A novel metric based approach of scoring early host immune response from oro- nasopharyngeal swabs predicts COVID-19 outcome (preprint)

Unpredictable fatal outcome of COVID-19 is attributed to dysregulated inflammation. Impaired early adaptive immune response leads to late stage inflammatory outcome. The purpose of this study was to develop biomarkers for early detection of host immune impairment at first diagnosis from leftover RNA samples, which may in turn identify high risk patients. Leftover RNA samples of COVID-19 patients at first diagnosis were stored. Following prospective follow-up, the samples were shorted and categorized into outcome groups. Impaired adaptive T cell response (severity score) and Impaired IL-10 response (undetectable IL-10 in the presence of high expression of a representative interferon response gene) were determined by RT-PCR based assay. We demonstrate that a T cell response based ‘severity score’ comprising rational combination of Ct values of a target genes’ signature can predict high risk noncomorbid potentially critical COVID-19 patients with a sensitivity of 91% (95%CI:58.7–99.8) and specificity of 92.6% (95% CI:75.7–99)(AUC:0.88). Although inclusion of comorbid patients reduced sensitivity to 77% (95%CI:54.6–92.2), the specificity was still 94% (95%CI:79.8–99.3)(AUC:0.82). The same for ‘impaired IL-10 response’ were little lower to predict high risk noncomorbid patients 64.2% (95%CI:35.1–87.2) and 82% (95%CI:65.5–93.2) respectively. Inclusion of comorbid patients drastically reduce sensitivity and specificity51.6% (95%CI:33.1–69.8) and 80.5% (95%CI:64.0-91.8) respectively. As best of our knowledge this is the first demonstration of a metric based approach showing the ‘severity score’ as an indicator of early adoptive immune response, could be used as predictor of severe COVID-19 outcome at the time of first diagnosis using the same leftover swab RNA. The work flow could reduce expenditure and reporting time of the prognostic test for an earliest clinical decision ensuring possibility of early rational management.

Quantile connectedness among real estate investment trusts during COVID-19: evidence from the extreme tails of distributions

Purpose: Given the evolving market integration, this study aims to explore the connectedness of 12 real estate investment trusts (REITs) during the COVID-19 period. Design/methodology/approach: The connectedness of 12 REITs was examined by considering three sample periods: full period, COVID peak period and COVID recovery period by using the quantile vector autoregressive (VAR) approach. Findings: The findings ascertain that REIT markets are sensitive to COVID, revealing significant connectedness during each sample period. The USA and The Netherlands are the major shock transmitters;thus, these countries are relatively better options for the predictive behavior of the rest of the REIT markets. In contrast, Hong Kong and Japan are the least favorable REIT markets with higher shock-receiving potential. Research limitations/implications: The study recommends implications for real estate industry agents and investors to evaluate and anticipate the direction of return connectedness at each phase of the pandemic, such that they can incorporate those global REITs less vulnerable to unplanned crises. Apart from these implications, the study is limited to the global REIT markets and only focused on the period of COVID-19, excluding the concept of other financial and health crises. Originality/value: This study uses a novel approach of the quantile-based VAR to determine the connectedness among REITs. Furthermore, the present work is a pioneer study because it is targeting different time periods of the pandemic. Additionally, the outcomes of the study are valuable for investors, policymakers and portfolio managers to formulate future development strategies and consolidate REITs during the period of crisis. © 2023, Emerald Publishing Limited.

Forecasting the volatility of precious metals prices with global economic policy uncertainty in pre and during the COVID-19 period: Novel evidence from the GARCH-MIDAS approach

Economic policy is a major determinant of investment and financial decisions;Moreover, prices of precious metals are highly influenced by any uncertainty recorded in the global economic policy. Therefore, the prime consideration of the authors is to assess how global economic policy uncertainty influences the volatility of precious metals prices;particularly "gold, palladium, platinum, and silver” in the pre and during the COVID-19 pandemic. This research analyzed the full sample period (the 1997–2022), pre-COVID period (1997–2019), and during the COVID period (2020−2022) to evaluate the impact during different sample periods. Therefore, the GARCH-MIDAS approach is employed at the data set of different frequencies, i.e., monthly data of GEPU and daily data of precious metals. The results reveal a significant nexus between global GEPU and precious metals price volatility. The findings infer that any uncertainty recorded in global economic policy escalate the price volatility of gold, palladium, platinum, and silver prices. The present study increments the existing literature and provides insights for future scholars, investors, and policymakers. © 2023 Elsevier B.V.

