Risk Factors For COVID-19 Research Articles

Does Pre-existing Diabetes Correlate with Long COVID-19 in Europe? Evidence from the Analysis of the Survey of Health, Ageing and Retirement in Europe's Corona Surveys.

A substantial proportion of those infected with COVID-19 are presenting with persistent symptoms, referred to as long COVID-19. Emerging evidence suggests that the presence of pre-existing chronic conditions, such as diabetes, may increase the risk of long COVID-19. To investigate whether having pre-existing diabetes increases the risk of developing long COVID-19 in the population of middle-aged and older adults (≥50 years old) in Europe, while assessing if this relationship can be accounted for or is modified by the known long COVID-19 and diabetes risk factors (age, sex, hospitalization, pre-existing hypertension, and weight status). A population-based longitudinal prospective study involving a sample of respondents aged 50 years and older (n = 4,004) with probable or confirmed COVID-19 infection from 27 countries that participated in both waves 7 and 8 of the Survey of Health, Ageing and Retirement in Europe and its 2020 and 2021 Corona Surveys. Logistic regression modeling was performed. Overall, 66.8% of the respondents affected by COVID-19 infection reported at least one long COVID-19 symptom; 55.2% were female, and the average age was 64.6 years; 13.2% had pre-existing diabetes. Respondents with pre-existing diabetes had significantly higher odds of developing long COVID-19, compared to those without diabetes (OR = 1.37; 95% CI = 1.12, 1.68). This relationship remained significant (OR = 2.00; 98% CI = 0.25, 1.14) after adjusting for sex (OR = 1.64 for females; 95% CI = 1.43, 1.88), hospitalization for COVID-19 illness (OR = 3.19; 95% CI = 2.41, 4.23), pre-existing hypertension (OR = 1.17; 95% CI = 1.01, 1.36), and overweight (OR = 1.31; 95% CI = 1.11, 1.56) and obese (OR = 1.77; 95% CI = 1.44, 2.19) weight status. The effect of pre-existing diabetes on the risk of long COVID-19 is moderated by age; it was highest at the age of 50 (OR = 2.00; 95% CI = 1.28, 3.14), and then, it declined with age. There is a relationship between pre-existing diabetes and long COVID-19, even after controlling for literature-based confounding factors, with age having a moderating effect on this relationship.

Conjecturing-Based Discovery of Patterns in Data

We propose the use of a conjecturing machine that suggests feature relationships in the form of bounds involving nonlinear terms for numerical features and Boolean expressions for categorical features. The proposed Conjecturing framework recovers known nonlinear and Boolean relationships among features from data. In both settings, true underlying relationships are revealed. We then compare the method to a previously proposed framework for symbolic regression on the ability to recover equations that are satisfied among features in a data set. The framework is then applied to patient-level data regarding COVID-19 outcomes to suggest possible risk factors that are confirmed in the medical literature. Discovering patterns in data is a first step toward establishing causal relationships, which can be the basis for effective decision making. Data Ethics & Reproducibility Note: Code and data to reproduce results are available here: https://github.com/jpbrooks/conjecturing . COVID-19 synthetic patient data were obtained as part of the Veterans Health Administration (VHA) Innovation Ecosystem and precisionFDA COVID-19 Risk Factor Modeling Challenge and are used here with permission from the Food and Drug Administration (FDA). The e-companion is available at https://doi.org/10.1287/ijds.2021.0043 . History: Olivia Sheng served as the senior editor for this article.

Effect of inactivated vaccine boosters against severe and critical COVID-19 during the Omicron BA.5 wave: A retrospective analysis of hospitalized patients in China.

