Recent Submissions

  • SARS-CoV-2 infection induces activation of ferroptosis in human placenta.

    Wang, Bingbing; Shen, Wei-Bin; Yang, Peixin; Turan, Sifa (2022-11-08)
    Ferroptosis, a regulated non-apoptotic form of cell death, has been implicated in the response to varied types of infectious agents including virus. In this study, we sought to determine whether SARS-CoV-2 infection can induce activation of ferroptosis in the human placenta. We collected placentas from 23 pregnant females with laboratory-confirmed SARS-CoV-2 following delivery and then used RNA in situ hybridization assay for detection of viral positive-sense strand (PSS) to confirm that these placentas have been infected. We also used immunohistochemistry assay to assess expression levels of acyl-CoA synthetase long-chain family member 4 (ACSL4), an essential executioner of ferroptosis in the same specimens. Our results showed that ACSL4 expression was significantly increased in the group with positive positive-sense strand staining compared to their negative counterparts (p = 0.00022). Furthermore, we found that there was a positive trend for increased PSS staining along with increased ACSL4 expression. Our study supports that ferroptosis is activated in the response to SARS-CoV-2 infection in the human placenta, highlighting a molecular mechanism potentially linking this coronavirus infection and pathogenesis of adverse pregnancy outcomes.
  • Editorial: The role of glycans in infectious disease, Volume II.

    Martínez-Duncker, Iván; Mora-Montes, Héctor M; Vasta, Gerardo R; Chiodo, Fabrizio (2022-11-04)
    Volume 2 of “The role of glycans in infectious disease” Research Topic offers a continuity of research articles highlighting the evolving relevance of the glycocode at the interphase of pathogens and human disease, where it modulates the dynamics of bacterial, viral and fungal infections through finely tuned mechanisms. In this sense, mucosal surfaces are probably the sites where the most complex host-microbe interactions take place. In an original research article, Suwandi et al. characterize the role of the beta-1,4-N-acetylgalactosaminyltransferase enzyme (B4galnt2) in modulating infections by Citrobacter rodentium, a murine model pathogen for human enteropathogenic and enterohemorrhagic Escherichia coli. Escherichia coli is a gram-negative bacteria that can usually colonizes the human gut, but can cause intestinal or extraintestinal infections, including severe invasive disease such as bacteremia and sepsis. In this regard, E. coli is the most common cause of bacteremia in high-income countries and is a leading cause of meningitis in neonates (Bonten et al., 2021). Through the use of adhesion assays based on intestinal epithelial organoid-derived monolayers from B4galnt2−/− and B4galnt2+/+ mice the authors show that lack of this enzyme causes increased C. rodentium adherence, promoting increased inflammation and less proficiency in pathogen clearance by the host. The enhanced pathogen adhesion is dependent on the interaction of type 1 fimbriae and host mannosylated glycans that are increased as a result of deficient B4galnt2, as revealed by increased staining of the Galanthus nivalis lectin. These novel findings contribute to establish a more precise role of this enzyme in modulating host-pathogen interactions, but also in the establishment of gut microbiota.
  • Breakthrough SARS-CoV-2 Infections after Vaccination in North Carolina.

    Uschner, Diane; Bott, Matthew; Lagarde, William H; Keating, Joseph; Tapp, Hazel; Berry, Andrea A; Seals, Austin L; Munawar, Iqra; Schieffelin, John; Yukich, Joshua; et al. (2022-11-13)
    We characterize the overall incidence and risk factors for breakthrough infection among fully vaccinated participants in the North Carolina COVID-19 Community Research Partnership cohort. Among 15,808 eligible participants, 638 reported a positive SARS-CoV-2 test after vaccination. Factors associated with a lower risk of breakthrough in the time-to-event analysis included older age, prior SARS-CovV-2 infection, higher rates of face mask use, and receipt of a booster vaccination. Higher rates of breakthrough were reported by participants vaccinated with BNT162b2 or Ad26.COV2.S compared to mRNA-1273, in suburban or rural counties compared to urban counties, and during circulation of the Delta and Omicron variants.
  • Social communication pathways to COVID-19 vaccine side-effect expectations and experience.

