Qualitative study on psychological experience of close contacts with covid-19 during the centralized isolation medical observation period

To analyze the psychological experience of close contacts with COVID-19 during the centralized isolation medical observation (centralized isolation for short) period, 17 close contacts of COVID-19 who received medical isolation observation at designated locations in a city of China were selected by purposive sampling using qualitative study methods, and the interviewees were interviewed by full-coverage structured telephone. By analyzing the obtained data and summarizing the themes, it was found that the psychological status of the COVID-19 close contacts during the centralized isolation period could be classified into three themes: Obvious negative emotions, somatization of psychological problems, and demand for social support. During the epidemic, when close contacts were quarantined as high-risk groups, they often had complex and difficult psychological experiences. Relevant departments should actively carry out online guidance channels and offline knowledge dissemination, actively conduct psychological interventions for close contacts, assist them to develop life plans to enrich the life of the centralized isolation period. At the same time, relevant departments should do a good job in logistics and life support services, create a comfortable isolated living environment, and effectively relieve the negative emotions of close contacts of COVID-19 during centralized isolation through a variety of positive and effective measures to ensure physical and mental health. © 2023, Editorial department of Chinese Medical Ethics. All rights reserved.

Qualitative study on psychological experience of close contacts with covid-19 during the centralized isolation medical observation period

To analyze the psychological experience of close contacts with COVID-19 during the centralized isolation medical observation (centralized isolation for short) period, 17 close contacts of COVID-19 who received medical isolation observation at designated locations in a city of China were selected by purposive sampling using qualitative study methods, and the interviewees were interviewed by full-coverage structured telephone. By analyzing the obtained data and summarizing the themes, it was found that the psychological status of the COVID-19 close contacts during the centralized isolation period could be classified into three themes: Obvious negative emotions, somatization of psychological problems, and demand for social support. During the epidemic, when close contacts were quarantined as high-risk groups, they often had complex and difficult psychological experiences. Relevant departments should actively carry out online guidance channels and offline knowledge dissemination, actively conduct psychological interventions for close contacts, assist them to develop life plans to enrich the life of the centralized isolation period. At the same time, relevant departments should do a good job in logistics and life support services, create a comfortable isolated living environment, and effectively relieve the negative emotions of close contacts of COVID-19 during centralized isolation through a variety of positive and effective measures to ensure physical and mental health. © 2023, Editorial department of Chinese Medical Ethics. All rights reserved.

Exploring alexithymia profiles and their associations with childhood adversity and COVID-19 burnout among Chinese college students: A person-centered approach

Alexithymia is associated with adverse developmental outcomes. However, this concept has been criticized for being heavily influenced by Western norms of emotional expression and for potentially pathologizing people from different cultural backgrounds. Furthermore, the widely employed variable-centered study approaches hinder research understanding of real-world alexithymia profiles. Using a person-centered approach, the current study investigated the alexithymia profiles among Chinese college students and tested the profiles' relations with childhood adversity and COVID-19 burnout. Four latent alexithymia profiles were identified. The High I profile (particular difficulty identifying feelings) emerged as a risk profile for childhood adversity and COVID-19 burnout. Our findings illustrate the heterogeneity of the alexithymia construct and represent a significant step toward expanding cross-cultural understanding of alexithymia profiles and their associations with related psychological constructs. When dealing with childhood adversity and COVID-19 burnout, health care programs should consider a specific alexithymia profile defined by difficulty identifying feelings. © 2022 Elsevier Inc.

[Annual update of pulmonary infectious diseases in 2022].

In 2022, coronavirus disease 2019 (COVID-19) remains rampant across the world. Several remarkable studies concerning pulmonary infectious diseases have been published during this pandemic. This review summarized the representative academic and translational medical progress over the past year (from October 1, 2021, to September 30, 2022), including COVID-19, community/hospital-acquired pneumonia, tuberculosis, and other respiratory viral infections.

