COVID-19 vaccine effectiveness among healthcare workers in Portugal: results from a hospital-based cohort study, December 2020 to November 2021

Introduction: Healthcare workers (HCW) were amongst the first prioritized for COVID-19 vaccination but data on COVID–19 vaccine effectiveness among HCW is still limited. This study aims to estimate the COVID–19 vaccine effectiveness (VE) against SARS–CoV–2 symptomatic infection among HCW from Portuguese hospitals. Methods: In this prospective cohort study, we analysed data from HCW (all professional categories) from two central hospitals in the Lisbon and Tagus Valley and Centre regions of mainland Portugal between December 2020 and November 2021. VE against symptomatic SARS–CoV–2 infection was estimated as one minus the confounder adjusted hazard ratios by Cox models considering age group, sex, presence of chronic disease and occupational exposure to patients diagnosed with COVID–19 as adjustment variables. Results: During the 11 months of follow up, the 2213 HCW contributed a total of 1950 person-years at risk and 171 SARS–CoV–2 events occurred. The COVID–19 incidence rate for unvaccinated HCW was 348.7 per 1000 person-years while for fully vaccinated HCW was 43.0 per 1000 person-years. We observed a VE against symptomatic SARS–CoV–2 infection of 73.9% (95% CI: 26.2–90.8%) for complete vaccination status. Conclusion: This cohort study found a high COVID-19 VE against symptomatic SARS–CoV–2 infection in Portuguese HCW, which is in concordance with previous studies from other countries. Monitoring of VE in this HCW cohort continues during the winter 2021/2022 to evaluate potential VE decay and booster vaccine effect. Keywords: Vaccine effectiveness, SARS–CoV–2 , COVID–19, symptomatic infection, healthcare workers.

Assessment of population infection with SARS-CoV-2 in Ontario, Canada, March to June 2020

Background Serosurveys for SARS-CoV-2 aim to estimate the proportion of the population that has been infected. Aim This observational study assesses the seroprevalence of SARS-CoV-2 antibodies in Ontario, Canada during the first pandemic wave. Methods Using an orthogonal approach, we tested 8,902 residual specimens from the Public Health Ontario laboratory over three time periods during March–June 2020 and stratified results by age group, sex and region. We adjusted for antibody test sensitivity/specificity and compared with reported PCR-confirmed COVID-19 cases. Results Adjusted seroprevalence was 0.5% (95% confidence interval (CI): 0.1–1.5) from 27 March–30 April, 1.5% (95% CI: 0.7–2.2) from 26–31 May, and 1.1% (95% CI: 0.8–1.3) from 5–30 June 2020. Adjusted estimates were highest in individuals aged ≥ 60 years in March–April (1.3%; 95% CI: 0.2–4.6), in those aged 20–59 years in May (2.1%; 95% CI: 0.8–3.4) and in those aged ≥ 60 years in June (1.6%; 95% CI: 1.1–2.1). Regional seroprevalence varied, and was highest for Toronto in March–April (0.9%; 95% CI: 0.1–3.1), for Toronto in May (3.2%; 95% CI: 1.0–5.3) and for Toronto (1.5%; 95% CI: 0.9–2.1) and Central East in June (1.5%; 95% CI: 1.0–2.0). We estimate that COVID-19 cases detected by PCR in Ontario underestimated SARS-CoV-2 infections by a factor of 4.9. Conclusions Our results indicate low population seroprevalence in Ontario, suggesting that public health measures were effective at limiting the spread of SARS-CoV-2 during the first pandemic wave.

Exposure to a Multilevel, Multicomponent Obesity Prevention Intervention (OPREVENT2) in Rural Native American Communities: Variability and Association with Change in Diet Quality

The OPREVENT2 obesity prevention trial was a multilevel multicomponent (MLMC) intervention implemented in rural Native American communities in the Midwest and Southwest U.S. Intervention components were delivered through local food stores, worksites, schools, community action coalitions, and by social and community media. Due to the complex nature of MLMC intervention trials, it is useful to assess participants’ exposure to each component of the intervention in order to assess impact. In this paper, we present a detailed methodology for evaluating participant exposure to MLMC intervention, and we explore how exposure to the OPREVENT2 trial impacted participant diet quality. There were no significant differences in total exposure score by age group, sex, or geographic region, but exposure to sub-components of the intervention differed significantly by age group, sex, and geographical region. Participants with the highest overall exposure scores showed significantly more improvement in diet quality from baseline to follow up compared to those who were least exposed to the intervention. Improved diet quality was also significantly positively associated with several exposure sub-components. While evaluating exposure to an entire MLMC intervention is complex and imperfect, it can provide useful insight into an intervention’s impact on key outcome measures, and it can help identify which components of the intervention were most effective.

