Clinical Epidemiology Commons^™

An Observational Study To Develop A Predictive Model For Bacterial Pneumonia Diagnosis In Severe Covid-19 Patients-C19-Pneumoscore, Eloisa Sofia Tanzarella, Joel Vargas, Marco Menghini, Stefania Postorino, Francesca Pozzana, Maria Sole Vallecoccia, Francesco Lorenzo De Matteis, Federico Franchi, Amato Infante, Luigi Larosa, Maria Antonietta Mazzei, Salvatore Lucio Cutuli, Domenico Luca Grieco, Alessandra Bisanti, Simone Carelli, Gianmarco Lombardi, Edoardo Piervincenzi, Gabriele Pintaudi, Tommaso Pirronti, Mario Tumbarello, Massimo Antonelli, Gennaro De Pascale

Faculty, Staff and Student Publications

In COVID-19 patients, antibiotics overuse is still an issue. A predictive scoring model for the diagnosis of bacterial pneumonia at intensive care unit (ICU) admission would be a useful stewardship tool. We performed a multicenter observational study including 331 COVID-19 patients requiring invasive mechanical ventilation at ICU admission; 179 patients with bacterial pneumonia; and 152 displaying negative lower-respiratory samplings. A multivariable logistic regression model was built to identify predictors of pulmonary co-infections, and a composite risk score was developed using β-coefficients. We identified seven variables as predictors of bacterial pneumonia: vaccination status (OR 7.01; 95% CI, 1.73-28.39); chronic kidney disease …

Clinically Stable Covid-19 Patients Presenting To Acute Unscheduled Episodic Care Venues Have Increased Risk Of Hospitalization: Secondary Analysis Of A Randomized Control Trial, Joseph Bledsoe, Scott C Woller, Maria Brooks, Frank C Sciurba, Jerry A Krishnan, Deborah Martin, Peter Hou, Janet Y Lin, Andrei Kindzelski, Eileen Handberg, Bridget-Anne Kirwan, Elaine Zaharris, Lauren Castro, Nancy L Shapiro, Carl J Pepine, Sarah Majercik, Zhuxuan Fu, Yongqi Zhong, Vidya Venugopal, Yu-Hsuan Lai, Paul M Ridker, Jean M Connors

Faculty, Staff and Student Publications

BACKGROUND: Assessment for risks associated with acute stable COVID-19 is important to optimize clinical trial enrollment and target patients for scarce therapeutics. To assess whether healthcare system engagement location is an independent predictor of outcomes we performed a secondary analysis of the ACTIV-4B Outpatient Thrombosis Prevention trial.

METHODS: A secondary analysis of the ACTIV-4B trial that was conducted at 52 US sites between September 2020 and August 2021. Participants were enrolled through acute unscheduled episodic care (AUEC) enrollment location (emergency department, or urgent care clinic visit) compared to minimal contact (MC) enrollment (electronic contact from test center lists of positive …

Covid-19 And Employee Job Performance Trajectories: The Moderating Effect Of Different Sources Of Status, Xin Liu, Xiaoming Zheng, Byron Y Lee, Yu Yu, Mengyi Zhang

Faculty, Staff and Student Publications

This study investigates the impact of the COVID-19 pandemic on employee job performance trajectories, and further examines the moderating effects of different sources of status. Drawing from event system theory (EST), we propose that employee job performance decreases upon COVID-19 onset, but gradually increases during the postonset period. Furthermore, we argue that status from society, occupation, and workplace functions to moderate such performance trajectories. We test our hypotheses with a unique dataset of 708 employees that combines survey responses and job performance archival data over 21 consecutive months (10,808 observations) spanning the preonset, onset, and postonset periods of the initial …

The Risk Of Sars-Cov-2 Omicron Variant Emergence In Low And Middle-Income Countries (Lmics), Kaiming Bi, Jose Luis Herrera-Diestra, Yuan Bai, Zhanwei Du, Lin Wang, Graham Gibson, Maureen Johnson-Leon, Spencer J Fox, Lauren Ancel Meyers

Faculty, Staff and Student Publications

We estimated the probability of undetected emergence of the SARS-CoV-2 Omicron variant in 25 low and middle-income countries (LMICs) prior to December 5, 2021. In nine countries, the risk exceeds 50 %; in Turkey, Pakistan and the Philippines, it exceeds 99 %. Risks are generally lower in the Americas than Europe or Asia.

