Longevity of Immunoglobulin-G Antibody Response Against Nucleocapsid Protein Against SARS-CoV-2 Among Healthcare Workers.

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused the latest pandemic and the most significant challenge in public health worldwide. Studying the longevity of naturally developed antibodies is highly important clinically and epidemiologically. This paper assesses the longevity of antibodies developed against nucleocapsid protein amongst our health-care workers. Methods: This longitudinal cohort study was conducted at a tertiary hospital, Saudi Arabia. Anti-SARSsCoV-2 antibodies were tested among health-care workers at three-point intervals (baseline, eight weeks, and 16 weeks). Results: Of the 648 participants, 112 (17.2%) tested positive for Coronavirus (COVID-19) by PCR before the study. Of all participants, 87 (13.4%) tested positive for anti-SARS-CoV-2 antibodies, including 17 (2.6%) participants who never tested positive for COVID-19 using rt-PCR. Out of the 87 positive IgG participants at baseline, only 12 (13.7%) had remained positive for anti-SARS-CoV-2 antibodies by the end of the study. The IgG titer showed a significant reduction in values over time, where the median time for the confirmed positive rt-PCR subgroup from infection to the last positive antibody test was 70 (95% CI: 33.4-106.5) days. Conclusion: Health-care workers are at high risk of exposure to the SARS-CoV-2 virus, and contracting an asymptomatic infection is not unlikely. Developing and sustaining natural immunity differs from one person to another, while the rate of positive IgG anti-SARS-CoV-2 wanes over time. Clinicaltrialsgov Identifier: NCT04469647, July 14, 2020.

Years of life lost due to the psychosocial consequences of COVID-19 mitigation strategies based on Swiss data.

BACKGROUND: The pandemic caused by coronavirus disease 2019 (COVID-19) has forced governments to implement strict social mitigation strategies to reduce the morbidity and mortality from acute infections. These strategies, however, carry a significant risk for mental health, which can lead to increased short-term and long-term mortality and is currently not included in modeling the impact of the pandemic. METHODS: We used years of life lost (YLL) as the main outcome measure, applied to Switzerland as an example. We focused on suicide, depression, alcohol use disorder, childhood trauma due to domestic violence, changes in marital status, and social isolation, as these are known to increase YLL in the context of imposed restriction in social contact and freedom of movement. We stipulated a minimum duration of mitigation of 3 months based on current public health plans. RESULTS: The study projects that the average person would suffer 0.205 YLL due to psychosocial consequence of COVID-19 mitigation measures. However, this loss would be entirely borne by 2.1% of the population, who will suffer an average of 9.79 YLL. CONCLUSIONS: The results presented here are likely to underestimate the true impact of the mitigation strategies on YLL. However, they highlight the need for public health models to expand their scope in order to provide better estimates of the risks and benefits of mitigation.

Bat ASC2 suppresses inflammasomes and ameliorates inflammatory diseases.

Bats are special in their ability to live long and host many emerging viruses. Our previous studies showed that bats have altered inflammasomes, which are central players in aging and infection. However, the role of inflammasome signaling in combating inflammatory diseases remains poorly understood. Here, we report bat ASC2 as a potent negative regulator of inflammasomes. Bat ASC2 is highly expressed at both the mRNA and protein levels and is highly potent in inhibiting human and mouse inflammasomes. Transgenic expression of bat ASC2 in mice reduced the severity of peritonitis induced by gout crystals and ASC particles. Bat ASC2 also dampened inflammation induced by multiple viruses and reduced mortality of influenza A virus infection. Importantly, it also suppressed SARS-CoV-2-immune-complex-induced inflammasome activation. Four key residues were identified for the gain of function of bat ASC2. Our results demonstrate that bat ASC2 is an important negative regulator of inflammasomes with therapeutic potential in inflammatory diseases.

Survey of emergency medicine doctors in London physical activity characteristics, awareness of guidelines and prescribing behaviours.

