• One Year of COVID-19 Pandemic in Italy: Effect of Sedentary Behavior on Physical Activity Levels and Musculoskeletal Pain among University Students

      Roggio, Federico; Trovato, Bruno; Ravalli, Silvia; Di Rosa, Michelino; Maugeri, Grazia; Bianco, Antonino; Palma, Antonio; Musumeci, Giuseppe; Musumeci|0000-0002-8260-8890 (2021-08-17)
      The COVID-19 outbreak forced Italian students to reduce their daily activities, inducing a seden-tary attitude that was worsened by distanced learning. This study aimed to survey the physical activity levels that were maintained before and during the social restrictions following the pan-demic, their correlation to musculoskeletal pain, as well as analyzing the impact of these COVID-19 restrictions on pain and fatigue that affects daily life activities. A total of 2044 students completed the online questionnaire, of which the results of 1654 participants were eligible. Before the pandemic, the levels of physical activity were distributed as: 19.9% no activity, 30.1% light ac-tivity, 21.5% moderate activity, and 28.5% high activity. After one year of the pandemic, 30.6% of the participants were inactive, 48.1%, 10.9%, and 10.5% stated as maintaining, respectively, light, moderate and high levels of physical activity. Furthermore, 43.5% reported neck pain and 33.5% stated to experience low back pain. Physical activity levels lower than 150 min/week may have predisposed students to suffer from neck pain (1.95 OR at 95% CI, 1.44–2.64) and low back pain (1.79 OR at 95% CI, 1.29–2.49). A positive correlation between physical activity levels, Verbal Descriptive Scale (VDS), and pain frequency have been observed for neck and low back pain (p-value < 0.05). Finally, low physical activity levels were associated with musculoskeletal pain onset and pain worsening.
    • Organelle Crosstalk Regulators Are Regulated in Diseases, Tumors, and Regulatory T Cells: Novel Classification of Organelle Crosstalk Regulators

      Centers for Cardiovascular Research (Temple University); Alzheimer's Center (Temple University); Metabolic Disease Research, Inflammation, Translational & Clinical Lung Research (Temple University); Thrombosis Research (Temple University) (2021-07-22)
      To examine whether the expressions of 260 organelle crosstalk regulators (OCRGs) in 16 functional groups are modulated in 23 diseases and 28 tumors, we performed extensive -omics data mining analyses and made a set of significant findings: (1) the ratios of upregulated vs. downregulated OCRGs are 1:2.8 in acute inflammations, 1:1 in metabolic diseases, 1:1.2 in autoimmune diseases, and 1:3.8 in organ failures; (2) sepsis and trauma-upregulated OCRG groups such as vesicle, mitochondrial (MT) fission, and mitophagy but not others, are termed as the cell crisis-handling OCRGs. Similarly, sepsis and trauma plus organ failures upregulated seven OCRG groups including vesicle, MT fission, mitophagy, sarcoplasmic reticulum–MT, MT fusion, autophagosome–lysosome fusion, and autophagosome/endosome–lysosome fusion, classified as the cell failure-handling OCRGs; (3) suppression of autophagosome–lysosome fusion in endothelial and epithelial cells is required for viral replications, which classify this decreased group as the viral replication-suppressed OCRGs; (4) pro-atherogenic damage-associated molecular patterns (DAMPs) such as oxidized low-density lipoprotein (oxLDL), lipopolysaccharide (LPS), oxidized-1-palmitoyl-2-arachidonoyl-sn-glycero-3-phosphocholine (oxPAPC), and interferons (IFNs) totally upregulated 33 OCRGs in endothelial cells (ECs) including vesicle, MT fission, mitophagy, MT fusion, endoplasmic reticulum (ER)–MT contact, ER– plasma membrane (PM) junction, autophagosome/endosome–lysosome fusion, sarcoplasmic reticulum–MT, autophagosome–endosome/lysosome fusion, and ER–Golgi complex (GC) interaction as the 10 EC-activation/inflammation-promoting OCRG groups; (5) the expression of OCRGs is upregulated more than downregulated in regulatory T cells (Tregs) from the lymph nodes, spleen, peripheral blood, intestine, and brown adipose tissue in comparison with that of CD4+CD25− T effector controls; (6) toll-like receptors (TLRs), reactive oxygen species (ROS) regulator nuclear factor erythroid 2-related factor 2 (Nrf2), and inflammasome-activated regulator caspase-1 regulated the expressions of OCRGs in diseases, virus-infected cells, and pro-atherogenic DAMP-treated ECs; (7) OCRG expressions are significantly modulated in all the 28 cancer datasets, and the upregulated OCRGs are correlated with tumor immune infiltrates in some tumors; (8) tumor promoter factor IKK2 and tumor suppressor Tp53 significantly modulate the expressions of OCRGs. Our findings provide novel insights on the roles of upregulated OCRGs in the pathogenesis of inflammatory diseases and cancers, and novel pathways for the future therapeutic interventions for inflammations, sepsis, trauma, organ failures, autoimmune diseases, metabolic cardiovascular diseases (CVDs), and cancers.
    • Patient Experiences with the Transition to Telephone Counseling during the COVID-19 Pandemic