Impact Of High Neutrophil-To-Lymphocyte Ratio On Survival In Hospitalized Cancer Patients With Covid-19, Fernando A Díaz-Couselo, Santiago Flagel, Carla Nicolini, Sebastián Halac, Natalia Manzano, Marina Aguirre, Juan Rébora, Sandra Valle, Laura Noro, Chirayu Mohindroo, Florencia Mcallister, Marcelo Zylberman

Faculty, Staff and Student Publications

Neutrophil-to-lymphocyte ratio (NLR) has been studied as a prognostic factor for mortality in COVID-19 patients. Our study aimed to evaluate the association between NLR at COVID-19 diagnosis and survival during the following 90 days in hospitalized patients with solid cancer. Between May 2020 and June 2021, 120 patients were included in a retrospective cohort study. Univariable analysis showed patients with an NLR > 8.3 were associated with an increased risk of death (HR: 4.34; 95% CI: 1.74-10.84) compared to patients with NLR < 3.82 and with NLR ≥3.82 and ≤8.30 (HR: 2.89; 95% CI: 1.32-6.36). Furthermore, on multivariable analysis, NLR > 8.30 independently correlated with increased mortality. In patients with solid malignancies with COVID-19, an NLR > 8.3 is associated with …

Identification Of And Mechanistic Insights Into Sars-Cov-2 Main Protease Non-Covalent Inhibitors: An In-Silico Study, Jian-Xin Shen, Wen-Wen Du, Yuan-Ling Xia, Zhi-Bi Zhang, Ze-Fen Yu, Yun-Xin Fu, Shu-Qun Liu

Faculty, Staff and Student Publications

The indispensable role of the SARS-CoV-2 main protease (Mpro) in the viral replication cycle and its dissimilarity to human proteases make Mpro a promising drug target. In order to identify the non-covalent Mpro inhibitors, we performed a comprehensive study using a combined computational strategy. We first screened the ZINC purchasable compound database using the pharmacophore model generated from the reference crystal structure of Mpro complexed with the inhibitor ML188. The hit compounds were then filtered by molecular docking and predicted parameters of drug-likeness and pharmacokinetics. The final molecular dynamics (MD) simulations identified three effective candidate inhibitors (ECIs) capable of maintaining …

The Orf7a Protein Of Sars-Cov-2 Initiates Autophagy And Limits Autophagosome-Lysosome Fusion Via Degradation Of Snap29 To Promote Virus Replication, Peili Hou, Xuefeng Wang, Hongmei Wang, Tiecheng Wang, Zhangping Yu, Chunqing Xu, Yudong Zhao, Wenqi Wang, Yong Zhao, Fengyun Chu, Huasong Chang, Hongchao Zhu, Jiahui Lu, Fuzhen Zhang, Xue Liang, Xingyu Li, Song Wang, Yuwei Gao, Hongbin He

Faculty, Staff and Student Publications

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is closely related to various cellular aspects associated with autophagy. However, how SARS-CoV-2 mediates the subversion of the macroautophagy/autophagy pathway remains largely unclear. In this study, we demonstrate that overexpression of the SARS-CoV-2 ORF7a protein activates LC3-II and leads to the accumulation of autophagosomes in multiple cell lines, while knockdown of the viral ORF7a gene via shRNAs targeting ORF7a sgRNA during SARS-CoV-2 infection decreased autophagy levels. Mechanistically, the ORF7a protein initiates autophagy via the AKT-MTOR-ULK1-mediated pathway, but ORF7a limits the progression of autophagic flux by activating CASP3 (caspase 3) to cleave the …

Hyaluronan In The Pathogenesis Of Acute And Post-Acute Covid-19 Infection, Henry W Barnes, Sally Demirdjian, Naomi L Haddock, Gernot Kaber, Hunter A Martinez, Nadine Nagy, Harry Karmouty-Quintana, Paul L Bollyky

Faculty, Staff and Student Publications

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) recently emerged as the cause of a global pandemic. Infection with SARS-CoV-2 can result in COVID-19 with both acute and chronic disease manifestations that continue to impact many patients long after the resolution of viral replication. There is therefore great interest in understanding the host factors that contribute to COVID-19 pathogenesis. In this review, we address the role of hyaluronan (HA), an extracellular matrix polymer with roles in inflammation and cellular metabolism, in COVID-19 and critically evaluate the hypothesis that HA promotes COVID-19 pathogenesis. We first provide a brief overview of COVID-19 infection. …

Identification Of Bradycardia Following Remdesivir Administration Through The Us Food And Drug Administration American College Of Medical Toxicology Covid-19 Toxic Pharmacovigilance Project, Jason M Devgun, Rongmei Zhang, Jeffrey Brent, Paul Wax, Keith Burkhart, Alison Meyn, Sharan Campleman, Stephanie Abston, Kim Aldy

Faculty, Staff and Student Publications

IMPORTANCE: The rapid spread and mortality associated with COVID-19 emphasized a need for surveillance system development to identify adverse events (AEs) to emerging therapeutics. Bradycardia is a remdesivir infusion-associated AE listed in the US Food and Drug Administration-approved prescribing information.

OBJECTIVE: To evaluate the magnitude and duration of bradycardic events following remdesivir administration.

DESIGN, SETTING, AND PARTICIPANTS: A multicenter cohort study of patients with recorded heart rate less than 60 beats per minute within 24 hours after administration of a remdesivir dose was conducted between November 23, 2020, and October 31, 2021. Participants included patients hospitalized with COVID-19 at 15 …

Association Between Covid-19 And Postoperative Neurological Complications And Antipsychotic Medication Use After Cancer Surgery: A Retrospective Study, Juan P Cata, Jian Hu, Lei Feng, Caroline Chung, Scott E Woodman, Larissa A Meyer

Faculty, Staff and Student Publications

Introduction: Millions of Americans infected with the severe acute respiratory syndrome-associated coronavirus-19 (COVID-19) need oncologic surgery. Patients with acute or resolved COVID-19 illness complain of neuropsychiatric symptoms. How surgery affects postoperative neuropsychiatric outcomes such as delirium is unknown. We hypothesize that patients with a history of COVID-19 could have an exaggerated risk of developing postoperative delirium after undergoing major elective oncologic surgery.

