A darkening spring: How preexisting distrust shaped COVID-19 skepticism.
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ABSTRACT:
SUBMITTER: Priniski JH
PROVIDER: S-EPMC8791533 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Objectives: To ascertain factors associated with worsening of psychiatric conditions during the coronavirus disease 2019 (COVID-19) pandemic. Methods: This study anonymously examined 2,734 psychiatric patients worldwide for worsening of their preexisting psychiatric conditions during the COVID-19 pandemic. An independent clinical investigation of 318 psychiatric patients from United States was used for verification. Results: Valid responses mainly from 12 featured countries indicated self-reported worsening of psychiatric conditions in two-thirds of the patients assessed that was through their significantly higher scores on scales for general psychological disturbance, posttraumatic stress disorder, and depression. Female gender, feeling no control of the situation, reporting dissatisfaction with the response of the state during the COVID-19 pandemic, and reduced interaction with family and friends increased the worsening of preexisting psychiatric conditions, whereas optimism, ability to share concerns with family and friends, and using social media like usual were associated with less worsening. An independent clinical investigation from the United States confirmed worsening of psychiatric conditions during the COVID-19 pandemic based on identification of new symptoms that necessitated clinical interventions such as dose adjustment or starting new medications in more than half of the patients. Conclusions: More than half of the patients are experiencing worsening of their psychiatric conditions during the COVID-19 pandemic.
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Project description:While vaccination is the single most effective intervention to drastically reduce severe disease and death following SARS-CoV-2 infection, as shown in UK and Israel, some serious concerns have been raised for an unusual adverse drug reaction (ADR), including vaccine-induced immune thrombotic thrombocytopenia (VITT) with concurrent low platelets as well as capillary leak syndrome. In fact, the overall safety of the vaccine is highlighted by the low frequency of ADR considering that in UK, by the early June, 40 million first doses and 29 million second doses have been injected; nonetheless, 390 thrombotic events, including 71 fatal events have been reported. Interestingly, the cases reported low platelet counts with the presence of anti-platelet factor-4 (PF4) antibodies, indicating an abnormal clotting reaction. Here, out of three referred cases, we report a post-vaccine clinical case of fatal thrombosis with postmortem examination and whole exome sequencing (WES) analysis, whose pathogenesis appeared associated to a preexisting condition of thrombocytopenia due to myelodysplasia.
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Project description:BackgroundNasopharyngeal swab has long been considered the specimen of choice for the diagnosis of respiratory viral infections, including SARS-CoV-2 infection, but it suffers from several drawbacks: its discomfort limits screening acceptability, and it is vulnerable to shortages in both specialized materials and trained healthcare workers in the context of a pandemic.MethodsWe prospectively compared natural spring water gargle to combined oro-nasopharyngeal swab (ONPS) for the diagnosis of coronavirus disease 2019 (COVID-19) in paired clinical specimens (1005 ONPS and 1005 gargles) collected from 987 unique early symptomatic as well as asymptomatic individuals from the community.ResultsUsing a direct RT-PCR method with the Allplex™ 2019-nCoV Assay (Seegene), the clinical sensitivity of the gargle was 95.3% (95% confidence interval [CI], 90.2 - 98.3%), similar to the sensitivity of the ONPS (93.8%; 95% CI, 88.2 - 97.3%), despite significantly lower viral RNA concentration in gargles, as reflected by higher cycle threshold values. No single specimen type detected all COVID-19 cases. SARS-CoV-2 RNA was stable in gargles at room temperature for at least 7 days.ConclusionThe simplicity of this sampling method coupled with the accessibility of spring water are clear advantages in a pandemic situation where testing frequency, turnaround time and shortage of consumables and trained staff are critical elements.
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Project description:BackgroundComorbidities are risk factors for development of severe coronavirus disease 2019 (COVID-19). However, the extent to which an underlying comorbidity influences the immune response to severe acute respiratory syndrome coronavirus 2 remains unknown.ObjectiveOur aim was to investigate the complex interrelations of comorbidities, the immune response, and patient outcome in COVID-19.MethodsWe used high-throughput, high-dimensional, single-cell mapping of peripheral blood leukocytes and algorithm-guided analysis.ResultsWe discovered characteristic immune signatures associated not only with severe COVID-19 but also with the underlying medical condition. Different factors of the metabolic syndrome (obesity, hypertension, and diabetes) affected distinct immune populations, thereby additively increasing the immunodysregulatory effect when present in a single patient. Patients with disorders affecting the lung or heart, together with factors of metabolic syndrome, were clustered together, whereas immune disorder and chronic kidney disease displayed a distinct immune profile in COVID-19. In particular, severe acute respiratory syndrome coronavirus 2-infected patients with preexisting chronic kidney disease were characterized by the highest number of altered immune signatures of both lymphoid and myeloid immune branches. This overall major immune dysregulation could be the underlying mechanism for the estimated odds ratio of 16.3 for development of severe COVID-19 in this burdened cohort.ConclusionThe combinatorial systematic analysis of the immune signatures, comorbidities, and outcomes of patients with COVID-19 has provided the mechanistic immunologic underpinnings of comorbidity-driven patient risk and uncovered comorbidity-driven immune signatures.
