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Canadian Publications on COVID-19

The Office of the Chief Science Advisor supports the statement of the Global Preparedness Monitoring Board on COVID-19. This statement asks that researchers voluntarily agree to make their COVID-19 and coronavirus-related publications, and the available data supporting them, rapidly accessible on public repositories. This page helps support the ongoing public health emergency response efforts by facilitating access to numerous Canadian scientists' publications.

COVID-19 Publications by Canadian Scientists
Date Article Abstract


Predictors of failure with high-flow nasal oxygen therapy in COVID-19 patients with acute respiratory failure: a multicenter observational study

Authors: Mellado-Artigas, Ricard; Eduardo Mujica, Luis; Liliana Ruiz, Magda; Ferreyro, Bruno Leonel; Angriman, Federico; Arruti, Egoitz; Torres, Antoni; Barbeta, Enric; Villar, Jesus; Ferrando, Carlos

JOURNAL OF INTENSIVE CARE Volume: 9 Issue: 1 Article Number: 23

This article describes the use of high-flow nasal oxygen (HFNO) in patients with COVID-19 acute respiratory failure and a shift to invasive mechanical ventilation. It is based on data from COVID-19 patients admitted to 36 Spanish and Andorran intensive care units who received HFNO on admission. Of patients treated with HFNO, 54% required invasive mechanical ventilation. Baseline non-respiratory Sequential Organ Failure Assessment (SOFA) score and the ROX (ratio of oxygen saturation) index were associated with intubation. Among adult critically ill patients with COVID-19 initially treated with HFNO, the SOFA score and the ROX index may help to identify patients with higher likelihood of intubation.


Expression of severe acute respiratory syndrome coronavirus 2 cell entry genes, angiotensin-converting enzyme 2 and transmembrane protease serine 2, in the placenta across gestation and at the maternal-fetal interface in pregnancies complicated by preterm birth or preeclampsia

Authors: Bloise, Enrrico; Zhang, Jianhong; Nakpu, Jittanan; Hamada, Hirotaka; Dunk, Caroline E.; Li, Siliang; Imperio, Guinever E.; Nadeem, Lubna; Kibschull, Mark; Lye, Phetcharawan; Matthews, Stephen G.; Lye, Stephen J.


This study investigated the expression pattern of specific SARS-CoV-2 cell entry genes, angiotensin-converting enzyme 2 (ACE2) and transmembrane protease serine 2, in human placenta and in pregnancies complicated by preterm birth or preeclampsia compared with those in term uncomplicated pregnancies. The increased expression of these entry-associated genes in the placenta in the first trimester compared with later stages of pregnancy suggests the possibility of differential susceptibility to placental entry to SARS-CoV-2 across pregnancy. There was some evidence of increased rates of preterm birth associated with SARS-CoV-2 infection, but no increase in mRNA expression of ACE2 or transmembrane protease serine 2 at the maternal-fetal interface.


Characterization of Critical Determinants of ACE2-SARS CoV-2 RBD Interaction

Authors: Brown, Emily E. F.; Rezaei, Reza; Jamieson, Taylor R. et al


This research identified and characterized the impact of mutating certain amino acid residues in the receptor binding domain (RBD) of SARS-CoV-2 and in ACE2 (angiotensin-converting enzyme 2) by utilizing the researchers’ NanoBiT technology-based biosensor as well as pseudotyped-virus infectivity assays. The researchers examined the mutational effects on RBD-ACE2 binding ability, efficacy of competitive inhibitors, as well as neutralizing antibody activity. These critical determinants of virus-host interactions may provide more effective targets for ongoing vaccines, drug development, and potentially pave the way for determining the genetic variation underlying disease severity.


How social capital helps communities weather the COVID-19 pandemic

Authors: Makridis, Christos A.; Wu, Cary

PLOS ONE Volume: 16 Issue: 1 Article Number: e0245135

This paper explored the role of social capital as a mediating factor in the spread of the virus. Because social capital is associated with greater trust and relationships within a community, it could endow individuals with a greater concern for others, thereby leading to more hygienic practices and social distancing. Using data from over 2,700 US counties, the authors found that moving a county from the 25th to the 75th percentile of the distribution of social capital would lead to an 18% and 5.7% decline in the cumulative number of infections and deaths, as well as a lower spread of the virus.


Shifts in office and virtual primary care during the early COVID-19 pandemic in Ontario, Canada

Authors: Glazier, Richard H.; Green, Michael E.; Wu, Fangyun C.; Frymire, Eliot; Kopp, Alexander; Kiran, Tara


This population-based study compared primary care physician billing data from January to July 2020 with the same period in 2019.  Total primary care visits between March and July 2020 decreased by 28.0% compared to a year earlier. The smallest declines were among patients with the highest expected health care use (8.3%), those who could not be attributed to a primary care physician (10.2%), and older adults (19.1%). In contrast, total visits in rural areas increased by 6.4%. Primary care in Ontario saw large shifts from office to virtual care over the first 4 months of the COVID-19 pandemic.


Angiotensin-converting enzyme 2 expression in COPD and IPF fibroblasts: the forgotten cell in COVID-19

Authors: Aloufi, Noof; Traboulsi, Hussein; Ding, Jun; Fonseca, Gregory J.; Nair, Parameswaran; Huang, Steven K.; Hussain, Sabah N. A.; Eidelman, David H.; Baglole, Carolyn J.


For those who recover from COVID-19, post infection complications may include development of pulmonary fibrosis. Factors contributing to disease severity or the development of complications are not known. Using computational analysis with experimental data, the authors report that idiopathic pulmonary fibrosis (IPF)- and chronic obstructive pulmonary disease (COPD)-derived lung fibroblasts express higher levels of angiotensin-converting enzyme 2 (ACE2), the receptor for SARS-CoV-2 entry and part of the renin-angiotensin system that is antifibrotic and anti-inflammatory. They found that chronic exposure to cigarette smoke significantly increased pulmonary ACE2 protein expression.


Take home injectable opioids for opioid use disorder during and after the COVID-19 Pandemic is in urgent need: a case study

Authors: Oviedo-Joekes, Eugenia; MacDonald, Scott; Boissonneault, Charles; Harper, Kelli


People with opioid use disorder (OUD) face unique COVID-19 challenges if they are financially insecure or living in shelters. They also have other medical conditions that make them more likely to be immunocompromised and at risk of developing COVID-19. In response, clinical guidance for prescribers was issued to allow take home opioid medications for opioid agonist treatment (OAT). This study presents the first case of a patient in Canada with long-term OUD that received take home injectable diacetylmorphine to self-isolate in an approved site after a COVID-19 diagnosis. The case demonstrated that it is feasible to provide iOAT outside the community clinic with no apparent negative consequences.


COVID-19, frailty and long-term care: Implications for policy and practice

Authors: Andrew, Melissa K; Searle, Samuel D; McElhaney, Janet E; McNeil, Shelly A; Clarke, Barry; Rockwood, Kenneth; Kelvin, David J


Many outbreaks of COVID-19 have occurred in Long Term Care Facilities (LTCFs). The authors discuss the vulnerability of LTCF residents using an ecological framework that includes individuals, families, caregivers, institutions, health services and systems, communities, and government policies.  Use of the Clinical Frailty Scale (CFS) is discussed, as are lessons learned from the study of frailty in relation to influenza. Biomarkers hold emerging promise in predicting disease severity and addressing why some frail LTCF residents are resilient to COVID-19, either remaining test-negative despite exposure or having asymptomatic infection, while others experience the full range of illness severity including critical illness and death.


Modeling shield immunity to reduce COVID-19 epidemic spread

Authors: Weitz, Joshua S; Beckett, Stephen J; Coenen, et al

NATURE MEDICINE Volume: 26 Issue: 6 Pages: 849

The authors developed and analyzed an epidemiological intervention model that leverages serological tests to identify and deploy recovered individuals who are seropositive for anti-SARS-CoV-2 antibodies into the community as focal points to sustain safer interactions to develop 'shield immunity' at the population scale. The objective of a shield immunity strategy is to sustain the interactions necessary for the functioning of essential goods and services while reducing the probability of transmission. This approach could substantively reduce the length and reduce the overall burden of the current outbreak and can work synergistically with social distancing.


De-Escalation by Reversing the Escalation with a Stronger Synergistic Package of Contact Tracing, Quarantine, Isolation and Personal Protection: Feasibility of Preventing a COVID-19 Rebound in Ontario, Canada, as a Case Study

Authors: Tang, Biao; Scarabel, Francesca; Bragazzi, Nicola, Luigi; McCarthy, Zachary; Glazer, Michael; Xiao, Yanyu; Heffernan, Jane M; Asgary, Ali; Ogden, Nicholas Hume; Wu, Jianhong

BIOLOGY-BASEL Volume: 9 Issue: 5 Article Number: 100

A transmission dynamics model fitted to cumulative case time series data permitted the authors to estimate the effectiveness of COVID-19 contact rate, probability of transmission per contact, proportion of isolated contacts, and detection rate interventions during various phases of social distancing and enhanced testing in Ontario. This allowed them to calculate the control reproduction number during different phases. This provided the necessary conditions in terms of enhanced social distancing, personal protection, contact tracing, quarantine/isolation strength at each escalation phase to avoid a rebound. They then quantified the conditions needed to prevent epidemic rebound during de-escalation by reversing the escalation process.


Presence of mismatches between diagnostic PCR assays and coronavirus SARS-CoV-2 genome

Authors: Khan, Kashif Aziz; Cheung, Peter

ROYAL SOCIETY OPEN SCIENCE Volume: 7 Issue: 6 DOI: 10.1098/rsos.200636

This study conducted a reassessment of published diagnostic PCR assays, including those recommended by the World Health Organization, to evaluate mismatches with publicly available viral sequences. An exhaustive evaluation of the sequence variability within the primer/probe target regions of the viral genome was performed using more than 17,000 viral sequences from around the world. The analysis showed the presence of mutations/mismatches in primer/probe binding regions of 7 out of 27 assays studied. A comprehensive bioinformatics approach for in silico inclusivity evaluation of PCR diagnostic assays of SARS-CoV-2 was validated using freely available software programs applicable to any diagnostic assay of choice.


Modeling the impact of mass influenza vaccination and public health interventions on COVID-19 epidemics with limited detection capability

Authors: Li, Qian; Tang, Biao; Bragazzi, Nicola Luigi; Xiao, Yanni; Wu, Jianhong

MATHEMATICAL BIOSCIENCES Volume: 325 Article Number: 108378 DOI: 10.1016/j.mbs.2020.108378

The authors devised a mathematical model focused on the treatment of people with influenza-like-illness symptoms potentially at risk of contracting COVID-19 or other respiratory infections during their admission at health-care settings, whose use of detection kits could cause a severe shortage of testing resources. The model assessed the effect of mass influenza vaccination on the spread of COVID-19 and other respiratory pathogens if an outbreak and the influenza season coincided.  Increasing influenza vaccine uptake or enhancing public health interventions would facilitate the management of respiratory outbreaks coinciding with the peak flu season and compensate the shortage of the detection resources.


Impact of climate and public health interventions on the COVID-19 pandemic: a prospective cohort study

Authors: Juni, Peter; Rothenbuhler, Martina; Bobos, Pavlos; Thorpe, Kevin E.; da Costa, Bruno R.; Fisman, David N.; Slutsky, Arthur S.; Gesink, Dionne


The authors studied 144 geopolitical areas worldwide with at least 10 COVID-19 cases and local transmission by Mach 20, 2020 (excluding China, South Korea, Iran, and Italy) to determine whether epidemic growth is associated with climate or public health interventions intended to reduce transmission of SARS-CoV-2. There were no associations of epidemic growth with latitude and temperature, but weak negative associations with relative humidity and absolute humidity. Strong associations were found for restrictions of mass gatherings, school closures and social distancing measures. Public health interventions were strongly associated with reduced epidemic growth.


Telepsychotherapy for Generalized Anxiety Disorder: Impact on the Working Alliance

Authors: Watts, Stephanie; Marchand, Andre; Bouchard, Stephane; Gosselin, Patrick; Langlois, Frederic; Belleville, Genevieve; Dugas, Michel J.