Methods: We conducted a retrospective study to determine the association between COVID-19 status and antipsychotic drugs during postsurgical hospitalization as a surrogate of delirium. Secondary outcomes included 30 days of postoperative complications, length of stay, and mortality. Patients …

Global Impact Of The Covid-19 Pandemic On Stroke Volumes And Cerebrovascular Events: A 1-Year Follow-Up, Thanh N Nguyen, Muhammad M Qureshi, Piers Klein, Hiroshi Yamagami, Robert Mikulik, Anna Czlonkowska, Mohamad Abdalkader, Petra Sedova, Anvitha Sathya, Hannah C Lo, Ossama Yassin Mansour, Husitha Reddy Vanguru, Emilie Lesaine, Georgios Tsivgoulis, Aaron I Loochtan, Jelle Demeestere, Ken Uchino, Violiza Inoa, Nitin Goyal, Andreas Charidimou, James E Siegler, Shadi Yaghi, Diana Aguiar De Sousa, Mahmoud H Mohammaden, Diogo C Haussen, Espen Saxhaug Kristoffersen, Virginia Pujol Lereis, Sergio Daniel Scollo, Bruce C V Campbell, Alice Ma, James Orton Thomas, Mark W Parsons, Shaloo Singhal, Lee-Anne Slater, Rodrigo Tomazini Martins, Chris Enzinger, Thomas Gattringer, Aminur Rahman, Thomas Bonnet, Noemie Ligot, Sylvie De Raedt, Robin Lemmens, Peter Vanacker, Fenne Vandervorst, Adriana Bastos Conforto, Raquel C T Hidalgo, Luciana De Oliveira Neves, Rodrigo Targa Martins, Daissy Liliana Mora Cuervo, Leticia C Rebello, Igor Bessa Santiago, Isabelle Lameirinhas Da Silva, Teodora Sakelarova, Rosen Kalpachki, Filip Alexiev, Luciana Catanese, Elena Adela Cora, Mayank Goyal, Michael D Hill, Michael E Kelly, Houman Khosravani, Pascale Lavoie, Lissa Peeling, Aleksandra Pikula, Rodrigo Rivera, Hui-Sheng Chen, Yimin Chen, Xiaochuan Huo, Zhongrong Miao, Shuiquan Yang, Marina Roje Bedekovic, Marina Bralic, Hrvoje Budincevic, Angel Basilio Corredor-Quintero, Osvaldo E Lara-Sarabia, Martin Cabal, Dusan Tenora, Petr Fibrich, Roman Herzig, Helena Hlaváčová, Emanuela Hrabanovska, David Hlinovsky, Lubomir Jurak, Jana Kadlcikova, Igor Karpowicz, Lukas Klecka, Martin Kovar, David Lauer, Jiri Neumann, Hana Palouskova, Martin Reiser, Petra Rekova, Vladimir Rohan, Ondrej Skoda, Miroslav Škorňa, Lenka Sobotková, Martin Sramek, Lenka Zakova, Hanne Christensen, Nicolas Drenck, Helle Klingenberg Iversen, Thomas Clement Truelsen, Troels Wienecke, Khalid Sobh, Pauli Ylikotila, Kemal Alpay, Daniel Strbian, Patricia Bernady, Philippe Casenave, Maria Dan, Jean-Marc Faucheux, Jean-Christophe Gentric, Elsa Magro, Candice Sabben, Peggy Reiner, Francois Rouanet, Ferdinand O Bohmann, Stefan Boskamp, Joshua Mbroh, Simon Nagel, Christian H Nolte, Peter A Ringleb, Michael Rosenkranz, Sven Poli, Götz Thomalla, Theodoros Karapanayiotides, Ioanna Koutroulou, Odysseas Kargiotis, Lina Palaiodimou, Jose Dominguo Barrientos Guerra, Vikram Huded, Bindu Menon, Shashank Nagendra, Chintan Prajapati, P N Sylaja, Nyoman Angga Krishna Pramana, Achmad Firdaus Sani, Abdoreza Ghoreishi, Mehdi Farhoudi, Elyar Sadeghi Hokmabadi, Tariq Abu Raya, Shani Avnery Kalmanovich, Levite Ronen, Sergiu Ionut Sabetay, Maurizio Acampa, Alessandro Adami, Lucio Castellan, Marco Longoni, Raffaele Ornello, Leonardo Renieri, Claudia Rolla Bigliani, Michele Romoli, Simona Sacco, Andrea Salmaggi, Davide Sangalli, Andrea Zini, Ryosuke Doijiri, Hiroki Fukuda, Toshiyuki Fujinaka, Kyohei Fujita, Hirotoshi Imamura, Nobuyuki Sakai, Takuya Kanamaru, Naoto Kimura, Ryuhei Kono, Kosuke Miyake, Manabu Sakaguchi, Kenichiro Sakai, Kazutaka Sonoda, Kenichi Todo, Fumio Miyashita, Naoki Tokuda, Yuji Matsumaru, Shoji Matsumoto, Nobuyuki Ohara, Seigo