Objective: To determine London emergency medicine (EM) doctors' physical activity (PA) characteristics, awareness of PA guidelines and PA prescription practice from London emergency departments (EDs). Methods: An anonymous online survey of EM doctors working in London over 6 weeks between 27 April 2021 and 12 June 2021. Inclusion criteria included EM doctors of any grade currently working in London EDs. Exclusion criteria were non-EM doctors, other healthcare professionals and those working outside London EDs. The Emergency Medicine Physical Activity Questionnaire created consisted of two parts: part 1, on basic demographic data and the Global Physical Activity Questionnaire and part 2, focused questions around awareness of guidelines and prescribing characteristics. Results: 122 participants attempted the survey, of which 75 (61.5%) met the inclusion criteria. 61.3% (n=46) were aware of and 77.3% (n=58) achieved minimum recommended aerobic PA guidelines. However, only 33.3% (n=25) were aware of and 48% (n=36) achieved muscle strengthening (MS) guidelines. The mean sedentary behaviour time/day was 5 hours. 75.3% (n=55) of EM doctors thought it was important to prescribe PA, yet only 41.8% (n=23) prescribed PA. Conclusions: Most London EM doctors are aware of and achieve minimum aerobic PA guidelines. Encouraging MS awareness and activities, as well as PA prescribing, should be areas of focus. Larger studies should take place to assess EM doctors' characteristics in UK regions and data using accelerometers to determine PA more precisely. Further research should also look at patient perceptions of PA.

Vaccine-induced correlate of protection against fatal COVID-19 in older and frail adults during waves of neutralization-resistant variants of concern: an observational study.

Background: To inform future preventive measures including repeated vaccinations, we have searched for a clinically useful immune correlate of protection against fatal COVID-19 among nursing homes residents. Methods: We performed repeated capillary blood sampling with analysis of S-binding IgG in an open cohort of nursing home residents in Sweden. We analyzed immunological and registry data from 16 September 2021 to 31 August 2022 with follow-up of deaths to 30 September 2022. The study period included implementation of the 3rd and 4th mRNA monovalent vaccine doses and Omicron virus waves. Findings: A total of 3012 nursing home residents with median age 86 were enrolled. The 3rd mRNA dose elicited a 99-fold relative increase of S-binding IgG in blood and corresponding increase of neutralizing antibodies. The 4th mRNA vaccine dose boosted levels 3.8-fold. Half-life of S-binding IgG was 72 days. A total 528 residents acquired their first SARS-CoV-2 infection after the 3rd or the 4th vaccine dose and the associated 30-day mortality was 9.1%. We found no indication that levels of vaccine-induced antibodies protected against infection with Omicron VOCs. In contrast, the risk of death was inversely correlated to levels of S-directed IgG below the 20th percentile. The death risk plateaued at population average above the lower 35th percentile of S-binding IgG. Interpretation: In the absence of neutralizing antibodies that protect from infection, quantification of S-binding IgG post vaccination may be useful to identify the most vulnerable for fatal COVID-19 among the oldest and frailest. This information is of importance for future strategies to protect vulnerable populations against neutralization resistant variants of concern. Funding: Swedish Research Council, SciLifeLab via Knut and Alice Wallenberg Foundation, VINNOVA. Swedish Healthcare Regions, and Erling Persson Foundation.

Rapid cytokine release assay in whole blood determines longitudinal T-cell responses against ancestral, Delta, and Omicron SARS CoV-2 variants

