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One Airway, One Disease In Pregnancy: A Prospective Observational Study On The Correlation Between Upper And Lower Airway Inflammation In Pregnant Women, Durga K, Yuvarajan S

Digital Journal of Clinical Medicine

Background: The well-established "One Airway, One Disease" concept recognizes the deep physiological and pathological connections between conditions affecting both the upper and lower respiratory tracts, most notably allergic rhinitis and asthma. During pregnancy, a woman's body undergoes significant immunological, hormonal, and physiological changes, which can profoundly influence and modulate existing or emerging airway inflammation.

Objective: This prospective observational study was designed with the primary objective of meticulously evaluating the correlation between upper and lower airway inflammation in pregnant women. We aimed to achieve this by assessing a range of clinical symptoms, objective functional parameters, and specific inflammatory markers.

Methods: We …

Racial Health Disparities Among Pregnant Women Of Color In New York City: Biological And Systemic Impacts, Kaylin Peña

Pitzer Senior Theses

Racial Health Disparities Among Pregnant Women of Color in New York City: Biological and Systemic Impacts

Abstract

This thesis aims to explore how racial health disparities, underrepresentation in gynecology, and socioeconomic barriers contribute to adverse pregnancy outcomes among women of color in New York City. Through an interdisciplinary approach that combines resources from medical anthropology and human biology, this research will examine the biological implications of chronic stress, specifically HPA axis dysregulation, and its role in maternal health outcomes. With the idea of intersectionality, as conceptualized by Kimberlé Crenshaw, the study analyzes the various effects of systemic inequities and social …

Association Between The Social Vulnerability Index And Adverse Pregnancy Outcomes, Tetsuya Kawakita, Misa Hayasaka, Lindsay Robbins, Juliana Martins, George Saade

Department of Obstetrics & Gynecology Faculty Publications

Objective: To assess the association between the Social Vulnerability Index (SVI) and racial disparities in pregnancy outcomes across U.S. counties and to quantify these racial disparities.

Methods: This was a cross-sectional study using restricted Centers for Disease Control and Prevention data sets, including natality data sets, fetal death data sets, and all-cause mortality data sets from 2016 to 2021. We limited analyses to Black or White individuals aged 15-44 years from 3,114 U.S. counties. Participants were categorized into quartiles based on county-level SVI. The primary outcome was maternal mortality rate while pregnant or within 42 days of the end of …

Impacts Of Ramadan Fasting During Pregnancy On Pregnancy And Birth Outcomes: An Umbrella Review, Abdullah Al-Taiar, Md Estiar Rahman, May Salama, Ali H. Ziyab, Wilfried Karmaus

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background

Despite a large number of primary research studies, and systematic and narrative reviews, there is no consensus on the impact of fasting during Ramadan while pregnant on pregnancy and birth outcomes. Currently, there is no evidence-based guideline for Muslim women regarding Ramadan fasting during pregnancy and clinicians cannot provide firm recommendations.

Objectives

To review the current evidence regarding the impact of Ramadan fasting during pregnancy on pregnancy and birth outcomes.

Search Strategy

We conducted an umbrella review of all systematic and narrative reviews examining the impacts of fasting during Ramadan while pregnant on pregnancy and birth outcomes by searching …

A Murine Model Of Gestational Diabetes Reveals Masld Risk And Alterations In Markers Of Hepatic Mitochondrial Metabolism, Grace E Shryack, Alexa A Krause, Simone Hernandez Ruano, Laura C Schulz, Kathleen A Pennington, R Scott Rector

Faculty, Staff and Students Publications

Introduction: Gestational Diabetes Mellitus (GDM) impacts roughly 1 in 7 pregnancies and results in metabolic dysfunction-associated steatotic liver disease (MASLD) in 30% of these women. Nonetheless, there exists a dearth of investigation into the relationship between GDM and MASLD. Here, we sought to investigate the potential role of hepatic mitochondrial function in GDM and MASLD.