Shindo, Yohei Takenobu, Takeshi Yoshimoto, Kazunori Toyoda, Takeshi Uwatoko, Yoshiki Yagita, Takehiro Yamada, Nobuaki Yamamoto, Ryoo Yamamoto, Yukako Yazawa, Yuri Sugiura, Peter Kuria Waweru, Jang-Hyun Baek, Si Baek Lee, Kwon-Duk Seo, Sung-Il Sohn, Anita Ante Arsovska, Yong Chieh Chan, Wan Asyraf Wan Zaidi, Ainul Syahrilfazli Jaafar, Fernando Gongora-Rivera, Manuel Martinez-Marino, Adrian Infante-Valenzuela, Stanislav Groppa, Pavel Leahu, Jonathan M Coutinho, Leon A Rinkel, Diederik W J Dippel, Dianne H K Van Dam-Nolen, Annemarei Ranta, Teddy Y Wu, Tajudeen Temitayo Adebayo, Abiodun H Bello, Ernest Okwundu Nwazor, Taofiki Ajao Sunmonu, Kolawole Wasiu Wahab, Ole Morten Ronning, Else Charlotte Sandset, Amal M Al Hashmi, Saima Ahmad, Umair Rashid, Liliana Rodriguez-Kadota, Miguel Ángel Vences, Patrick Matic Yalung, Jon Stewart Hao Dy, Maria Carissa Pineda-Franks, Christian Oliver Co, Waldemar Brola, Aleksander Debiec, Malgorzata Dorobek, Michal Adam Karlinski, Beata M Labuz-Roszak, Anetta Lasek-Bal, Halina Sienkiewicz-Jarosz, Jacek Staszewski, Piotr Sobolewski, Marcin Wiacek, Justyna Zielinska-Turek, Andre Pinho Araujo, Mariana Rocha, Pedro Castro, Vitor Tedim Cruz, Paulo Venancio Ferreira, Patricia Ferreira, Ana Paiva Nunes, Luisa Fonseca, João Pedro Marto, Teresa Pinho E Melo, Miguel Rodrigues, M Luis Silva, Adela Dimitriade, Cristian Falup-Pecurariu, May Adel Hamid, Narayanaswamy Venketasubramanian, Georgi Krastev, Miroslav Mako, Oscar Ayo-Martin, Francisco Hernández-Fernández, Jordi Blasco, Alejandro Rodríguez-Vázquez, Antonio Cruz-Culebras, Francisco Moniche, Joan Montaner, Soledad Perez-Sanchez, María Jesús García Sánchez, Marta Guillán Rodríguez, Katarina Jood, Annika Nordanstig, Michael V Mazya, Tiago T P Moreira, Gianmarco Bernava, Morin Beyeler, Manuel Bolognese, Emmanuel Carrera, Tomas Dobrocky, Grzegorz Marek Karwacki, Emanuela Keller, Chang Yang Hsieh, Surawan Boonyakarnkul, Anchalee Churojana, Ozlem Aykac, Atilla Ã-Zcan Ozdemir, Arsida Bajrami, Songul Senadim, Syed Irteza Hussain, Seby John, Soma Banerjee, Joseph Kwan, Kailash Krishnan, Robert Lenthall, Ashok Matthews, Ken Wong, Liqun Zhang, Dorothea Altschul, Kaiz S Asif, Zeelalem Bahiru, Kristine Below, José Biller, Sean Ruland, Saqib A Chaudry, Michael Chen, Alex Chebl, Jackie Cibulka, Leon Cistrunk, Judith Clark, Marco Colasurdo, Alexandra Czap, Adam De Havenon, Salvatore D'Amato, Sushrut Dharmadhikari, Kasey B Grimmett, Adam A Dmytriw, Mark R Etherton, Chizoba Ezepue, Mudassir Farooqui, Steven K Feske, Lauren Fink, Ulviyya Gasimova, Amy K Guzik, Maryam Hakemi, Majesta Hovingh, Muhib Khan, Dinesh Jillela, Peter T Kan, Rakesh Khatri, Ayaz M Khawaja, Naim N Khoury, Nicole L Kiley, Benny S Kim, Murali K Kolikonda, Anna Luisa Kuhn, Stephanie Lara, Guillermo Linares, Italo Linfante, Timothy G Lukovits, Sarah Lycan, Shailesh S Male, Laith Maali, John Mancin, Hesham Masoud, Ghada A Mohamed, Andre Monteiro, Fadi Nahab, Krishna Nalleballe, Santiago Ortega-Gutierrez, Ajit S Puri, Yazan Radaideh, Rahul H Rahangdale, Ansaar Rai, Pankajavalli Ramakrishnan, Aravind B Reddy, Diana M Rojas-Soto, Jose Rafael Romero, Natalia S Rost, Aaron Rothstein, Setareh Salehi Omran, Sunil A Sheth, Adnan H Siddiqui, Amy K Starosciak, Nicholas E Tarlov, Robert A Taylor, Michael J Wang, Jared Wolfe, Ka-Ho Wong, Huynh Vu Le, Quy Viet Nguyen, Thong Nhu Pham, Trung Thanh Nguyen, Hoang Thi Phan, Mai Duy Ton, Urs Fischer, Patrik Michel, Davide Strambo, Sheila O Martins, Osama O Zaidat, Raul G Nogueira