Background: A simple, accurate and rapid whole blood-based T-cell test was previously developed to determine SARS-CoV- 2- specific T-cell immunity. Herein, the test was utilized to measure the magnitude of T-cell responses up to 6 months post-vaccination, assess the effects of vaccine boosters, and to elucidate any effect that Delta and Omicron variants may have on T-cell immunity. Method(s): Immunocompetent individuals (n = 44) were recruited to donate a blood sample between one-and six-months post-vaccination. Whole blood was stimulated overnight with peptides spanning immunodominant regions specific for ancestral SARS-CoV- 2. Blood plasma samples were analysed for IL-2 production via Luminex xMAP cytokine array, as this was previously demonstrated to be the most accurate biomarker for the test. Following booster vaccinations, 58 individuals donated a blood sample between one-and four-months post-booster and T-cell responses after overnight stimulations were assessed. Additionally, 30 samples were stimulated with peptides from the immunodominant regions of the Delta and Omicron SARS-CoV- 2 variants and IL-2 levels were compared. Result(s): A comparison of T-cell responses from samples donated up to one-month and six-months post-vaccination revealed no significant differences in the magnitude of IL-2 production (p = 0.9252), with near equivalent means. Booster vaccinations increased the magnitude of the T-cell response in 69% of individuals analysed, with the mean production of IL-2 rising from 77pg/ml six-months pre-booster to 141pg/ml 3-weeks post-booster. Analysis of the longevity of post-booster T-cell response demonstrated no significant differences in the magnitude of IL-2 (p = 0.8141) production, with near equivalent means at one-month and 4-months post-booster (119pg/ml and 111pg/ml, respectively). Finally, no significant differences in the magnitude of IL-2 were observed between samples stimulated with either ancestral, Delta or Omicron peptides, with the means of each group being highly comparable. Conclusion(s): Results from this rapid whole blood-based T-cell test indicate that T-cell immunity to multiple variants of SARS-CoV- 2 within immunocompetent cohorts does not wane significantly over time. However, booster vaccinations may be important for individuals who have lower levels of immunity following their first complete vaccination doses. This test could be a valuable tool in the assessment of SARS-CoV- 2 immunity in multiple cohorts of clinical vulnerable individuals.

Survival Analysis and Its Application of Discharge Time Likelihood Prediction Using Clinical Data on COVID-19 Patients-Machine-Learning Approaches

COVID-19 has significant fatality rate since its appearance in December 2019 as a respiratory ailment that is extremely contagious. As the number of cases in reduction zones rises, highly health officials are control that authorized treatment centers may become overrun with corona virus patients. Artificial neural networks (ANNs) are machine coding that can be used to find complicate relationships between datasets. They enable the detection of category in complicated biological datasets that would be impossible to identify with traditional linear statistical analysis. To study the survival characteristics of patients, several computational techniques are used. Men and older age groups had greater mortality rates than women, according to this study. COVID-19 patients discharge times were predicted;also, utilizing various machine learning and statistical tools applied technically. In medical research, survival analysis is a regularly used technique for identifying relevant predictors of adverse outcomes and developing therapy guidelines for patients. Historically, demographic statistics have been used to predict outcomes in such patients. These projections, on the other hand, have little meaning for the individual patient. We present the training of neural networks to predict outcomes for individual patients at one institution, as well as their predictive performance using data from another institution in a different region. The research output show that the Gradient boosting longevity model beats the all other different models, also in this research study for predicting patient longevity. This study aims to assist health officials in making more informed decisions during the outbreak. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Multisystem Imaging Recommendations/Guidelines: In the Pursuit of Precision Oncology

With an increasing rate of cancers in almost all age groups and advanced screening techniques leading to an early diagnosis and longer longevity of patients with cancers, it is of utmost importance that radiologists assigned with cancer imaging should be prepared to deal with specific expected and unexpected circumstances that may arise during the lifetime of these patients. Tailored integration of preventive and curative interventions with current health plans and global escalation of efforts for timely diagnosis of cancers will pave the path for a cancer-free world. The commonly encountered circumstances in the current era, complicating cancer imaging, include coronavirus disease 2019 infection, pregnancy and lactation, immunocompromised states, bone marrow transplant, and screening of cancers in the relevant population. In this article, we discuss the imaging recommendations pertaining to cancer screening and diagnosis in the aforementioned clinical circumstances.Copyright © 2023 Wolters Kluwer Medknow Publications. All rights reserved.