Methods: One week prior to conception and throughout pregnancy, mice were fed either a low-fat control diet (CD) or a high-fat, high-sucrose (HFHS) diet to induce an established model of GDM. Maternal livers were collected at day 0, 6.5, 13.5 and 17.5 of pregnancy. Hepatic …

The Dna Demethylase Tet1 Modifies The Impact Of Maternal Folic Acid Status On Embryonic Brain Development, Lehua Chen, Bernard K Van Der Veer, Qiuying Chen, Spyridon Champeris Tsaniras, Wannes Brangers, Harm H M Kwak, Rita Khoueiry, Yunping Lei, Robert Cabrera, Steven S Gross, Richard H Finnell, Kian Peng Koh

Faculty, Staff and Students Publications

Folic acid (FA) is well known to prevent neural tube defects (NTDs), but we do not know why many human NTD cases still remain refractory to FA supplementation. Here, we investigate how the DNA demethylase TET1 interacts with maternal FA status to regulate mouse embryonic brain development. We determined that cranial NTDs display higher penetrance in non-inbred than in inbred Tet1−/− embryos and are resistant to FA supplementation across strains. Maternal diets that are either too rich or deficient in FA are linked to an increased incidence of cranial deformities in wild type and Tet1+/− offspring and to …

Facilitated Group Care For Maternal And Child Health Model Fidelity: A Scoping Review, Ashley Gresh, Phoebe Parker, Anne Batchelder, Jalana Lazar, Christina X. Marea, Camilla Bjelland, Rohan D. Jeremiah, Giovanna Cristina Machado-Kayzuka, Hayden Geibel, Dhruvi R. Patel, Esnath Kapito, Kathleen F. Norr, Crystal L. Patil

Department of Pediatrics Faculty Publications

Group care is a transformative model of prenatal, postnatal, and well-child care. The Centering-based group care model has three core components: health care, interactive learning, and community building. It has been implemented in 33 countries with associated improved maternal and child health outcomes. Maintaining fidelity to the model is essential for its effectiveness. However, to date no standardised measure of fidelity to the group care model exists. This review aimed to explore how fidelity is measured in group care and identify common themes to understand what is essential to maintain fidelity. We used the scoping review framework by Arksey & …

Scrolling For Two: An Exploration Of Pregnant Women's Social Support And Information Seeking Behaviors Using Technology During The Covid-19 Pandemic, Sarah Knowlton

Theses and Dissertations

Pregnant women faced additional challenges in accessing reliable support and pregnancy- related information, leading to increased distress during the COVID-19 pandemic. Quarantine measures limited doctor’s appointments and isolated pregnant women from their families, which meant that meaningful connections and convenient information was important.

The purpose of this study is to explore the implications of COVID-19 social distancing on pregnant women, with a focus on three questions: 1) what digital technologies did pregnant women use for support and information seeking purposes during the pandemic? 2) how did pregnant women use technology to seek social support during the pandemic? 3) how did …

Association Between Vitamin D Status And Cortisol Concentration Among Pregnant Women, Kenneth Addae

Open Access Master's Theses

Objective: Vitamin D deficiency (VDD) and high circulating cortisol during pregnancy have each been linked to adverse maternal and child outcomes such as preterm birth. However, limited research has explored the association between vitamin D status and cortisol concentration during pregnancy. Our objective for this study was to determine the association between vitamin D status and cortisol concentration among pregnant women.

Methods: The Prenatal Health and Nutrition (PHAN) study was a pilot cross-sectional study of 30 healthy pregnant women conducted in targeted areas in Rhode Island. Data was collected on sociodemographic characteristics, substance use, perceived stress scale, household food security, …

Promoting Perinatal Mental Well-Being: Empowering Healthcare Professionals, Deborah Flam

PCOM Psychology Dissertations

This pilot study aimed to address the critical need to enhance healthcare providers’ knowledge and shift their beliefs regarding perinatal mental health disorders through the development and implementation of a targeted educational workshop, “Promoting Perinatal Mental Health Well-Being”, designed to improve their understanding and attitudes toward identifying, treating, and supporting affected individuals. Using a qualitative approach, pre- and post-tests were administered to assess changes in knowledge and beliefs. While statistical significance was not achieved, likely due to a small sample size, prior training among participants, and other limitations, the findings revealed a meaningful shift in provider beliefs. Participants reported increased …

Differential Plasma Carotenoid Profiles In Hypertensive Disorders Of Pregnancy, Colman Freel, Jonah Scheffler, Rebecca Drakowski, Elizabeth Lyden, Matthew Van Ormer, Melissa K. Thoene, Paras K. Mishra, Corrine K. Hanson, Ann Anderson-Berry