Multisystem Inflammatory Syndrome in Children.

BACKGROUND: Multisystem inflammatory syndrome in children (MIS-C) is a newly recognized condition affecting children with recent infection or exposure to coronavirus disease 2019 (COVID-19). MIS-C has symptoms that affect multiple organs systems, with some clinical features resembling Kawasaki disease (KD) and toxic shock syndrome (TSS). OBJECTIVE OF THE REVIEW: Our goal was to review the current literature and describe the evaluation and treatment algorithms for children suspected of having MIS-C who present to the emergency department. DISCUSSION: MIS-C has a wide clinical spectrum and diagnosis is based on a combination of both clinical and laboratory findings. The exact mechanism of immune dysregulation of MIS-C is not well understood. Physical findings may evolve and do not necessarily appear at the same time. Gastrointestinal, cardiac, inflammatory, and coagulopathy manifestations and dysfunction are seen frequently in MIS-C. CONCLUSIONS: The diagnosis of MIS-C is based on clinical presentation and specific laboratory findings. In the emergency setting, a high level of suspicion for MIS-C is required in patients exposed to COVID-19. Early diagnosis and prompt initiation of therapy offer the best chance for optimal outcomes.

Face Mask Wearing Recognition System for Big Data Video Streaming

With the outbreak of the covid-19 pandemic in recent years, Video Stream Analytics technology quickly became a hot topic of discussion across technology forums. As it has appeared, in the pandemic situation in recent years, the use of masks when interacting with the community is a must, that's why the research works on mask identification today and more. receiving more and more attention. Understanding the situation, the team conducted facial recognition analysis inside the video to determine if the people appearing in the video were wearing masks. to then apply the trained model into practice. After a period of research, the team has also successfully built a mask recognition system that can generate images and can display the results as real-time video. Especially, the model is trained successful using systemml machine learning system. This is considered a positive result with real-time masked face recognition analysis. © 2022 IEEE.

Colchicine anti-inflammatory therapy for non-intensive care unit hospitalized COVID-19 patients: results from a pilot open-label, randomized controlled clinical trial.

Systemic inflammation is a hallmark of severe coronavirus disease-19 (COVID-19). Anti-inflammatory therapy is considered crucial to modulate the hyperinflammatory response (cytokine storm) in hospitalized COVID-19 patients. There is currently no specific, conclusively proven, cost-efficient, and worldwide available anti-inflammatory therapy available to treat COVID-19 patients with cytokine storm. The present study aimed to investigate the treatment benefit of oral colchicine for hospitalized COVID-19 patients with suspected cytokine storm. Colchicine is an approved drug and possesses multiple anti-inflammatory mechanisms. This was a pilot, open-label randomized controlled clinical trial comparing standard of care (SOC) plus oral colchicine (colchicine arm) vs. SOC alone (control arm) in non-ICU hospitalized COVID-19 patients with suspected cytokine storm. Colchicine treatment was initiated within first 48 hours of admission delivered at 1.5 mg loading dose, followed by 0.5 mg b.i.d. for next 6 days and 0.5 mg q.d. for the second week. A total of 96 patients were randomly allocated to the colchicine (n=48) and control groups (n=48). Both colchicine and control group patients experienced similar clinical outcomes by day 14 of hospitalization. Treatment outcome by day 14 in colchicine vs control arm: recovered and discharged alive: 36 (75.0%) vs. 37 (77.1%), remain admitted after 14-days: 4 (8.3%) vs. 5 (10.4%), ICU transferred: 4 (8.3%) vs. 3 (6.3%), and mortality: 4 (8.3%) vs. 3 (6.3%). The speed of improvement of COVID-19 acute symptoms including shortness of breath, fever, cough, the need of supplementary oxygen, and oxygen saturation level, was almost identical in the two groups. Length of hospitalization was on average 1.5 day shorter in the colchicine group. There was no evidence for a difference between the two groups in the follow-up serum levels of inflammatory biomarkers including C-reactive protein (CRP), D-dimer, lactate dehydrogenase (LDH), ferritin, interleukin-6 (IL-6), high-sensitivity troponin T (hs-TnT) and N-terminal pro b-type natriuretic peptide (NT pro-BNP). According to the results of our study, oral colchicine does not appear to show clinical benefits in non-ICU hospitalized COVID-19 patients with suspected cytokine storm. It is possible that the anti-inflammatory pathways of colchicine are not crucially involved in the pathogenesis of COVID-19.