      Kang, Augustine W.; Walton, Mary; Hoadley, Ariel; DelaCuesta, Courtney; Hurley, Linda; Martin, Rosemarie; Hoadley|0000-0003-1360-0358 (2021-06-02)
      Background: To identify and document the treatment experiences among patients with opioid use disorder (OUD) in the context of the rapid move from in-person to telephone counseling due to the COVID-19 pandemic. Methods: Participants (n = 237) completed a survey with open-ended questions that included the following domains: (1) satisfaction with telephone counseling, (2) perceived convenience, (3) changes to the therapeutic relationship, (4) perceived impact on substance use recovery, and (5) general feedback. Responses were coded using thematic analysis. Codes were subsequently organized into themes and subthemes (covering 98% of responses). Interrater reliability for coding of participants’ responses ranged from 0.89 to 0.95. Results: Overall, patients reported that telephone counseling improved the therapeutic experience. Specifically, 74% of respondents were coded as providing responses consistently indicating “positive valency”. “Positive valency” responses include: (1) feeling supported, (2) greater comfort and privacy, (3) increased access to counselors, and (4) resolved transportation barriers. Conversely, “negative valency” responses include: (1) impersonal experience and (2) reduced privacy. Conclusions: Telephone counseling presents its own set of challenges that should be investigated further to improve the quality of care and long-term patient outcomes.
    • Physical Activity Levels and Related Energy Expenditure during COVID-19 Quarantine among the Sicilian Active Population: A Cross-Sectional Online Survey Study

      Center for Biotechnology, Sbarro Institute for Cancer Research and Molecular Medicine (Temple University) (2020-05-26)
      Background: During the coronavirus disease 2019 (COVID-19) pandemic, the Italian government has adopted containment measures to control the virus’s spread, including limitations to the practice of physical activity (PA). The aim of this study was to estimate the levels of PA, expressed as energy expenditure (MET–minute/week), among the physically active Sicilian population before and during the last seven days of the COVID-19 quarantine. Furthermore, the relation between this parameter and specific demographic and anthropometric variables was analyzed. Methods: 802 Sicilian physically active participants (mean age: 32.27 ± 12.81 years; BMI: 23.44 ± 3.33 kg/m2) were included in the study and grouped based on gender, age and BMI. An adapted version of the International Physical Activity Questionnaire—short form (IPAQ-SF) was administered to the participants through an online survey. The Wilcoxon signed-rank test and the Kruskal-Wallis rank-sum test were used for statistical analyses. Results: As expected, we observed a significant decrease of the total weekly energy expenditure during the COVID-19 quarantine (p < 0.001). A significant variation in the MET–min/wk in the before quarantine condition (p = 0.046) and in the difference between before and during quarantine (p = 0.009) was found for males and females. The male group decreased the PA level more than the female one. Moreover, a significant difference in the MET–min/wk was found among groups distributions of BMI (p < 0.001, during quarantine) and of age (p < 0.001, both before and during quarantine). In particular, the highest and the lowest levels of PA were reported by the young and the elderly, respectively, both before and during quarantine. Finally, the overweight group showed the lowest level of PA during quarantine. Conclusion: Based on our outcomes, we can determine that the current quarantine has negatively affected the practice of PA, with greater impacts among males and overweight subjects. In regards to different age groups, the young, young adults and adults were more affected than senior adults and the elderly.
    • Pneumothorax bei COVID-19-Erkrankung – Inzidenz und klinische Merkmale

