• A call to action: Documenting and sharing solutions and adaptations in sexual, reproductive, maternal and newborn health care provision during the COVID-19 pandemic

      Benova, Lenka; Sarkar, Nandini D. P.; Fasehun, Luther-King; Semaan, Aline; Affun-Adegbulu, Clara; 0000-0002-8798-5433 (2020-10-19)
    • A Citywide ‘Virus Testing': Chinese Government's Response to Preventing and Controlling the Second Outbreak of SARS-CoV-2

      Zhou, Liting; Seesaghur, Hans Nibshan; Akhtar, Nadeem; Boolakee, Jason; Pratt, Cornelius; Pratt|0000-0002-8033-9818 (2021-06-16)
      Containing the spread of SARS-CoV-2 is a daunting challenge globally. China, as well as a handful of other countries, has, for the most part, contained it by implementing strict policies. Wuhan's citywide virus-testing program presents a way forward in preventing and controlling the uncertainty, anxiety, instability and complexity it faces over the outbreak of SARS-CoV-2. Inarguably, the health crisis requires time-tested strategies and tactics for coordinating governments' and social entities' response to the health crisis, with a goal toward having and ensuring sustained effectiveness. Because of a possible recurrence of SARS-CoV-2 in Wuhan, the Prevention and Control Headquarters of Wuhan on COVID-19 launched a massive virus testing of Wuhan's 11 million residents; it was completed within 10 days. In light of this unprecedented mass testing, this study applies the situational crisis communication theory to analyze this massive virus-testing process and the mechanisms involved to contain SARS-CoV-2 in Wuhan. While many countries still have partial lockdowns, the second outbreak in Wuhan was an indication of what awaited all SARS-CoV-2-stricken countries post-lockdowns and after community restrictions had been lifted. Therefore, the recently implemented Wuhan control mechanism (in cities, districts and townships) may become a hortatory guide to other world regions as they contend with and consider appropriate measures to control the spread of SARS-CoV-2 and to ensure public safety.
    • A Cohort Study on the Immunogenicity and Safety of the Inactivated SARS-CoV-2 Vaccine (BBIBP-CorV) in Patients With Breast Cancer; Does Trastuzumab Interfere With the Outcome?

      Center for Inflammation and Lung Research (Temple University) (2022-03-01)
      Aim: To determine the efficacy and safety of inactivated SARS-CoV-2 vaccine (BBIBP-CorV) in patients with breast cancer. Methods: In this multi- institutional cohort study, a total of 160 breast cancer patients (mean age of 50.01 ± 11.5 years old) were assessed for the SARS-CoV-2 Anti-Spike IgG and SARS-CoV2 Anti RBD IgG by ELISA after two doses of 0.5 mL inactivated, COVID-19 vaccine (BBIBP-CorV). All patients were followed up for three months for clinical COVID-19 infection based on either PCR results or imaging findings. Common Terminology Criteria for Adverse Events were used to assess the side effects. Results: The presence of SARS-CoV-2 anti-spike IgG, SARS-CoV2 anti-RBD IgG, or either of these antibodies was 85.7%, 87.4%, and 93.3%. The prevalence of COVID-19 infection after vaccination was 0.7%, 0% and 0% for the first, second and third months of the follow-up period. The most common local and systemic side-effects were injection site pain and fever which were presented in 22.3% and 24.3% of patients, respectively. Discussion: The inactivated SARS-CoV-2 vaccine (BBIBP-CorV) is a tolerable and effective method to prevent COVID-19.
    • A deficit of more than 250,000 public health workers is no way to fight Covid-19

      Taylor Wilson, Robin; Troisi, Catherine L.; Gary-Webb, Tiffany L. (2020-04-05)
    • A Longitudinal Study of BNT162b2 Vaccine-Induced Humoral Response and Reactogenicity in Health Care Workers with Prior COVID-19 Disease