Longer-term impacts of COVID-19 on SMEs: follow-up research in Sichuan Province, China

Small and medium enterprises (SMEs) are continuing to be impacted by the COVID-19 pandemic as it moves into its third year. The 'dynamic COVID-zero' policy adopted in China from August 2021 to the end of 2022 has inevitably put pressure on local SMEs, which makes the situation in Chinese SMEs not only different from the situation during the initial outbreak, but also unique in the world. In July 2022, an online follow-up questionnaire was conducted on SMEs in Sichuan Province to assess their performances, pressures, and requirements in this particular period of time and compare the results with our findings from 2020 to reveal the longer-term impacts of COVID-19. It was found that: (1) most SMEs had poorer revenue and profit performances;(2) while the pressure of increasing production cost and declining market demand has increased significantly, normal productions and operations are no longer as strongly disturbed;(3) SMEs require more financial support but less operating and employment subsidies;(4) and the SMEs' overall confidence has recovered and the willingness to invest is rising. The situation in different sectors was also analysed and compared, with the results revealing problems within the tertiary industrial sector (wholesale and retail businesses).

Unveiling the spatial-temporal variation of urban land use efficiency of Yangtze River Economic Belt in China under carbon emission constraints

Under the constraint of carbon emission, measuring and analyzing the spatial-temporal evolution characteristics of urban land use efficiency in the Yangtze River Economic Belt is the inherent requirement of its ecological protection and sustainable development. In this paper, we calculated the urban land use efficiency of 107 cities in the Yangtze River Economic Belt from 2006 to 2020 by using the SBM-Undesirable model with unexpected output, and analyzed its temporal evolution trend and spatial correlation relationship by using kernel density and spatial autocorrelation method. The results showed that: except in 2020, the urban land use efficiency was generally low due to the COVID-19 epidemic, and the urban land use efficiency in other years was mostly concentrated in the middle levels, and showed a trend of slow fluctuation and rise year by year. The difference of urban land use efficiency level between regions increased, and the dispersion degree in upstream, midstream and downstream increased with each passing year. Urban land use efficiency spatial imbalance was significant, and the urban land use efficiency level of large and medium-sized cities was generally lower than that of cities with low economic development level. The spatial correlation was weak, and the global spatial autocorrelation was basically insignificant, while the local spatial agglomeration areas were mainly distributed in the upstream and downstream regions, with a small distribution range and weak spatial interaction. The distribution areas of the standard deviation ellipse were gradually flattened, and the center of gravity as a whole shift significantly to the southwest. The research results are helpful to understand the development history and future trend of urban land use efficiency in various regions, and propose that cities should consider the impact of public crisis events in advance, reasonably control the scale of land expansion, and lead coordinated development and other reasonable suggestions when formulating land use policies. Copyright © 2023 Yang, Pu, Jiang, Gong, Tan, Wang and He.

Plain language summary of Pfizer-BioNTech BNT162b2 COVID-19 vaccine safety in participants 16 years or older and protection against COVID-19 in participants 12 years or older

What is this summary about?This is a summary of an article about part of a clinical study for the BNT162b2 COVID-19 vaccine, also called the Pfizer-BioNTech vaccine. The article was published in the New England Journal of Medicine in September 2021. The part of the study described in the article began in July 2020 and is ongoing. This means that the final results may be different from the results included in this summary.What happened in this study?The participants in this study received 2 injections of either the BNT162b2 vaccine or a placebo, 21 days apart. The placebo looked like the BNT162b2 vaccine but had no active vaccine in it. None of the trial participants or study teams knew who received vaccine or placebo.What were the results?Most of the reactions to the injections were mild or moderate and lasted for a short period of time. The most common reactions were pain at the injection site, extreme tiredness (fatigue), and headache. These reactions usually happened in the first 7 days after receiving a vaccine dose. A small number of participants had severe reactions to the vaccine.Compared to participants who received the placebo, participants who received the BNT162b2 vaccine were much less likely to become ill if they were infected with the virus that causes COVID-19. The vaccine also had very good efficacy at preventing severe COVID-19.Participants in South Africa who received the BNT162b2 vaccine were less likely to become ill after infection with the beta variant of the virus compared to participants who received the placebo. The beta variant was very common in South Africa when the study was taking place.