Multisystem Inflammatory Syndrome in Children.

Multisystem inflammatory syndrome in children (MIS-C) is an uncommon but emerging syndrome related to SARS-CoV-2 infection. While the presentation of MIS-C is generally delayed after exposure to the virus that causes coronavirus 2019, both MIS-C and Kawasaki disease (KD) share similar clinical features. Multisystem inflammatory syndrome in children poses a diagnostic and therapeutic challenge given the lack of definitive diagnostic tests and a paucity of evidence regarding treatment modalities. We review the clinical presentation, diagnostic evaluations, and management of MIS-C and compare its clinical features to those of KD.

Gravity of Covid-19

In this study, we analyze the impact of the Covid-19 pandemic on bilateral trade using monthly data from January to June 2020. Imports of the OECD member states are analyzed using a structural gravity model of trade estimated with the Poisson pseudo maximum likelihood estimator. The analysis is conducted for total imports and for fruit and vegetables. Our findings show a significantly negative impact of the pandemic on both import measures, which is more pronounced for the perishable goods than for aggregate imports. © 2022. Economics Bulletin. All Rights Reserved.

Renal Profile of patients Diagnosed with Corona Virus Disease (Covid-19) admitted in Tertiary Care Hospital

Aim: To assess the baseline renal profile of patients with COVID-19. Methods: It was a cross sectional study, conducted in hospitals of Rawalpindi Medical University from March to August 2020. Consecutive 169 confirmed cases of COVID-19 were enrolled. Patients with history of kidney disease were not included. Peripheral blood samples were analysed for renal functions on fully automated chemistry analyser. Estimated glomerular filtration rate (eGFR) for every patient was calculated using two equations for chronic kidney disease epidemiology collaboration (CKD-EPI) and modification of diet in renal disease (MDRD). Results: Out of total 169 COVID-19 patients, 97(57%) were males 72(43%) were females. The mean age was 54.1±16.30 (18 to 92) years. A total of 96(57%) patients were below 60 years of age. Mean Urea, serum creatinine (Scr) and blood urea nitrogen (BUN) were found to be elevated in this study cohort with no statistically significant difference with respect to age and gender (P value >0.05). Scr was raised in 46(27%) while 113(67%) and 103 (62%) patients had elevated serum Urea and BUN respectively. eGFR of <60mL/min/1.73m2 was observed in 50(30%) of patients. Conclusion: Elevated mean Urea, Scr and BUN were observed in COVID 19 patients without any significant difference according to age and gender. Moderate to severe derangement in eGFR was noted in one third of COVID 19 patients.

HRCT Pattern in COVID-19 Patients

Background: In December 2019, a group of cases of pneumonia of unknown cause was found in Wuhan, China, now known as coronavirus disease 2019, and the coronavirus was named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). High-resolution computed1tomography (HRCT) is currently regarded as a significant imaging technique for aiding in the diagnosis & management of COVID-19 patients. Objective: To find the different patterns of1manifestation in HRCT chest in COVID-19 patients. Study Design: Descriptive Cross-Sectional Setting: University of Lahore Teaching Hospital, Lahore Methodology: A descriptive, cross-sectional study was conducted in Radiology Department in University of teaching hospital, Lahore. 240 participants' medical histories were thoroughly reviewed, both directly from them and on case sheets. All patients with confirmed cases of COVID-19 pneumonia were admitted to the hospital and received a chest HRCT. Three follow-up HRCT chest scans were performed on one patient. The distribution and patterns of lung involvement were studied. Each of the five lung lobes was evaluated visually for degree of involvement and categorized as mild (26-50 percent), moderate (51-75 percent), or severe (75 percent) (76-100 percent). Data was analyzing in SPSS. Age was presented as mean + SD. Gender and other HRCT patterns were presented as frequency & percentage. Result: Total 240 COVID-19 patients included. There were 142(59.4%) male and 97(40.6%) female. The mean age was 54.0+15.71 with age range of 4 to 84 years. Large number of patients 114(47.7%) were in the age group 45-64 years. Ground glass opacity was the most common CT abnormality, with 236(99.2%) cases. Among them 49(20.5%) cases had GGO plus consolidations. Crazy paving pattern was seen in 136(56.9%) cases. Only 10(4.2%) patients with GGO pulmonary nodules and pleural effusion were involved. The majority of the patients had a fever 114(47.5%), while the least frequent symptom was a runny nose (7(2.9%). Conclusion: Pure GGO pneumonia is the most prevalent pattern of COVID-19 pneumonia seen on HRCT scans, GGO consolidation, with crazy paving with prominent distribution in the lung posterior & peripheral area.