    Clemens, Kelly S; Faasse, Kate; Tan, Winston; Colagiuri, Ben; Colloca, Luana; Webster, Rebecca; Vase, Lene; Jason, Emily; Geers, Andrew L (2022-11-10)
    Objective: Negative beliefs about medication and vaccine side-effects can spread rapidly through social communication. This has been recently documented with the potential side-effects from the COVID-19 vaccines. We tested if pre-vaccination social communications about side-effects from personal acquaintances, news reports, and social media predict post-vaccination side-effect experiences. Further, as previous research suggests that side-effects can be exacerbated by negative expectations, we assessed if personal expectations mediate the relationships between social communication and side-effect experience. Method: In a prospective longitudinal survey (N = 551), COVID-19 vaccine side-effect information from three sources-social media posts, news reports, and first-hand accounts from personal acquaintances-as well as side-effect expectations, were self-reported pre-vaccination. Vaccination side-effect experience was assessed post-vaccination. Results: In multivariate regression analyses, the number of pre-vaccination social media post views (β = 0.17) and impressions of severity conveyed from personal acquaintances (β = 0.42) significantly predicted an increase in pre-vaccination side-effect expectations, and the same variables (βs = 0.11, 0.14, respectively) predicted post-vaccination side-effect experiences. Moreover, pre-vaccination side-effect expectations mediated the relationship between both sources of social communication and experienced side-effects from a COVID-19 vaccination. Conclusions: This study identifies links between personal acquaintance and social media communications and vaccine side-effect experiences and provides evidence that pre-vaccination expectations account for these relationships. The results suggest that modifying side-effect expectations through these channels may change the side-effects following a COVID-19 vaccination as well as other publicly discussed vaccinations and medications.
  • Increased levels of anti-PfCSP antibodies in post-pubertal females versus males immunized with PfSPZ Vaccine does not translate into increased protective efficacy.

    KC, Natasha; Church, L W Preston; Riyahi, Pouria; Chakravarty, Sumana; Seder, Robert A; Epstein, Judith E; Lyke, Kirsten E; Mordmüller, Benjamin; Kremsner, Peter G; Sissoko, Mahamadou S; et al. (2022-10-25)
    Background: While prior research has shown differences in the risk of malaria infection and sickness between males and females, little is known about sex differences in vaccine-induced immunity to malaria. Identifying such differences could elucidate important aspects of malaria biology and facilitate development of improved approaches to malaria vaccination. Methods: Using a standardized enzyme-linked immunosorbent assay, IgG antibodies to the major surface protein on Plasmodium falciparum (Pf) sporozoites (SPZ), the Pf circumsporozoite protein (PfCSP), were measured before and two weeks after administration of a PfSPZ-based malaria vaccine (PfSPZ Vaccine) to 5-month to 61-year-olds in 11 clinical trials in Germany, the US and five countries in Africa, to determine if there were differences in vaccine elicited antibody response between males and females and if these differences were associated with differential protection against naturally transmitted Pf malaria (Africa) or controlled human malaria infection (Germany, the US and Africa). Results: Females ≥ 11 years of age made significantly higher levels of antibodies to PfCSP than did males in most trials, while there was no indication of such differences in infants or children. Although adult females had higher levels of antibodies, there was no evidence of improved protection compared to males. In 2 of the 7 trials with sufficient data, protected males had significantly higher levels of antibodies than unprotected males, and in 3 other trials protected females had higher levels of antibodies than did unprotected females. Conclusion: Immunization with PfSPZ Vaccine induced higher levels of antibodies in post-pubertal females but showed equivalent protection in males and females. We conclude that the increased antibody levels in post-pubertal females did not contribute substantially to improved protection. We hypothesize that while antibodies to PfCSP (and PfSPZ) may potentially contribute directly to protection, they primarily correlate with other, potentially protective immune mechanisms, such as antibody dependent and antibody independent cellular responses in the liver.
  • The quarantine paradox: The economic cost of the increase in violence against women and girls in Sub-Saharan Africa.

