摘要： This paper explores patterns of communication during the COVID-19 pandemic in four countries with right-wing populist governments during that period, Brazil, Poland, Serbia and the United States, based on interviews with key actors involved in that process. We look at a number of characteristics normally associated with populist rule and political culture likely to affect pandemic communication, including polarization, cultural populism hostile to expertise, personalized rule and machismo, the performance of crisis, and illiberalism. We find that many of these characteristics can be seen in patterns of pandemic communication across the four countries, but also find significant differences in the response of populist leaders between, the U.S. and Brazil, on one hand, and Poland and Serbia on the other. Differences can be linked to different varieties of populism in the four countries and specifically their commitment to libertarian or more statist approaches, which also inform disparate public health policies, as well as to different levels of entrenchment of populists in positions of power. We conclude by discussing the politicization of public health and the lessons of the COVID pandemic for emergency risk communication in the era of populism.

摘要： We previously showed worse outcomes among lower socioeconomic status (SES) groups following metabolic/bariatric surgery (MBS). In light of healthcare changes in response to COVID-19, this study aims to evaluate post-pandemic MBS outcomes and determine if prior socioeconomic disparities persisted in the post-COVID era. A retrospective chart review of patients undergoing primary Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) between 2015 and 2022 was performed. Patients were stratified into pre- and post-COVID groups. Post-COVID cohort was further stratified into high (HT) and low (LT) tier status based on Distressed Communities Index, a geocoded composite measure of SES. Preoperative characteristics and postoperative outcomes were compared between pre- and post-COVID cohorts, as well as between post-COVID HT and LT groups. Of 709 patients, 82.9% were pre-COVID and 17.1% were post-COVID. Post-COVID cohort had greater rate of public insurance (46% vs. 37%, p < 0.001), longer wait time to surgery (mean 358 ± 609.8 days vs 241.9 ± 368.5 days, p = 0.045), and were more likely to undergo RYGB (69% vs. 56%, p = 0.010). Post-COVID patients also had lower risk of any complications on multivariable analysis (OR 0.599, 95% CI 0.372–0.963), had higher follow-up rates at post-discharge (95.8% vs 79.7%, p < 0.005), 6-month (93% vs. 82%, p < 0.001) and 12-month visits (75% vs. 63%, p = 0.005), and lost more weight at 12 months (67% excess weight loss (%EWL) vs. 58%EWL, p = 0.002). Among post-COVID HT and LT cohorts, previously seen disparities in complications were no longer seen. Finally, there were no differences in weight or follow-up rates between post-COVID HT and LT. Post-COVID changes to MBS care have resulted in improved short-term outcomes and reduced disparities for patients of lower SES. Further studies are needed to identify these positive factors to perpetuate practice patterns that optimize care for patients of all socioeconomic status.

摘要： Hybrid immunity provides better protection against COVID-19 than vaccination or prior natural infection alone. It induces high magnitude and broadly cross-reactive neutralising anti-Spike IgG antibodies. However, it is not clear how long these potent antibodies last, especially in the context of adenovirus-based COVID-19 vaccines. We conducted a longitudinal cohort study and enrolled 20 adults who had received an adenovirus-based COVID-19 vaccine before a laboratory-confirmed SARS-CoV-2 infection. We followed up the study participants for 390 days post the initial breakthrough infection. We assessed the longevity and cross-reactive breadth of serum antibodies against SARS-CoV-2 variants of concern (VOCs), including Omicron. The binding anti-Spike IgG antibodies remained within the reported putative levels for at least 360 days and were cross-neutralising against Beta, Gamma, Delta, and Omicron. During the follow up period, a median of one SARS-CoV-2 re-infection event was observed across the cohort, but none resulted in severe COVID-19. Moreover, the re-exposure events were associated with augmented anti-Spike and anti-RBD IgG antibody titres. This study confirms that hybrid immunity provides durable broadly cross-reactive antibody immunity against SARS-CoV-2 variants of concern for at least a year (360 days), and that it is further augment by SARS-CoV-2 re-exposure.

关键词： COVID-19   Liver function abnormality   Long COVID syndrome in the digestive system   Post-acute sequelae  

摘要： Background Clinical practice showed that many patients with SARS-CoV-2 infection presented with long COVID syndrome in digestive system. We sought to investigate the factor affecting the incidence of long COVID syndrome in digestive system. Methods and Results Patients with SARS-CoV-2 infection diagnosed at two centers of Zhongshan Hospital and one center of Shanghai Pudong Hospital from March 01, 2022 to May 21, 2022 were enrolled, collected in the hospital database, and followed up until March 30, 2023. The primary outcome of the study was the occurrence of post-acute sequelae of COVID-19 in the digestive system(long COVID syndrome). Modified Poisson regression was used to calculate the relative risk (RR). This cohort study included 494 patients with SARS-CoV-2 infection, 144 (29.1%) patients developed liver function abnormality on admission. During the follow-up period, the primary study outcome occurred in 30 (20.8%) of the group presenting with liver function abnormality on admission and in 20 (5.7%) of the group without liver function abnormality on admission (adjusted, RR= 3.550, 95%CI: 2.099-6.006, P ≤ 0.001). Conclusion Our study suggests that patients with COVID-19 who experience liver function abnormality on admission have an increased risk of developing long COVID syndrome in the digestive system.

