COVID-19 Symptoms Research Articles

Abstract B030: Assessing COVID-19 vaccination status and symptoms in persons with a history of cancer

Abstract Background: Persons with a history of cancer are at a higher risk of adverse COVID-19 outcomes due to their immunosuppressed status. Vaccination to COVID-19 has proven effective in decreasing complications from COVID-19 infection. This study explored the vaccination status of persons receiving cancer care (received 1st dose/2nd dose/booster) and their symptoms. Methods: Persons with a cancer diagnosis receiving care at a cancer center clinical site were randomly invited to complete a voluntary survey via email, the EMR, or during an in-person appointment. Paper surveys were completed in the clinic, placed in a sealed collection bin, and collected by research staff weekly. Responses were anonymous. Participants were asked if they had received their 1st/2nd COVID-19 vaccine, their symptoms, and if they had/intended to receive the booster. The study was conducted between September 2021 to September 2022. An EMR review of vaccination uptake was conducted to assess representativeness of our sample. Results: 6,302 persons were invited to complete the survey; 1,733 (28%) responded. 1694 (98%) had received at least one vaccine dose. 67.46% of the participants were white, non-Latinx; 25.39% were Black; 3.17% were Asian. 13.25% were 18-50 years; 30.61% were 50-64;36.81% were 65-74; 19.33% were 75+. 33.13% had a breast cancer diagnosis; 5.47% had lung cancer, 5.41% had prostate cancer, 4.29% had colorectal carcinoma, and 47.42% had other cancers. 1016 (58.63%) received their 1st COVID-19 vaccine, 1437 (82.92%) the 1st/2nd dose, and 1052 (60.70%) had received the booster (3rd dose). Frequently reported symptoms were muscle soreness, pain, fatigue, fever and headache. Those over 65 years were significantly more likely to report fatigue (p<0.001), fever (p<0.0001), headache (p<0.0001), nausea (p=0.0005). Black persons were less likely to report fever (OR: 0.54, 95% CI: 0.34 – 0.86, p=0.0097) and more likely to report pain (OR: 1.58, 95% CI: 1.02 – 2.46, p=0.0427). For persons with breast cancer--29.46% reported muscle soreness, 12.95% reported fatigue, 10.13% reported headache, 9.19% reported fever, 7.13% reported pain. We were unable to stratify by other demographics or cancer type due insufficient sample size. EMR review of vaccination uptake revealed 24.17% had not initiated vaccination. Conclusion: Survey respondents were more likely to have initiated the COVID-19 vaccination process. Older adults were more likely to report fatigue, fever, headache and nausea. Black persons were less likely to report fever and more likely to report pain. Anticipating differences in COVID-19 vaccination symptoms allow for the development of tailored education and resources for self-management and care. Citation Format: Iqra Siddiqui, Ana Maria Lopez, FNU Nikita. Assessing COVID-19 vaccination status and symptoms in persons with a history of cancer [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B030.

Abstract A141: Exploring patient barriers and facilitators to colorectal cancer screening during the SARS-CoV-2 pandemic

