Canadian Publications on COVID-19

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

Crystallization of Feline Coronavirus M-pro With GC376 Reveals Mechanism of Inhibition

Authors: Lu, Jimmy; Chen, Sizhu Amelia; Khan, Muhammad Bashir; Brassard, Raelynn; Arutyunova, Elena; Lamer, Tess; Vuong, Wayne; Fischer, Conrad; Young, Howard S.; Vederas, John C.; Lemieux, M. Joanne

FRONTIERS IN CHEMISTRY Volume: 10 Article Number: 852210

The authors solved the crystal structure of feline infectious peritonitis virus (FIPV) coronavirus main protease (M-pro) in complex with the drug GC373 and prodrug GC376, to reveal the architecture of the active site with bound inhibitors. As GC376 and GC373 were successfully used to treat feline infectious peritonitis in cats, they are considered strong starting points in drug design to treat COVID-19 in humans. In this study, the authors compare the structural similarities and differences between SARS-CoV-2 Mpro and FIPV Mpro with the feline drugs for antiviral drug optimization against SARS-CoV-2 and the development of future broad-spectrum antivirals. 

SARS-CoV-2 Omicron variant: Antibody evasion and cryo-EM structure of spike protein-ACE2 complex

Authors: Mannar, Dhiraj; Saville, James W.; Zhu, Xing; Srivastava, Shanti S.; Berezuk, Alison M.; Tuttle, Katharine S.; Marquez, Ana Citlali; Sekirov, Inna; Subramaniam, Sriram

SCIENCE Volume: 375 Issue: 6582 Page760-+

The Omicron variant is poised to replace Delta as the most prevalent SARS-CoV-2 variant across the world. Cryo-electron microscopy structural analysis of the Omicron variant spike protein in complex with human angioten-sinconverting enzyme 2 (ACE2) reveals new salt bridges and hydrogen bonds. Neutralization assays show that pseudoviruses that display the Omicron spike protein exhibit increased antibody evasion. The increase in antibody evasion and the retention of strong interactions at the ACE2 interface represent important molecular features that likely contribute to the rapid spread of the Omicron variant.

COVID-19 vaccine inequity, dependency, and production capability in low-income and middle-income countries: the case of Bangladesh

Authors: Mahmud-Al-Rafat, Abdullah; Hewins, Benjamin; Mannan, Adnan; Kelvin, David J.; Billah, Md Morsaline

LANCET INFECTIOUS DISEASES Volume: 22 Issue: 3 Page: 310-312

As of December 2021, roughly 50% of the Bangladeshi population has received at least one dose and roughly 25% has been administered two doses of COVID-19 vaccines. In addition to procuring vaccines from a diverse portfolio of manufacturers, Bangladesh has adopted a model to become self-reliant in vaccine manufacturing. Looking forward, Bangladesh should focus on hosting clinical trials. Initiatives should be undertaken to acquire and distribute vaccines among low-income and middle-income countries. Without such initiatives there remains a growing concern for the persistent presence of COVID-19 hot spots in low-income countries, which increases the risk of escape variants of SARS-COV-2.

Adverse effects of remdesivir, hydroxychloroquine and lopinavir/ritonavir when used for COVID-19: systematic review and meta-analysis of randomised trials

Authors: Izcovich, Ariel; Siemieniuk, Reed Alexander; Bartoszko, Jessica Julia; Ge, Long; Zeraatkar, Dena; Kum, Elena; Qasim, Anila; Khamis, Assem M.; Rochwerg, Bram; Agoritsas, Thomas; Chu, Derek K.; McLeod, Shelley L.; Mustafa, Reem A.; Vandvik, Per; Brignardello-Petersen, Romina

BMJ OPEN Volume: 12 Issue: 3 Article Number: e048502

This systematic review and meta-analysis provides a comprehensive overview of the evidence for drug-specific adverse effects of interest for three commonly used drugs for treatment of COVID-19. The authors observe that hydroxychloroquine probably increases the risk of diarrhoea and nausea and/or vomiting and may increase the risk of cardiac toxicity and cognitive dysfunction/delirium. They also observe that lopinavir/ritonavir may increase the risk of diarrhoea and nausea and/or vomiting, while remdesivir may have no important effect on risk of acute kidney injury or cognitive dysfunction/delirium. These findings provide information to support the development of evidence-based management strategies for patients with COVID-19.

Efficient incorporation and template-dependent polymerase inhibition are major determinants for the broad-spectrum antiviral activity of remdesivir

Authors: Gordon, Calvin J.; Lee, Hery W.; Tchesnokov, Egor P.; Perry, Jason K.; Feng, Joy Y.; Bilello, John P.; Porter, Danielle P.; Gotte, Matthias

JOURNAL OF BIOLOGICAL CHEMISTRY Volume: 298 Issue: 2 Article Number: 101529

Remdesivir exhibits broad-spectrum antiviral activity against positive-sense RNA viruses, for example, SARS-CoV and hepatitis C virus, and nonsegmented negative-sense RNA viruses, for example, Nipah virus, whereas segmented negative-sense RNA viruses such as influenza virus or Crimean-Congo hemorrhagic fever virus are not sensitive to the drug. The reasons for this apparent efficacy pattern are unknown. In this study, the authors expressed and purified representative RNA-dependent RNA polymerases and studied three biochemical parameters that have been associated with the inhibitory effects of Remdesivir-triphosphate. They found a strong correlation between antiviral effects and efficient incorporation of Remdesivir-triphosphate.

Ontario COVID-19 and Kids Mental Health Study: a study protocol for the longitudinal prospective evaluation of the impact of emergency measures on child and adolescent mental health during the COVID-19 pandemic

Authors: Korczak, Daphne J.; Cost, Katherine T.; LaForge-MacKenzie, Kaitlyn; Anagnostou, Evdokia; Birken, Catherine S.; Charach, Alice; Monga, Suneeta; Crosbie, Jennifer

BMJ OPEN Volume: 12 Issue: 3 Article Number: e057248

Little is known about the impact of the COVID-19 emergency measures (EMs) on children's mental health (MH) over the course of the pandemic. Primary outcomes include the impact of EMs on depression, anxiety, irritability, inattention, hyperactivity and obsessive-compulsive behaviours. Risk and protective factors related to youth MH profiles and trajectories will be identified. The effects of school mitigation strategies, changes in MH services and family factors (i.e., parental MH, economic deprivation and family functioning) on children's MH will be examined. Data will be collected via repeated online survey measures. Results will be disseminated through a knowledge translation partnership.

Long COVID and episodic disability: advancing the conceptualisation, measurement and knowledge of episodic disability among people living with Long COVID - protocol for a mixed-methods study

Authors: O'Brien, Kelly K.; Brown, Darren A.; Bergin, Colm; Erlandson, Kristine M.; Vera, Jaime H.; Avery, Lisa; Carusone, Soo Chan; Cheung, Angela M.; Goulding, Susie; Harding, Richard; McCorkell, Lisa; O'Hara, Margaret; Robinson, Larry; Thomson, Catherine; Wei, Hannah; St Clair-Sullivan, Natalie; Torres, Brittany; Bannan, Ciaran; Roche, Niamh; Stokes, Ruth; Gayle, Patriic; Solomon, Patricia

BMJ OPEN Volume: 12 Issue: 3 Article Number: e060826

This study aims to characterise disability experiences among people living with Long COVID; and to develop a patient-reported outcome measure to assess the presence, severity and episodic nature of disability with Long COVID. First, the authors will conduct interviews with adults living with Long COVID and establish an episodic disability framework in the context of Long COVID. Using the framework, they will establish the Long COVID Episodic Disability Questionnaire (EDQ). In phase 2, they will examine the validity and reliability of the EDQ for use in Long COVID. Using phase 2 data, they will characterise the profile of disability.

Physiological health indexes predict deterioration and mortality in patients with COVID-19: a comparative study

Authors: Strazhesko, Irina; Tkacheva, Olga; Kashtanova, Daria; Ivanov, Mikhail; Kljashtorny, Vladislav; Esakova, Antonina; Karnaushkina, Maria; Guillemette, Cassandra; Hewett, Amber; Legault, Veronique; Maytesian, Lilit; Litvinova, Maria; Cohen, Alan; Moskalev, Alexey

AGING-US Volume: 14 Issue: 4 Page: 1611-1626

The authors proposed that the physiological health status and biological age, beyond the chronological age itself, could affect COVID-19 severity and mortality. A total of 155 participants with confirmed COVID-19 were recruited for the study. Four physiological summary indices were calculated (Klemera and Doubal's biological age, PhenoAge, physiological dysregulation (PD), integrated albunemia), and all significantly predicted the risk of death. The PD was shown to be a good predictor of deterioration or death. Their results are partly attributed to common chronic diseases that aggravate COVID-19, but they also suggest that the underlying physiological state could capture vulnerability to severe COVID-19.

Differential interferon-alpha subtype induced immune signatures are associated with suppression of SARS-CoV-2 infection

Authors: Schuhenn, Jonas; Meister, Toni Luise; Todt, Daniel; Bracht, Thilo; Schork, Karin; Billaud, Jean-Noel; Elsner, Carina; Heinen, Natalie; Karakoese, Zehra; Haid, Sibylle; Kumar, Sriram; Brunotte, Linda; Eisenacher, Martin; Di, Yunyun; Lew, Jocelyne; Falzarano, Darryl; Chen, Jieliang; Yuan, Zhenghong; Pietschmann, Thomas; Wiegmann, Bettina; Uebner, Hendrik; Taube, Christian; Le-Trilling, Vu Thuy Khanh; Trilling, Mirko; Krawczyk, Adalbert; Ludwig, Stephan; Sitek, Barbara; Steinmann, Eike; Dittmer, Ulf; Lavender, Kerry J.; Sutter, Kathrin; Pfaender, Stephanie


Article Number: e2111600119

Type I interferons (IFN-I) exert pleiotropic biological effects during viral infections and have been successfully employed for the treatment of viral diseases. Humans express 12 IFN-alpha subtypes. Inborn errors in IFN-I immunity and the presence of anti-IFN auto antibodies account for very severe courses of COVID-19; therefore, early administration of IFN-I may be protective against life-threatening disease. The researchers comprehensively analyzed the antiviral activity of all IFN alpha subtypes against SARS-CoV-2 to identify the underlying immune signatures and explore their therapeutic potential. Their data provide a systemic, multimodular definition of antiviral host responses mediated by defined IFN-I.