This research assessed the impact of cognitive behavioral therapy administered via telepsychotherapy or face-to-face on the quality of the working alliance during the COVID-19 pandemic. One hundred and 15 participants suffering from generalized anxiety disorder took part in the randomized controlled trial, 50 of whom were assigned to telepsychotherapy in videoconference and 65 of whom were assigned to conventional psychotherapy. Telepsychotherapy did not interfere with the establishment of the working alliance over the course of the treatment.  On the contrary, clients had a stronger working alliance in telepsychotherapy delivered in videoconference than in conventional psychotherapy.


A simple model for COVID-19

Authors: Arino, Julien; Portet, Stephanie

INFECTIOUS DISEASE MODELLING Volume: 5 Pages: 309-315 Published: Volume 5, 2020

Most early modeling work on COVID-19 concerned predictions over a short time period, often no more than a month. The authors incorporated an Erlang distribution of times of sojourn in incubating, symptomatically and asymptomatically infectious compartments - a simple variation on the classic SLIAR epidemic model for susceptible, latently infected, symptomatic, and asymptomatic infectious and removed individuals.  Incorporating a better description of sojourn times is extremely important in reasonably approximating the details of progression through infection with a minimal number of parameters and the convenience of an ODE (ordinary differential equation) model over integral or PDE (partial differential equation) models.


Canada needs to rapidly escalate public health interventions for its COVID-19 mitigation strategies

Authors: Scarabel, Francesca; Pellis, Lorenzo; Bragazzi, Nicola Luigi; Wu, Jianhong

INFECTIOUS DISEASE MODELLING Volume: 5 Pages: 316-322 Published: Volume 5, 2020

The authors estimated the growth rates of the COVID-19 epidemics in Italy and Canada by fitting an exponential curve to daily reported cases to predict trends in Canada under different public health intervention scenarios. In Italy, the initial 0.22 growth rate was reduced to 0.1 two weeks after the lockdown of the country. In comparison, the growth rate in Canada increased from 0.13 between March 1-13, to 0.25 between March 13-22, a doubling time of 2.7 days. Prompt interventions are critical to counteract the rapid growth of the COVID-19 epidemic in Canada given the delayed effect of interventions by up to 2-weeks and the short doubling time of 3-4 days.


A Global Digital Citizen Science Policy to Tackle Pandemics Like COVID-19

Authors: Katapally, Tarun R.


The COVID-19 pandemic is an existential threat that requires a cohesive effort and enormous public trust to follow health guidelines, maintain social distance, and share necessities. Mobile technology provides access to big data in terms of volume, velocity, veracity, and variety that are particularly relevant to understand and mitigate the spread of pandemics.  This article outlines an evidence-based global digital citizen science policy that provides the theoretical and methodological foundation for ethically sourcing big data from citizens to tackle pandemics such as COVID-19.


Insights on early mutational events in SARS-CoV-2 virus reveal founder effects across geographical regions)

Authors: Farkas, Carlos; Fuentes-Villalobos, Francisco; Garrido, Jose Luis; Haigh, Jody; Ines Barria, Maria

PEERJ Volume: 8 Article Number: e9255

The authors described early mutational events across samples from publicly available SARS-CoV-2 sequences.  They downloaded 50 datasets, mostly from China, USA, and Australia. They found 60% contained at least a single founder mutation and most of the variants were missense (over 63%). Five-point mutations with founder effect were identified in USA next-generation sequencing samples. Sequencing samples from North America in GenBank present this signature with up to 39% allele frequencies. Australian variant signatures were more diverse than USA samples, but founder events also were identified in these samples. Mutations in the helicase suggest these regions were actively evolving in March 2020.


Inhibition of SARS-CoV-2 Infections in Engineered Human Tissues Using Clinical-Grade Soluble Human ACE2

Authors: Monteil, Vanessa; Kwon, Hyesoo; Prado, Patricia; Hagelkruys, Astrid; et al

CELL Volume: 181 Issue: 4 Pages: 905-+

These authors previously provided the first genetic evidence that angiotensin converting enzyme 2 (ACE2) is the critical receptor for SARS-CoV-2. ACE2 provides a molecular explanation for severe lung failure and death due to SARS-CoV infections. In this research they show that clinical grade hrsACE2 reduced SARS-CoV-2 recovery from Vero cells by a factor of 1,000-5,000. An equivalent mouse rsACE2 had no effect. They also show that SARS-CoV-2 can directly infect engineered human blood vessel organoids and human kidney organoids, which can be inhibited by hrsACE2. These data demonstrate that hrsACE2 can significantly block early stages of SARS-CoV-2 infections.


Monitoring the effects of COVID‐19 in emerging adults with pre‐existing mood and anxiety disorders

Authors: Elizabeth Osuch, Jazzmin Demy, Michael Wammes, Paul Tremblay, Evelyn Vingilis, Chlöe Carter

Early Intervention in Psychiatry

This research demonstrated a method to monitor the mental health status of patients with reduced access to mental health services during COVID-19 quarantine. Patients in the First‐Episode Mood and Anxiety Program participated in online questionnaires. Patients were flagged for high level of risk based on depression scores, suicidal ideation and worsening in anxiety, depression, or quality of health. All patients were also asked if they wanted contact with a clinician.  Of participating patients, 32.5% requested help. Participants flagged for concerning scores were younger, more likely to be on the wait list for treatment, to have been laid off from work, and have more functional impairment.


Personal Protective Equipment in COVID-19: Impacts on Health Performance, Work-Related Injuries, and Measures for Prevention

Authors: Duan, Xiaoqin; Sun, Hongzhi; He, Yuxuan; Yang, Junling; Li, Xinming; Taparia, Kritika; Zheng, Bin

Journal of Occupational and Environmental Medicine

The authors conducted a cross-sectional survey of over 50 hospitals in China to assess the impact of personal protective equipment (PPE) on healthcare providers (HCPs) caring for COVID-19 patients.  All 104 frontline HCPs reported negative impacts of PPE on their clinical performance, with 97% of them experiencing discomfort and injuries caused by wearing PPE for long hours. Frontline HCPs provided suggestions to alleviate the negative impacts, such as improving the design of PPE and enhancing communication between healthcare staff and patients. Two hundred eighty-two non-frontline HCPs also revealed similar problems.


COVID-19 street reallocation in mid-sized Canadian cities: socio-spatial equity patterns (Can J Public Health Mar 1, 2021)

Authors: Jaimy Fischer and Meghan Winters

Canadian Journal of Public Health

The authors collected data on interventions to expand street space for active transportation or physical distancing in three mid-sized Canadian cities from April 1 to August 15, 2020.  They assessed socio-spatial patterning of interventions by comparing differences in where they were implemented by area-level mobility, accessibility, and socio-demographic characteristics. They discovered 2 themes motivating street reallocations: supporting mobility, recreation, and physical distancing in populous areas, and bolstering COVID-19 recovery for businesses. As cities move toward recovery and resilience, they should leverage early learnings as they create more permanent solutions that support safe and equitable mobility.


Patients in hospital with laboratory-confirmed COVID-19 in a network of Canadian acute care hospitals, Mar. 1 to Aug. 31, 2020: a descriptive analysis

Authors: Robyn Mitchell, Kelly Baekyung Choi, Linda Pelude, Wallis Rudnick, Nisha Thampi, Geoffrey Taylor; for the CNISP COVID-19 Working Group

Canadian Medical Association Journal

This research described the epidemiology of patients in hospital with laboratory-confirmed COVID-19 in a network of Canadian acute care hospitals between Mar. 1 and Aug. 31, 2020.  Most patients were older (median age 71 years) and had underlying medical conditions (85.8%). Few children were admitted to a participating hospital (1.9%). A total of 32.8% of patients were admitted from a long-term care facility or retirement home. Health care workers constituted 10.6% of adult patients aged 18–65 years in hospital with COVID-19. Thirty-day attributable mortality was 16.2%. Acquisition of COVID-19 in hospitals was infrequent at 6.4% of all cases.


Genomic characterization and evolution of SARS-CoV-2 of a Canadian population

Authors: Manna Zhang, Lin Li, Ma Luo and Binhua Liang

PLoS One

This study analyzed 129 full-length genomes of SARS-CoV-2 viruses in a Canadian population during the early phase of the pandemic. Phylogenetic analysis revealed three major paths of transmission of the viruses into Canada. Twenty-one substitutions with frequencies greater than 3% of viral population were identified. Analysis of these substitutions indicated that P1427I (ORF1b), Y1464C (ORF1b), and Q57H (ORF3a) might affect functions of the corresponding SARS-CoV-2 encoded proteins. There also was evidence of positive selection on the ORF3a and codon 614 of Spike protein, suggesting the viral components responsible for host entry and activation of inflammation response were targeted by host immune responses.


Psychological distress and sleep problems in healthcare workers in a developing context during COVID-19 pandemic: Implications for workplace wellbeing

Authors: Andrew T. Olagunju, Ayodeji A. Bioku, Tinuke O. Olagunju, Foluke O. Sarimiye, Obiora E. Onwuameze and Uriel Halbreich

Progress in Neuro-Psychopharmacology and Biological Psychiatry

The emotional wellbeing of healthcare workers is critical to patient care and the effective functioning of health services. This study investigated psychological distress and sleep problems in healthcare workers in a COVID-19 referral hospital in Nigeria. A significant proportion of healthcare workers reported psychological distress and poor sleep quality during the COVID-19 pandemic. Psychological distress was much higher during the COVID-19 pandemic than previously reported, and inter-related with poor sleep. Psychosocial support for health workers based on a viable holistic model is indicated during emergency situations.  The authors strongly suggest the development of a culturally sensitive, interdisciplinary blueprint for locally viable actions.


Implementation and evaluation of the virtual Graded Repetitive Arm Supplementary Program (GRASP) for individuals with stroke during the COVID-19 pandemic and beyond

Authors:  Chieh-ling Yang, Seonaid Waterson and Janice J Eng

Physical Therapy and Rehabilitation Journal

During the COVID-19 pandemic, telerehabilitation that enables the remote delivery of rehabilitation services is needed to mitigate the spread of SARS-CoV-2. This research assessed the effectiveness of the virtual Graded Repetitive Arm Supplementary Program delivered via videoconferencing in individuals with stroke. Between baseline and post-test, participants with stroke demonstrated significant improvement in upper extremity function. The program was implemented as intended and participants’ adherence was high, verified by the average attendance and practice time. In addition to its effectiveness in treating stroke patients, this study also informs the implementation of other telerehabilitation services.


Methodological quality of COVID-19 clinical research

Authors: Jung, Richard G.; Di Santo, Pietro; Clifford, Cole; Prosperi-Porta, Graeme; Skanes, Stephanie; Hung, Annie; Parlow, Simon; Visintini, Sarah; Ramirez, F. Daniel; Simard, Trevor; Hibbert, Benjamin

NATURE COMMUNICATIONS Volume: 12 Issue: 1 Article Number: 943

Concerns have been raised regarding the scientific rigor in published reports related to COVID-19. This systematic review evaluated the methodological quality of currently available COVID-19 studies compared to historical controls. A total of 9895 titles and abstracts were screened, and 686 COVID-19 articles were included in the final analysis. Comparative analysis revealed a shorter time to acceptance (13.0 days vs. 110.0) days in COVID-19 and control articles, respectively. Furthermore, methodological quality scores are lower in COVID-19 articles across all study designs. These studies should be revisited with the emergence of stronger evidence.


Inflammatory biomarkers as independent prognosticators of 28-day mortality for COVID-19 patients admitted to general medicine or ICU wards: a retrospective cohort study

Authors: Pitre, Tyler; Jones, Aaron; Su, Johnny; Helmeczi, Wryan; Xu, Grace; Lee, Catherine; Shamsuddin, Adib; Mir, Adhora; MacGregor, Sarah; Duong, MyLinh; Ho, Terence; Beauchamp, Marla K.; Costa, Andrew P.; Kruisselbrink, Rebecca


These researchers sought to determine whether commonly ordered inflammatory biomarkers can predict 28-day mortality by analyzing COVID-19-positive patients admitted to medical wards or intensive care units. Of 336 COVID-19-positive patients, 267 required hospital admission, and 69 were seen in the emergency room and discharged. The median age was 63 and the female-to-male ratio was 49:51. The authors provided estimates of cut-off values for inflammatory biomarkers and indices measured at the time of admission that may be useful to clinicians to predict 28-day mortality in North American COVID-19 patients.