Journal Articles: Pediatrics

Background: Hypertensive disorders of pregnancy (HDP) affect one in six pregnancies globally. The etiology of HDP remains unclear but is known to involve oxidative stress. While the body produces endogenous antioxidants, antioxidative nutrients, like carotenoids, remain critical in modulating oxidative stress. The statuses of several carotenoids have been linked to hypertension in both pregnant and non-pregnant populations. However, their associations with the spectrum of HDP, including gestational hypertension (GH), chronic hypertension (CH), and preeclampsia (PE), remains unclear. Our objective was to quantify and compare carotenoid intake and plasma levels among HDP. Methods: We conducted a prospective cohort study …

Critical Analysis Of Gestational Diabetes Risk Factors: A Systematic Review, Madison Keich, Madeleine Ray, Mia Ross

Williams Honors College, Honors Research Projects

Gestational Diabetes Mellitus (GDM) is a common complication of pregnancy that causes an increased blood sugar that can affect both the mother's and baby’s health. A variety of factors can increase the risk of developing the disease, including race, socioeconomic status, and prenatal education. Each of these factors contributes to the experience of one’s maternal care. Expecting mothers may not understand how significant GDM is, and its potential to result in negative outcomes. It is important to review these factors, acknowledge them, and help reduce health disparities caused by them. Nurses are vital to assessing and delivering patient education on …

Prediction Of Preterm Birth Among Infants With Orofacial Cleft Defects, Katherine L Ludorf, Renata H Benjamin, Mark A Canfield, Michael D Swartz, A J Agopian

Faculty, Staff and Student Publications

Objective: To develop risk prediction models for preterm birth among infants with orofacial clefts.

Design: Data from the Texas Birth Defects Registry for infants with orofacial clefts born between 1999-2014 were used to develop preterm birth predictive models. Logistic regression was used to consider maternal and infant characteristics, and internal validation of the final model was performed using bootstrapping methods. The area under the curve (AUC) statistic was generated to assess model performance, and separate predictive models were built and validated for infants with cleft lip and cleft palate alone. Several secondary analyses were conducted among subgroups of interest.

Setting: …

Effectiveness And Safety Of Intravenous Iron Therapy In Outpatient Obstetrical Clinic For Treatment Of Iron-Deficiency Anemia During Pregnancy, Ellen M. Murrin, Olivia S. Lebeau, Lillian Singer, Mark A. Kassab, Peyton Kalan, Julie Costanzo, Scott A. Sullivan, George L. Maxwell, George R. Saade, Antonio F. Saad

Department of Obstetrics & Gynecology Faculty Publications

Background

Iron-deficiency anemia (IDA) affects over one-third of pregnant patients globally, contributing to severe maternal morbidity and adverse neonatal outcomes. Oral iron supplementation, while cost-effective, is limited by poor absorption, significant gastrointestinal side effects, and poor adherence. The use of intravenous (IV) iron addresses many of these concerns, including eliminating GI side effects and the need for daily therapy. However, administration of IV iron in pregnant patients is typically restricted to specialized infusion centers or hospitals due to concerns about acute side effects, cost, resource utilization, the need for fetal heart rate monitoring, and extended infusion times.

Methods

This descriptive …

Evaluating Impacts Of The Trichloroethylene Metabolite S-(1,2-Dichlorovyinyl)-L-Cysteine On Transcriptomic Responses And Cytokine Release In A Macrophage Model: Implications For Pregnancy Outcomes, Annella Benjamin, Erica Boldenow, Sammy Jaber, Kelly M. Bakulski, John Dou, Justin Colacino, Peter Mancuso, Sean Harris

University Faculty Publications and Creative Works

Trichloroethylene (TCE) is a volatile synthetic chemical used in various industrial processes like metal degreasing. Large amounts of TCE have been released into the environment. Exposure to TCE can occur through routes, such as inhalation for workers using TCE or ingestion of drinking water in contaminated areas. Macrophages are key immune cells in virtually all tissues in the human body, including the fetal membranes, making them a plausible target for DCVC-induced immunotoxicity. Macrophages are critical for maintaining anti-microbial defenses during pregnancy, but little data exists on TCE immunotoxicity during pregnancy. We previously showed that the TCE metabolite, S-(1,2-dichlorovinyl)-L-cysteine (DCVC), …

