UNC-Chapel Hill Coronavirus Research // Carolina Digital Repository

Works (1024)

41. Viral afterlife: SARS-CoV-2 as a reservoir of immunomimetic peptides that reassemble into proinflammatory supramolecular complexes

Title Tesim:: Viral afterlife: SARS-CoV-2 as a reservoir of immunomimetic peptides that reassemble into proinflammatory supramolecular complexes
Creator:: Wong G.C.L., Wolfgang M.C., Schisler J.C., Adkins J.N., Yeaman M.R., Weiss T.M., Schepmoes A.A., Nakamura Y., Zhao R., Mackman N., Anda J.D., Thurlow L.R., Coady A., Luo E.W.C., Dokoshi T., Nizet V., Matsui T., Gallo R.L., Kulkarni N.N., Lipton M.S., Zhang Y., Zurich R., Lee H., Lee M.W., Chan L.C., Hagan R.S., Antoniak S., Chen J., Wang L., Chen X., Bharathi V., Clair G.C., Xu H., Ursery L.T., and Li M.M.H.
Date of publication:: 2024
Abstract Tesim:: It is unclear how severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection leads to the strong but ineffective inflammatory response that characterizes severe Coronavirus disease 2019 (COVID-19), with amplified immune activation in diverse cell types, including cells without angiotensin-converting enzyme 2 receptors necessary for infection. Proteolytic degradation of SARS-CoV-2 virions is a milestone in host viral clearance, but the impact of remnant viral peptide fragments from high viral loads is not known. Here, we examine the inflammatory capacity of fragmented viral components from the perspective of supramolecular self-organization in the infected host environment. Interestingly, a machine learning analysis to SARS-CoV-2 proteome reveals sequence motifs that mimic host antimicrobial peptides (xenoAMPs), especially highly cationic human cathelicidin LL-37 capable of augmenting inflammation. Such xenoAMPs are strongly enriched in SARS-CoV-2 relative to low-pathogenicity coronaviruses. Moreover, xenoAMPs from SARS-CoV-2 but not low-pathogenicity homologs assemble double-stranded RNA (dsRNA) into nanocrystalline complexes with lattice constants commensurate with the steric size of Toll-like receptor (TLR)-3 and therefore capable of multivalent binding. Such complexes amplify cytokine secretion in diverse uninfected cell types in culture (epithelial cells, endothelial cells, keratinocytes, monocytes, and macrophages), similar to cathelicidin’s role in rheumatoid arthritis and lupus. The induced transcriptome matches well with the global gene expression pattern in COVID-19, despite using <0.3% of the viral proteome. Delivery of these complexes to uninfected mice boosts plasma interleukin-6 and CXCL1 levels as observed in COVID-19 patients.
Resource type:: Article
Affiliation Label Tesim:: Department of Microbiology and Immunology, Department of Pharmacology, Department of Medicine, and Department of Pathology and Laboratory Medicine
DOI:: https://doi.org/10.17615/qa56-6j82
Edition:: Publisher
Identifier:: https://doi.org/10.1073/pnas.2300644120
ISSN:: 0027-8424
Journal Issue:: 6
Journal Title:: Proceedings of the National Academy of Sciences of the United States of America
Journal Volume:: 121
Keyword:: Animals, proteome, Proteome, Mice, peptide, Peptides, coronavirus disease 2019, COVID-19, animal, endothelium cell, Severe acute respiratory syndrome coronavirus 2, SARS-CoV-2, Endothelial Cells, mouse, Humans, and human
Language Label:: English
License Label:: Attribution 4.0 International
Other Affiliation:: University of California, Los Angeles, Pacific Northwest National Laboratory, Stanford University, University of California San Diego, , Harbor-University of California Los Angeles Medical Center, and Harvard Medical School
Person:: Wong G.C.L., Wolfgang M.C., Schisler J.C., Adkins J.N., Yeaman M.R., Weiss T.M., Schepmoes A.A., Nakamura Y., Zhao R., Mackman N., Anda J.D., Thurlow L.R., Coady A., Luo E.W.C., Dokoshi T., Nizet V., Matsui T., Gallo R.L., Kulkarni N.N., Lipton M.S., Zhang Y., Zurich R., Lee H., Lee M.W., Chan L.C., Hagan R.S., Antoniak S., Chen J., Wang L., Chen X., Bharathi V., Clair G.C., Xu H., Ursery L.T., and Li M.M.H.
Publisher:: National Academy of Sciences
Rights Statement Label:: In Copyright
Source:: 0b3a5b4f-401b-405d-962e-3b8e1fbe49b6