      Kelsen, Steven; Braverman, Alan S.; Aksoy, Mark O.; Hayman, Jacob A.; Patel, Puja; Rajput, Charu; Zhao, Huaqing; Fisher, Susan G.; Ruggieri, Michael; GENTILE, NINA; Kelsen|0000-0002-5214-145X; Zhao|0000-0002-0953-4768; Ruggieri Sr.|0000-0003-3052-3630; Gentile|0000-0002-1222-5966 (2021-07-31)
      Background: Current recommendations in the United States are that subjects with a previous history of COVID-19 disease receive the full 2 dose mRNA vaccine regimen. We tested the hypothesis that humoral immune responses and reactogenicity to a SARS-CoV-2 mRNA vaccine (BNT-162b2) differ qualitatively and quantitatively in subjects with prior SARS-CoV-2 infection versus infection-naïve subjects. Methods: Health care workers (n=61) from a single academic institution with and without prior COVID-19 received two 30 µg doses of BNT162b2 vaccine 3 weeks apart. The COVID group (n=30) received vaccine approximately 7 months post infection. IgG antibody against the Spike receptor-binding domain (RBD), serum neutralizing activity and vaccine adverse reactions were assessed every 2 weeks for 56 days after the 1st injection. A longitudinal design and long study duration allowed the onset, maximum response and initial decay rate of Spike IgG antibody to be assessed in each subject. In addition, Spike IgG antibody levels are expressed as µg / mL to provide normal values for clinical decision making. Findings: Spike IgG responses were highly variable in both groups. However, the COVID group manifested rapid increases in Spike IgG antibody and serum neutralizing activity post 1st vaccine dose but little or no increase in Spike IgG or serum neutralizing activity after the 2nd dose. In fact, Spike IgG was maximum prior to the 2nd dose in 36% of the COVID group and 0% of controls. Peak IgG antibody was lower but appeared to fall more slowly in the COVID than in the control group. Finally, adverse systemic reactions e.g., fever, headache and malaise, after both the 1st and 2nd injection were more frequent and lasted longer in the COVID group than in the control group. Conclusions: Health care workers with prior COVID-19 demonstrate a robust, accelerated humoral immune response to the 1st dose of the COVID-19 mRNA vaccine but attenuated response to the 2nd dose. They also experience greater reactogenicity than controls. Accordingly, subjects with prior COVID-19 may require only a single dose of vaccine.
    • A Mixed Method Analysis of Burnout and Turnover Intentions Among Higher Education Professionals During COVID-19

      Winfield, Jake; Paris, Joseph; Paris|0000-0001-7636-903X; Winfield|0000-0001-6181-8664 (2021-10-11)
      The COVID-19 pandemic rapidly and dramatically altered higher education including changes to the workplace. Many staff and faculty positions were eliminated while other employees experienced furloughs or reduced work hours. Our study examines the experiences of 1,080 higher education professionals serving in various functional roles during the COVID-19 pandemic from 830 institutions of higher education in the United States. We utilized an explanatory sequential mixed methods research design to examine quantitative and qualitative survey data from October 2020 to understand how jobs in higher education changed during the pandemic and how these changes were associated with an individual's burnout and intention to leave higher education. Using multiple regression and thematic analysis and the job-demands and resources framework, we find that higher education professionals who experienced significant disruption in their work had increased odds of experiencing burnout. We also find that eliminating staff positions and significant levels of burnout were associated with increased intentions to leave their current profession in higher education. In open ended responses, higher education professionals described how increased job demands through decreased staff and increased workloads were not accompanied with increased resources, leading to burnout. These working conditions negatively affected participants' personal lives, including their physical and mental health. We conclude with recommendations for research on working conditions in higher education in the pandemic-era and emphasize that institutional leaders should seek systemic changes to support employees.
    • A Partition-Based Group Testing Algorithm for Estimating the Number of Infected Individuals