Perceptions of love and sex in young and middle Greek adults, relationship satisfaction and duration

Sexuality is perceived either as result or prerequisite of love or as working in tandem with love in romantic relationships. Hendrick & Hendrick (2002) proposed a theory and a measure capturing the lay perceptions of the love-sex link. The PLSS (Perceptions of Love and Sex Scale) comprises four themes/subscales, Love is Most Important, Love Comes Before Sex (“love themes”), Sex is Declining, Sex Demonstrates Love (“sex themes”). We examined the validity of PLSS in the Greek context, across two age-groups, young (18-40) and middle adults (41-65), and whether the themes predicted relationship satisfaction and duration. Greek participant (N=631) in romantic relationships responded online to the PLSS and other measures of relationship constructs (e.g., passionate, companionate love, sex, satisfaction). Exploratory and confirmatory factor analyses revealed that the PLSS maintained its fourfold structure. The PLSS sexual themes correlated more strongly with relationship constructs than love themes. Young adult women stated that Sex was Declining less than middle adult ones and reported shorter relationships than men. Irrespective of age-group, Sex is (not) Declining, Love is Most Important, and Sex Demonstrates Love predicted satisfaction. Love Comes Before Sex and Sex is Declining predicted duration among young adults. Sex is Declining was the only predictor of duration among middle adults. Our findings suggest that love and sex work in tandem but sexual themes are more important for the Greek population. The study corroborated the validity of PLSS in the Greek context, demonstrating its sensitivity to capture cultural developments in conceptions of intimacy.

Prevalence of ESBL-producing and multi-drug resistant Escherichia coli isolated from urine of HIV patients in General Hospital Gboko, Benue State

Prevalence of ESBL-producing and multi-drug resistant Escherichia coli in HIV patients attending General Hospital Gboko, Benue State was investigated. A total of two hundred and five urine samples were collected from patients in the hospital and inoculated on Cysteine lactose electrolyte deficient (CLED) agar. The plates were incubated at 37 0C for 24 hours for isolation of bacteria. Bacteria isolates were characterized by Gram staining and biochemical tests. Antibiotic resistance testing was performed using Kirby-Bauer disc diffusion method. The results revealed a prevalence of 23(11.22%) in this group. Sex prevalence of ESBL-producing Escherichia coli was observed to be significantly higher in female subjects 20(12.98%) compared to male patients 3(5.88%). All isolates were resistant to Cefuroxime 23(100.0%), Augmentin 23(100.0%), followed by Ceftazidime 22(95.65%), Gentamycin 20(86.96%), Nitrofurantoin 19(82.6%), Ofloxacin 18(78.26%), and Ciprofloxacin 18(78.26%). The least resistance was observed with the antibiotic Cefotaxime 13(56.5%). The presence of ESBL-producing and multi-drug resistant Escherichia coli in urine samples of HIV patients indicates an infection which presents a major threat to public health since such infections may be difficult to treat and may subsequently result to death of the patients. Constant periodic surveillance of urinary tract pathogens isolated from HIV patients and non-abuse of antibiotics will help check this ugly trend especially in developing nations like Nigeria.

Rehabilitation and In-Hospital Mortality in COVID-19 patients

Background COVID-19 guidelines endorse early rehabilitation to improve outcomes in hospitalized patients, but the evidence-base to support this recommendation is lacking. We examined the association between early rehabilitation and in-hospital deaths in COVID-19 patients. Methods Single center retrospective study involving 990 COVID-19 patients (42·4% women, mean age 67.8 years) admitted between March 1, 2020 and May 31, 2020 to a community hospital. Association of rehabilitation during hospitalization with in-hospital mortality was examined using logistic regression analysis adjusted for demographics, length of stay, body mass index, comorbid illnesses, functional status as well as for COVID-19 presentations, treatments, and complications. Results Over the 3-month study period, 475 (48·0%) in-patients were referred for rehabilitation. Patients who received rehabilitation were older (73·7 ± 14·0 vs. 62·3 ± 17·2). There were 61 hospital deaths (12·8%) in the rehabilitation group and 165 (32·0%) in the non-rehabilitation group. Receiving rehabilitation was associated with an 89% lower in-hospital mortality (OR 0·11, 95% CI 0·06–0·19) after adjusting for multiple confounders and COVID-19 disease markers. In sensitivity analyses, the results were significant in sub-populations defined by age group, sex, race, length of hospitalization, or pulmonary presentations. Each additional rehabilitation session was associated with a 29% lower risk of in-hospital mortality (OR per session 0·71, 95% CI 0·64-0·79) in the fully adjusted model. Conclusion Among hospitalized COVID-19 patients, receiving early rehabilitation was associated with lower in-hospital mortality. Our findings support implementation of rehabilitation services for COVID-19 patients in acute care settings, but further research from randomized clinical trials is needed.