Impact of Local and Demographic Factors on Early COVID-19 Vaccine Hesitancy among Health Care Workers in New York City Public Hospitals.

Despite the development of several effective vaccines, SARS-CoV-2 continues to spread, causing serious illness among the unvaccinated. Healthcare professionals are trusted sources of information about vaccination, and therefore understanding the attitudes and beliefs of healthcare professionals regarding the vaccines is of utmost importance. We conducted a survey-based study to understand the factors affecting COVID-19 vaccine attitudes among health care professionals in NYC Health and Hospitals, at a time when the vaccine was new, and received 3759 responses. Machine learning and chi-square analyses were applied to determine the factors most predictive of vaccine hesitancy. Demographic factors, education, role at the hospital, perceptions of the pandemic itself, and location of work and residence were all found to significantly contribute to vaccine attitudes. Location of residence was examined for both borough and neighborhood, and was found to have a significant impact on vaccine receptivity. Interestingly, this borough-level data did not correspond to the number or severity of cases in the respective boroughs, indicating that local social or other influences likely have a substantial impact. Local and demographic factors should be strongly considered when preparing pro-vaccine messages or campaigns.

Comparison of Mortality between Health Workers and General Population Infected with Covid-19

Objective: The main purpose of this study is to compare the mortality between health workers and general population infected with coronavirus disease. Study Design: Comparative/Retrospective study Place and Duration: Study was conducted at Medicine and Gastroenterology department of Ayub Teaching Hospital, Abbottabad for duration of six months from 1st January 2021 to 30th June 2021. Methods: In this study 250 patients of both genders with coronavirus infection were presented. Age of the patients was between 18-70 years. Informed written consent was taken from all the cases for baseline details including age, sex, body mass index, socio-economic status and residency. Included patients were both symptomatic and asymptomatic to disease. Among 250 cases 125 patients were in the general population included in group I while other 125 cases were health workers included in group II. Patients were admitted to the hospital and examined for recovery. Outcomes among both groups were assessed and compared in terms of ICU admission, ventilation requirement and rate of mortality. We used the SPSS 25.0 version to analyze complete data. Results: In group I, 65 (52%) patients were males and 60 (48%) cases were females with mean age 47.66±8.87 years and in group II, 70 (56%) were males and 55 (45%) females with mean age 27.66±8.87. Mean BMI in group I was 25.11±8.33 kg/m2 and in group II, body mass index was 22.32±7.54 kg/m2. Majority of the patients i.e 73 (58.4%) in group I had poor socio economic status but in group II 50 (40%) cases had poor economic status. Majority of the cases among both groups were from urban areas 75 (60%) and 85 (64%). 48 (38.4%) were symptomatic in group I and 53 (42.4%) were in group II. Hypertension, diabetes mellitus and heart disease were the most common comorbidities. Frequency of ICU admission, ventilation requirement and mortality was significantly higher in general population 19 (15.2%), 24 (19.2%), 14 (11.2%) as compared to health workers 6 (4.8%), 7 (5.6%) and 5 (4%) with p value < 0.05. Conclusion: We concluded in this study that the severity of pandemic disease among general population was higher because of less use of preventive measures as compared to health workers and frequency of deaths, ICU admission and use of invasive ventilation in general population were also very high.

Experiencing the Unprecedented COVID-19 Lockdown: Abu Dhabi Older Adults' Challenges and Concerns.