      Beigel, Richard; Webber, Max J. (2021-07-28)
      The dangers of COVID-19 remain ever-present worldwide. The asymptomatic nature of COVID-19 obfuscates the signs policy makers look for when deciding to reopen public areas or further quarantine. In much of the world, testing resources are often scarce, creating a need for testing potentially infected individuals that prioritizes efficiency. This report presents an advancement to Beigel and Kasif’s Approximate Counting Algorithm (ACA). ACA estimates the infection rate with a number of tests that is logarithmic in the population size. Our newer version of the algorithm provides an extra level of efficiency: each subject is tested exactly once. A simulation of the algorithm, created for and presented as part of this paper, can be used to find a linear regression of the results with R2 > 0.999. This allows stakeholders and members of the biomedical community to estimate infection rates for varying population sizes and ranges of infection rates.
    • A Randomized Placebo-Controlled Trial of Sarilumab in Hospitalized Patients with Covid-19

      Sarilumab-COVID-19 Study Team (2021-06-19)
      BACKGROUND: Sarilumab (anti-interleukin-6 receptor-α monoclonal antibody) may attenuate the inflammatory response in Covid-19. METHODS: We performed an adaptive, phase 2/3, randomized, double-blind, placebo-controlled trial of intravenous sarilumab 200 mg or 400 mg in adults hospitalized with Covid-19. The phase 3 primary analysis population (cohort 1) was patients with critical Covid-19 receiving mechanical ventilation (MV) randomized to sarilumab 400 mg or placebo. The primary end point for phase 3 was the proportion of patients with ≥1-point improvement in clinical status from baseline to day 22. RESULTS: Four-hundred fifty-seven (457) and 1365 patients were randomized and treated in phases 2 and 3, respectively. Among phase 3 critical patients receiving MV (n=289; 34.3% on corticosteroids), the proportion with ≥1-point improvement in clinical status (alive not receiving MV) at day 22 was 43.2% in sarilumab 400 mg and 35.5% in placebo (risk difference [RD] +7.5%; 95% confidence interval [CI], –7.4 to 21.3; P=0.3261), representing a relative risk improvement of 21.7%. Day 29 all-cause mortality was 36.4% in sarilumab 400 mg versus 41.9% in placebo (RD –5.5%; 95% CI, –20.2 to 8.7; relative risk reduction 13.3%). In post hoc analyses pooling phase 2 and 3 critical patients receiving MV, the hazard ratio (HR) for death in sarilumab 400 mg compared with placebo was 0.76 (95% CI, 0.51 to 1.13) overall, improving to 0.49 (95% CI, 0.25 to 0.94) in patients receiving corticosteroids at baseline. CONCLUSION: In hospitalized patients with Covid-19 receiving MV, numerical benefits with sarilumab did not achieve statistical significance, but benefit may be greater in patients receiving corticosteroids. A larger study is required to confirm this observed numerical benefit.
    • A Statistical Approach to Batched Prevalence Testing for Coronavirus

      Berger, William; Dabrowski, Konrad; Robinson, Jake; Sales, Adam (2020-03-30)
      As cases of novel coronavirus mount, the ability to conduct expeditious prevalence testing becomes paramount. A statistical approach to batched prevalence testing offers a more rapid and efficient means of monitoring at-risk populations.
    • A Survey on the Impact of COVID-19 on Lacrimal Surgery: The Asia-Pacific Perspective

      Nair, Akshay Gopinathan; Narayanan, Natasha; Ali, Mohammad Javed; Narayanan|0000-0002-9670-7865 (2020-11-04)
      Aim: To assess the impact of the COVID-19 pandemic-related lockdown on lacrimal surgery among oculoplastic surgeons in the Asia-Pacific region. Methods: An institutional board review approved anonymous electronic survey was sent out via email to oculoplastic surgeons across the Asia-Pacific region. All responses were tabulated and analysed. Results: A total of 259 valid responses were received. Nearly 87% of the surgeons agreed that lacrimal procedures were associated with a high risk of COVID-19 transmission. In all, at the time of taking the survey, 151/259 (58.3%) of the surgeons were not performing any lacrimal surgeries in view of the COVID-19 pandemic and 71/259 (27.4%) of the respondents were only performing emergency lacrimal surgeries. External dacryocystorhinostomy was the most commonly performed lacrimal procedure across the region and lacrimal procedures contributed to at least 25% of the income for nearly a third of the respondents. Majority of the respondents were female (52.9%), but a significantly higher proportion of male oculoplastic surgeons were still performing lacrimal surgeries during the lockdown. Over 75% of respondents indicated that resuming lacrimal procedures is important to their practice. Conclusion: The survey showed that there was a general agreement among the surveyed oculoplastic surgeons in the Asia-Pacific region that lacrimal procedures were associated with a high risk of COVID-19 transmission and over 85% of them of had either stopped performing elective lacrimal surgeries altogether or were providing only emergent care. It is likely that not performing elective lacrimal procedures, COVID-19 has financially impacted a high percentage of the surveyed oculoplastic surgeons.
    • Abortion Opportunism