Oxygen therapy limiting peripheral oxygen saturation to 89-93% is associated with a better survival prognosis for critically ill COVID-19 patients at high altitudes

Authors: Viruez-Soto, Antonio; Arias, Samuel; Casas-Mamani, Ronnie; Rada-Barrera, Gabriel; Merino-Luna, Alfredo; Molano-Franco, Daniel; Tinoco-Solorzano, Amilcar; Marques, Danuzia A.; Zubieta-DeUrioste, Natalia; Zubieta-Calleja, Gustavo; Arias-Reyes, Christian; Soliz, Jorge

RESPIRATORY PHYSIOLOGY & NEUROBIOLOGY Volume: 299 Article Number: 103868

In high altitude dwellers, a peripheral oxygen saturation (SatpO(2)) of 89-95% and an arterial partial pressure of oxygen of 50-67 mmHg are considered normal values for arterial blood. Consequently, it has been suggested that limiting oxygen therapy to maintain SatpO(2) around normoxia may help avoid episodes of hypoxemia, hyperoxemia, intermittent hypoxemia, and ultimately, mortality. The authors evaluated the impact of oxygen therapy on the mortality of critically ill COVID-19 patients who permanently live at high altitudes. Their findings indicate that high-altitude patients entering an ICU at altitudes of 3,400 - 4,150 m should undergo oxygen therapy to maintain oxygenation levels between 89 and 93 %.

Understanding the dynamics of SARS-CoV-2 variants of concern in Ontario, Canada: a modeling study

Authors: Layton, Anita T.; Sadria, Mehrshad

SCIENTIFIC REPORTS Volume: 12 Issue: 1 Article Number: 2114

The authors developed and applied a Susceptible-Infection-Recovered-type model to understand the spread of multiple variants of concern (VOC), and assessed the effectiveness of vaccination and non-pharmaceutical interventions (NPI). The model reveals the mutual inhibitory effects of competing VOCs. By separately tracking asymptomatic and symptomatic infections, model simulations identify a significant role of vaccine breakthrough in the spread of Delta. Furthermore, the severity of a Delta outbreak depends not only on the NPI and vaccination rate but also on the vaccine types. To stop a future VOC, the province may need the deployment of a third booster vaccine and stringent NPI.

Geographic concentration of SARS-CoV-2 cases by social determinants of health in metropolitan areas in Canada: a cross-sectional study

Authors: Xia, Yiqing; Ma, Huiting; Moloney, Gary; Garcia, Hector A. Velasquez; Sirski, Monica; Janjua, Naveed Z.; Vickers, David; Williamson, Tyler; Katz, Alan; Yiu, Kristy; Kustra, Rafal; Buckeridge, David L.; Brisson, Marc; Baral, Stefan D.; Mishra, Sharmistha; Maheu-Giroux, Mathieu


This study aims to quantify social determinants of geographic concentration of SARS-CoV-2 cases across 16 Canadian cities. The authors observed geographic concentration of SARS-CoV-2 cases in cities, as half of the cumulative cases were concentrated in dissemination areas (DAs) containing 21%-35% of their population. Cases were disproportionately concentrated in areas with lower income and educational attainment, and in areas with a higher proportion of visible minorities, recent immigrants, high-density housing and essential workers. Although a consistent feature across cities was concentration by the proportion of visible minorities, the magnitude of concentration by social determinant varied across cities.


Assessment of Functional Mobility After COVID-19 in Adults Aged 50 Years or Older in the Canadian Longitudinal Study on Aging

Authors: Beauchamp, Marla K.; Joshi, Divya; McMillan, Jacqueline; Oz, Urun Erbas; Griffith, Lauren E.; Basta, Nicole E.; Kirkland, Susan; Wolfson, Christina; Raina, Parminder

JAMA NETWORK OPEN Volume: 5 Issue: 1 Article Number: e2146168

This study aimed to evaluate the association between a COVID-19 diagnosis and change in mobility and physical function of adults aged 50 years or older during the initial pandemic lockdown. Individuals with confirmed or probable COVID-19 had higher odds of worsening mobility in terms of ability to engage in household activity, physical activity, and standing up after sitting in a chair compared with adults without COVID-19 during the same pandemic time period. This study among older adults in Canada found that receiving a COVID-19 diagnosis was significantly associated with worse mobility and functioning outcomes even in the absence of hospitalization.

Investigation of discordant SARS-CoV-2 RT-PCR results using minimally processed saliva

Authors: White, Dawn; Gu, Jimmy; Steinberg, Catherine-Jean; Yamamura, Deborah; Salena, Bruno J.; Balion, Cynthia; Filipe, Carlos D. M.; Capretta, Alfredo; Li, Yingfu; Brennan, John D.

SCIENTIFIC REPORTS Volume: 12 Issue: 1 Article Number: 2806

Saliva is an attractive sample for coronavirus disease 2019 testing due to its ease of collection and amenability to detect viral RNA with minimal processing. Using a direct-to-RT-PCR method with saliva self-collected from confirmed COVID-19 positive volunteers, the authors observed 32% false negative results. Confirmed negative and healthy volunteer samples spiked with 10(6) genome copies/mL of heat-inactivated SARS-CoV-2 showed false negative results of 10% and 13%, respectively. Additional sample heating or dilution of the false negative samples conferred only modest improvements. These results highlight the potential to significantly underdiagnose COVID-19 infections when testing directly from minimally processed heterogeneous saliva samples.

Structural and biochemical rationale for enhanced spike protein fitness in delta and kappa SARS-CoV-2 variants

Authors: Saville, James W.; Mannar, Dhiraj; Zhu, Xing; Srivastava, Shanti S.; Berezuk, Alison M.; Demers, Jean-Philippe; Zhou, Steven; Tuttle, Katharine S.; Sekirov, Inna; Kim, Andrew; Li, Wei; Dimitrov, Dimiter S.; Subramaniam, Sriram

NATURE COMMUNICATIONS Volume: 13 Issue: 1 Article Number: 742

The authors assess structural and biochemical aspects of viral fitness for these two variants using cryo-electron microscopy, ACE2-binding and antibody neutralization analyses. Both variants demonstrate escape of antibodies targeting the N-terminal domain, an important immune hotspot for neutralizing epitopes. Compared to wild-type and Kappa lineages, Delta variant spike proteins show modest increase in ACE2 affinity, likely due to enhanced electrostatic complementarity at the RBD-ACE2 interface. Unexpectedly, Kappa variant spike trimers form a structural head-to-head dimer-of-trimers assembly. The combination of increased antibody escape and enhanced ACE2 binding provides an explanation, in part, for the rapid global dominance of the Delta variant.


Comparison of Self-harm or Overdose Among Adolescents and Young Adults Before vs During the COVID-19 Pandemic in Ontario

Authors: Ray, Joel G.; Austin, Peter C.; Aflaki, Kayvan; Guttmann, Astrid; Park, Alison L.

JAMA NETWORK OPEN Volume: 5 Issue: 1 Article Number: e2143144

This study evaluates the risk of self-harm, overdose, and all-cause mortality among adolescents and young adults during the COVID-19 pandemic. It compares the COVID-19 pandemic era (April 1, 2020 to June 30, 2021), relative to the 2 years preceding the pandemic (March 1, 2018 to February 28, 2020). After follow-up, 6224 adolescents and young adults experienced the primary outcome of self-harm or overdose during the pandemic (39.7 per 10 000 person-years) vs 12 970 (51.0 per 10 000 person-years) prepandemic. The risk of self-harm, overdose, or death was also lower during than before the pandemic, but not all-cause mortality.


Daily cannabis use during the novel coronavirus disease (COVID-19) pandemic in Canada: a repeated cross-sectional study from May 2020 to December 2020

Authors: Imtiaz, Sameer; Wells, Samantha; Rehm, Jurgen; Wickens, Christine M.; Hamilton, Hayley; Nigatu, Yeshambel T.; Jankowicz, Damian; Elton-Marshall, Tara


In the context of the COVID-19 pandemic, the authors characterized trends in daily cannabis use in the overall sample and various population subgroups, and examined risk characteristics associated with daily cannabis use. Daily cannabis use did not change in the overall sample or various population subgroups. Pandemic-related risks (e.g., male, self-identified as white, had less than college or university completion, engaged in heavy episodic drinking, etc.) and impacts (e.g., had a job that increased the risk of contracting COVID-19, felt very worried or somewhat worried about the pandemic's impact on their financial situation, etc.) were associated with daily cannabis use.

Reducing Inequities During the COVID-19 Pandemic: A Rapid Review and Synthesis of Public Health Recommendations

Authors: Brown, Chloe; Wilkins, Katie; Craig-Neil, Amy; Upshaw, Tara; Pinto, Andrew David

PUBLIC HEALTH REVIEWS Volume: 42 Article Number: 1604031

While public health experts have commented on health inequities, no analysis had yet synthesized recommendations into a guideline for practitioners. The objective of this review was to identify the areas of greatest concern and synthesize recommendations. Income, housing, mental health, age and occupation were the most discussed social determinants of health. The authors categorized recommendations into primordial, primary, secondary and tertiary prevention that spoke to the social determinants of COVID-19 and equity. These recommendations can assist efforts to contain COVID-19 and reduce health inequities during the pandemic. Using these recommendations, public health practitioners could support a more equitable pandemic response.

LIVES for families psychological first aid training programme to address COVID-19 psychological distress: a mixed methods acceptability and feasibility protocol

Authors: Kimber, Melissa; Harms, Sheila; Soreni, Noam; Inrig, Maggie; Acai, Anita; Lipman, Ellen Louise; Sassi, Roberto; Streiner, David L.; MacMillan, Harriet L.

