Objectives
To provide baseline cohort descriptives and assess change in health behaviours since the UK COVID‐19 lockdown.
Design
A prospective cohort (N = 1,044) of people recruited online, ...purposively targeting vulnerable populations.
Methods
After a baseline survey (April 2020), participants completed 3 months of daily ecological momentary assessments (EMA). Dietary, physical activity, alcohol, smoking, vaping and substance use behaviours collected retrospectively for the pre‐COVID‐19 period were compared with daily EMA surveys over the first 30 days during early lockdown. Predictors of behaviour change were assessed using multivariable regression models.
Results
30% of the cohort had a COVID‐19 at risk health condition, 37% were classed as deprived and 6% self‐reported a mental health condition. Relative to pre‐pandemic levels, participants ate almost one portion of fruit and vegetables less per day (vegetables mean difference −0.33, 95% CI −0.40, −0.25; fruit −0.57, 95% CI −0.64, −0.50), but showed no change in high sugar portions per day (−0.03, 95% CI −0.12, 0.06). Participants spent half a day less per week doing ≥30 min of moderate to vigorous physical activity (−0.57, 95% CI −0.73, −0.40) but slightly increased days of strength training (0.21, 95% CI 0.09, 0.34), increased alcohol intake (AUDIT‐C score change 0.25, 95% CI 0.13, 0.37), though did not change smoking, vaping or substance use behaviour. Worsening health behaviour change was associated with being younger, female and higher body mass index.
Conclusions
The cohort reported worsening health behaviours during early lockdown. Longer term changes will be investigated using further waves of data collection.
Background: In April 2020, most undergraduate medical education programs across the country ceased in-person activities. In the months that followed, the return to clinical care was often ...inconsistent, sporadic and unpredictable. As the pandemic wore on, the impact of COVID-19 on professional identity formation in medical students was an area ripe for investigation. This study reveals student perceptions of the impact of COVID-19 on their developing sense of professional identity.
Methods: Students in the Class of 2021 at the Pennsylvania State University College of Medicine were invited to participate. After approval from the Institutional Review Board, participating students submitted an image of themselves wearing a mask of their choosing ("selfie") with an accompanying reflective narrative describing the impact of the pandemic on their educational experience. In addition, students submitted words to describe the self they projected (external) on the outside of a templated surgical mask and words to describe their true (internal) sense of self on the inside of the mask.
Results: Common narrative themes that emerged included doubt, anxiety, fear, disconnection, loss of control, guilt, sacrifice, resilience and survival. Analysis of descriptors of internal and external aspects of the templated surgical masks revealed common themes of anxiety, fear, confusion and hope.
Conclusions: This study provides a glimpse into the student experience of COVID-19 through several lenses. From the narrative perspective, students expressed elements of disconnection and doubt as well as resilience and grit. From the visual perspective, similar themes emerged from the mask descriptors. Overall, COVID-19 significantly impacted the emotional experiences of this cohort of fourth-year medical students, particularly in the context of sustained uncertainty and feelings of anxiety.
SARS‐CoV‐2 exploits many strategies to subvert innate immune responses allowing the virus to replicate and disseminate within the host. The extent to which the virus replicates within the host, and ...the efficacy of the host innate immune response to eradicate the infection and trigger effective adaptive immune responses, but not hyper‐responses of innate immunity strongly determines the disease outcome. Understanding the innate immune factors that exacerbate vascular complications following infection will be crucial to control severe disease.