Using Twitter to Understand the COVID-19 Experiences of People with Dementia: Infodemiology Study

Authors: Bacsu, Juanita-Dawne; O'Connell, Megan E.; Cammer, Allison; Azizi, Mahsa; Grewal, Karl; Poole, Lisa; Green, Shoshana; Sivananthan, Saskia; Spiteri, Raymond J.

JOURNAL OF MEDICAL INTERNET RESEARCH Volume: 23 Issue: 2 Article Number: e26254

This study used Twitter tweets to understand the experiences of COVID-19 for people with dementia and their care partners.  The authors collected tweets using the GetOldTweets application in Python from February 15 to September 7, 2020 and identified 4 main themes: separation and loss; COVID-19 confusion, despair, and abandonment; stress and exhaustion exacerbation; and unpaid sacrifices by care providers. They conclude governments need to rethink using a one-size-fits-all response to COVID-19 policy to support people with dementia and apply more evidence-informed research and collaboration to improve the quality of life for people with dementia and their care partners.


Fighting the storm: could novel anti-TNF alpha and anti-IL-6 C. sativa cultivars tame cytokine storm in COVID-19?

Authors: Kovalchuk, Anna; Wang, Bo; Li, Dongping; Rodriguez-Juarez, Rocio; Ilnytskyy, Slava; Kovalchuk, Igor; Kovalchuk, Olga

AGING-US Volume: 13 Issue: 2 Pages: 1571-1590

COVID-19 patients often suffer from lung fibrosis, a serious and untreatable condition. Of all cytokines, TNF alpha and IL-6 play crucial roles in cytokine storm pathogenesis and are likely responsible for the escalation in disease severity. Cannabis sativa has been proposed to modulate gene expression and inflammation and is under investigation for several potential therapeutic applications against autoinflammatory diseases and cancer. Novel anti-TNF alpha and anti-IL-6 cannabis extracts can be useful additions to the current anti-inflammatory regimens to treat COVID-19, as well as various rheumatological diseases and conditions, and 'inflammaging' - the inflammatory underpinning of aging and frailty.


A glucose meter interface for point-of-care gene circuit-based diagnostics

Authors: Amalfitano, Evan; Karlikow, Margot; Norouzi, Masoud; Jaenes, Katariina; Cicek, Seray; Masum, Fahim; Mousavi, Peivand Sadat; Guo, Yuxiu; Tang, Laura; Sydor, Andrew; Ma, Duo; Pearson, Joel D.; Trcka, Daniel; Pinette, Mathieu; Ambagala, Aruna; Babiuk, Shawn; Pickering, Bradley; Wrana, Jeff; Bremner, Rod; Mazzulli, Tony; Sinton, David; Brumell, John H.; Green, Alexander A.; Pardee, Keith

NATURE COMMUNICATIONS Volume: 12 Issue: 1 Article Number: 724

The authors leveraged the glucose meter, one of the most widely available point-of-care sensing devices, to serve as a universal reader for decentralized diagnostics. They showed the development of new glucogenic reporter systems, multiplexed reporter outputs and detection of nucleic acid targets down to the low attomolar range. Using this glucose-meter interface, they demonstrated the detection of a small-molecule analyte, sample-to-result diagnostics for typhoid, paratyphoid A/B, and show the potential for pandemic response with nucleic acid sensors for SARS-CoV-2. However, getting synthetic biology circuit-based sensors into field applications is still a challenge.


MicroRNA Mimics or Inhibitors as Antiviral Therapeutic Approaches Against COVID-19

Authors: Hum, Christine; Loiselle, Julia; Ahmed, Nadine; Shaw, Tyler A.; Toudic, Caroline; Pezacki, John Paul


While conventional therapeutics often involve administering small molecules to fight viral infections, small non-coding RNA sequences, known as microRNAs (miRNAs), may present a novel antiviral strategy. The authors utilized their ability to modulate host-virus interactions through mediating RNA degradation or translational inhibition. Investigations into miRNA and SARS-CoV-2 interactions can reveal novel therapeutic approaches against this virus. Several relevant miRNAs were identified and their potential roles in regulating SARS-CoV-2 infections assessed. By investigating the interactions between miRNAs and SARS-CoV-2, miRNA-based antiviral therapies, including miRNA mimics and inhibitors, may be developed as an alternative strategy to fight COVID-19.


Isolation, Sequence, Infectivity and Replication Kinetics of Severe Acute Respiratory Syndrome Coronavirus 2

Authors: Banerjee, Arinjay; Nasir, Jalees A.; Budylowski, Patrick; Yip, Lily; Aftanas, Patryk; Christie, Natasha; Ghalami, Ayoob; Baid, Kaushal; Raphenya, Amogelang R.; Hirota, Jeremy A.; Miller, Matthew S.; McGeer, Allison J.; Ostrowski, Mario; Kozak, Robert A.; McArthur, Andrew G.; Mossman, Karen; Mubareka, Samira

EMERGING INFECTIOUS DISEASES Volume: 26 Issue: 9 Pages: 2054-2063

This research team isolated SARS-CoV-2 from 2 infected patients in Toronto, Canada to determine the genomic sequences and identify single-nucleotide changes in representative populations of their virus stocks. They tested a wide range of human immune cells for productive infection and confirmed that human primary peripheral blood mononuclear cells are not permissive for SARS-CoV-2.  They stressed that it is essential to monitor single-nucleotide polymorphisms in the virus and to continue to isolate circulating viruses to determine viral genotype and phenotype by using in vitro and in vivo infection models.


"One more time": why replicating some syntheses of evidence relevant to COVID-19 makes sense

Authors: Page, Matthew J.; Welch, Vivian A.; Haddaway, Neal R.; Karunananthan, Sathya; Maxwell, Lara J.; Tugwell, Peter


Systematic reviews are required to address not only the etiology, diagnosis, prognosis, and treatment of symptoms of COVID-19, but also the social impacts of the disease. However, previous research suggests that a high proportion of systematic reviews and meta-analyses duplicate those that came before. The authors encourage the evidence synthesis community to prioritize purposeful replication of systematic reviews of relevant evidence and use reporting guidelines for systematic reviews.  The guidelines recommend authors report what question(s) the review addressed, the types of studies they considered eligible, how they identified such studies, which data they collected, and how the results were synthesized.


Feline coronavirus drug inhibits the main protease of SARS-CoV-2 and blocks virus replication

Authors: Vuong, Wayne; Khan, Muhammad Bashir; Fischer, Conrad; Arutyunova, Elena; Lamer, Tess; Shields, Justin; Saffran, Holly A.; McKay, Ryan T.; van Belkum, Marco J.; Joyce, Michael A.; Young, Howard S.; Tyrrell, D. Lorne; Vederas, John C.; Lemieux, M. Joanne

NATURE COMMUNICATIONS Volume: 11 Issue: 1 Article Number: 4282

The main protease, Mpro in SARS-CoV-2 is a viable drug target because of its essential role in the cleavage of the virus polypeptide. Feline infectious peritonitis, a fatal coronavirus infection in cats, was successfully treated previously with a prodrug GC376, a dipeptide-based protease inhibitor. The authors show the prodrug and its parent GC373, are effective inhibitors of the Mpro from both SARS-CoV and SARS-CoV-2. They are strong drug candidates for the treatment of human coronavirus infections because they have already been successful in animals. This work here lays the framework for their use in human trials for the treatment of COVID-19.


Perspective Fighting COVID-19: Integrated Micro- and Nanosystems for Viral Infection Diagnostics

Authors: Qin, Zhen; Peng, Ran; Baravik, Ilina Kolker; Liu, Xinyu

MATTER Volume: 3 Issue: 3 Pages: 628-651

The pandemic has highlighted the importance of rapid and sensitive diagnostics of viral infection that enable the efficient tracing of cases and the implementation of public health measures for disease containment. Many clinically validated systems have significantly benefited from the recent advances in micro- and nanotechnologies in terms of platform design, analytical method, and system integration and miniaturization. The authors reviewed previous and ongoing research efforts to develop integrated micro- and nanosystems for nucleic acid-based virus detection.  They highlight promising technologies that could provide better solutions for the diagnosis of COVID-19 and other viral infectious diseases.


Broad and Differential Animal Angiotensin-Converting Enzyme 2 Receptor Usage by SARS-CoV-2  

Authors: Zhao, Xuesen; Chen, Danying; Szabla, Robert; Zheng, Mei; Li, Guoli; Du, Pengcheng; Zheng, Shuangli; Li, Xinglin; Song, Chuan; Li, Rui; Guo, Ju-Tao; Junop, Murray; Zeng, Hui; Lin, Hanxin

JOURNAL OF VIROLOGY Volume: 94 Issue: 18 Article Number: e00940-20

SARS-CoV-2 harbors a polybasic furin cleavage site in its spike (S) glycoprotein and uses human angiotensin-converting enzyme 2 (ACE2) as its receptor to infect cells. The researchers examined receptor activity of ACE2 from 14 mammal species and found that ACE2s from multiple species can support the infectious entry of lentiviral particles pseudotyped with the wild-type or furin cleavage site-deficient S protein of SARS-CoV-2. ACE2 of human/rhesus monkey and rat/mouse exhibited the highest and lowest receptor activities, respectively. These findings have important implications for understanding potential natural reservoirs, zoonotic transmission, human-to-animal transmission, and use of animal models.


Feasibility of Rapidly Developing and Widely Disseminating Patient Decision Aids to Respond to Urgent Decisional Needs due to the COVID-19 Pandemic

Authors: Stacey, Dawn; Ludwig, Claire; Archambault, Patrick; Babulic, Kevin; Edwards, Nancy; Lavoie, Josee; Sinha, Samir; O'Connor, Annette M.

MEDICAL DECISION MAKING Volume: 41 Issue: 2 Pages: 233-239

To meet the urgent decision-making needs of retirement/nursing home residents and their families, this interdisciplinary team rapidly developed and disseminated patient decision aids (PtDAs) regarding leaving one's residence during the COVID-19 pandemic. Development efficiencies included access to a well-tested theory-based PtDA template, recent evidence syntheses, and values-based public responses to media reports. Within 3 weeks of their dissemination (websites, international PtDA inventory, Twitter, Facebook, media interviews), the PtDAs were downloaded 10,000 times, and user feedback was positive.


Rapid conversion of an in-patient hospital unit to accommodate COVID-19: An interdisciplinary human factors, ethnography, and infection prevention and control approach

Authors: Fadaak, Raad; Davies, Jan M.; Blaak, Marlot Johanna; Conly, John; Haslock, Joanne; Kenny, Ashley; Pinto, Nicole; Leslie, Myles

PLOS ONE Volume: 16 Issue: 1 Article Number: e024521

This interdisciplinary team of applied Human Factors, Ethnography, and Infection Prevention and Control experts assisted a hospital unit normally serving general surgical and orthopedic patients as it rapidly converted to deliver COVID-19-specific care. They deployed walkthroughs, simulations, and ethnography to identify safety gaps in care delivery processes on the unit. They recommended three interventions: the de-cluttering and re-organization of personal protective equipment; the reconfiguring of designated 'dirty' tray tables and supplies; and the redesign of handling pathways for 'dirty' linens and laundry to minimize nosocomial transmission potential in the acute healthcare setting.