BMJ OPEN Volume: 11 Issue: 5 Article Number: e049995

Best practice approaches for addressing COVID-19-related psychological distress among young people (<25 years) and their families remain unclear. Psychological first aid (PFA) is promoted by public health authorities to provide psychological support in the context of extreme events; however, there is limited evidence for its effectiveness. As a prerequisite to conducting a randomised controlled trial to examine programme effectiveness, this project is evaluating the acceptability and feasibility of implementing and evaluating a PFA training programme (“LIVES for Families”) for mental health (MH) practitioners to improve their ability to recognise and respond to COVID-19-related psychological distress among their clients.


Inferring the COVID-19 infection fatality rate in the community-dwelling population: a simple Bayesian evidence synthesis of seroprevalence study data and imprecise mortality data

Authors: Campbell, Harlan; Gustafson, Paul

EPIDEMIOLOGY AND INFECTION Volume: 149 Article Number: e243; PII S0950268821002405


Estimating the coronavirus disease-2019 (COVID-19) infection fatality rate (IFR) has proven to be particularly challenging -and rather controversial- due to the fact that both the data on deaths and the data on the number of individuals infected are subject to many different biases. The authors conduct two separate parallel analyses based on two lists of eligible studies obtained from two different research teams. The results from both analyses are rather similar. Their results suggest that, as one might expect, lower IFRs are associated with younger populations (and may also be associated with wealthier populations).


Routine saliva testing for the identification of silent coronavirus disease 2019 (COVID-19) in healthcare workers

Authors: Zhang, Kevin; Shoukat, Affan; Crystal, William; Langley, Joanne M.; Galvani, Alison P.; Moghadas, Seyed M.


The authors simulated a routine testing program with different nasopharyngeal and saliva testing frequencies to determine COVID-19 case detection percentages for healthcare workers during the infectious period, as well as the presymptomatic stage. They constructed a sensitivity function based on the average infectiousness profile of symptomatic cases to determine the probability of being identified at the time of testing. Their findings highlight the utility of routine noninvasive saliva testing for frontline healthcare workers to protect vulnerable patient populations. A 5-day saliva testing schedule should be considered to help identify silent infections and prevent outbreaks in nursing homes and healthcare facilities.


Communicating scientific uncertainty in a rapidly evolving situation: a framing analysis of Canadian coverage in early days of COVID-19

Authors: Capurro, Gabriela; Jardine, Cynthia G.; Tustin, Jordan; Driedger, Michelle

BMC PUBLIC HEALTH Volume: 21 Issue: 1 Article Number: 2181

The analysis focused on how scientific uncertainty was covered and compared how specialist health and science reporters discussed scientific evidence versus non-specialist reporters. While specialist journalists understood that scientific knowledge evolves and the process is fraught with uncertainty, non-specialist reporters and commentators expressed frustration over changing public health guidelines. Managing scientific uncertainty requires timely and clear communication and access to data. Public health officials should quickly engage in communication course corrections if original messages are missing the intended mark, and clearly explain the shift. More care and effort are needed in these communication engagements to minimize inconsistencies, uncertainty, and politicization.

Available medications used as potential therapeutics for COVID-19: What are the known safety profiles in pregnancy

Authors: Anick Bérard, Odile Sheehy, Jin-Ping Zhao, Evelyne Vinet, Caroline Quach, Behrouz Kassa and Sasha Bernatsky

PLoS One

Medications already available to treat other conditions are being studied in clinical trials as potential treatments for COVID-19. Given that pregnant women are excluded from these trials, this study aimed to investigate their safety when used during pregnancy. Adjusting for potential confounders, the authors observed an increased risk of prematurity related to dexamethasone, anti-thrombotics, and HIV medications use. An increased risk for low birth weight associated with anti-thrombotics, and HIV medications use were also found. Gestational exposure to anti-thrombotics, and HIV medications were associated with small for gestational age. First-trimester dexamethasone and azithromycin exposures were associated with major congenital malformation.  


Retrospective testing of respiratory specimens for COVID-19 to assess for earlier SARS-CoV-2 infections in Alberta, Canada

Authors: Jamil N Kanji, Mathew Diggle, Dennis E Bulman, Stacey Hume, Sherry Taylor, Rhonda Kelln, Shelagh Haase, Robert Tomaszewski, Christine Walker, Kanti Pabbaraju, Vincent Li, Matthew Croxen, Nathan Zelyas, Deena Hinshaw and Graham Tipples

JAMMI Journal of the Association of Medical Microbiology and Infectious Disease Canada

Journal de l’Association pour la microbiologie médicale et l’infectiologie Canada

The aim of the authors was to retrospectively evaluate specimens submitted for respiratory virus testing from December 1, 2019, through March 7, 2020, for undetected SARS-CoV-2 infections before the first confirmed case. Testing of 23,517 samples identified 1 patient positive for SARS-CoV-2 who had recently returned from the western United States. Phylogenetic analysis confirmed this viral isolate belonged to lineage B.1. The epidemiology of this case is consistent with those of other early cases before sustained community transmission, which included a travel history outside of Canada. This exercise provides support that local public health pandemic planning was satisfactory and timely.


The Impact of COVID-19 on Psychiatric Emergency and Inpatient Services in the First Month of the Pandemic in a Large Urban Mental Health Hospital in Ontario, Canada

Authors: Helena K. Kim, Andre F. Carvalho, David Gratzer, Albert H. C. Wong, Shayla Gutzin, M. Ishrat Husain, Benoit H. Mulsant, Vicky Stergiopoulos and Zafiris J. Daskalakis

Frontiers of Psychology

The authors evaluated the immediate effect of COVID-19 on psychiatric emergency and inpatient services in psychiatric hospital in the first month of the pandemic. There was a decrease in the number of emergency department visits and inpatient occupancy rates in March 2020 compared to March 2019. There was also a significant decrease in the number of emergency department visits and inpatient occupancy rates in the second half of March 2020 compared to the first half. Future studies will need to assess whether this decrease will be followed by a return to baseline or an increase in need for these services.


Peroxisomes exhibit compromised structure and matrix protein content in SARS-CoV-2-infected cells

Authors: Barbara Knoblach, Ray Ishida, Tom C. Hobman, and Richard A. Rachubinski

Mol Bio Cell

The authors report the effects of SARS-CoV-2 infection on peroxisomes of human cell. Peroxisomes undergo changes in morphology in SARS-CoV-2-infected cells. Rearrangement of peroxisomal membranes is followed by redistribution of peroxisomal matrix proteins to the cytosol, resulting in a dramatic decrease in the number of mature peroxisomes. A SARSCoV-2 protein was shown to interact physically with a human peroxisomal membrane protein required for matrix protein import and peroxisome biogenesis. Given the important roles of peroxisomes in innate immunity, SARS-CoV-2 may directly target peroxisomes, resulting in loss of peroxisome structural integrity, matrix protein content and ability to function in antiviral signaling.


Phase 1 randomized trial of a plant-derived virus-like particle vaccine for COVID-19

Authors: Brian J. Ward, Philipe Gobeil, Annie Séguin, Judith Atkins, Iohann Boulay, Pierre-Yves Charbonneau, Manon Couture, Marc-André D’Aoust, Jiwanjeet Dhaliwall, Carolyn Finkle, Karen Hager, Asif Mahmood, Alexander Makarkov, Matthew P. Cheng, Stéphane Pillet, Patricia Schimke, Sylvie St-Martin, Sonia Trépanier & Nathalie Landry

Nature Medicine

This article reports interim safety and immunogenicity data from a study of a virus-like particle vaccine candidate produced in plants that displays the SARS-CoV-2 spike glycoprotein (CoVLP). Randomized adults received two doses of CoVLP, alone or adjuvanted. All formulations were well tolerated, and adverse events after vaccination were generally mild to moderate, transient and highest in the adjuvanted groups. There was no CoVLP dose effect on serum neutralizing antibodie (Nabs), but titers increased significantly with both adjuvants. After the second dose, NAbs in the CoVLP + AS03 adjuvant groups were more than tenfold higher than titers in SARS-CoV-2 convalescent sera.


Comparison of SARS-CoV-2 indirect and direct RT-qPCR detection methods

Authors: Joel D. Pearson, Daniel Trcka, Suying Lu, Sharon J. Hyduk, Mark Jen, Marie-Ming Aynaud, J. Javier Hernández, Philippos Peidis, Miriam Barrios-Rodiles, Kin Chan, Jim Woodgett, Tony Mazzulli, Liliana Attisano, Laurence Pelletier, Myron I. Cybulsky, Jeffrey L. Wrana, Rod Bremner

Virology Journal

The authors assessed indirect methods that require RNA extraction with direct RT-qPCR on patient samples, and tested and optimized direct, extraction-free detection and performed a cost analysis of the different methods evaluated. Most RNA isolation procedures performed similarly. While all RT-qPCR modules effectively detected purified viral RNA, the BGI system provided superior performance, but is more expensive than other options tested. With direct RT-qPCR, adding an RNase inhibitor greatly improved detection, without the need for other treatments. The best direct methods detected ~ 10-fold less virus than indirect methods, but this approach reduced sample handling, as well as assay time and cost.


Assessing the Risk of SARS-CoV-2 Transmission via Surgical Electrocautery Plume

Authors: Leigh J. Sowerby, Anthony C. Nichols, Richard Gibson, Doron D. Sommer, Corey Moore, Douglas D. Fraser and Eric Arts


The authors investigated the presence of live SARS-CoV-2 in electrocautery plumes. Electrocautery at 25 W was applied using 3 methods (monopolar cut, monopolar coagulate, and bipolar electrocautery). SARS-CoV-2 was not detectable in aerosol cautery plume generated from electrocautery under any of the conditions studied. By mimicking surgery on a patient with a high SARS-CoV-2 load, there was a minimum of a 9-log reduction of viral RNA with any of the electrocautery methods. This suggests that electrocautery smoke is an unlikely source of SARS-CoV-2 transmission for health care workers. This study is limited by the in vitro nature of the experiment.