Summary
Innate immune sensing of viral molecular patterns is essential for development of antiviral responses. Like many viruses, SARS‐CoV‐2 has evolved strategies to circumvent innate immune detection, including low cytosine–phosphate–guanosine (CpG) levels in the genome, glycosylation to shield essential elements including the receptor‐binding domain, RNA shielding and generation of viral proteins that actively impede anti‐viral interferon responses. Together these strategies allow widespread infection and increased viral load. Despite the efforts of immune subversion, SARS‐CoV‐2 infection activates innate immune pathways inducing a robust type I/III interferon response, production of proinflammatory cytokines and recruitment of neutrophils and myeloid cells. This may induce hyperinflammation or, alternatively, effectively recruit adaptive immune responses that help clear the infection and prevent reinfection. The dysregulation of the renin–angiotensin system due to down‐regulation of angiotensin‐converting enzyme 2, the receptor for SARS‐CoV‐2, together with the activation of type I/III interferon response, and inflammasome response converge to promote free radical production and oxidative stress. This exacerbates tissue damage in the respiratory system, but also leads to widespread activation of coagulation pathways leading to thrombosis. Here, we review the current knowledge of the role of the innate immune response following SARS‐CoV‐2 infection, much of which is based on the knowledge from SARS‐CoV and other coronaviruses. Understanding how the virus subverts the initial immune response and how an aberrant innate immune response contributes to the respiratory and vascular damage in COVID‐19 may help to explain factors that contribute to the variety of clinical manifestations and outcome of SARS‐CoV‐2 infection.
An estimated 10-15% of those infected with SARS-CoV-2 may have post-COVID-19 condition. Common lingering signs and symptoms include shortness of breath, fatigue, high heart rate, and memory and ...cognitive dysfunction even several months after infection, often impacting survivors' quality of life. The prevalence and duration of individual symptoms remain difficult to ascertain due to the lack of standardized research methods across various studies and limited patient follow-up in clinical studies. Nonetheless, data indicate post-COVID-19 condition may occur independent of acuity of initial infection, hospitalization status, age, or pre-existing comorbidities. Risk factors may include female sex and underlying respiratory or psychiatric disease. Supportive therapies to mitigate symptoms remain the mainstay of treatment. Reassuringly, most patients experience a reduction in symptoms by 1 year. The use of a universal case definition and shared research methods will allow for further clarity regarding the pervasiveness of this entity and its long-term health consequences.
Interleukin-10 (IL-10) is a pleiotropic cytokine that has a fundamental role in modulating inflammation and in maintaining cell homeostasis. It primarily acts as an anti-inflammatory cytokine, ...protecting the body from an uncontrolled immune response, mostly through the Jak1/Tyk2 and STAT3 signaling pathway. On the other hand, IL-10 can also have immunostimulating functions under certain conditions. Given the pivotal role of IL-10 in immune modulation, this cytokine could have relevant implications in pathologies characterized by hyperinflammatory state, such as cancer, or infectious diseases as in the case of COVID-19 and Post-COVID-19 syndrome. Recent evidence proposed IL-10 as a predictor of severity and mortality for patients with acute or post-acute SARS-CoV-2 infection. In this context, IL-10 can act as an endogenous danger signal, released by tissues undergoing damage in an attempt to protect the organism from harmful hyperinflammation. Pharmacological strategies aimed to potentiate or restore IL-10 immunomodulatory action may represent novel promising avenues to counteract cytokine storm arising from hyperinflammation and effectively mitigate severe complications. Natural bioactive compounds, derived from terrestrial or marine photosynthetic organisms and able to increase IL-10 expression, could represent a useful prevention strategy to curb inflammation through IL-10 elevation and will be discussed here. However, the multifaceted nature of IL-10 has to be taken into account in the attempts to modulate its levels.
Chronicling a Crisis is a powerful primary source collection compiled during the peak of the COVID pandemic between spring 2020 and spring 2021. This upstate New York college was the only school in ...the state that had to send home all its students twice due to COVID, which attracted international media attention. This book was inspired by the UK’s Mass Observation Project from the 1930s, which drew on the war-time diaries of ordinary British citizens to track the impact of World War II on their lives. With over two hundred blog entries from students, faculty, and staff—including diary reflections, poems, pictures, and thought pieces—this volume lays bare the grief, frustration, fear, resilience, and upheavals of this tumultuous period. This book will be of interest for students of New York history, American history and the digital humanities as well as general readers interested in understanding the impact of the COVID pandemic on universities and their students.
Sensemaking in the Time of COVID‐19 Christianson, Marlys K.; Barton, Michelle A.
Journal of management studies,
March 2021, Letnik:
58, Številka:
2
Journal Article
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