Public Health Messages About Face Masks Early in the COVID-19 Pandemic: Perceptions of and Impacts on Canadians

Authors: Zhang, Ying Shan Doris; Young Leslie, Heather; Sharafaddin-zadeh, Yekta; Noels, Kimberly; Lou, Nigel Mantou


Early in the COVID-19 pandemic, Canadians faced ambiguity in public health messages around face mask use. This study used online focus groups to examine Canadians' opinions on the early messaging they received regarding personal protection, especially around mask use, to identify potential improvements to strengthen future health messaging. Despite demonstrating trust in scientific evidence and public health authorities, the inconsistencies in public health messaging fostered confusion, and induced mistrust toward health professionals. Information deficits were identified pertaining to the scientific efficacy, safe use, and disposal of masks. The findings stress that consistency in public health messages should be prioritized.


2-Pyridone natural products as inhibitors of SARS-CoV-2 main protease

Authors: Forrestall, Katrina L.; Burley, Darcy E.; Cash, Meghan K.; Pottie, Ian R.; Darvesh, Sultan

CHEMICO-BIOLOGICAL INTERACTIONS Volume: 335 Article Number: 109348

The SARS-CoV-2 main protease (M-pro) is an important enzyme for viral replication. Small molecules that inhibit this protease could lead to an effective COVID-19 treatment. The authors sought natural, antimicrobial products with the 2-pyridone moiety and investigated their calculated potency as inhibitors of SARS-CoV-2 M-pro. Thirty-three natural products containing the 2-pyridone scaffold were identified from the literature. All compounds investigated bound to the active site of SARS-CoV-2 M-pro, close to the catalytic dyad (His-41 and Cys-145). This work has identified 2-pyridone natural products with calculated potent inhibitory activity against SARS-CoV-2 M-pro and with desirable drug-like properties, which may lead to the rapid discovery of a treatment for COVID-19.


Virtual barriers: unpacking the sustainability implications of online food spaces and the Yellowknife Farmers Market's response to COVID-19

Authors: Radcliffe, Josalyn; Skinner, Kelly; Spring, Andrew; Picard, Lise; Benoit, France; Dodd, Warren

NUTRITION JOURNAL Volume: 20 Issue: 1 Article Number: 12

The researchers explored the potential of online marketplaces to contribute to a resilient, sustainable food system through a case study of the Yellowknife Farmers Market (YKFM) in the Northwest Territories, Canada. The evaluation included an in-person survey and questionnaire of market patrons from two YKFM dates prior to the pandemic. The top motivators for attendance were eating dinner, atmosphere, and supporting local businesses. During the pandemic, the YKFM did not move online but instead opted for a physically distanced market, which was well attended. Online markets may prove useful for future emerging stressors to enhance the resiliency of local systems.


Social capital and public health: responding to the COVID-19 pandemic

Authors: Wong, Anna S. Y.; Kohler, Jillian C.

GLOBALIZATION AND HEALTH Volume: 16 Issue: 1 Article Number: 88

The authors examined the role of social capital in the COVID-19 health policy response. They analyzed current research with respect to mental health, public health policy compliance, and the provision of care for vulnerable populations.  This article argues that considerations of social capital - including virtual community building, fostering solidarity between high-risk and low-risk groups, and trust building between decision-makers, healthcare workers, and the public - offer a powerful frame of reference for understanding how response and recovery programs can be best implemented to ensure the inclusive provision of COVID-19 health services.


A Comprehensive, Flexible Collection of SARS-CoV-2 Coding Regions

Authors: Kim, Dae-Kyum; Knapp, Jennifer J.; Kuang, Da; Chawla, Aditya; Cassonnet, Patricia; Lee, Hunsang; Sheykhkarimli, Dayag; Samavarchi-Tehrani, Payman; Abdouni, Hala; Rayhan, Ashyad; Li, Roujia; Pogoutse, Oxana; Coyaud, Etienne; van der Werf, Sylvie; Demeret, Caroline; Gingras, Anne-Claude; Taipale, Mikko; Raught, Brian; Jacob, Yves; Roth, Frederick P.

G3-GENES GENOMES GENETICS Volume: 10 Issue: 9 Pages: 3399-3402

Progress on molecular characterization has been made on several viral proteins, providing valuable insights into host-virus interaction. The Gateway system offers efficient and high-throughput transfer of the viral coding sequences into a large selection of Gateway-compatible destination vectors used for protein expression in many biological systems. Broad availability of a collection of SARS-CoV-2 CDSs has the potential to enable many downstream biochemical and structural studies and thus a better understanding of processes within the viral life cycle.  This includes scalable assays for screening drug candidates that could potentially disrupt these processes. The collection is freely available.


Accelerated Intermittent Theta Burst Stimulation in Late-Life Depression: A Possible Option for Older Depressed Adults in Need of ECT During the COVID-19 Pandemic

Authors: Konstantinou, Gerasimos N.; Downar, Jonathan; Daskalakis, Zafiris J.; Blumberger, Daniel M.

AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY Volume: 28 Issue: 10 Pages: 1025-1029

Electroconvulsive therapy (ECT) is an essential psychiatric service in treating older adults with severe or treatment-resistant depression. During the COVID-19 pandemic, ECT services have been constrained by infection control measures. The authors report a case of a patient with a severe major depressive episode who was treated with two modified accelerated intermittent theta-burst stimulation (aiTBS) consisting of eight daily sessions over five consecutive days, followed by gradual tapering. Moderate to severe baseline depressive symptoms reached remission levels after both courses.


Do pre-existing anxiety-related and mood disorders differentially impact COVID-19 stress responses and coping?

Authors: Asmundson, Gordon J. G.; Paluszek, Michelle M.; Landry, Caeleigh A.; Rachor, Geoffrey S.; McKay, Dean; Taylor, Steven

JOURNAL OF ANXIETY DISORDERS Volume: 74 Article Number: 102271

The authors assessed COVID-19-related stress by comparing adults from a population-representative sample from the US and Canada who reported anxiety-related or mood disorders to a random sample of respondents who did not report a current mental health diagnosis. People with anxiety-related or mood disorders were more negatively affected by COVID-19 compared to those with no mental health disorder. Those with anxiety-related disorders reported greater fears about danger and contamination, socioeconomic consequences, xenophobia, and traumatic stress symptoms than the other groups.  COVID-19-related mental health interventions need to be tailored to meet the specific needs of people with pre-existing mental health conditions.


Fear and avoidance of healthcare workers: An important, under-recognized form of stigmatization during the COVID-19 pandemic  

Authors: Taylor, Steven; Landry, Caeleigh A.; Rachor, Geoffrey S.; Paluszek, Michelle M.; Asmundson, Gordon J. G.

JOURNAL OF ANXIETY DISORDERS Volume: 75 Article Number: 102289

During past disease outbreaks, healthcare workers (HCWs) have been stigmatized by members in their community, for fear they are sources of infection. This study examined HCW stigmatization during the COVID-19 pandemic. Non-HCW adults from the US and Canada completed an online survey, including measures of HCW stigmatization, COVID Stress Syndrome, and avoidance. Over a quarter of respondents believed that HCWs should have severe restrictions placed on their freedoms, such as isolation from their communities and their families. Over a third of respondents avoided HCWs for fear of infection. Analysis suggested that HCW stigmatization is linked to the COVID Stress Syndrome.


Mental distress during the COVID-19 pandemic among US adults without a pre-existing mental health condition: Findings from American trend panel survey

Authors: Holingue, Calliope; Badillo-Goicoechea, Elena; Riehm, Kira E.; Veldhuis, Cindy B.; Thrul, Johannes; Johnson, Renee M.; Fallin, M. Daniele; Kreuter, Frauke; Stuart, Elizabeth A.; Kalb, Luther G.

PREVENTIVE MEDICINE Volume: 139 Article Number: 106231

Most individuals in the US have no history of a mental health condition yet are at risk for psychological distress due to the COVID-19 pandemic. This study assessed the frequency and risk and protective factors of psychological distress using data from a Pew Research Center's American Trends Panel online representative survey of the US adult population. Risk factors for higher distress included searching online or using social media to post about coronavirus, reporting that the outbreak caused major changes to personal life, and perception that the virus is a threat to the US economy, the individual's personal health or finances.


Key Highlights of the Canadian Thoracic Society's Position Statement on the Optimization of COPD Management During the Coronavirus Disease 2019 Pandemic

Authors: Bhutani, Mohit; Hernandez, Paul; Bourbeau, Jean; Dechman, Gail; Penz, Erika; Aceron, Raymond; Beauchamp, Marla; Wald, Joshua; Stickland, Michael; Olsen, Sharla-Rae; Goodridge, Donna

CHEST Volume: 158 Issue: 3 Pages: 869-872

Patients living with chronic obstructive pulmonary disease (COPD) represent a vulnerable population in confronting COVID-19. Physicians and patients have many questions regarding the acute and chronic management of COPD during this challenging period. This article summarizes the Canadian Thoracic Society’s (CTS) position statement on managing COPD during the pandemic in an easy, frequently asked questions format. The full COPD position statement, and other valuable clinical tools including links to online patient support programs for self-management and exercise/pulmonary rehabilitation are available online.


Healthy movement behaviours in children and youth during the COVID-19 pandemic: Exploring the role of the neighbourhood environment

Authors: Mitra, Raktim; Moore, Sarah A.; Gillespie, Meredith; Faulkner, Guy; Vanderloo, Leigh M.; Chulak-Bozzer, Tala; Rhodes, Ryan E.; Brussoni, Mariana; Tremblay, Mark S.

HEALTH & PLACE Volume: 65 Article Number: 102418

This paper explores increased and decreased physical activity, sedentary and sleep behaviours among Canadian children and youth aged 5-17 during the pandemic and examines how these changes are associated with the built environment near residential locations. A cluster analysis identified two groups who were primarily distinguished by the changes in outdoor activities. For children, houses (versus apartments) were correlated with increased outdoor activities while proximity to major roads was a barrier. For youth, low dwelling density and access to parks in high-density neighbourhoods increased the odds of increased outdoor activities.


The psychological impact of fertility treatment suspensions during the COVID-19 pandemic  

Authors: Gordon, Jennifer L.; Balsom, Ashley A.

PLOS ONE Volume: 15 Issue: 9 Article Number: e0239253

The authors examined the psychological impact of fertility treatment suspensions resulting from the COVID-19 pandemic and psychosocial predictors of better or worse mental health. Canadian and US women aged 20 to 45 whose fertility treatments were cancelled were recruited via social media.  They completed questionnaires assessing depressive symptoms, perceived mental health impact, and change in quality of life related to treatment suspensions.  Half (52%) of respondents endorsed clinical levels of depressive symptoms and a significant decline in overall quality of life. However, the findings also point to several protective psychosocial factors that can be fostered to help women cope.


The influence of sex and gender domains on COVID-19 cases and mortality

Authors: Tadiri, Christina P.; Gisinger, Teresa; Kautzy-Willer, Alexandra; Kublickiene, Karolina; Herrero, Maria Trinidad; Raparelli, Valeria; Pilote, Louise; Norris, Colleen M.

CANADIAN MEDICAL ASSOCIATION JOURNAL Volume: 192 Issue: 36 Pages: E1041-E1045

Both sex, a biological attribute, and gender, a complex social construct incorporating identity, roles, and institutionalized gender, may influence infectious disease risk and outcomes.  SARS-CoV-2 appears to be no exception.  The authors found institutionalized gender inequality, as measured by the United Nations Development Project’s Gender Inequality Index, to be positively associated with the male: female ratio reported cases of COVID-19 among countries that report sex-disaggregated data.  Males accounted for more cases in countries with higher gender inequality. Institutionalized gender and culturally entrenched roles and norms may influence who is most at risk of acquiring infection or who is able to receive a test.


Comparison analysis of different swabs and transport mediums suitable for SARS-CoV-2 testing following shortages

Authors: Garnett, Lauren; Bello, Alexander; Tran, Kaylie N.; Audet, Jonathan; Leung, Anders; Schiffman, Zachary; Griffin, Bryan D.; Tailor, Nikesh; Kobasa, Darwyn; Strong, James E.

JOURNAL OF VIROLOGICAL METHODS Volume: 285 Article Number: 113947

The high demand for nasopharyngeal testing has led to a depletion of the recommended swabs and viral transport media (VTM) required for sampling. The authors evaluated different swabs and transport mediums for the molecular detection of SARS-CoV-2. The study compared the performance of six swabs commonly found in primary and tertiary health care settings for their efficacy in testing for SARS-CoV-2. Separately, the molecular detection of SARS-CoV-2 was completed from different transport. They found no meaningful difference in viral yield from different swabs and most transport mediums, indicating swab and medium alternatives could be used if supplies run out.