Few real-world analyses of the ability of vaccines to protect against severe COVID-19 have been published. In this real-world study, we compared the prevalence of severe or critical COVID-19 between patients at our hospital who were not vaccinated against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or who had been vaccinated partial, full, or booster course with the CoronaVac, containing inactivated virus propagated in Vero cells. Data from electronic health records were retrospectively analyzed for 4090 inpatients with COVID-19 who were treated at West China Hospital, Chengdu between December 6, 2022 and February 14, 2023. Clinicodemographic characteristics and COVID-19 severity were compared among patients who had been vaccinated 0, 1, 2 or more times with inactivated vaccine CoronaVac. To evaluate vaccine effectiveness over time, we plotted Kaplan-Meier curves with the percentage of patients with the outcome of severe or critical COVID-19 from the time of their last vaccine dose according to vaccination status. Ordinal logistic regression was used to assess associations between vaccination status and COVID-19 severity. Cox regression was used to identify risk factors for severe or critical COVID-19. Among the 4090 patients, 171 had been vaccinated partial and 423 twice with the full CoronaVac regimens, while 905 had been vaccinated three times (boosted). The prevalence of severe or critical COVID-19 among patients was 11 percentage points lower among those vaccinated (40%) at least twice than among those unvaccinated (51%) (p＜0.001), while it was 10% points lower among those who had received a booster (41%) than among those unvaccinated (51%) (p＜0.001). Protection against severe or critical COVID-19 due to vaccination was significantly weakened by being older than 65 years, being male, or having diabetes, chronic heart disease, autoimmune disease, or chronic lung disease. Completing a full course of immunization with inactivated vaccine CoronaVac against SARS-CoV-2 can reduce the risk of severe or critical COVID-19 due to the Omicron BA.5 subvariant.

No causal association between atopic dermatitis and COVID-19 outcomes: A Mendelian randomization study.

Frequent hand washing and disinfection during the corona virus disease (COVID-19) pandemic may lead to skin-related disability. The causal relationship between atopic dermatitis (AD), the most common chronic, noninfectious, inflammatory skin disease, and COVID-19 remains unclear. We used Mendelian randomization (MR) to explore the causal inference of atopic dermatitis with COVID-19 outcomes. Genome-wide association study (GWAS) data for AD, consisting of 8383 cases and 236,162 controls of European ethnicity, were provided by the FinnGen database. The GWAS outcome data were derived from the COVID-19 Host Genetics Initiative and consisted of COVID-19 susceptibility (122,616 cases and 2,475,240 controls), hospitalization (32,519 cases and 2,062,805 controls), and very severe respiratory disease (13,769 cases and 1,072,442 controls). The inverse variance weighted with a fixed effects model (IVW (fe)) was used as the main statistical approach to assess the causality between AD and COVID-19 in this study. Several other analytical methods have also been used to complement or identify pleiotropy and heterogeneity. MR analysis showed no causality between AD and COVID-19 outcomes. The odds ratios (OR) were 1.00 (95% confidence interval (CI), 0.99-1.02) for susceptibility, 1.00 (95% CI, 0.96-1.04) for hospitalization, 0.97 (95% CI, 0.92-1.03) for very severe respiratory disease by the method of IVW (fe). In conclusion, we found no causal relationship between AD and COVID-19 outcomes. This study provides additional ideas for the exploration of the risk factors for COVID-19.

Research on COVID-19 pandemic's clinical features and risk factors for long-term hospitalizations

The authors of this study were interested in learning more about the clinical aspects of COVID-19 and risk factors associated with in-hospital mortality among older patients in hospitals due to the established association between advanced age and poor prognosis. This nationwide, multicenter, retrospective, observational study comprised patients aged 80 and up hospitalized during the COVID-19 pandemic. There had been no previous evaluation of reliance and mortality in COVID-19 pandemic patients over the age of 65, but this study indicated that it was an independent predictor. Despite greater rates of severe reliance among individuals residing in nursing homes, the study found that survival rates for the elderly in these settings were comparable to those of the elderly in their own homes. This study emphasizes the necessity of assessing the functional state of very elderly hospitalized patients having the COVID-19 pandemic and sheds light on the risk variables associated with death in this population.