Impact of COVID 19 on bacterial respiratory isolates (2018-2021) from a UK tertiary cardio-thoracic ICU

Aim: To study the impact of COVID-19 admissions during 1st and 2nd surges on bacteriology of ICU respiratory isolates. Method(s): Retrospective time trend analysis of bacterial respiratory isolates from a single centre, tertiary cardiothoracic ICU (CT-ICU) from patients admitted from Jan 2018- June 2021. We compared pre-COVID-19 (January 2018- March 2020) and COVID-19 periods (April 2020- June 2021) and surge periods (surge 1: March 2020- June 2020, surge 2: January- March 2021) to similar time frames in previous years. Chi-square test used to compare proportions. Result(s): 4974 respiratory isolates (Sputum-4230, BAL-563, ET secretions-181) included. During surge 2, culture positivity and gram-negative rates tripled from baseline (20% to 75%;p<0.05). Comparing the pre- pandemic to pandemic period, rates of Klebsiella sp, Acinetobacter sp and Stenotrophomonas sp increased from 12% to 21.3%, 2.4% to 6.2% and 10.5% to 14.3% respectively, while Pseudomonas sp dropped from 30.7% to 23.1% (all p<0.05). MDR Pseudomonas increased significantly from 38.9% to 47.9% (p<0.05), with a non-significant increase in MRSA (5.2% to 9.3%;p=0.34) and MDR enterobacterales (22.6% to 23%;p=0.48). Conclusion(s): This is the first report from a UK CTICU showing a marked epidemiological shift in the bacteriology of respiratory isolates in terms of organism profile, increase in culture positivity and MDR Pseudomonas rates during the pandemic. Analyzing trends on longevity of the findings will help guide changes to infection control and antibiotic policies. This emphasizes the importance of unit specific ecology in choosing appropriate timely antimicrobial therapy and therefore improving patient outcome.

Prediction of mental health disorders during COVID 19 pandemic using analytical model

Introduction: Occupational Health Services (OHS) promotes the partnership between employees and their mental well-being at the workplace to ensure the safety and health of the employees by setting and enforcing standards, to minimize fatigue, injury, and ill-health from workplaces. This paper deals with analytical tools especially Machine Learning Modelling which combines operational data with data analysis of stress-related mental disorders due to the COVID pandemic to present complex and competitive medical information to OHS physicians and management. Objective(s): To predict the mental health disorder trends from medical history and Covid-19 data samples due to the ongoing COVID pandemic Material(s) and Method(s): The Case study of the computing analytical tools by using data available (COVID 19 positive cases in industry setup) of employees and will be used to track signs and symptoms of mental health disorders of employees and is user friendly and helpful to key decision-makers. This paper deals with attributes of stressrelated disorders depending on signs and symptoms and classifies patients into mild, moderate, and severe stress categories. Result(s): The resultant mental disorder tendency in employees is related to a stressful environment, both at home and work due to the surge in COVID 19 cases. It may be a cause for mental disorders in the future also. Thus, OH physician may suggest remedial measures to give early-stage treatment for mental health disorders that may impair the mental health and vitality of employees leading to accidents and also preventing potential chronic mental health diseases in future Conclusion(s): This analysis will provide healthy, happy & productive employees at the workplace by helping OH physicians in identifying mental health disorders at an early stage and suggesting employees continue positive mental attributes which will promote their health and longevity. Thus, this tool helps in the promotion, prevention, and protection of the health of employees especially the mental aspect which is often ignored.

Life Course Education, Health, and Ageing Well: A Short Inter-Academic Report.

After the first wave of the COVID-19 pandemic, during which the severity of the disease in certain countries was attributed to a lack of basic education of the inhabitants, the authors of this paper initiated a literature review of educational trajectories, health, and ageing well. The findings strongly demonstrate that alongside genetics, the affective and educational family environment, as well as the general environment, greatly interact starting from the very first days of life. Thus, epigenetics plays a major role in the determination of health and disease [DOHAD] in the first 1,000 days of life as well as in the characterization of gender. Other factors such as socio-economic level, parental education, schooling in urban or rural areas, also play a major role in the differential acquisition of health literacy. This determines adherence (or lack thereof) to healthy lifestyles, risky behaviours, substance abuse, but also compliance with hygiene rules, and adherence to vaccines and treatments. The combination of all these elements and lifestyle choices facilitates the emergence of metabolic disorders (obesity, diabetes), which promote cardiovascular and kidney damage, and neurodegenerative diseases, explaining that the less well educated have shorter survival and spend more years of life in disability. After having demonstrated the impact of the educational level on health and longevity, the members of this inter-academic group propose specific educational actions at three levels: (1) teachers and health professionals, (2) parents, (3) the public, emphasizing that these crucial actions can only be carried out with the unfailing support of state and academic authorities.

