19 March, 2021

Perception and practices followed by AYUSH practitioners and health seekers for prevention of COVID-19: Cross-sectional analysis of an app-based data -

Abstract AYUSH Sanjivani is a mobile application launched by the Ministry of AYUSH (MoA) to gather information regarding the utilization of AYUSH (Ayurveda, Yoga, Unani, Siddha, and Homeopathy) advocacies for the prevention of COVID-19 infection. A cross-sectional analysis of the data generated through this mobile application has been performed and presented in this article to examine the acceptability and extent of utilization of AYUSH preventive measures in India. Objectives: The objectives of this cross-sectional analysis was to determine the trends of the utilization of AYUSH measures by the beneficiaries as reported by AYUSH practitioners and by the practitioners themselves for the prevention of COVID-19 and to determine the benefit obtained in terms of self-reported parameters of general well being, the overall impact on general health and in preventing the onset of flu-like symptoms. Methods: A secondary data analysis was undertaken, utilizing the cross-sectional data generated through the AYUSH Sanjivani App from May to July 2020. The responses in terms of demographic profile, utilization pattern, benefits obtained, the interventions used and the data of beneficiaries in terms of geographic location and interventions prescribed were analyzed statistically to assess the trends of the utilization of AYUSH measures for prophylaxis. Results: Data of 74,568 AYUSH physicians and 1,35,21,245 beneficiaries/health seekers whose data were reported by 3623 AYUSH practitioners were used for analysis. AYUSH advocacies/measures were utilized by 69,195 (92.8%) physicians for prophylaxis. Samshamani Vati, Chyavanprash, and Arsenicum Album-30 were the most commonly used AYUSH interventions. Improvement in terms of appetite, bowel movements, sleep, mental well being, stamina, change in pre-existing disease, and change in disposition were reported by 42400 (61.3%) physicians. Maximum beneficiaries were from the state of Gujarat followed by Madhya Pradesh. Arsenicum Album-30 was the most commonly prescribed/distributed intervention among the beneficiaries/ health seekers. Conclusion: Maximum physicians have reported having benefited from the use of AYUSH prophylactic measures for the prevention of COVID-19. Moreover, a good proportion of the Indian population was provided the AYUSH prophylactic measures as recorded in the app.

🖺 Full Text HTML: Perception and practices followed by AYUSH practitioners and health seekers for prevention of COVID-19: Cross-sectional analysis of an app-based data

Expert Predictions of Societal Change: Insights from the World after COVID Project -

How will the world change after the COVID-19 pandemic? Is there a consensus on the most significant psychological and societal changes ahead? To answer these questions, we analyzed interviews from the World after COVID project – reflections of more than 50 of the world’s top behavioral and social science experts, including fellows of National Academies and presidents of major scientific societies. These experts independently shared their thoughts on what societal shifts would emerge after the COVID-19 pandemic and provided advice for how to respond to new challenges and opportunities these changes may bring. Using mixed-method and natural language processing analyses, we distilled and analyzed these predictions and suggestions. Most predictions were unique, not statistically reducible to broader categories, and most themes were mentioned by fewer than 10% of experts. Half of the experts approached their post-COVID predictions dialectically, highlighting both positive and negative features of the same domain of change. The project provides a time capsule of experts’ predictions for the effects of the pandemic on a wide range of outcomes. We discuss the implications of heterogeneity in these predictions, the value of uncertainty and dialecticism in forecasting, and the value of balancing explanations with predictions in expert psychological judgment.