A Brief History Of Antenatal Colostrum Expression, And Where To From Here, Therese A. O’Sullivan, Connie N. Ihlein

Research outputs 2022 to 2026

The practice of antenatal colostrum expression (ACE), or the extraction of colostrum from the breasts during pregnancy, has an interesting history and continues to evolve. This narrative review aims to describe how perception and practices of ACE have changed over time, summarise the evidence on ACE in maternal and infant care, and highlight areas for future research. The literature demonstrates that ACE is safe for low-risk women when done from around 36 weeks’ gestation. Women should be reassured that the skill of hand expressing is a valuable tool post-birth, regardless of whether they are able to collect colostrum antenatally or …

Of Scents And Cytokines: How Olfactory And Food Aversions Relate To Nausea And Immunomodulation In Early Pregnancy, Dayoon Kwon, Daniel M.T. Fessler, Delaney A. Knorr, Kyle S. Wiley, Julie Sartori, David A. Coall, Molly M. Fox

Research outputs 2022 to 2026

Background: During pregnancy, the maternal body undergoes extensive physiological adaptations to support embryonic growth, including whole-body remodeling, that may induce odor and food aversions, as well as nausea and vomiting. The biological mechanisms behind odor and food aversions, as well as nausea and vomiting in early pregnancy, remain largely unexplored. Our study investigated associations between these changes and cytokine profiles during pregnancy. Methodology: A cohort of pregnant Latina women in Southern California (n = 58) completed a structured questionnaire on pregnancy "morning sickness"-related symptoms and aversions. Maternal plasma cytokine levels were measured between 5 and 17 weeks' gestation. Results: About …

Factors Affecting The Adoption Of Malaria Interventions For Pregnant Women In Tanzania: Tanzania Demographic Health Survey 2022, Melisa Nyamukondiwa, Asri C. Adisasmita, Renti Mahkota, Same Betera

Jurnal Epidemiologi Kesehatan Indonesia

Tanzania is endemic to malaria and pregnant women due to their vulnerability are among the high-risk groups. The adoption of malaria interventions targeted to pregnant women is affected by a number of factors. A cross-sectional study using secondary data from Tanzania Demographic Health Survey (TDHS) for 2022 was used. A logistic regression was used for bivariate analysis to identify factors affecting the adoption of malaria interventions during pregnancy in Tanzania. Data from pregnant women between 15 to 49 years (N=1408) were analyzed in this study. Insecticide treated nets (ITNs) and intermittent preventive therapy in pregnancy using sulfadoxine-pyrimethamine (IPTp-SP) were the …

The Camden Study - A Pregnancy Cohort Study Of Pregnancy Complications And Birth Outcomes In Camden, New Jersey, Usa., Stephanie Shiau, Xinhua Chen, Ayana April-Sanders, Ellen C Francis, Shristi Rawal, Megan Hansel, Kehinde Adeyemi, Zorimar Rivera-Núñez, Emily S Barrett

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Pregnancy is a unique stage of the life course characterized by trade-offs between the nutritional, immune, and metabolic needs of the mother and fetus. The Camden Study was originally initiated to examine nutritional status, growth, and birth outcomes in adolescent pregnancies and expanded to study dietary and molecular predictors of pregnancy complications and birth outcomes in young women.

METHODS: From 1985-2006, 4765 pregnant participants aged 12 years and older were recruited from Camden, NJ, one of the poorest cities in the US. The cohort reflects a population under-represented in perinatal cohort studies (45% Hispanic, 38% non-Hispanic Black, 17% White …

Personalized And Culturally Tailored Features Of Mobile Apps For Gestational Diabetes Mellitus And Their Impact On Patient Self-Management: Scoping Review, Catherine Jones, Yi Cui, Ruth Jeminiwa, Elina Bajracharya, Katie Chang, Tony Ma

College of Pharmacy Faculty Papers

BACKGROUND: Gestational diabetes mellitus (GDM) is an increasingly common high-risk pregnancy condition requiring intensive daily self-management, placing the burden of care directly on the patient. Understanding personal and cultural differences among patients is critical for delivering optimal support for GDM self-management, particularly in high-risk populations. Although mobile apps for GDM self-management are being used, limited research has been done on the personalized and culturally tailored features of these apps and their impact on patient self-management.