Cognitive reappraisal moderates the protective effect of body satisfaction on mental health and wellbeing in adults: A prospective study during COVID-19 lockdown

BackgroundBody satisfaction is associated with mental health and well-being in adults. However, prospective studies are needed to better understand its protective effects, and in whom these are most beneficial. This study investigated body satisfaction as a predictor of depressive symptoms, generalised anxiety, and well-being in a representative Australian sample collected during the initial COVID-19 lockdown. Two emotion regulation strategies – cognitive reappraisal and expressive suppression – were also tested as moderating variables. MethodsThe sample comprised 684 adults aged 19 to 87 years who completed three primary waves of data spanning two months [Wave 3 (W3), W4 and W7] from the Australian National COVID-19 Mental Health, Behaviour and Risk Communication Survey. ResultsHierarchical multiple regression models controlling for demographic and COVID-19 risk factors, as well as W3 for each outcome variable, indicated that W3 body satisfaction predicted greater W7 well-being, and fewer W7 depressive symptoms and greater W7 well-being in participants reporting low levels of W4 cognitive reappraisal. No moderation for W4 expressive suppression was observed, nor predictive relationships between W3 body satisfaction and W7 anxiety. LimitationsThe two-month follow-up period precludes conclusions relating to the longer-term protective effects of body satisfaction within and beyond the pandemic context. Examination of focal relationships in clinical samples, and inclusion of broader indices of body image, emotion regulation and mental health, is needed in future studies. ConclusionsFindings suggest body satisfaction warrants attention in community well-being promotion in adults, and may be particularly beneficial for those lack adaptive emotion regulation strategies.

Covid-19 disease burden, vaccine uptake, and workplace disease prevention efforts in temporary agricultural workers in the US

Objective. To compare Covid-19 risk factors, self-reported Covid-19 testing and infection, and Covid-19 vaccination among H-2A workers and agricultural workers without H-2A visas. Materials and methods. Farmworkers completed surveys at randomly selected sites in five U.S. states from March – August 2022. Descriptive statistics and bivariate analyses were conducted for key characteristics and outcomes. Results. A total of 532 H-2A workers and 748 non-H-2A workers participated in the surveys. H-2A workers had significantly higher Covid-19 primary vaccine series uptake than non-H-2A workers (94.7 vs. 65.9%). More than one in four H-2A workers (29.6%) continued working while ill or positive with Covid-19. Fewer H-2A than non-H-2A workers reported receiving a Covid-19 test (51.5 vs. 59.2%, respectively) and a positive test result for Covid-19 (24.5 vs. 44.9% among those tested). Conclusions. Although H-2A workers had a lower self-reported prevalence of Covid-19 and higher Covid-19 primary vaccine series uptake than non-H-2A workers, findings such as reporting to work while ill or positive for Covid-19 indicate areas for improvement by binational public health leaders.

Exploring the Knowledge Structure and Trends for Severe COVID-19 Risk Factors Using Text Network Analysis.

This study was aimed to identify knowledge structure and trends in severe COVID-19 risk factor using text network analysis. The 22,628 papers published during from January 2020 to December 2021. We analyzed and visualized using Text Rank analyzer and Gephi software. They were grouped into 5 central themes - biomedical factors, occupational environmental factors, demographic factors, health behavior factors, and complications. The emerging topics were identified to the chronological trends. This study can promote a systematic understanding of severe COVID-19 risk factors.

Vitamin D Supplementation and Prior Oral Poliovirus Vaccination Decrease Odds of COVID-19 Outcomes among Adults Recently Inoculated with Inactivated Poliovirus Vaccine.

