Study shows meaningful lockdown activity is more satisfying than busyness

January 11, 2021

Science Daily/RMIT University

New research shows people who pursue meaningful activities -- things they enjoy doing -- during lockdown feel more satisfied than those who simply keep themselves busy.

The study, published in PLOS ONE, shows you're better off doing what you love and adapting it to suit social distancing, like swapping your regular morning walk with friends for a zoom exercise session.

Simply increasing your level of activity by doing mindless busywork will leave you unsettled and unsatisfied.

Co-lead researcher Dr Lauren Saling from RMIT University in Melbourne, Australia said while novelty lockdown activities -- like baking or painting -- have their place, trying to continue what you enjoyed before lockdown can be more rewarding.

"Busyness might be distracting but it won't necessarily be fulfilling," she said.

"Rather, think about what activities you miss most and try and find a way of doing them."

Survey participants rated their level of wellbeing as it was during social distancing and retrospectively one month beforehand.

They also indicated how much time they spent engaged in various activities and nominated how important each activity was for them.

Although participants reported feeling more positive emotions while doing novelty 'meaningless' activities like binge watching TV, they also felt more negative emotions -- they felt unhappy just as much as they felt happy.

But when substituting activities enjoyed before lockdown -- like dining with friends -- for a virtual alternative, their positive and negative emotions were more subdued.

Saling said busyness riles you up, prompting you to change your behaviour, but meaningful activity -- doing what you enjoy -- calms you down.

"Extreme emotions are not necessarily a good thing," she said.

"Emotions are a mechanism to make you change your behaviour.

"But when you're doing what you love, it makes sense that you feel more balanced -- simply keeping busy isn't satisfying."

Saling said the study challenged assumptions that we are either happy or sad and that we can stave off sadness by keeping busy.

Rather, those who kept busy with mindless tasks felt more frustrated and even when they were happy felt less fulfilled.

"The study showed positive and negative affect worked together, not as opposites," Saling said.

"Respondents who simply stayed busy during lockdown reported an increase in both positive and negative emotions.

"This heightened emotionality will tend to shift you away from activity in general and towards meaningful activity."

The study also found the biggest change in positive emotions before and during lockdown was experienced by people aged under 40.

Saling said this was likely because it was harder for that age group to successfully substitute meaningful activities into a lockdown context.

https://www.sciencedaily.com/releases/2021/01/210111112126.htm

Heading outdoors keeps lockdown blues at bay

Study finds time spent outdoors is associated with higher levels of happiness

January 8, 2021

Science Daily/Anglia Ruskin University

A new study has found that spending time outdoors and switching off our devices is associated with higher levels of happiness during a period of COVID-19 restrictions.

Previous academic studies have indicated how being outdoors, particularly in green spaces, can improve mental health by promoting more positive body image, and lowering levels of depression and anxiety.

Jointly led by academics from Anglia Ruskin University (ARU) in the UK, the Karl Landsteiner University of Health Sciences in Austria, and Perdana University in Malaysia, this new research examined how levels of happiness during a national lockdown were affected by being outdoors, the amount of daily screen time (use of TV, computer and smartphone) and feelings of loneliness.

Using an experience sampling method (ESM), the researchers measured levels of happiness amongst a group of 286 adults three times a day, at random intervals, over a 21-day period. This allowed the participants to provide data in real-time rather than retrospectively, helping to avoid recall biases.

The research, published in the Journal of Happiness Studies, was carried out in April 2020, when the Austrian participants were allowed to leave their homes only for specific activities, which included exercise.

It found that levels of happiness were higher when participants were outdoors rather than indoors. In addition, more daily screen time and higher levels of loneliness were both associated with lower levels of happiness. The impact of loneliness on happiness was also weaker when participants were outdoors.

Co-lead author Viren Swami, Professor of Social Psychology at Anglia Ruskin University (ARU), said: "While lockdowns can help slow down the transmission of COVID-19, research has also shown that prolonged periods of lockdown take their toll on mental health.

"Our results are important in this context because they show that being able to spend time outdoors under conditions of lockdown has a beneficial impact on psychological wellbeing. Being outdoors provides opportunities to escape from the stresses of being confined at home, maintain social relationships with others, and engage in physical activity -- all of which can improve mental health.

"Our findings have practical health policy implications. Given that further lockdown restrictions have now become necessary in the UK, public health messages that promote getting some fresh air instead of staying indoors and staring at our screens could really help to lift people's mood this winter."

https://www.sciencedaily.com/releases/2021/01/210108084121.htm

Researchers identify features that could make someone a virus super-spreader

November 19, 2020

Science Daily/University of Central Florida

Researchers used computer-generated models to numerically simulate sneezes in different types of people and determine associations between people's physiological features and how far their sneeze droplets travel and linger in the air. They found that people's features, like a stopped-up nose or a full set of teeth, could increase their potential to spread viruses by affecting how far droplets travel when they sneeze.

New research from the University of Central Florida has identified physiological features that could make people super-spreaders of viruses such as COVID-19.

In a study appearing this month in the journal Physics of Fluids,researchers in UCF's Department of Mechanical and Aerospace Engineering used computer-generated models to numerically simulate sneezes in different types of people and determine associations between people's physiological features and how far their sneeze droplets travel and linger in the air.

They found that people's features, like a stopped-up nose or a full set of teeth, could increase their potential to spread viruses by affecting how far droplets travel when they sneeze.

According to the U.S. Centers for Disease Control and Prevention, the main way people are infected by the virus that causes COVID-19 is through exposure to respiratory droplets, such as from sneezes and coughs that are carrying infectious virus.

Knowing more about factors affecting how far these droplets travel can inform efforts to control their spread, says Michael Kinzel, an assistant professor with UCF's Department of Mechanical Engineering and study co-author.

"This is the first study that aims to understand the underlying 'why' of how far sneezes travel," Kinzel says. "We show that the human body has influencers, such as a complex duct system associated with the nasal flow that actually disrupts the jet from your mouth and prevents it from dispersing droplets far distances."

For instance, when people have a clear nose, such as from blowing it into a tissue, the speed and distance sneeze droplets travel decrease, according to the study.

This is because a clear nose provides a path in addition to the mouth for the sneeze to exit. But when people's noses are congested, the area that the sneeze can exit is restricted, thus causing sneeze droplets expelled from the mouth to increase in velocity.

Similarly, teeth also restrict the sneeze's exit area and cause droplets to increase in velocity.

"Teeth create a narrowing effect in the jet that makes it stronger and more turbulent," Kinzel says. "They actually appear to drive transmission. So, if you see someone without teeth, you can actually expect a weaker jet from the sneeze from them."

To perform the study, the researchers used 3D modeling and numerical simulations to recreate four mouth and nose types: a person with teeth and a clear nose; a person with no teeth and a clear nose; a person with no teeth and a congested nose; and a person with teeth and a congested nose.

When they simulated sneezes in the different models, they found that the spray distance of droplets expelled when a person has a congested nose and a full set of teeth is about 60 percent greater than when they do not.

The results indicate that when someone keeps their nose clear, such as by blowing it into a tissue, that they could be reducing the distance their germs travel.

The researchers also simulated three types of saliva: thin, medium and thick.

They found that thinner saliva resulted in sneezes composed of smaller droplets, which created a spray and stayed in the air longer than medium and thick saliva.

For instance, three seconds after a sneeze, when thick saliva was reaching the ground and thus diminishing its threat, the thinner saliva was still floating in the air as a potential disease transmitter.

The work ties back to the researchers' project to create a COVID-19 cough drop that would give people thicker saliva to reduce the distance droplets from a sneeze or cough would travel, and thus decrease disease-transmission likelihood.

The findings yield novel insight into variability of exposure distance and indicate how physiological factors affect transmissibility rates, says Kareem Ahmed, an associate professor in UCF's Department of Mechanical and Aerospace Engineering and study co-author.

"The results show exposure levels are highly dependent on the fluid dynamics that can vary depending on several human features," Ahmed says. "Such features may be underlying factors driving superspreading events in the COVID-19 pandemic."