      Rebouché, Rachel (2020-05-18)
      Eleven states have tried to suspend abortion care in response to COVID-19. State officials claim that they will preserve medical supplies, hospital space, and health care capacity by classifyingabortion as an elective, non-essential surgery that must be delayed. Advocacy groups representing abortion providers sued in several states to enjoin these bans. What has emerged is a fight that ignores medical evidence and threatens to exacerbate the current public health emergency. The Executive Order issued in Texas offers an apt example. Though abortion may be available in Texas for the time being, opinions from the U.S. Court of Appeals for the Fifth Circuit provide a troubling roadmap for suspending constitutional rights as a health emergency measure.
    • Adapted Physical Activity to Ensure the Physical and Psychological Well-Being of COVID-19 Patients

      Center for Biotechnology, Sbarro Institute for Cancer Research and Molecular Medicine (Temple University) (2021-01-29)
      The novel coronavirus disease 2019 (COVID-19) has been responsible for a global pandemic involving massive increases in the daily numbers of cases and deaths. Due to the emergency caused by the pandemic, huge efforts have been made to develop COVID-19 vaccines, the first of which were released in December 2020. Effective vaccines for COVID-19 are needed to protect the population, especially healthcare professionals and fragile individuals, such as older people or chronic-disease-affected patients. Physical exercise training generally has health benefits and assists in the prevention of several chronic diseases. Moreover, physical activity improves mental health by reducing anxiety, depression, and negative mood and improving self-esteem. Therefore, the present review aims to provide a detailed view of the literature, presenting updated evidence on the beneficial effects of adapted physical activity, based on personalized and tailor-made exercise, in preventing, treating, and counteracting the consequences of COVID-19.
    • Addressing the Housing Crisis: Challenges and Innovations

      Levine, Judith A.; Hammar, Colin J.; Public Policy Lab (Temple University) (Temple University. Public Policy Lab, 2021)
    • Addressing the Question of Dermatologic Manifestations of SARS-CoV-2 Infection in the Lower Extremities: A Closer Look at the Available Data and its Implications

      Basatneh, Rami; Vlahovic, Tracey; Vlahovic|0000-0002-5310-4706 (2020-04-20)
      The first case of SARS-CoV-2 infection, also known as the Coronavirus Disease of 2019 (COVID-19) was reported in December of 2019 by doctors in Wuhan, China.(1) Since then, physicians have reported a peculiar sequelae for the novel coronavirus involving various manifestations and courses of the disease as well as a predilection for morbidity and mortality based on certain pre-existing conditions and age groups. Recently, there has been growing interest in anecdotal findings of skin manifestations by several healthcare providers who are postulating a possible correlation to COVID-19.
    • AI-Based Information Systems

      Buxmann, Peter; Hess, Thomas; Thatcher, Jason Bennett (2020-12-01)
    • Aorta in Pathologies May Function as an Immune Organ by Upregulating Secretomes for Immune and Vascular Cell Activation, Differentiation and Trans-Differentiation—Early Secretomes may Serve as Drivers for Trained Immunity