      Zantah, Massa; Dominguez-Castillo, Eduardo; Townsend, Ryan; Dikengil, Fusun; Criner, Gerard J. (2021-02)
      Background: Spontaneous pneumothorax is a rarely occurring complication of viral pneumonia in COVID-19. The exact incidence and risk factors are still unclear. In the present work we examine the incidence and outcomes of more than 3,000 patients with pneumothorax who were admitted to our clinic with suspected COVID-19 pneumonia. METHODS: We retrospectively reviewed the cases of COVID-19 patients admitted to our clinic. To calculate the incidence of this event, patients diagnosed with spontaneous pneumothorax were identified and their clinical features were extensively documented. Clinical outcome data were collected. The individual cases are each presented in the form of a short summary. Results: Between March 1st and March 8th June 2020, 3368 patients with suspected COVID-19 pneumonia were admitted to our clinic; of these, 902 patients had a positive nasopharyngeal smear. Six COVID-19 patients who developed spontaneous pneumothorax were identified (0.66%). Baseline imaging showed diffuse bilateral frosted glass opacities and consolidations in these patients, predominantly in the posterior and peripheral lung regions. Four of the six patients were mechanically ventilated. Chest drainage was required in all patients. In all cases there was no direct relationship between the pneumothorax and mortality (66.6%). Conclusion: Spontaneous pneumothorax is a rare complication of viral pneumonia in COVID-19 that can occur without mechanical ventilation.
    • Pneumothorax in COVID-19 disease- incidence and clinical characteristics

      Zantah, Massa; Dominguez Castillo, Eduardo; Townsend, Ryan; Dikengil, Fusun; Criner, Gerard J.; 0000-0002-3030-6639; 0000-0002-1828-6524 (2020-09-16)
      Background: Spontaneous pneumothorax is an uncommon complication of COVID-19 viral pneumonia. The exact incidence and risk factors are still unknown. Herein we review the incidence and outcomes of pneumothorax in over 3000 patients admitted to our institution for suspected COVID-19 pneumonia. Methods: We performed a retrospective review of COVID-19 cases admitted to our hospital. Patients who were diagnosed with a spontaneous pneumothorax were identified to calculate the incidence of this event. Their clinical characteristics were thoroughly documented. Data regarding their clinical outcomes were gathered. Each case was presented as a brief synopsis. Results: Three thousand three hundred sixty-eight patients were admitted to our institution between March 1st, 2020 and June 8th, 2020 for suspected COVID 19 pneumonia, 902 patients were nasopharyngeal swab positive. Six cases of COVID-19 patients who developed spontaneous pneumothorax were identified (0.66%). Their baseline imaging showed diffuse bilateral ground-glass opacities and consolidations, mostly in the posterior and peripheral lung regions. 4/6 cases were associated with mechanical ventilation. All patients required placement of a chest tube. In all cases, mortality (66.6%) was not directly related to the pneumothorax. Conclusion: Spontaneous pneumothorax is a rare complication of COVID-19 viral pneumonia and may occur in the absence of mechanical ventilation. Clinicians should be vigilant about the diagnosis and treatment of this complication.
    • Policing and public health calls for service in Philadelphia

      Ratcliffe, Jerry; Ratcliffe|0000-0002-0730-6761 (2021-03-02)
      This contribution outlines various spatial and temporal aspects of medical or public-health related calls for service from the public to police in Philadelphia in 2019. These incidents comprise about 8% of the police department’s workload that originates from the public. Calls appear to be highly concentrated in a few areas, and specifically the Center City and Kensington neighborhoods. They are also more likely to occur late afternoon and evening. The article shows that some medical or public health activity initially masquerades as crime or other policing work and some events eventually determined to be police/crime activity can initially appear to be public health related. About 20% of activity in this area does not appear predictable from the initial call type as handled by police dispatch.
    • Predicting the mutational drivers of future SARS-CoV-2 variants of concern