The researchers say they hope to move the work toward clinical studies next to compare their simulation findings with those from real people from varied backgrounds.

Study co-authors were Douglas Fontes, a postdoctoral researcher with the Florida Space Institute and the study's lead author, and Jonathan Reyes, a postdoctoral researcher in UCF's Department of Mechanical and Aerospace Engineering.

Fontes says to advance the findings of the study, the research team wants to investigate the interactions between gas flow, mucus film and tissue structures within the upper respiratory tract during respiratory events.

"Numerical models and experimental techniques should work side by side to provide accurate predictions of the primary breakup inside the upper respiratory tract during those events," he says.

"This research potentially will provide information for more accurate safety measures and solutions to reduce pathogen transmission, giving better conditions to deal with the usual diseases or with pandemics in the future," he says.

The work was funded by the National Science Foundation.

https://www.sciencedaily.com/releases/2020/11/201119153944.htm

Study finds low risk of pregnancy complications from COVID-19

November 19, 2020

Science Daily/UT Southwestern Medical Center

Pregnant women who test positive for COVID-19 and their newborn babies have a low risk of developing severe symptoms, according to a new study from UT Southwestern.

The study, published today in JAMA Network Open, shows that 95 percent of women who tested positive for COVID-19 during pregnancy had no adverse outcomes. Additionally, the study found that the virus was transmitted to the fetus in just 3 percent of the cases.

"Our findings are that approximately 5 percent of all delivered women with COVID-19 infection develop severe or critical illness. Five percent is a major concern when a pandemic is making its way through a population; however, it's lower than previous reports from the Centers for Disease Control and Prevention (CDC)," says Emily Adhikari, M.D., an obstetrician, gynecologist, and first author of the study. "Most women with asymptomatic or mild infection will be relieved to know that their babies are unlikely to be affected by the virus."

The researchers set out to measure how COVID-19 infection impacts pregnancy outcomes, how severely ill a pregnant woman gets, placental pathology, and neonatal infections by studying women at Parkland Health and Hospital System -- a high-volume prenatal clinic system and public hospital affiliated with UT Southwestern. The team followed 3,374 mothers, 252 of whom tested positive for the virus during pregnancy, from March through August. The group was predominantly Hispanic (75 percent), followed by Black (18 percent) and white (4 percent). There were no significant differences between the expectant mothers in age, number of previous births, BMI, or diabetes.

The pandemic has hit the Hispanic population in Dallas particularly hard. "While they make up 75 percent of the population of over 12,000 women delivering annually at our institution, women of Hispanic ethnicity made up over 90 percent of COVID-19-positive women. The higher frequency among Hispanic women in our study is consistent with data on racial and ethnic disparities in COVID-19 cases and deaths reported nationwide," says Adhikari, medical director of perinatal infectious diseases at Parkland Memorial Hospital and an assistant professor of obstetrics and gynecology.

Among the 252 women who tested positive, 239, or 95 percent, were asymptomatic or had mild symptoms at first. Six of those women subsequently developed severe or critical COVID-19 pneumonia. Comparing mothers with and without COVID-19 diagnosed any time during pregnancy, the COVID-19 virus did not increase the risk of adverse outcomes, including preterm birth, preeclampsia with severe features, or cesarean delivery for abnormal fetal heart rate. However, preterm birth was increased among mothers who developed severe or critical illness before reaching 37 weeks in their pregnancy, and it's hard to predict who that will be. The study found that diabetes may be one factor that increases the risk for severe or critical maternal illness.

Pathologists who examined placentas -- the organ that functions as the source of oxygen and nourishment for unborn babies -- found that the majority were unaffected by the virus.

COVID-19 mothers who were outpatients were followed using telemedicine with a scripted evaluation of symptoms and protocol-based management, including instructions for referral to the emergency department for worsening respiratory symptoms or obstetric concerns. Telemedicine has been a vital tool used by many UT Southwestern and Parkland physicians during the pandemic.

Further study is needed to understand whether maternal infection with COVID-19 impacts long-term maternal or infant health.

"Our goal is to develop evidence-based guidelines for the majority of pregnant women who are recovering at home," Adhikari says. "It's difficult to predict who will become severely ill, which is why prevention strategies such as hand-washing, masking, and social distancing are still extremely important."

https://www.sciencedaily.com/releases/2020/11/201119141710.htm

Social isolation during COVID-19 pandemic linked with high blood pressure

November 19, 2020

Science Daily/European Society of Cardiology

Lockdown due to the COVID-19 pandemic is associated with an increase in high blood pressure among patients admitted to emergency. That's the finding of a study presented at the 46th Argentine Congress of Cardiology (SAC).

SAC 2020 is a virtual meeting during 19 to 21 November. Faculty from the European Society of Cardiology (ESC) will participate in joint scientific sessions with the Argentine Society of Cardiology as part of the ESC Global Activities programme.

"Admission to the emergency department during the mandatory social isolation period was linked with a 37% increase in the odds of having high blood pressure -- even after taking into account age, gender, month, day and time of consultation, and whether or not the patient arrived by ambulance," said study author Dr. Matías Fosco of Favaloro Foundation University Hospital, Buenos Aires.

Mandatory social isolation due to COVID-19 was implemented on 20 March in Argentina as a part of a general lockdown. People were told to stay at home, except for essential workers (e.g. doctors and nurses). The general public were permitted to leave home only to buy food, medicine and cleaning supplies. Schools and universities were closed, and public events were suspended.

"After social isolation began, we observed that more patients coming to emergency had high blood pressure," said Dr. Fosco. "We conducted this study to confirm or reject this impression."

The study was conducted in the emergency department of Favaloro Foundation University Hospital. The frequency of high blood pressure1 among patients aged 21 and above during the three-month social isolation (20 March to 25 June 2020) was compared to two previous time periods: the same three months in 2019 (21 March to 27 June 2019) and the three months immediately before social isolation (13 December 2019 to 19 March 2020).

Blood pressure is a standard measurement on admission to the emergency department and almost every patient (98.2%) admitted between 21 March 2019 and 25 June 2020 was included in the study. The most common reasons for admission were chest pain, shortness of breath, dizziness, abdominal pain, fever, cough, and hypertension.

The study included 12,241 patients. The average age was 57 years and 45.6% were women. During the three-month isolation period 1,643 patients were admitted to the emergency department. This was 56.9% less than during the same three months in 2019 (3,810 patients) and 53.9% lower than during the three months immediately before social isolation (3,563 patients).

During the social isolation period, 391 (23.8%) patients admitted to emergency had high blood pressure. This proportion was significantly higher compared to the same period in 2019, when it was 17.5%, and compared to the three months before social isolation, when it was 15.4% (p<0.01).

Dr. Fosco said: "There are several possible reasons for the connection between social isolation and high blood pressure. For example, increased stress because of the pandemic, with limited personal contact and the onset or exacerbation of financial or family difficulties. Changed behaviours may have played a role, with higher intake of food and alcohol, sedentary lifestyles and weight gain."

Dr. Fosco noted that the reasons for admission were similar between the periods studied, so were not responsible for the increase in high blood pressure. But he said: "Patients may have felt more psychological tension during transportation to the hospital because of travel restrictions and police controls and a fear of becoming infected with coronavirus after leaving home. In addition, patients being treated for high blood pressure may have stopped taking their medicine due to preliminary warnings about possible adverse effects on COVID-19 outcomes (which were later dismissed)."

He concluded: "Blood pressure control helps prevent heart attacks and strokes and serious illness from COVID-19, so it's essential to maintain healthy lifestyle habits, even under social isolation and lockdown conditions. Many regulations related to the pandemic have now relaxed and we are investigating if this is reflected in the blood pressure of patients admitted to emergency."

Dr. Héctor Deschle, Scientific Programme Chair of SAC 2020, said: "This study illustrates the collateral damage generated by isolation. There has been a significant decrease in heart disease consultations, which inevitably leads to avoidable complications. But I would like to emphasise the psychological damage pointed out by the authors, which we perceive daily in consultations and which is expressed as fear, hopelessness, irritability, and difficulty concentrating. This affects interpersonal relationships and physical health. This study puts the spotlight on the concomitant consequences of the outbreak and the restrictions used to struggle against it."