42. Racial and ethnic differences in the degree of participation and retention in a decentralized cohort study of COVID-19 immunization in patients with inflammatory bowel diseases

Title Tesim:: Racial and ethnic differences in the degree of participation and retention in a decentralized cohort study of COVID-19 immunization in patients with inflammatory bowel diseases
Creator:: Firestine A.M., Craig R., Boccieri M., Kappelman M.D., Long M.D., and Zhang X.
Date of publication:: 2024
Abstract Tesim:: Introduction: Disparities in the recruitment of minority populations in research are well-documented. However, the degree of participation and retention of minorities following enrollment is less known, particularly in decentralized studies. Although decentralized clinical research methods may allow researchers to engage broader study populations with less participation burden, they may present different retention challenges. To evaluate racial and ethnic differences in the degree of participation after enrollment in a decentralized study, we analyzed data from a cohort of patients with inflammatory bowel diseases following COVID-19 immunization. Methods: We compared by race and ethnicity the following post-enrollment participation metrics: response to > 50% of follow-up surveys, donation of a blood sample for antibody testing, consent to use of bio samples for future research, and withdrawal prior to study completion. Results: Overall, we observed higher levels of post-enrollment study participation among non-Hispanic White (NHW) participants as compared to Black or Hispanic participants: 95% of NHW participants completed follow-up versus 87% of Black participants and 91% of Hispanic participants, 73% of NHW participants provided bio samples versus 64% Black participants and 67% Hispanic participants, and 65% of NHW participants provided consent for future research versus 62% of Black participants and 52% of Hispanic participants. Conclusions: Our findings demonstrate that the degree of study participation after enrollment in this decentralized study differed by race and ethnicity, indicating that attention to diversity, equity, and inclusion is needed not only in clinical research recruitment but also throughout study administration.
Resource type:: Article
Affiliation Label Tesim:: School of Medicine
DOI:: https://doi.org/10.17615/q35q-hw54
Edition:: Publisher
Identifier:: https://doi.org/10.1017/cts.2024.5
ISSN:: 2059-8661
Journal Issue:: 1
Journal Title:: Journal of Clinical and Translational Science
Journal Volume:: 8
Keyword:: COVID-19, virtual study, inflammatory bowel diseases, Decentralized research, and diversity equity inclusivity
Language Label:: English
License Label:: Attribution 4.0 International
Other Affiliation:
Person:: Firestine A.M., Craig R., Boccieri M., Kappelman M.D., Long M.D., and Zhang X.
Publisher:: Cambridge University Press
Rights Statement Label:: In Copyright
Source:: a10dfff1-080e-4482-87ed-c7621a827a8c