Structural and functional commonalities between poliovirus and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) suggest that poliovirus inoculation may induce antibodies that mitigate the coronavirus disease (COVID-19). No known studies have evaluated COVID-19 risk factors in adults recently vaccinated against poliovirus. Among adults with no history of COVID-19 infection or vaccination, who recently received an inactivated poliovirus vaccine (IPV), we sought to determine which biological factors and social determinants of health (SDOH) may be associated with (1) testing positive for SARS-CoV-2, (2) experiencing COVID-19 symptoms, and (3) a longer duration of COVID-19 symptoms. The influence of biological factors and SDOH on SARS-CoV-2 infection and COVID-19 symptoms were evaluated among 282 adults recently inoculated with IPV. Participant-reported surveys were analyzed over 12 months post-enrollment. Bivariate and multivariate linear and logistic regression models identified associations between variables and COVID-19 outcomes. Adjusting for COVID-19 vaccinations, variants, and other SDOH, secondary analyses revealed that underlying conditions, employment, vitamin D, education, and the oral poliovirus vaccination (OPV) were associated with COVID-19 outcomes. The odds of testing positive for SARS-CoV-2 and experiencing symptoms were significantly reduced among participants who took vitamin D (OR 0.12 and OR 0.09, respectively). Unemployed or part-time working participants were 72% less likely to test positive compared with full-time workers. No prior dose of OPV was one of the strongest predictors of SARS-CoV-2 infection (OR 4.36) and COVID-19 symptoms (OR 6.95). Findings suggest that prophylactic measures and mucosal immunity may mitigate the risk and severity of COVID-19 outcomes. Larger-scale studies may inform future policies.

Genetic association of ACE2 and TMPRSS2 polymorphisms with COVID-19 severity; a single centre study from Egypt

BackgroundSince the emergence of the COVID-19 infection in China, it has caused considerable morbidity, mortality, and economic burden. It causes the vast majority of clinical manifestations, ranging from mild or even no symptoms to severe respiratory failure. There are many risk factors for severe COVID-19, such as old age, male gender, and associated comorbidities. A major role for genetic factors may exist. The SARS-CoV-2 virus enters the cell primarily through ACE2 receptors. rs2285666 is one of many polymorphisms found in the ACE2 receptor gene. To enable endosome-independent entry into target cells, the transmembrane protease serine-type 2 (TMPRSS2) is necessary to cleave the virus’ spike (S) glycoprotein. TMPRSS2 is characterized by an androgen receptor element. The rs12329760 polymorphism in TMPRSS2 may explain different genetic susceptibilities to COVID-19.MethodThis cross-sectional study was held in Mansoura University Hospitals during the period from June 2020 to April 2022 on patients who had mild and severe COVID-19. Demographic, clinical, and laboratory data were collected, and the TaqMan real-time polymerase chain was used for allelic discrimination in the genotyping of rs2285666 and rs12329760.ResultsThis study included 317 Egyptian patients, aged from 0.2 to 87 years. Males were 146, while females were 171. They were divided into mild and severe groups (91 and 226 patients, respectively) based on their clinical symptoms. There was a significant association between COVID-19 severity and male gender, hypertension, diabetes mellitus, and high CRP. The genotype and allele frequency distributions of the ACE2 rs2285666 polymorphism showed no significant association with the severity of COVID-19 in both. In contrast, in TMPRSS2 rs12329760 minor T allele and CT, TT genotypes were significantly associated with a reduced likelihood of developing severe COVID-19.ConclusionOur study indicates that the ACE2 rs2285666 polymorphism is not related to the severity of COVID-19, whether genotypes or alleles. In TMPRSS2 rs12329760, the dominant model and T allele showed significantly lower frequencies in severe cases, with a protective effect against severity. The discrepancies with previous results may be due to variations in other ACE2 receptor-related genes, inflammatory mediators, and coagulation indicators. Haplotype blocks and differences in racial makeup must be taken into consideration. Future research should be done to clarify how ethnicity affects these polymorphisms and how other comorbidities combine to have an additive effect.