Faculty, Staff and Student Publications

BACKGROUND AND OBJECTIVES: Declines in stroke admission, IV thrombolysis (IVT), and mechanical thrombectomy volumes were reported during the first wave of the COVID-19 pandemic. There is a paucity of data on the longer-term effect of the pandemic on stroke volumes over the course of a year and through the second wave of the pandemic. We sought to measure the effect of the COVID-19 pandemic on the volumes of stroke admissions, intracranial hemorrhage (ICH), IVT, and mechanical thrombectomy over a 1-year period at the onset of the pandemic (March 1, 2020, to February 28, 2021) compared with the immediately preceding year …

Neighborhood Condition Prevalence Rates Correlate With Covid-19 Mortality In Milwaukee County, Wisconsin, George L. Morris Iii

Journal of Patient-Centered Research and Reviews

Purpose: We sought to determine if census tract-level (ie, neighborhood) COVID-19 death rates in Milwaukee County correlated with the census tract-level condition prevalence rates (CPRs) for individual COVID-19 mortality risk.

Methods: This study used Milwaukee County-reported COVID-19 death rates per 100,000 lives for the 296 census tracts within the county to perform a linear regression with individual COVID-19 mortality risk CPR, mean age, racial composition of census tract (by percentage of non-White residents), and poverty (by percentage within census tract), followed by multiple regression with all 7 CPRs as well as the 7 CPRs combined with the additional demographic variables. …

Enhancing Reciprocity, Equity And Quality Of Ethics Review For Multisite Research During Public Health Crises: The Experience Of The Covid-19 Clinical Research Coalition Ethics Working Group, Vasiliki Rahimzadeh, Jennyfer Ambe, Jantina De Vries

Center for Medical Ethics and Health Policy Staff Publications

In this paper we report findings from a commissioned report to the COVID-19 Clinical Research Coalition on approaches to streamline multinational REC review/approval during public health emergencies. As currently envisioned in the literature, a system of REC mutual recognition is theoretically possible based on shared procedural REC standards, but raises numerous concerns about perceived inequities and mistrust.

Changes In Severity Of Diabetes At Diagnosis Following The Onset Of The Sars-Cov-2 Pandemic, Annelise King

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

During the SARS-CoV-2 pandemic it was seen that diabetes was a risk factor for severe COVID-19. The objective of this study is to assess the severity of diabetes at diagnosis during the COVID-19 pandemic compared to pre-pandemic to see how the pandemic and SARS-CoV-2 infection impacted the severity of diabetes. This study used University of Kentucky electronic health records of 13,794 patients who developed diabetes. The majority of patients were female, white non-Hispanic, 65+, and living in an urban area. There were differences seen between the COVID-19 positive and negative cohorts in the DKA and HbA₁c variables, with …

Assessing Pandemic Preparedness, Response, And Lessons Learned From The Covid-19 Pandemic In Four South American Countries: Agenda For The Future, Andrea Ramírez Varela, Michael Touchton, J Jaime Miranda, Juliana Mejía Grueso, Rachid Laajaj, Gabriel Carrasquilla, Martha Vives Florez, Ana María Vesga Gaviria, Ana María Ortiz Hoyos, Esteban Orlando Vanegas Duarte, Alejandra Velásquez Morales, Nubia Velasco, Silvia Restrepo Restrepo

Faculty, Staff and Student Publications

INTRODUCTION: The COVID-19 pandemic emerged in a context that lacked adequate prevention, preparedness, and response (PPR) activities, and global, regional, and national leadership. South American countries were among world's hardest hit by the pandemic, accounting for 10.1% of total cases and 20.1% of global deaths.

METHODS: This study explores how pandemic PPR were affected by political, socioeconomic, and health system contexts as well as how PPR may have shaped pandemic outcomes in Argentina, Brazil, Colombia, and Peru. We then identify lessons learned and advance an agenda for improving PPR capacity at regional and national levels. We do this through a …

Trem-1, Trem-2 And Their Association With Disease Severity In Patients With Covid-19, Ruyue Fan, Zuowang Cheng, Zhisheng Huang, Ying Yang, Na Sun, Bin Hu, Peibin Hou, Bo Liu, Chuanjun Huang, Shuai Liu

Faculty, Staff and Student Publications

BACKGROUND: Delayed diagnosis and inadequate treatment caused by limited biomarkers are associated with the outcomes of COVID-19 patients. It is necessary to identify other promising biomarkers and candidate targets for defining dysregulated inflammatory states.