43. Prefusion-stabilized SARS-CoV-2 S2-only antigen provides protection against SARS-CoV-2 challenge

Title Tesim:: Prefusion-stabilized SARS-CoV-2 S2-only antigen provides protection against SARS-CoV-2 challenge
Creator:: Hsieh C.-L., Leist S.R., Jangra R.K., Zhou L., Miller E.H., West A., Chandran K., Baric R.S., Schisler J.C., Wang A., McLellan J.S., Powers J.M., Zweigart M.R., and Tse A.L.
Date of publication:: 2024
Abstract Tesim:: Ever-evolving SARS-CoV-2 variants of concern (VOCs) have diminished the effectiveness of therapeutic antibodies and vaccines. Developing a coronavirus vaccine that offers a greater breadth of protection against current and future VOCs would eliminate the need to reformulate COVID-19 vaccines. Here, we rationally engineer the sequence-conserved S2 subunit of the SARS-CoV-2 spike protein and characterize the resulting S2-only antigens. Structural studies demonstrate that the introduction of interprotomer disulfide bonds can lock S2 in prefusion trimers, although the apex samples a continuum of conformations between open and closed states. Immunization with prefusion-stabilized S2 constructs elicits broadly neutralizing responses against several sarbecoviruses and protects female BALB/c mice from mouse-adapted SARS-CoV-2 lethal challenge and partially protects female BALB/c mice from mouse-adapted SARS-CoV lethal challenge. These engineering and immunogenicity results should inform the development of next-generation pan-coronavirus therapeutics and vaccines.
Resource type:: Article
Affiliation Label Tesim:: Department of Epidemiology and Department of Pharmacology
DOI:: https://doi.org/10.17615/wfcd-xw35
Edition:: Publisher
Identifier:: https://doi.org/10.1038/s41467-024-45404-x
ISSN:: 2041-1723
Journal Issue:: 1
Journal Title:: Nature Communications
Journal Volume:: 15
Language Label:: English
License Label:: Attribution 4.0 International
Other Affiliation:: The University of Texas at Austin, , and Albert Einstein College of Medicine
Person:: Hsieh C.-L., Leist S.R., Jangra R.K., Zhou L., Miller E.H., West A., Chandran K., Baric R.S., Schisler J.C., Wang A., McLellan J.S., Powers J.M., Zweigart M.R., and Tse A.L.
Publisher:: Nature Research
Rights Statement Label:: In Copyright
Source:: fa5812dd-6330-4ee6-96ab-fb404db9bb21

44. Impact of the COVID-19 Pandemic on People Living With Rare Diseases and Their Families: Results of a National Survey

Title Tesim:: Impact of the COVID-19 Pandemic on People Living With Rare Diseases and Their Families: Results of a National Survey
Creator:: Ferkol T., Benatar M., Macaluso M., Chehade M., Kimberlin D.W., Kaminski H.J., Kuhnell P., and Rothenberg M.E.
Date of publication:: 2024
Abstract Tesim:: BACKGROUND: With more than 103 million cases and 1.1 million deaths, the COVID-19 pandemic has had devastating consequences for the health system and the well-being of the entire US population. The Rare Diseases Clinical Research Network funded by the National Institutes of Health was strategically positioned to study the impact of the pandemic on the large, vulnerable population of people living with rare diseases (RDs). OBJECTIVE: This study was designed to describe the characteristics of COVID-19 in the RD population, determine whether patient subgroups experienced increased occurrence or severity of infection and whether the pandemic changed RD symptoms and treatment, and understand the broader impact on respondents and their families. METHODS: US residents who had an RD and were <90 years old completed a web-based survey investigating self-reported COVID-19 infection, pandemic-related changes in RD symptoms and medications, access to care, and psychological impact on self and family. We estimated the incidence of self-reported COVID-19 and compared it with that in the US population; evaluated the frequency of COVID-19 symptoms according to self-reported infection; assessed infection duration, complications and need for hospitalization; assessed the influence of the COVID-19 pandemic on RD symptoms and treatment, and whether the pandemic influenced access to care, special food and nutrition, or demand for professional psychological assistance. RESULTS: Between May 2, 2020, and December 15, 2020, in total, 3413 individuals completed the survey. Most were female (2212/3413, 64.81%), White (3038/3413, 89.01%), and aged ≥25 years (2646/3413, 77.53%). Overall, 80.6% (2751/3413) did not acquire COVID-19, 2.08% (71/3413) acquired it, and 16.58% (566/3413) did not know. Self-reported cases represented an annual incidence rate of 2.2% (95% CI 1.7%-2.8%). COVID-19 cases were more than twice the expected (71 vs 30.3; P<.001). COVID-19 was associated with specific symptoms (loss of taste: odds ratio [OR] 38.9, 95% CI 22.4-67.6, loss of smell: OR 30.6, 95% CI 17.7-53.1) and multiple symptoms (>9 symptoms vs none: OR 82.5, 95% CI 29-234 and 5-9: OR 44.8, 95% CI 18.7-107). Median symptom duration was 16 (IQR 9-30) days. Hospitalization (7/71, 10%) and ventilator support (4/71, 6%) were uncommon. Respondents who acquired COVID-19 reported increased occurrence and severity of RD symptoms and use or dosage of select medications; those who did not acquire COVID-19 reported decreased occurrence and severity of RD symptoms and use of medications; those who did not know had an intermediate pattern. The pandemic made it difficult to access care, receive treatment, get hospitalized, and caused mood changes for respondents and their families. CONCLUSIONS: Self-reported COVID-19 was more frequent than expected and was associated with increased prevalence and severity of RD symptoms and greater use of medications. The pandemic negatively affected access to care and caused mood changes in the respondents and family members. Continued surveillance is necessary.
Resource type:: Article
Affiliation Label Tesim:: Department of Pediatrics
DOI:: https://doi.org/10.17615/ezkb-eh92
Edition:: Postprint
Identifier:: https://doi.org/10.2196/48430
ISSN:: 2369-2960
Journal Title:: JMIR public health and surveillance
Journal Volume:: 10
Keyword:: cross-sectional, surveys, changes in symptoms and use of medications, SARS-CoV-2, COVID-19 infection, nationwide, accessibility, cross-sectional survey, COVID-19, chronic, vulnerable, comorbid, access to care, coronavirus, survey, comorbidity, rare, psychological impact on self and family, rare diseases, national, and access
Language Label:: English
License Label:: Attribution 4.0 International
Other Affiliation:: , University of Miami, Cincinnati Children's Hospital Medical Center, Icahn School of Medicine at Mount Sinai, University of Alabama at Birmingham, George Washington University, and University of Cincinnati College of Medicine
Page Start:: e48430
Person:: Ferkol T., Benatar M., Macaluso M., Chehade M., Kimberlin D.W., Kaminski H.J., Kuhnell P., and Rothenberg M.E.
Rights Statement Label:: In Copyright
Source:: b81cf552-4771-48f5-b843-5ffb6b24d0ad