      Institute for Genomics and Evolutionary Medicine (iGEM) (Temple University) (2021-06-22)
      SARS-CoV-2 evolution threatens vaccine- and natural infection-derived immunity, and the efficacy of therapeutic antibodies. Herein we sought to predict Spike amino acid changes that could contribute to future variants of concern. We tested the importance of features comprising epidemiology, evolution, immunology, and neural network-based protein sequence modeling. This resulted in identification of the primary biological drivers of SARS-CoV-2 intra-pandemic evolution. We found evidence that resistance to population-level host immunity has increasingly shaped SARS-CoV-2 evolution over time. We identified with high accuracy mutations that will spread, at up to four months in advance, across different phases of the pandemic. Behavior of the model was consistent with a plausible causal structure wherein epidemiological variables integrate the effects of diverse and shifting drivers of viral fitness. We applied our model to forecast mutations that will spread in the future, and characterize how these mutations affect the binding of therapeutic antibodies. These findings demonstrate that it is possible to forecast the driver mutations that could appear in emerging SARS-CoV-2 variants of concern. This modeling approach may be applied to any pathogen with genomic surveillance data, and so may address other rapidly evolving pathogens such as influenza, and unknown future pandemic viruses.
    • Preliminary predictive criteria for COVID-19 cytokine storm

      COVID-19 Research Group (Temple University) (2020-09-25)
      Objectives: To develop predictive criteria for COVID-19-associated cytokine storm (CS), a severe hyperimmune response that results in organ damage in some patients infected with COVID-19. We hypothesised that criteria for inflammation and cell death would predict this type of CS. Methods: We analysed 513 hospitalised patients who were positive for COVID-19 reverse transcriptase PCR and for ground-glass opacity by chest high-resolution CT. To achieve an early diagnosis, we analysed the laboratory results of the first 7 days of hospitalisation. We implemented logistic regression and principal component analysis to determine the redictive criteria. We used a ’genetic algorithm’ to derive the cut-offs for each laboratory result. We validated the criteria with a second cohort of 258 patients. Results: We found that the criteria for macrophage activation syndrome, haemophagocytic lymphohistiocytosis and the HScore did not identify the COVID-19 cytokine storm (COVID-CS). We developed new predictive criteria, with sensitivity and specificity of 0.85 and 0.80, respectively, comprising three clusters of laboratory results that involve (1) inflammation, (2) cell death and tissue damage, and (3) prerenal electrolyte imbalance. The criteria identified patients with longer hospitalisation and increased mortality. These results highlight the relevance of hyperinflammation and tissue damage in the COVID-CS. Conclusions: We propose new early predictive criteria to identify the CS occurring in patients with COVID-19. The criteria can be readily used in clinical practice to determine the need for an early therapeutic regimen,block the hyperimmune response and possibly decrease mortality.
    • Preschoolers Benefit Equally From Video Chat, Pseudo-Contingent Video, and Live Book Reading: Implications for Storytime During the Coronavirus Pandemic and Beyond