    Atalay, Rediet; Ayele, Girma; Clarke, Saba; Michael, Miriam (2022-10-25)
    The worst global crisis since the Second World War, the COVID-19 pandemic, as of July 2022, has killed around 6.3 million people globally (1) and interrupted lives in countless ways. In response to the pandemic, public health officials implemented quarantine as a protective measure, while also leaving women and children to fell victim to increased violence: therein lies the paradox of the quarantine. Although “home quarantine” has proven an effective measure to fight pandemics since the fourteenth century, it has also created a pandemic of violence that dramatically increased the number of women abused by their intimate partners and the frequency of violent encounters. According to UN-Women (2), “as the pandemic raged on, the threat of a ‘shadow pandemic’ of violence against women emerged.” In addition to incurring heavy tolls for the victims, i.e., trauma and decreased quality of life, violence against women (VAW) also generates dire social and economic costs. The WHO argues that women suffer isolation, inability to work, lack of participation in regular activities, and failure to take care of themselves and their families due to intimate partners and sexual violence (3). The global cost of VAW is estimated to be 1.5 trillion dollars, which increased during the pandemic (4). The sub-Saharan African (SSA) region has the highest VAW prevalence worldwide, significantly worsening during the pandemic. This is alarming because VAW’s social and economic burden further exacerbates the already high poverty rates in the region. In addition, women in these areas lack access to essential services, a plight that worsened during the lockdown. We will discuss the prevalence of VAW in the SSA region during COVID-1
  • Editorial: "Source-tracking," molecular epidemiology and antigenic diversity of SARS-CoV-2 infections causing coronavirus disease 2019, COVID-19.

    Narh, Charles A; Manickum, Cordelia; Vajravelu, Bathri; Zella, Davide; Mosi, Lydia (2022-10-25)
    In December 2019, Chinese Health Authorities reported the first cases of COVID-19, caused by SARS-CoV-2, to the WHO Country Office in China (Zhu et al.), noting a spectrum of symptoms from mild to severe pneumonia. Following global spread of the virus, the World Health Organization (WHO), on 30 January 2020, declared COVID-19 a Public Health Emergency of International Concern (Jee, 2020). As of 22 August 2022, there have been more than 590 million cases and over 6.4 million deaths due to the SARS-CoV-2 pandemic, with several thousands of cases being confirmed daily across the WHO regions (WHO, 2022). This Research Topic sought to publish both research and review articles on the epidemiology, population genetics, antigenic diversity, transmission dynamics and evolution of SARS-CoV-2. We, the editorial team, encouraged submissions from different disciplines of SARS-CoV-2 research, and recommended 36 articles for publication following at least two peer-reviews. We hope these articles, briefly summarised with their major findings, appeal to the wider readership of the scientific community, to inform further research, clinical practice and public health control of the COVID-19 pandemic.
  • Enhanced virulence and waning vaccine-elicited antibodies account for breakthrough infections caused by SARS-CoV-2 Delta and beyond.

    Kwon, Hyung-Joon; Kosikova, Martina; Tang, Weichun; Ortega-Rodriguez, Uriel; Radvak, Peter; Xiang, Ruoxuan; Mercer, Kelly E; Muskhelishvili, Levan; Davis, Kelly; Ward, Jerrold M; et al. (2022-11-05)
    Here we interrogate the factors responsible for SARS-CoV-2 breakthrough infections in a K18-hACE2 transgenic mouse model. We show that Delta and the closely related Kappa variant cause viral pneumonia and severe lung lesions in K18-hACE2 mice. Human COVID-19 mRNA post-vaccination sera after the 2nd dose are significantly less efficient in neutralizing Delta/Kappa than early 614G virus in vitro and in vivo. By 5 months post-vaccination, ≥50% of donors lack detectable neutralizing antibodies against Delta and Kappa and all mice receiving 5-month post-vaccination sera die after the lethal challenges. Although a 3rd vaccine dose can boost antibody neutralization against Delta in vitro and in vivo, the mean log neutralization titers against the latest Omicron subvariants are 1/3-1/2 of those against the original 614D virus. Our results suggest that enhanced virulence, greater immune evasion and waning of vaccine-elicited protection account for SARS-CoV-2 variants caused breakthrough infections.
  • Trajectories and predictors of vicarious traumatization in Chinese college students during the COVID-19 pandemic: A longitudinal study.