OBJECTIVE: This scoping review aims to explore the extent to which published studies report the integration and effectiveness of personalized and culturally tailored features in …

Prenatal Social Disadvantage Is Associated With Alterations In Functional Networks At Birth, Ashley N Nielsen, Regina L Triplett, Lourdes M Bernardez, Ursula A Tooley, Max P Herzberg, Rachel E Lean, Sydney Kaplan, Dominique Meyer, Jeanette K Kenley, Dimitrios Alexopoulos, David Losielle, Aidan Latham, Tara A Smyser, Arpana Agrawal, Josh S Shimony, Joshua J Jackson, J Philip Miller, Marcus E Raichle, Barbara B Warner, Cynthia E Rogers, Chad M Sylvester, Deanna M Barch, Joan L Luby, Christopher D Smyser

2020-Current year OA Pubs

Childhood exposure to social disadvantage is a major risk factor for psychiatric disorders and poor developmental, educational, and occupational outcomes, presumably because adverse exposures alter the neurodevelopmental processes that contribute to risk trajectories. Yet, given the limited social mobility in the United States and other countries, childhood social disadvantage is frequently preceded by maternal social disadvantage during pregnancy, potentially altering fetal brain development during a period of high neuroplasticity through hormonal, microbiome, epigenetic, and immune factors that cross the placenta and fetal blood-brain barrier. The current study examines prenatal social disadvantage to determine whether these exposures in utero are associated …

Cohort Profile: The Origins Pregnancy And Birth Cohort, Jacqueline Davis, Zenobia Talati, Sarah Whalan, Wesley Billingham, Nina D'Vaz, Lisa Gibson, Susan L. Prescott, Desiree T. Silva

Research outputs 2022 to 2026

No abstract provided.

Are Prediction Models Moving Closer To Clinical Application In The Diagnosis Of Type Of Diabetes In Youth?, Fida Bacha

Children’s Nutrition Research Center Staff Publications

No abstract provided.

The Impact Of The Fruit And Seed Of Date On Childbirth Stages And Pregnancy Complications, Fatemeh A. Rahnemaei, Zahra A. Kashani, Mohammadamin Jandaghian-Bidgoli, Farinaz Rahimi, Farzaneh Zaheri, Fatemeh Abdi

Sultan Qaboos University Medical Journal

This review aimed to investigate the effects of date fruit products on childbirth and pregnancy-related complications. MeSH keywords were systematically searched in scientific databases, and 16 articles were reviewed. It was found that consuming 7 date fruits (average of 80 g) per day for 2–4 weeks before the estimated date of delivery leads to a better cervical dilatation at admission or improvement of Bishop score, a decrease in the need for induction or stimulation of labour and an increase in effective uterine contractions, which, in turn, decreases the duration of pregnancy and the different stages of labour. Additionally, date fruit …

Benchmarking Machine Learning Models To Predict Low Birthweight Baby Outcomes And Identify Associated Risk Factors From An Extremely Unbalanced Large-Scale Dataset, Yang Ren, Dezhi Wu, Yan Tong Ph.D., Ana Lopez-De Fede Ph.D., Sarah J. Gareau

Publications

Background: Low birthweight (LBW) is one of the leading causes of neonatal mortality in the United States (US), and also is a major causative factor of short- and long-term adverse health effects in newborns. To prevent adverse birth outcomes, it is critical to precisely predict and identify which mothers are at high risk of bearing LBW babies in the early stage of their pregnancy. Previous studies proposed various LBW prediction models from different ML algorithms primarily on small datasets. However, their model performance is significantly limited by data access barriers and data quality issues with one major technical challenge of …

Fetal Sex Effects On Maternal Health Can Now Be Tested Via Randomization: A First-In-Class Illustration In Cows On Glucoregulatory Outcomes, Aridany Suarez-Trujillo, Colby J Vorland, Griffin T Nicholls, Daniella E Chusyd, Chelsie Parker, Lilian Golzarri-Arroyo, Sophia Swann, Bethany J Funnell, Kara R Stewart, David B Allison

Children’s Nutrition Research Center Staff Publications

Background: The maternal-offspring relationship, such as whether fetal sex influences maternal health, is essential to explore to advance prenatal and maternal health. While associations exist between fetal sex and maternal health outcomes, it is unclear whether these reflect a causal relationship.