This study focused on older adults (60+ years old) of both genders in Abu Dhabi during the COVID-19 pandemic before vaccines were made available (age ranged from 60 years to 75 years). They faced more strict rules of movement restriction and isolation that might have resulted in certain psychological feelings and social reactions. The main objective was to understand Abu Dhabi older adults' psychological feelings during the pandemic and to identify their main concerns and challenges considering the various COVID-19-related policies and restrictions. The psychological feelings focused on fear, loneliness, sadness, irritability, emotional exhaustion, depressive symptoms, sleeping disorders, overeating, and excessive screen use. The objectives also included the changes in the psychological feelings concerning time. Other objectives covered better understanding the differences in (some activities) compared to the other age categories. Data were gathered through an online survey of community members from February to July 2020 as part of government initiatives (Department of Community Development). Responses were collected from 574 older adults in Abu Dhabi (60.1% male and 39.9% female). The analysis mainly used descriptive analysis, t-tests, analysis of variance (ANOVA), and simple trend analysis. For all tests, a p-value less than 0.05 was used for significance. The results pointed to the significant rise in feelings related to excessive screen use, fear, loneliness, and stress. The most significant concerns were related to more restrictions being imposed and not being able to see the grandchildren.The impact of new technologies on their quality of life was significantly reflected by respondents. The influence of the pandemic on older adults' health and weight was also investigated. Analysis of variance, t-tests, and regression analysis with relevant tests were employed. The relevant results showed that some negative psychological feelings were common among older adults during the pandemic. However, the psychological feelings did not portray significant changes with time, except for sleeping disorders and overeating. Overall, older adults scored significantly different from other age groups on many challenges, concerns, and views regarding new technologies during the pandemic. No significant differences were observed regarding gender and marital status for the challenges and concerns. The research summarizes some policy guidance while noting some limitations of this study and future research directions.

Analysis of Serial C-Reactive Protein Levels in Critically Ill COVID-19 Patients Receiving Tocilizumab

Background and Objective: COVID-19 can cause severe acute respiratory distress syndrome. With deteriorating disease, most of the patients may require intensive care admission. This study was carried out to determine and evaluate the response of Tocilizumab with special reference to C-reactive protein (CRP) in critically ill patients presented to Farooq Hospital, West Wood Lahore. Methods: This retrospective study included the data of 55 critically ill COVID-19 patients (respiratory rate ≥30, SpO2<93%, oxygen requirement ≥5L/min, PaO2/FiO2 ≤300 mmHg) admitted in Corona unit of Farooq Hospital West Wood Lahore, who were being treated with Tocilizumab alongwith standard treatment protocol between April 27 and June 21, 2020. The data has been retrieved from hospital records after taking appropriate permission and consent. Demographic, clinical features and serum CRP were recorded for each of them, before and after administration of Tocilizumab. Data analysis was done by Statistical Package for the Social Sciences (SPSS) version 22.0 and expressed as frequency and percentages. Results: Out of 55 patients who were administered Tocilizumab, 72.7% survived whereas 27.3% died. There was higher median reduction of CRP levels in patients who survived (77.5 to 34.9 mg/L) as compared to those who died (65.5 to 45.3 mg/L). There was a statistically significant difference between CRP levels at the time of admission, 72 hours after Tocilizumab was administered (P<0.0001). Conclusion: Tocilizumab administration might be helpful in reducing the complications of cytokine storm in patients with severe COVID-19 pneumonia. © 2020, Biomedica. All Rights Reserved.

Mother’s knowledge regarding oral health practices and risk factors with respect to their children in the twin cities of Pakistan

Objective: To analyze the way mothers perceive oral health in their children, the importance of oral health amongst children, so that preventive advice and regime can be tailored accordingly and reinforced during the pandemic. Study Design: Questionnaire base survey. Place and Duration of Study: This study was conducted in the various sectors of the twin cities of Pakistan, from May to Sep 2020. Methodology: This study was a questionnaire-based study in which survey forms were distributed online as well as in person among mothers above 18 years of age. A questionnaire was formulated and distributed amongst different areas and sectors of the twin cities in Pakistan. The data was analyzed quantitatively and entered in SPSS version 23 for analysis. Results: Mothers from various socioeconomic backgrounds had dissimilar knowledge with regards to oral health. There was a greater gap in the knowledge of mothers from low and high socioeconomic status as compared to middle and high. Conclusion: It is imperative that knowledge regarding oral health practices, preventive measures, risk factors of oral diseases should be imparted equally in the various socioeconomic areas of the country. Also, a widespread oral health plan to indoctrinate preventive knowledge as well as basic knowledge of oral health practices is strongly recommended. © 2021, Army Medical College. All rights reserved.