METHODS: The triggering receptors expressed on myeloid cell (TREM)-1 and TREM-2 expression from hospitalized COVID-19 patients were characterized using ELISA and flow cytometry, respectively. Their correlation with disease severity and contrast with the main clinical indicators were evaluated.

RESULTS: Increased expression of soluble TREM-1 and TREM-2 in the plasma of COVID-19 patients was found compared to the control group. Moreover, membrane-bound TREM-1 and TREM-2 expression was …

Risk Of Depression In A Suburban Primary Care Setting Before And During The Covid-19 Pandemic, Carman H Whiting, Pouran Yousefi, Jude K A Des Bordes, Nahid J Rianon

Faculty, Staff and Student Publications

INTRODUCTION: Major depression is a common disorder affecting millions of adults each year. Many population-based surveys showed an increase in the number people with symptoms of depression at the onset of the COVID-19 pandemic. Our aim was to determine and compare the prevalence of depression risk in a primary care setting before and during the COVID-19 pandemic.

METHODS: We conducted a cross-sectional study based on retrospective review of medical records from a large suburban primary care clinic. Records of adults 18 years and older, seen between January 1, 2019 and December 31, 2020 and who had also been screened for …

Public Mental Health During And After The Sars-Cov-2 Pandemic: Opportunities For Intervention, Melissa M Karnaze, Brent M Kious, Lindsay Z Feuerman, Sarah Classen, Jill O Robinson, Cinnamon S Bloss, Amy L Mcguire

Center for Medical Ethics and Health Policy Staff Publications

Importance: During the pandemic, the number of United States adults reporting clinically significant symptoms of anxiety and depression sky-rocketed, up from 11% in 2020 to more than 40% in 2021. Our current mental healthcare system cannot adequately accommodate the current crisis; it is therefore important to identify opportunities for public mental health interventions.

Objective: Assess whether modifiable emotional factors may offer a point of intervention for the mental health crisis.

Design setting and participants: From January 13 to 15, 2022, adults living in the United States were recruited via Amazon Mechanical Turk to complete an anonymous survey.

Main outcomes and …

The Challenges And Opportunities Of Scrna-Seq In Covid-19 Research And Clinical Translation, Wendao Liu, Xiaohua Ye, Zhiqiang An, Zhongming Zhao

Faculty, Staff and Student Publications

The application of single-cell RNA sequencing in COVID-19 research has greatly improved our understanding of COVID-19 pathogenesis and immunological characteristics. In this commentary, we discuss the current challenges, limitations, and perspectives in harnessing the power of single-cell RNA sequencing to accelerate both basic research and therapeutic development for COVID-19 and other emerging infectious diseases.

Sars-Cov-2 Incubation Period According To Vaccination Status During The Fifth Covid-19 Wave In A Tertiary-Care Center In Spain: A Cohort Study, Jordi Cortés Martínez, Daewoo Pak, Gabriela Abelenda-Alonso, Klaus Langohr, Jing Ning, Alexander Rombauts, Mireia Colom, Yu Shen, Guadalupe Gómez Melis

Faculty, Staff and Student Publications

Background: The incubation period of an infectious disease is defined as the elapsed time between the exposure to the pathogen and the onset of symptoms. Although both the mRNA-based and the adenoviral vector-based vaccines have shown to be effective, there have been raising concerns regarding possible decreases in vaccine effectiveness for new variants and variations in the incubation period.

Methods: We conducted a unicentric observational study at the Hospital Universitari de Bellvitge, Barcelona, using a structured telephone survey performed by trained interviewers to estimate the incubation period of the SARS-CoV-2 Delta variant in a cohort of Spanish hospitalized patients. The …

Cardiovascular Outcomes In Patients With Chronic Kidney Disease And Covid-19: A Multi-Regional Data-Linkage Study, Emilie J Lambourg, Peter J Gallacher, Robert W Hunter, Moneeza Siddiqui, Eve Miller-Hodges, James D Chalmers, Dan Pugh, Neeraj Dhaun, Samira Bell

Faculty, Staff and Student Publications

BACKGROUND: Data describing cardiovascular outcomes in patients with coronavirus disease 2019 (COVID-19) and chronic kidney disease (CKD) are lacking. We compared cardiovascular outcomes of patients with and without COVID-19, stratified by CKD status.

METHODS: This retrospective, multi-regional data-linkage study utilised individual patient-level data from two Scottish cohorts. All patients tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Cohort 1 between 1 February 2020 and 31 March 2021 and in Cohort 2 between 28 February 2020 and 8 February 2021 were included.