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Risk perception, Unhealthy Behavior, and Anxiety due to Viral Epidemic among Healthcare Workers: The Relationships with Depressive and Insomnia symptoms during COVID-19 -

We aimed to investigate the relationship between mental health problems and unhealthy behaviors among healthcare workers in response to the COVID-19 pandemic. Using an online survey, we collected data on healthcare workers’ perception regarding COVID-19 exposure in a work unit. Workers’ depression, insomnia, and anxiety symptoms were assessed using the Patient Health Questionnaire-9, Insomnia Severity Index, and Generalized Anxiety Disorder-7 scale, respectively. Work-related stress and anxiety in response to the viral epidemic were measured using the Stress and Anxiety to Viral Epidemic-9 (SAVE-9) scale. We found that work-related stress and anxiety in response to the viral epidemic was associated with female sex, perception of the workplace as being dangerous, and depressive symptoms. Unhealthy behaviors, such as smoking and drinking as coping behaviors during the pandemic, were associated with male sex, young age, depression, and insomnia. During the COVID-19 pandemic, it is necessary to closely observe the patterns of work-related stress and anxiety reactions among healthcare workers to reduce their burnout.

🖺 Full Text HTML: Risk perception, Unhealthy Behavior, and Anxiety due to Viral Epidemic among Healthcare Workers: The Relationships with Depressive and Insomnia symptoms during COVID-19

The B1.351 and P.1 variants extend SARS-CoV-2 host range to mice -

Receptor recognition is a major determinant of viral host range, as well as infectivity and pathogenesis. Emergences have been associated with serendipitous events of adaptation upon encounters with a novel host, and the high mutation rate of RNA viruses has been proposed to explain their frequent host shifts. SARS-CoV-2 extensive circulation in humans has been associated with the emergence of variants, including variants of concern (VOCs) with diverse mutations in the spike and increased transmissibility or immune escape. Here we show that unlike the initial virus, VOCs are able to infect common laboratory mice, replicating to high titers in the lungs. This host range expansion is explained in part by the acquisition of changes at key positions of the receptor binding domain that enable binding to the mouse angiotensin-converting enzyme 2 (ACE2) cellular receptor, although differences between viral lineages suggest that other factors are involved in the capacity of SARS-CoV-2 VOCs to infect mice. This abrogation of the species barrier raises the possibility of wild rodent secondary reservoirs and provides new experimental models to study disease pathophysiology and countermeasures.

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Mental Health and Behavior of College Students in the COVID-19 Pandemic: A Longitudinal Mobile Smartphone and Ecological Momentary Assessment Study - Part II -

Background: Since late 2019, the lives of people across the globe have been disrupted by COVID-19. Millions of people have become infected; billions have been continually asked or required by local and national governments to change their behavioral patterns. Previous research on the COVID-19 pandemic suggests that it is associated with large-scale behavioral and mental health changes, but few studies have been able to track these changes with frequent, near real-time sampling or compare these changes to previous years of data for the same individuals. Objectives: By combining mobile phone sensing and self-reported mental health data in a cohort of college-aged students enrolled in a longitudinal study, we seek to understand the behavioral and mental health impacts associated with the pandemic, measured by search term interest in “coronavirus” and “covid fatigue” across the United States. Methods: Behaviors such as the number of locations visited, distance traveled, duration of phone usage, number of phone unlocks, sleep duration, and sedentary time were measured using the StudentLife mobile smartphone sensing app. Depression and anxiety were assessed using weekly self-reported Ecological Momentary Assessments (EMAs), including the Patient Health Questionnaire-4 (PHQ-4). Participants were 217 undergraduate students. Differences in behaviors and self-reported mental health collected during the Spring 2020 term, as compared to previous terms in the same cohort, were modeled using mixed linear models. Results: Linear mixed models observed differences in phone usage, sleep, sedentary time and the number of locations visited associated with the COVID-19 pandemic. In further models, these behaviors were strongly associated with increased interest in covid fatigue. When mental health metrics (e.g., depression and anxiety) were added to the previous measures (week of term, number of locations visited, phone usage, sedentary time), both anxiety and depression (P<.001) were significantly associated with interest in covid fatigue. Notably, these behavioral and mental health changes are consistent with those observed around the initial implementation of COVID-19 lockdowns in the spring of 2020 [@Huckins2020]. Conclusions: In the initial lockdown phase of the COVID-19 pandemic, people spent more time on their phones, were more sedentary, visited fewer locations, and exhibited increased symptoms of anxiety and depression. As the pandemic persisted through the spring, people continued to exhibit very similar changes in both mental health and behaviors. Though unsurprising, understanding these large-scale shifts in mental health and behaviors is critical in disrupting the negative consequences to mental health during the ongoing pandemic.