Abstract Intro While there has been a national initiative to achieve 80% colorectal cancer (CRC) screening rates, not all population subgroups reach this target. Specifically, Latino populations have shown lower CRC screening rates compared to non-Latino White populations. Furthermore, the SARS-CoV-2 pandemic led to a decline in CRC screening uptake, particularly in Federally Qualified Health Centers (FQHCs). One large, urban FQHC, primarily serving Latino patients, has invested in stool-based, home-mailed CRC screening outreach. This FQHC serves as the site for the RESTORE study. Here, we describe patient-level barriers and facilitators to home fecal immunochemical test (FIT) screening throughout the COVID-19 pandemic. Methods Patients (n=15) were interviewed between August 2022 and May 2023. Interviews addressed health care utilization and CRC screening throughout the COVID-19 pandemic. Patient interviews were audio recorded and transcribed. A preliminary review of these interviews was conducted to assess patients’ use of telehealth as well as patients’ self-reported FIT completion. Results Participants’ average age was 58.5 years old; 53% identify as female; 66% report Spanish as their preferred language; and 80% identify as Latino. Ten patients (6 Spanish-speaking and 4 English-speaking) reported completing a home-mailed screening test. Among them, four emphasized the convenience of completing their CRC screening at home and found it beneficial to have wordless instructions included in their mailed FIT to guide them through the process. While these patients were able to complete their FIT, 3 reported that they never received their result. Of note, one of the Spanish speakers postponed FIT completion until in-person care resumed. Of the 4 Spanish-speaking patients who did not complete a FIT: 2 completed a colonoscopy, while the other 2 disposed of their FIT. The lone English speaker who did not complete FIT cited a fear of cancer as a barrier to screening. Patients who completed a colonoscopy described the procedure as easy; however, one patient experienced complications post-procedure. Telehealth visits were utilized by 80% of patients in 2020 and 73% in 2021, covering various health topics such as COVID-19 symptoms, infection, medication refills, and exam referral and results, with some patients citing convenience and quicker access to providers. Conclusions Throughout the SARS-CoV-2 period, patients continued to benefit from the FQHC’s mailed FIT outreach. As a novel primary care modality, patients reported completing clinical encounters via telehealth during the COVID-19 pandemic to discuss a range of health topics with a provider. To improve preparedness for future natural disasters, it is imperative to understand FQHC patients’ CRC screening experiences during this dynamic period. Citation Format: Anne Escaron, Robert Lara, Karina Ramirez, Adolfo Jacobo, Jennifer Schneider, Jennifer Rivelli, Crystal Gomez, Alexis Perez, Gloria Coronado. Exploring patient barriers and facilitators to colorectal cancer screening during the SARS-CoV-2 pandemic [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A141.

Portal Vein Thrombosis in COVID-19: An Underdiagnosed Disease?

Background: Multiple studies have linked COVID-19 to a higher incidence of thromboembolic disorders. However, the association of COVID-19 with other potentially life-threatening complications, such as splanchnic vein thrombosis, is less well understood. This study aims to assess the prevalence, patient characteristics, clinical presentation, and outcomes of patients with portal vein thrombosis (PVT) and COVID-19. Methods: This was a retrospective observational study. From all positive patients for a reverse-transcription polymerase chain reaction (RT-PCR) swab test from March 2020 to June 2020, we included those who were older than 18 years, had received abdominal contrast-enhanced computed tomography (CT) in the 6 months following the positive RT-PCR swab, and had no previously known splanchnic vein thrombosis. Results: A total of 60 patients with abdominal CT were selected from all those positive for SARS-CoV-2 (n = 2987). The prevalence of PVT was 3/60 (5%). The mean age was 66.1 ± 16.5 years and 51.7% were male. In two of the three patients, there was no underlying pathology as a risk factor for PVT and one of them presented cirrhosis. The number of days from the start of COVID-19 symptoms until the PVT diagnosis were 21, 12, and 10 days. Anticoagulation treatment achieved recanalization in 100% of cases. During a mean follow-up of 803 days, none of the patients experienced long-term complications. Conclusions: Portal vein thrombosis is uncommon, and its incidence may be higher in COVID-19 patients. A greater understanding of the features of this disease in the context of COVID-19 could aid towards its diagnosis and allow for early detection and management.

Estimates of vaccine effectiveness of the updated monovalent XBB.1.5 COVID-19 vaccine against symptomatic SARS-CoV-2 infection, hospitalization, and receipt of oxygen therapy in South Korea - October 26 to December 31, 2023