Professor Jose Luis Zamorano, ESC regional Ambassador for Argentina at SAC 2020, said: "This very interesting study simply highlights that we as cardiologists must keep a watchful eye on our cardiology patients beyond the pandemic. If we do not treat and carefully follow our cardiac patients during the pandemic, we will see an increase of adverse outcomes in the future."

https://www.sciencedaily.com/releases/2020/11/201119083923.htm

Alarming' COVID-19 study shows 80 percent of respondents report significant symptoms of depression

Young adults across the United States took part in loneliness study

November 16, 2020

Science Daily/Taylor & Francis Group

A new national survey, looking at how the COVID-19 pandemic has impacted young US adults' loneliness, reveals "significant depressive symptoms" in 80% of participants.

Over 1,000 Americans aged 18-35 took part in the online anonymous questionnaire, which also asked the subjects to report on their anxiety and substance use.

The analysed findings, published in the peer-reviewed Journal of Psychoactive Drugs, show that "alarming" levels of loneliness are associated with significant mental health issues, asapproximately 61% of respondents reporting moderate (45%) to severe (17%) anxiety.

Meanwhile, 30% of interviewees disclosed harmful levels of drinking. And, although only 22% of the respondents reported using drugs, 38% of these reported severe drug use.

Therefore, a response with mental health care provision is "imperative," lead author Professor Viviana Horigian, from the University of Miami, states.

"The convergence of the COVID-19 pandemic and the loneliness and addiction epidemics in the US is here to stay," she said.

"These young adults are the future of our nation's social fabric. They need to be given access to psychological help, coupled with the development and dissemination of brief online contact-based interventions that encourage healthy lifestyles.

"Addressing mental health and substance use problems in young adults, both during and after the COVID-19 pandemic, is an imperative."

And co-author Renae Schmidt adds: "As we invest in developing the sense of cohesion and social connectedness in these generations, we can address social and physical resiliency in our communities at large.

"Students need sustaining online delivery of [relevant] coursework, increasing counseling services, and deploying outreach through telehealth services. For young adults not engaged in school, aggressive patient outreach by primary care physicians should be used to ensure screening and intervention, also via telehealth. Access to psychological help coupled with the development and dissemination of brief online contact-based interventions that encourage healthy lifestyles."

The online, 126-item, survey was carried out between April 22 and May 11. 1,008 participants took part, with the average age 28 and 86% being over 23.

Each symptom (loneliness, anxiety, depression, alcohol use, drug use) was measured against internationally recognized scoring systems.

To examine the associations between loneliness and the mental health conditions highlighted, the researchers used a model which looked at the direct effects of both loneliness and social connectedness on depression, anxiety, alcohol use, and drug use. They also looked at the indirect effects of loneliness and social connectedness on alcohol and drug use working through anxiety and depression. In addition, they characterized relationships in pre-COVID and post-COVID behaviors and psychosocial symptomatology.

The results show that most participants who reported an increase in feelings of loneliness also indicated an increase in drinking (58%), drug use (56%), anxiety (76%), and depression (78%), and a decrease in feelings of connectedness (58%).

Looking at general increases of mental health issues or substance use due to the pandemic, most issues were recorded by participants as rising, with their feelings of loneliness going up by 65%, lack of connectedness 53%, alcohol use 48%, drug use 44%, anxiety 62%, and depression 64%.

Overall, an "alarming" 49% of respondents reported a great degree of loneliness.

Most respondents (80%) reported drinking alcohol, with 30% revealing harmful and dependent levels of drinking. 19% of respondents reported binge drinking at least weekly and 44% reported binging at least monthly.

The team hopes that the results will now be used to guide intervention efforts.

"Social prescribing, which draws from and promotes usage of community resources, also shows promise of improving social and psychological wellbeing," Professor Horigian adds.

"This could be positioned to then encourage service to others, bringing social comfort and reward as a result of connecting with others in need.

"These efforts, and others, can help to alleviate the problems of loneliness and its manifestations; yet it may take an integrated, multi-faceted, and concerted approach, rooted, and supported by mental health prevention and wellbeing promotion boosted by workforce development and research on intervention development, to readdress these trajectories."

https://www.sciencedaily.com/releases/2020/11/201116112918.htm

Loneliness in youth could impact mental health over the long term

Children and adolescents more likely to experience higher rates of depression and anxiety during and after enforced isolation ends

November 19, 2020

Science Daily/Elsevier

A new review reports on the available evidence about children and young people specifically, stating that loneliness is associated with mental health problems, including depression and anxiety-potentially affecting them years later.

The COVID-19 pandemic has necessitated widespread social isolation, affecting all ages of global society. A new rapid review in the Journal of the American Academy of Child and Adolescent Psychiatry(JAACAP), published by Elsevier, reports on the available evidence about children and young people specifically, stating that loneliness is associated with mental health problems, including depression and anxiety-potentially affecting them years later.

The review, which synthesizes over 60 pre-existing, peer-reviewed studies on topics spanning isolation, loneliness and mental health for young people aged between 4 and 21 years of age, found extensive evidence of an association between loneliness and an increased risk of mental health problems for children and young people.

"As school closures continue, indoor play facilities remain closed and at best, young people can meet outdoors in small groups only, chances are that many are lonely (and continue to be so over time)," said lead author, Maria Loades, DClinPsy, Senior Lecturer in Clinical Psychology at the University of Bath, UK.

"This rapid review of what is known about loneliness and its impact on mental health in children and young people found that loneliness is associated with both depression and anxiety. This occurs when studies measured both loneliness and mental health at the same point in time; when loneliness was measured separately; and when depression and anxiety were measured subsequently, up to 9 years later," Dr. Loades added. "Of relevance to the COVID-19 context, we found some evidence that it is the duration of loneliness that is more strongly associated with later mental health problems."

From the selected studies there was evidence that children and young people who are lonely might be as much as three times more likely to develop depression in the future, and that the impact of loneliness on mental health outcomes like depressive symptoms could last for years. There was also evidence that the duration of loneliness may be more important, than the intensity of loneliness, in increasing the risk of future depression among young people.

For many young people, loneliness will decrease as they re-establish social contacts and connections as lockdown eases (e.g., as they return to school or college). For some a sense of loneliness may persist as they struggle to resume social life, particularly for those who were more vulnerable to being socially isolated before lockdown.

"It's key that children and young people are allowed to return to activities such as playing together, even if outdoors, as soon as possible, and that they are able to resume attending school, which gives them a structure for their day, and provides them with opportunities to see peers and to get support from adults outside of the nuclear family," said Dr. Loades. Furthermore, she added "children need more in their strategy for easing lockdown. Alongside this, the government could target children's wellbeing in public health messaging. And meanwhile, we should also continue to embrace technology as a way to keep in touch."

So whilst we do what we can to mitigate the effects of loneliness and re-establish social connections, we also need to prepare for an increase in mental health problems, in part due to loneliness, and also due to the other unintended consequences of lockdown, such as a lack of structure, physical inactivity and social and/separation anxiety that might be triggered when resuming social interactions outside of the home.

There are several levels at which we can prepare for the heightened demand:

• Take a universal approach to promoting wellbeing through public messaging, and by schools doing activities to promote wellbeing in children and young people as they resume normal activities.

• Seek to identify those who are struggling with loneliness as early as possible and do so by targeted interventions to help them overcome their struggles. This may be through the provision of extra support in schools, helping them overcome anxieties about returning to school, or giving them an extra hand with reconnecting socially with peers.

For those who continue to struggle over time, and can't get back to doing the things they normally do as a result of their struggles, we need to ensure that they are made aware that services are open, and can provide specialist help, and to make sure that they know how to access this help and are supported to do so.

https://www.sciencedaily.com/releases/2020/11/201119124626.htm

Social distancing is increasing loneliness in older adults

November 9, 2020

Science Daily/University of Stirling

Social distancing introduced in response to COVID-19 is increasing feelings of loneliness in Scotland's older population and impacting their wellbeing, according to a new University of Stirling study.