    Luo, Hong; Yu, Zhen; Li, Ju; Wang, Yujie; Shi, Xiaopan; Luo, Dan; Chen, Jie; Yang, Bing Xiang (2022-10-21)
    Objectives: This longitudinal study aimed to identify the trajectories and the predictors among sociodemographic and psychosocial variables at baseline of vicarious traumatization (VT) in Chinese college students during the COVID-19 pandemic. Materials and methods: A total of 544 Chinese college students enrolled in a public University in central China, majored in Clinical Medicine, Nursing, Musicology, Physics, etc., participated in this longitudinal study lasting 19 months. Three-wave (wave 1: February 2020; wave 2: November 2020; wave 3: September 2021) of data were collected. Resourcefulness Scale and the 10-item Kessler scale (K10) were only assessed in the first-wave survey, and the Event Scale-Revised (IES-R) was repeatedly measured in all three-wave surveys. A link to an online survey created by Questionnaire Star ( was sent to the students to collect data. The Growth mixture modeling (GMM) and multiple logistic regression were used to identify the trajectories of VT and predictors for the distinct trajectories. Results: The incidence of VT at each wave varied from 9.9% at wave 1, 4.0% at wave 2, to 2.6% at wave 3. Three trajectories of VT were the medium-level escalating group (3.0%), medium-level maintaining group (32.3%), and the low-level descending group (64.7%). Seniors (OR = 1.575, 95% CI: 1.059-2.341; OR = 1.161, 95% CI: 1.043-1.293) and those with poor mental health status (OR = 1.101, 95% CI: 1.030-1.177; OR = 1.083, 95% CI: 1.060-1.106) at baseline were more likely to be classified into the medium-level escalating group and medium-level maintaining group, respectively. Additionally, females (OR = 3.601, 95% CI: 1.311-9.887) were more likely to be included in the medium-level escalating group. Conclusion: Targeted psychological interventions are urgently needed for students vulnerable to VT. Further studies with more representative samples, longer period of follow-up, and predictors based on scientific theoretical framework, are needed to update the findings.
  • Analyzing Disparities in Access to Teledermatology Compared to Dermatology Clinic Visits Before, During, and After COVID-19 Quarantine.

    Jallow, Mariama; Ewulu, Adaora; Ajilore, Priscilla; Hussain, Aamir N; Geng, Xue; Cardis, Michael A (2022-11-03)
    Background: The COVID-19 pandemic has caused significant changes in dermatologic care, likely exacerbating health disparities for specific minority populations. The use of teledermatology has also become more prevalent during this period. Objective: To determine if the proportion of teledermatology versus office-based visits varied significantly during 3 study periods of the COVID-19 pandemic. The secondary objective is to determine whether there are significant differences in the use of dermatology office-based versus teledermatology care across the demographic sub-groups: insurance type, race/ethnicity, age, or language during the same periods. Methods: Chart review ofdermatology visits in electronic medical records (EMR) at a tertiary referral center in Washington, DC. Results: Overall telehealth visit rate was 0% in the pre-quarantine period, 61.12% during the quarantine period, and 10.59% in the post-quarantine period. After assessing telehealth utilization rates amongstthe demographic subgroups, Medicaid users, Black patients, 64-year-olds or older, and English speakers may benefit the least from telehealth services. Conclusion: Teledermatology utilization necessitated by the COVID-19 pandemic may have promoted healthcare disparities for specific marginalized populations.
  • Mucosal and Systemic Responses to Severe Acute Respiratory Syndrome Coronavirus 2 Vaccination Determined by Severity of Primary Infection.