Association of empirically derived dietary patterns and COVID-19 among adults in Iran

Purpose The COVID-19 pandemic has caused significant mortality and morbidity worldwide. However, the role of dietary patterns as a potential risk factor for COVID-19 has not been well established, especially in studies with large samples. Therefore, this study aims to identify and evaluate the association between major dietary patterns and COVID-19 among adults from Iran. Design/methodology/approach In this cross-sectional study, the authors included 9,189 participants aged 20–70 who participated in the Yazd Health Study (YaHS) and Taghzieh Mardom-e-Yazd study (TAMIZ). They used factor analysis to extract dietary patterns based on a food frequency questionnaire (FFQ). Then, they assessed the relationship between these dietary patterns and the odds of COVID-19. Findings This study identified two major dietary patterns: “high protein and high fiber” and “transitional”. Participants in the highest tertile of the “high protein and high fiber” dietary pattern, which included vegetables, fruits, dairy and various kinds of meats such as red meat, fish and poultry, had a lower odds of COVID-19 compared with those in the lowest tertile. However, the “transitional” dietary pattern did not affect the risk of COVID-19. Originality/value In conclusion, a “high protein, high fiber” diet may lower the odds of COVID-19. This study suggests that dietary patterns may influence the severity and spread of future similar pandemics.

Incidence and risk factors of COVID-19 in a tertiary hospital and the effectiveness of booster vaccination among health care workers: A retrospective cohort study, January 2020 to June 2022

Health care workers (HCWs) face a higher risk of infection and may transmit pathogens to patients during a pandemic. This study aims to evaluate infection-control measures by analyzing the incidence and risk factors of COVID-19 and estimating vaccine effectiveness (VE) at a tertiary hospital in Seoul, Republic of Korea. This study included 2,516 HCWs from January 1, 2020, to June 30, 2022. Data were analyzed to determine the incidence density and cumulative incidence; the results were compared by the age- and gender-specific standardized incidence ratios (SIR). VE was estimated with multivariate Cox proportional-hazard models as 1-adjusted hazard ratio×100%. SIR indicated a lower COVID-19 risk in the hospital population than in the general Korean population (SIR, 0.81; 95% confidence interval [CI]: 0.76-0.87). Multivariate Cox analysis indicated that, compared to doctors, nonmedical service supporters and other HCWs (excluding doctors and nurses) were high-risk groups (adjusted hazard ratio [95% CI], 1.72 [1.04-2.83] and 1.76 [1.20-2.58], respectively). Compared to the outpatient unit, the emergency department was a high-risk department (1.70 [1.16-2.50]). The VE of the booster dose was 55.47%, compared to no or incomplete vaccination (95% CI: 22.63-74.37). Besides encouraging HCWs vaccination, effective infection-control measures should target high-risk groups and departments.

The impact of obesity in hospitalized patients with COVID-19: a retrospective cohort study

BackgroundObesity is believed to be a risk factor for COVID-19 and unfavorable outcomes, although data on this remains to be better elucidated.ObjectiveTo evaluate the impact of obesity on the endpoints of patients hospitalized due to SARS-CoV-2.MethodsThis retrospective cohort study evaluated patients hospitalized at a tertiary hospital (Hospital das Clínicas da Faculdade de Medicina da USP) from March to December 2020. Only patients positive for COVID-19 (real-time PCR or serology) were included. Data were collected from medical records and included clinical and demographic information, weight and height, SAPS-3 score, comorbidities, and patient-centered outcomes (mortality, and need for mechanical ventilation, renal replacement therapy, or vasoactive drugs). Patients were divided into categories according to their BMI (underweight, eutrophic, overweight and obesity) for comparison porpoise.ResultsA total of 2547 patients were included. The mean age was 60.3 years, 56.2% were men, 65.2% were white and the mean BMI was 28.1 kg/m2. SAPS-3 score was a risk factor for all patient-centered outcomes (HR 1.032 for mortality, OR 1.03 for dialysis, OR 1.07 for vasoactive drug use, and OR 1.08 for intubation, p < 0.05). Male sex increased the risk of death (HR 1.175, p = 0.027) and dialysis (OR 1.64, p < 0.001), and underweight was protective for vasoactive drug use (OR 0.45, p = 0.027) and intubation (OR 0.31, p < 0.003).ConclusionObesity itself was not an independent factor for worse patient-centered outcomes. Critical clinical state (indirectly evaluated by SAPS-3) appears to be the most important variable related to hard outcomes in patients infected with COVID-19.