The research has identified a link between increases in loneliness in over 60s and the worsening of wellbeing and health. Increasing loneliness due to social distancing was associated with a smaller social network, lower perceived social support and a decrease in wellbeing, the study found.

The findings emerge from research launched under the Scottish Government's Chief Scientist Office Rapid Research in COVID-19 programme in May. Professor Anna Whittaker, of the University's Faculty of Health Sciences and Sport, led the work and hopes it will help to inform decision-making on the virus and support post-pandemic recovery strategies.

Professor Whittaker said: "Previous studies have demonstrated the negative impacts of social isolation and loneliness. This is a key issue for older adults who may be more likely to have few social contacts. We know that social distancing guidelines introduced in response to COVID-19 have restricted social activity engagement and impacted vulnerable groups, including older adults.

"Our study, which involved a survey of more than 1,400 older people, examined the impact of social distancing during the pandemic on social activity, loneliness and wellbeing. The majority of survey participants reported that social distancing has made them experience more loneliness, social contact with fewer people, and less social contact overall.

"We found that a larger social network and better perceived social support seems to be protective against loneliness and poorer health and wellbeing, due to social distancing. This underlines the importance of addressing loneliness and social contact in older adults, but particularly during pandemics or situations where the risk of isolation is high."

Of the 1,429 survey participants, 84 percent were aged 60 or over and had an average social network of five people. On average, the participants socialised five days per week, for more than 6.6 hours per week. Fifty-six percent reported that social distancing regulations made them experience more loneliness -- with scores that were significantly higher than reported norms; the same quality of perceived support; but social contact with fewer people and less social contact overall.

Greater loneliness was significantly associated with a smaller social network, lower perceived social support, and a decrease in social support frequency, quality, and amount -- and a worsening of wellbeing and health.

Physical activity

Using the same survey data, the research also considered the impact of social distancing on physical activity. The majority of participants reported continuing to meet physical activity guidelines during lockdown -- with 35 percent moderately active and 41 percent highly active. Walking was the greatest contributor to total physical activity, with just over a quarter (26.4%) walking more than before lockdown. Those living in rural areas reported greater volumes of physical activity.

Forty percent of people said they were walking less, compared to before lockdown, and a similar proportion were engaging in less moderate physical activity. Those who reported in engaging in lower physical activity had poorer wellbeing.

Individuals who reported no change in moderate physical activity were the most active pre-lockdown and those who reported no change in walking had significantly higher levels of total physical activity pre-lockdown.

Professor Whittaker said: "Physical activity engagement during lockdown varied and this study indicates a positive link with wellbeing -- supporting the notion that physical activity should be considered an important contributor in recovery strategies targeted at older adults as we emerge from the pandemic.

"There appears to be a relationship between pre-lockdown physical activity and physical activity changes due to lockdown. This may be of significance in the context of trying to get older adults to maintain or increase physical activity, where appropriate, as we emerge from this pandemic, given our understanding of the benefits of physical activity in this age group.

"Additionally, irrespective of pre-lockdown physical activity, older adults should continue to be encouraged to be active, and particularly to engage in some sort of strength and balance training -- such as tai chi, yoga, or weights -- which was very low in the sample but is vital for maintaining balance and physical function. Just 12 percent of the sample met the physical activity guidelines, which indicate strength training should be undertaken at least twice per week."

https://www.sciencedaily.com/releases/2020/11/201109110230.htm

Over 80 percent of COVID-19 patients have vitamin D deficiency

Vitamin D deficiency was more prevalent in men

October 27, 2020

Science Daily/The Endocrine Society

Over 80 percent of 200 COVID-19 patients in a hospital in Spain have vitamin D deficiency, according to a new study published in the Endocrine Society's Journal of Clinical Endocrinology & Metabolism.

Vitamin D is a hormone the kidneys produce that controls blood calcium concentration and impacts the immune system. Vitamin D deficiency has been linked to a variety of health concerns, although research is still underway into why the hormone impacts other systems of the body. Many studies point to the beneficial effect of vitamin D on the immune system, especially regarding protection against infections.

"One approach is to identify and treat vitamin D deficiency, especially in high-risk individuals such as the elderly, patients with comorbidities, and nursing home residents, who are the main target population for the COVID-19," said study co-author José L. Hernández, Ph.D., of the University of Cantabria in Santander, Spain. "Vitamin D treatment should be recommended in COVID-19 patients with low levels of vitamin D circulating in the blood since this approach might have beneficial effects in both the musculoskeletal and the immune system."

The researchers found 80 percent of 216 COVID-19 patients at the Hospital Universitario Marqués de Valdecilla had vitamin D deficiency, and men had lower vitamin D levels than women. COVID-19 patients with lower vitamin D levels also had raised serum levels of inflammatory markers such as ferritin and D-dimer.

Other authors of the study include: Daniel Nan, José M. Olmos, Javier Crespo, and Víctor M. Martínez-Taboada of the University of Cantabria; Marta Fernandez-Ayala, Mayte García-Unzueta, Miguel A. Hernández-Hernández, Marcos López-Hoyos, Manuel Gutiérrez-Cuadra, and Juan J. Ruiz-Cubillán of the Hospital Marqués de Valdecilla-IDIVAL in Santander, Spain; Pedro Muñoz Cacho of the Servicio Cántabro de Salud in Santander, Spain;

https://www.sciencedaily.com/releases/2020/10/201027092216.htm

Scientist develops new way to test for COVID-19 antibodies

October 23, 2020

Science Daily/Seattle Children's

When Dr. Stephen Smith of Seattle Children's Research Institute came down with muscle aches, gastrointestinal distress and a sudden loss of smell in late February, he suspected he had COVID-19. The testing criteria had yet to be expanded to include individuals with Smith's symptoms and so he did what many scientists with his expertise would do: he developed a way to test himself.

The fruits of his curiosity, now published in The Journal of Infectious Diseases, offer a reliable way to quantify whether an individual has neutralizing antibodies that could prevent the novel coronavirus from infecting cells using a method that is more broadly applicable than those currently available.

"If you think you've had COVID-19 and go to the doctor, they can test your blood and tell you whether or not you have antibodies to COVID-19, but that doesn't tell you whether your antibodies are any good at functionally blocking the virus from binding to cells," Smith said. "There are tests on the market now that can tell you that, but they are expensive and take a long time to get results. We wanted to develop a way to give you additional information about your immune status without all the barriers that make it difficult to use in a community setting."

The newly developed diagnostic could have a range of potential commercial applications from broad community testing to assessing vaccine responses and screening for convalescent plasmas that have particularly high levels of neutralizing antibodies as a potential treatment.

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Cell-free test looks at protein interactions

The novel coronavirus enters cells when the viral spike protein binds to the ACE2 protein on the surface of human cells. Neutralizing antibodies that block this binding are thought to contribute to immunity to the virus in people who recover from COVID-19.

Smith applied a technique called immunoprecipitation detected by flow cytometry (IP-FCM) to study the interactions between the proteins and to look for evidence that antibodies were inhibiting the interaction and blocking the virus from binding to cells. Instead of relying on live cells and viruses like other available blood tests, IP-FCM uses recombinant -- or lab-made -- proteins and instruments commonly available in commercial serological labs.

"Other tests that provide insight into immunity work by taking antibodies from your blood and mixing them together with a virus and then exposing that mixture to live cells. Three days later they can determine immunity based on whether your blood prevented the viruses from infecting the cells or not," Smith said. "Our cell-free test can provide that same information overnight."

Collaborative science launches innovative study

Smith is among a small group of scientists in the U.S. who have pioneered IP-FCM to study the interactions between proteins. His lab in Seattle Children's Center for Integrative Brain Research uses IP-FCM to uncover new treatments for autism by studying the more than 100 genetic variations known to contribute to the condition. To apply his expertise to the current pandemic, Smith collaborated with Drs. Lisa Frenkel and Whitney Harrington from the research institute's Center for Global Infectious Global Disease Research who are following a community cohort of Seattle Children's employees who were never hospitalized and had recovered from mild to moderate COVID-19. The researchers hope by tracking their recovery and taking blood samples over time as part of the Seattle Children's Recovered SARS2 Cohort study they can shed light on the immune responses to the novel coronavirus.