    Sajadi, Mohammad M; Myers, Amber; Logue, James; Saadat, Saman; Shokatpour, Narjes; Quinn, James; Newman, Michelle; Deming, Meagan; Rikhtegaran Tehrani, Zahra; Magder, Laurence S; et al. (2022-11-02)
    With much of the world infected with or vaccinated against severe acute respiratory syndrome coronavirus 2 (commonly abbreviated SARS-CoV-2; abbreviated here SARS2), understanding the immune responses to the SARS2 spike (S) protein in different situations is crucial to controlling the pandemic. We studied the clinical, systemic, mucosal, and cellular responses to two doses of SARS2 mRNA vaccines in 62 individuals with and without prior SARS2 infection that were divided into three groups based on antibody serostatus prior to vaccination and/or degree of disease symptoms among those with prior SARS2 infection: antibody negative (naive), low symptomatic, and symptomatic. Antibody negative were subjects who were antibody negative (i.e., those with no prior infection). Low symptomatic subjects were those who were antibody negative and had minimal or no symptoms at time of SARS2 infection. Symptomatic subjects were those who were antibody positive and symptomatic at time of SARS2 infection. All three groups were then studied when they received their SARS2 mRNA vaccines. In the previously SARS2-infected (based on antibody test) low symptomatic and symptomatic groups, reactogenic symptoms related to a recall response were elicited after the first vaccination. Anti-S trimer IgA and IgG titers, and neutralizing antibody titers, peaked after the 1st vaccination in the previously SARS2-infected groups and were significantly higher than for the SARS2 antibody-negative group in the plasma and nasal samples at most time points. Nasal and plasma IgA antibody responses were significantly higher in the low symptomatic group than in the symptomatic group at most time points. After the first vaccination, differences in cellular immunity were not evident between groups, but the activation-induced cell marker (AIM+) CD4+ cell response correlated with durability of IgG humoral immunity against the SARS2 S protein. In those SARS2-infected subjects, severity of infection dictated plasma and nasal IgA responses in primary infection as well as response to vaccination (peak responses and durability), which could have implications for continued protection against reinfection. Lingering differences between the SARS2-infected and SARS2-naive up to 10 months postvaccination could explain the decreased reinfection rates in the SARS2-infected vaccinees recently reported and suggests that additional strategies (such as boosting of the SARS2-naive vaccinees) are needed to narrow the differences observed between these groups. IMPORTANCE This study on SARS2 vaccination in those with and without previous exposure to the virus demonstrates that severity of infection dictates IgA responses in primary infection as well as response to vaccination (peak responses and durability), which could have implications for continued protection against reinfection.
  • Expanding current guidelines for management of COVID-19 focusing on low- and middle-income countries.

    Fonseca, Yudy; Urbina, Evangelina; Bhutta, Adnan (2022-10-11)
    Within a short time, Coronavirus disease 2019 (COVID-19) has evolved into a pandemic spreading at a speed and scale that has been able to overwhelm even the most advanced health care systems quickly. Multiple guidelines published by organizations such as the WHO and US' CDC address the response to COVID-19 at the international, national, and local levels. Although these guidelines are meant to be globally accessible, implementing them is a challenge given the variability in the health care systems worldwide between low- and middle income countries (LMIC) and high-income countries and even amongst different regions within each LMIC. We have chosen to evaluate the current guidelines focusing on LMIC and expand on the guidelines as necessary.
  • Expanding current guidelines for management of COVID-19 f ocusing on low-and middle-income countries

    Fonseca, Yudy; Urbina, Evangelina; Bhutta, Adnan (2022-09-07)
    Within a short time, Coronavirus disease 2019 (COVID-19) has evolved into a pandemic spreading at a speed and scale that has been able to overwhelm even the most advanced health care systems quickly. Multiple guidelines published by organizations such as the WHO and US’ CDC address the response to COVID-19 at the international, national, and local levels. Although these guidelines are meant to be globally accessible, implementing them is a challenge given the vari-ability in the health care systems worldwide between low-and middle-income countries (LMIC) and high-income countries and even amongst different regions within each LMIC. We have chosen to evaluate the current guidelines focusing on LMIC and expand on the guidelines as necessary. © 2022 The Authors.
  • One vaccine to counter many diseases? Modeling the economics of oral polio vaccine against child mortality and COVID-19.

