Corona citizens' science project-repeated surveys of the Irish response to COVID-19 and subsequent lockdown and restrictive measures.

BACKGROUND: Worldwide, many people have been affected by COVID-19, a novel respiratory illness, caused by a new type of coronavirus SARS-CoV2. The COVID-19 outbreak is considered a pandemic and has created a number of challenges for the general population, patients, and healthcare professionals. Lockdowns have been implemented to slow down the spread of the virus with the expectation that these restrictions will limit the number of cases, and hence the number of hospitalizations and ICU admissions. However, these restrictions, and in particular lockdowns, impact on the life of everyone living in Ireland. AIM: To record how the COVID-19 pandemic and subsequent restrictive measures impacted on people's activities, work, schooling, and childcare. METHODS: The Corona Citizens' Science Project was set up as a population-wide survey. A questionnaire was designed, and the survey was first launched on the 8th of April 2020. An overview of results was released in the press days later. Data was collected in four waves: April 8, April 22, May 6, and June 17, 2020. Each wave had core questions allowing to compare each wave, and wave-specific questions, to understand current impact of changing measures. RESULTS: Over four waves, 152,259 responses were collected. The mean age of respondents was 47 with about 10% over the age of 65. Around 75% were female and 85% had a higher degree. Nearly 70% of the respondents were in employment, and around 13% were retired. Up to 20% of the respondents were essential workers, and 10% of respondents indicated they were in receipt of the COVID-19 pandemic unemployment payment. Around 10% of the people who responded were living alone. The number of people talked to the previous day was on average 2.3 in the first survey; during the lockdown, this went up over time, and in the last survey, the mean was 3.9. The percentage of respondents who did not talk to anyone the previous day decreased from 40 to 22% over the waves. In the first wave, about 6% of respondents reported having had flu-like symptoms in the last 14 days, which declined to 3.3%, 2.5%, and 2.0% in waves 2, 3, and 4 respectively. Similarly, over the four waves, the respondents who indicated that someone they lived with had flu-like symptoms declined from 17 to 12%, 9%, and 11%. Throughout the four waves, nearly one third of people reported one or more underlying conditions. CONCLUSIONS: As a result of the COVID-19 pandemic, a number of restrictive measures, in particular lockdown, were implemented in Ireland to protect populations and healthcare systems. To record some of the major impacts on society, we launched a Corona Citizens Science Project, with the aim to support decision-making. This report provides detail of its findings.

Comparative hemodynamic, left ventricular functional, and antiadrenergic effects of chronic treatment with metoprolol versus carvedilol in the failing heart.

BACKGROUND: The basic pharmacology of the third-generation beta-blocking agent carvedilol differs considerably from second-generation compounds such as metoprolol. Moreover, carvedilol may produce different, ie, more favorable, clinical effects in chronic heart failure. For these reasons, we compared the effects of carvedilol and metoprolol on adrenergic activity, receptor expression, degree of clinical beta-blockade, hemodynamics, and left ventricular function in patients with mild or moderate chronic heart failure. METHODS AND RESULTS: The effects of carvedilol versus metoprolol were compared in two concurrent placebo-controlled trials with carvedilol or metoprolol that had common substudies focused on adrenergic, hemodynamic, and left ventricular functional measurements. All subjects in the substudies had chronic heart failure resulting from idiopathic dilated cardiomyopathy. Carvedilol at 50 to 100 mg/d produced reductions in exercise heart rate that were similar to metoprolol at 125 to 150 mg/d, indicating comparable degrees of beta-blockade. Compared with metoprolol, carvedilol was associated with greater improvement in New York Heart Association functional class. Although there were no significant differences in hemodynamic effects between the carvedilol and metoprolol active-treatment groups, carvedilol tended to produce relatively greater improvements in left ventricular ejection fraction, stroke volume, and stroke work compared with changes in the respective placebo groups. Carvedilol selectively lowered coronary sinus norepinephrine levels, an index of cardiac adrenergic activity, whereas metoprolol did not lower coronary sinus norepinephrine and actually increased central venous norepinephrine levels. Finally, metoprolol was associated with an increase in cardiac beta-receptor density, whereas carvedilol did not change cardiac beta-receptor expression. CONCLUSIONS: The third-generation beta-blocking agent carvedilol has substantially different effects on left ventricular function, hemodynamics, adrenergic activity, and beta-receptor expression than dose the second-generation compound metoprolol. Some or all of these differences may explain the apparent differences in clinical results between the two compounds.