Funding in part by Seattle Children's COVID-19 Research Fund helped Smith design and launch the study.

Using IP-FCM, Smith tested the blood samples from 24 cohort participants. The test showed that 92% of the participants had antibodies to the novel coronavirus at an average of a little over a month post-infection. Results were validated with 30 control samples.

"Not only did the participants have antibodies, but our test also showed that their antibodies were pretty effective at neutralizing the binding between the spike protein and the cell's receptor," he said. "It's consistent with other studies from cell-based tests showing that people who get COVID do make neutralizing antibodies."

Interestingly, when researchers looked at the test results against other data gathered from the cohort, they found that those who mounted a fever had higher levels of antibodies. The research team also plans to retest the samples to see how antibody levels change over time.

"It's going to be very important to look at people over a longer time period to track their antibody levels and whether or not they get re-infected," Smith said. "Until we do those studies, we really don't know how these clinical measures of antibody neutralization relate to susceptibility in the real world."

Identifying new drug candidates for COVID-19

In addition to exploring opportunities to commercialize the diagnostic, Smith and his team are now using the test to rapidly screen thousands of approved drugs that could potentially interfere with the binding between ACE2 and the spike protein.

Lab manager, Edward Gniffke, and Stanford University undergraduate and summer intern, Kaleb Tsegay, helped run the initial screen that could potentially identify drugs capable of preventing or treating COVID-19.

"We already have some compounds that look like they are inhibiting, which is pretty exciting," Smith said. "This first line screen will help us pinpoint the most promising agents for further tests."

https://www.sciencedaily.com/releases/2020/10/201022201404.htm

Aspirin use reduces risk of death in hospitalized COVID-19 patients

October 22, 2020

Science Daily/University of Maryland School of Medicine

Hospitalized COVID-19 patients who were taking a daily low-dose aspirin to protect against cardiovascular disease had a significantly lower risk of complications and death compared to those who were not taking aspirin, according to a new study led by researchers at the University of Maryland School of Medicine (UMSOM). Aspirin takers were less likely to be placed in the intensive care unit (ICU) or hooked up to a mechanical ventilator, and they were more likely to survive the infection compared to hospitalized patients who were not taking aspirin, The study, published today in the journal Anesthesia and Analgesia, provides "cautious optimism," the researchers say, for an inexpensive, accessible medication with a well-known safety profile that could help prevent severe complications.

"This is a critical finding that needs to be confirmed through a randomized clinical trial," said study leader Jonathan Chow, MD, Assistant Professor of Anesthesiology at UMSOM. "If our finding is confirmed, it would make aspirin the first widely available, over-the-counter medication to reduce mortality in COVID-19 patients."

To conduct the study, Dr. Chow and his colleagues culled through the medical records of 412 COVID-19 patients, age of 55 on average, who were hospitalized over the past few months due to complications of their infection. They were treated at the University of Maryland Medical Center in Baltimore and three other hospitals along the East Coast. About a quarter of the patients were taking a daily low-dose aspirin (usually 81 milligrams) before they were admitted or right after admission to manage their cardiovascular disease.

The researchers found aspirin use was associated with a 44 percent reduction in the risk of being put on a mechanical ventilator, a 43 percent decrease in the risk of ICU admission and -- most importantly -- a 47 percent decrease in the risk of dying in the hospital compared to those who were not taking aspirin. The patients in the aspirin group did not experience a significant increase in adverse events such as major bleeding while hospitalized.

The researchers controlled for several factors that may have played a role in a patient's prognosis including age, gender, body mass index, race, hypertension and diabetes. They also accounted for heart disease, kidney disease, liver disease and the use of beta blockers to control blood pressure.

COVID-19 infections increase the risk of dangerous blood clots that can form in the heart, lungs, blood vessels and other organs. Complications from blood clots can, in rare cases, cause heart attacks, strokes and multiple organ failure as well as death.

Doctors often recommend a daily low-dose aspirin for patients who have previously had a heart attack or stroke caused by a blood clot to prevent future blood clots. Daily use, however, can increase the risk of major bleeding or peptic ulcer disease.

"We believe that the blood thinning effects of aspirin provides benefits for COVID-19 patients by preventing microclot formation," said study co-author Michael A. Mazzeffi, MD, Associate Professor of Anesthesiology at UMSOM. "Patients diagnosed with COVID-19 may want to consider taking a daily aspirin as long as they check with their doctor first." Those at increased bleeding risk due to chronic kidney disease, for example, or because they regularly use certain medications, like steroids or blood thinners, may not be able to safely take aspirin, he added.

Researchers from Wake Forest School of Medicine, George Washington University School of Medicine, Northeast Georgia Health System, and Walter Reed National Military Medical Center also participated in this study.

"This study adds to the tremendous work our researchers are doing in the School of Medicine to help find new treatments against COVID-19 and save patients' lives," said E. Albert Reece, MD, PhD, MBA, Executive Vice President for Medical Affairs, UM Baltimore, and the John Z. and Akiko K. Bowers Distinguished Professor and Dean, University of Maryland School of Medicine. "While confirmatory studies are needed to prove that aspirin use leads to better outcomes in COVID-19, the evidence thus far suggests that patients may want to discuss with their doctor whether it is safe for them to take aspirin to manage potentially prevent serious complications."

https://www.sciencedaily.com/releases/2020/10/201022195637.htm

COVID-19 anxiety linked to body image issues

Study finds association between stress and anxiety, and negative body image

October 23, 2020

Science Daily/Anglia Ruskin University

A new study has found that anxiety and stress directly linked to COVID-19 could be causing a number of body image issues amongst women and men.

The research, led by Professor Viren Swami of Anglia Ruskin University (ARU) and published in the journal Personality and Individual Differences, involved 506 UK adults with an average age of 34.

Amongst women, the study found that feelings of anxiety and stress caused by COVID-19 were associated with a greater desire for thinness. It also found that anxiety was significantly associated with body dissatisfaction.

Amongst the male participants, the study found that COVID-19-related anxiety and stress was associated with greater desire for muscularity, with anxiety also associated with body fat dissatisfaction.

Negative body image is one of the main causes of eating disorders, such as anorexia and bulimia, and this new study adds to recent research indicating that fears around COVID-19, and the consequences of the restrictions introduced to help tackle it, could be contributing to a number of serious mental health issues.

Lead author Viren Swami, Professor of Social Psychology at Anglia Ruskin University (ARU), said: "In addition to the impact of the virus itself, our results suggest the pandemic could also be leading to a rise in body image issues. In some cases, these issues can have very serious repercussions, including triggering eating disorders.

"Certainly during the initial spring lockdown period, our screen time increased, meaning that we were more likely to be exposed to thin or athletic ideals through the media, while decreased physical activity may have heightened negative thoughts about weight or shape. At the same time, it is possible that the additional anxiety and stress caused by COVID-19 may have diminished the coping mechanisms we typically use to help manage negative thoughts.

"Our study also found that when stressed or anxious, our pre-occupations tend to follow gender-typical lines. During lockdown, women may have felt under greater pressure to conform to traditionally feminine roles and norms, and messaging about self-improvement may have led to women feeling dissatisfied with their bodies and having a greater desire for thinness.

"Similarly, our findings reflect the way in which stress and anxiety impact men's relationships with their bodies, particularly in terms of masculine body ideals. Given that masculinity typically emphasises the value of toughness, self-reliance, and the pursuit of status, COVID-19-related stress and anxiety may be leading men to place greater value on the importance of being muscular."

https://www.sciencedaily.com/releases/2020/10/201022201407.htm

Alcohol use changed right after COVID-19 lockdown

October 13, 2020

Science Daily/Washington State University

One in four adults reported a change in alcohol use almost immediately after stay-at-home orders were issued, according to a study of twins led by Washington State University researchers.

