Tracking smell loss to identify healthcare workers with SARS-CoV-2 infection

Introduction Healthcare workers (HCW) treating COVID-19 patients are at high risk for infection and may also spread infection through their contact with vulnerable patients. Smell loss has been associated with SARS-CoV-2 infection, but it is unknown whether monitoring for smell loss can be used to identify asymptomatic infection among high risk individuals. In this study we sought to determine if tracking smell sensitivity and loss using an at-home assessment could identify SARS-CoV-2 infection in HCW. Methods and findings We performed a prospective cohort study tracking 473 HCW across three months to determine if smell loss could predict SARS-CoV-2 infection in this high-risk group. HCW subjects completed a longitudinal, behavioral at-home assessment of olfaction with household items, as well as detailed symptom surveys that included a parosmia screening questionnaire, and real-time quantitative polymerase chain reaction testing to identify SARS-CoV-2 infection. Our main measures were the prevalence of smell loss in SARS-CoV-2-positive HCW versus SARS-CoV- 2-negative HCW, and timing of smell loss relative to SARS-CoV-2 test positivity. SARS-CoV-2 was identified in 17 (3.6%) of 473 HCW. HCW with SARS-CoV-2 infection were more likely to report smell loss than SARS-CoV-2-negative HCW on both the at-home assessment and the screening questionnaire (9/17, 53% vs 105/456, 23%, P < .01). 6/9 (67%) of SARS-CoV-2-positive HCW reporting smell loss reported smell loss prior to having a positive SARS-CoV-2 test, and smell loss was reported a median of two days before testing positive. Neurological symptoms were reported more frequently among SARS-CoV-2-positive HCW who reported smell loss compared to those without smell loss (9/9, 100% vs 3/8, 38%, P < .01). Conclusions In this prospective study of HCW, self-reported changes in smell using two different measures were predictive of SARS-CoV-2 infection. Smell loss frequently preceded a positive test and was associated with neurological symptoms

Gut Microbiome Dysbiosis in Antibiotic-Treated COVID-19 Patients is Associated with Microbial Translocation and Bacteremia

Although microbial populations in the gut microbiome are associated with COVID-19 severity, a causal impact on patient health has not been established. Here we provide evidence that gut microbiome dysbiosis is associated with translocation of bacteria into the blood during COVID-19, causing life-threatening secondary infections. We first demonstrate SARS-CoV-2 infection induces gut microbiome dysbiosis in mice, which correlated with alterations to Paneth cells and goblet cells, and markers of barrier permeability. Samples collected from 96 COVID-19 patients at two different clinical sites also revealed substantial gut microbiome dysbiosis, including blooms of opportunistic pathogenic bacterial genera known to include antimicrobial-resistant species. Analysis of blood culture results testing for secondary microbial bloodstream infections with paired microbiome data indicates that bacteria may translocate from the gut into the systemic circulation of COVID-19 patients. These results are consistent with a direct role for gut microbiome dysbiosis in enabling dangerous secondary infections during COVID-19

Patterns Of Athlete Abuse In The U.s. Center For Safesport Central Disciplinary Database

The goal of this study is to identify patterns of reported abuse in the U.S. Center for SafeSport Centralized Disciplinary Database, which tracks violations of SafeSport code across different American sports.This study was informed by 1164 individuals listed in the SafeSport database for violations of SafeSport code, which were adjudicated between January 1, 1980 and January 16, 2020. Data were analyzed to identify trends based on year, sport, type of misconduct, and other characteristics. Logistic regressions were performed to identify characteristics that were associated with cases involving sexual misconduct, or involvement of a minor. Of the 1164 cases in the database, adjudicated between January 1, 1980 and January 16, 2020, 1159 distinct individuals were represented, with 5 individuals listed multiple times. 40 different sports had affiliated individuals in the database. U.S.A Gymnastics (N=217, 18.6%), U.S.A Swimming (N=185, 15.9%), and U.S.A Hockey (N=110, 9.5%) had the highest number of affiliated individuals. Over half the individuals in the database had decision dates in 2017 or later. We dichotomized the misconduct listed based on offense type, specifically, whether cases mentioned sexual misconduct (N=527; 45.5%) or not (N=632; 54.5%). Individuals who perpetrated sexual misconduct tended to be affiliated with sports which were characterized by low (p\u3c0.01) or moderate (p\u3c0.01) levels of clothing coverage, non-team sports (p\u3c0.01), male gender culture (p=0.01) and mixed-gender events (p\u3c0.01). 473 out of 1159 unique (40.1%) individuals perpetrated abuse, misconduct, or harassment of a child under the age of 18. These individuals tended to be affiliated with sports characterized by high levels of clothing coverage (p\u3c0.01), female gender culture (p=0.05), and same-gender events (p\u3c0.01). The association between the reports and characteristics of sports such as team structure, level of clothing coverage, gender culture, and mixed-gender events may indicate true risk factors for misconduct or a stronger culture of reporting or sanctioning in these sports. Further analysis of reported violations of SafeSport code may help identify trends in American athlete victimization, as well as potential intervention targets