🖺 Full Text HTML: Mental Health and Behavior of College Students in the COVID-19 Pandemic: A Longitudinal Mobile Smartphone and Ecological Momentary Assessment Study - Part II

Knowledge barriers in the symptomatic-COVID-19 testing programme in the UK: an observational study -

Background Symptomatic testing programmes are crucial to the COVID-19 pandemic response. We sought to examine United Kingdom (UK) testing rates amongst individuals with test-qualifying symptoms, and factors associated with not testing. Methods We analysed a cohort of untested symptomatic app users (N=1,237), nested in the Zoe COVID Symptom Study (Zoe, N= 4,394,948); and symptomatic survey respondents who wanted, but did not have a test (N=1,956), drawn from the University of Maryland-Facebook Covid-19 Symptom Survey (UMD-Facebook, N=775,746). Findings The proportion tested among individuals with incident test-qualifying symptoms rose from ~20% to ~75% from April to December 2020 in Zoe. Testing was lower with one vs more symptoms (73.0% vs 85.0%), or short vs long symptom duration (72.6% vs 87.8%). 40.4% of survey respondents did not identify all three test-qualifying symptoms. Symptom identification decreased for every decade older (OR=0.908 [95% CI 0.883-0.933]). Amongst symptomatic UMD-Facebook respondents who wanted but did not have a test, not knowing where to go was the most cited factor (32.4%); this increased for each decade older (OR=1.207 [1.129-1.292]) and for every 4-years fewer in education (OR=0.685 [0.599-0.783]). Interpretation Despite current UK messaging on COVID-19 testing, there is a knowledge gap about when and where to test, and this may be contributing to the ~25% testing gap. Risk factors, including older age and less education, highlight potential opportunities to tailor public health messages.

🖺 Full Text HTML: Knowledge barriers in the symptomatic-COVID-19 testing programme in the UK: an observational study

Immune response during lactation after anti-SARS-CoV2 mRNA vaccine -

Importance: Data regarding efficacy and safety of anti-COVID-19 mRNA vaccines during lactation is needed to address vaccination guidelines, ease vaccine hesitancy concerns, and inform public health strategies for this population. Objective: To determine whether anti-COVID-19 mRNA-based vaccines administered during lactation illicit an immune response or the transfer of anti-SARS-CoV2 antibodies into human milk. Design: Plasma and milk samples were collected from a prospective cohort of lactating individuals who received the mRNA-based vaccines for COVID-19 and from individuals who recovered from COVID-19 infection. Setting: Ambulatory or during postpartum hospitalization. Participants: We report results from lactating participants who received the mRNA-1273 (Moderna, n=9) or the BNT162b2 (Pfizer, n=14) vaccine or recovered from natural SARS-CoV-2 infection (n=3). Interventions and Exposures: Anti-COVID-19 mRNA vaccination (BNT-162b2 and mRNA-1273) or natural SARS-CoV-2 infection. Main Outcome(s) and Measure(s): Plasma and milk samples were collected from lactating individuals before first vaccine dose, on the day of the second dose, and 4 weeks after the second dose. Maternal plasma was evaluated for vaccine-derived IgM and IgG antibodies. Human milk was evaluated by ELISA for vaccine-induced IgA antibodies specific for SARS-CoV-2. Results: Twenty-three lactating individuals were recruited for this study. Levels of IgG and IgM were significantly increased in plasma samples on the day of the second vaccine dose (post vaccine 1), when compared to pre-vaccine samples. In addition, plasma IgG levels 4 weeks after second vaccine dose were significantly higher than plasma IgG levels pre-vaccine or on the day of the second dose. In addition, our results show transfer of anti-SARS-CoV2-Receptor Binding Domain (RBD) IgA antibodies to human milk, 3-4 weeks after each dose of the COVID-19 mRNA vaccines (BNT-162b2 and mRNA-1273). The levels of anti-SARS-CoV2-RBD IgA antibody in milk of vaccinated individuals were not significantly different from levels among participants who experienced SARS-CoV-2 infection. Conclusions and Relevance: Administration of anti-COVID-19 mRNA vaccines during lactation leads to increased anti-SARS-CoV2 IgM and IgG levels in the plasma of lactating mothers and increased anti-SARS-CoV2-RBD IgA levels in human milk. Lactating women who receive the vaccine should continue breastfeeding their infant human milk to allow continuing transfer of anti-SARS-CoV-2 IgA antibodies to the neonate. Additional studies are needed to evaluate the effect of these vaccines on lactation outcomes and infant health.