      Gaudreau, Caroline; King, Yemimah A.; Dore, Rebecca A.; Puttre, Hannah; Nichols, Deborah; Hirsh-Pasek, Kathy; Golinkoff, Roberta Michnick; 0000-0003-2947-4544 (2020-09-03)
      During the unprecedented coronavirus disease (COVID-19) crisis, virtual education activities have become more prevalent than ever. One activity that many families have incorporated into their routines while at home is virtual storytime, with teachers, grandparents, and other remote adults reading books to children over video chat. The current study asks how dialogic reading over video chat compares to more traditional forms of book reading in promoting story comprehension and vocabulary learning. Fifty-eight 4-year-olds (Mage = 52.7, SD = 4.04, 31 girls) were randomly assigned to one of three conditions (Video chat, Live, and Prerecorded). Across conditions, children were read the same narrative storybook by a female experimenter who used the same 10 scripted dialogic reading prompts during book reading. In the Video chat (n = 21) and Live conditions (n = 18), the experimenter gave the scripted prompts and interacted naturally and contingently, responding in a timely, relevant manner to children’s behaviors. In the Prerecorded condition (n = 19), children viewed a video of an experimenter reading the book. The Prerecorded condition was pseudo-contingent; the reader posed questions and paused for a set period of time as if to wait for a child’s response. After reading, children completed measures of vocabulary and comprehension. Results revealed no differences between conditions across six different outcome measures, suggesting that children comprehended and learned from the story similarly across book formats. Further, children in the three experimental conditions scored significantly higher on measures than children in a fourth condition (control) who had never read the book, confirming that children learned from the three different book formats. However, children were more responsive to the prompts in the Live and Video chat conditions than the Prerecorded condition, suggesting that children recognized that these interactions were contingent with their responses, a feature that was lacking in the Prerecorded condition. Results indicate that children can comprehend books over video chat, suggesting that this technology is a viable option for reading to children, especially during the current pandemic.
    • Profiles of Social Distance Compliance: Psychological and Situational Predictors of Risky Behavior during COVID-19

      Haupt, Michael Robert; Meredith Weiss, Staci; Chiu, Michelle; Cuomo, Raphael; Chein, Jason; Mackey, Tim; 0000-0002-9178-6680; 0000-0002-8430-7899 (2020-06-05)
      The purpose of this study was to explore the factors underlying variability in compliance with CDC guidelines in response to the novel coronavirus, or COVID-19. To do this, we examined the frequency of once ordinary, but newly risky behavior (as deemed by CDC guidelines) in a sample of 482 MTurkers. We ran analyses probing the situational and dispositional variables that predicted variance in risky behavior using data-driven and hypothesis-generated approaches. We found situational and dispositional variables contributed unique variance to risky behavior, controlling for variability accounted for by demographic factors. More frequent report of risky activity was associated with higher extraversion, need for cognitive closure, behavior activation, and perceived resource scarcity; in contrast, more frequent report of risky activity was associated with less empathy and living space access, as well as younger age. To break down these findings, we used a cluster analysis to profile individuals, using only situational and dispositional variables belonging to seven clusters. Combined with testing differences in risk taking by cluster identity, we suggest this profile approach might allow consideration of multi-faceted attributes that influence adherence with public health guidance in the context of health emergencies like the COVID-19 pandemic.
    • Progress for Journal of Functional Morphology and Kinesiology in 2020

      Sbarro Institute for Cancer Research and Molecular Medicine (Temple University) (2021-01-22)
    • QAIS-DSNN: Tumor Area Segmentation of MRI Image with Optimized Quantum Matched-Filter Technique and Deep Spiking Neural Network

      Ahmadi, Mohsen; Sharifi, Abbas; Hassantabar, Shayan; Enayati, Saman (2021-01-21)
      Tumor segmentation in brain MRI images is a noted process that can make the tumor easier to diagnose and lead to effective radiotherapy planning. Providing and building intelligent medical systems can be considered as an aid for physicians. In many cases, the presented methods’ reliability is at a high level, and such systems are used directly. In recent decades, several methods of segmentation of various images, such as MRI, CT, and PET, have been proposed for brain tumors. Advanced brain tumor segmentation has been a challenging issue in the scientific community. The reason for this is the existence of various tumor dimensions with disproportionate boundaries in medical imaging. This research provides an optimized MRI segmentation method to diagnose tumors. It first offers a preprocessing approach to reduce noise with a new method called Quantum Matched-Filter Technique (QMFT). Then, the deep spiking neural network (DSNN) is implemented for segmentation using the conditional random field structure. However, a new algorithm called the Quantum Artificial Immune System (QAIS) is used in its SoftMax layer due to its slowness and nonsegmentation and the identification of suitable features for selection and extraction. The proposed approach, called QAIS-DSNN, has a high ability to segment and distinguish brain tumors from MRI images. The simulation results using the BraTS2018 dataset show that the accuracy of the proposed approach is 98.21%, average error-squared rate is 0.006, signal-to-noise ratio is 97.79 dB, and lesion structure criteria including the tumor nucleus are 80.15%. The improved tumor is 74.50%, and the entire tumor is 91.92%, which shows a functional advantage over similar previous methods. Also, the execution time of this method is 2.58 seconds.
    • Rate of Decompensation of Normoxic Emergency Department Patients with SARS-CoV-2