Depression increases subjective stigma of chronic pain

BackgroundIndividuals suffering from mental as well as physical conditions often face stigma, which can adversely affect functioning, treatment seeking, and emotional health. We compared levels of stigma experienced by individuals with depression and/or chronic pain, to contrast the perception of stigma experienced by the sufferers with that of individuals who have never experienced these conditions, and to determine whether depression is related to greater experience of stigma for chronic pain.MethodsFour groups of participants (N=236) took part in the study: depression only, chronic pain only, comorbid depression and chronic pain, and healthy controls. Participants underwent a clinical interview and completed a stigma measure that assessed general self-stigma, public stigma, treatment stigma, secrecy, and stigmatizing experiences.ResultsHealthy controls largely underestimated the stigma experienced by individuals with depression, but were not inaccurate in estimating stigma experienced by individuals with chronic pain. Further, individuals with chronic pain alone generally perceived less stigma for their condition than did those with depression alone. However, comorbid individuals perceived worse stigma of chronic pain compared to individuals with chronic pain alone, suggesting that depression may affect the stigma felt by sufferers of conditions other than depression.LimitationsSocial desirability may have influenced stigma scores. Comparing several groups required adapting a standardized instrument.ConclusionsResults suggest that depression may play a role in the social experience of having a health condition, as well as indicate that the general public continues to fail to appreciate the negative social pressures experienced by individuals with mental health conditions

COVID-19 Pandemic: A Remedial Measure Through Convalescent Serum

An acute respiratory syndrome Corona Virus 2 has affected humanity throughout the world. Scientifically, Corona Virus 2 is known as SARS-COV-2 which is abbreviated as COVID-2019. China was the first victim of this outbreaks in December 2019 [1] which was later recognized as pandemic on March 11, 2020 by World Health Organization (WHO) [2,3]. At the time of this writing, about 8.75 million individuals of 188 countries [4] have been effected by COVID resulting in 463000 deaths primarily, corona virus communicates from one body to another body through close contacts via droplets produced by sneezing, coughing or taking by infected badly within a buffer zone of 3 to 6 feet [5,6,7]. These droplets fall onto a surface and can survive up to 72 hours [8]. Various studies have proved that droplets may travel up to 37 feet by an uncovered cough [9,10,11]. Corona virus is not an airborne, however it may transport through respiratory droplets during talking and breathing [12]. Full Tex

Depression increases subjective stigma of chronic pain

BackgroundIndividuals suffering from mental as well as physical conditions often face stigma, which can adversely affect functioning, treatment seeking, and emotional health. We compared levels of stigma experienced by individuals with depression and/or chronic pain, to contrast the perception of stigma experienced by the sufferers with that of individuals who have never experienced these conditions, and to determine whether depression is related to greater experience of stigma for chronic pain.MethodsFour groups of participants (N=236) took part in the study: depression only, chronic pain only, comorbid depression and chronic pain, and healthy controls. Participants underwent a clinical interview and completed a stigma measure that assessed general self-stigma, public stigma, treatment stigma, secrecy, and stigmatizing experiences.ResultsHealthy controls largely underestimated the stigma experienced by individuals with depression, but were not inaccurate in estimating stigma experienced by individuals with chronic pain. Further, individuals with chronic pain alone generally perceived less stigma for their condition than did those with depression alone. However, comorbid individuals perceived worse stigma of chronic pain compared to individuals with chronic pain alone, suggesting that depression may affect the stigma felt by sufferers of conditions other than depression.LimitationsSocial desirability may have influenced stigma scores. Comparing several groups required adapting a standardized instrument.ConclusionsResults suggest that depression may play a role in the social experience of having a health condition, as well as indicate that the general public continues to fail to appreciate the negative social pressures experienced by individuals with mental health conditions

Sex differences in immune responses that underlie COVID-19 disease outcomes

There is increasing evidence that coronavirus disease 2019 (COVID-19) produces more severe symptoms and higher mortality among men than among women1,2,3,4,5. However, whether immune responses against severe acute respiratory syndrome coronavirus (SARS-CoV-2) differ between sexes, and whether such differences correlate with the sex difference in the disease course of COVID-19, is currently unknown. Here we examined sex differences in viral loads, SARS-CoV-2-specific antibody titres, plasma cytokines and blood-cell phenotyping in patients with moderate COVID-19 who had not received immunomodulatory medications. Male patients had higher plasma levels of innate immune cytokines such as IL-8 and IL-18 along with more robust induction of non-classical monocytes. By contrast, female patients had more robust T cell activation than male patients during SARS-CoV-2 infection. Notably, we found that a poor T cell response negatively correlated with patients’ age and was associated with worse disease outcome in male patients, but not in female patients. By contrast, higher levels of innate immune cytokines were associated with worse disease progression in female patients, but not in male patients. These findings provide a possible explanation for the observed sex biases in COVID-19, and provide an important basis for the development of a sex-based approach to the treatment and care of male and female patients with COVID-19