🖺 Full Text HTML: Immune response during lactation after anti-SARS-CoV2 mRNA vaccine

Genetic variability associated with OAS1 expression in myeloid cells increases the risk of Alzheimer’s disease and severe COVID-19 outcomes -

Genome-wide association studies of late-onset Alzheimer’s disease (AD) have highlighted the importance of variants associated with genes expressed by the innate immune system in determining risk for AD. Recently, we and others have shown that genes associated with variants that confer risk for AD are significantly enriched in transcriptional networks expressed by amyloid-responsive microglia. This allowed us to predict new risk genes for AD, including the interferon-responsive oligoadenylate synthetase 1 (OAS1). However, the function of OAS1 within microglia and its genetic pathway are not known. Using genotyping from 1,313 individuals with sporadic AD and 1,234 control individuals, we confirm that the OAS1 variant, rs1131454, is associated with increased risk for AD and decreased OAS1 expression. Moreover, we note that the same locus was recently associated with critical illness in response to COVID-19, linking variants that are associated with AD and a severe response to COVID-19. By analysing single-cell RNA-sequencing (scRNA-seq) data of isolated microglia from APPNL-G-F knock-in and wild-type C57BL/6J mice, we identify a transcriptional network that is significantly upregulated with age and amyloid deposition, and contains the mouse orthologue Oas1a, providing evidence that Oas1a plays an age-dependent function in the innate immune system. We identify a similar interferon-related transcriptional network containing OAS1 by analysing scRNA-seq data from human microglia isolated from individuals with AD. Finally, using human iPSC-derived microglial cells (h-iPSC-Mg), we see that OAS1 is required to limit the pro-inflammatory response of microglia. When stimulated with interferon-gamma (IFN-{gamma}), we note that cells with lower OAS1 expression show an exaggerated pro-inflammatory response, with increased expression and secretion of TNF-. Collectively, our data support a link between genetic risk for AD and susceptibility to critical illness with COVID-19 centred on OAS1 and interferon signalling, a finding with potential implications for future treatments of both AD and COVID-19, and the development of biomarkers to track disease progression.

🖺 Full Text HTML: Genetic variability associated with OAS1 expression in myeloid cells increases the risk of Alzheimer’s disease and severe COVID-19 outcomes

Evaluation of a new spike (S) protein based commercial immunoassay for the detection of anti-SARS-CoV-2 IgG -

Background: The investigation of antibody response to SARS-CoV-2 represents a key aspect in facing the COVID-19 pandemic. In the present study, we compared one new and four widely used commercial serological assays for the detection of antibodies targeting S (spike) and NC (nucle-ocapsid) protein. Methods: Serum samples from a group of apparently non-responders, from an unbiased group of convalescent patients and from a negative control group were simultaneously analyzed by the LIAISON SARS-CoV-2 S1/S2 IgG test, Euroimmun anti-SARS-CoV-2 S1 IgG ELISA and IDK anti-SARS-CoV-2 S1 IgG assays. IgG binding NC were detected by the Abbott SARS-CoV-2 IgG assay and by the pan-immunoglobulin immunoassay Elecsys An-ti-SARS-CoV-2. Additionally, samples were also tested by live virus and pseudovirus neutrali-zation tests. Results: Overall, about 50% of convalescent patients with undetectable IgG antibodies using the commercial kit by Euroimmun were identified as IgG positive by Immundiagnostik and Roche. While both assays achieved similarly high sensitivities, Immundiagnostik correlated better with serum neutralizing activity than Roche. Conclusions: Although the proportion of IgG se-ropositive individuals appears to be higher using more sensitive immunoassays, the protective ability and the potential to serve as indirect markers of other beneficial immune responses war-rants for further research.