The study, published recently in Frontiers in Psychiatry, surveyed more than 900 twin pairs from the Washington State Twin Registry from March 26 to April 5, 2020, just after stay-at-home orders were issued in Washington on March 23. An estimated 14% of survey respondents said they drank more alcohol than the week prior and reported higher levels of stress and anxiety than those who did not drink alcohol and those whose use stayed the same.

"We expected that down the road people might turn to alcohol after the stay-at-home orders were issued, but apparently it happened right off the bat," said Ally Avery, lead author of the study and a scientific operations manager at WSU's Elson S. Floyd College of Medicine. "It shows the need to make sure there is more mental health support since it had an impact on people right away."

Surprisingly, the study showed that the 11% who decreased their drinking also had higher levels of stress and anxiety than the groups with no change -- suggesting that any change in alcohol use may be associated with mental health issues.

The study did not examine the reasons behind the link between a decrease in drinking and increase in stress and anxiety, but Avery said one possibility is that these were social drinkers who were missing out on after-work happy hours and other occasions where they drank with friends.

The researchers conducted the study with twins so that they could look at whether changes in alcohol use and mental health were mediated by genetic or shared environmental factors since twins raised in the same family share many formative experiences. Twins also have common genetics with fraternal twins sharing approximately half of their genes while identical twins share all of their genes.

In this study, the researchers found that the association between changes in alcohol use, and stress and anxiety were relatively small and confounded by between-family factors and demographic characteristics.

Still the link between the pandemic, alcohol use, and stress and anxiety is concerning, Avery said. The researchers are continuing to survey this group at longer intervals to see if the increased drinking persists and whether it becomes a bigger problem.

https://www.sciencedaily.com/releases/2020/10/201013124134.htm

Social media use linked with depression, secondary trauma during COVID-19

September 29, 2020

Science Daily/Penn State

Can't stop checking social media for the latest COVID-19 health information? You might want to take a break, according to researchers at Penn State and Jinan University who discovered that excessive use of social media for COVID-19 health information is related to both depression and secondary trauma.

"We found that social media use was rewarding up to a point, as it provided informational, emotional and peer support related to COVID-19 health topics," said Bu Zhong, associate professor of journalism, Penn State. "However, excessive use of social media led to mental health issues. The results imply that taking a social media break may promote well-being during the pandemic, which is crucial to mitigating mental health harm inflicted by the pandemic."

The study, which published online on Aug. 15 in the journal Computers in Human Behavior, included 320 participants living in urban districts of Wuhan, China. In February 2020, the team gave the participants an online survey that investigated how they accessed and shared health information with family members, friends and colleagues on social media, specifically WeChat, China's most popular social media mobile app.

The team used an instrument created to measure Facebook addiction to assess participants' use of WeChat. Using a 5-point Likert-type scale, ranging from strongly disagree to strongly agree, the survey assessed participants' views of WeChat in providing them with informational, emotional and peer support. The survey also assessed participants' health behavior changes as a result of using social media.

Statements related to informational support included, "I use WeChat to gain information about how to manage the coronavirus epidemic," and "If I have a question or need help related to the coronavirus epidemic, I can usually find the answers on WeChat." Statements related to emotional support included, "My stress levels go down while I'm engaging with others on WeChat," and "The health information on WeChat helps me alleviate feelings of loneliness." Statements related to peer support included, "I use WeChat to share practical advice and suggestions about managing the coronavirus epidemic," and "I have used some of the information I learned from WeChat friends as part of my management strategies for coping with the coronavirus epidemic."

The survey also investigated participants' health behavior changes related to the use of WeChat, asking them to rate statements such as, "The health information on WeChat has changed many of my health behaviors, such as but not limited to wearing face masks, using sanitizer, or washing hands."

To assess depression, the researchers used a 21-item Depression Anxiety Stress Scale in which participants rated statements such as, "I couldn't seem to experience any positive feeling at all," and "I felt that life was meaningless."

According to Zhong, secondary trauma refers to the behaviors and emotions resulting from knowledge about a traumatizing event experienced by a significant other. Using the Secondary Trauma Stress Scale, the researchers asked respondents to rate statements such as, "My heart started pounding when I thought about the coronavirus epidemic," and "I had disturbing dreams about the coronavirus epidemic."

"We found that the Wuhan residents obtained tremendous informational and peer support but slightly less emotional support when they accessed and shared health information about COVID-on WeChat," said Zhong. "The participants also reported a series of health behavior changes, such as increased hand washing and use of face masks.

More than half of the respondents reported some level of depression, with nearly 20% of them suffering moderate or severe depression. Among the respondents who reported secondary trauma, the majority reported a low (80%) level of trauma, while fewer reported moderate (13%) and high (7%) levels of trauma. None of the participants reported having any depressive or traumatic disorders before the survey was conducted.

"Our results show that social media usage was related to both depression and secondary trauma during the early part of the COVID-19 outbreak in Wuhan," said Zhong. "The findings suggest that taking a social media break from time to time may help to improve people's mental well-being during the COVID-19 pandemic."

https://www.sciencedaily.com/releases/2020/09/200929152149.htm

COVID-19 taking a toll on everyday lives

More stress expected as lockdowns continue, people get sick, unemployment persists

August 25, 2020

Science Daily/University of California - Davis

Rare research on the effects of a pandemic undertaken during an ongoing disaster shows that COVID-19 has severely affected people's daily emotional lives and mental health, increasing their stresses the longer lockdowns, fear of getting sick and financial strains continue.

Having a lower education level and speaking English as a second language further reduced resilience and hindered people's ability to cope, suggests new University of California, Davis, research based on surveys that began in April -- just a few weeks after lockdowns started in the United States.

"This is some of the first information we have on resilience in the face of COVID-19," said Clare Cannon, assistant professor in the Department of Human Ecology at UC Davis and co-author on the study. "Our hypothesis, for our continuing research, is that it's getting worse. The longer this goes on, the less resilient we are going to be."

Cannon and researchers at Tulane University surveyed 374 people online, using social media, websites and other outlets, mostly in the United States, over a 10-week period beginning in April. More research is planned as the pandemic progresses.

Those surveyed were asked about previous disaster experience, their resilience, their perceived stress, their current situation as it relates to COVID-19, and personal and household demographics. The online Qualtrics survey took an estimated 10 minutes to complete.

Respondents in the current study had filled out questionnaires before masks were mandatory, before closures were prolonged, before large job losses had occurred and prior to full realization that the world was experiencing a global economic recession and deadly public health crisis, she added. Additionally, fewer people, at the time of the survey, had experienced family illness and loss to COVID-19 as would be the case now and in future surveys, Cannon said.

The study's authors sought to look at the role of perceived stress, assess demographic variables and add to the literature on disasters, infectious disease and resilience. Their article was published this month in the journal Sustainability.

Contact with others is stressful

Historically, in environmental disasters (such as hurricanes), people find comfort in asking for and getting help from neighbors and friends. However, this kind of dependence and interaction increased stress for people in the survey, Cannon said. That's because in a pandemic, contact with others increases their risks and fears of getting sick, she said.

"There seems to be a real fear of contagion," Cannon said. "There's something unique about it being an infectious disease in that people pose a risk to each other. If we need things from other people, it increases our stress."

"The more that people perceive stress the less resilient they are."

Research on pandemics and their effects on people is scant, given that it's been a century since a pandemic the size of COVID-19 has occurred. Additionally, very little research has taken place during a pandemic, researchers said.

A population facing uncertainty

The findings showed that just 28 days, on average, into the pandemic two-thirds of survey respondents reported moderate to high levels of stress. Most of the respondents were female (75 percent), well-educated, white and employed at the time.

"It begs the question," researchers wrote in their article, "of whether populations with less social capital and fewer financial resources would be reporting even higher levels of stress and lower levels of resilience."

The authors said the research points to the need for solutions for a population facing so much uncertainty.