Suboptimal Biological Sampling as a Probable Cause of False-Negative COVID-19 Diagnostic Test Results

Authors: Kinloch, Natalie N.; Ritchie, Gordon; Brumme, Chanson J.; Dong, Winnie; Dong, Weiyan; Lawson, Tanya; Jones, R. Brad; Montaner, Julio S. G.; Leung, Victor; Romney, Marc G.; Stefanovic, Aleksandra; Matic, Nancy; Lowe, Christopher F.; Brumme, Zabrina L.

JOURNAL OF INFECTIOUS DISEASES Volume: 222 Issue: 6 Pages: 899-902

False-negative SARS-CoV-2 results can negatively impact the clinical and public health response to COVID-19. The research team used droplet digital polymerase chain reaction (ddPCR) to demonstrate that human DNA levels, a stable molecular marker of sampling quality, were significantly lower in samples from 40 confirmed or suspected COVID-19 cases that yielded negative diagnostic test results (suspected false-negative test results) compared with a representative pool of 87 specimens submitted for testing. These results support suboptimal biological sampling as a contributor to false-negative COVID-19 test results and underscore the importance of proper training and technique in the collection of nasopharyngeal specimens.


The Impact of COVID-19 on Health Behavior, Stress, Financial and Food Security among Middle to High Income Canadian Families with Young Children

Authors: Carroll, Nicholas; Sadowski, Adam; Laila, Amar; Hruska, Valerie; Nixon, Madeline; Ma, David W. L.; Haines, Jess

NUTRIENTS Volume: 12 Issue: 8 Article Number: 2352

This study explored how health behaviors, level of stress, financial and food security have been impacted by the pandemic among Canadian families with young children. Parents from 254 families completed an online survey. More than half reported that their eating and meal routines have changed since COVID-19. They reported eating more snack foods and spending more time cooking. Screen time increased among 74% of mothers, 61% of fathers, and 87% of children and physical activity decreased among 59% of mothers, 52% of fathers, and 52% of children. Key factors influencing family stress include balancing work with childcare/homeschooling and financial instability.


COVID-19, obsessive-compulsive disorder and invisible life forms that threaten the self

Authors: Aardema, Frederick


This paper argues that the personal meaning attributed to viruses and germs, including their personification as entities that possess human-like characteristics, allows them to threaten and violate an individual's identity. Specifically, it suggests that fears of contamination become obsessional when the threat of viruses and germs becomes personal in how these life forms threaten the self as the result of a fear of inner corruption characterizing those with OCD. The person with OCD may act upon an underlying fear of inner corruption that is confused with reality itself.


Association between early childhood oral health impact scale (ECOHIS) scores and pediatric dental surgery wait times

Authors: Lee, Victor H. K.; Grant, Cameron G.; Mittermuller, Betty-Anne; Singh, Sarbjeet; Weiss, Brenda; Edwards, Jeanette M.; Schroth, Robert J.

BMC ORAL HEALTH Volume: 20 Issue: 1 Article Number: 285

Severe Early Childhood Caries is an aggressive form of tooth decay that often requires pediatric dental rehabilitative surgery. This study examined whether there is an association between Early Childhood Oral Health Impact Scale (ECOHIS) scores and surgery wait times for children undergoing dental treatment under general anesthesia. No significant associations were observed between ECOHIS scores and wait times. ECOHIS scores could, however, still be used to help prioritize children for dental surgery to ensure that they receive timely access to dental care under GA. This is essential given the challenges posed by COVID-19 on timely access to surgical care.


Reactions to COVID-19: Differential predictors of distress, avoidance, and disregard for social distancing

Authors: Taylor, Steven; Landry, Caeleigh A.; Paluszek, Michelle M.; Asmundson, Gordon J. G.


People who do not take the pandemic seriously may be less likely to adhere to social distancing policies. This study investigated the predictors of over- and under-responses to COVID-19.  A large community sample from the US and Canada completed measures of beliefs associated with over- and under-responses, along with distress, excessive avoidance, and nonadherence to social distancing. Over-response beliefs involved the dangerousness of COVID-19 (personal health and socio-economic threats) and COVID-19-related xenophobia (beliefs that foreigners are spreading the virus). Under-response beliefs included beliefs that the threat of COVID-19 has been exaggerated, and that one is sufficiently healthy to be robust against the effects of COVID-19.


COVID-19 conspiracy beliefs: Relations with anxiety, quality of life, and schemas

Authors: Talia Leibovitz, Amanda L. Shamblaw, Rachel Rumas, and Michael W. Best

Personality and Individual Differences

Conspiracy beliefs regarding the origin of COVID-19 are prevalent. This study examined predictors and mental health consequences of conspiracy beliefs. Participants in Canada and the United States were surveyed via Amazon Mechanical Turk in April 2020. Half of the sample (49.7%) believed at least one conspiracy theory. Greater conspiracy beliefs were associated with more anxiety at follow up, but not quality of life. Religiosity/spirituality, not knowing someone at high-risk for COVID-19, and non-white ethnicity were associated with greater conspiracy beliefs.


Prevalence of Co-Infections with Respiratory Viruses in Individuals Investigated for SARS-CoV-2 in Ontario, Canada

Authors: Adriana Peci, Vanessa Tran, Jennifer L. Guthrie, Ye Li, Paul Nelson, Kevin L. Schwartz, Ali Reza Eshaghi, Sarah A. Buchan and Jonathan B. Gubbay


This research assessed the prevalence of co-infection of SARS-CoV-2 with seasonal respiratory viruses. Specimens included in this study were submitted as part of routine clinical testing to the Public Health Ontario Laboratory from individuals requiring testing for SARS-CoV-2 and/or seasonal respiratory viruses. Co-infection was detected in a smaller proportion (2.5%) of individuals with laboratory confirmed SARS-CoV-2 than those with seasonal respiratory viruses (4.3%). Individuals with any respiratory virus co-infection were more likely to be younger than 65 years of age and male than those with single infection.


Attitudes of healthcare workers towards COVID-19 vaccination: a survey in France and French-speaking parts of Belgium and Canada, 2020

Authors: Kodzo Awoenam Adedzi (mid co-author), Arnaud Gagneur and Eve Dubé (last authors)


In October and November 2020, the authors conducted a survey of 2,678 healthcare workers (HCWs) involved in general population immunization in France, French-speaking Belgium and Quebec, Canada to assess their willingness to receive or recommend future COVID-19 vaccines. Of the HCWs, 48.6% showed high acceptance, 23.0% moderate acceptance and 28.4% showed hesitancy or reluctance. Hesitancy was mostly driven by vaccine safety concerns, issues that must be addressed before and during vaccination campaigns.


Tracking COVID-19 Discourse on Twitter in North America: Infodemiology Study Using Topic Modeling and Aspect-Based Sentiment Analysis

Authors: Hyeju Jang, Emily Rempel, David Roth, Giuseppe Carenini, and Naveed Zafar Janjua

Journal of Medical Internet Research

The authors analyzed COVID-19–related tweets, using topic modeling and aspect-based sentiment analysis, to gauge the effectiveness of specific public health interventions for COVID-19. The results showed negative sentiments related to the overall outbreak, misinformation and Asians, and positive sentiments related to physical distancing. This kind of information could help public health agencies to understand public concerns as well as what public health messages resonate in populations that use Twitter when designing a policy for new interventions.


The Trends in Pharmacotherapy for Anxiety, Depression and Insomnia During COVID-19: A North York Area Pilot Study

Authors: Carmen Yu, Charlotte Boone, Roya Askarian-Monavvari, and Thomas Brown

University of Toronto Medical Journal

This study collected refill information of 365 patients from an independent community pharmacy in North York, Ontario to compare initiation, dose change, dispensing frequency, and defined daily dose of first-line antidepressants during the COVID-19 pandemic. It compared data from January to May 2019 with data from the same months in 2020. The number of newly initiated antidepressant and antianxiety medications during the pandemic was not meaningfully affected but there was a significant difference in dose changes and more frequent dispensing of benzodiazepine tablet, emphasizing the need for benzodiazepine deprescribing due to the risk of misuse, tolerance, and dependence.


Phylogenomics reveals viral sources, transmission, and potential superinfection in early-stage COVID-19 patients in Ontario, Canada

Authors: Calvin P. Sjaarda, Nazneen Rustom, Gerald A. Evans, David Huang, Santiago Perez-Patrigeon, Melissa L. Hudson, Henry Wong, Zhengxin Sun, T. Hugh Guan, Muhammad Ayub, Claudio N. Soares, Robert I. Colautti & Prameet M. Sheth

Scientific Reports

Nasopharyngeal swabs were obtained from 32 of the first SARS-CoV-2 positive cases in Kingston Ontario, Canada. Viral genomes sequencing revealed that SARS-CoV-2 genomes carried 46 polymorphic sites, including two missense and three synonymous variants in the spike protein gene. Phylogenetic analysis with 87,738 genomes in the GISAID database identified global origins and transmission events including multiple, international introductions as well as community spread. Earlier detection and screening in this way could improve the effectiveness of regional public health interventions to limit future pandemics.


High-flow nasal oxygen in patients with COVID-19-associated acute respiratory failure

Authors: Bruno L. Ferreyro, Federico Angriman, Jesús Villar and Laurent Brochard (mid co-authors)

Critical Care

The researchers set out to determine whether high-flow nasal oxygen in adult patients with COVID-19 associated acute respiratory failure improved clinically relevant outcomes. They assessed the effect of high-flow nasal oxygen on ventilator-free days compared to early initiation of invasive mechanical ventilation. When compared to early intubation, the use of high-flow nasal oxygen was associated with an increase in ventilator-free days (8.0 days) and a reduction in ICU length of stay (− 8.2 days).


Compliance with COVID-19 safety measures: A test of an objectification theory model

Authors: Megan Earlea, Elvira Prusaczyk, Becky Chomab, and Rachel Calogeroc

Body Image

This paper tested compliance with COVID-19 safety measures recommended by governments and health organizations, including monitoring one’s body and interpersonal and social distance from others. The authors contend that the diffuse safety anxiety stemming from sexual and self-objectification encourages people to adopt behaviors that protect against body-based dangers. The analyses revealed self-objectification predicted adherence to COVID-19 measures via safety anxiety. Women reported higher levels of sexual objectification, internalization of observers’ perspectives, safety anxiety, appearance anxiety, and COVID-19 safety measure compliance.


Limiting mobility during COVID-19, when and to what level? An international comparative study using change point analysis

Authors: Suliman A. Gargoum and Ali S. Gargoum

Journal of Transport and Health

To halt the spread ofCOVID-19, governments across the world limited mobility and human interaction. This paper conducted a statistical change point analysis of mobility data from 10 different countries to establish links between mobility trends, COVID-19 infections, and COVID-19 mortality rates where different policies were adopted. The analysis revealed that slow responders experienced significantly higher mortality rates per 100,000 people and were forced to implement stricter lockdown strategies when compared to early responders. It also shows that operating at 40% level of mobility is achievable if appropriate action is taken early enough.


The “nurse as hero” discourse in the COVID-19 pandemic: A poststructural discourse analysis

Authors: Shan Mohammed, Elizabeth Peter, Tieghan Killackey, and Jane Maciver

International Journal of Nursing Studies

Nurses have been labelled “heroes” for providing front-line care to people with COVID-19. This analysis found nurses are portrayed either as selfless, sacrificing, and outstanding moral subjects for working without adequate protective gear and other resources or compliant, hardworking, and obedient “model citizens.” A third view is that “hero” is a fitting reward for nurses who are unappreciated, rather than supporting long-term policy change. The authors conclude this normalizes nurses’ exposure to risk, enforces model citizenship, and preserves existing power relationships that limit the ability of front-line nurses to determine the conditions of their work.