Evaluation of Genetic or Cellular Impairments in Type I IFN Immunity in a Cohort of Young Adults with Critical COVID-19

Several genetic and immunological risk factors for severe COVID-19 have been identified, with monogenic conditions relating to 13 genes of type I interferon (IFN) immunity proposed to explain 4.8% of critical cases. However, previous cohorts have been clinically heterogeneous and were not subjected to thorough genetic and immunological analyses. We therefore aimed to systematically investigate the prevalence of rare genetic variants causing inborn errors of immunity (IEI) and functionally interrogate the type I IFN pathway in young adults that suffered from critical COVID-19 yet lacked comorbidities. We selected and clinically characterized a cohort of 38 previously healthy individuals under 50 years of age who were treated in intensive care units due to critical COVID-19. Blood samples were collected after convalescence. Two patients had IFN-α autoantibodies. Genome sequencing revealed very rare variants in the type I IFN pathway in 31.6% of the patients, which was similar to controls. Analyses of cryopreserved leukocytes did not indicate any defect in plasmacytoid dendritic cell sensing of TLR7 and TLR9 agonists in patients carrying variants in these pathways. However, lymphocyte STAT phosphorylation and protein upregulation upon IFN-α stimulation revealed three possible cases of impaired type I IFN signaling in carriers of rare variants. Together, our results suggest a strategy of functional screening followed by genome analyses and biochemical validation to uncover undiagnosed causes of critical COVID-19.

Characteristics of Elderly-Onset Rheumatoid Arthritis Patients With COVID-19

Abstract This study aimed to investigate the clinical characteristics of elderly-onset rheumatoid arthritis (EORA) patients with COVID-19. We retrospectively enrolled EORA patients diagnosed with COVID-19 from December 2022 through February 2023 and followed them up. Demographic characteristics of the patients and clinical data on COVID-19 were collected, and EORA-related data at the onset of rheumatoid arthritis and during COVID-19 episodes were evaluated. A total of 102 EORA outpatients were enrolled and stratified into the COVID-19 group (n = 60) and the non–COVID-19 group (n = 42). In the COVID-19 group, 56 (93.3%) had symptoms, 8 (13.3%) had viral pneumonia, and 4 (6.7%) developed severe COVID-19. Multivariate logistic regression analysis showed that lack of COVID-19 vaccination (P = 0.016 and P = 0.030, respectively) and having interstitial lung disease (P = 0.013 and P = 0.001, respectively) were independent risk factors for viral pneumonia and severe COVID-19. Compared with the general population, EORA patients did not show significantly higher susceptibility to COVID-19 or a higher risk of severe COVID-19. However, EORA patients with interstitial lung disease require special consideration during COVID-19 episodes.

COVID-19 in patients with acute leukemia: 3 years' experience of pandemic

Patients with acute leukemia are one of the most vulnerable risk groups for infection with SARS-CoV-2 and severe course of coronavirus infection. During the first 2 years of the pandemic, the mortality rate of patients with acute leukemia was 11-48 %, depending on leukemia type, and only reached population levels in 2022. Risk factors for severe COVID-19 in patients with acute leukemia are old age, concomitant cardiac pathology, metabolic syndrome, and the absence of acute leukemia remission. Chemotherapy administered one month before hospitalization with COVID-19 diagnosis showed statistical significance in influencing hospital mortality only in the group of patients with acute myeloid leukemia. Despite this, the international medical community has recommended delaying the start of chemotherapy until clinical symptoms of coronavirus infection have completely resolved and a negative test result for SARS-CoV-2 has been obtained for all types of leukemia. Currently, the most optimal tactic is to prevent SARS-CoV-2 infection by vaccinating patients with acute leukemia receiving antitumor treatment. If the immunological response to vaccination is insufficient, it is possible to use virus-neutralizing monoclonal antibodies as a safe and effective method of primary prevention of COVID-19.

Exploring Paxlovid Efficacy in COVID-19 Patients with MAFLD: Insights from a Single-Center Prospective Cohort Study.