Molecular Biology of SARS-CoV-2 and its Evolution within the Princeton University Campus Community

Background. SARS-CoV-2, a novel and highly pathogenic coronavirus, has caused unprecedented global disruption following its introduction into the human population. Beginning in January 2021, a NJ university invited all students to campus and initiated an asymptomatic testing protocol using weekly to twice-weekly PCR-based detection of human saliva samples. RNA extracted from PCR-positive human saliva samples was sequenced for surveillance purposes. Methods. Positive samples were submitted for RNA-Seq analysis (ARTIC amplicon sequencing protocol, Illumina MiSeq) and analyzed using Nextclade and USHER (comparison data from GISAID). Using sequencing data, the evolution, transmission, and emergence of SARS-CoV-2 variants were monitored over time in the campus community. Using sequencing data from NY, PA, and NJ in combination with University data, we performed an IQ-TREE based phylogenetic analysis. Results. Analyzing sequencing data of 1,011 University positive samples we demonstrate that SARS-CoV-2 variants Delta (B.1.617.2) and Omicron (BA.1 and BA.2) were first to emerge following widespread vaccination and, quickly, became predominant. These trends witnessed on campus preceded those same variants emerging in New Jersey, providing evidence of local campus spread distinct from the state-wide pandemic. The analysis of 2,359 total sequences from NY, PA, and NJ in combination with University data, provided evidence of the SARS-CoV-2 transmission chain on campus evolving from out-of-state (January 2021) to local (January 2022) spread over one year of the virus circulating within the community at large. Upon performing a Ct value analysis of 2,822 Princeton University sequences, no significant differences were discovered between N gene Ct values when grouped by age or vaccination status. However, there were significant differences in Ct values between strains. The Emergence of SARS-CoV-2 Variants at Princeton University This plot represents the emergence of SARS-CoV-2 clades at Princeton University, organized by Nextstrain clade and displayed as a proportion out of one. Dates of sample collection range from January 25, 2021, to March 1, 2022. X-axis represents SARS-CoV-2 sample test date (grouped by month);Y-axis represents the count per day organized by Nextstrain clade. Conclusion. Sequencing of positive SARS-CoV-2 samples from population screening of a highly vaccinated University campus community allowed the detection of emergence of new variants that became predominant on campus irrespective of the circulation of variants in the surrounding area.

COVID-19 and its impact on tourism sectors: implications for green economic recovery

The COVID-19 pandemic posed huge hurdles to green economic recovery and the tourism sector. This paper examines challenges in the Zhejiang, Fujian, and Shandong provinces of China' coastal tourism and green economic growth in the wake of the COVID-19 pandemic. To assess this impact, the study used econometrics models based on the Chinese provincial data from March 2020 to April 2021. According to the results, coastal tourism's related income fell drastically regardless of where the people live. Fisherman's earnings dropped by 26%, while captains and owner's earnings dropped by 49% on average. This also resulted in a shortage of food supply that endangered food security. During the pandemic, the number and duration of tourism trips dropped in all study locations. In addition, results indicated that in the wake of COVID-19, lower economic growth and recessions resulted in a significant decline in green investments. The paper proposes that to achieve green recovery and the recovery of the tourism sector, the local and central governments need to increase green investments and the literacy of the people in charge of coastal tourism.