    Chang, Angela Y; Aaby, Peter; Avidan, Michael S; Benn, Christine S; Bertozzi, Stefano M; Blatt, Lawrence; Chumakov, Konstantin; Khader, Shabaana A; Kottilil, Shyam; Nekkar, Madhav; et al. (2022-10-05)
    Introduction: Recent reviews summarize evidence that some vaccines have heterologous or non-specific effects (NSE), potentially offering protection against multiple pathogens. Numerous economic evaluations examine vaccines' pathogen-specific effects, but less than a handful focus on NSE. This paper addresses that gap by reporting economic evaluations of the NSE of oral polio vaccine (OPV) against under-five mortality and COVID-19. Materials and methods: We studied two settings: (1) reducing child mortality in a high-mortality setting (Guinea-Bissau) and (2) preventing COVID-19 in India. In the former, the intervention involves three annual campaigns in which children receive OPV incremental to routine immunization. In the latter, a susceptible-exposed-infectious-recovered model was developed to estimate the population benefits of two scenarios, in which OPV would be co-administered alongside COVID-19 vaccines. Incremental cost-effectiveness and benefit-cost ratios were modeled for ranges of intervention effectiveness estimates to supplement the headline numbers and account for heterogeneity and uncertainty. Results: For child mortality, headline cost-effectiveness was $650 per child death averted. For COVID-19, assuming OPV had 20% effectiveness, incremental cost per death averted was $23,000-65,000 if it were administered simultaneously with a COVID-19 vaccine <200 days into a wave of the epidemic. If the COVID-19 vaccine availability were delayed, the cost per averted death would decrease to $2600-6100. Estimated benefit-to-cost ratios vary but are consistently high. Discussion: Economic evaluation suggests the potential of OPV to efficiently reduce child mortality in high mortality environments. Likewise, within a broad range of assumed effect sizes, OPV (or another vaccine with NSE) could play an economically attractive role against COVID-19 in countries facing COVID-19 vaccine delays.
  • Post-traumatic stress in healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis.

    Andhavarapu, Sanketh; Yardi, Isha; Bzhilyanskaya, Vera; Lurie, Tucker; Bhinder, Mujtaba; Patel, Priya; Pourmand, Ali; Tran, Quincy K (2022-10-08)
    The SARS-CoV-2 (COVID-19) pandemic has increased healthcare worker (HCW) susceptibility to mental illness. We conducted a meta-analysis to investigate the prevalence and possible factors associated with post-traumatic stress disorder (PTSD) symptoms among HCW during the COVID-19 pandemic. We searched PubMed, SCOPUS and EMBASE databases up to May 4th, 2022. We performed random effects meta-analysis and moderator analyses for the prevalence of PTSD-relevant symptoms and severe PTSD symptoms. We identified 1276 studies, reviewed 209 full-text articles, and included 119 studies (117,143 participants) with a total of 121 data points in our final analysis. 34 studies (24,541 participants) reported prevalence of severe PTSD symptoms. Approximately 25.2% of participants were physicians, 42.8% nurses, 12.4% allied health professionals, 8.9% auxiliary health professionals, and 10.8% "other". The pooled prevalence of PTSD symptoms among HCWs was 34% (95% CI, 0.30-0.39, I2 >90%), and 14% for severe PTSD (95% CI, 0.11 - 0.17, I2 >90%). The introduction of COVID vaccines was associated with a sharp decline in the prevalence of PTSD, and new virus variants were associated with small increases in PTSD rates. It is important that policies work towards allocating adequate resources towards protecting the well-being of healthcare workers to minimize adverse consequences of PTSD.
  • Metabolic modeling of single bronchoalveolar macrophages reveals regulators of hyperinflammation in COVID-19.