ObjectivesWe evaluated the vaccine effectiveness of monovalent XBB.1.5 vaccine against symptomatic COVID-19 infection, hospitalization, and the need for oxygen therapy in South Korea. DesignThis study employed a test-negative case-control design. COVID-19 test results in symptomatic subjects from six university hospitals across South Korea were collected (October 26–December 31, 2023). The adjusted absolute and relative vaccine effectiveness were assessed. ResultsIn total, 5516 subjects were enrolled: 4,824 were unvaccinated with XBB.1.5, and 692 were vaccinated with XBB.1.5 COVID-19 mRNA vaccines. The absolute vaccine effectiveness when comparing the odds between XBB.1.5 vaccination and no vaccination against symptomatic COVID-19 infection, hospitalization, and oxygen therapy was 65.2% (95% CI, 36.1-81.0), 77.3% (95% CI, 51.1-89.5), and 85.3% (95% CI, 57.8-94.9), respectively. The relative vaccine effectiveness when comparing the odds between XBB.1.5 vaccination and no XBB.1.5 vaccination against symptomatic COVID-19 infection, hospitalization, and oxygen therapy was 57.7% (95% CI, 34.7-72.6), 64.3% (95% CI, 35.9-80.2), and 65.5% (95% CI, 27.0-83.7), respectively. ConclusionThe short-term effectiveness of the XBB.1.5 vaccine against symptomatic COVID-19 infection, hospitalization, and receipt of oxygen therapy in South Korea was significant. Long-term vaccine effectiveness warrants evaluation, and these assessments should be conducted regularly.

Long COVID is not the same for everyone: a hierarchical cluster analysis of Long COVID symptoms 9 and 12 months after SARS-CoV-2 test

BackgroundIdentifying symptom clusters in Long COVID is necessary for developing effective therapies for this diverse condition and improving the quality of life of those affected by this heterogeneous condition. In this study, we aimed to identify and compare symptom clusters at 9 and 12 months after a SARS-CoV-2 positive test and describe each cluster regarding factors at infection.MethodsThis is a cross-sectional study with individuals randomly selected from the Portuguese National System of Epidemiological Surveillance (SINAVE) database. Individuals who had a positive SARS-CoV-2 test in August 2022 were contacted to participate in a telephonic interview approximately 9 and 12 months after the test. A hierarchical clustering analysis was performed, using Euclidean distance and Ward’s linkage. Clustering was performed in the 35 symptoms reported 9 and 12 months after the SARS-CoV-2 positive test and characterised considering age, sex, pre-existing health conditions and symptoms at time of SARS-CoV-2 infection.Results552 individuals were included at 9 months and 458 at 12 months. The median age was 52 years (IQR: 40–64 years) and 59% were female. Hypertension and high cholesterol were the most frequently reported pre-existing health conditions. Memory loss, fatigue or weakness and joint pain were the most frequent symptoms reported 9 and 12 months after the positive test. Four clusters were identified at both times: no or minor symptoms; multi-symptoms; joint pain; and neurocognitive-related symptoms. Clusters remained similar in both times, but, within the neurocognitive cluster, memory loss and concentration issues increased in frequency at 12 months. Multi-symptoms cluster had older people, more females and more pre-existing health conditions at 9 months. However, at 12 months, older people and those with more pre-existing health conditions were in joint pain cluster.ConclusionsOur results suggest that Long COVID is not the same for everyone. In our study, clusters remained similar at 9 and 12 months, except for a slight variation in the frequency of symptoms that composed each cluster. Understanding Long COVID clusters might help identify treatments for this condition. However, further validation of the observed clusters and analysis of its risk factors is needed.

Long COVID Cardiopulmonary Symptoms and Health Resort Treatment: A Retrospective Study.

Background/Objectives: Long COVID covers many cardio-pulmonary symptoms, worsening individuals' health status. Health resort treatment applies balneological factors, physical medicine modalities, climate actions, and exercises that may be beneficial for COVID-19 survivors. This study aimed to assess the severity of the cardiopulmonary symptoms in people qualified for health resort treatment and its efficacy in this group of patients. Methods: Medical records of 239 people attending health resort treatment were analysed. A total of 122 people (71 women and 51 men) with a mean age of 64.35 years ± 8.66 years were enrolled in the analysis. The cardiopulmonary symptoms of long COVID were assessed twice: before and after health resort treatment. Results: Persisting COVID-19 symptoms do not differentiate between women and men. Health resort treatment reduces symptoms severity in both sexes. Age does not mediate the efficacy of health resort treatment. Conclusions: The persistent symptoms of COVID-19 are of low intensity in people qualified for health resort treatment and are independent of gender. Health resort treatment effectively mitigates dyspnoea, tightness of chest, and sputum in long COVID patients, so it should be implemented into the standard treatment course for COVID-19 survivors as a continuation of therapy.