A Case of New Onset Primary Adrenal Insufficiency in COVID Infection

Background: Accumulating body of evidence shows that SARS-CoV-2 infection in COVID-19 is linked to a variety of autoimmune complications including autoimmune endocrinopathies. Here we report a case of newly diagnosed Addison's disease post-COVID-19 infection. Case Description: A 23-year-old male with a history of three episodes of acute disseminated encephalomyelitis (ADEM) in childhood, was brought into the emergency department (ED) by EMS after being found down with a blood glucose of 28 at the field. Prior to presentation, he reported 3 days of sore throat, nausea, vomiting, fatigue, and chills. He takes no home medications, and is not vaccinated against COVID-19. In the ED, the physical exam is notable for temperature 39°C, pulse 145, BP 80/42, RR 39, and no mucocutaneous hyperpigmentation. Labs revealed a positive COVID test, serum sodium 125 mmol/L (135-145), potassium 3.1 mmol/L (3.5-4.1), and persistent hypoglycemia. TSH 1.89 μIU/mL (0.45-4.12). A morning baseline cortisol was 4 mcg/dl (ref: >18) with ACTH level of >1250 pg/ml (0-45). A high-dose 250 mcg ACTH stimulation test followed;with cortisol levels of 3, and 3 mcg/dl (ref: >18) at 30, and 60 minutes;respectively. Aldosterone <3. 0 ng/dl (4. 0-31. 0), and anti-21-hydroxylase antibody was positive (ref: negative). A CT scan of the abdomen with contrast demonstrated mildly atrophied bilateral adrenal glands. The hypotension and hyponatremia resolved after initiation of intravenous hydrocortisone, and he was discharged on hydrocortisone and fludrocortisone. Conclusion: The patient's symptoms, elevated ACTH, low cortisol, and presence of 21-hydroxylase antibodies, are consistent with autoimmune Addison's disease. Since ADEM is an autoimmune condition, it is likely that the patient had underlying undiagnosed Addison's disease and COVID-19 triggered an adrenal crisis. There is also a possibility that SARS-CoV-2 infection may have induced a higher titer of adrenal antibody, leading to the exacerbation of Addison's disease. The case highlights the importance of considering adrenal insufficiency as a diagnostic differential in hemodynamically unstable COVID-19 patients, especially those with underlying autoimmune conditions.Presentation: No date and time listed

From ran(bp2) dom to Recurrent: A Case of Familial Acute Necrotizing Encephalopathy

Introduction: Acute necrotizing encephalopathy (ANE) is a rare condition often triggered by infection and characterized by febrile prodromal illness, seizures, altered mental status and bilateral brain lesions. While many cases are isolated, a recurrent familial pattern has been linked to missense mutation of the gene encoding RAN binding protein 2 (RANBP2). Early administration of high dose steroids has been associated with improved outcomes, while IVIG and tocilizumab have also shown benefit. Case Description: A two-year-old male presented with vomiting, somnolence and seizure-like activity. Evaluation revealed positive SARS-CoV2, adenovirus and rhinovirus/enterovirus PCR by nasopharyngeal swab, and Mycoplasma pneumoniae IgM. MRI showed numerous foci of restricted diffusion and microhemorrhage as well as necrotic change in the internal capsules. He was diagnosed with ANE. He recovered to neurologic baseline following treatment with IVIG and corticosteroids. After six months, the patient presented with similar symptoms. SARS-CoV2 IgG was positive, but no new infectious pathogens were identified. Cerebrospinal fluid (CSF) analysis showed elevated IL-6 and IL-8 levels, suggestive of inflammatory breakdown of the blood-brain barrier. Brain MRI demonstrated worsened bilateral T2/fluid attenuated inversion reduction signal abnormalities and necrosis within the midbrain and pons bilaterally, concerning for recurrent ANE. Following multidisciplinary consultation, the patient was treated with corticosteroids and IVIG. Tocilizumab was later added due to elevated CSF IL-6. Worsening MRI findings (Figure 1) coupled with decrease in strength and spontaneous movement prompted plasma exchange (PLEX) therapy. While his exam improved after PLEX, treatment was discontinued due to development of a pericardial effusion. The patient steadily improved neurologically and was transitioned to inpatient rehabilitation with an ongoing steroid taper, monthly IVIG, and tocilizumab therapy. Given recurrence of ANE, an epilepsy genetic sequencing panel was ordered and revealed heterozygous mutation in RANBP2 (c.1966A>G p.Ile656Val). Discussion: During the patient's initial presentation, it was reasonable to conclude an infectious trigger for ANE given the presence of several potential inciting pathogens. Upon recurrence, investigation of underlying genetic predisposition was warranted. This patient exhibited the classic clinical and radiographic findings of recurrent ANE and was found to have RANBP2 mutation. Available literature suggests pathogenicity of the same mutation identified in this case due to its location in a highly conserved genetic region and its presence in affected members of a family with ANE. To our knowledge, this is the second report of this specific RANBP2 mutation in association with ANE. Conclusion: While ANE may present as a singular event following infection, recurrence is rare and should prompt evaluation of underlying genetic predisposition. Consideration of familial ANE with testing for RANBP2 mutation may lead to early genetic counseling. Our case also provides additional support for the pathogenicity of the RANBP2 (p.Ile656Val) mutation. (Figure Presented).