    Zhao, Qiuchen; Yu, Zhenyang; Zhang, Shengyuan; Shen, Xu-Rui; Yang, Hao; Xu, Yangyang; Liu, Yang; Yang, Lin; Zhang, Qing; Chen, Jiaqi; et al. (2022-10-10)
    SARS-CoV-2 infection induces imbalanced immune response such as hyperinflammation in patients with severe COVID-19. Here we studied the immunometabolic regulatory mechanisms for the pathogenesis of COVID-19. We depicted the metabolic landscape of immune cells, especially macrophages, from bronchoalveolar lavage fluid of COVID-19 patients at single-cell level. We found that most metabolic processes were upregulated in macrophages from lungs of mild COVID-19 patients compared to cells from heathy controls, whereas macrophages from severe COVID-19 showed downregulation of most of the core metabolic pathways including glutamate metabolism, fatty acid oxidation, citrate cycle and oxidative phosphorylation, and upregulation of a few pathways such as glycolysis. Rewiring cellular metabolism by amino acid supplementation, glycolysis inhibition or PPARγ stimulation reduces inflammation in macrophages stimulated with SARS-CoV-2. Altogether, this study demonstrates that metabolic imbalance of bronchoalveolar macrophages may contribute to hyperinflammation in patients with severe COVID-19, and provides insights into treating COVID-19 by immunometabolic modulation.
  • Strengthening pandemic preparedness: Build the vaccine manufacturing capacity in low- and middle-income countries.

    Zeng, Wu; Bajnauth, Daana; Jarawan, Eva; Ahn, Haksoon; Li, Guohong; Cai, Yuyang; Yang, Ling; Shen, Jie (2022-10-07)
    It has been over two years since the World Health Organization (WHO) declared COVID-19 a global pandemic on March 11, 2020. The COVID-19 virus continues to mutate and spread, causing many countries to experience multiple waves of the pandemic. Although nontherapeutic protective measures have slowed the spread of the virus and decreased case numbers, the COVID-19 vaccines are taking precedence as the leading measure of therapeutic protection against the virus. Low and middle-income countries (LMICs), however, face challenges and uncertainty regarding vaccine access, despite the growing supply of COVID-19 vaccines. This paper describes the unequal access to COVID19 vaccines, argues that vaccine nationalism and fragmented COVID-19 vaccine procurement are key reasons for the unfair distribution of COVID-19 vaccines, and advocates for building vaccine manufacturing capacity in LMICs and establishing South-North partnerships to improve vaccine access and prepare for future pandemics.
  • The Impact of COVID-19, Mental Health Distress, and School-Based Sociocultural Protective Factors among Elementary-Aged Children and their Caregivers

    Goodwin, Aijah K.B.; Roberson, Anthony J.; Watson, Ar’Reon; Chen, Grace L.; Long, Anna C.J. (2022)
    Given the individual and systemic stress endured by children and families during the COVID-19 pandemic, research examining culturally responsive school experiences and supports to enhance resilience is critical. This study examined the relationship between caregivers’ perceptions of COVID-19 impact, mental health distress among children and caregivers, and school-based sociocultural protective factors, including culturally responsive practices in schools and the relationships between teachers and caregivers, concurrently and longitudinally. Data were collected from caregivers of elementary-aged children at two-time points from March to April 2020 (N = 174) and one year later in 2021 (N = 114). Regression analyses revealed that COVID-19 impact positively predicted and parent-teacher joining negatively predicted mental health concerns among children and families, concurrently and longitudinally. Furthermore, there was a positive relationship between caregivers’ perceptions of teachers’ social awareness and justice practices and mental health symptoms for children in 2020. Parent-teacher joining longitudinally moderated the relationship between COVID-19 impact and caregivers’ mental health concerns. This study provides implications regarding sociocultural resilience factors that should be considered in schools amidst the COVID-19 pandemic. © The Author(s) 2022.
  • Racial/Ethnic Differences in Non-Discretionary Risk Factors for COVID-19 Among Patients in an Early COVID-19 Hotspot