Retinal and Corneal OCT Results of Patients Hospitalized and Treated in the Acute Phase of COVID-19.

Objective: This study aimed to assess changes in the morphology of the retina and cornea in patients treated and hospitalized during the acute active phase of SARS-CoV-2 infection. Methods: A total of 24 patients with symptomatic early COVID-19 disease and 38 healthy participants from a control group were enrolled in our study. Among them, 20 received oxygen therapy at flow rates ranging from 1-10 L, while four received high-flow intranasal oxygen therapy (HFNOT). Some patients were treated with other types of therapy, such as Remdesivir, COVID-19 convalescent plasma therapy, or Tocilizumab. In the study, we focused on the analysis of optical coherence tomography (OCT) images of the cornea and retina including corneal thickness, central retinal thickness, retinal nerve fiber layer (RNFL), and optic disc parameters. The measurements were acquired using Spectral-domain OCT REVO FC 130. Results: The analysis did not show significant changes between the examined ophthalmological parameters before and after therapy. Furthermore, there were no detected significant differences between the tested parameters of the retina and cornea in COVID-19-positive patients compared to the control group. Conclusions: No ophthalmological manifestations of COVID-19 disease were observed during the study. Taking into account the results of other publications, the lack of an unambiguous position on this topic requires further research.

Creatine supplementation: facts and myths

Introduction: Creatine (N-methylguanidinoacetic acid) is a peptide built of three amino acids: glycine, arginine and methionine. Its function is to store energy. It is common practice to intake creatine as a dietary supplement. Because of that, we decided to try to answer the question if there are scientifically documented advantages of creatine supplementation. Review method: We analyzed the newest research conducted from 2017 to 2024. The studies were searched in online databases like PubMed and Google Scholar. We focused on the impact of creatine supplementation on the ageing population, professional athletes, the course of some diseases, cognitive functions and body composition Results: Creatine supplementation is beneficial in professional sports. There are some signals that creatine may worsen lung conditions in sportsmen. In the ageing population, creatine supplementation boosts the results of resistance training on ageing muscle performance. There are suggestions that in this population bone geometry changes due to a combination of training and creatine supplementation may be protective against hip fracture. Creatine can also enhance cognitive functions as well as lead to positive changes in body composition. Supplementation of creatine seems to reduce symptoms of long COVID-19. It may be also beneficial among children with dermatomyositis and patients with ischemic heart disease. Conclusions: Creatine supplementation may be beneficial in some populations. It can also enhance cognitive functions as well as lead to changes in body composition. Some effects of creatine supplementation are still controversial and further investigation is needed to determine its usefulness. Keywords: creatine, body composition, long COVID-19, ageing population, professional sport, cognitive functions, dermatomyositis, ischemic heart disease

Tracking temporal variations of fatality and symptomology correlated with COVID-19 dominant variants and vaccine effectiveness in the United States.

We described how COVID-19 fatality and symptoms varied by dominant variant and vaccination in the US. Using the Restricted Access Dataset from the US CDC (1/1/2020-10/20/2022), we conducted a cross-sectional study assessing differences in COVID-19 deaths, severity indicators (hospitalization, ICU, pneumonia, abnormal X-ray, acute respiratory distress syndrome, mechanical ventilation) and 12 mild symptoms by dominant variant/vaccination periods using logistic regression after controlling for confounders. We found the highest fatality during the dominant periods of Wild (4.6%) and Delta (3.4%). Most severe symptoms appeared when Delta was dominant (Rate range: 2.0-9.4%). Omicron was associated with higher mild symptoms than other variants. Vaccination showed consistent protection against death and severe symptoms for most variants (Risk Ratio range: 0.41-0.93). Boosters, especially the second, provided additional protection, reducing severe symptoms by over 50%. This dataset may serve as a useful tool to monitor temporospatial changes of fatality and symptom for case management and surveillance.

Long COVID or Post-Acute Sequelae of SARS-CoV-2 Infection (PASC) and the Urgent Need to Identify Diagnostic Biomarkers and Risk Factors.