Impact of the COVID-19 pandemic on the pharmacological, physical, and psychological treatments of pain: findings from the Chronic Pain & COVID-19 Pan-Canadian Study

Authors: Anais Lacasse, M. Gabrielle Page, Lise Dassieu, Nadia Sourial, Audree Janelle-Montcalm, Marc Dorais, Hermine Lore Nguena Nguefack, Marimee Godbout-Parent, Maria Hudspith, Gregg Moor, Kathryn Sutton, James M.Thompson and Manon Choiniere Pain Report

This study explored the impact of the COVID-19 pandemic on pharmacological and physical/psychological treatments of chronic pain. Among medication users, 38.3% reported changes in their pharmacological pain treatment. The main reasons were changes in pain symptoms, lack of access to prescribers/cancellation of medical appointments, and increased medication intake in compensation for stopping physical/psychological treatments because of the pandemic. Among participants, 68.3% had to modify their treatments or self-management strategies. Common reasons were lack of access to clinics/exercise facilities and the need to compensate for having to stop another type of physical/psychological treatment because of the pandemic-related public health safety measures.


Approche de surveillance de la population afin de détecter les nouveaux agrégats de cas de COVID-19 et y répondre

Authors: Erin E. Rees, Rachel Rodin, Nicholas H. Ogden

Canada Communicable Disease Report

This study presents a targeted surveillance strategy, combining passive and active surveillance samples, to determine the number of samples to be collected per unit area and per unit of time to detect new clusters of COVID-19 cases. The authors observe that detection of COVID-19 is most effective when surveillance is focused on requiring testing of symptomatic patients. In voluntary populations, the higher the contact rates and the expected prevalence level are, the fewer samples are needed to detect it at a predetermined threshold.


Pandémie de COVID-19 : de nouvelles contraintes journalistiques qui menacent le droit à l’information

Authors : Caroline Lacroix and Marie-Ève Carignan

Enjeux et société Volume 7, Numéro 2, automne 2020

This article looks at the challenges journalists faced during the first weeks of the coronavirus pandemic and their effects on professional practices. It shows that the crisis has increased the pressure on journalists through increased workloads and the pace of production as well as new difficulties in accessing sources of information. It has created challenges related to the practice of journalism in confinement and field work. Overall, these challenges have hampered journalists' professional practices and threatened the public's right to information.

Établir les priorités de la vaccination contre la COVID-19 en fonction de la prévalence des facteurs de risque chez les adultes au Canada

Authors: Finlay A. McAlister, Tracey Bushnik, Alexander A. Leung, Lynora Saxinger

Canadian Medical Association Journal

This analysis examines the burden of risk factors, it is intended to complement analyzes of provincial administrative datasets, and is intended to better inform priority setting for SARS-CoV-2 vaccination in Canada. The authors note that consideration should be given to the prevalence of risk factors, the weight to be given to each, and geographic and occupational risk exposure. They recommend that public health recommendations continue to be followed during the rollout of vaccination programmes and acknowledge that policies that allow for a longer interval between the first and second doses of vaccine are appropriate.

Incidence de la COVID-19 sur les issues de grossesse: examen systématique et méta-analyse

Authors: Shu Qin Wei, Marianne Bilodeau-Bertrand, Shiliang Liu, Nathalie Auger

Canadian Medical Association Journal (CMAJ)

The authors conducted a systematic review and meta-analysis of maternal, fetal and neonatal outcomes in pregnant individuals with COVID-19 to determine whether there is an association between SARS-CoV-2 infection and adverse pregnancy outcomes. Compared to no SARS-CoV-2 infection during pregnancy, the diagnosis of COVID-19 was associated with pre-eclampsia, preterm birth and stillbirth. Compared to mild COVID-19, severe COVID-19 was strongly associated with preeclampsia, preterm birth, gestational diabetes and low birth weight.

Enquête sur une éclosion importante de SRAS-CoV-2 dans un établissement de soins de longue durée au début de la pandémie (CMAJ Jul 19, 2021)

Authors: Michelle Murti, Monika Goetz, Andrea Saunders, Vidya Sunil, Jennifer L. Guthrie, AliReza Eshaghi, Sandra Zittermann, Sarah Teatero, Nahuel Fittipaldi, Heather Rilkoff, Jonathan B. Gubbay, Gary Garber, Sandra Callery, Anne Marie Holt and A. Lynn Noseworthy

CMAJ July 19, 2021 193 (28) E1098-E1106

This report focuses on one of the first and largest outbreaks of SARS-CoV-19 to occur in a long-term care facility (LTCF) in Ontario. Laboratory and phylogenetic analyses of confirmed cases in residents, visitors and staff show, with one exception, a single strain of SARS-CoV-2. The gradual implementation of management measures after the peak of the outbreak prevented the contamination of backup staff. These measures have guided subsequent provincial recommendations for the management of SARS-CoV-2 outbreaks in LTCFs, thereby reducing the frequency and severity of outbreaks.

Preclinical evaluation of a SARS-CoV-2 mRNA vaccine PTX-COVID19-B

Authors: Liu, Jun; Budylowski, Patrick; Samson, Reuben; Griffin, Bryan D.; Babuadze, Giorgi; Rathod, Bhavisha; Colwill, Karen; Abioye, Jumai A.; Schwartz, Jordan A.; Law, Ryan; Yip, Lily; Ahn, Sang Kyun; Chau, Serena; Naghibosadat, Maedeh; Arita, Yuko; Hu, Queenie; Yue, Feng Yun; Banerjee, Arinjay; Rod Hardy, W.; Mossman, Karen; Mubareka, Samira; Kozak, Robert A.; Pollanen, Michael S.; Orozco, Natalia Martin; Gingras, Anne-Claude; Marcusson, Eric G.; Ostrowski, Mario A.

SCIENCE ADVANCES Volume: 8 Issue: 3 Article Number: eabj9815

This article reports the preclinical development of a lipid nanoparticle-formulated SARS-CoV-2 mRNA vaccine, PTX-COVID19-B. Tests in mice and hamsters indicated that PTX-COVID19-B induced robust humoral and cellular immune responses and completely protected the vaccinated animals from SARS-CoV-2 infection in the lung. Studies in hamsters showed that PTX-COVID19-B protected the upper respiratory tract from SARS-CoV-2 infection. Mouse immune sera elicited by PTX-COVID19-B vaccination were able to neutralize SARS-CoV-2 variants of concern. No adverse effects were induced by PTX-COVID19-B in either mice or hamsters. Health Canada authorized PTX-COVID19-B to enter clinical trials in December 2020 with a phase 2 clinical trial ongoing.


Multimorbidity resilience and COVID-19 pandemic self-reported impact and worry among older adults: a study based on the Canadian Longitudinal Study on Aging (CLSA)

Authors: Wister, Andrew; Li, Lun; Cosco, Theodore D.; McMillan, Jacqueline; Griffith, Lauren E.

BMC GERIATRICS Volume: 22 Issue: 1 Article Number: 92

This paper examines older adults with multimorbidity to ascertain why some of them coped with pandemic-induced risk and stressors better than others. It investigates their pre-pandemic levels of functional, social and psychological forms of resilience on two outcomes - self-reported comprehensive pandemic impact and personal worry. This study was conducted using Follow-up 1 data from CLSA, and the Baseline and Exit COVID-19 study. Logistic regression and Generalized Linear Mixed Models were employed. The findings show that psychological resilience is most pronounced in protecting against pandemic comprehensive impact and personal worry. In addition, several covariates were also associated with the outcomes.


Persistence of T Cell and Antibody Responses to SARS-CoV-2 Up to 9 Months after Symptom Onset

Authors: Law, Jaclyn C.; Girard, Melanie; Chao, Gary Y. C.; Ward, Lesley A.; Isho, Baweleta; Rathod, Bhavisha; Colwill, Karen; Li, Zhijie; Rini, James M.; Yue, Feng Yun; Mubareka, Samira; McGeer, Allison J.; Ostrowski, Mario A.; Gommerman, Jennifer L.; Gingras, Anne-Claude; Watts, Tania H.

JOURNAL OF IMMUNOLOGY Volume: 208 Issue: 2 Page: 429-443

SARS-CoV-2 induces T cell, B cell, and Ab responses that are detected for several months in recovered individuals. The authors followed T cell and Ab responses in 24 mainly nonhospitalized human subjects who had recovered from SARS-CoV-2 infection at two time points. Ab responses were detected in 95% of subjects. All study subjects had a T cell response to at least one SARS-CoV-2 Ag. Their findings suggest that the memory T cell phenotype after a single infection with SARS-CoV-2 persists over time, with an altered cytokine and cytotoxicity profile compared with long-term memory to whole IAV within the same subjects.

Reliable detection of SARS-CoV-2 with patient-collected swabs and saline gargles: A three-headed comparison on multiple molecular platforms

Authors: Jason J. Le Blanc, Janice Pettipas, Melanie Di Quinzio, Todd F. Hatchette and Glenn Patriquin

Journal of Virological Methods Volume 295

This study aimed to compare the sensitivity of healthcare workers (HCW)-collected oropharynx and anterior nares (OP/N) swabs, self-collected OP/N swabs, and self-collected saline gargles. The sensitivity of self-collected OP/N swabs was equivalent to HCW-collected OP/N swabs at 100.0 % for all three molecular tests. The sensitivity of saline gargles was not significantly different than HCW-collected OP/N swabs, but varied slightly between instruments at 93.8 % for the laboratory-developed test, 96.8 % for the Cobas assay, and 96.7 % for the Panther assay. Overall, self-collections using OP/N swabs or saline gargles are reasonable alternatives to HCW-based collections for SARS-CoV-2 detection.

SARS-CoV-2 vaccination intentions among mothers of children aged 9 to 12 years: a survey of the All Our Families cohort

Authors: Erin Hetherington, Sarah A. Edwards, Shannon E. MacDonald, Nicole Racine, Sheri Madigan, Sheila McDonald and Suzanne Tough


This study aimed to understand mothers’ SARS-CoV-2 vaccine intentions to explore reasons for and against SARS-CoV-2 vaccination. A total of 60.4% of mothers intended to vaccinate their children with the SARS-CoV-2 vaccine, 8.6% did not intend to vaccinate and 31.0% were unsure. Participants with lower education, lower income and incomplete vaccination history were less likely to intend to vaccinate their children. Thematic analysis of qualitative responses showed 10 themes, including safety and efficacy, long-term effects and a rushed process. Within a cohort with historically high infant vaccination, a third of mothers remained unsure about vaccinating their children against SARS-CoV-2.