"Given the findings from the study, governments must mitigate the associated risks of a pandemic by providing the needed resources for individuals, households, and communities to maintain resilience over a long period of time," the authors concluded. "The uncertain end of COVID-19 requires governments to offer a buffer against the pandemic impact and to ultimately reduce stress to create optimal health and well-being for citizens facing adversity."

https://www.sciencedaily.com/releases/2020/08/200825110606.htm

COVID-19: Immune system derails

August 6, 2020

Science Daily/DZNE - German Center for Neurodegenerative Diseases

Contrary to what has been generally assumed so far, a severe course of COVID-19 does not solely result in a strong immune reaction -- rather, the immune response is caught in a continuous loop of activation and inhibition. Experts from Charité -- Universitätsmedizin Berlin, the University of Bonn, the German Center for Neurodegenerative Diseases (DZNE), the Helmholtz Centre for Infection Research (HZI) and the German Center for Infection Research (DZIF), along with colleagues from a nationwide research network, present these findings in the scientific journal Cell.

Most patients infected with the coronavirus SARS-CoV-2 show mild or even no symptoms. However, 10 to 20 percent of those affected develop pneumonia during the course of COVID-19 disease, some of them with life-threatening effects. "There is still not very much known about the causes of these severe courses of the disease. The high inflammation levels measured in those affected actually indicate a strong immune response. Clinical findings, however, rather tend to indicate an ineffective immune response. This is a contradiction," says Joachim Schultze, professor at the University of Bonn and research group leader at the DZNE. "We therefore assume that although immune cells are produced in large quantities, their function is defective. That is why we examined the blood of patients with varying degrees of COVID-19 severity," explains Leif Erik Sander, Professor of Infection Immunology and Senior Physician Charité's Medical Department, Division of Infectious Diseases and Respiratory Medicine.

High-precision methods

The study was carried out within the framework of a nationwide consortium -- the "German COVID-19 OMICS Initiative" (DeCOI) -- resulting in the analysis and interpretation of the data being spread across various teams and sites. Joachim Schultze was significantly involved in coordinating the project. The blood samples came from a total of 53 men and women with COVID-19 from Berlin and Bonn, whose course of disease was classified as mild or severe according to the World Health Organization classification. Blood samples from patients with other viral respiratory tract infections as well as from healthy individuals served as important controls.

The investigations involved the use of single-cell OMICs technologies, a collective term for modern laboratory methods that can be used to determine, for example, the gene activity and the amount of proteins on the level of single, individual cells -- thus with very high resolution. Using this data, the scientists characterized the properties of immune cells circulating in the blood -- so-called white blood cells. "By applying bioinformatics methods on this extremely comprehensive data collection of the gene activity of each individual cell, we could gain a comprehensive insight of the ongoing processes in the white blood cells," explains Yang Li, Professor at the Centre for Individualised Infection Medicine (CiiM) and Helmholtz Centre for Infection Research (HZI) in Hannover. "In combination with the observation of important proteins on the surface of immune cells, we were able to decipher the changes in the immune system of patients with COVID-19," adds Birgit Sawitzki, Professor at the Institute of Medical Immunology on Campus Virchow-Klinikum.

"Immature" cells

The human immune system comprises a broad arsenal of cells and other defense mechanisms that interact with each other. In the current study, the focus was on so-called myeloid cells, which include neutrophils and monocytes. These are immune cells that are at the very front of the immune response chain, i.e. they are mobilized at a very early stage to defend against infections. They also influence the later formation of antibodies and other cells that contribute to immunity. This gives the myeloid cells a key position.

"With the so-called neutrophils and the monocytes we have found that these immune cells are activated, i.e. ready to defend the patient against COVID-19 in the case of mild disease courses. They are also programmed to activate the rest of the immune system. This ultimately leads to an effective immune response against the virus," explains Antoine-Emmanuel Saliba, head of a research group at the Helmholtz Institute for RNA-based Infection Research (HIRI) in Würzburg.

But the situation is different in severe cases of COVID-19, explains Sawitzki: "Here, neutrophils and monocytes are only partially activated and they do not function properly. We find considerably more immature cells that have a rather inhibitory effect on the immune response." Sander adds: "The phenomenon can also be observed in other severe infections, although the reason for this is unclear. Many indications suggest that the immune system stands in its own way during severe courses of COVID-19. This could possibly lead to an insufficient immune response against the corona virus, with a simultaneous severe inflammation in the lung tissue."

Approaches to therapy?

The current findings could point to new therapeutic options, says Anna Aschenbrenner from the LIMES Institute at the University of Bonn: "Our data suggest that in severe cases of COVID-19, strategies should be considered that go beyond the treatment of other viral diseases." The Bonn researcher says that in the case of viral infections one does not actually want to suppress the immune system. "If, however, there are too many dysfunctional immune cells, as our study shows, then one would very much like to suppress or reprogram such cells." Jacob Nattermann, Professor at the Medical Clinic I of the University Hospital Bonn and head of a research group at the DZIF, further explains: "Drugs that act on the immune system might be able to help. But this is a delicate balancing act. After all, it's not a matter of shutting down the immune system completely, but only those cells that slow down themselves, so to speak. In this case these are the immature cells. Possibly we can learn from cancer research. There is experience with therapies that target these cells."

Nationwide team effort

In view of the many people involved, Schultze emphasizes the cooperation within the research consortium: "As far as we know, this study is one of the most comprehensive studies to date on the immune response in COVID-19 based on single cell data. The parallel analysis of two independent patient cohorts is one of the strengths of our study. We analyzed patient cohorts from two different sites using different methods and were thus able to validate our findings directly. This is only possible if research data is openly shared and cooperation is based on trust. This is extremely important, especially in the current crisis situation."

https://www.sciencedaily.com/releases/2020/08/200806111822.htm

COVID-19: The long road to recovery

August 6, 2020

Science Daily/University of Leeds

Researchers have identified a pattern of longer-term symptoms likely to be experienced by people who were hospitalised with the COVID-19 infection.

They include fatigue, breathlessness, psychological distress -- including problems with concentration and memory -- and a general decline in quality of life.

Some patients, particularly those who had been in intensive care, had symptoms associated with cases of PTSD (post-traumatic stress disorder).

The findings provide the first detailed insight into problems facing patients recovering from COVID-19 in the UK.

Dr Manoj Sivan, Associate Clinical Professor at the University of Leeds and a Consultant in Rehabilitation Medicine at Leeds General Infirmary, supervised the research project. He said: "COVID-19 is a new illness and we have very little information on longer term problems in individuals after discharge from hospital."

"The emerging evidence is that for some, the road to recovery may take months and it is vital specialist rehabilitation is on hand to support them. This research gives an important insight into patient needs, and that will help shape services in the community."

The findings -- Post-discharge symptoms and rehabilitation needs in survivors of COVID-19 infection: a cross-sectional evaluation -- have been published in the Journal of Medical Virology.

Dr Stephen Halpin, Senior Research Fellow at the University of Leeds and Consultant with Leeds Teachings Hospitals NHS Trust, said: "This research follows our previous work of predicting COVID-19 patients' long-term needs based on previous coronavirus outbreaks of SARS in 2002 and MERS in 2012. The health problems are similar but on a larger scale given the number of people affected."

The research team -- involving multidisciplinary specialists from the University of Leeds, Leeds Teaching Hospitals NHS Trust, Leeds Community Healthcare NHS Trust and Leeds Beckett University -- followed 100 people recovering from COVID-19, four-to-eight weeks after being discharged from hospital in Leeds.

The COVID-19 survivors were divided into two groups: those who had become critically ill and needed intensive care -- 32 people were in this category; and those who were treated on a ward without needing intensive care -- 68 people were in this category.

Patients were contacted by a member of the hospital's rehabilitation team and asked a series of questions about their recovery and symptoms they were still experiencing.

Results

The most prevalent symptom was fatigue. More than 60 percent of people who had been treated on a ward reported fatigue, and one-third of them described it as moderate or severe. For patients who had been in intensive care, 72 percent reported fatigue. Of those, more than half said it was moderate or severe.

The second most common symptom was breathlessness. People in both groups said they had feelings of breathlessness which had not existed before they contracted COVID-19. This was higher in the group that had been the most ill, the intensive care group versus those who had been treated in a ward -- 65.6 percent versus 42.6 percent.

The third most prevalent symptoms were neuropsychological. The research survey found that almost one quarter of the people who had been on a ward and just under a half of the people who had been in intensive care had some of the symptoms of PTSD.