Long COVID, or post-acute sequelae of SARS-CoV-2 infection (PASC), also known as post-COVID-19 condition or post-COVID syndrome, can affect anyone infected with SARS-CoV-2, regardless of age or the severity of the initial symptoms of COVID-19. Long COVID/PASC is the continuation or development of new symptoms after three months from the initial SARS-CoV-2 infection, which lasts for at least two months and has no other identifiable cause. Long COVID/PASC occurs in 10-20% of patients infected with SARS-CoV-2. The most common symptoms include fatigue, cognitive impairment (brain fog), and shortness of breath. However, more than 200 symptoms have been reported. No phenotypic or diagnostic biomarkers have been identified for developing long COVID/PASC, which is a multisystem disorder that can present with isolated or combined respiratory, hematological, immunological, cardiovascular, and neuropsychiatric symptoms. There is no cure. Therefore, individualized patient management requires a multidisciplinary clinical approach. Because millions of people have had and continue to have COVID-19, even in the era of vaccination and antiviral therapies, long COVID/PASC is now and will increasingly become a health and economic burden that the world must prepare for. Almost five years from the beginning of the COVID-19 pandemic, this article aims to review what is currently known about long COVID/PASC, the anticipated increasing global health burden, and why there is still an urgent need to identify diagnostic biomarkers and risk factors to improve prevention and treatment.

Can a Trusted Messenger Change Behavior When Information Is Plentiful? Evidence from the First Months of the COVID-19 Pandemic in West Bengal

Abstract Can information from a credible messenger shift behavior in an information-saturated environment? In a randomized controlled trial involving twenty-eight million individuals in West Bengal, we find that SMS-delivered video messages containing information about COVID-19 symptoms and health-preserving behaviors recorded by a credible messenger increased adherence to targeted and non-targeted preventive behaviors, measured by two objective measures (symptoms reported to a health worker, and phone usage at home), as well as self-reported behaviors. We find large spillovers onto non-targeted recipients. Credible light-touch messaging can play an important role in crisis response, even when similar information is widely available.

COVID-19’s effects on symptoms associated with benign prostatic hyperplasia

PurposeThe objective of this study was to identify the relationship between COVID-19 and lower urinary tract symptoms in patients with benign prostatic hyperplasia.Materials and methodsData from forty outpatients who had recovered from COVID-19 and had previously been diagnosed with and treated medically for benign prostatic hyperplasia were assessed. Pre- and post-COVID-19 assessments were also conducted for prostate volume, total serum PSA concentration, and lower urinary tract symptoms. Hospitalizations related to COVID-19, the time interval between COVID-19 recovery and urologist referrals, and comorbidities were considered. Independent Student’s t-tests or chi-square tests were used to compare changes in all variables. For the Spearman rank correlation analysis, only variables with a univariate analysis of p < 0.10 were included in the multiple regression models, with the significance threshold set at two-tailed p < 0.05.ResultsAfter COVID-19, there was an increase in IPSS (12.87 ± 3.76), total serum PSA (1.56 ± 0.87), and prostate volume (10.68 ± 11.73). Multiple linear regression analysis of the independent predictors of IPSS increase revealed pre-COVID-19 IPSS with intermittency and straining as leading symptoms and bladder catheterization during COVID-19. Pre-COVID-19 frequency and nocturia status were found to be independent predictors of increased blood volume, hospital treatment for COVID-19, and bladder catheterization. A weak stream, UTI, and hypertension were found to be independent predictors of a PSA increase. The time from COVID-19 recovery to urologist referral was shorter in patients with post-COVID-19 IPSS increase (p < 0.05).ConclusionDetermining the predictors of the effects of COVID-19 on worsening BPH symptoms is essential for continued monitoring and treatment.

Prevalence of symptoms of post-COVID-19 condition (long COVID) in children hospitalized with COVID-19: A systematic review of observational studies.