45. Gap in protective behaviors between Han and minority ethnicities during COVID-19 pandemic in rural western China: A decomposition analysis

Title Tesim:: Gap in protective behaviors between Han and minority ethnicities during COVID-19 pandemic in rural western China: A decomposition analysis
Creator:: Sun C., Feng C., Ye R., Wang Q., Pappas L., Chen Y., Ma Y., Wu Y., Rozelle S., and Zhou H.
Date of publication:: 2024
Abstract Tesim:: Understanding the ethnic gap in protective behavior and its explanatory factors is a promising step for reducing pandemic-induced disparities. However, no studies have endeavored to identify the factors contributing to a gap in protective behaviors between Han and minority ethnicities during COVID-19 pandemic in rural China. We aimed to analyze the gap in protective behaviors between Han and minority residents in rural China. We conducted cross-sectional studies in multi-ethnic rural China in 2020. A total of 1640 participants from Han and minority groups were invited to participate. The decomposition method was applied to analyze the gap in protective behaviors and its associated factors between the Han and minority groups. Participants in the Han group had a higher protective behavioral score (9.26 ± 1.20) than the minority group (8.97 ± 1.50), yielding a significant gap in protective behaviors between Han and minority ethnicities of 0.29. Socio-demographic characteristics, health status, the degree of knowledge held about COVID-19, and psychological responses to COVID-19 explained 79.3 % (0.23/0.29) of the behavioral gap between the Han and minority groups. The difference in household asset levels was the largest explained contributor to the behavioral gap (52.17 %) (0.12/0.23), followed by fear felt for COVID-19 (−21.74 %) (−0.05/0.23). Differences in educational attainment, degree of knowledge held about COVID-19, and self-efficacy in response to COVID-19 each explained 17.4 % (0.04/0.23) of the behavioral gap. In conclusion, Han group show greater protective behaviors than minority ethnic groups. To drive better protective behavior in the most vulnerable communities, targeted, group-specific COVID-19 preventative messages deployed in public health communication strategies is suggested to enhance individual confidence in coping with the pandemic while creating a healthy amount of fear for public health crisis.
Resource type:: Article
Affiliation Label Tesim:: Department of Health Policy and Management
DOI:: https://doi.org/10.17615/rxt5-fh84
Edition:: Publisher
Identifier:: https://doi.org/10.1016/j.pmedr.2024.102617
ISSN:: 2211-3355
Journal Title:: Preventive Medicine Reports
Journal Volume:: 39
Keyword:: Ethnic gap, Protective behavior, COVID-19 pandemic, Decomposition analysis, and Rural area
Language Label:: English
License Label:: Attribution-NonCommercial 4.0 International
Other Affiliation:: Sichuan University, Stanford University, and
Person:: Sun C., Feng C., Ye R., Wang Q., Pappas L., Chen Y., Ma Y., Wu Y., Rozelle S., and Zhou H.
Publisher:: Elsevier Inc.
Rights Statement Label:: In Copyright
Source:: 674342ff-f6c5-423e-94f7-827c26f2f6a6