Genetics of symptom remission in outpatients with COVID-19

Authors: Marie-Pierre Dubé, Audrey Lemaçon, Amina Barhdadi, Louis-Philippe Lemieux Perreault, Essaïd Oussaïd, Géraldine Asselin, Sylvie Provost, Maxine Sun, Johanna Sandoval, Marc-André Legault, Ian Mongrain, Anick Dubois, Diane Valois, Emma Dedelis, Jennifer Lousky, Julie Choi, Elisabeth Goulet, Christiane Savard, Lea-Mei Chicoine, Mariève Cossette, Malorie Chabot-Blanchet, Marie-Claude Guertin, Simon de Denus, Nadia Bouabdallaoui, Richard Marchand, Zohar Bassevitch, Anna Nozza, Daniel Gaudet, Philippe L. L’Allier, Julie Hussin, Guy Boivin, David Busseuil & Jean-Claude Tardif

Nature Scientific reports

The authors conducted a genome-wide association study of time to remission of COVID-19 symptoms in outpatients with at least one risk factor for disease severity. They found a significant association at 5p13. In participants not treated with placebo, there was a significant association at 9q33.1 in interaction with placebo without impact on risk of hospitalisations, highlighting a possibly shared mechanistic pathway. For 5p13, by day 15 of the study, 44%, 54% and 59% of participants with 0, 1, or 2 copies of the effect allele respectively, had symptom remission. For 9q33.1, it was 46%, 62% and 64%. The findings need to be replicated.


Outbreak investigation of SARS-CoV-2 transmission in an emergency childcare centre

Authors: Julio C. Soto, Mireille Barakat, Juliana Ayres Hutter, Marilou Kiely, Sandrine Moreira, B. Jesse Shapiro, Carmen Lia Murall, Nicolas Parenteau, Joane Désilets and Richard Lessard


This study aimed to characterize SARS-CoV-2 transmission following a COVID-19 outbreak in an emergency childcare centre in April 2020 in Quebec. Phylogenetic analysis identified two separate introductions of distinct lineages of SARS-CoV-2 and estimated an average effective reproductive number of Re = 1.9 with a mean doubling time of 3.2 days. The first and most prevalent lineage was introduced by two asymptomatic children who were likely infected by their parent. The analyses carried out showed the probable origin and direction of the transmission of the infection (adult-child, child-adult, and child-child), thus highlighting how asymptomatic children can efficiently transmit SARS-CoV-2.


Asymptomatic Cases, the Hidden Challenge in Predicting COVID-19 Caseload Increases

Authors: Brett Snider, Bhumi Patel, Edward McBean


Analyses of individual cases in Ontario indicated that asymptomatic and pre-symptomatic cases are substantial in number. Large numbers of cases in children aged 0–9 were asymptomatic or had only one symptom and resulted in fever as the most common symptom. COVID-19 cases in children were more likely to be milder symptomatic with cough not seen as frequently as in adults aged over 40, and past research has shown children to be index cases in familial clusters. These findings highlight the importance of targeting asymptomatic and mild infections in the continuing effort to control the spread of COVID-19.

The social determinants of health as predictors of adherence to public health preventive measures among parents and young children during the COVID-19 pandemic: a longitudinal cohort study

Authors: Yulika Yoshida-Montezuma, Charles D. G. Keown-Stoneman, Susitha Wanigaratne, Xuedi Li, Shelley M. Vanderhout, Cornelia M. Borkhoff, Catherine S. Birken, Jonathon L. Maguire and Laura N. Anderson


This study aimed to investigate whether social determinants of health (SDOH) are predictive of adherence to public health preventive measures and to describe changes in adherence over time among parents and children. Unemployment, apartment living, and essential worker in the household were associated with decreased likelihood of adherence among parents; however, no associations were observed for other SDOH, including family income and ethnicity. Furthermore, there was no strong evidence that SDOH were associated with child adherence. Children consistently had greater adherence than parents. Adherence was high among parents and children but decreased over time.


Intention to receive a COVID-19 vaccine: results from a population-based survey in Canada

Authors: Gina S. Ogilvie, Shanlea Gordon, Laurie W. Smith, Arianne Albert, C. Sarai Racey, Amy Booth, Anna Gottschlich, David Goldfarb, Melanie C. M. Murray, Liisa A. M. Galea, Angela Kaida, Lori A. Brotto and Manish Sadarangani

BMC Public Health

This study determined overall intention to receive a COVID-19 vaccine and identified factors that predict intentions to be vaccinated against COVID-19. In multivariable modeling, respondents who intended to receive the vaccine (79.8%) had higher vaccine attitudinal scores, reported greater influence of direct social norms, and indirect social norms, including their family physician, and Provincial Health Officer. Older individuals were more likely to intend to receive the vaccine, while females, those with less than high school education, those who self-identified as non-white or Indigenous and essential non-health care workers had lower adjusted odds of intending to receive a COVID-19 vaccine.


The impact of the COVID-19 pandemic on mental health of nurses in British Columbia, Canada using trends analysis across three time points

Authors: Farinaz Havaei, Peter Smith, John Oudyk and Guy G. Potter

ScienceDirect Annals of Epidemiology Volume 62

This study examined trends over time in the prevalence of anxiety and depression among Canadian nurses: 6 months before (Time 1), 1-month after (Time 2), and 3 months after COVID-19 was declared a pandemic (Time 3). This study found a significant increase of 10% to 15% in anxiety and depression between Time 1 and Time 2, and relative stability between Time 2 and Time 3. Analyses showed similar patterns of findings for acute care and community nurses. Long-term care nurses showed a two-fold increase in the prevalence of anxiety early pandemic, followed by a sharper decline mid pandemic.


Predicting the Severity of Symptoms of the COVID Stress Syndrome From Personality Traits: A Prospective Network Analysis

Authors: Steven Taylor, Allan Fong and Gordon J. G. Asmundson

Frontiers in Psychology

Research provides evidence of a COVID Stress Syndrome (CSS), consisting of worry about the dangerousness of getting infected with SARSCoV2 and coming into contact with infected surfaces, worry concerning the personal socioeconomic consequences of COVID-19, xenophobic fears that SARSCOV2 is being spread by foreigners, COVID-19-related traumatic stress symptoms, and compulsive checking and reassurance-seeking about COVID-19. The authors conducted a prospective network analysis of trait predictors of CSS. Results suggest that the effects of broad personality traits (e.g., negative emotionality, trait resilience) on symptoms of the CSS were mediated by narrower traits (e.g., intolerance of uncertainty). Treatment implications are discussed.

Identities: experiences and impacts of the COVID-19 pandemic from the perspectives of older Chinese immigrants in Canada

Authors: Qianyun Wang, Jacky Ka Kei Liu and Christine Ann Walsh

China Journal of Social Work Volume 14, 2021 - Issue 2

In this study, interviews were held to understand the unique experiences of older Chinese adults in Canada in the early stages of the pandemic. Participants’ narratives were shaped by their multiple and intersecting identities as immigrants, older adults, people of Chinese descent and as family members. In the face of challenges related to grief, loneliness, social isolation, ageism and racism, participants demonstrated considerable resilience and strength, particularly with the adoption of technology in their daily lives. Study findings reinforce the need for anti-ageism, anti-racism and strength-based social work practice, research, and policies aimed at improving older immigrants’ lives during pandemics.


Changes in presentation, presenting severity and disposition among patients accessing emergency services during the first months of the COVID-19 pandemic in Calgary, Alberta: a descriptive study

Authors: Daniel J. Lane, Ian E. Blanchard, Jason E. Buick, Marta Shaw and Andrew D. McRae


The first wave of the pandemic was associated with changes in the frequency and disposition of patients accessing emergency services. The number of patients accessing emergency medical services (EMS) increased and the number of those presenting to an adult emergency department or urgent care centre decreased. The proportion of patients presenting to an emergency department or urgent care centre with the highest-priority triage classification increased. A smaller proportion of patients were transported by EMS, and a greater proportion of emergency department patients were admitted to hospital. After the first case was reported, the mortality rate among EMS patients increased by 265%.


SARS-CoV-2 RNA quantification using droplet digital RT-PCR

Authors: Natalie N. Kinloch, Gordon Ritchie, Winnie Dong, Kyle D. Cobarrubias, Hanwei Sudderuddin, Tanya Lawson, Nancy Matic, Julio S.G. Montaner, Victor Leung, Marc G. Romney, Christopher F. Lowe, Chanson J. Brumme, Zabrina L. Brumme

The Journal of Molecular Diagnostics

Quantitative viral load assays have transformed our understanding of viral diseases. They hold similar potential to advance COVID-19 control and prevention, but SARS-CoV-2 viral load tests are not yet widely available. SARS-CoV-2 molecular diagnostic tests, which typically employ real-time RT-PCR, yield semiquantitative results only. Droplet digital RT-PCR (RT-ddPCR) offers an attractive platform for SARS-CoV-2 RNA quantification. In this study, eight primer/probe sets originally developed for real-time RT-PCR–based SARS-CoV-2 diagnostic tests were evaluated for use in RT-ddPCR; the authors identified three as the most efficient, precise, and sensitive for RT-ddPCR–based SARS-CoV-2 RNA quantification.


Simple mathematical modelling approaches to assessing the transmission risk of SARS-CoV-2 at gatherings

Authors: David Champredon, Aamir Fazil, Nicholas H Ogden

Canada Communicable Disease Report (CCDR)

The authors used a generic modelling framework, based on fundamental probability principles, to derive simple formulas to assess introduction and transmission risks associated with gatherings, as well as the potential efficiency of some testing strategies to mitigate these risks. Introduction risk can be broadly assessed with the population prevalence and the size of the gathering, while transmission risk at a gathering is mainly driven by the gathering size. For recurrent gatherings, the cohort structure does not have a significant impact on transmission between cohorts. Testing strategies can mitigate risk, but frequency of testing and test performance are factors in finding a balance between detection and false positives.


