MARKED CHANGES ARE SEEN IN THE SMALL BOWEL MICROBIOME AS A RESULT OF THE COVID-19 PANDEMIC

SARS-CoV-2 has had a profound impact on the human population in the last 24 months. This includes dramatic changes in lifestyle, hygiene, and altered food sources/consumption patterns, which could directly impact the small bowel microbiome on an individual and perhaps even at a population level. To date, this has not been examined. Here, we compare small bowel microbial profiles in subjects before SARS-CoV-2 and intra-pandemic. Methods: The REIMAGINE study is a large-scale study using validated methods for duodenal aspirate collection and microbiome sequencing in subjects undergoing upper endoscopy. Subjects were divided into 2 groups: pre-pandemic, from February 2019 to March 2020;and intrapandemic, from April 2021 to September 2021. Groups were matched for gender, age, and BMI. Duodenal aspirates were collected, and microbial DNA was isolated using the MagAttract PowerSoilDNA Kit. V3 and V4 libraries were sequenced on a MiSeq. Reference-based Operational Taxonomic Unit clustering was performed using SILVA v132 database. Taxonomic analysis was performed with CLC Microbial Genomics Module v.2.5 and MicrobiomeAnalyst, and duodenal microbial alpha- and beta-diversity indices were calculated. Significance was determined by Wilcox test. Results: In total 94 subjects were included in the analysis. The overall duodenal microbiome profile (beta-diversity) of intra-pandemic subjects (n=38, mean age= 51 ± 18, mean BMI =23.9 ± 4.7) was significantly different from pre-pandemic subjects (n=56, mean age= 51 ± 15, mean BMI = 25.24 ± 4.9)(p<0.002, Fig1A), with no significant changes in duodenal microbial alpha diversity between groups (Fig1B). Significant duodenal microbial taxonomic differences were identified between groups, including changes in the relative abundance (RA) of 2 phyla, 3 classes, 6 orders, 4 families and 23 genera (Fig2A). At the phylum level, Actinobacteria RA was significantly decreased in the intra vs. the pre group (FC=-1.99, P=9.83E-8, Fig2B). Additionally, at the genus level, RA of Rothia (P= 6.85E-7), Pseudomonas (P=0.0376), and Escherichia (P=0.0092) were significantly decreased in the intra group (Fig2A). Of note, the phylum Deinococcus (P=0.0016) was increased in the intra vs. the pre group (Fig2B). Conclusion: In this first study examining the effect of the COVID-19 pandemic on the small bowel microbiome, we show substantial changes in microbial profiles intra-pandemic as compared to pre-pandemic. The duodenal microbiome of intra-pandemic subjects was associated with less disrupter bacteria (Escherichia and Pseudomonas), commonly associated with GI disorders. In contrast, Deinococcus phylum was increased intra-pandemic. This phylum includes organisms resistant to sanitation and increased in the nasal passage of people during the pandemic. The short and long term impact of these changes on human health require further study.(Figure Presented)

Comparisons of Sustainability Behaviors Pre- and Early Pandemic Among Botanical Garden Members

The COVID-19 outbreak drastically altered the behaviors of millions of Americans in 2020, including behaviors that contribute to carbon emissions. As many Americans stayed home midyear, environmental groups noted the decrease in driving and transportation-related pollution, theorizing that the pandemic could have a positive impact on the environment by decreasing individuals' carbon emissions. However, it is dubious that individuals will behave in a more eco-friendly manner under the uncertain and stressful conditions of a global pandemic simply because they are more likely to be confined to their homes. We examined sustainability behaviors in 2018 and in the early pandemic in 2020 among a sample of members of a U.S., botanical garden. We surveyed members in May–July 2018, asking whether they had or had not done 11 sustainability behaviors (e.g., used alternative transportation, took shorter showers) in the past month. We resurveyed members about their engagement in those behaviors in April 2020 as well as to recall their engagement in those behaviors pre-pandemic in February 2020. We examined differences in self-reported behaviors among respondents who had taken both the May–July 2018 and April 2020 surveys (matched group n = 227), and then among respondents who had taken either the May–July (n = 1057) or the April 2020 survey (n = 881), but not both. Respondents in the matched group were more likely to report recycling, reducing red meat consumption, eating a plant-based diet, and reducing food waste in April 2020 compared to May–July 2018;they were less likely to compost, check the air in their tires, and use a smart thermostat. However, these differences also emerged when examining recalled behavior in February 2020, suggesting that matched group respondents' self-reports may reflect changes in behavior over time rather than due to the pandemic. The unmatched group was more likely to reduce food waste but less likely to use alternative transportation to commute, check the air in their tires for fuel efficiency, and recycle in April 2020 compared to May–July 2018. Thus, few changes in sustainability behaviors can be attributed to the pandemic, but those that do involve personal travel or home confinement. Copyright © 2021 Mascatelli, Drummond Otten, Piacentini, Wong-Parodi and States.