46. Factors associated with COVID-19 vaccine uptake and hesitancy among healthcare workers in the Democratic Republic of the Congo

Title Tesim:: Factors associated with COVID-19 vaccine uptake and hesitancy among healthcare workers in the Democratic Republic of the Congo
Creator:: Nzaji, Michel K., Sessoms, Dana, Kapit, Anselme Manyong, Fogarty, Alanna S., Meyou, Shanice Fezeu, Stolka, Kristen B., Lungayo, Christophe Luhata, Bene, Aime Cikomola Mwana, Standley, Claire J., de Dieu Kamenga, Jean, and MacDonald, Pia D. M.
Date of publication:: 2024
Abstract Tesim:: Vaccination is a critical intervention to reduce morbidity and mortality and limit strain on health systems caused by COVID-19. The slow pace of COVID-19 vaccination uptake observed in some settings raises concerns about COVID-19 vaccine hesitancy. The Democratic Republic of the Congo experienced logistical challenges and low uptake at the start of vaccine distribution, leading to one of the lowest overall COVID-19 vaccine coverage rates in the world in 2021. This study assessed the magnitude and associated factors of COVID-19 vaccine uptake among healthcare workers (HCWs) in seven provinces in DRC. We implemented a cross-sectional Knowledge, Attitudes, and Practices (KAP) questionnaire targeting HCWs, administered by trained data collectors in Haut-Katanga, Kasaï Orientale, Kinshasa, Kongo Centrale, Lualaba, North Kivu, and South Kivu provinces. Data were summarized and statistical tests were performed to assess factors associated with vaccine uptake. HCWs across the seven provinces completed the questionnaire (N = 5,102), of whom 46.3% had received at least one dose of COVID-19 vaccine. Older age, being married, being a medical doctor, being a rural resident, and having access to or having previously worked in a COVID-19 vaccination site were all strongly associated with vaccination uptake. Vaccinated individuals most frequently cited protection of themselves, their families, and their communities as motivations for being vaccinated, whereas unvaccinated individuals were most concerned about safety, effectiveness, and risk of severe side effects. The findings suggest an opinion divide between vaccine-willing and vaccine-hesitant HCWs. A multidimensional approach may be needed to increase the acceptability of the COVID-19 vaccine for HCWs. Future vaccine campaign messaging could center around the positive impact of vaccination on protecting friends, family, and the community, and also emphasize the safety and very low risk of adverse effects. These types of messages may further be useful when planning future immunization campaigns with new vaccines.
Resource type:: Article
Affiliation Label Tesim:: Department of Epidemiology
DOI:: https://doi.org/10.17615/swqy-r903
Edition:: Publisher
Identifier:: https://doi.org/10.1371/journal.pgph.0002772
ISSN:: 2767-3375
Journal Issue:: 2
Journal Title:: PLOS Global Public Health
Journal Volume:: 4
Keyword:: Vaccines, Viral vaccines, COVID 19, Medical risk factors, Vaccine development, Vaccination and immunization, Questionnaires, and Virus testing
Language Label:: English
License Label:: Attribution 4.0 International
ORCID:
Other Affiliation:: RTI International, Georgetown University, Ministry of Public Health, and
Page Start:: e0002772
Person:: Nzaji, Michel K., Sessoms, Dana, Kapit, Anselme Manyong, Fogarty, Alanna S., Meyou, Shanice Fezeu, Stolka, Kristen B., Lungayo, Christophe Luhata, Bene, Aime Cikomola Mwana, Standley, Claire J., de Dieu Kamenga, Jean, and MacDonald, Pia D. M.
Publisher:: Public Library of Science
Source:: 978bfc31-3bd8-4054-813b-29556ac6abab