摘要： Nirmatrelvir/ritonavir (NM/r) is a safe and effective oral antiviral therapeutic used for treatment of mild-to-moderate COVID-19. Case reports described a clinical rebound syndrome whereby individuals experience a relapse of symptoms shortly after completing successful treatment. There is a lack of information on frequency of COVID-19 rebound after NM/r in routine clinical care, contributing factors, and clinical outcomes. We reviewed electronic medical records to verify COVID-19 diagnosis, symptoms, and treatment with NM/r from January-June 2022. We defined COVID-19 clinical rebound as clear improvement in symptoms followed by recurrence or worsening of symptoms within 30 days of a five-day course of NM/r. We studied 268 adults with median age 57 (IQR 47, 68), 80% White race, 85% non-Hispanic ethnicity, 55% female, 80% vaccinated and boosted against SARS-CoV-2, and 68% with any co-morbidity. Sixteen (6.0%) of studied patients were determined to have COVID-19 clinical rebound. The median time from starting NM/r to rebound was 11 days (IQR 9, 13). Notable demographic and clinical factors with higher proportion (not statistically significant) among COVID-19 rebound patients were female sex (75% rebound vs. 54.5% no rebound), Black race (12.5% rebound vs. 4.9% no rebound), presence of at least one co-morbidity (81.3% rebound vs. 67.5% no rebound), and lack of prior SARS-CoV-2 infection (100% rebound vs. 92.9% no rebound). Only one patient (6.25%) was hospitalized after COVID-19 rebound. COVID-19 clinical rebound after treatment with NM/r is mild with favorable outcomes and more common than previously reported from real-world clinical care studies.

摘要： Coronavirus Disease 2019 (COVID–19) has been associated with adverse effects and death among people with low immunity, including pregnant women. Despite introducing the vaccine as the proper means to curb the spread of the pandemic, vaccine uptake is still low. This study assessed the influence of perception, attitude, and trust toward COVID-19 vaccine uptake among pregnant women attending Antenatal Care Clinics. A cross-sectional study design was used, utilizing a quantitative approach with a cross-sectional analytical design conducted in Mbeya urban, distribution of sample size during data collection based on client’s volume at three government health facilities (one tertiary health facility, one secondary health facility, and one primary health facility) in Mbeya Urban, Tanzania. Data were collected from 333 pregnant women who attended ANC during the data collection period using a questionnaire with closed-ended questions administered to respondents face-to-face. Data cleaning and analysis were done using Excel and Stata/SE 14.1 software for bivariate and multivariate data; Pearson’s chi-squire and Fisher’s test were used to analyze the independent determinants of COVID-19 vaccine uptake. The proportion of pregnant women vaccinated with the COVID-19 vaccine was 27%. There was a statistically significant association between the respondents’ vaccine uptake with primary education and < 5 work experience to vaccine uptake P = 0.015 (AOR = 6.58; 95% CI; 1.45–29.85), and P = 0.046 (AOR = 2.45; 95% CI; 1.02–5.89) respectively. The association of attitude influence to COVID-19 vaccine uptake was statistically significant (acceptance of vaccine due to its availability, vaccine acceptance for protection against COVID-19 pandemic to respondent and her baby, experience from other vaccines) was statistically significant at P = 0.011 (AOR = 4.43; 95% CI; 1.41–13.93), P = 0.001 (AOR = 45.83; 95% CI; 18.6-112.89) respectively. The level of trust in the COVID-19 vaccine influe

摘要： The study aimed to examine postural stability changes in individuals who have recovered from COVID-19 infection. Fifty patients who recovered from the COVID-19 infection and 50 healthy controls were compared using the dizziness handicap inventory (DHI), a modified clinical test of sensory interaction balance (mCTSIB), limits of stability (LOS), rhythmic weight shift (RWS), and Romberg and fall risk (FR) tests. Regarding mCTSIB, regardless of gender patients, female patients, or male patients, there were no significant differences from controls (p > 0.05). There was a significant difference in LOS between the patients and controls regarding (p < 0.05) in some parameters. There was a significant difference between the patients and controls concerning RWS (p < 0.05) for some parameters. There was a significant difference between the patients and controls regarding the Romberg test in some parameters (p < 0.05). There was no statistically significant difference between the patients and control groups regarding FR. Studies in which the effects of COVID-19 infection sequels have been evaluated on the vestibular system in the literature are subjective. The main concern is the prevalence of dizziness or vertigo in subjective studies. There may be a decrease in postural reflexes in female individuals who recovered from the COVID-19 infection in this study, thanks to the objective test measurement. Increased oscillations with eyes closed on regular ground and soft ground in the Romberg test may likely indicate vestibular problems.