Factors associated with depression in residents in the post-epidemic era.

OBJECTIVE: To explore the factors associated with depression in residents in the post-epidemic era of COVID-19. METHODS: A multi-stage stratified random sampling method was used to conduct a questionnaire survey among community residents through self-designed questionnaires and self-rating depression scale (SDS). Multivariate logistic regression analysis was performed on the influencing factors of depressive symptoms. RESULTS: A total of 1993 residues completed the survey of depression status. The incidence of depressive symptoms was 27.04%. The multivariate logistic regression analysis showed that female (odds ratio (OR): 6.239, 95% confidence interval (CI): 2.743-10.698), body mass index (BMI) > 24 (OR: 2.684, 95% CI: 1.059-3.759) and drinking (OR: 1.730, 95% CI: 1.480-3.153) were the risk factors for developing depressive symptoms. Married (OR: 0.417, 95% CI: 0.240-0.652), monthly income (3001-5000 yuan, OR: 0.624, 95% CI: 0.280-0.756; >5000 yuan, OR: 0.348, 95% CI: 0.117-0.625), ordinary residents (OR: 0.722, 95% CI: 0.248-0.924) and urban residents (OR: 0.655, 95% CI: 0.394-0.829) were the protective factors of depressive symptoms. CONCLUSIONS: Under the post-epidemic era of COVID-19, depressive symptoms are still common among community residents in China. Gender, BMI, drinking, marriage, monthly income and nature of personnel and residential area are associated with the incidence of depressive symptoms.

Genera of phytopathogenic fungi: GOPHY 4.