This study investigates the intricate interplay between Metabolic-associated Fatty Liver Disease (MAFLD) and COVID-19, exploring the impact of MAFLD on disease severity, outcomes, and the efficacy of the antiviral agent Paxlovid (nirmatrelvir/ritonavir). MAFLD, affecting a quarter of the global population, emerges as a potential risk factor for severe COVID-19, yet the underlying pathophysiological mechanisms remain elusive. This study focuses on the clinical significance of Paxlovid, the first orally bioavailable antiviral agent granted Emergency Use Authorization in the United States. Notably, outcomes from phase II/III trials exhibit an 88% relative risk reduction in COVID-19-associated hospitalization or mortality among high-risk patients. Despite conflicting data on the association between MAFLD and COVID-19 severity, this research strives to bridge the gap by evaluating the effectiveness of Paxlovid in MAFLD patients with COVID-19, addressing the scarcity of relevant studies.

Socioeconomic and Health Determinants of the Prevalence of COVID-19 in a Population of Children with Respiratory Diseases and Symptoms.

Most epidemiological studies indicate that bronchial asthma is not a risk factor for COVID-19, but previous analyses have not additionally focused on the socioeconomic determinants of SARS-CoV-2 infection in children with asthma, bronchitis, and respiratory symptoms. This research aimed to investigate the correlation between the socioeconomic status of families and the prevalence of respiratory conditions such as asthma, bronchitis, and respiratory symptoms in children, in addition to exploring their association with the prevalence of COVID-19. The study involved a cross-sectional epidemiological investigation conducted in 2022, encompassing 2454 students from elementary schools in Poland. The parents of the students completed a questionnaire modeled after the International Study on Asthma and Allergies in Childhood (ISAAC). Socioeconomic status (SES) indicators were determined based on parental education, self-reported economic status, and housing conditions. To assess the impact of social factors and health on the occurrence of COVID-19, odds ratios (ORs) were calculated. The findings revealed several COVID-19 risk factors, including higher maternal (OR 2.2; 95%CI: 1.3-3.0) and paternal education (OR 1.9; 95%CI: 1.3-2.4), urban residence (OR 1.7; 95%CI: 1.3-2.1), the presence of mold in residences (OR 1.7; 95%CI: 1.0-2.3), bronchitis (OR 1.5; 95%CI: 1.2-2.0), and chronic cough (OR 1.8; 95%CI: 1.3-2.4). Further analysis, stratifying children based on their baseline health status (i.e., presence or absence of asthma, bronchitis, and chronic cough), indicated that higher parental education increased the risk of COVID-19 solely for children without pre-existing conditions. The occurrence of SARS-CoV-2 infections was found to be notably associated with mold exposure in children who did not have bronchial asthma. Rigorous multivariate analyses substantiated the collective impact of factors such as residential environment, the existence of mold and moisture, and a history of bronchitis. This study's conclusions highlight a higher frequency of SARS-CoV-2 infections in cases where bronchitis had been diagnosed previously and chronic cough was prevalent. Interestingly, the initially hypothesized higher prevalence of COVID-19 among children with bronchial asthma did not receive confirmation in our findings. This study highlights the importance of urban residence, exposure to mold or dampness, and higher parental education in the incidence of COVID-19. Higher parental education was a significant factor in increasing the risk of COVID-19 among children without bronchitis, chronic cough, and asthma.

COVID-19 infection characteristics, risk factors and its potential impacts on Takayasu arteritis: a web-based survey in a large cohort.