      Cardiovascular Research Center (Temple University); Center for Metabolic Disease Research (Temple University); Sol Sherry Thrombosis Research (Temple University) (2022-03-07)
      To determine whether aorta becomes immune organ in pathologies, we performed transcriptomic analyses of six types of secretomic genes (SGs) in aorta and vascular cells and made the following findings: 1) 53.7% out of 21,306 human protein genes are classified into six secretomes, namely, canonical, caspase 1, caspase 4, exosome, Weibel–Palade body, and autophagy; 2) Atherosclerosis (AS), chronic kidney disease (CKD) and abdominal aortic aneurysm (AAA) modulate six secretomes in aortas; and Middle East Respiratory Syndrome Coronavirus (MERS-CoV, COVID-19 homologous) infected endothelial cells (ECs) and angiotensin-II (Ang-II) treated vascular smooth muscle cells (VSMCs) modulate six secretomes; 3) AS aortas upregulate T and B cell immune SGs; CKD aortas upregulate SGs for cardiac hypertrophy, and hepatic fibrosis; and AAA aorta upregulate SGs for neuromuscular signaling and protein catabolism; 4) Ang-II induced AAA, canonical, caspase 4, and exosome SGs have two expression peaks of high (day 7)-low (day 14)-high (day 28) patterns; 5) Elastase induced AAA aortas have more inflammatory/immune pathways than that of Ang-II induced AAA aortas; 6) Most disease-upregulated cytokines in aorta may be secreted via canonical and exosome secretomes; 7) Canonical and caspase 1 SGs play roles at early MERS-CoV infected ECs whereas caspase 4 and exosome SGs play roles in late/chronic phases; and the early upregulated canonical and caspase 1 SGs may function as drivers for trained immunity (innate immune memory); 8) Venous ECs from arteriovenous fistula (AVF) upregulate SGs in five secretomes; and 9) Increased some of 101 trained immunity genes and decreased trained tolerance regulator IRG1 participate in upregulations of SGs in atherosclerotic, Ang-II induced AAA and CKD aortas, and MERS-CoV infected ECs, but less in SGs upregulated in AVF ECs. IL-1 family cytokines, HIF1α, SET7 and mTOR, ROS regulators NRF2 and NOX2 partially regulate trained immunity genes; and NRF2 plays roles in downregulating SGs more than that of NOX2 in upregulating SGs. These results provide novel insights on the roles of aorta as immune organ in upregulating secretomes and driving immune and vascular cell differentiations in COVID-19, cardiovascular diseases, inflammations, transplantations, autoimmune diseases and cancers.
    • Approaches to Reducing Risk of COVID-19 Infections in Prisons and Immigration Detention Centers: A Commentary

      Kelly, Kate; Soto, Nai; Wisseh, Nadi Damond; Clerget, Shaina A.; 0000-0002-5155-0518 (2020-09-18)
      Although often left out of public health efforts and policy decisions, prisons, jails, and detention centers are integral to community health. With an average of 650,000 citizens returning home from prison each year in the United States, and thousands of correctional staff members returning home every night, there are millions of touchpoints between outside communities and carceral settings. For this reason, carceral communities should be central to planning and policy making in response to the spread of the COVID-19 illness. As social workers and clinicians, we are urgently concerned that efforts to prevent COVID-19 infections in prisons are underdeveloped and inadequate in the face of a fast-spreading virus. In this commentary, we outline a set of public health, policy, and clinical recommendations based upon the existing literature to mitigate various risks to the well-being of carceral communities.
    • Approaching Inflammation Paradoxes—Proinflammatory Cytokine Blockages Induce Inflammatory Regulators