      Schreyer, Kraftin; Isenberg, Derek; Satz, Wayne A.; Lucas, Nicole; Rosenbaum, Jennifer; Zandrow, Gregory; Gentle, Nina T.; Schreyer|0000-0001-8955-2060; Isenberg|0000-0001-5814-1023; Lucas|0000-0002-5251-2230 (2021-04-02)
      Introduction: As of October 30, 2020, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected over 44 million people worldwide and killed over 1.1 million people. In the emergency department (ED), patients who need supplemental oxygen or respiratory support are admitted to the hospital, but the course of normoxic patients with SARS-CoV-2 infection is unknown. In our health system, the policy during the coronavirus 2019 (COVID-19) pandemic was to admit all patients with abnormal chest imaging (CXR) regardless of their oxygen level. We also admitted febrile patients with respiratory complaints who resided in congregate living. We describe the rate of decompensation among patients admitted with suspected SARS-CoV-2 infection but who were not hypoxemic in the ED. Methods: This is a retrospective observational study of patients admitted to our health system between March 1–May 5, 2020 with suspected SARS-CoV-2 infection. We queried our registry to find patients who were admitted to the hospital but had no recorded oxygen saturation of <92% in the ED and received no supplemental oxygen prior to admission. Our primary outcome was decompensation at 72 hours, defined by the need for respiratory support (oxygen, high-flow nasal cannula, non-invasive ventilation, or intubation). Results: A total of 840 patients met our inclusion criteria. Of those patients, 376 (45%) tested positive for SARS-CoV-2. Sixty patients (7.1%) with suspected COVID-19 required respiratory support at 72 hours including 27 (3%) of confirmed SARS-CoV-2 positive patients. Among the 376 patients who tested positive for SARS-CoV-2, 54 patients (14%) had normal CXR in the ED. One-third of patients with normal CXRs decompensated at 72 hours. Seven SARS-CoV-2 positive patients in our cohort died during their hospitalization, of whom five had normal CXRs on admission. Conclusion: Sixty (7.1%) of suspected COVID-19 patients hospitalized at 72 hours required respiratory support despite being normoxic in the ED. Further research should look to identify the normoxic SARS-CoV-2 patients at risk for decompensation.
    • #RealCollege 2021: Basic Needs Insecurity During the Ongoing Pandemic

      The Hope Center for College, Community, and Justice (Temple University) (Temple University. The Hope Center for College, Community, and Justice, 2021-03-31)
      Entering the fall 2020 term, higher education was reeling from the coronavirus pandemic. Enrollment was down—particularly among students most at risk of basic needs insecurity; fewer students had completed the Free Application for Federal Student Aid (FAFSA); and college retention rates had dropped. Students and faculty were stressed and anxious. By the end of the term, more than 267,000 Americans died. At the same time, the federal government pumped an unprecedented $6 billion into student emergency aid via the Coronavirus Aid, Relief, and Economic Security (CARES) Act. This report examines the pandemic’s impact on #RealCollege students who were able to continue their education in this challenging environment. Using our sixth annual #RealCollege Survey, fielded in fall 2020, we assessed students’ basic needs security and their well-being, as indicated by employment status, academic engagement, and mental health. In total, over 195,000 students from 130 two-year colleges and 72 four-year colleges and universities responded to the 2020 #RealCollege Survey.
    • Recent Smell Loss Is the Best Predictor of COVID-19 Among Individuals With Recent Respiratory Symptoms