47. Evaluation of the ability of commercial enzyme-linked immunosorbent assays to measure mouse tissue factor

Title Tesim:: Evaluation of the ability of commercial enzyme-linked immunosorbent assays to measure mouse tissue factor
Creator:: Sachetto A.T.A. and Mackman N.
Date of publication:: 2024
Abstract Tesim:: Background: Tissue factor (TF) is the primary cellular initiator of the blood coagulation cascade. Increased levels of TF expression on circulating monocytes or on extracellular vesicles (EVs) are associated with thrombosis in a variety of diseases, including sepsis and COVID-19. Objectives: Here, we aimed to evaluate the ability of 4 commercial TF enzyme-linked immunosorbent assays (ELISAs) to measure mouse TF in cells and plasma. Methods: We used 4 commercial mouse TF ELISAs (SimpleStep, R&D Systems, MyBioSource [sandwich], and MyBioSource [competitive]). We used recombinant mouse TF (rmTF; 16-1000 pg/mL), cell lysates from a TF-expressing mouse pancreatic cancer cell line, and plasma and EVs isolated from plasma from mice injected with vehicle or bacterial lipopolysaccharide (LPS). Results: The 2 MyBioSource kits failed to detect rmTF or TF in cell lysates. The SimpleStep and R&D kits detected rmTF in buffer or spiked into plasma in a concentration-dependent manner. These kits also detected TF in cell lysates from a mouse pancreatic cancer cell line. A higher signal was observed with the SimpleStep kit compared to the R&D kit. However, the SimpleStep and R&D kits failed to detect TF in plasma or EVs from LPS-treated mice. Conclusion: Our results indicate that some commercial ELISAs can be used to measure mouse TF levels in cell lysates but they cannot detect TF in plasma or EVs from endotoxemic mice.
Resource type:: Article
Affiliation Label Tesim:: Department of Medicine
DOI:: https://doi.org/10.17615/dgyf-qv87
Edition:: Publisher
Identifier:: https://doi.org/10.1016/j.rpth.2024.102325
ISSN:: 2475-0379
Journal Issue:: 1
Journal Title:: Research and Practice in Thrombosis and Haemostasis
Journal Volume:: 8
Keyword:: plasma, lipopolysaccharide, enzyme-linked immunosorbent assay, blood coagulation, extracellular vesicles, and tissue factor
Language Label:: English
License Label:: Attribution-NonCommercial-NoDerivs 4.0 International
Other Affiliation:
Person:: Sachetto A.T.A. and Mackman N.
Publisher:: Elsevier B.V.
Rights Statement Label:: In Copyright
Source:: 030675e4-c638-41e3-860d-80e4198141e0

48. Comparative effectiveness of alternative intervals between first and second doses of the mRNA COVID-19 vaccines

Title Tesim:: Comparative effectiveness of alternative intervals between first and second doses of the mRNA COVID-19 vaccines
Creator:: Chamberlain A.T., Harati P., Rogawski McQuade E.T., Lopman B.A., Shioda K., Breskin A., and Komura T.
Date of publication:: 2024
Abstract Tesim:: The optimal interval between the first and second doses of COVID-19 mRNA vaccines has not been thoroughly evaluated. Employing a target trial emulation approach, we compared the effectiveness of different interdose intervals among >6 million mRNA vaccine recipients in Georgia, USA, from December 2020 to March 2022. We compared three protocols defined by interdose interval: recommended by the Food and Drug Administration (FDA) (17-25 days for Pfizer-BioNTech; 24-32 days for Moderna), late-but-allowable (26-42 days for Pfizer-BioNTech; 33-49 days for Moderna), and late ( ≥ 43 days for Pfizer-BioNTech; ≥50 days for Moderna). In the short-term, the risk of SARS-CoV-2 infection was lowest under the FDA-recommended protocol. Longer-term, the late-but-allowable protocol resulted in the lowest risk (risk ratio on Day 120 after the first dose administration compared to the FDA-recommended protocol: 0.83 [95% confidence interval: 0.82-0.84]). Here, we showed that delaying the second dose by 1-2 weeks may provide stronger long-term protection.
Resource type:: Article
Affiliation Label Tesim:: Department of Epidemiology
DOI:: https://doi.org/10.17615/2j3g-an19
Edition:: Publisher
Identifier:: https://doi.org/10.1038/s41467-024-45334-8
ISSN:: 2041-1723
Journal Issue:: 1
Journal Title:: Nature communications
Journal Volume:: 15
Language Label:: English
License Label:: Attribution 4.0 International
Other Affiliation:: Emory University, Georgia Department of Public Health, Boston University, and
Page Start:: 1214
Person:: Chamberlain A.T., Harati P., Rogawski McQuade E.T., Lopman B.A., Shioda K., Breskin A., and Komura T.
Rights Statement Label:: In Copyright
Source:: fbfdff62-bb4c-4ff6-9b21-0e32c7343728