This systematic review aimed to investigate the prevalence of symptoms of post-COVID-19 condition (long COVID), in children hospitalized with COVID-19. We searched PUBMED and EMBASE on 15 March, 2023, using search strategy: "long COVID" OR "post-COVID-19" OR "postacute COVID-19" OR "long-term COVID" OR "COVID-19 sequelae" OR "persistent COVID-19" OR "chronic COVID-19". We included observational studies (case-control, cross-sectional, cohort, or case series) that investigated symptoms of post-COVID-19 condition (long COVID) in children (<18 years) admitted with COVID-19. We used the WHO case definition of post-COVID-19 condition. Long COVID was defined as persistence of otherwise unexplained symptoms for at least three months after SARS-CoV-2 infection. We used the command "metaprop" to perform random-effects meta-analysis. Eleven studies involving 2279 patients were included. In the period between ≥3 months and <12 months after acute COVID-19, the most frequent symptom was exercise intolerance with a pooled prevalence of 29% (95% CI: 7%-57%, I2 = 95%), followed by nonspecific respiratory symptoms (12%, 95% CI: 0%-48%, I2 = 0%), psychological disorders (10%, 95% CI: 1%-25%, I2 = 97%), and nonspecific gastrointestinal symptoms (10%, 95% CI: 0%-37%, I2 = 99%). In the period ≥12 months after the initial infection, the pooled prevalence of post COVID symptoms was lower, with 6% (95% CI: 2%-10%, I2 = 83%) for exercise intolerance and 3% (95% CI: 0%-8%, I2 = 89%) for fatigue. In conclusion, symptoms of post-COVID condition (long COVID) in hospitalized children affect multiple organ systems, with higher prevalence in the period up to 12 months after the acute phase of COVID-19.

Humoral response to anti SARS-CoV2 vaccination at one and seven months is not different in shift workers and non-shift workers

Since previous studies, mostly performed in healthy adults, show that sleep restriction around time of vaccination impairs antibody response and shift work affects sleep, aim of the study was to test the hypothesis that the antibody response to vaccination is impaired in shift workers, when compared to non-shift workers.Employees (n = 445; mean age 44 ± 11 years; 35 % men) of the Centro Cardiologico Monzino, IRCCS (Milan, Italy) were vaccinated against SARS-CoV2 in February 2021 with an mRNA-based vaccine. Antibody titers were assayed 1 and 7 months later. Differences between groups were assessed using ANOVA, after log-transformation of variables with right-skewed distribution.We report that the antibody titer was significantly higher in shift workers (33 % of employees) compared to non-shift workers at first assay [median (IQR): 2495 (1700; 4665) vs 2060 (1619; 2970) BAU/mL, p = 0.0123], as well as at the second one, and that this difference was abolished after adjustment for previous development of symptomatic COVID-19. Results were not affected by age or sex at birth.These results show that shift workers were able to mount an unimpaired antibody response to vaccination. Since vaccinations were performed during the pandemic urgency, our retrospective study has several limitations, nevertheless it underlines the need for large prospective, controlled studies on the effects of acute and chronic sleep restriction on response to vaccination in the general population and on the impact of shift work on immune response.

Tracking aspects of healthcare activity during the first nine months of COVID-19 in Ireland: a secondary analysis of publicly available data.

Sláintecare aims to introduce universal healthcare in Ireland. The COVID-19 pandemic poses both challenges and opportunities to this process. This study explored the impact of COVID-19 on aspects of Irish healthcare during the first nine months of the pandemic and considers the implications for Sláintecare implementation. Secondary analysis was undertaken on publicly available data on three key domains of the Irish healthcare system: primary care, community-based allied healthcare, and hospitals. Descriptive statistics were computed using Microsoft Excel 2016. Up to March 2021, 3.76 million COVID-19 tests were performed by Ireland's public healthcare system, 2.48 million (66.0%) of which were referred from the community. General practitioners delivered 2.31 million telephone triages of COVID-19 symptoms, peaking in December 2020 when 416,607 consultations occurred. Patient numbers across eight allied healthcare specialties fell by 35.1% versus previous years, with the greatest reductions seen in speech and language therapy (49.0%) and audiology (46.1%). Hospital waiting lists increased from 729,937 to 869,676 (or by 19.1%) from January 2019 to January 2021. In January 2021, 629,919 patients awaited a first outpatient clinic appointment, with 170,983 (27.1%) waiting longer than 18 months. The largest outpatient lists were observed in orthopaedic surgery (n=77,257); ear, nose and throat surgery (n=68,073); and ophthalmology (n=47,075). The proportion of patients waiting more than 12 months for a day-case gastrointestinal endoscopy rose from 6.0% in January 2020 to 19.0% in January 2021. Healthcare activity has been significantly disrupted by COVID-19, leading to increased wait times and greater barriers to healthcare access during the pandemic. Yet, Ireland's health system responses also revealed strong willingness and ability to adapt and to implement novel solutions for healthcare delivery, rapidly and at scale. This has demonstrated what is achievable under Sláintecare and provides a unique opportunity to 'build back better' towards sustainable recovery.