Anxiety related to COVID-19: An examination of its effects in workplaces

Authors: V. Robert and C. Vandenberghe

Psychology of Work and Organizations

The anxiety engendered by the COVID-19 pandemic is a novel emotional phenomenon. Due to its recency and novelty, this form of anxiety and its effects are largely unknown. This study of 650 civil servants in the Quebec government during the first wave of the pandemic examined the effects of COVID-19-triggered anxiety on job engagement, organizational commitment, psychological empowerment, and ego depletion. The analyses indicate that COVID-19-triggered anxiety is positively related to organizational commitment and ego depletion and negatively related to psychological empowerment. In contrast, COVID-19-triggered anxiety was not significantly related to job engagement.


Positive no-touch surfaces and undetectable SARS-CoV-2 aerosols in long-term care facilities: an attempt to understand the contributing factors and the importance of timing in air sampling campaigns

Authors: Nathan Dumont-Leblond, Marc Veillette, Luc Bherer, Karine Boissoneault, Samira Mubareka, Lily Yip, Marie-Eve Dubuis, Yves Longtin, Philippe Jouvet, Alison McGeer and Caroline Duchaine

American Journal of Infection Control

Long-term care facilities (LTCF) are favorable to SARS-CoV-2 outbreaks due to their at-risk population and residents’ close proximity. Air and no-touch surfaces of 31 rooms from 7 LTCFs were sampled, and SARS-CoV-2 was quantified by real-time reverse transcription polymerase chain reaction. Air samples were negative but viral genomes were recovered from roughly 32% of surface samples at concentrations from 13 to 36,612 genomes/surface. The presence of viral RNA on no-touch surfaces is evidence of viral dissemination through air, but the lack of airborne viral particles in air samples suggests they were not significantly aerosolized during air sampling sessions.


Virtual care use before and during the COVID-19 pandemic: a repeated cross-sectional study

Authors: R. Sacha Bhatia, Cherry Chu, Andrea Pang, Mina Tadrous, Vess Stamenova, Peter Cram

Canadian Medical Association Journal

The researchers assessed the uptake of virtual care during the COVID-19 pandemic using comprehensive population-based data from Ontario. They evaluated changes in in-person and virtual visits among all residents before (2012–2019) and during (January–August 2020) the COVID-19 pandemic. They found that virtual care increased from 1.6% of total ambulatory visits to 70.6%, the proportion of physicians providing virtual visits rose from 7.0% to 85.9% and the proportion of Ontarians who had a virtual visit increased from 1.3% in 2019 to 29.2% in 2020. Older patients were the highest users of virtual care.


Use of symptom checkers for COVID-19-related symptoms among university students: a qualitative study

Authors: Stephanie Aboueid, Samantha B Meyer, James R Wallace, Shreya Mahajan, Teeyaa Nur, Ashok Chaurasia

BMJ Innovations

The authors wanted to understand the perspectives and experiences of young adults related to using symptom checkers to assess COVID-19-related symptoms and to identify areas for improvement. They conducted qualitative interviews with young adults at a university in Ontario, Canada. Participants who used symptom checkers shared by governmental entities reported an overall positive experience. Individuals who used non-credible sources reported suboptimal experiences due to lack of perceived credibility. Symptom checkers can potentially reduce the burden on healthcare systems during pandemics, but these platforms could be improved to increase use.


Immunoglobulin-A Vasculitis with Renal Involvement in a Patient with COVID-19: A Case Report and Review of Acute Kidney Injury Related to SARS-CoV-2

Authors: Nicholas L. Li , Adam B. Papini, Tiffany Shao, and Louis Girard

Canadian Journal of Kidney Health and Disease

Acute kidney injury is a common complication of COVID-19 and is associated with significantly increased mortality. A 30-year-old man with no prior medical history presented to the emergency department with symptoms of COVID-19 and new onset painful purpuric rash, arthralgia, and abdominal pain. SARS-CoV-2 infection was confirmed. The patient was treated conservatively for COVID-19 in the community. A 7-day course of prednisone was started for the vasculitic rash. With conservative management, the patient’s COVID-19 symptoms were resolved, and he did not require hospital admission.


COVID-19 pandemic: demographic and clinical correlates of disturbed sleep among 6,041 Canadians

Authors: Felix Osiogo , Reham Shalaby , Sapara Adegboyega , Marianne Hrabok , April Gusnowski , Wesley Vuong , Shireen Surood , Andrew J. Greenshaw, and Vincent I. O. Agyapong

International Journal of Psychiatry in Clinical Practice

The authors investigated the prevalence of disturbed sleep among subscribers to Text4Hope, a daily text message program launched in Alberta to support residents to deal with stress, anxiety, and depression. A survey link was sent to Text4Hope subscribers to assess demographic and clinical variables. Overall, 18.4% of Text4Hope subscribers completed the survey. Prevalence of disturbed sleep was 77.8%. Subscribers aged 41–60 years were twice as likely to present with sleep disturbance compared to individuals ≤25 years. Individuals with moderate/high anxiety and stress symptoms and those with passive death wish/suicidal ideation had higher probability for sleep disturbance.


Lung and Kidney ACE2 and TMPRSS2 in Renin-Angiotensin System Blocker–Treated Comorbid Diabetic Mice Mimicking Host Factors That Have Been Linked to Severe COVID-19

Authors: Sri Nagarjun Batchu, Harmandeep Kaur, Veera Ganesh Yerra, Suzanne L. Advani, M. Golam Kabir, Youan Liu and Andrew Advani


It has been speculated that renin-angiotensin system (RAS) blockers may promote COVID-19 in people with diabetes by increasing ACE2, which SARS-CoV-2 uses to enter host cells, along with the host protease TMPRSS2. The authors studied lung and kidney ACE2 and TMPRSS2 in diabetic mice, mimicking host factors linked to severe COVID-19. In healthy young mice, neither the ACE inhibitor ramipril nor the AT1 receptor blocker telmisartan affected lung or kidney ACE2 or TMPRSS2. In contrast, mice with comorbid diabetes (aging, high-fat diet, and streptozotocin-induced diabetes) had heightened lung ACE2 and TMPRSS2 protein levels and increased lung ACE2 activity.


Myoclonus and cerebellar ataxia associated with COVID-19: a case report and systematic review

Authors: Jason L. Chan, Keely A. Murphy, and Justyna R. Sarna

Journal of Neurology

Relatively rare movement disorders associated with COVID-19 are increasingly described in case reports. This systematic review used PubMed and Ovid MEDLINE databases to identify myoclonus and cerebellar ataxia associated with COVID-19. Of the 51 cases identified, the mean age was 59.6 years and 21.6% were female. Myoclonus had an acute onset, usually within 1 month of COVID-19 symptoms. Ataxia had an acute onset, usually within 1 month of COVID-19 symptoms, but could be an initial symptom. Most cases improved within 2 months, either spontaneously or with immunotherapy. Myoclonus and ataxia associated with COVID-19 are rare and treatable.


Post‐mortem molecular investigations of SARS‐CoV‐2 in an unexpected death of a recent kidney transplant recipient

Authors: Emily Lauren Simms, Hyunjae Chung, Lisa Oberding, Daniel Muruve, Braedon McDonald, Amy Bromley, Dylan R. Pillai, and Justin Chun

American Journal of Transplantation

Solid organ transplant recipients are vulnerable to severe infection. This article reports on the unexpected death of a 67‐year‐old male 10 days after receiving a kidney transplant, shortly after the first confirmed case of COVID‐19 in Canada. The authors confirmed the presence of SARS‐CoV‐2 components in the renal allograft and native lung tissue. The results were reaffirmed with the Food and Drug Administration Emergency Use Authorization approved Bio‐Rad SARS‐CoV‐2 digital droplet PCR for the kidney specimen. This case highlights the importance of patient autopsies in a global pandemic and demonstrates the utility of molecular assays to diagnose SARS‐CoV‐2 post‐mortem.


Measures of Adiposity and Risk of Testing Positive for SARS-CoV-2 in the UK Biobank Study

Authors: Rebecca A. G. Christensen, Shelby L. Sturrock, Jasleen Arneja, and Jennifer D. Brooks

Journal of Obesity

This research assessed whether body mass index (BMI) and high waist circumference (HWC) are associated with testing positive for SARS-CoV-2, based on an analysis of 9,386 UK Biobank study participants tested for COVID-19. Analyses were stratified by age due to a significant first-order interaction between age and HWC. Approximately 17% of participants tested positive for SARS-CoV-2. BMI had a linear association with testing positive for SARS-CoV-2 among participants <65 years. For participants ≥65 years, only obesity class II had a significantly greater risk of testing positive than those who were underweight/normal weight.


Public Opinions and Concerns Regarding the Canadian Prime Minister’s Daily COVID-19 Briefing: Longitudinal Study of YouTube Comments Using Machine Learning Techniques

Authors: Chengda Zheng, Jia Xue, and Yumin Sun

Journal of Medical Internet Research

This study examined comments from Canadian Prime Minister Trudeau’s COVID-19 daily briefings by YouTube users to extract public opinions and concerns over time. The researchers used machine learning techniques to analyze a total of 46,732 English YouTube comments retrieved from the Prime Minister’s daily briefings, summarizing salient topics into prominent themes. They found 11 prominent themes, including strict border measures, responses to Prime Minister Trudeau’s policies, essential work and frontline workers, individuals’ financial challenges, rental and mortgage subsidies, quarantine, financial aid for enterprises and individuals, personal protective equipment, Canada and China’s relationship, vaccines, and reopening.


COVID-19 Pandemic: Demographic Predictors of Self-Isolation or Self-Quarantine and Impact of Isolation and Quarantine on Perceived Stress, Anxiety, and Depression

Authors: Nnamdi Nkire, Kelly Mrklas, Marianne Hrabok, April Gusnowski, Wesley Vuong, Shireen Surood, Adam Abba-Aji, Liana Urichuk, Bo Cao, Andrew J. Greenshaw, and Vincent I. O. Agyapong

Frontiers in Psychiatry

The authors explored the impacts of self-isolation and self-quarantine on stress, anxiety, and depression during the COVID-19, based on self reporting from individuals who subscribed to Text4Hope, a service delivering text messages based on a cognitive behavioral therapy framework. Subscribers were asked via a survey link for demographic information and if they had to self-isolate or self-quarantine during the pandemic. The results revealed that older age and employment status were significantly associated with the likelihood of self-isolation or self-quarantine. Elevated self-reported levels of anxiety and depression were associated with self-reported COVID-19 pandemic-related self-isolation and self-quarantine activity.


Socio-cultural correlates of self-reported experiences of discrimination related to COVID-19 in a culturally diverse sample of Canadian adults

Authors: Diana Miconi, Zhi Yin Li, Rochelle L. Frounfelker, Vivek Venkatesh, Cécile Rousseau

International Journal of Intercultural Relations

Minorities and marginalized groups have increasingly become the target of discriminatory actions during the COVID-19 pandemic. This study investigated experiences of perceived discrimination in a culturally diverse sample of adults in Quebec (Canada), using an online survey completed by 3,273 Quebec residents. Discrimination was reported primarily in association with participants’ ethno-cultural group, age, occupation, physical health and in the context of public spaces. Participants of East-Asian descent and essential workers were more likely to report discrimination because of their ethnicity and occupation, respectively. Older participants were discriminated against in grocery stores and because of their age.


Impact of a Public Policy Restricting Staff Mobility Between Nursing Homes in Ontario, Canada During the COVID-19 Pandemic (JAMDA Mar 1, 2021)

Authors: Aaron Jones, Alexander G. Watts, Salah Uddin Khan, Jack Forsyth, Kevin A. Brown, Andrew P. Costa, Isaac I. Bogoch and Nathan M. Stall

Journal of the American Medical Directors Association

The authors assessed changes in staff mobility between nursing homes before and after enactment of public policy restricting staff from working at multiple homes. They used GPS location data from mobile devices to approximate connectivity among all 623 nursing homes in Ontario during the 7 weeks before and after staff movement was restricted. In the period preceding restrictions, 42.7% nursing homes had a connection with at least one other home, compared with 12.7% of homes after restrictions. Reducing mobility should be a focus of efforts to reduce risk within the long-term care sector during the COVID-19 pandemic.