    Newton, Erika H.; Valenzuela, Rolando G.; Cruz-Menoyo, Priscilla M.; Feliberti, Kimberly; Shub, Timothy D.; Trapini, Cadence Z.M.; Espinosa de los Reyes, Santiago; Melian, Christina M.; Peralta, Leslie D.; Alcalá, Héctor E. (2022)
    Background: Baseline disparities in non-discretionary risk factors, i.e., those not readily altered, like family size and work environment, appear to underlie the disproportionate COVID-19 infection rates seen among Hispanic persons and, at surge onsets, Black persons. No study has systematically compared such risk factors by race/ethnicity among infected individuals. Methods: Using a cross-sectional survey, we compared household, job, and socioeconomic characteristics among 260 Hispanic, non-Hispanic Black, and non-Hispanic White adults with confirmed or probable COVID-19 in New York from March to May 2020. We used logistic regression to identify independent relationships. Results: In bivariate analysis, we found significant differences by race/ethnicity in the following: (1) rates of household crowding (p < 0.001), which were highest for Hispanic patients (45.1%) and lowest for White patients (0.9%); (2) rates of non-healthcare frontline work (p < 0.001), which were highest for Hispanic patients (71.0% of those employed) and lowest for White patients (31.4%); (3) rates of working close to people (p < 0.001), which were highest for Black patients (69.4%) and lowest for Hispanic patients (32.3%); and (4) rates of frontline healthcare work (p = 0.004), which were higher for Black (44.9%) and White (44.3%) patients than Hispanic patients (19.4%). Adjusting for covariates eliminated most differences but not that for household crowding. Conclusions: Non-discretionary COVID-19 risk factors among patients in the initial surge differed substantially by race/ethnicity. Socioeconomic factors explained most differences, but household crowding was independently associated with Hispanic ethnicity. Our findings highlight the ongoing need for universal safeguards for US frontline workers, including mandated paid sick leave and expanded affordable housing options. © 2022, W. Montague Cobb-NMA Health Institute.
  • Impact of SARS-CoV-2 Vaccination on Inflammatory Bowel Disease Activity and Development of Vaccine-Related Adverse Events: Results From PREVENT-COVID

    Weaver, Kimberly N.; Zhang, Xian; Dai, Xiangfeng; Watkins, Runa; Adler, Jeremy; Dubinsky, Marla C.; Kastl, Arthur; Bousvaros, Athos; Strople, Jennifer A.; Cross, Raymond K.; et al. (2022-10-03)
    BACKGROUND: Severe acute respiratory syndrome coronavirus 2 vaccination is recommended for all individuals with inflammatory bowel disease (IBD), including those on immunosuppressive therapies; however, little is known about vaccine safety and efficacy in these patients or the impact of vaccination on IBD disease course. METHODS: We evaluated coronavirus disease 2019 (COVID-19) vaccine-related adverse events (AEs) and the effect of vaccination on IBD disease course among participants in the PREVENT-COVID (Partnership to Report Effectiveness of Vaccination in populations Excluded from iNitial Trials of COVID) study, a prospective, observational cohort study. Localized and systemic reactions were assessed via questionnaire. Disease flare was defined by worsening IBD symptoms and change in IBD medications. Outcomes were stratified by vaccine type and IBD medication classes. RESULTS: A total of 3316 individuals with IBD received at least 1 COVID-19 vaccine. Injection site tenderness (68%) and fatigue (46% dose 1, 68% dose 2) were the most commonly reported localized and systemic AEs after vaccination. Severe localized and systemic vaccine-related AEs were rare. The mRNA-1273 vaccine was associated with significantly greater severe AEs at dose 2 (localized 4% vs 2%, systemic 15% vs 10%; P < .001 for both). Prior COVID-19 infection, female sex, and vaccine type were associated with severe systemic reactions to dose 1, while age <50 years, female sex, vaccine type, and antitumor necrosis factor and vedolizumab use were associated with severe systemic reactions to dose 2. Overall rates (2%) of IBD flare were low following vaccination. CONCLUSIONS: Our findings provide reassurance that the severe acute respiratory syndrome coronavirus 2 vaccine is safe and well tolerated among individuals with IBD, which may help to combat vaccine hesitancy and increase vaccine confidence. © 2021 Crohn’s & Colitis Foundation. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: severe acute respiratory syndrome coronavirus 2 vaccine is safe and well tolerated among individuals with inflammatory bowel disease (IBD). Severe localized and systemic vaccine-related adverse events were rare, and rates of IBD flare were low (2%) following severe acute respiratory syndrome coronavirus 2 vaccination in a cohort of 3316 participants with IBD.

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