This paper is the fourth contribution in the Genera of Phytopathogenic Fungi (GOPHY) series. The series provides morphological descriptions and information about the pathology, distribution, hosts and disease symptoms, as well as DNA barcodes for the taxa covered. Moreover, 12 whole-genome sequences for the type or new species in the treated genera are provided. The fourth paper in the GOPHY series covers 19 genera of phytopathogenic fungi and their relatives, including Ascochyta, Cadophora, Celoporthe, Cercospora, Coleophoma, Cytospora, Dendrostoma, Didymella, Endothia, Heterophaeomoniella, Leptosphaerulina, Melampsora, Nigrospora, Pezicula, Phaeomoniella, Pseudocercospora, Pteridopassalora, Zymoseptoria, and one genus of oomycetes, Phytophthora. This study includes two new genera, 30 new species, five new combinations, and 43 typifications of older names. Taxonomic novelties: New genera: Heterophaeomoniella L. Mostert, C.F.J. Spies, Halleen & Gramaje, Pteridopassalora C. Nakash. & Crous; New species: Ascochyta flava Qian Chen & L. Cai, Cadophora domestica L. Mostert, R. van der Merwe, Halleen & Gramaje, Cadophora rotunda L. Mostert, R. van der Merwe, Halleen & Gramaje, Cadophora vinacea J.R. Úrbez-Torres, D.T. O'Gorman & Gramaje, Cadophora vivarii L. Mostert, Havenga, Halleen & Gramaje, Celoporthe foliorum H. Suzuki, Marinc. & M.J. Wingf., Cercospora alyssopsidis M. Bakhshi, Zare & Crous, Dendrostoma elaeocarpi C.M. Tian & Q. Yang, Didymella chlamydospora Qian Chen & L. Cai, Didymella gei Qian Chen & L. Cai, Didymella ligulariae Qian Chen & L. Cai, Didymella qilianensis Qian Chen & L. Cai, Didymella uniseptata Qian Chen & L. Cai, Endothia cerciana W. Wang. & S.F. Chen, Leptosphaerulina miscanthi Qian Chen & L. Cai, Nigrospora covidalis M. Raza, Qian Chen & L. Cai, Nigrospora globospora M. Raza, Qian Chen & L. Cai, Nigrospora philosophiae-doctoris M. Raza, Qian Chen & L. Cai, Phytophthora transitoria I. Milenkovic, T. Májek & T. Jung, Phytophthora panamensis T. Jung, Y. Balci, K. Broders & I. Milenkovic, Phytophthora variabilis T. Jung, M. Horta Jung & I. Milenkovic, Pseudocercospora delonicicola C. Nakash., L. Suhaizan & I. Nurul Faziha, Pseudocercospora farfugii C. Nakash., I. Araki, & Ai Ito, Pseudocercospora hardenbergiae Crous & C. Nakash., Pseudocercospora kenyirana C. Nakash., L. Suhaizan & I. Nurul Faziha, Pseudocercospora perrottetiae Crous, C. Nakash. & C.Y. Chen, Pseudocercospora platyceriicola C. Nakash., Y. Hatt, L. Suhaizan & I. Nurul Faziha, Pseudocercospora stemonicola C. Nakash., Y. Hatt., L. Suhaizan & I. Nurul Faziha, Pseudocercospora terengganuensis C. Nakash., Y. Hatt., L. Suhaizan & I. Nurul Faziha, Pseudocercospora xenopunicae Crous & C. Nakash.; New combinations: Heterophaeomoniella pinifoliorum (Hyang B. Lee et al.) L. Mostert, C.F.J. Spies, Halleen & Gramaje, Pseudocercospora pruni-grayanae (Sawada) C. Nakash. & Motohashi., Pseudocercospora togashiana (K. Ito & Tak. Kobay.) C. Nakash. & Tak. Kobay., Pteridopassalora nephrolepidicola (Crous & R.G. Shivas) C. Nakash. & Crous, Pteridopassalora lygodii (Goh & W.H. Hsieh) C. Nakash. & Crous; Typification: Epitypification: Botrytis infestans Mont., Cercospora abeliae Katsuki, Cercospora ceratoniae Pat. & Trab., Cercospora cladrastidis Jacz., Cercospora cryptomeriicola Sawada, Cercospora dalbergiae S.H. Sun, Cercospora ebulicola W. Yamam., Cercospora formosana W. Yamam., Cercospora fukuii W. Yamam., Cercospora glochidionis Sawada, Cercospora ixorana J.M. Yen & Lim, Cercospora liquidambaricola J.M. Yen, Cercospora pancratii Ellis & Everh., Cercospora pini-densiflorae Hori & Nambu, Cercospora profusa Syd. & P. Syd., Cercospora pyracanthae Katsuki, Cercospora horiana Togashi & Katsuki, Cercospora tabernaemontanae Syd. & P. Syd., Cercospora trinidadensis F. Stevens & Solheim, Melampsora laricis-urbanianae Tak. Matsumoto, Melampsora salicis-cupularis Wang, Phaeoisariopsis pruni-grayanae Sawada, Pseudocercospora angiopteridis Goh & W.H. Hsieh, Pseudocercospora basitruncata Crous, Pseudocercospora boehmeriigena U. Braun, Pseudocercospora coprosmae U. Braun & C.F. Hill, Pseudocercospora cratevicola C. Nakash. & U. Braun, Pseudocercospora cymbidiicola U. Braun & C.F. Hill, Pseudocercospora dodonaeae Boesew., Pseudocercospora euphorbiacearum U. Braun, Pseudocercospora lygodii Goh & W.H. Hsieh, Pseudocercospora metrosideri U. Braun, Pseudocercospora paraexosporioides C. Nakash. & U. Braun, Pseudocercospora symploci Katsuki & Tak. Kobay. ex U. Braun & Crous, Septogloeum punctatum Wakef.; Neotypification: Cercospora aleuritis I. Miyake; Lectotypification: Cercospora dalbergiae S.H. Sun, Cercospora formosana W. Yamam., Cercospora fukuii W. Yamam., Cercospora glochidionis Sawada, Cercospora profusa Syd. & P. Syd., Melampsora laricis-urbanianae Tak. Matsumoto, Phaeoisariopsis pruni-grayanae Sawada, Pseudocercospora symploci Katsuki & Tak. Kobay. ex U. Braun & Crous. Citation: Chen Q, Bakhshi M, Balci Y, Broders KD, Cheewangkoon R, Chen SF, Fan XL, Gramaje D, Halleen F, Horta Jung M, Jiang N, Jung T, Májek T, Marincowitz S, Milenkovic T, Mostert L, Nakashima C, Nurul Faziha I, Pan M, Raza M, Scanu B, Spies CFJ, Suhaizan L, Suzuki H, Tian CM, Tomsovský M, Úrbez-Torres JR, Wang W, Wingfield BD, Wingfield MJ, Yang Q, Yang X, Zare R, Zhao P, Groenewald JZ, Cai L, Crous PW (2022). Genera of phytopathogenic fungi: GOPHY 4. Studies in Mycology 101: 417-564. doi: 10.3114/sim.2022.101.06.