RESULTS: Overall, 86 964 patients were tested for SARS-CoV-2. There were 36 904 patients (mean±sd age 61±21 …

Evaluation Of The Effectiveness Of Uv-C Dose For Photoinactivation Of Sars-Cov-2 In Contaminated N95 Respirator, Surgical And Cotton Fabric Masks, Patrícia Metolina, Lilian Gomes De Oliveira, Bruno Ramos, Yan De Souza Angelo, Paola Minoprio, Antonio Carlos Silva Costa Teixeira

Faculty, Staff and Student Publications

As part of efforts to combat the Covid-19 pandemic and decrease the high transmissibility of the new coronavirus, SARS-CoV-2, effective inactivation strategies, such as UV-C decontamination technologies, can be reliably disseminated and well-studied. The present study investigated the susceptibility of a high viral load of SARS-CoV-2 in filtering facepiece respirators (FFR) N95, surgical mask, cotton fabric mask and N95 straps under three different doses of UV-C, applying both real-time PCR (qPCR) and plaque formation assays to quantify viral load reduction and virus infectivity, respectively. The results show that more than 95% of the amount of SARS-CoV-2 RNA could be reduced …

Central Nervous System (Cns) Inflammatory Demyelinating Diseases (Idds) Associated With Covid-19: A Case Series And Review, Parissa Feizi, Kanika Sharma, Shreya R Pasham, Lalit Nirwan, Joe Joseph, Shruti Jaiswal, Shitiz Sriwastava

Faculty, Staff and Student Publications

BACKGROUND: Over the past two years, SARS-CoV-2 has frequently been documented with various post and para-infectious complications, including cerebrovascular, neuromuscular, and some demyelinating conditions such as acute disseminated encephalomyelitis (ADEM). We report two rare neurological manifestations post-COVID-19 infection; multiple sclerosis (MS) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). Further, we reviewed other CNS inflammatory demyelinating diseases (IDDs) associated with SARS-CoV-2, including optic neuritis (ON) and neuromyelitis optica spectrum disorders (NMOSD).

METHODS: A descriptive analysis and literature search of Google Scholar and PubMed was conducted by two independent reviewers from December 1st, 2019, to March 30th, 2022, and included all the …

Measurement Of Severe Acute Respiratory Syndrome Coronavirus 2 Antigens In Plasma Of Pediatric Patients With Acute Coronavirus Disease 2019 Or Multisystem Inflammatory Syndrome In Children Using An Ultrasensitive And Quantitative Immunoassay, George B Sigal, Tanya Novak, Anu Mathew, Janet Chou, Yubo Zhang, Navaratnam Manjula, Pradeepthi Bathala, Jessica Joe, Nikhil Padmanabhan, Daniel Romero, Gabriella Allegri-Machado, Jill Joerger, Laura L Loftis, Stephanie P Schwartz, Tracie C Walker, Julie C Fitzgerald, Keiko M Tarquinio, Matt S Zinter, Jennifer E Schuster, Natasha B Halasa, Melissa L Cullimore, Aline B Maddux, Mary A Staat, Katherine Irby, Heidi R Flori, Bria M Coates, Hillary Crandall, Shira J Gertz, Adrienne G Randolph, Nira R Pollock, Overcoming Covid-19 Investigators

Center for Medical Ethics and Health Policy Staff Publications

Background: Detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antigens in blood has high sensitivity in adults with acute coronavirus disease 2019 (COVID-19), but sensitivity in pediatric patients is unclear. Recent data suggest that persistent SARS-CoV-2 spike antigenemia may contribute to multisystem inflammatory syndrome in children (MIS-C). We quantified SARS-CoV-2 nucleocapsid (N) and spike (S) antigens in blood of pediatric patients with either acute COVID-19 or MIS-C using ultrasensitive immunoassays (Meso Scale Discovery).

Methods: Plasma was collected from inpatients (< 21 years) enrolled across 15 hospitals in 15 US states. Acute COVID-19 patients (n = 36) had a range of disease severity and positive nasopharyngeal SARS-CoV-2 RT-PCR within 24 hours of blood collection. Patients with MIS-C (n = 53) met CDC criteria and tested positive for SARS-CoV-2 (RT-PCR or serology). Controls were patients pre-COVID-19 (n = 67) or within 24 hours of negative RT-PCR (n = 43).

Results: Specificities of N and S assays were 95-97% and 100%, respectively. In acute COVID-19 patients, N/S plasma assays …

Efficacy And Safety Of A Single Dose Of Casirivimab And Imdevimab For The Prevention Of Covid-19 Over An 8-Month Period: A Randomised, Double-Blind, Placebo-Controlled Trial, Gary A Herman, Meagan P O'Brien, Eduardo Forleo-Neto, Neena Sarkar, Flonza Isa, Peijie Hou, Kuo-Chen Chan, Katharine J Bar, Ruanne V Barnabas, Dan H Barouch, Myron S Cohen, Christopher B Hurt, Dale R Burwen, Mary A Marovich, Bret J Musser, John D Davis, Kenneth C Turner, Adnan Mahmood, Andrea T Hooper, Jennifer D Hamilton, Janie Parrino, Danise Subramaniam, Alina Baum, Christos A Kyratsous, A Thomas Dicioccio, Neil Stahl, Ned Braunstein, George D Yancopoulos, David M Weinreich, Covid-19 Phase 3 Prevention Trial Team

Faculty, Staff and Student Publications

BACKGROUND: There is an unmet need for COVID-19 prevention in patient populations who have not mounted or are not expected to mount an adequate immune response to complete COVID-19 vaccination. We previously reported that a single subcutaneous 1200 mg dose of the monoclonal antibody combination casirivimab and imdevimab (CAS + IMD) prevented symptomatic SARS-CoV-2 infections by 81·4% in generally healthy household contacts of SARS-CoV-2-infected individuals over a 1-month efficacy assessment period. Here we present additional results, including the 7-month follow-up period (months 2-8), providing additional insights about the potential for efficacy in pre-exposure prophylaxis settings.