Objective: To demonstrate that fetal sex can be randomly assigned to test the causal effect of fetal sex on maternal outcomes.

Methods: Holstein dairy cows were stratified and randomized using sealed opaque envelopes to be artificially inseminated with either X- or Y-sorted bull semen until 40 cows became pregnant. Monthly body weight measurements were recorded, and an intravenous glucose …

Care Of Women With Thyroid Disease: Guideline Update, Donna Williams, Kathryn Trotter

Group: National Association of Nurse Practitioners in Women's Health (NPWH)

Problem Statement: Endocrinology guidelines for the diagnosis and management of thyroid disease differ in pregnancy and postpartum compared to the preconception state. Aim: NPs need to be aware of the management updates within the 2017 American Thyroid Association Guidelines. Hypothyroidism is second only to diabetes in endocrine disorders in pregnancy. Background: Due to the structural similarities of hCG to TSH and the increase in thyroxine binding globulin during pregnancy, nurse practitioners should understand the relative physiologic changes. These changes result in varied interpretation of free T4 values, forcing clarification in thyroid hormone laboratory assays. Population: Women across the lifespan were …

Demographic Characteristics, Perinatal Smoking Patterns, And Risk For Neonatal Health Complications Among Pregnant Smokers In The United States Who Begin Using Electronic Cigarettes During Pregnancy: A Descriptive Study Using Population-Based Surveillance Data., Hui Nian, Rachel Odland, Samantha Mindlin, Lin Ammar, Hilary Tindle, Angela M Miller, Kelli K Ryckman, Ethan Xie, Tina V Hartert, Brittney M Snyder, Steven M Brunwasser, Pingsheng Wu

Rowan-Virtua School of Osteopathic Medicine Departmental Research

INTRODUCTION: Health agencies have called for research evaluating e-cigarette (EC) use in supporting prenatal smoking cessation. This study aimed to describe (1) the characteristics of smokers who begin using electronic cigarettes (ECs) during pregnancy, (2) how frequently smokers reduce or eliminate pre- and post-natal combustible cigarette (CC) use, and (3) the risk for neonatal health complications among smokers who initiate ECs during pregnancy.

AIMS AND METHODS: Pregnant women using CCs exclusively during prepregnancy, who participated in a U.S. surveillance study, were classified by their reported late-pregnancy smoking behavior as CC-exclusive users, EC initiators, or quitters. EC initiators were further subclassified …

Precision Interventions Targeting The Maternal Metabolic Milieu For Healthy Pregnancies In Obesity, Alexandra M. Niclou, Hannah E. Cabre, Emily W. Flanagan, Leanne M. Redman

Clinical Research Faculty Publications

Purpose of Review: Entering pregnancy with obesity increases the risk of adverse health outcomes for parent and child. As such, research interventions are largely focused on limiting excess gestational weight gain during pregnancy, especially in those with obesity. Yet, while many lifestyle interventions are successful in reducing GWG, few affect pregnancy outcomes. Here we review work targeting the metabolic milieu instead of focusing solely on weight. Recent Findings: Work done in non-pregnant populations suggests that specifically targeting glucose, triglyceride, and leptin levels or inflammatory makers improves the metabolic milieu and overall health. We posit that precision interventions that include strategies …

Corrigendum: Sars-Cov-2 Seroprevalence In Pregnant Women In Kilifi, Kenya From March 2020 To March 2022, Angela Koech, Geoffrey Omuse, Joseph Mutunga, Moses Mukhanya, Onesmus Wanje, Grace Mwashigadi, Geoffrey Katana, Rachel Craik, Alex Mugo, Marleen Temmerman

Pathology, East Africa

Background: Seroprevalence studies are an alternative approach to estimating the extent of transmission of SARS-CoV-2 and the evolution of the pandemic in different geographical settings. We aimed to determine the SARS-CoV-2 seroprevalence from March 2020 to March 2022 in a rural and urban setting in Kilifi County, Kenya.

Methods: We obtained representative random samples of stored serum from a pregnancy cohort study for the period March 2020 to March 2022 and tested for antibodies against the spike protein using a qualitative SARS-CoV-2 ELISA kit (Wantai, total antibodies). All positive samples were retested for anti-SARS-CoV-2 anti-nucleocapsid antibodies (Euroimmun, ELISA kits, NCP, …