      Center for Cardiovascular Research (Temple University); Center for Inflammation, Translational & Clinical Lung Research (Temple University); Center for Metabolic Disease Research (Temple University); Center for Cardiovascular Research (Temple University); Center for Thrombosis Research (Temple University) (2020-10-19)
      The mechanisms that underlie various inflammation paradoxes, metabolically healthy obesity, and increased inflammations after inflammatory cytokine blockades and deficiencies remain poorly determined. We performed an extensive –omics database mining, determined the expressions of 1367 innate immune regulators in 18 microarrays after deficiencies of 15 proinflammatory cytokines/regulators and eight microarray datasets of patients receiving Mab therapies, and made a set of significant findings: 1) proinflammatory cytokines/regulators suppress the expressions of innate immune regulators; 2) upregulations of innate immune regulators in the deficiencies of IFNγ/IFNγR1, IL-17A, STAT3 and miR155 are more than that after deficiencies of TNFα, IL-1β, IL-6, IL-18, STAT1, NF-kB, and miR221; 3) IFNγ, IFNγR and IL-17RA inhibit 10, 59 and 39 proinflammatory cytokine/regulator pathways, respectively; in contrast, TNFα, IL-6 and IL-18 each inhibits only four to five pathways; 4) The IFNγ-promoted and -suppressed innate immune regulators have four shared pathways; the IFNγR1-promoted and -suppressed innate immune regulators have 11 shared pathways; and the miR155-promoted and -suppressed innate immune regulators have 13 shared pathways, suggesting negative-feedback mechanisms in their conserved regulatory pathways for innate immune regulators; 5) Deficiencies of proinflammatory cytokine/regulator-suppressed, promoted programs share signaling pathways and increase the likelihood of developing 11 diseases including cardiovascular disease; 6) There are the shared innate immune regulators and pathways between deficiency of TNFα in mice and anti-TNF therapy in clinical patients; 7) Mechanistically, up-regulated reactive oxygen species regulators such as myeloperoxidase caused by suppression of proinflammatory cytokines/regulators can drive the upregulation of suppressed innate immune regulators. Our findings have provided novel insights on various inflammation paradoxes and proinflammatory cytokines regulation of innate immune regulators; and may re-shape new therapeutic strategies for cardiovascular disease and other inflammatory diseases.
    • Are environmental pollution and biodiversity levels associated to the spread and mortality of COVID-19? A four-month global analysis

      Fernández, Daniel; Giné-Vázquez, Ialago; Liu, Ivy; Yucel, Recai; Nai Ruscone, Marta; Morena, Marianthi; García, Víctor Gerardo; Haro, Josep Maria; Pan, William; Tyrovolas, Stefanos (2020-12-21)
      On March 12th, 2020, the WHO declared COVID-19 as a pandemic. The collective impact of environmental and ecosystem factors, as well as biodiversity, on the spread of COVID-19 and its mortality evolution remain empirically unknown, particularly in regions with a wide ecosystem range. The aim of our study is to assess how those factors impact on the COVID-19 spread and mortality by country. This study compiled a global database merging WHO daily case reports with other publicly available measures from January 21st to May 18th, 2020. We applied spatio-temporal models to identify the influence of biodiversity, temperature, and precipitation and fitted generalized linear mixed models to identify the effects of environmental variables. Additionally, we used count time series to characterize the association between COVID-19 spread and air quality factors. All analyses were adjusted by social demographic, country-income level, and government policy intervention confounders, among 160 countries, globally. Our results reveal a statistically meaningful association between COVID-19 infection and several factors of interest at country and city levels such as the national biodiversity index, air quality, and pollutants elements (PM10, PM2.5, and O3). Particularly, there is a significant relationship of loss of biodiversity, high level of air pollutants, and diminished air quality with COVID-19 infection spread and mortality. Our findings provide an empirical foundation for future studies on the relationship between air quality variables, a country’s biodiversity, and COVID-19 transmission and mortality. The relationships measured in this study can be valuable when governments plan environmental and health policies, as alternative strategy to respond to new COVID-19 outbreaks and prevent future crises.
    • Assessing Legal Responses to COVID-19

      Burris, Scott; de Guia, Sarah; Gable, Lance; Levin, Donna E.; Parmet, Wendy E.; Terry, Nicolas P.; Center for Public Health Law Research (Temple University); ChangeLab Solutions; Wayne State University; The Network for Public Health Law; et al. (2020-08)
      In August 2020, as the nation continued to address the ongoing COVID-19 pandemic, which had resulted in hundreds of thousands of deaths and a severe economic recession, 50 top national experts offered an assessment of the U.S. policy response to the crisis. The research details the widespread failure of the country’s leadership in planning and executing a cohesive, national response, and how the crisis exposed weaknesses in the nation’s health care and public health systems. In Assessing Legal Responses to COVID-19, the authors also offer recommendations on how federal, state and local leaders can better respond to COVID-19 and future pandemics.