49. The impact of the COVID-19 pandemic on the utilization of emergency department services for the treatment of injuries

Title Tesim:: The impact of the COVID-19 pandemic on the utilization of emergency department services for the treatment of injuries
Creator:: Peticolas, K., Harmon, K.J., Marshall, S.W., Waller, A.E., Proescholdbell, S.K., and Fliss, M.D.
Date of publication:: 2021
Abstract Tesim:: Context: The global COVID-19 pandemic has had a major impact on the utilization of healthcare services; however, the impact on population-level emergency department (ED) utilization patterns for the treatment of acute injuries has not been fully characterized. Objective: This study examined the frequency of North Carolina (NC) EDs visits for selected injury mechanisms during the first eleven months of the COVID-19 pandemic. Methods: Data were obtained from the NC Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT), NC's legislatively mandated statewide syndromic surveillance system for the years 2019 and 2020. Frequencies of January – November 2020 NC ED visits were compared to frequencies of 2019 visits for selected injury mechanisms, classified according to International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) injury diagnosis and mechanism codes. Results: In 2020, the total number of injury-related visits declined by 19.5% (N = 651,158) as compared to 2019 (N = 809,095). Visits related to motor vehicle traffic crashes declined by a greater percentage (29%) and falls (19%) declined by a comparable percentage to total injury-related visits. Visits related to assault (15%) and self-harm (10%) declined by smaller percentages. Medication/drug overdose visits increased (10%), the only injury mechanism studied to increase during this period. Conclusion: Both ED avoidance and decreased exposures may have contributed to these declines, creating implications for injury morbidity and mortality. Injury outcomes exacerbated by the pandemic should be addressed by timely public health responses.
Resource type:: Article
Affiliation Label Tesim:: Department of Emergency Medicine, Highway Safety Research Center, and Injury Prevention Research Center
DOI:: https://doi.org/10.17615/kpgx-ag18
Identifier:: https://doi.org/10.1016/j.ajem.2021.04.019
ISSN:: 0735-6757
Journal Title:: American Journal of Emergency Medicine
Journal Volume:: 47
Keyword:: Sentinel surveillance, Emergency medicine, Injury, and COVID-19
Language Label:: English
ORCID:
Other Affiliation:: and NC Department of Health and Human Services
Page End:: 191
Page Start:: 187
Person:: Peticolas, K., Harmon, K.J., Marshall, S.W., Waller, A.E., Proescholdbell, S.K., and Fliss, M.D.
Publisher:: W.B. Saunders
Source:: 78ea9116-9354-4e34-897f-60b784c205a5

50. Multisite clinical validation of isothermal amplification-based SARS-CoV-2 detection assays using different sampling strategies