A time-series analysis of testing and COVID-19 outbreaks in Canadian federal prisons to inform prevention and surveillance efforts

Authors: Alexandra Blair, Abtin Parnia, Arjumand Siddiqi

Canada Communicable Disease Report (CCDR)

The objective of this report was to examine outcomes of COVID-19 testing, prevalence, case recovery and death within federal prisons and to contrast these data with those of the general population. Of the 50 facilities studied, 64% reported fewer individuals tested per 1,000 population than observed in the general population. Testing tended to be reactive. Six prisons reported viral outbreaks. Cumulatively, in prisons, 29% of individuals tested received a positive result, compared to 6% in the general population. Two of the 360 cases died. Female prisoners (5% of the total prisoner population) represented 17% of cases overall.

Practical guidance for clinical laboratories for SARS-CoV-2 serology testing

Authors: Carmen Charlton, Jamil Kanji, Vanessa Tran, Julianne Kus, Jonathan Gubbay, Carla Osiowy, Jason Robinson, Inna Sekirov, Michael Drebot, Todd Hatchette, Derek Stein, Nadia El-Gabalawy, Amanda Lang, Lei Jiao, Paul Levett, Heidi Wood, Christian Therrien, L Robbin Lindsay, Muhammad Morshed, Jessica Forbes, Antonia Dibernardo on behalf of the Canadian Public Health Laboratory Network (CPHLN) Serology Working Group

Canada Communicable Disease Report (CCDR)

While serology testing has limited diagnostic capacity for acute infection, its role in providing population-based information on positivity rates and informing evidence-based decision making for public health recommendations is increasing. With the global availability of vaccines, there is increasing pressure on clinical laboratories to provide antibody screening and result interpretation for vaccinated and non-vaccinated individuals. The authors present data on SARS-CoV-2 antibody timelines, including the longevity of antibodies, and the production and detection of neutralizing antibodies. Additionally, they provide practical guidance for clinical microbiology laboratories to both verify commercial serology assays and choose appropriate testing algorithms for their local populations.

Familial cluster of asymptomatic COVID-19 cases in a First Nation community in Northern Saskatchewan, Canada

Authors: Shree Lamichhane, Sabyasachi Gupta, Grace Akinjobi, Nnamdi Ndubuka

Canada Communicable Disease Report (CCDR)

Asymptomatic or presymptomatic cases make up what may be a large portion of all COVID-19 infections. The authors are reporting a familial cluster of COVID-19 cases that started with a paucisymptomatic case and led to two asymptomatic cases. In this familial cluster, five out of nine cases (55%) were found to be presymptomatic at the time of testing, while two cases (22%) remained asymptomatic throughout the course of the infection. Transmissibility by asymptomatic or presymptomatic patients in the setting of crowded living conditions, such as those often seen in remote, northern and Indigenous communities, can contribute to higher transmission rates.

COVID-19 outbreak in a personal service setting in Kingston, Ontario, 2020

Authors: Anthony Li, Stéphanie Parent, Azim Kasmani, T Hugh Guan, Kieran Moore

Canada Communicable Disease Report (CCDR)

The objective of this report was to describe a COVID-19 outbreak, linked to a personal service setting, and the public health response to contain the outbreak. The outbreak investigation included all COVID-19 cases in the provincial public health administration region of Kingston, Frontenac, Lennox and Addington between June 20, 2020, and July 3, 2020. The authors observed that interplay of aggressive accessible testing, quick lab turnaround time, contact tracing within 24 hours of positive laboratory results as per provincial standards, frequent public communication, rapid inspections, mandatory self-isolation and face coverings were measures successful in halting the outbreak.


Covid-19 vaccine acceptance, hesitancy, and refusal among Canadian healthcare workers: A multicenter survey

Authors: Stefania Dzieciolowska, Denis Hamel, Souleymane Gadio, Maude Dionne, Dominique Gagnon, Lucie Robitaille, Erin Cook, Isabelle Caron, Amina Talib, Leighanne Parkes, Ève Dubé, Yves Longtin

American Journal of Infection Control  
The authors assessed healthcare workers’ willingness to be vaccinated and reasons underlying hesitancy. Among respondents (72% female, average age, 44), 80.9% accepted the vaccine. Physicians, environmental services workers and healthcare managers were more likely to accept vaccination compared to nurses. Male sex, age over 50, rehabilitation center workers, and occupational COVID-19 exposure were independently associated with vaccine acceptance by multivariate analysis. Factors for refusal included vaccine novelty, wanting others to receive it first, and insufficient time for decision-making. Vaccine firm refusers were more likely than vaccine hesitants to distrust pharmaceutical companies and to prefer developing a natural immunity by getting COVID-19.

Older adolescents and young adults willingness to receive the COVID-19 vaccine: Implications for informing public health strategies

Authors: Tracie O. Afifi, Samantha Salmon, Tamara Taillieu, Ashley Stewart-Tufescu, Janique Fortier and S. Michelle Driedger

ScienceDirect Vaccines

The objective of this longitudinal study is to understand willingness of getting a vaccine and reasons for vaccine hesitancy among a sample of older adolescents and young adults. Willingness to get a COVID-19 vaccine was 65.4%. Willingness did not differ by age, sex, or mental health conditions, but did differ for other sociodemographic characteristics, physical health conditions, COVID-19 knowledge, practicing social/physical distancing, and adversity history. Common reasons for not wanting a vaccine were related to safety, knowledge, and effectiveness. Sex differences were noted. Public health messaging should aim at vaccine safety, how it works, and importance of not becoming infected.


Longitudinal analysis of humoral immunity against SARS-CoV-2 Spike in convalescent individuals up to 8 months post-symptom onset

Authors: Sai Priya Anand, Jérémie Prévost, Manon Nayrac, Guillaume Beaudoin-Bussières, Mehdi Benlarbi, Romain Gasser, Nathalie Brassard, Annemarie Laumaea, Shang Yu Gong, Catherine Bourassa, Elsa Brunet Ratnasingham, Halima Medjahed, Gabrielle Gendron-Lepage, Guillaume Goyette, Laurie Gokool, Chantal Morrisseau, Philippe Bégin, Valérie Martel-Laferrière, Cécile Tremblay, Jonathan Richard, Renée Bazin, Ralf Duerr, Daniel E. Kaufmann and Andrés Finzi

Cell Reports Medicine

With the recent approval of highly effective COVID-19 vaccines, functional and lasting immunity to SARS-CoV-2 is currently under investigation as antibody levels in plasma were shown to decline during convalescence.

Since the absence of antibodies does not equate to absence of immune memory, the authors evaluate the presence of SARS-CoV-2-specific memory B cells in convalescent individuals. Their observations indicate that anti-Spike and anti-receptor binding domain immunoglobulin M in plasma decay rapidly, whereas the reduction of immunoglobulin G is less prominent. Neutralizing activity also declines rapidly when compared to Fc-effector functions. SARS-CoV-2-specific B cell immunity persists despite overall antibody decline.


Increased household secondary attacks rates with Variant of Concern SARS-CoV-2 index cases

Authors: Sarah A Buchan, Semra Tibebu, Nick Daneman, Michael Whelan, Thuva Vanniyasingam, Michelle Murti and Kevin A Brown

Clinical Infectious Diseases

The prevalence of variants having the N501Y mutation has rapidly increased globally, including in Ontario, Canada, where this prevalence increased dramatically in February 2021. Higher secondary attack rates related to VOC index cases have been reported, but have not been explored within households. The authors compared secondary attack rates in households with B.1.1.7 variant of concern (VOC) versus non-VOC index cases in a matched cohort in Ontario, Canada. The secondary attack rate for VOC index cases was 1.31 times higher than non-VOC index cases. This increase was particularly accentuated for asymptomatic or presymptomatic index cases.


Identification and evaluation of the inhibitory effect of Prunella vulgaris extract on SARS-coronavirus 2 virus entry

Authors: Zhujun Ao, Mable Chan, Maggie Jing Ouyang, Titus Abiola Olukitibi, Mona Mahmoudi, Darwyn Kobasa and Xiaojian Yao

PLoS One

The authors established a sensitive SCoV-2 Spike glycoprotein (SP), pseudotyped HIV-1-based vector system and tested their ability to infect ACE2-expressing cells. Based on their system, they have demonstrated that an aqueous extract from the Natural herb Prunella vulgaris (NhPV) displayed potent inhibitory effects on SCoV-2 SP pseudotyped virus mediated infections. Their results demonstrated that the combination of NhPV/Suramin with an anti-SARS-CoV-2 neutralizing antibody mediated a more potent blocking effect against them. Overall, by using their system, the authors provided strong evidence that NhPV and Suramin have anti-SARS-CoV-2 activity and may be developed as a novel antiviral approach against SARS-CoV-2 infection.


Adjunct Immune Globulin for Vaccine-Induced Thrombotic Thrombocytopenia

Authors: Alex Bourguignon, Donald M. Arnold, Theodore E. Warkentin, James W. Smith, Tania Pannu, Jeffrey M. Shrum, Zainab A.A. Al Maqrashi, Anjali Shroff, Marie-Claude Lessard, Normand Blais, John G. Kelton and Ishac Nazy

The New England Journal of Medecine

The authors describe the response to intravenous immune globulin (IVIG) therapy in three of the first patients in whom vaccine-induced immune thrombotic thrombocytopenia (VITT) was identified in Canada after the receipt of the ChAdOx1 nCoV-19 vaccine. Two of the patients in our study presented with limb-artery thrombosis; the third had cerebral venous and arterial thrombosis. Variable patterns of serum-induced platelet activation were observed in response to heparin and platelet factor 4, indicating the heterogeneity of the manifestations of VITT in serum. After the initiation of IVIG, reduced antibody-induced platelet activation in serum was seen in all three patients.

Social, economic, and environmental factors influencing the basic reproduction number of COVID-19 across countries

Authors: Jude Dzevela Kong, Edward W. Tekwa and Sarah A. Gignoux-Wolfsohn

PLoS One

This study aimed to assess whether the basic reproduction number (R0) of COVID-19 is different across countries and what national-level demographic, social, and environmental factors other than interventions characterize initial vulnerability to the virus. They found that the mean R0 is 1.70, with a range between 1.10 (Ghana) and 3.52 (South Korea). They identified four factors (youth, city, social media and GINI income inequality) as having strong relationships with R0, across countries. An intermediate level of youth and GINI inequality are associated with high R0, while high city population and high social media use are associated with high R0.