Corrigendum to “Composition decipherment of Ficus pumila var. awkeotsang and its potential on COVID-19 symptom amelioration and in silico prediction of SARS-CoV-2 interference.”

Corrigendum to “Composition decipherment of Ficus pumila var. awkeotsang and its potential on COVID-19 symptom amelioration and in silico prediction of SARS-CoV-2 interference.”

A - 23 Duration of COVID-19 Predicts Reports of Cognitive Symptoms

Abstract Objective Most individuals recover from COVID-19 within a few weeks; however, some develop chronic symptoms. COVID-19 can affect the brain, and some patients report cognitive issues. Symptom chronicity may be associated with a greater rate of cognitive complaints. This study examined the relationship between COVID-19 symptom duration and reported cognitive problems. Method An archival database was used for this study’s data analyses. United States residents were recruited through Qualtrics and surveyed on their COVID-19 experiences (N = 1918). 173 participants (42% female, 82% Caucasian/White) who reported active COVID-19 symptoms when completing the survey were included in the data analyses. Participants answered how long they had experienced COVID-19 symptoms (ordinal variable with seven levels) and a checklist of the symptoms they experienced, including five cognitive symptoms. Items were “Brain/mind fog,” “Difficulty Concentrating,” “Forgetfulness,” “Word finding problems,” and “Confusion.” Results Five logistic regressions were conducted with symptom duration as the predictor variable and reported cognitive symptoms as the dependent variables. COVID-19 symptom duration significantly predicted all self-reported cognitive issues. Symptom duration most strongly predicted forgetfulness, B = 0.39, SE = 0.11, Wald = 13.71, p &amp;lt; 0.001. The probability of reporting forgetfulness increased by 47% (Exp(B) = 1.47, 95%CI[1.20, 1.81]) per unit increase in symptom duration. Conclusions These results suggest that a longer duration of COVID-19 symptoms predicts cognitive complaints. As this is a cross-sectional database, directionality cannot be determined. Cognitive effects could derive from chronic illness or to other physiological and psychological changes in chronic COVID. Both possibilities imply that healthcare providers should consider cognitive symptoms when evaluating complaints of chronic COVID-19 patients.

Early, robust mucosal secretory IgA but not IgG response to SARS-CoV-2 spike in oral fluid is associated with faster viral clearance and COVID-19 symptom resolution.

High priority efforts are underway to support the development of novel mucosal COVID-19 vaccines, such as the US Government's Project NextGen and the Center for Epidemic Preparedness Innovations' goal to respond to the next pandemic with a new vaccine in 100 days. However, there is limited consensus about the complementary role of mucosal immunity in disease progression and how to evaluate immunogenicity of mucosal vaccines. This study investigated the role of oral mucosal antibody responses in viral clearance and COVID-19 symptom duration. Participants with PCR-confirmed SARS-CoV-2 infection provided oral fluid for testing with SARS-CoV-2 antibody multiplex assays, nasal swabs for RT-PCR and symptom information at up to eight follow-ups from April 2020 to February 2022. High and moderate oral fluid anti-spike (S) secretory IgA (SIgA) post infection was associated with significantly faster viral clearance and symptom resolution across age groups with effect sizes equivalent to having COVID-19 vaccine immunity at the time of infection. Those with high and moderate anti-S SIgA cleared the virus 14 days (95% CI: 10-18) and recovered 9-10 days (95% CI: 6-14) earlier. Delayed and higher anti-S IgG was associated with significantly longer time to clearance and recovery. Experiencing symptoms longer than four weeks was associated with lower anti-RBD SIgA 15-30 days after infection onset (p<0.001). Robust mucosal SIgA early post infection appears to support faster clearance of SARS-CoV-2 and recovery from COVID-19 symptoms. This research underscores the importance of harmonizing mucosal immune response assays to evaluate new mucosal vaccines.