Title Tesim:: Multisite clinical validation of isothermal amplification-based SARS-CoV-2 detection assays using different sampling strategies
Creator:: Maza, M., Felix, J.C., Cremer, M., Plump, M., Acosta, C.D., Wentzensen, N., Wu, T., Faron, M., Valenzuela, A., Alfaro, K., Masch, R., Desai, K.T., Martínez, M., Einstein, M.H., Novetsky, A.P., Douglas, N.C., Mesich, B., Gabrilovich, S., Dominguez, R., Mendoza, L., and Smith, J.S.
Date of publication:: 2021
Abstract Tesim:: Isothermal amplification-based tests have been introduced as rapid, low-cost, and simple alternatives to real-time reverse transcriptase PCR (RT-PCR) tests for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection. The clinical performance of two isothermal amplification-based tests (Atila Biosystems iAMP coronavirus disease of 2019 [COVID-19] detection test and OptiGene COVID-19 direct plus RT-loop-mediated isothermal amplification [LAMP] test) was compared with that of clinical RT-PCR assays using different sampling strategies. A total of 1,378 participants were tested across 4 study sites. Compared with standard of care RT-PCR testing, the overall sensitivity and specificity of the Atila iAMP test for detection of SARS-CoV-2 were 76.2% and 94.9%, respectively, and increased to 88.8% and 89.5%, respectively, after exclusion of an outlier study site. Sensitivity varied based on the anatomic site from which the sample was collected. Sensitivity for nasopharyngeal sampling was 65.4% (range across study sites, 52.8% to 79.8%), for midturbinate was 88.2%, for saliva was 55.1% (range across study sites, 42.9% to 77.8%), and for anterior nares was 66.7% (range across study sites, 63.6% to 76.5%). The specificity for these anatomic collection sites ranged from 96.7% to 100%. Sensitivity improved in symptomatic patients (overall, 82.7%) and those with a higher viral load (overall, 92.4% for cycle threshold [CT] of #25). Sensitivity and specificity of the OptiGene direct plus RT-LAMP test, which was conducted at a single study site, were 25.5% and 100%, respectively. The Atila iAMP COVID test with midturbinate sampling is a rapid, low-cost assay for detecting SARS-CoV-2, especially in symptomatic patients and those with a high viral load, and could be used to reduce the risk of SARS-CoV-2 transmission in clinical settings. Variation of performance between study sites highlights the need for site-specific clinical validation of these assays before clinical adoption. IMPORTANCE Numerous SARS-CoV-2 detection assays have been developed and introduced into the market under emergency use authorizations (EUAs). EUAs are granted primarily based on small studies of analytic sensitivity and specificity with limited clinical validations. A thorough clinical performance evaluation of SARS-CoV-2 assays is important to understand the strengths, limitations, and specific applications of these assays. In this first large-scale multicentric study, we evaluated the clinical performance and operational characteristics of two isothermal amplification-based SARS-CoV-2 tests, namely, (i) iAMP COVID-19 detection test (Atila BioSystems, USA) and (ii) COVID-19 direct plus RT-LAMP test (OptiGene Ltd., UK), compared with those of clinical RT-PCR tests using different sampling strategies (i.e., nasopharyngeal, self-sampled anterior nares, self-sampled midturbinate, and saliva). An important specific use for these isothermal amplification-based, rapid, low-cost, and easy-to-perform SARS-CoV-2 assays is to allow for a safer return to preventive clinical encounters, such as cancer screening, particularly in low- and middle-income countries that have low SARS-CoV-2 vaccination rates.
Resource type:: Article
Affiliation Label Tesim:: Department of Epidemiology
DOI:: https://doi.org/10.17615/tm9e-9c25
Edition:: Publisher
Identifier:: https://doi.org/10.1128/Spectrum.00846-21
ISSN:: 2165-0497
Journal Issue:: 2
Journal Title:: Microbiology Spectrum
Journal Volume:: 9
Keyword:: Isothermal amplification, Cancer screening, COVID-19, SARS-CoV-2, and Clinical validation
Language Label:: English
License Label:: Public Domain Mark 1.0
ORCID:
Other Affiliation:: Basic Health International, Medical College of Wisconsin, Cleveland Clinic Lerner College of Medicine, Rutgers New Jersey Medical School, Universidad Nacional de Asunción, NIH, El Salvador National Institute of Health, and
Person:: Maza, M., Felix, J.C., Cremer, M., Plump, M., Acosta, C.D., Wentzensen, N., Wu, T., Faron, M., Valenzuela, A., Alfaro, K., Masch, R., Desai, K.T., Martínez, M., Einstein, M.H., Novetsky, A.P., Douglas, N.C., Mesich, B., Gabrilovich, S., Dominguez, R., Mendoza, L., and Smith, J.S.
Publisher:: American Society for Microbiology
Source:: d05a16a0-eaa8-4a78-ae11-312b572e2db6

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