8876, p < 0.001), a longer sedentary time (1.5 h, p < 0.001), longer lying time (1.4 h, p < 0.001) and shorter standing (1.9 h, p < 0.001) and stepping (1.3 h, p < 0.001) times. The "indoor and exercise" days had a smaller number of steps compared to "outdoor active" (7932 vs 8876, p < 0.05). There is a strong relationship between reduced daily stepping, and increased sedentary time, with a range of poor health outcomes. This has important implications for public health policy and messaging during pandemics.

High Rates of Hidden HCV Infections among Hospitalized Patients Aged 55-85.

BACKGROUND AND AIMS: The WHO has solicited all countries to eliminate HCV by 2030. The Italian government started routine screening for HCV infection in January 2021, initially targeting subjects born between 1969 and 1989. With the aim of achieving micro-elimination, we designed a hospital-wide project focusing on inpatients born from 1935 to 1985 and conducted it in our institution. METHOD: All inpatients aged 35 to 85, admitted from 10 February 2020 to 9 February 2021 for many different diseases and conditions underwent HCV antibody (HCVAb) testing by third-generation ELISA. When positive, reflex HCV RNA testing and genotyping were performed. Clinical history, fibrosis diagnosis, laboratory data and concomitant medications were available for all. RESULTS: The HCV screening rate of inpatients was 100%. In total, 11,748 participants were enrolled, of whom 53.50% were male. The HCVAb positivity rate was 3.03%. The HCVAb rate increased with age and was higher for patients born between 1935 and 1944 (4.81%). The rate of HCV RNA positivity was 0.97%. The vast majority (80.70%) of HCV RNA-positive participants were 55 or older; in about 40% of cases, HCV RNA-positive patients were unaware of their infection. Although 16 patients died after HCV chronic infection diagnosis (two due COVID-19) or HCV treatment prescription (one due to COVID-19), 74.56% of patient HCV diagnoses were linked to HCV treatment, despite their co-morbidities. All patients older than 65 who died had an active HCV infection. CONCLUSION: The present study revealed a rate of active HCV infections among inpatients lower than what has been reported in the past in the general population; this appears to be a result of the widespread use of pangenotypic direct-acting antiviral agents (DAAs). The overall rate of active infection was lower than the rate observed in the 1935-1954 cohort. The high rate of inpatients unaware of HCV infections and the high number of deaths among subjects with an active HCV infection born from 1935 to 1954, suggest that, at least in southern Italy, targeted screening of this birth cohort may be required to reduce the number of undiagnosed cases and hidden infections.

Knowledge, attitude and practice of Sari birth cohort members during early weeks of COVID-19 outbreak in Iran.

BACKGROUND: It has been determined that the coronavirus disease 2019 (COVID-19) pandemic needs social distancing and proper measures to prevent its spreading. This study aimed to determine COVID-19 knowledge, attitude, and practice among Sari Birth Cohort (SBC) members. METHODS: In this cross-sectional study linked to the SBC in north of Iran, mothers living in Sari and its suburbs from March 28 to April 8, 2020 were evaluated. The measurement tool was an online researcher-made, self-reported knowledge, attitude, and practice questionnaire related to COVID-19. RESULTS: In total, 1449 mothers with a mean age of 31.51 ± 5.73 years participated. Of them, 82.4% had good knowledge (98.6% in healthcare workers and 79.2% in housewives, p = 0.000). Most of them were worried about spread of the disease in the country (97.4%) and agreed that COVID-19 will finally be successfully controlled around the world (72.2%). Sleep disturbance was reported in 42.7% of mothers. Eighty-eight percent of cases wore masks and gloves when leaving home, 99.4% washed their hands frequently while 12.9% went to any crowded places. People with better knowledge followed safer practices (p = 0.000) and were more worried about the spread of the disease in the country and infection (among themselves and their first-degree relatives) (p = 0.000). CONCLUSIONS: Most of the SBC members had a good level of knowledge about COVID-19 but were worried about a long-term pandemic period. They also had good practices regarding the prevention of the disease.