SARS-CoV2 spike protein gene variants with N501T and G142D mutation–dominated infections in mink in the United States

Authors: Hugh Y. Cai and Allison Cai

Journal of Veterinary Diagnostic Investigation

To evaluate the genetic characteristics of the mink-derived SARS-CoV2 sequences, the authors analyzed all animal-derived and all Canadian and U.S. SARS-CoV2 sequences deposited in GISAID from December 2019 to March 12, 2021, and identified the N501T-G142D variant and N501T-G142D-F486L variant, in the U.S. mink-derived SARS-CoV2 sequences. The N501T mutation occurred 2 months earlier in humans than in mink in the United States, and the novel N501T-G142D and N501T-G142D-F486L variants were found in humans prior to mink. Their results suggest that the SARS-CoV2 variants may have evolved during human infection and were then transmitted to mink populations in the U.S.

Evaluation of Dried Blood Spot Testing for SARS-CoV-2 Serology Using a Quantitative Commercial Assay

Authors: Davor Brinc, Mia J. Biondi, Daniel Li, Heng Sun, Camelia Capraru, David Smookler, Muhammad Atif Zahoor, Julia Casey, Vathany Kulasingam and Jordan J. Feld


Dried blood spots (DBS) collection could be used to facilitate widespread testing for SARS-CoV-2 antibodies to document past infection, vaccination, and potentially immunity. The authors investigated the characteristics of Roche’s Anti-SARS-CoV-2 (S) assay, a quantitative commercial assay for antibodies against the spike glycoprotein. Antibody levels were reduced relative to plasma following elution from DBS. Quantitative results from DBS samples were highly correlated with values from plasma, allowing for extrapolation using DBS results to accurately estimate plasma antibody levels. High concordance between plasma and fingerpick DBS was observed in PCR-confirmed COVID-19 patients tested 90 days or more after the diagnosis.

Chemokines and Eicosanoids Fuel the Hyperinflammation Within the Lungs of Patients with Severe COVID-19

Authors: Younes Zaid, Étienne Doré, Isabelle Dubuc, Anne-Sophie Archambault, Olivier Flamand, Michel Laviolette, Nicolas Flamand, Éric Boilard, Louis Flamand

The Journal of Allergy and Clinical Immunology

The aim of this study was to analyze and compare the plasma and bronchoalveolar lavage (BAL) fluids of patients with severe COVID-19 for the presence of cytokines and lipid mediators of inflammation (LMIs). The authors revealed high concentrations of numerous cytokines, chemokines, and LMIs in the BAL fluid of patients with severe COVID-19. Of the 13 most abundant mediators in BAL fluid, 11 were chemokines. Eicosanoid levels were also elevated in the lungs of subjects with severe COVID-19. Their findings indicate that hyperinflammation of the lungs of patients with severe COVID-19 is fueled by excessive production of chemokines and eicosanoids.


Assessment of Psychological Distress in Health-care Workers during and after the First Wave of COVID-19: A Canadian Longitudinal Study // Évaluation de la Détresse Psychologique Chez Les Travailleurs de la Santé Durant et Après la Première Vague de la COVID-19: une étude longitudinale canadienne

Authors: Marie-Michèle Dufour, Nicolas Bergeron, Axelle Rabasa, Stéphane Guay and Steve Geoffrion

The Canadian Journal of Psychiatry

Health-care workers (HCW) exposed to COVID-19 are at risk of experiencing psychological distress. This study assessed the evolution of psychological distress and identified psychological distress trajectories of Canadian HCW during and after the first wave of COVID-19. During and after the first wave of COVID-19, the rates of clinical mental health symptoms of HCW varied between 6.2% and 22.2% for post-traumatic stress, 10.1% and 29.9% for depression, and 7.3% and 26.9% for anxiety. Four trajectories were identified: recovered (18.77%), resilient (65.95%), subchronic (7.24%), and delayed (8.04%). Their data illustrated that the majority of HCW follow a resilience trajectory.


Distribution of incubation periods of COVID-19 in the Canadian context

Authors: Subhendu Paul and Emmanuel Lorin

Nature Scientific Reports

The authors propose a novel model based on a set of coupled delay differential equations with fourteen delays in order to accurately estimate the incubation period of COVID-19, employing publicly available data of confirmed corona cases. In this goal, they separate the total cases into fourteen groups for the corresponding fourteen incubation periods. The estimated mean incubation period they obtain is 6.74 days, and the 90th percentile is 11.64 days, corresponding to a good agreement with statistical supported studies. This model provides an almost zero-cost computational complexity to estimate the incubation period.


Multivalency transforms SARS-CoV-2 antibodies into ultrapotent neutralizers

Authors: Edurne Rujas, Iga Kucharska, Yong Zi Tan, Samir Benlekbir, Hong Cui, Tiantian Zhao, Gregory A. Wasney, Patrick Budylowski, Furkan Guvenc, Jocelyn C. Newton, Taylor Sicard, Anthony Semesi, Krithika Muthuraman, Amy Nouanesengsy, Clare Burn Aschner, Katherine Prieto, Stephanie A. Bueler, Sawsan Youssef, Sindy Liao-Chan, Jacob Glanville, Natasha Christie-Holmes, Samira Mubareka, Scott D. Gray-Owen, John L. Rubinstein, Bebhinn Treanor & Jean-Philippe Julien

Nature Communications

The authors use the human apoferritin protomer as a modular subunit to drive oligomerization of antibody fragments and transform antibodies targeting SARS-CoV-2 into exceptionally potent neutralizers. Using this platform, half-maximal inhibitory concentration values are achieved as a result of up to 10,000-fold potency enhancements compared to corresponding IgGs. Combination of three different antibody specificities and the fragment crystallizable domain on a single multivalent molecule conferred the ability to overcome viral sequence variability together with outstanding potency and IgG-like bioavailability. The MULTi-specific, multi-Affinity antiBODY platform thus uniquely leverages binding avidity together with multi-specificity to deliver ultrapotent and broad neutralizers against SARS-CoV-2.


SARS-CoV-2 infection and transmission in the North American deer mouse

Authors: Bryan D. Griffin, Mable Chan, Nikesh Tailor, Emelissa J. Mendoza, Anders Leung, Bryce M. Warner, Ana T. Duggan, Estella Moffat, Shihua He, Lauren Garnett, Kaylie N. Tran, Logan Banadyga, Alixandra Albietz, Kevin Tierney, Jonathan Audet, Alexander Bello, Robert Vendramelli, Amrit S. Boese, Lisa Fernando, L. Robbin Lindsay, Claire M. Jardine, Heidi Wood, Guillaume Poliquin, James E. Strong, Michael Drebot, David Safronetz, Carissa Embury-Hyatt, Darwyn Kobasa

Nature Communications

Circulation of SARS-CoV-2 in humans raises the theoretical risk of reverse zoonosis events with wildlife, reintroductions of SARS-CoV-2 into nondomesticated animals. This study reports that North American deer mice (Peromyscus maniculatus) are susceptible to SARS-CoV-2 infection following intranasal exposure to a human isolate, resulting in viral replication in the upper and lower respiratory tract with little or no signs of disease. Shed infectious virus is detectable in nasal washes, oropharyngeal and rectal swabs. Viral RNA is detectable in feces and occasionally urine. The authors show that deer mice are capable of transmitting SARS-CoV-2 to naïve deer mice through direct contact.


Modelling the impact of shutdowns on resurging SARS-CoV-2 transmission in Canada

Authors: Victoria Ng, Aamir Fazil, Lisa A. Waddell, Patricia Turgeon, Nicholas H. Ogden

Royal Society Open Science

Shutdowns are enacted when alternative public health measures are insufficient to control the epidemic and the population is largely susceptible. Using an age-stratified agent-based model, the authors found a negative relationship between reducing SARS-CoV-2 transmission and the number of shutdown days. However, they also found that for shutdowns to be optimally effective, they need to be implemented fast with minimal delay, initiated when community transmission is low, sustained for an adequate period and be stringent and target multiple sectors, particularly those driving transmission. This paper contrasts a range of shutdown strategies and trade-offs between health outcomes and economic metrics.

Duration of SARS-CoV-2 shedding: A population-based, Canadian study

Authors: Susan P. Phillips , Xuejiao Wei, Jeffrey C. Kwong, Jonathan Gubbay, Kevin L. Schwartz, Anna Majury, Patti A. Groome

PLoS One

This study demonstrates that viral remnants remain detectable well beyond the 14-day period hypothesised early in the pandemic. This duration varies with patients’ sociodemographic characteristics. Clarifying the temporal relationship of initial and subsequent positive RT-PCR testing with ongoing infectivity, infection severity, prolongation of symptoms or sequelae of infection should be explored with further research. This study of the course of viral shedding, as measured by RT-PCR, documented overall median shedding and resolution durations of 19 and 25 days, respectively. As SARS-CoV-2 shedding appears to continue well beyond infectivity, other methods for determining the duration of infection are necessary.

Could a New COVID-19 Mutant Strain Undermine Vaccination Efforts? A Mathematical Modelling Approach for Estimating the Spread of B.1.1.7 Using Ontario, Canada, as a Case Study

Authors: Mattew Betti, Nicola Bragazzi, Jane Heffernanm Jude Kong and Angie Raad


The authors developed a framework to estimate the time at which a mutant variant is able to take over a wild-type strain during an emerging infectious disease outbreak. They used COVID-19 as a case study. They found that, in the context of under-reporting and the current case levels, a variant strain was unlikely to dominate until March/April 2021. The spread of a variant strain will likely be observed by a widened peak of the daily reported cases. If vaccine efficacy is maintained across strains, it is still possible to achieve high levels of immunity by the end of 2021.


Perinatal Outcomes During the COVID-19 Pandemic in Ontario, Canada

Authors: Andrea N. Simpson, John W. Snelgrove, Rinku Sutradhar, Karl Everett, Ning Liu, Nancy N. Baxter

JAMA Network Open

This population-based cohort study evaluated rates of preterm birth and stillbirth during the first 6 months of the pandemic because previous studies conducted early in the pandemic have had inconsistent results. There was no difference in the overall risk of preterm birth, stillbirth, or other perinatal outcomes during the first 6 months of the COVID-19 pandemic in Ontario. The authors observed a small reduction in preterm birth at less than 32 weeks’ gestational age. They did not evaluate the risk of preterm birth among women who experienced COVID-19 during pregnancy because this number was small.