To investigate the characteristics of COVID-19 and its impact on patients with Takayasu's arteritis (TAK). A web-based survey was administered to a TAK cohort and their co-residents in China during January 2023. Infection symptoms, post-acute sequelae of COVID-19 (PASC), potential impacts of COVID-19 on patients' disease condition, treatment and immune-related parameters were analyzed. In addition, risk factors for COVID-19 and disease relapse after infection were explored. The infection rate was significantly lower in patients with TAK than in co-residents (79.13% vs 90.67%, p=0.025). TAK patients were more prone to gastrointestinal symptoms (17.78% vs 5.88%, p=0.024), sleep problems (25.15% vs 10.29%, p=0.011), and symptoms involving more than 2 organs (58.90% vs 35.29%, p=0.001) after infection. Although only 2.45% of TAK patients were hospitalized and none progressed to life-threatening conditions, they were more likely to suffer from PASC (26.38% vs 13.24%, p=0.029), especially active patients. Active disease after the pandemic was significantly lower in infected patients than uninfected patients (21/163, 12.88% vs. 11/43, 25.58%, p=0.041). The presence of multiple system symptoms was a risk factor for active TAK after infection [OR: 3.62 (95% CI 1.06-12.31), p=0.040]. Moreover, csDMARDs treatment was a risk factor for COVID-19 infection [OR: 3.68 (95% CI 1.56-8.66), p=0.002]. Although TAK patients with COVID-19 have more acute and post-acute symptoms, there is no adverse outcome and the risk of disease relapse does not increase. Patients treated with csDMARDs may be at higher risk of infection and deserve more clinical attention.

Educational Intervention to Increase COVID-19 Vaccine Uptake in Rural Patients with Chronic Diseases: Lessons Learned from An Innovative Academic-Community Partnership.

The pandemic has disproportionately impacted rural communities with a higher burden of chronic disease and COVID-19 infection. West Virginia is a rural state with a high rate of diabetes, hypertension, and COPD, which are known risk factors for severe COVID-19 and long COVID. Yet, there is a significant hesitancy regarding COVID-19 vaccination uptake in the state. The purpose of this study was to use an educational intervention to increase vaccine knowledge and vaccine acceptance in rural patients with chronic disease(s) in West Virginia. This project used an academic-community partnership comprised of researchers, practitioners, community organizations, community-engaged partners, and patient stakeholders to increase COVID-19 health literacy and increase vaccine acceptance among rural West Virginians with chronic conditions. A quasi-experimental study design was used to deliver an educational intervention by trained Health Navigators using short videos to increase COVID-19 health literacy and address participants' vaccine concerns. Eligibility included adults (18 years and older) who have at least one chronic condition. A statewide community advisory board (CAB) guided the development of the educational training curriculum and implementation strategies. An adapted version of the Exploration, Preparation, Implementation, Sustainment (EPIS) framework guided the development of the intervention. Health Navigators (n = 45) delivered the educational intervention in their local communities between November 2022 and October 2023 (project implementation is still ongoing). Intervention fidelity checks, an adaptable script, and a flow chart allowed tailoring of brief videos to address participants' specific COVID-19 questions and vaccine concerns. A validated online survey, monitored by an online Research Electronic Data Capture (REDCap) database, assessed participants' knowledge, perceived susceptibility, and vaccine intention. Health Navigators delivered the intervention to 1368 West Virginians in 52 counties (59.2% women; 61.8% without a college degree). Participants reported living with an average of 2.1 ± 1.4 chronic conditions. The mean age was 43.5 ± 18.8 years. The majority of participants (81.2%) had received the primary vaccination series, and 63.1% had at least one booster. However, 18% were unvaccinated or did not complete the primary COVID-19 vaccine series. Discussions to improve vaccine literacy focused on how the vaccine was so quickly developed and protects against variants, addressing concerns related to the safety, short- and long-term side effects, and importance of vaccine uptake for immunocompromised individuals. Participants with higher concerns were more likely to be unvaccinated and to have not completed their primary series or boosters (p < 0.001). However, the educational intervention improved the willingness of individuals who were either unvaccinated or did not complete their primary vaccine series to get vaccinated (11.4%). Our findings highlight the importance of vaccine literacy in increasing vaccination rates among rural patients with chronic diseases. Using the EPIS framework allowed us to reflect upon the challenges, ensure resilience during changing local contexts, and plan and implement a promising, cost-effective intervention in rural areas. This study provides insights into the need for tailored educational interventions based on disease status, which has implications for public health and patient care in rural and underserved communities. Academic-community partnerships can be useful for successful knowledge transfer for vaccine acceptance to reduce rural health disparities.