In-Hospital Mortality in Non-COVID-19-Related Diseases before and during the Pandemic: A Regional Retrospective Study

Italy was one of the nations most affected by SARS-CoV-2. During the pandemic period, the national government approved some restrictions to reduce diffusion of the virus. We aimed to evaluate changes in in-hospital mortality and its possible relation with patient comorbidities and different restrictive public health measures adopted during the 2020 pandemic period. We analyzed the hospital discharge records of inpatients from public and private hospitals in Apulia (Southern Italy) from 1 January 2019 to 31 December 2020. The study period was divided into four phases according to administrative restriction. The possible association between in-hospital deaths, hospitalization period, and covariates such as age group, sex, Charlson comorbidity index (CCI) class, and length of hospitalization stay (LoS) class was evaluated using a multivariable logistic regression model. The risk of death was slightly higher in men than in women (OR 1.04, 95% CI: 1.01–1.07) and was lower for every age group below the >75 years age group. The risk of in-hospital death was lower for hospitalizations with a lower CCI score. In summary, our analysis shows a possible association between in-hospital mortality in non-COVID-19-related diseases and restrictive measures of public health. The risk of hospital death increased during the lockdown period.

Sexual Dimorphism in Testosterone Programming of Cardiomyocyte Development in Sheep

Perturbed in-utero hormone milieu leads to intrauterine growth retardation (IUGR), a known risk factor for left ventricular (LV) dysfunction later in life. Gestational testosterone (T) excess predisposes offspring to IUGR and leads to LV myocardial disarray and hypertension in adult females. However, the early impact of T excess on LV programming and if it is female-specific is unknown. LV tissues were obtained at day 90 gestation from days 30-90 T-treated or control fetuses (n=6/group/sex) and morphometric and molecular analyses were conducted. Gestational T treatment increased cardiomyocyte number only in female fetuses. T excess up-regulated receptor expression of insulin and insulin-like growth factor. Furthermore, in a sex-specific manner, T increased expression of Phosphatidylinositol 3-kinase (PI3K) while down regulating phosphorylated mammalian target of rapamycin (pmTOR) /mTOR ratio suggestive of compensatory response. T excess 1) upregulated atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP), markers of stress and cardiac hypertrophy 2) upregulated estrogen receptors1 (ESR1) and 2 (ESR2) but not in androgen receptor (AR). Thus, gestational T excess upregulated markers of cardiac stress and hypertrophy in both sexes while inducing cardiomyocyte hyperplasia only in females, likely mediated via insulin and estrogenic programming.

33 Impact of Including the Cause of Missing Records on Genetic Evaluations for Growth in Commercial Pigs

It is of interest to evaluate crossbred pigs for hot carcass weight (HCW) and birth weight (BW); however, obtaining a HCW record is dependent on livability (LIV) and retained tag (RT). The purpose of this study is to analyze how HCW evaluations are affected when herd removal and missing identification are included in the model and examine if accounting for the reasons for missing traits improves the accuracy of predicting breeding values. Pedigree information was available for 1,965,077 purebred and crossbred animals. Records for 503,716 commercial three-way crossbred terminal animals from 2014 to 2019 were provided by Smithfield Premium Genetics. Two pedigree-based models were compared; model 1 (M1) was a threshold-linear model with all four traits (BW, HCW, RT, and LIV), and model 2 (M2) was a linear model including only BW and HCW. The fixed effects used in the model were contemporary group, sex, age at harvest (for HCW only), and dam parity. The random effects included direct additive genetic and random litter effects. Accuracy, dispersion, bias, and Pearson correlations were estimated using the linear regression method. The heritabilities were 0.11, 0.07, 0.02, and 0.04 for BW, HCW, RT, and LIV, respectively, with standard errors less than 0.01. No difference was observed in heritabilities or accuracies for BW and HCW between M1 and M2. Accuracies were 0.33, 0.37, 0.19, and 0.23 for BW, HCW, RT, and LIV respectively. The genetic correlation between BW and RT was 0.34 ± 0.03, and between BW and LIV was 0.56 ± 0.03. The positive and moderate genetic correlations between BW and other traits imply a heavier BW resulted in a higher probability of surviving to harvest. Despite the heritable and correlated aspects of RT and LIV, results imply no major differences between M1 and M2; hence, it is unnecessary to include these traits in classical models for BW and HCW.