Empowerment of SME's sustainability in halal cosmetics' ecosystem by diagnosing growth constraints

Purpose This study aims to identify and examine the growth constraints of the halal cosmetics ecosystem in which SMEs are operating in, with special focus on the situation in Malaysia. Design/methodology/approach The study adopted a qualitative methodology consisting of a systematic literature review and interviews with selected consumers and policymakers. The instruments were developed based on cybernetics and a systems-based approach, which allows for the understanding of the dynamics of growth variables in the halal cosmetics ecosystem. Based on data gathered, their relationships were mapped and major growth constraints were identified. Findings Cybernetics and systems approach coupled with growth diagnostics framework has enabled identification of comprehensive growth constraint variables for halal cosmetics ecosystem and mapping of growth constraints (variables) in a relationships network. The study found that the enforcement activities of the National Pharmaceutical Research Agency (Cosmetics Unit) directly affect five growth constraints and is associated with three other growth constraint variables;subsequently the most binding growth constraint. The relationship network derived from the mapping of the growth constraints indicated that changes in the behaviour of any element will affect the overall operations of the ecosystem. Research limitations/implications While the cosmetics industry is large and varied, this study is centred on halal colour cosmetics only. The growth constraint variables studied are those chosen by researchers and other growth constraints could be studied to guide policymakers. Future research can revolve around other halal cosmetics business sectors;impact of IR4.0 technology, COVID-19 pandemic impact;crisis and risk management issues, in the halal cosmetics industry. Practical implications The results derived from the cybernetics analysis affirms the "outside-in" marketing perspective, thus stakeholders should continuously monitor changes in the halal cosmetics ecosystem to ensure to ensure sustainability and profitability. Small and medium enterprises (SMEs) and policymakers can initiate pre-emptive actions by conducting simulations of various situations on the halal ecosystem. Social implications Enabled to simulate the effect of changes to the halal cosmetics ecosystem, stakeholders are able to take intervention initiatives, safeguard accessibility to halal cosmetics and make the halal cosmetics industry sustainable. Originality/value To the best of the authors' knowledge, this is the first comprehensive research to identify the growth constraints of the halal cosmetics industry in Malaysia that focusses on three groups of stakeholders (consumers, SMEs and government institutions) concurrently. The growth constraints relationship network of the halal cosmetics ecosystem can be further used to simulate the impact of changes within the system.

Longitudinal humoral antibody response to SARS-CoV-2 infection among healthcare workers in a New York City hospital.

OBJECTIVE: Dynamics of humoral immune responses to SARS-CoV-2 antigens following infection suggest an initial decay of antibody followed by subsequent stabilisation. We aim to understand the longitudinal humoral responses to SARS-CoV-2 nucleocapsid (N) protein and spike (S) protein and to evaluate their correlation to clinical symptoms among healthcare workers (HCWs). DESIGN: A prospective longitudinal study. SETTING: This study was conducted in a New York City public hospital in the South Bronx, New York. PARTICIPANTS: HCWs participated in phase 1 (N=500) and were followed up 4 months later in phase 2 (N=178) of the study. They underwent SARS-CoV-2 PCR and serology testing for N and S protein antibodies, in addition to completion of an online survey in both phases. Analysis was performed on the 178 participants who participated in both phases of the study. PRIMARY OUTCOME MEASURE: Evaluate longitudinal humoral responses to viral N (qualitative serology testing) and S protein (quantitative Mount Sinai Health System ELISA to detect receptor-binding domain and full-length S reactive antibodies) by measuring rate of decay. RESULTS: Anti-N antibody positivity was 27% and anti-S positivity was 28% in phase 1. In phase 1, anti-S titres were higher in symptomatic (6754 (5177-8812)) than in asymptomatic positive subjects (5803 (2825-11 920)). Marginally higher titres (2382 (1494-3797)) were seen in asymptomatic compared with the symptomatic positive subgroup (2198 (1753-2755)) in phase 2. A positive correlation was noted between age (R=0.269, p<0.01), number (R=0.310, p<0.01) and duration of symptoms (R=0.434, p<0.01), and phase 1 anti-S antibody titre. A strong correlation (R=0.898, p<0.001) was observed between phase 1 titres and decay of anti-S antibody titres between the two phases. Significant correlation with rate of decay was also noted with fever (R=0.428, p<0.001), gastrointestinal symptoms (R=0.340, p<0.05), and total number (R=0.357, p<0.01) and duration of COVID-19 symptoms (R=0.469, p<0.001). CONCLUSIONS: Higher initial anti-S antibody titres were associated with larger number and longer duration of symptoms as well as a faster decay between the two time points.