Mostly worse, occasionally better: impact of COVID-19 pandemic on the mental health of Canadian children and adolescents

Authors: Katherine Tombeau Cost, Jennifer Crosbie, Evdokia Anagnostou, Catherine S. Birken, Alice Charach, Suneeta Monga, Elizabeth Kelley, Rob Nicolson, Jonathon L. Maguire, Christie L. Burton, Russell J. Schachar, Paul D. Arnold, Daphne J. Korczak

European Child and Adolescent Psychiatry

This study examined the impact of COVID-19 emergency measures on mental health for children and adolescents with and without pre-existing psychiatric diagnoses. Changes in mental health included depression, anxiety, irritability, attention, hyperactivity, and obsessions/compulsions. Depending on the age group, 67–70% of children/adolescents experienced deterioration in at least one mental health domain; however, 19–31% of children/adolescents experienced improvement in at least one domain. Children/adolescents without and with psychiatric diagnoses tended to experience deterioration during the first wave of COVID-19. Rates of deterioration were higher in those with a pre-exiting diagnosis. Deterioration was associated with increased stress from social isolation.


Programmed-1 Ribosomal Frameshifting in coronaviruses: A therapeutic target

Authors: Kelly, Jamie A.; Woodside, Michael T.; Dinman, Jonathan D.

VIROLOGY Volume: 554

Human population growth, climate change, and globalization are accelerating the emergence of novel pathogenic viruses. Coronaviruses use a programmed -1 ribosomal frameshift (-1 PRF) mechanism to direct synthesis of their replicase proteins. This critical switch in their replication program can be therapeutically targeted. The authors discuss how nearly half a century of research into -1 PRF have provided insight into the virological importance of -1 PRF, the molecular mechanisms that drive it, and approaches that can be used to manipulate it towards therapeutic outcomes with particular emphasis on SARS-CoV-2.


Susceptibility of Domestic Swine to Experimental Infection with Severe Acute Respiratory Syndrome Coronavirus 2

Authors: Pickering, Brad S.; Smith, Greg; Pinette, Mathieu M.; Embury-Hyatt, Carissa; Moffat, Estella; Marszal, Peter; Lewis, Charles E.

EMERGING INFECTIOUS DISEASES Volume: 27 Issue: 1 Pages: 104-112

SARS-CoV-2 has been shown to infect several species. The role of domestic livestock and associated risks for humans in close contact with food production animals remains unknown. The authors examined the susceptibility of pigs to SARS-CoV-2, which is critical to manage potential risk for zoonotic transmission. They found pigs are susceptible to SARS-CoV-2 after oronasal inoculation. Their data highlight the need for additional livestock assessment to determine the potential role of domestic animals in the SARS-CoV-2 pandemic.


The impact of non-pharmaceutical interventions, demographic, social, and climatic factors on the initial growth rate of COVID-19: A cross-country study

Authors: Duhon, Jacqueline; Bragazzi, Nicola; Kong, Jude Dzevela

SCIENCE OF THE TOTAL ENVIRONMENT Volume: 760 Article Number: 144325

This paper analyses how the implementation of non-pharmaceutical interventions (NPI) as well as climatic, social, and demographic variables affected the initial growth rate of COVID-19. Based on available data, NPI put in place by governments around the world may not have had a significant impact on the initial growth of COVID-19. Only restrictions on international movements had a relative significance with respect to the initial growth rate, whereas demographic, climatic, and social variables seemed to play a greater role in the initial growth rate of COVID-19.


The SARS-CoV-2 Conserved Macrodomain Is a Mono-ADP-Ribosylhydrolase

Authors: Alhammad, Yousef M. O.; Kashipathy, Maithri M.; Roy, Anuradha; Gagne, Jean-Philippe; McDonald, Peter; Gao, Philip; Nonfoux, Louis; Battaile, Kevin P.; Johnson, David K.; Holmstrom, Erik D.; Poirier, Guy G.; Lovell, Scott; Fehr, Anthony R.

JOURNAL OF VIROLOGY Volume: 95 Issue: 3 Article Number: e01969-20

All coronaviruses encode a highly conserved macrodomain (Mac1) that binds to and removes ADP-ribose adducts from proteins in a process increasingly recognized as an important factor that regulates viral infection. The macrodomain is essential for CoV pathogenesis and may be a novel therapeutic target for SARS-CoV-2. The authors report the crystal structure of SARS-CoV-2 Mac1 in complex with ADP-ribose and describe its ADP-ribose binding and hydrolysis activities in direct comparison to those of SARS-CoV and MERS-CoV Mac1 proteins. These results are a first step for the design and testing of potential therapies targeting this unique protein domain.


Evaluating the impact of Archway: a personalized program for 1st year student success and mental health and wellbeing

Authors: Kwan, Matthew Y. W.; Brown, Denver; MacKillop, James; Beaudette, Sean; Van Koughnett, Sean; Munn, Catharine

BMC PUBLIC HEALTH Volume: 21 Issue: 1 Article Number: 59

In response to COVID-19 and its potential effects on mental health and wellbeing, McMaster University has developed a support program for first year students to help prevent, and to intervene early to address, common transitional issues they experience. The initiative’s ultimate objective is to increase student connectedness, supports, and retention. The study will determine the effectiveness of the program and help the institution to better understand the challenges of this transition period more broadly to inform future efforts to support students and protect their mental health and wellbeing.


Modeling the structure of the frameshift-stimulatory pseudoknot in SARS-CoV-2 reveals multiple possible conformers

Authors: Omar, Sara Ibrahim; Zhao, Meng; Sekar, Rohith Vedhthaanth; Moghadam, Sahar Arbabi; Tuszynski, Jack A.; Woodside, Michael T.

PLOS COMPUTATIONAL BIOLOGY Volume: 17 Issue: 1 Article Number: e1008603

SARS-CoV-2 uses -1 programmed ribosomal frameshifting (-1 PRF) to control the relative expression of viral proteins. As modulating -1 PRF can inhibit viral replication, the RNA pseudoknot stimulating -1 PRF may be a fruitful target for therapeutics treating COVID-19. The researchers found several possible conformations for the SARS-CoV-2 pseudoknot, all having an extended stem 3 but with different packing of stems 1 and 2. Several conformations featured rarely seen threading of a single strand through junctions formed between two helices. These structural models may help interpret future experiments and support efforts to discover ligands inhibiting -1 PRF in SARS-CoV-2.


Evolutionary and structural analyses of SARS-CoV-2 D614G spike protein mutation now documented worldwide

Authors: Isabel, Sandra; Grana-Miraglia, Lucia; Gutierrez, Jahir M.; Bundalovic-Torma, Cedoljub; Groves, Helen E.; Isabel, Marc R.; Eshaghi, AliReza; Patel, Samir N.; Gubbay, Jonathan B.; Poutanen, Tomi; Guttman, David S.; Poutanen, Susan M.

SCIENTIFIC REPORTS Volume: 10 Issue: 1 Article Number: 14031

The authors identified a missense mutation, D614G, in the spike protein of SARS-CoV-2, which has emerged as a predominant clade in Europe that is spreading worldwide. They also applied structural bioinformatics to assess the potential impact of D614G on the virulence and epidemiology of SARS-CoV-2. In silico analyses on the spike protein structure suggest the mutation is most likely neutral to protein function as it relates to its interaction with the human ACE2 receptor. The lack of clinical metadata prevented an investigation of association between viral clade and disease severity.


When a pandemic and an epidemic collide: COVID-19, gut microbiota, and the double burden of malnutrition

Authors: Littlejohn, Paula; Finlay, B. Brett

BMC MEDICINE Volume: 19 Issue: 1 Article Number: 31

The COVID-19 pandemic is expected to drastically increase all forms of malnutrition. Of particular concern is the potential to increase the double burden of malnutrition (DBM) epidemic. Although multiple factors contribute to the DBM, food insecurity and gut microbiota dysbiosis play a crucial role. The observed microbiome dysbiosis within severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) coupled with the DBM presents a viscous cycle. Low- to mid-income countries will likely see an increase in the DBM epidemic. Access to nutritious foods and protecting individuals' gut microbiome to "flatten the curve" of DBM should be prioritized.


Effects of anxiety sensitivity, disgust, and intolerance of uncertainty on the COVID stress syndrome: a longitudinal assessment of transdiagnostic constructs and the behavioural immune system

Authors: Paluszek, Michelle M.; Asmundson, Aleiia J. N.; Landry, Caeleigh A.; McKay, Dean; Taylor, Steven; Asmundson, Gordon J. G.


Excessive fear and worry in response to the COVID-19 pandemic, COVID stress syndrome, is prevalent and associated with adverse outcomes. Research from the current and past pandemics supports the association between anxiety sensitivity (AS), disgust propensity (DP), disgust sensitivity (DS), intolerance of uncertainty (IU), and pandemic-related distress. Greater AS-physical concerns, DP, and DS predicted more severe COVID stress syndrome assessed one month later. IU did not interact with AS-physical concerns and DS or DP. Theoretical and clinical implications regarding cognitive behavioural therapy for pandemic-related distress are discussed.


Decision-making in Surgery or Active Surveillance for Low Risk Papillary Thyroid Cancer During the COVID-19 Pandemic

Authors: Sawka, Anna M.; Ghai, Sangeet; Ihekire, Ogemdi; Jones, Jennifer M.; Gafni, Amiram; Baxter, Nancy N.; Goldstein, David P.

CANCERS Volume: 13 Issue: 3 Article Number: 371

Beginning early in the pandemic, cancer care rapidly transitioned from in-person to virtual outpatient cancer care. Elective surgeries were also restricted, particularly for low-risk malignancies. This study examines decision-making regarding surgery or active surveillance (AS) for small, low risk papillary thyroid cancer during the COVID-19 pandemic. Of the 133 study patients who were under AS during the study period, the percentage of patients who missed appointments was 8.3% and delayed appointments was 23.3%. This preliminary data suggests that prospective observational research on AS of thyroid cancer can safely continue during the pandemic.


Optimization and clinical validation of dual-target RT-LAMP for SARS-CoV-2

Authors: Mohon, Abu Naser; Oberding, Lisa; Hundt, Jana; van Marle, Guido; Pabbaraju, Kanti; Berenger, Byron M.; Lisboa, Luiz; Griener, Thomas; Czub, Markus; Doolan, Cody; Servellita, Venice; Chiu, Charles Y.; Greninger, Alexander L.; Jerome, Keith R.; Pillai, Dylan R.

JOURNAL OF VIROLOGICAL METHODS Volume: 286 Article Number: 113972

A novel reverse-transcriptase loop mediated amplification (RT-LAMP) method targeting genes encoding the Spike (S) protein and RNA-dependent RNA polymerase (RdRP) of SARS-CoV-2 achieves a comparable limit of COVID-19 detection (25-50 copies per reaction) to commonly used RT-PCR (real time-polymerase chain reaction) protocols using clinical samples quantified by digital droplet PCR. Precision, cross-reactivity, inclusivity, and limit of detection studies were performed according to regulatory standards. Clinical validation of dual-target RT-LAMP achieved a PPA (positive predictive agreement) of 98.48 % and NPA (negative predictive agreement) 100.00 % based on the reference RT-PCR methods.