      Gerkin, Richard C.; Ohla, Kathrin; Veldhuizen, Maria G.; Joseph, Paule V.; Kelly, Christine E.; Bakke, Alyssa J.; Steele, Kimberley E.; Farruggia, Michael C.; Pellegrino, Robert; Pepino, Marta Y.; Bouysset, Cédric; Soler, Graciela M.; Pereda-Loth, Veronica; Dibattista, Michele; Cooper, Keiland W.; Croijmans, Ilja; Di Pizio, Antonella; Ozdener, Mehmet Hakan; Fjaeldstad, Alexander W.; Lin, Cailu; Sandell, Mari A.; Singh, Preet B.; Brindha, V. Evelyn; Olsson, Shannon B.; Saraiva, Luis R.; Ahuja, Gaurav; Alwashahi, Mohammed K.; Bhutani, Surabhi; D'Errico, Anna; Fornazieri, Marco A.; Golebiowski, Jérôme; Hwang, Liang Dar; Öztürk, Lina; Roura, Eugeni; Spinelli, Sara; Whitcroft, Katherine L.; Faraji, Farhoud; Fischmeister, Florian Ph S.; Heinbockel, Thomas; Hsieh, Julien W.; Huart, Caroline; Konstantinidis, Iordanis; Menini, Anna; Morini, Gabriella; Olofsson, Jonas K.; Philpott, Carl M.; Pierron, Denis; Shields, Vonnie D.C.; Voznessenskaya, Vera V.; Albayay, Javier; Altundag, Aytug; Bensafi, Moustafa; Bock, María Adelaida; Calcinoni, Orietta; Fredborg, William; Laudamiel, Christophe; Lim, Juyun; Lundström, Johan N.; Macchi, Alberto; Meyer, Pablo; Moein, Shima T.; Santamaría, Enrique; Sengupta, Debarka; Dominguez, Paloma Rohlfs; Yanik, Hüseyin; Hummel, Thomas; Hayes, John E.; Reed, Danielle R.; Niv, Masha Y.; Munger, Steven D.; Parma, Valentina (2020-12-25)
      In a preregistered, cross-sectional study, we investigated whether olfactory loss is a reliable predictor of COVID-19 using a crowdsourced questionnaire in 23 languages to assess symptoms in individuals self-reporting recent respiratory illness. We quantified changes in chemosensory abilities during the course of the respiratory illness using 0–100 visual analog scales (VAS) for participants reporting a positive (C19+; n = 4148) or negative (C19−; n = 546) COVID-19 laboratory test outcome. Logistic regression models identified univariate and multivariate predictors of COVID-19 status and post-COVID-19 olfactory recovery. Both C19+ and C19− groups exhibited smell loss, but it was significantly larger in C19+ participants (mean ± SD, C19+: −82.5 ± 27.2 points; C19−: −59.8 ± 37.7). Smell loss during illness was the best predictor of COVID-19 in both univariate and multivariate models (ROC AUC = 0.72). Additional variables provide negligible model improvement. VAS ratings of smell loss were more predictive than binary chemosensory yes/no-questions or other cardinal symptoms (e.g., fever). Olfactory recovery within 40 days of respiratory symptom onset was reported for ~50% of participants and was best predicted by time since respiratory symptom onset. We find that quantified smell loss is the best predictor of COVID-19 amongst those with symptoms of respiratory illness. To aid clinicians and contact tracers in identifying individuals with a high likelihood of having COVID-19, we propose a novel 0–10 scale to screen for recent olfactory loss, the ODoR-19. We find that numeric ratings ≤2 indicate high odds of symptomatic COVID-19 (4 < OR < 10). Once independently validated, this tool could be deployed when viral lab tests are impractical or unavailable.
    • Recombination and purifying selection preserves covariant movements of mosaic SARS-CoV-2 protein S

