Detection of Severe Acute Respiratory Syndrome Coronavirus 2 on Self-Collected Saliva or Anterior Nasal Specimens Compared With Healthcare Personnel-Collected Nasopharyngeal Specimens.

BACKGROUND: Nasopharyngeal specimens (NPS) are commonly used for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing but can be uncomfortable for patients. Self-collected saliva specimens (SS) or anterior nasal specimens (ANS) for SARS-CoV-2 detection are less invasive, but the sensitivity of these specimen types has not been thoroughly evaluated. METHODS: During September-November 2020, 730 adults undergoing SARS-CoV-2 testing at community testing events and homeless shelters in Denver provided self-collected SS and ANS before NPS collection and answered a short survey about symptoms and specimen preference. Specimens were tested for SARS-CoV-2 by means of real-time reverse-transcription polymerase chain reaction (rRT-PCR); viral culture was performed on a subset of specimens positive by rRT-PCR. The sensitivity of SS and ANS for SARS-CoV-2 detection by rRT-PCR was measured against that of NPS. Subgroup analyses included test outcomes by symptom status and culture results. RESULTS: Sensitivity for SARS-CoV-2 detection by rRT-PCR appeared higher for SS than for ANS (85% vs 80%) and higher among symptomatic participants than among those without symptoms (94% vs 29% for SS; 87% vs 50% for ANS). Among participants with culture-positive SARS-CoV-2 by any specimen type, the sensitivities of SS and ANS by rRT-PCR were 94% and 100%, respectively. SS and ANS were equally preferred by participants; most would undergo NPS collection again despite this method's being the least preferred. CONCLUSIONS: SS were slightly more sensitive than ANS for SARS-CoV-2 detection with rRT-PCR. With both SS and ANS, SARS-CoV-2 was reliably detected among participants with symptoms. Self-collected SS and ANS offer practical advantages, are preferred by patients, and might be most useful for testing people with coronavirus disease 2019 symptoms.

Epidemiology and Transmission Dynamics of COVID-19 in an Urban Pediatric US Population.

OBJECTIVE: This analysis summarizes observational epidemiologic data and transmission dynamics of SARS-CoV-2 among people aged <18 years to better characterize the pediatric COVID-19 pandemic. METHODS: We conducted a retrospective study of public health surveillance data among children in Denver, Colorado, who were reported to have COVID-19 from March 1, 2020, through September 30, 2021. We used descriptive statistics and bivariate rate ratios (RRs) to describe demographic and clinical characteristics, transmission dynamics, case trends, and ecological associations. RESULTS: A total of 9815 children and adolescents who had COVID-19 were reported during the study period. Adolescents aged 14-17 years had the highest incidence rate (IR) per 1000 people (IR = 107.5; 3021 of 28 108). Hispanic/Latino children had a 1.6 times higher rate of infection than non-Hispanic White children (RR = 1.57; 95% CI, 1.50-1.65; P < .001). Few hospitalizations (n = 138, 1.4%) and deaths (n = 3, 0%) occurred. Most children were symptomatic (4487 of 5499, 81.6%). Within household clusters, a large proportion of pediatric cases (n = 6136) were a secondary case (n = 3959, 64.5%), followed by index case (n = 1170, 19.1%) and co-index case (n = 1007, 16.4%). Non-Hispanic White children had an increased risk of being an index or co-index case (RR = 1.14; 95% CI, 1.06-1.23; P < .001), while Hispanic/Latino children had an increased risk of being a secondary case (RR = 1.07; 95% CI, 1.03-1.11; P < .001). From 2020 to 2021, the association between pediatric case rates and neighborhoods with higher poverty and households with ≥3 people decreased. CONCLUSIONS: Older children and those identifying as Hispanic/Latino had a disproportionate incidence of disease. A sizable proportion of children were considered index cases or co-index cases. Pediatric prevention strategies, especially vaccinations, are vital for pandemic control.

Qualitative Research Studies Online: Using Prompted Weekly Journal Entries During the COVID-19 Pandemic.

Solicited journal entries are a qualitative research method with a fairly strong tradition in sociological research and particularly in qualitative health research. However, the practices and strengths associated with solicited journal entries have not been explored as frequently or comprehensively as more conventional qualitative research methods, such as interviews. During the COVID-19 pandemic we carried out two online studies employing solicited written journal entries and photos. One study focused on pregnancy and health care experiences during the pandemic and the other on everyday life while working from home due to public health restrictions. Here, we discuss solicited online journal entries as a qualitative method and reflect on the strengths and challenges we encountered, including those related to using the online survey tool LimeSurvey for a qualitative diary-based study. The richness of data and the ability to solicit participants' contemporaneous reflections over the course of a set length of time, the ability to reach people across time zones and in multiple places, and the ability to adapt prompts in a quickly changing research context are major strengths of online journaling. The level of commitment required by participants, the potential for attrition, the need for literacy and technology access, and the large amount of data from each participant are potential limitations for researchers to consider.

When work came home: Formation of feeling rules in the context of a pandemic.

The shift of middle-class jobs to home settings, which occurred as a result of COVID-19 health measures that also closed schools and daycares, introduced dynamic changes to everyday life. We investigate these changes drawing on data from our study in which participants in Nova Scotia, Canada, who were working at home due to the pandemic, wrote journal entries in response to weekly prompts. Participants not only documented changes to their routines and challenges of managing work and parenting simultaneously and in the same physical space, but also reflected on their conflicted emotions about life during the pandemic and their vision for life as things return to "normal." Their narratives prompt us to consider these experiences and emotions in relation to Arlie Hochschild's scholarship on feeling rules, emotion work, and gender and work more broadly. We find that from our participants' struggle to meet existing expectations on activities and emotion while simultaneously managing new sets of protocols and feeling rules what emerges is a resistance to norms of busyness, productivity, and exhaustion.

HIV and COVID-19: review of clinical course and outcomes.

Background:Understanding the relationship between HIV and SARS-CoV-2 has important public health implications.Objective:To summarize current research on COVID-19 among people with HIV (PWH) as published through 15 July 2021.Methods: We conducted a search of PubMed, Scopus, preprint databases (medRxiv, bioRxiv), and the references of publications found using key terms relevant to COVID-19 ('COVID-19' OR 'SARS-CoV-2' OR 'coronavirus') AND to HIV ('HIV' OR 'Human Immunodeficiency Virus' OR 'AIDS' OR 'Acquired Immunodeficiency Syndrome'). We summarized all articles that reported data or opinions on SARS-CoV-2 and HIV coinfection.Conclusions: Although many initial case series and cohort studies found no increased risk for SARS-CoV-2 infection or severe COVID-19 outcomes among PWH, recent studies have signaled an increased risk for severe COVID-19 disease progression even in the setting of well-controlled HIV. Whether this is due to the increased prevalence of comorbidities in PWH and other social determinants of health is unknown. These conflicting findings highlight the continued need for COVID-19 related research among PWH that addresses COVID-19 disease course as well as exacerbation of existing comorbidities already disproportionately represented among PWH.