Echocardiographic assessment of right ventricular function and pulmonary pressures in hospitalized patients with COVID-19

Aims: Pulmonary involvement in Coronavirus 19 disease (COVID-19) may affect right ventricular (RV) function and pulmonary pressures resulting in further deterioration of patient clinical status. However, the prognostic value of echocardiographic parameters including tricuspid annular plane systolic excursion (TAPSE), systolic pulmonary artery pressure (PASP), and TAPSE/PASP ratio has been poorly investigated in this clinical setting. Methods and results: This is a multicentre Italian study including patients admitted for severe COVID-19 in seven Italian Hospitals. Transthoracic echocardiography (TTE) was performed within 48 h from admission in all cases. In-hospital mortality and pulmonary embolism (PE) were identified as the primary and secondary outcome measures, respectively. Of 1401 patients with severe COVID-19, 227 (16.1%) subjects underwent TTE within 48 h from admission and were included in this study. The mean age was 68±13 years and 62.6% of patients were male. Intensive care unit (ICU) admission was reported in 73 patients (32.2%);ICU patients showed lower left ventricular ejection fraction (LVEF), lower TAPSE, and higher LV end systolic volume and PASP values than non-ICU patients. Also, ICU patients showed higher incidence of acute respiratory distress syndrome (82.2% vs. 30.5%;P<0.001), acute cardiac injury (46.6% vs. 22.7%;P<0.001), acute heart failure (34.2% vs. 9.1%;P<0.001), and death (63.9% vs. 14.3%;P<0.001) compared with non-ICU patients. By stratifying the study population into tertiles according to TAPSE, PASP, and TAPSE/PASP values, patients in the lower TAPSE and TAPSE/PASP ratio tertiles, and those in the higher PASP tertile, showed a significantly higher incidence of death during the hospitalization. At univariable logistic regression analysis, TAPSE, PASP, and TAPSE/PASP were significantly associated with a higher risk of death and PE, both in patients admitted or not to ICU. After propensity score weighting adjustment for multiple baseline potential confounders and further multivariable adjustment for LVEF value, the regression analysis showed that TAPSE, PASP and TAPSE/PASP were independently associated with risk of death (TAPSE: OR: 0.85, CI: 0.74-0.97, P=0.017;PASP: OR: 1.08, CI: 1.03-1.13, P=0.002;TAPSE/PASP: OR: 0.02, CI: 0.02 × 10-1-0.20, P<0.001) and with the risk of PE (TAPSE: OR: 0.70, CI: 0.60-0.82, P<0.001;PASP: OR: 1.10, CI: 1.05-1.14, P<0.001;TAPSE/PASP: OR: 0.02 × 10-1, CI: 0.01 × 10-2- 0.04, P<0.001) during the hospitalization. The risk death according to TAPSE, PASP, and TAPSE/PASP ratio tertiles was estimated considering discharge alive as competing risk (Figure). The lowest TAPSE and TAPSE/PASP tertiles, and the highest PASP tertile, were significantly associated with poorer survival during the hosptialization (P<0.001). Conclusions: Echocardiographic evidence of RV systolic dysfunction, increased PASP and a poor RV-arterial coupling assessed by TAPSE/PAPS ratio may help to identify COVID-19 patients at higher risk of mortality and PE during the hospitalization.

The COVID-19 lockdowns: a window into the Earth System

The COVID-19 pandemic has caused substantial global impact. This Perspective provides insight into the environmental effects of the pandemic, documenting how it offers an opportunity to better understand the Earth System. Restrictions to reduce human interaction have helped to avoid greater suffering and death from the COVID-19 pandemic, but have also created socioeconomic hardship. This disruption is unprecedented in the modern era of global observing networks, pervasive sensing and large-scale tracking of human mobility and behaviour, creating a unique test bed for understanding the Earth System. In this Perspective, we hypothesize the immediate and long-term Earth System responses to COVID-19 along two multidisciplinary cascades: energy, emissions, climate and air quality;and poverty, globalization, food and biodiversity. While short-term impacts are dominated by direct effects arising from reduced human activity, longer-lasting impacts are likely to result from cascading effects of the economic recession on global poverty, green investment and human behaviour. These impacts offer the opportunity for novel insight, particularly with the careful deployment of targeted data collection, coordinated model experiments and solution-oriented randomized controlled trials, during and after the pandemic.