🖺 Full Text HTML: Evaluation of a new spike (S) protein based commercial immunoassay for the detection of anti-SARS-CoV-2 IgG

Exploring surveillance data biases when estimating the reproduction number: with insights into subpopulation transmission of Covid-19 in England -

The time-varying reproduction number (R_t: the average number secondary infections caused by each infected person) may be used to assess changes in transmission potential during an epidemic. While new infections are not usually observed directly, they can be estimated from data. However, data may be delayed and potentially biased. We investigated the sensitivity of R_t estimates to different data sources representing Covid-19 in England, and we explored how this sensitivity could track epidemic dynamics in population sub-groups. We sourced public data on test-positive cases, hospital admissions, and deaths with confirmed Covid-19 in seven regions of England over March through August 2020. We estimated R_t using a model that mapped unobserved infections to each data source. We then compared differences in Rt with the demographic and social context of surveillance data over time. Our estimates of transmission potential varied for each data source, with the relative inconsistency of estimates varying across regions and over time. R_t estimates based on hospital admissions and deaths were more spatio-temporally synchronous than when compared to estimates from all test-positives. We found these differences may be linked to biased representations of subpopulations in each data source. These included spatially clustered testing, and where outbreaks in hospitals, care homes, and young age groups reflected the link between age and severity of disease. We highlight that policy makers could better target interventions by considering the source populations of R_t estimates. Further work should clarify the best way to combine and interpret R_t estimates from different data sources based on the desired use.

🖺 Full Text HTML: Exploring surveillance data biases when estimating the reproduction number: with insights into subpopulation transmission of Covid-19 in England

A novel SARS-CoV-2 related virus with complex recombination isolated from bats in Yunnan province, China -

A novel beta-coronavirus, SARS-CoV-2, emerged in late 2019 and rapidly spread throughout the world, causing the COVID-19 pandemic. However, the origin and direct viral ancestors of SARS-CoV-2 remain elusive. Here, we discovered a new SARS-CoV-2-related virus in Yunnan province, in 2018, provisionally named PrC31, which shares 90.7% and 92.0% nucleotide identities with SARS-CoV-2 and the bat SARSr-CoV ZC45, respectively. Sequence alignment revealed that several genomic regions shared strong identity with SARS-CoV-2, phylogenetic analysis supported that PrC31 shares a common ancestor with SARS-CoV-2. The receptor binding domain of PrC31 showed only 64.2% amino acid identity with SARS-CoV-2. Recombination analysis revealed that PrC31 underwent multiple complex recombination events within the SARS-CoV and SARS-CoV-2 sub-lineages, indicating the evolution of PrC31 from yet-to-be-identified intermediate recombination strains. Combination with previous studies revealed that the beta-CoVs may possess more complicated recombination mechanism. The discovery of PrC31 supports that bats are the natural hosts of SARS-CoV-2.

🖺 Full Text HTML: A novel SARS-CoV-2 related virus with complex recombination isolated from bats in Yunnan province, China

Identification of guanylyltransferase activity in the SARS-CoV-2 RNA polymerase -