Longitudinal analysis of severe acute respiratory syndrome coronavirus 2 seroprevalence using multiple serology platforms.

Current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serological tests are based on the full-length spike (S), the receptor-binding domain (RBD), or the nucleoprotein (NP) as substrates. Here, we used samples from healthcare workers (HCWs) to perform a longitudinal analysis of the antibody responses using a research-grade RBD and spike-based enzyme-linked immunosorbent assay (ELISA), a commercial RBD and spike-based ELISA, and a commercial NP-based chemiluminescent microparticle immunoassay. Seroprevalence ranged around 28% early during the pandemic and a good correlation was observed between RBD and spike-based ELISAs. Modest correlations were observed between NP and both RBD and spike-based assays. The antibody levels in HCWs declined over time; however, the overall seroprevalence measured by RBD and spike-based assays remained unchanged, while the seroprevalence of NP-reactive antibodies significantly declined. Moreover, RBD and spike-based assays effectively detected seroconversion in vaccinees. Overall, our results consolidate the strength of different serological assays to assess the magnitude and duration of antibodies to SARS-CoV-2.

Knowledge, Attitudes and Perceptions of COVID-19 Vaccination among Healthcare Workers of an Inner-City Hospital in New York.

Introduction: New York City is one of the areas most affected by the COVID-19 pandemic in the United States. Healthcare workers are among those at high risk of contracting the virus, and a vital source of information and trust in vaccines to the community. Methods: This study was conducted about attitudes towards COVID-19 vaccination among healthcare workers at a public hospital in New York City during the beginning of COVID-19 vaccination. 428 hospital employees responded. Results: Several factors were significantly associated with vaccine attitudes, including demographics such as gender (p = 0.002), age (p = 0.005), race (p < 0.001) and home location (p < 0.001), role within the hospital (p < 0.001), knowledge about the virus (p < 0.001) and confidence in and expectations about personal protective equipment and behaviors (p < 0.001). Structural equation modeling revealed that the most predictive factors were prior vaccine attitudes and concern with the speed of testing and approval of the vaccines (p < 0.001). Multivariate analysis reinforced these, while also identifying perceived personal risk as significant (p = 0.033). Conclusions: Several modifiable factors that reflect confidence in science, scientific knowledge, personal risk perception, experience and medical authority are correlated with vaccine attitudes, indicating that a holistic educational approach to improve trust in science is likely to be effective in long-term reduction in vaccine hesitancy.

High Initial Titres of Anti-Spike Antibodies following SARS-CoV-2 Infection is Associated with Faster Decay Rates at Four Months Follow-Up (preprint)

Background Dynamics of humoral immune responses to SARS-CoV-2 antigens following infection suggests an initial decay of antibody followed by subsequent stabilization. We aim to understand the longitudinal humoral responses to SARS-CoV-2 nucleocapsid (N) protein and spike (S) protein and to evaluate their correlation to clinical symptoms among healthcare workers (HCW). Methods In this cross-sectional longitudinal cohort study done in two phases over four months, HCW underwent serial qualitative serology testing for anti-N antibody, quantitative MSH-ELISA to detect Receptor Binding Domain and full-length S reactive antibodies and completed online surveys about COVID-19 related symptoms and healthcare/community exposure. Results Anti-N antibody positivity was 27% and anti-S positivity was 28% in Phase 1. In Phase 2 anti-S titres were higher in symptomatic than in asymptomatic positive subjects in Phase 1. Marginally higher titers were seen in asymptomatic compared to the symptomatic positive subgroup in Phase 2. A positive correlation was noted between age, number and duration of symptoms, and Phase 1 anti-S antibody titre. A strong correlation was observed between Phase 1 titers and decay of anti-S antibody titres between the two phases. Significant correlation with rate of decay was also noted with fever, GI symptoms, and total number and duration of COVID-19 symptoms. Conclusions Higher initial anti-S antibody titres were associated with larger number and longer duration of symptoms as well as faster decay during the two time points.