URINARY BIOMARKER ANALYSES ON JAPANESE, MEDITERRANEAN AND EURO-WESTERN POPULATIONS: WHICH IS BETTER FOR POSTPANDEMIC LONGEVITY?

Objective: Since nutrition could extend lifespan even in stroke-prone rats developing stroke genetically, our WHO-Collaborating Center for Primary Prevention of Cardio-vascular Diseases (CVD) started world-wide hearth examination to investigate nutrition good for healthy longevity by collecting 24-hour urine (24U) samples. Design: Urinary biomarkers of nutritions, sodium for salt, potassium (K) for vegetables and fruits, isoflavones(Is) for soy, taurine(Ta) for fish and magnesium (Mg) for beans and nuts were analyzed in 24U among 4211 participants (49.7% females(F)), aged 48-56 years in 50 populations from 22 countries according to WHO-CARDIAC(Cardiovascular Diseases and Alimentary Compression) Study Protocol, and studied comparatively in 6 Japanese(J), 6 Mediterranean(M) populations from Greece, Italy(2), Spain(2), Portugal and 6 Euro-Western(EW) populations from Sweden, Ireland, Scotland, Canada, Australia, New Zealand. Results with Discussion: The quintile analyses of Ta and Mg/creatine ratio in the world were inversely associated with CVD risks. The Odds ratios of obesity, hypercholesterolemia and hypertension in the lowest quintile of both Ta and Mg were 6.3, 4.6 and 1.8, respectively. J and M populations had significantly higher Ta and Mg therefore, lower CVD risks than EW, but J and M took more salt increasing the risk of stroke (Table 1). Despite the high salt intake, M had the merit of significantly high K intake to attenuate the adverse salt effect. J had a merit to take Is from soy containing Mg. Since Is intake was inversely associated with lower BMI in the world populations, high Japanese Mg intake was related to high Is intake which was inversely associated with obesity in Japan. In fact, the Japanese populations who took significantly higher T and Mg had lower BMI as well as higher HDL and folic acid in the blood, expected to prevent atherosclerosis and dementia. In contrast to M and EW, particularly severe obesity over BMI 30 was obviously less in J, ranking 182nd among 190 populations (WHO). The mortality rates of COVID-19 were significantly positively related to the ratio of severe obesity among 20 major countries in the world and this mortality was obviously lower in J, suggestive of the potential of J diet for post-pandemic longevity. Conclusion: 24U biomarker analyses indicated low-salted J and M diets are recommendable for CVD prevention. J diet is so far better than M diet because of lower CVD risks such as obesity and lipidemia, which were proven by urinary biomarkers to be related with traditional fish and soy intakes.

Health Wire

This section offers news briefs pertaining to health as of January 1, 2023. Research suggests that regular home monitoring can help keep blood pressure at a lower level. A study found that drinking java made with ground coffee may help lower the risk of dying over 12 years than drinking no coffee. Older adults who did yoga or a short course of cognitive behavioral therapy reported less anxiety and insomnia.

Induction and subsequent decline of S1-specific T cell reactivity after COVID-19 vaccination.