Venous thromboembolism among medicare beneficiaries hospitalized with acute ischemic stroke with and without history of COVID-19

Introduction: Venous thromboembolism (VTE) is a common medical complication following acute ischemic stroke (AIS). Studies have suggested that VTE rates were higher among patients with a history of COVID-19. We examined the risk of VTE in AIS patients with and without a history of COVID-19 among Medicare beneficiaries. Methods: We identified Medicare fee-for-service (FFS) beneficiaries aged ≥65 years with AIS hospitalizations from 04/01/2020 to 06/30/2021. COVID-19 cases were identified by the first diagnosis of COVID-19 on a claim at any health care setting. We defined AIS with COVID-19 if the dates of COVID-19 diagnoses were earlier than AIS admission dates. To identify VTE for each AIS admission, we used the following secondary diagnoses codes: ICD-CM-10: I80, I81, I82, I26. We compared the prevalence ratio (PR) of VTE between AIS patients with and without a history of COVID-19. Results: Among 178,830 Medicare FFS beneficiaries with AIS admissions, 6.1% had a history of COVID-19 and 2.6% had VTE as a complication. VTE prevalence among AIS patients with a history of COVID-19 was 3.98% (95% confidence interval (CI), 3.62-4.36%) and 2.53% (95% CI, 2.46- 2.61%) among patients without a history of COVID-19. The adjusted PR of VTE was 1.55 (95% CI, 1.40-1.70, p<0.001) comparing AIS admissions with a history of COVID-19 and those without a history of COVID-19. Non-Hispanic Black patients had the highest VTE prevalence, 6.14% among those with a history of COVID-19 and 3.89% among those without a history of Covid-19, as compared to other race/ethnicity groups. Both Non-Hispanic White and non-Hispanic Black patients with a history of COVID-19 had >50% increased risk of VTE than those without a history of COVID-19 (Adjusted PR, 1.59, 95% CI, 1.42-1.78 for Non-Hispanic White, 1.58, 95% CI, 1.28-1.94 for Non-Hispanic Black, p<0.001). Conclusion: AIS patients with a history of COVID-19 had an increased risk of VTE compared with patients without COVID-19. Healthcare professionals should be aware of the increased risks of VTE among AIS patients with COVID-19 and implement protocols for early VTE prevention.