| S-EPMC9212690 | biostudies-literature
Project description:Objective: Altered coagulation parameters in COVID-19 patients is associated with a poor prognosis. We tested whether COVID-19 patients on chronic oral anticoagulants (cOACs) for thromboembolism prophylaxis could receive protection from developing more severe phenotypes of the disease. Approach and Results: We searched the database of the SARS-RAS study (Clinicaltrials.gov: NCT04331574), a cross-sectional observational multicenter nationwide survey in Italy designed by the Italian Society of Hypertension. The database counts 2,377 charts of Italian COVID-19 patients in 26 hospitals. We calculated the Charlson comorbidity index (CCI), which is associated with death in COVID-19 patients. In our population (n = 2,377, age 68.2 ± 0.4 years, CCI: 3.04 ± 0.04), we confirm that CCI is associated with increased mortality [OR: 1.756 (1.628-1.894)], admission to intensive care units [ICU; OR: 1.074 (1.017-1.134)], and combined hard events [CHE; OR: 1.277 (1.215-1.342)]. One hundred twenty-five patients were on cOACs (age: 79.3 ± 0.9 years, CCI: 4.35 ± 0.13); despite the higher CCI, cOACs patients presented with a lower risk of admissions to the ICU [OR 0.469 (0.250-0.880)] but not of death [OR: 1.306 (0.78-2.188)] or CHE [OR: 0.843 (0.541-1.312)]. In multivariable logistic regression, cOACs confirmed their protective effect on ICU admission and CHE. The CCI remains the most important risk factor for ICU admission, death, and CHE. Conclusions: Our data support a mechanism for the continuation of cOAC therapy after hospital admission for those patients who are on chronic treatment. Our preliminary results suggest the prophylactic use of direct cOACs in patients with elevated CCI score at the time of the COVID-19 pandemic even in absence of other risks of thromboembolism.
| S-EPMC8155285 | biostudies-literature
Project description:We experienced a case with multiple arterial and venous thromboses associated with COVID-19. During this pandemic, physicians should consider COVID-19 in patients with unexplained thrombosis.
| S-EPMC8657516 | biostudies-literature
Project description:BackgroundDespite the availability of safe and efficacious COVID-19 vaccines, a significant proportion of the American public remains unvaccinated and does not appear immediately interested in receiving the vaccine.MethodsIn this study, we analyzed data from the U.S. Census Bureau's Household Pulse Survey, a biweekly cross-sectional survey of U.S. households. We estimated the prevalence of vaccine hesitancy across states and nationally and assessed the predictors of vaccine hesitancy and vaccine rejection. Additionally, we examined the underlying reasons for vaccine hesitancy, grouped into thematic categories.ResultsA total of 459,235 participants were surveyed from January 6 to March 29, 2021. While vaccine uptake increased from 7.7 to 47 percent, vaccine hesitancy rates remained relatively fixed: overall, 10.2 percent reported that they would probably not get a vaccine, and 8.2 percent would definitely not get a vaccine. Income, education, and state political leaning strongly predicted vaccine hesitancy. However, while both female sex and Black race were factors predicting hesitancy, among those who were hesitant, these same characteristics predicted vaccine reluctance rather than rejection. Those who expressed reluctance invoked mostly "deliberative" reasons while those who rejected the vaccine were also likely to invoke reasons of "dissent" and "distrust".ConclusionVaccine hesitancy comprises a sizable proportion of the population and is large enough to threaten achieving herd immunity. Distinct subgroups of hesitancy have distinctive socio-demographic associations as well as cognitive and affective predilections. Segmented public health solutions are needed to target interventions and optimize vaccine uptake.
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Project description:Recent work points to the heterogeneous nature of science skepticism. However, most research on science skepticism has been conducted in the United States. The current work addresses the generalizability of the knowledge acquired so far by investigating individuals from a Western European country (The Netherlands). Results indicate that various previously reported findings hold up: Mirroring North American patterns, climate change skepticism is associated with political conservatism (but only modestly), and scientific literacy does not contribute to skepticism, except about genetic modification (Study 1 only) and vaccine skepticism (Study 2 only). Results also reveal a crucial difference: Religiosity does not consistently contribute to science skepticism, except about evolution. Instead, spirituality is found to most consistently predict vaccine skepticism and low general faith in science-which in turn predicts willingness to support science. Concerns about societal impact play an additional role. These findings speak to the generalizability of previous findings, improving our understanding of science skepticism.
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