The Long Haul to Surgery: Long COVID Has Minimal Burden on Surgical Departments.

Many patients infected with the SARS-CoV-2 virus (COVID-19) continue to experience symptoms for weeks to years as sequelae of the initial infection, referred to as "Long COVID". Although many studies have described the incidence and symptomatology of Long COVID, there are little data reporting the potential burden of Long COVID on surgical departments. A previously constructed database of survey respondents who tested positive for COVID-19 was queried, identifying patients reporting experiencing symptoms consistent with Long COVID. Additional chart review determined whether respondents had a surgical or non-routine invasive procedure on or following the date of survey completion. Outcomes from surgeries on patients reporting Long COVID symptoms were compared to those from asymptomatic patients. A total of 17.4% of respondents had surgery or a non-routine invasive procedure in the study period. A total of 48.8% of these patients reported experiencing symptoms consistent with Long COVID. No statistically significant differences in surgical outcomes were found between groups. The results of this analysis demonstrate that Long COVID does not appear to have created a significant burden of surgical disease processes on the healthcare system despite the wide range of chronic symptoms and increased healthcare utilization by this population. This knowledge can help guide surgical operational resource allocation as a result of the pandemic and its longer-term sequelae.

Prevalence and factors influencing long COVID among primary healthcare workers after epidemic control policy adjustment in Jiangsu, China

ObjectiveThe persistent symptoms arising from COVID-19 infection pose a substantial threat to patients’ health, carrying significant implications. Amidst the evolving COVID-19 control strategies in China, healthcare workers (HCWs) endure considerable stress. This study aims to evaluate the prevalence of long COVID infections and their influencing factors among primary HCWs after epidemic control policy adjustment in Jiangsu.MethodsA self-designed questionnaire was administered through on-site surveys among primary HCWs in five counties and districts within Jiangsu Province from July 4 to July 20, 2023. Logistic regression analysis was employed to identify factors associated with long COVID.ResultsThe prevalence of long COVID among primary HCWs stood at 12.61%, with a 95% confidence interval (CI) of 11.67-13.55%. Among those affected, the most common long COVID symptoms were hypomnesia (4.90%, 95%CI: 4.29-5.51%), sleep difficulties (2.73%, 95%CI: 2.27-3.19%), fatigue (2.35%, 95%CI: 1.92-2.78%), disturbances in the reproductive system (1.93%, 95%CI: 1.54-2.32%), hair loss (1.85%, 95%CI: 1.47-2.23%), and myalgia/arthralgia (1.51%, 95%CI: 1.16-1.86%). Multivariate logistic regression revealed that older age groups (30–45 years (adjusted odds ratio (aOR) = 1.93, 95%CI: 1.44–2.58), 45–60 years (aOR = 2.82, 95%CI: 2.07–3.84)), females (aOR = 1.26, 95%CI: 1.03–1.55), and higher work stress (high stress (aOR = 1.52, 95%CI: 1.24–1.86), extremely high stress (aOR = 1.37, 95%CI: 1.03–1.82)) were more prone to long COVID. Conversely, individuals with educational attainment below the bachelor’s degree (aOR = 0.67, 95%CI: 0.55–0.82) and those who received four or more doses of the COVID-19 vaccine (aOR = 0.55, 95%CI: 0.33–0.92) were at a reduced risk.ConclusionThis study investigates the prevalence of long COVID among primary HCWs and identifies key influencing factors. These findings are crucial for assisting in the early identification of COVID-19 patients at risk for long-term complications, developing targeted interventions aimed at optimizing healthcare resource allocation and enhancing the work conditions and quality of life of HCWs. To mitigate the prevalence of long COVID, healthcare providers and local authorities should implement effective measures, such as optimizing work-rest schedules and actively advocating for vaccination.