COVID-19 and risk of acute ischemic stroke among medicare beneficiaries: Self-controlled case series study

Introduction: Findings of association between COVID-19 and stroke remain inconsistent, ranging from significant association, absence of association to less than expected ischemic stroke among hospitalized patients with COVID-19. The present study examined the association between COVID19 and risk of acute ischemic stroke (AIS). Methods: We included 19,553 Medicare fee-for-service (FFS) beneficiaries aged ≥65 years diagnosed with COVID-19 between April 1 and November 30, 2020 and AIS hospitalization from January 1, 2019 through November 30, 2020. We used a self-controlled case series design to examine the association between COVID-19 and AIS and estimated the incident rate ratios (IRR) by comparing incidence of AIS in risk periods (0-3, 4-7, 8-14, 15-28 days after diagnosis of COVID-19) vs. control periods. Results: Among 19,553 Medicare FFS beneficiaries with COVID-19 and AIS, the median age at diagnosis of COVID-19 was 80.5 (interquartile range 73.6-87.3) years and 57.5% were women. IRRs at 0-3, 4-7, 8-14, and 15-28 days following COVID-19 diagnosis were 10.97 (95% confidence interval 10.30-11.68), 1.59 (1.35-1.87), 1.23 (1.07-1.41), and 1.06 (0.95-1.18), respectively. The association appeared to be stronger among younger beneficiaries and among beneficiaries without prior history of stroke but largely consistent across sex and race/ethnicities. Conclusions: Risk of AIS among Medicare FFS beneficiaries was ten times as high during the first 3 days after diagnosis of COVID-19 as during the control period and the risk associated with COVID-19 appeared to be stronger among those aged 65-74 years and those without prior history of stroke.

A method to detect and quantify SARS-CoV-2 in nasal exhaled breath

SARS-CoV-2 is assumed to spread through exhaled respiratory droplets and aerosols, but very little research has directly measured the virus in exhaled breath, and our understanding of the relationship between olfactory symptoms of COVID-19 and infectious shedding of the virus is limited. Whether there is any relationship between olfactory dysfunction and viral shedding in nasal exhalate is unknown. Here, we developed a device and a method for collecting and quantifying SARS-CoV-2 RNA in the exhaled breath condensate of COVID-19 patients. Our device is portable, inexpensive and simple enough to use that breath samples can be self-collected by patients in their homes. It has configurations for both oral and nasal breath collection, allowing for comparison of viral loads across the two breathing routes. This device can be used to determine whether there is a difference between oral and nasal shedding of the virus on breath, and to determine whether viral shedding on nasal or oral breath is related to chemosensory symptoms.

COVID-19-related motivation to lose weight on a digital weight loss program

Background: Obesity is considered a risk factor for severe COVID-19 illness. Thus, individuals with obesity may be especially motivated to lose weight because of COVID-19. To our knowledge, this is the first study to assess COVID-related motivators to lose weight and whether they predict weight loss. Methods: In this prospective study, 530 new users of a digital commercial weight loss program completed a baseline survey in January 2021 assessing overall motivation to lose weight due to COVID (one item: 'how much of your interest in losing weight is because of COVID-19 or its impact, however minor, on your life?'), and three specific COVID motivators. These specific motivators were measured by the validated Fear of COVID-19 scale (F-C), one item assessing motivation to improve eating habits which got worse during COVID-19 (EH-C), and one item assessing motivation to prevent diseases that could increase COVID-19 risk (D-C). The main outcome was weight loss at 2 months, extracted from self-reported weight on the program. Results: Participants were 84% female, had a median age of 46, mean baseline BMI of 32.12 (SD = 6.96), and lost 3.13kg (3.49%) at 2 months (SD = 2.72kg). Overall COVID motivation was high;66% reported that their interest in losing weight was due to COVID. There was high F-C (M = 25.2 out of 35) and EH-C (M = 7.7 out of 10), and moderate D-C (M = 5.4 out of 10). Despite high COVID-related motivation, overall motivation, F-C, and EH-C did not predict weight loss at 2 months. D-C marginally significantly predicted weight loss at 2 months (B = -. 09, p = .06). Conclusions: Results suggest that even though individuals showed initial high motivation due to COVID, it did not manifest in actual weight loss, except in the most at-risk individuals who sought to prevent diseases that put them at greater risk. Individuals may need support to translate initial COVID-related motivation to actual weight loss. Next, we will examine relationships between COVID motivators, vaccination status, and weight loss at 4 months.