      Tagliamonte, Massimiliano S.; Abid, Nabil; Ostrov, David A.; Chillemi, Giovanni; Pond, Sergei; Salemi, Marco; Mavian, Carla; 0000-0003-4817-4029 (2020-06-10)
      In depth evolutionary and structural analyses of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) isolated from bats, pangolins, and humans are necessary to assess the role of natural selection and recombination in the emergence of the current pandemic strain. The SARS-CoV-2 S glycoprotein unique features have been associated with efficient viral spread in the human population. Phylogeny-based and genetic algorithm methods clearly show that recombination events between viral progenitors infecting animal hosts led to a mosaic structure in the S gene. We identified recombination coldspots in the S glycoprotein and strong purifying selection. Moreover, although there is little evidence of diversifying positive selection during host-switching, structural analysis suggests that some of the residues emerged along the ancestral lineage of current pandemic strains may contribute to enhanced ability to infect human cells. Interestingly, recombination did not affect the long-range covariant movements of SARS-CoV-2 S glycoprotein monomer in pre-fusion conformation but, on the contrary, could contribute to the observed overall viral efficiency. Our dynamic simulations revealed that the movements between the host cell receptor binding domain (RBD) and the novel furin-like cleavage site are correlated. We identified threonine 333 (under purifying selection), at the beginning of the RBD, as the hinge of the opening/closing mechanism of the SARS-CoV-2 S glycoprotein monomer functional to hACE2 binding. Our findings support a scenario where ancestral recombination and fixation of amino acid residues in the RBD of the S glycoprotein generated a virus with unique features, capable of extremely efficient infection of the human host.
    • Repeated COVID-19 relapse during post-discharge surveillance with viral shedding lasting for 67 days in a recovered patient infected with SARS-CoV-2

      Liu, Fang; Cai, Zhao-bin; Huang, Jin-song; Niu, Hai-ying; Yu, Wen-yan; Zhang, Yan; Yan, Ting-bo; Chen, Chen; Liu, Yuan; Xu, Ai-fang (2020-08-06)
      A case who revealed the longest duration of viral shedding (67 days) in current reports, presented complicated characteristic on the relapse of COVID-19 due to the inconsistent performance of chest radiography and SARS-CoV-2-RNA detection after discharge. Lopinavir-interferon α2b boosted ribavirin following with lopinavir boosted budesonide might be a potent treatment for viral clearance.
    • Response to: ‘Correspondence on ‘Preliminary predictive criteria for COVID-19 cytokine storm’’ by Tampe et al

      Caricchio, Roberto; Gallucci, Marcello; Dass, Chandra; Zhang, Xinyan; Gallucci, Stefania; Fleece, David; Bromberg, Michael; Criner, Gerard J.; Caricchio|0000-0002-1379-1118 (2021-01-07)
    • Retrospective analysis of high flow nasal therapy in COVID-19-related moderate-to-severe hypoxaemic respiratory failure

      Patel, Maulin; Gangemi, Andrew; Marron, Robert; Chowdhury, Junad; Yousef, Ibraheem; Zheng, Matthew; Mills, Nicole; Tragesser, Lauren; Giurintano, Julie; Gupta, Rohit; Gordon, Matthew; Rali, Parth; D'Alonso, Gilbert; Fleece, David; Zhao, Huaqing; Patlakh, Nicole; Criner, Gerard; 0000-0001-6558-1924; 0000-0002-8764-6538; 0000-0003-2775-2918; 0000-0002-0953-4768| (2020-08-26)
      Invasive mechanical has been associated with high mortality in COVID-19. Alternative therapy of high flow nasal therapy (HFNT) has been greatly debated around the world for use in COVID-19 pandemic due to concern for increased healthcare worker transmission.This was a retrospective analysis of consecutive patients admitted to Temple University Hospital in Philadelphia, Pennsylvania, from 10 March 2020 to 24 April 2020 with moderate-to-severe respiratory failure treated with HFNT. Primary outcome was prevention of intubation. Of the 445 patients with COVID-19, 104 met our inclusion criteria. The average age was 60.66 (+13.50) years, 49 (47.12 %) were female, 53 (50.96%) were African-American, 23 (22.12%) Hispanic. Forty-three patients (43.43%) were smokers. Saturation to fraction ratio and chest X-ray scores had a statistically significant improvement from day 1 to day 7. 67 of 104 (64.42%) were able to avoid invasive mechanical ventilation in our cohort. Incidence of hospital-associated/ventilator-associated pneumonia was 2.9%. Overall, mortality was 14.44% (n=15) in our cohort with 13 (34.4%) in the progressed to intubation group and 2 (2.9%) in the non-intubation group. Mortality and incidence of pneumonia was statistically higher in the progressed to intubation group.