Writing in the paper, the researchers said: "PTSD symptoms are a well-recognised component of post- intensive care unit syndrome caused by a variety of factors including fear of dying, invasive treatment, pain, delirium, inability to communicate, weakness, immobility, and sensory problems and sleep deprivation."

More than two-thirds (68.8 percent) of patients in the intensive care group and just under half (45.6 percent) of the other group said their overall quality of life had deteriorated.

The researchers say the rehabilitation needs of patients who did not require hospital care need to be further investigated and they are working on understanding this in future research.

https://www.sciencedaily.com/releases/2020/08/200806122820.htm

Young kids could spread COVID-19 as much as older children and adults

Findings important to nationwide conversations on reopening schools and daycare

July 30, 2020

Science Daily/Ann & Robert H. Lurie Children's Hospital of Chicago

A study from Ann & Robert H. Lurie Children's Hospital of Chicago discovered that children younger than 5 years with mild to moderate COVID-19 have much higher levels of genetic material for the virus in the nose compared to older children and adults.

Findings, published in JAMA Pediatrics, point to the possibility that the youngest children transmit the virus as much as other age groups. The ability of younger children to spread COVID-19 may have been under-recognized given the rapid and sustained closure of schools and daycare during the pandemic.

"We found that children under 5 with COVID-19 have a higher viral load than older children and adults, which may suggest greater transmission, as we see with respiratory syncytial virus, also known as RSV," says lead author Taylor Heald-Sargent, MD, PhD, pediatric infectious diseases specialist at Lurie Children's and Assistant Professor of Pediatrics at Northwestern University Feinberg School of Medicine. "This has important public health implications, especially during discussions on the safety of reopening schools and daycare."

Dr. Heald-Sargent and colleagues analyzed 145 cases of mild to moderate COVID-19 illness within the first week of symptom onset. They compared the viral load in three age groups -- children younger than 5 years, children 5-17 years and adults 18-65 years.

"Our study was not designed to prove that younger children spread COVID-19 as much as adults, but it is a possibility," says Dr. Heald-Sargent. "We need to take that into account in efforts to reduce transmission as we continue to learn more about this virus."

https://www.sciencedaily.com/releases/2020/07/200730141324.htm

Pregnant Black and Hispanic women five times more likely to be exposed to coronavirus

July 29, 2020

Science Daily/University of Pennsylvania School of Medicine

Black and Hispanic pregnant women in Philadelphia are five times as likely as white and Asian women to have been exposed to the novel coronavirus, according to a new study led by Scott Hensley, PhD, an associate professor of Microbiology in the Perelman School of Medicine at the University of Pennsylvania, and Karen Marie Puopolo, MD, PhD, an associate professor of Pediatrics and neonatologist at the Children's Hospital of Philadelphia. The study was published today in Science Immunology.

"Pregnant women are fairly representative of community exposure, and these data provide more evidence, on top of what we already know with COVID-19, that health and socio-economic equity are inextricably linked," Hensley said, "Hopefully, this will help lead to policies that address these inequities."

The research team measured levels of SARS-CoV-2 antibodies to estimate rates of exposure to the novel coronavirus in pregnant women cared for at two Philadelphia hospitals. They found that, overall, 6.2 percent of these women possessed antibodies to the virus, but with significant variation across racial and ethnic groups -- 9.7 percent in Black women, 10.4 percent in Hispanic/Latina women, 2.0 percent in White/Non-Hispanic women, and 0.9 percent in Asian women.

Researchers said these data can inform clinical practice and care for pregnant women during the coronavirus pandemic, and be used to better understand the prevalence of the virus in the community, and how socio-economic factors and inequities may affect its spread.

"Identifying the disparity in virus exposure will ideally help lead to the discovery of what is causing these differences, including factors rooted in systemic racism, and inform public health measures aimed at preventing further infections," Puopolo said.

As of June 2020 -- the time period encompassed in this study -- there were 23,160 confirmed cases of COVID-19 in the city of Philadelphia, which has a population size of nearly 1.6 million people. This suggests an infection rate of approximately 1.4 percent, which is more than 4 times lower than the estimates based on the research team's serological data.

Researchers analyzed 1,293 women who gave birth between April and June at Pennsylvania Hospital and the Hospital of the University of Pennsylvania, which combined represent 50 percent of live births during that time in Philadelphia. The research team's serological test utilized a SARS-CoV-2 spike protein receptor binding domain antigen and a modified ELISA protocol. Researchers used samples stored at the Penn Medicine Biobank collected from 834 people prior to the pandemic and 31 people who recovered from known Covid-19 infections to test the efficacy of their antibody test. The researchers also tested samples from 140 pregnant women collected before the pandemic. Based on these data, the overall false positive rate is ~1.0 percent in the serological assay used for this study.

The researchers caution that the clinical meaning of the detected antibody remains unknown. Additionally, estimates of virus prevalence need to be interpreted carefully until studies directly comparing pregnant women and the general population are completed.

https://www.sciencedaily.com/releases/2020/07/200729151652.htm

COVID-19 has likely tripled depression rate

September 2, 2020

Science Daily/Boston University School of Medicine

A first-of-its-kind study from the Boston University School of Public Health (BUSPH) finds 27.8% of U.S. adults had depression symptoms as of mid-April, compared to 8.5% before the COVID-19 pandemic.

Published in the journal JAMA Network Open, the study also found that income and savings are the most dramatic predictors of depression symptoms in the time of COVID.

"Depression in the general population after prior large scale traumatic events has been observed to, at most, double," says study senior author Dr. Sandro Galea, Dean and Robert A. Knox Professor at BUSPH, citing examples such as September 11, the Ebola outbreak, and civil unrest in Hong Kong.

"We were surprised to see these results at first, but other studies since conducted suggest similar-scale mental health consequences," Galea says. These studies have mainly been conducted in Asia and focused on specific populations such as healthcare workers and college students (one such study found depression symptoms among half of Chinese healthcare workers who had treated COVID patients).

But the new BUSPH study is the first nationally-representative study in the U.S. to assess the change in depression prevalence before and during COVID using the Patient Health Questionnaire-9 (PHQ 9), the leading self-administered depression screening tool.

The researchers used data from 5,065 respondents to the 2017-2018 National Health and Nutrition Examination Survey (NHANES), and 1,441 respondents from the COVID-19 Life Stressors Impact on Mental Health and Well-Being (CLIMB) study, which was conducted from March 31 to April 13, 2020, when 96% of the U.S. population was under stay-at-home advisories or shelter-in-place policies.

Both surveys used the PHQ 9 to assess depression symptoms and gathered the same demographic data, and the 2020 survey also gathered data on COVID-related stressors including job loss, the death of a friend or loved one from COVID, and financial problems.

Across the board, the researchers found an increase in depression symptoms among all demographic groups. Not surprisingly, experiencing more COVID-related stressors was a major predictor of depression symptoms.

However, the biggest demographic difference came down to money. After adjusting for all other demographics, the researchers found that, during COVID, someone with less than $5,000 in savings was 50% more likely to have depression symptoms than someone with more than $5,000.

"Persons who were already at risk before COVID-19, with fewer social and economic resources, were more likely to report probable depression, suggesting that inequity may increase during this time and that health gaps may widen," says study lead author Catherine Ettman, a doctoral student at the Brown University School of Public Health and director of strategic development in the Office of the Dean at BUSPH.

"We would hope that these findings promote creating a society where a robust safety net exists, where people have fair wages, where equitable policies and practices exist, and where families can not only live on their income but can also save money towards the future," she says.

As COVID continues to grip the country, Ettman says, "There may be steps that policymakers can take now to help reduce the impact of COVID-19 stressors on depression, such as eviction moratoria, providing universal health insurance that is not tied to employment, and helping people return to work safely for those able to do so."

At the same time, Ettman says she and her colleagues hope the study findings will also help those who are experiencing depression in this incredibly difficult time see that they are not alone: On the contrary, one in four U.S. adults is probably going through the same thing.

https://www.sciencedaily.com/releases/2020/09/200902152202.htm