Early mobilisation in critically ill COVID-19 patients: a subanalysis of the ESICM-initiated UNITE-COVID observational study

Background Early mobilisation (EM) is an intervention that may improve the outcome of critically ill patients. There is limited data on EM in COVID-19 patients and its use during the first pandemic wave. Methods This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020. We analysed variables associated with the initiation of EM (within 72 h of ICU admission) and explored the impact of EM on mortality, ICU and hospital length of stay, as well as discharge location. Statistical analyses were done using (generalised) linear mixed-effect models and ANOVAs. Results Mobilisation data from 4190 patients from 280 ICUs in 45 countries were analysed. 1114 (26.6%) of these patients received mobilisation within 72 h after ICU admission; 3076 (73.4%) did not. In our analysis of factors associated with EM, mechanical ventilation at admission (OR 0.29; 95% CI 0.25, 0.35; p = 0.001), higher age (OR 0.99; 95% CI 0.98, 1.00; p ≤ 0.001), pre-existing asthma (OR 0.84; 95% CI 0.73, 0.98; p = 0.028), and pre-existing kidney disease (OR 0.84; 95% CI 0.71, 0.99; p = 0.036) were negatively associated with the initiation of EM. EM was associated with a higher chance of being discharged home (OR 1.31; 95% CI 1.08, 1.58; p = 0.007) but was not associated with length of stay in ICU (adj. difference 0.91 days; 95% CI − 0.47, 1.37, p = 0.34) and hospital (adj. difference 1.4 days; 95% CI − 0.62, 2.35, p = 0.24) or mortality (OR 0.88; 95% CI 0.7, 1.09, p = 0.24) when adjusted for covariates. Conclusions Our findings demonstrate that a quarter of COVID-19 patients received EM. There was no association found between EM in COVID-19 patients' ICU and hospital length of stay or mortality. However, EM in COVID-19 patients was associated with increased odds of being discharged home rather than to a care facility. Trial registration ClinicalTrials.gov: NCT04836065 (retrospectively registered April 8th 2021)

A masculinizing supergene underlies an exaggerated male reproductive morph in a spider

In many species, individuals can develop into strikingly different morphs, which are determined by a simple Mendelian locus. How selection shapes loci that control complex phenotypic differences remains poorly understood. In the spider Oedothorax gibbosus, males develop either into a ‘hunched’ morph with conspicuous head structures or as a fast-developing ‘flat’ morph with a female-like appearance. We show that the hunched-determining allele contains a unique genomic fragment of approximately 3 megabases that is absent in the flat-determining allele. This fragment comprises dozens of genes that duplicated from genes found at the same as well as different chromosomes. All functional duplicates, including a duplicate of the key sexual differentiation regulatory gene doublesex, show male-specific expression, which illustrates their integrated role as a masculinizing supergene. Our findings demonstrate how extensive indel polymorphisms and duplications of regulatory genes may contribute to the evolution of co-adapted gene clusters, sex-limited reproductive morphs and the enigmatic evolution of exaggerated sexual traits in general

Progressive spread of chromosomal inversions blends the role of colonization and evolution in a parallel Galápagos beetle radiation

Archipelago island fauna include some of the most compelling examples of parallel adaptation to ecological gradients. However, despite the insular nature of these systems, the possibility that repeated instances of within-island divergence resulted from independent evolutionary rather than repeated colonization events remains most often unclear. Here, we investigated the genomic underpinning of a progressive adaptive radiation of caterpillar-hunter beetles in the low- and highland habitats from the Galápagos. These Calosoma beetles have evolved only partially reduced wings in the highland of the youngest islands but evolved to distinct short-winged species in the highland of the oldest islands. In support of independent evolutionary events, the extent of genome-wide divergence between long-winged lowland and short-winged highland populations decreased towards younger islands. However, in support of repeated colonization events, adaptation to highland habitats was driven by repeated selection of alleles that are shared across all highland species and populations. These alleles comprised extensive chromosomal inversions whose origin was traced back to an initial high-lowland divergence event on the oldest island. Moreover, we found evidence that after this initial divergence event, highland alleles spread to younger islands through dispersal of highland individuals as well as dispersal of lowland individuals that were polymorphic at adaptive loci, both providing the opportunity for the establishment of highland populations on the younger islands. These findings highlight the importance of an old divergence in driving repeated adaptation to ecological gradients. Complex histories of colonization and introgression may thus result in a mixed contribution of inter-island dispersal and within-island evolution in shaping parallel species communities on islands

Data from: Evolution at two time frames: polymorphisms from an ancient singular divergence event fuel contemporary parallel evolution

When environments change, populations may adapt surprisingly fast, repeatedly and even at microgeographic scales. There is increasing evidence that such cases of rapid parallel evolution are fueled by standing genetic variation, but the source of this genetic variation remains poorly understood. In the saltmarsh beetle Pogonus chalceus, short-winged ‘tidal’ and long-winged ‘seasonal’ ecotypes have diverged in response to contrasting hydrological regimes and can be repeatedly found along the Atlantic European coast. By analyzing genomic variation across the beetles’ distribution, we reveal that alleles selected in the tidal ecotype are spread across the genome and evolved during a singular and, likely, geographically isolated divergence event, within the last 190 Kya. Due to subsequent admixture, the ancient and differentially selected alleles are currently polymorphic in most populations across its range, which could potentially allow for the fast evolution of one ecotype from a small number of random individuals, as low as 5 to 15, from a population of the other ecotype. Our results suggest that cases of fast parallel ecological divergence can be the result of evolution at two different time frames: divergence in the past, followed by repeated selection on the same divergently evolved alleles after admixture. These findings highlight the importance of an ancient and, likely, allopatric divergence event for driving the rate and direction of contemporary fast evolution under gene flow. This mechanism is potentially driven by periods of geographic isolation imposed by large-scale environmental changes such as glacial cycles

Pogo_stats.40ind.Sp.nodup

RADtag sequence statistics of population pair S

BEL_bayescan

Results of the BayeScan analysis of population pair B

SPA_bayescan

Results of the BayeScan analysis of population pair S

Pogo_stats.40ind.Po.nodup

RADtag sequence statistics of population pair P

POR_bayescan

Results of the BayeScan analysis of population pair P

Pogo_stats.40ind.Be.nodup

RADtag sequence statistics of population pair B