METHODS: This was a randomised, …

Surge In Incidence And Coronavirus Disease 2019 Hospital Risk Of Death, United States, September 2020 To March 2021, Bela Patel, Robert E Murphy, Siddharth Karanth, Salsawit Shiffaraw, Richard M Peters, Samuel F Hohmann, Raymond S Greenberg

Faculty, Staff and Student Publications

BACKGROUND: Studies of the early months of the coronavirus disease 2019 (COVID-19) pandemic indicate that patient outcomes may be adversely affected by surges. However, the impact on in-hospital mortality during the largest surge to date, September 2020-March 2021, has not been studied. This study aimed to determine whether in-hospital mortality was impacted by the community surge of COVID-19.

METHODS: This is a retrospective cohort study of 416 962 adult COVID-19 patients admitted immediately before or during the surge at 229 US academic and 432 community hospitals in the Vizient Clinical Database. The odds ratios (ORs) of death among hospitalized patients …

Pin-Pointing The Key Hubs In The Ifn-Γ Pathway Responding To Sars-Cov-2 Infection, Ayelen Toro, Sofia Lage-Vickers, Juan Bizzotto, Felipe Vilicich, Agustina Sabater, Gaston Pascual, Sabrina Ledesma-Bazan, Pablo Sanchis, Maria Sol Ruiz, Ana Paula Arevalo, Jorge L Porfido, Mercedes Abbate, Rocio Seniuk, Estefania Labanca, Nicolas Anselmino, Nora M Navone, Daniel F Alonso, Elba Vazquez, Martina Crispo, Javier Cotignola, Geraldine Gueron

Faculty, Staff and Student Publications

Interferon gamma (IFN-γ) may be potential adjuvant immunotherapy for COVID-19 patients. In this work, we assessed gene expression profiles associated with the IFN-γ pathway in response to SARS-CoV-2 infection. Employing a case-control study from SARS-CoV-2-positive and -negative patients, we identified IFN-γ-associated pathways to be enriched in positive patients. Bioinformatics analyses showed upregulation of MAP2K6, CBL, RUNX3, STAT1, and JAK2 in COVID-19-positive vs. -negative patients. A positive correlation was observed between STAT1/JAK2, which varied alongside the patient's viral load. Expression of MX1, MX2, ISG15, and OAS1 (four well-known IFN-stimulated genes (ISGs)) …

Pivoting The Biosafety Program In Response To Covid-19: Recommendations Of Key Services And Tasks To Consider For The Next Pandemic, Robert J Emery, Scott J Patlovich, Kristin G King, Janelle Rios

Faculty, Staff and Student Publications

INTRODUCTION: With the onset of the COVID-19 pandemic, a rapid adjustment of work tasks was necessary for many biosafety programs (and other safety programs) to address drastic shifts in workload demands amid pandemic-related shutdowns and subsequent needs for supporting COVID-19-related safe work protocols, diagnostic testing, research, vaccine development, and so forth. From a program management standpoint, evaluating and understanding these tasks were critically important to ensure that appropriate support and resources were in place, especially during such unprecedented times of rapid change and significant impact to normal life and routine.

METHODS: Described here are examples of how the biosafety program …

The Effect Of Body Mass Index On Therapeutic Response To Bacterial Vaginosis In Pregnancy, Kevin P Lee, Misha V Koshelev, D3code Team, Omar Pacha

Faculty, Staff and Student Publications

No abstract provided.

Improved Sars-Cov-2 Sequencing Surveillance Allows The Identification Of New Variants And Signatures In Infected Patients, Antonio Grimaldi, Francesco Panariello, Patrizia Annunziata, Teresa Giuliano, Michela Daniele, Biancamaria Pierri, Chiara Colantuono, Marcello Salvi, Valentina Bouché, Anna Manfredi, Maria Concetta Cuomo, Denise Di Concilio, Claudia Tiberio, Mariano Fiorenza, Giuseppe Portella, Ilaria Cimmino, Antonio Sorrentino, Giovanna Fusco, Maria Rosaria Granata, Pellegrino Cerino, Antonio Limone, Luigi Atripaldi, Andrea Ballabio, Davide Cacchiarelli

Duncan NRI Faculty and Staff Publications

Background: Genomic surveillance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the only approach to rapidly monitor and tackle emerging variants of concern (VOC) of the COVID-19 pandemic. Such scrutiny is crucial to limit the spread of VOC that might escape the immune protection conferred by vaccination strategies or previous virus exposure. It is also becoming clear now that efficient genomic surveillance would require monitoring of the host gene expression to identify prognostic biomarkers of treatment efficacy and disease progression. Here we propose an integrative workflow to both generate thousands of SARS-CoV-2 genome sequences per week and analyze host …