Persistence of serum and saliva antibody responses to SARS-CoV-2 spike antigens in COVID-19 patients

Authors: Isho, Baweleta; Abe, Kento T.; Zuo, Michelle; Jamal, Alainna J.; Rathod, Bhavisha; Wang, Jenny H.; Li, Zhijie; Chao, Gary; Rojas, Olga L.; Bang, Yeo Myong; Pu, Annie; Christie-Holmes, Natasha; Gervais, Christian; Ceccarelli, Derek; Samavarchi-Tehrani, Payman; Guvenc, Furkan; Budylowski, Patrick; Li, Angel; Paterson, Aimee; Yue, Feng Yun; Marin, Lina M.; Caldwell, Lauren; Wrana, Jeffrey L.; Colwill, Karen; Sicheri, Frank; Mubareka, Samira; Gray-Owen, Scott D.; Drews, Steven J.; Siqueira, Walter L.; Barrios-Rodiles, Miriam; Ostrowski, Mario; Rini, James M.; Durocher, Yves; McGeer, Allison J.; Gommerman, Jennifer L.; Gingras, Anne-Claude

SCIENCE IMMUNOLOGY Volume: 5 Issue: 52 Article Number: eabe5511

Antibodies play an important role in neutralizing a virus. The antibody response to SARS-CoV-2 has been extensively studied in blood, but little is known about the antibody response in saliva, which can be a reservoir for the virus. This study profiled enzyme-linked immunosorbent assays in both serum and saliva of acute and convalescent COVID-19 patients, ranging from 3 to 115 days post-symptom onset, compared to negative controls. This study confirms that serum and saliva antibodies to SARS-CoV-2 are maintained in most COVID-19 patients for at least 3 months. Saliva may serve as a surrogate measure of systemic immunity to SARS-CoV-2.


The emergence of SARS-CoV-2 in Europe and North America

Authors: Worobey, Michael; Pekar, Jonathan; Larsen, Brendan B.; Nelson, Martha I.; Hill, Verity; Joy, Jeffrey B.; Rambaut, Andrew; Suchard, Marc A.; Wertheim, Joel O.; Lemey, Philippe

SCIENCE Volume: 370 Issue: 6516 Pages: 564-570

This research examined when, where, and how the earliest sustained SARS-CoV-2 transmission networks became established in Europe and North America. The results suggest rapid early interventions successfully prevented early introductions of the virus from taking hold in Germany and the United States. Later introductions of the virus from China to Italy and Washington state, US, founded the earliest sustained European and North America transmission networks. These analyses demonstrate the effectiveness of public health measures in preventing onward transmission and show intensive testing and contact tracing could have prevented SARS-CoV-2 outbreaks from becoming established in these regions.


Template-dependent inhibition of coronavirus RNA-dependent RNA polymerase by remdesivir reveals a second mechanism of action

Authors: Tchesnokov, Egor P.; Gordon, Calvin J.; Woolner, Emma; Kocinkova, Dana; Perry, Jason K.; Feng, Joy Y.; Porter, Danielle P.; Gotte, Matthias

JOURNAL OF BIOLOGICAL CHEMISTRY Volume: 295 Issue: 47 Pages: 16156-16165

Remdesivir (RDV) is a direct-acting antiviral agent used to treat patients with severe COVID-19. This study shows that RDV residues could be embedded in copies of the first RNA strand that is later used as a template. It also shows the efficiency of incorporation of the complementary UTP opposite template RDV is compromised, providing a second opportunity to inhibit replication. The research further shows that the V557L mutation in RdRp lowers the nucleotide concentration required to bypass this template-dependent inhibition. The collective data provide strong evidence to show that template-dependent inhibition of SARS-CoV-2 RdRp by RDV is biologically relevant.


Kokums to the Iskwesisisak COVID-19 and Urban Metis Girls and Young Women

Authors: Jones, Carly; Monchalin, Renee; Bourgeois, Cheryllee; Smylie, Janet


Métis Peoples account for over a third of the Indigenous population in Canada and experience major gaps in access to culturally safe health services. Métis Peoples are also most likely to experience severe disparities in health determinants and outcomes compared to the non-Indigenous population. Despite these inequalities, the matrilineal social kinship and traditional knowledge exchange systems that Métis women and girls rely on for safety, security and wellbeing is helping them to respond to COVID-19. Urban Métis girls and women are both managing and tackling COVID-19 through innovative and community-based initiatives like Well Living House and the Call Auntie Hotline.


Influenza Vaccine Does Not Increase the Risk of Coronavirus or Other Noninfluenza Respiratory Viruses: Retrospective Analysis From Canada, 2010-2011 to 2016-2017

Authors: Skowronski, Danuta M.; Zou, Macy; Clarke, Quinten; Chambers, Catharine; Dickinson, James A.; Sabaiduc, Suzana; Olsha, Romy; Gubbay, Jonathan B.; Drews, Steven J.; Charest, Hugues; Winter, Anne-Luise; Jassem, Agatha; Murti, Michelle; Krajden, Mel; De Serres, Gaston

CLINICAL INFECTIOUS DISEASES Volume: 71 Issue: 16 Pages: 2285-2288 Special Issue: SI

Influenza vaccine effectiveness against influenza and noninfluenza respiratory viruses (NIRVs) was assessed by test-negative design using historic datasets of the community-based Canadian Sentinel Practitioner Surveillance Network, spanning 2010-2011 to 2016-2017. Vaccine significantly reduced the risk of influenza illness by >40% with no effect on coronaviruses or other NIRV risk. These findings provide reassurance against the speculation that influenza vaccine may negatively affect COVID-19 risk. Addressing such speculation is important to maintain influenza vaccine coverage through the ongoing COVID-19 pandemic.


Evaluation of the Sequence Variability within the PCR Primer/Probe Target Regions of the SARS-CoV-2 Genome

Authors: Khan, Kashif Aziz; Cheung, Peter

BIO-PROTOCOL Volume: 10 Issue: 24 Article Number: e3871

Polymerase chain reaction (PCR) is the current standard method to diagnose COVID-19 from patient samples. As PCR assays are prone to sequence mismatches due to mutations in the viral genome, it is important to verify the genomic variability at primer/probe binding regions periodically. This step-by-step protocol describes a bioinformatics approach for an extensive evaluation of the sequence variability within the primer/probe target regions of the SARS-CoV-2 genome. The protocol can be applied to any molecular diagnostic assay of choice using freely available software programs and the ready-to-use multiple sequence alignment file provided.


Validation of the COVID-19 Fears Questionnaires for Chronic Medical Conditions: A Scleroderma Patient-centered Intervention Network COVID-19 Cohort study

Authors: Wu, Yin; Kwakkenbos, Linda; Henry, Richard S.; Tao, Lydia; Harb, Sami; Bourgeault, Angelica; Carrier, Marie-Eve; Levis, Brooke; Sun, Ying; Bhandari, Parash Mani; Carboni-Jimenez, Andrea; Gagarine, Maria; He, Chen; Krishnan, Ankur; Negeri, Zelalem F.; Neupane, Dipika; Mouthon, Luc; Bartlett, Susan J.; Benedett, Andrea; Thombs, Brett D.; Culos-Reed, Nicole; El-Baalbaki, Ghassan; Hebblethwaite, Shannon; Patten, Scott; Varga, John; Bustamante, Laura; Duchek, Delaney; Ellis, Kelsey; Rice, Danielle; Dyas, Laura; Fortune, Catherine; Gietzen, Amy; Guillot, Genevieve; Lewis, Nancy; Nielsen, Karen; Richard, Michelle; Sauve, Maureen; Welling, Joep

JOURNAL OF PSYCHOSOMATIC RESEARCH Volume: 139 Article Number: 110271

Fear associated with medical vulnerability should be considered when assessing mental health among individuals with chronic medical conditions during the COVID-19 pandemic. The researchers developed and validated the COVID-19 Fears Questionnaire for Chronic Medical Conditions to achieve this objective. Fifteen initial items were generated based on suggestions from 121 people with the chronic autoimmune disease systemic sclerosis (SSc; scleroderma). The COVID-19 Fears Questionnaire for Chronic Medical Conditions can be used to assess fear among people at risk due to pre-existing medical conditions during the pandemic.


Changes in mental health symptoms from pre-COVID-19 to COVID-19 among participants with systemic sclerosis from four countries: A Scleroderma Patient-centered Intervention Network (SPIN) Cohort study

Authors: Thombs, Brett D.; Kwakkenbos, Linda; Henry, Richard S.; Carrier, Marie-Eve; Patten, Scott; Harb, Sami; Bourgeault, Angelica; Tao, Lydia; Bartlett, Susan J.; Mouthon, Luc; Varga, John; Benedetti, Andrea; Fortune, Catherine; Gietzen, Amy; Guillot, Genevieve; Lewis, Nancy; Richard, Michelle; Sauve, Maureen; Welling, Joep; Fligelstone, Kim; Gottesman, Karen; Leite, Catarina; Perez, Elisabet; Baron, Murray; Malcarne, Vanessa; Mayes, Maureen D.; Nielson, Warren R.; Riggs, Robert; Assassi, Shervin; Ells, Carolyn; van den Ende, Cornelia; Frech, Tracy; Harel, Daphna; Hinchcliff, Monique; Hudson, Marie; Johnson, Sindhu R.; Larche, Maggie; Nguyen, Christelle; Pope, Janet; Rannou, Francois; Reyna, Tatiana Sofia Rodriguez; Schouffoer, Anne A.; Suarez-Almazor, Maria E.; Agard, Christian; Albert, Alexandra; Bernstein, Elana J.; Berthier, Sabine; Bissonnette, Lyne; Bruns, Alessandra; Carreira, Patricia; Chaigne, Benjamin; Chung, Lorinda; Correia, Chase; Denton, Christopher; Domsic, Robyn; Dunne, James, V; Dunogue, Bertrand; Farge-Bancel, Dominique; Fortin, Paul R.; Gordon, Jessica; Granel-Rey, Brigitte; Hatron, Pierre-Yves; Herrick, Ariane L.; Hoa, Sabrina; Jones, Niall; Fernandes, Artur Jose de B.; Kafaja, Suzanne; Khalidi, Nader; Launay, David; Manning, Joanne; Marie, Isabelle; Martin, Maria; Mekinian, Arsene; Melchor, Sheila; Nikpour, Mandana; Olagne, Louis; Proudman, Susanna; Regent, Alexis; Riviere, Sebastien; Robinson, David; Rodriguez, Esther; Roux, Sophie; Sobanski, Vincent; Steen, Virginia; Sutton, Evelyn; Thorne, Carter; Wilcox, Pearce; Ayala, Mara Canedo; Carboni-Jimenez, Andrea; Gagarine, Maria; Nordlund, Julia; Ostbo, Nora; Rice, Danielle B.; Turner, Kimberly A.; Culos-Reed, Nicole; Dyas, Laura; El-Baalbaki, Ghassan; Hebblethwaite, Shannon; Bustamante, Laura; Duchek, Delaney; Ellis, Kelsey

JOURNAL OF PSYCHOSOMATIC RESEARCH Volume: 139 Article Number: 110262

This research compared anxiety and depression symptoms among people with a pre-existing medical condition and factors associated with changes. Pre-COVID-19 Scleroderma Patient-centered Intervention Network Cohort data were linked to COVID-19 data from April 2020. Mean anxiety symptoms increased 4.9 points while depression symptom change was negligible. Compared to France, adjusted anxiety symptom change scores were significantly higher in the United Kingdom, United States and Canada. Older age and adequate financial resources were associated with less continuous anxiety increase, while employment and shorter time since diagnosis were associated with lower odds of a minimal clinically important difference increase.


Evaluation of Nasopharyngeal Swab Collection Techniques for Nucleic Acid Recovery and Participant Experience: Recommendations for COVID-19 Diagnostics

Authors: Kinloch, Natalie N.; Shahid, Aniqa; Ritchie, Gordon; Dong, Winnie; Lawson, Tanya; Montaner, Julio S. G.; Romney, Marc G.; Stefanovic, Aleksandra; Matic, Nancy; Brumme, Chanson J.; Lowe, Christopher F.; Brumme, Zabrina L.; Leung, Victor

OPEN FORUM INFECTIOUS DISEASES Volume: 7 Issue: 11 Article Number: ofaa488

Nasopharyngeal swabs are critical to diagnosing respiratory infections, including COVID-19, but collection techniques vary. The authors compared 2 recommended nasopharyngeal swab collection techniques and found that swab rotation following nasopharyngeal contact did not recover additional nucleic acid. Rotation was also less tolerable for participants. Both discomfort and nucleic acid recovery were significantly higher in Asian participants, consistent with nasal anatomy differences. The results suggest it is unnecessary to rotate the swab in place following contact with the nasopharynx and reveal that procedural discomfort levels can differ by ethnicity.

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