SARS-CoV-2 is a positive-sense RNA virus that is responsible for the ongoing Coronavirus Disease 2019 (COVID-19) pandemic, which continues to cause significant morbidity, mortality and economic strain. SARS-CoV-2 can cause severe respiratory disease and death in humans, highlighting the need for effective antiviral therapies. The RNA synthesis machinery of SARS-CoV-2 is an ideal drug target and consists of non-structural protein 12 (nsp12), which is directly responsible for RNA synthesis, and numerous co-factors that are involved in RNA proofreading and 5’ capping of viral mRNAs. The formation of the 5’ cap-1 structure is known to require a guanylyltransferase (GTase) as well as 5’ triphosphatase and methyltransferase activities. However, the mechanism of SARS-CoV-2 mRNA capping remains poorly understood. Here we show that the SARS-CoV-2 RNA polymerase nsp12 functions as a GTase. We characterise this GTase activity and find that the nsp12 NiRAN (nidovirus RdRP-associated nucleotidyltransferase) domain is responsible for carrying out the addition of a GTP nucleotide to the 5’ end of viral RNA via a 5’ to 5’ triphosphate linkage. We also show that remdesivir triphosphate, the active form of the antiviral drug remdesivir, inhibits the SARS-CoV-2 GTase reaction as efficiently as RNA polymerase activity. These data improve understanding of coronavirus mRNA cap synthesis and highlight a new target for novel or repurposed antiviral drugs against SARS-CoV-2.

🖺 Full Text HTML: Identification of guanylyltransferase activity in the SARS-CoV-2 RNA polymerase

Cultural influence on COVID-19 cognitions and growth speed: the role of cultural collectivism -

Many challenges faced by humans require large-scale cooperation for communal benefits. We examined what motivates such cooperation in the context of social distancing and mask wearing to reduce the transmission intensity of the novel coronavirus (COVID-19). We hypothesized that collectivism, a cultural variable characterizing the extent that individuals see themselves in relation to others, contributes to people’s willingness to engage in these behaviors. Consistent with preregistered predictions, across three studies (n=2864), including a U.S. nationally representative sample, people’s collectivist orientation is positively associated with intentions, positive beliefs, norm perceptions, and policy support for the preventive behaviors. In separate analyses at the country level (n=69 countries), more collectivist countries demonstrated lower growth rate in both COVID-19 confirmed cases and deaths. Together, these studies demonstrate the positive role of collectivism at the individual- and country-level in reducing COVID-19 transmission, and highlight the need to consider culture in public health policies and communications.

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Logarithmic Axis Graphs Distort Lay Judgment -

COVID-19 data is often presented using graphs with either a linear or logarithmic scale. Given the importance of this information, understanding how choice of scale changes interpretations is critical. To test this, we presented laypeople with the same data plotted using differing scales. We found that graphs with a logarithmic, as opposed to linear, scale resulted in laypeople making less accurate predictions of growth, viewing COVID-19 as less dangerous, and expressing both less support for policy interventions and less intention to take personal actions to combat COVID-19. Education reduces, but does not eliminate these effects. These results suggest that public communications should use logarithmic graphs only when necessary, and such graphs should be presented alongside education and linear graphs of the same data whenever possible.

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Myocarditis in naturally infected pets with the British variant of COVID-19 -

Domestic pets can contract SARS-CoV-2 infection but, based on the limited information available to date, it is unknown whether the new British B.1.1.7 variant can more easily infect certain animal species or increase the possibility of human-to-animal transmission. In this study, we report the first cases of infection of domestic cats and dogs by the British B.1.1.7 variant of SARS-CoV-2 diagnosed at a specialist veterinary hospital in the South-East of England. Furthermore, we discovered that many owners and handlers of these pets had developed Covid-19 respiratory symptoms 3-6 weeks before their pets became ill and had also tested PCR positive for Covid-19. Interestingly, all these B.1.1.7 infected pets developed atypical clinical manifestations, including severe cardiac abnormalities secondary to myocarditis and a profound impairment of the general health status of the patient but without any primary respiratory signs. Together, our findings demonstrate for the first time the ability for companion animals to be infected by the B.1.1.7 variant of SARS-CoV-2 and raise questions regarding its pathogenicity in these animals. Moreover, given the enhanced infectivity and transmissibility of B.1.1.7 variant for humans, these findings also highlights more than ever the risk that companion animals may potentially play a significant role in SARS-CoV-2 outbreak dynamics than previously appreciated.

🖺 Full Text HTML: Myocarditis in naturally infected pets with the British variant of COVID-19

Covid-19 Sentry

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