We analyzed magnitude and duration of SARS-CoV-2-specific T cell responses in healthy, infection-naïve subjects receiving COVID-19 vaccines. Overlapping peptides spanning the N-terminal spike 1 (S1) domain of the spike protein triggered secretion of the T cell-derived cytokine interleukin-2 ex vivo in 94/94 whole blood samples from vaccinated subjects at levels exceeding those recorded in all 45 pre-vaccination samples. S1-specific T cell reactivity was stronger in vaccinated subjects compared with subjects recovering from natural COVID-19 and decayed with an estimated half-life of 134 days in the first six months after the 2nd vaccination. We conclude that COVID-19 vaccination induces robust T cell immunity that subsequently declines. EudraCT 2021-000349-42. https://www.clinicaltrialsregister.eu/ctr-search/search?query=2021-000349-42.

Spike Ab seroconversion following SARS-CoV-2 vaccination in Australian people with Multiple Sclerosis

Background: SARS-CoV-2 antibody responses after COVID-19 vaccination are attenuated in people living with MS on high efficacy DMTs such as Fingolimod and Ocrelizumab. Uncertainties on how to manage vaccination schedule and DMT administration persist. Furthermore, data on effects of newer related DMTs like Siponimod and Ofatumumab are limited. Objective(s): We aimed to determine the seroprevalance of Spike antibody and the longevity of antibody mediatedimmune protection after COVID-19 vaccination in MS patients. Method(s): Spike IgG antibodies against Wuhan SARS CoV-2 were assessed in sera (n=520) of MS patients collected pre-vaccination (baseline n= 304), 1 month post second dose (n=172), 6 months post second dose (n=23) and 1 month post third dose (n=21). Demographic and clinical information including age, gender, DMT treatment and timing of COVID-19 vaccination were collected from 160 of these MS patients. Result(s): 151/172 sera at 1 month post second dose, 20/23 sera at 6 months post second dose, and 15/21 sera at 1 month post third dose were positive for Spike antibodies. Seropositive patients were treated on Alemtuzumab;n=3, Cladribine;n=32, Dimethyl fumarate;n=8, Fingolimod;n=16, IFN;n =4, Ocrelizumab;n=14, Ofatumumab;n=4, Natalizumab;n=11, Siponimod;n=1 and Teriflunomide;n=1. Out of the 21 patients who did not seroconvert at a month post second dose, treatment information was available in 12 patients. n=9 were treated by Ocrelizumab and n=2 were treated by Cladribine and n=1 was treated by Fingolimod, confirming certain DMTs prevent seroconversion. Out of the 151 patients that did seroconvert, 120 had titers that were comparable to controls (healthy general population) and 31 had reduced titres. Treatment information was available in 21/31 of these patients. Interestingly, 9/21 were on Ocrelizumab, 8/21 were on Fingolimod, 2/21 were on Ofatumumab, 1/21 was on Natalizumab and 1/21 was on Siponimod. This finding confirmed that certain DMTs such as Fingolimod, Ocrelizumab, Ofatumumab and Siponimod cause a reduction in post-vaccination Spike antibody titers in MS patients in comparison to general population. Expectedly, 304/304 sera were negative at baseline. Conclusion(s): Some High efficacy DMTs reduce Spike Ab titers or even prevent seroconversion. To maximize vaccine-mediated immune protection against COVID-19, timing of DMT administration and vaccine schedule may need intricate co-ordination in people living with MS.

Role of Sex and Age in Fatal Outcomes of COVID-19: Women and Older Centenarians Are More Resilient.

In the present paper, we have analysed the role of age and sex in the fatal outcome of COVID-19, as there are conflicting results in the literature. As such, we have answered three controversial questions regarding this aspect of the COVID-19 pandemic: (1) Have women been more resilient than men? (2) Did centenarians die less than the remaining older people? (3) Were older centenarians more resistant to SARS-CoV-2 than younger centenarians? The literature review demonstrated that: (1) it is women who are more resilient, in agreement with data showing that women live longer than men even during severe famines and epidemics; however, there are conflicting data regarding centenarian men; (2) centenarians overall did not die less than remaining older people, likely linked to their frailty; (3) in the first pandemic wave of 2020, centenarians > 101 years old (i.e., born before 1919), but not "younger centenarians", have been more resilient to COVID-19 and this may be related to the 1918 Spanish flu epidemic, although it is unclear what the mechanisms might be involved.