Contribution of single mutations to selected SARS-CoV-2 emerging variants spike antigenicity

Authors: Gong, Shang Yu; Chatterjee, Debashree; Richard, Jonathan; Prevost, Jeremie; Tauzin, Alexandra; Gasser, Romain; Bo, Yuxia; Vezina, Dani; Goyette, Guillaume; Gendron-Lepage, Gabrielle; Medjahed, Halima; Roger, Michel; Cote, Marceline; Finzi, Andres

VIROLOGY Volume: 563 Page: 134-145

This study aims to evaluate the impact of single mutations on the overall antigenicity of selected variants and their binding to the ACE2 receptor. The authors observe a differential contribution of single mutants to the global variants phenotype related to ACE2 interaction and antigenicity. Using biolayer interferometry, they observe that enhanced ACE2 interaction is mostly modulated by a decrease in off-rate. They made the observation that the Spikes from tested emerging variants bind better to ACE2 at 37 degrees C compared to the D614G variant. Whether improved ACE2 binding at higher temperature facilitates emerging variants transmission remain to be demonstrated.

Molecular Determinants of SARS-CoV-2 Variants

Authors: Banerjee, Arinjay; Mossman, Karen; Grandvaux, Nathalie

TRENDS IN MICROBIOLOGY Volume: 29 Issue: 10 Page: 871-873

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) evolution is expected, given the nature of virus replication. Selection and establishment of variants in the human population depend on viral fitness and on molecular and immunological selection pressures. In this editorial material, the authors discuss how mechanisms of replication and recombination may contribute to the emergence of current and future variants of SARS-CoV-2.

Restricted visitation policies in acute care settings during the COVID-19 pandemic: a scoping review

Authors: Moss, Stephana J.; Krewulak, Karla D.; Stelfox, Henry T.; Ahmed, Sofia B.; Anglin, Melanie C.; Bagshaw, Sean M.; Burns, Karen E. A.; Cook, Deborah J.; Doig, Christopher J.; Fox-Robichaud, Alison; Fowler, Robert; Hernandez, Laura; Kho, Michelle E.; Kredentser, Maia; Makuk, Kira; Murthy, Srinivas; Niven, Daniel J.; Olafson, Kendiss; Parhar, Ken Kuljit S.; Patten, Scott B.; Rewa, Oleksa G.; Rochwerg, Bram; Sept, Bonnie; Soo, Andrea; Spence, Krista; Spence, Sean; Straus, Sharon; West, Andrew; Leigh, Jeanna Parsons; Fiest, Kirsten M.

CRITICAL CARE Volume: 25 Issue: 1 Article Number: 347

The objective of this scoping review is to identify impacts of restricted visitation policies in acute care settings during COVID-19, and describe perspectives and mitigation approaches among patients, families, and healthcare professionals. Restricted visitation policies impacted coping and daily function and mental health outcomes of patients, families, and healthcare professionals. Participants described a need for coping and support, connection and communication, and awareness of state of well-being. Approaches to mitigate impact of restricted visitation were identified, targeting families, patients, and healthcare professionals. The authors concluded that future pandemic policy development should include the perspectives of patients, families, and healthcare professionals.

Impact of cobas PCR Media freezing on SARS-CoV-2 viral RNA integrity and whole genome sequencing analyses

Authors: Benoit, Patrick; Point, Floriane; Gagnon, Simon; Kaufmann, Daniel E.; Tremblay, Cecile; Harrigan, Richard Paul; Hardy, Isabelle; Coutlee, Francois; Lapierre, Simon Grandjean


Freezing of primary clinical nasopharyngeal swabs and shipment to reference laboratories is usually required for sequencing. Cobas PCR Media transport medium facilitates high throughput SARS-CoV-2 RT-PCR analyses on cobas platforms. The manufacturer does not recommend freezing this transport medium. The objective of this study was to compare the quality and results of SARS-CoV-2 genomic sequencing when performed on fresh or frozen samples in cobas PCR Media. The authors conclude that freezing of cobas PCR Media does not negatively affect SARS-CoV-2 RNA sequencing results and it is therefore a suitable transport medium for outsourcing sequencing analyses to reference laboratories.

External validation of the 4C mortality score among COVID-19 patients admitted to hospital in Ontario, Canada: a retrospective study

Authors: Jones, Aaron; Pitre, Tyler; Junek, Mats; Kapralik, Jessica; Patel, Rina; Feng, Edward; Dawson, Laura; Tsang, Jennifer L. Y.; MyLinh Duong; Ho, Terence; Beauchamp, Marla K.; Costa, Andrew P.; Kruisselbrink, Rebecca

SCIENTIFIC REPORTS Volume: 11 Issue: 1 Article Number: 18638

Risk prediction scores are important tools to support clinical decision-making for patients with coronavirus disease (COVID-19). The objective of this paper was to validate the 4C mortality score, originally developed in the United Kingdom, for a Canadian population, and to examine its performance over time. The authors examined the validity of the 4C score to prognosticate in-hospital mortality. They conclude that the 4C score is a valid tool to prognosticate mortality from COVID-19 in Canadian hospitals and can be used to prioritize care and resources for patients at greatest risk of death.

COVID-19 Vaccine Perceptions and Differences by Sex, Age, and Education in 1,367 Community Adults in Ontario

Authors: Syan, Sabrina K.; Gohari, Mahmood R.; Levitt, Emily E.; Belisario, Kyla; Gillard, Jessica; DeJesus, Jane; MacKillop, James

FRONTIERS IN PUBLIC HEALTH Volume: 9 Article Number: 719665

The present study examined willingness to receive a COVID-19 vaccine, the associated reasons for willingness/unwillingness, and vaccine safety perceptions. Overall, 82.8% of the sample reported they were willing to receive a COVID-19 vaccine and 17.2% reported they were unwilling. The three most common reasons for unwillingness were long-term side effects, immediate side effects, and lack of trust in the vaccine. Perception of COVID-19 vaccine safety was significantly lower than vaccines in general and differed by age, sex and education, with females, older adults, and individuals with less than a bachelor's degree reporting lower perceived COVID-19 vaccine safety.

Ontario adults’ health behaviors, mental health, and overall well-being during the COVID-19 pandemic

Authors: Shillington, Katie J.; Vanderloo, Leigh M.; Burke, Shauna M.; Ng, Victor; Tucker, Patricia; Irwin, Jennifer D.

BMC PUBLIC HEALTH Volume: 21 Issue: 1 Article Number: 1679

The purpose of this paper is two-fold: (1) to provide an overview of Ontario adults' health behaviors (that is, physical activity, sedentary behaviors, and dietary intake), mental health, and well-being during the first few months of the COVID-19 pandemic; and (2) to explore the difference between physical activity and various health behaviors (that is, well-being, mental health, and dietary intake). Descriptive statistics indicated that respondents met physical activity and sedentary behavior guidelines, reported double the amount of recommended recreational screen time, practiced moderately healthy dietary behaviors, experienced mental health problems, and scored below “normal” in some well-being domains.

Clinical trials in COVID-19 management & prevention: A meta-epidemiological study examining methodological quality

Authors: Honarmand, Kimia; Penn, Jeremy; Agarwal, Arnav; Siemieniuk, Reed; Brignardello-Petersen, Romina; Bartoszko, Jessica J.; Zeraatkar, Dena; Agoritsas, Thomas; Burns, Karen; Fernando, Shannon M.; Foroutan, Farid; Ge, Long; Lamontagne, Francois; Jimenez-Mora, Mario A.; Murthy, Srinivas; Yepes-Nunez, Juan Jose; Vandvik, Per O.; Ye, Zhikang; Rochwerg, Bram


This study aimed to describe the characteristics of Covid-19 randomized clinical trials (RCTs) and examine the association between trial characteristics and the likelihood of finding a significant effect. The authors conducted a systematic review to identify RCTs (up to October 21, 2020) evaluating drugs or blood products to treat or prevent Covid-19. On 91 RCTs, 38 trials reported a statistically significant effect. Risk of bias (RoB) due to randomization and being a single-center trial were associated with increased odds of finding a statistically significant effect. The authors conclude that there is high variability in RoB among Covid-19 trials.

Implementation of serological and molecular tools to inform COVID-19 patient management: protocol for the GENCOV prospective cohort study

Authors: Taher, Jennifer; Mighton, Chloe; Chowdhary, Sunakshi; Casalino, Selina; Frangione, Erika; Arnoldo, Saranya; Bearss, Erin; Binnie, Alexandra; Bombard, Yvonne; Borgundvaag, Bjug; Chertkow, Howard; Clausen, Marc; Devine, Luke; Faghfoury, Hanna; Friedman, Steven Marc; Gingras, Anne-Claude; Khan, Zeeshan; Mazzulli, Tony; McGeer, Allison; McLeod, Shelley L.; Pugh, Trevor J.; Richardson, David; Simpson, Jared; Stern, Seth; Strug, Lisa; Taher, Ahmed; Lerner-Ellis, Jordan

BMJ OPEN Volume: 11 Issue: 9 Article Number: e052842

This study aims to identify characteristics of the antibody response that result in maintained immune response and better outcomes, determine the impact of genetic differences on infection severity and immune response, determine the impact of viral lineage on antibody response and patient outcomes and evaluate patient-reported outcomes of receiving host genome, antibody and viral lineage results. A prospective, observational cohort study is being conducted among adult patients with COVID-19 in the Greater Toronto Area. Blood samples are collected during infection and 1, 6 and 12 months after diagnosis. Serial antibody titres, isotype, antigen target and viral neutralisation will be assessed.


A Colorimetric Test to Differentiate Patients Infected with Influenza from COVID-19

Authors: Kozlowski, Hannah N.; Mohamed, Mohamed A. Abdou; Kim, Jisung; Bell, Natalie G.; Zagorovsky, Kyryl; Mubareka, Samira; Chan, Warren C. W.

SMALL STRUCTURES Volume: 2 Issue: 8 Article Number: 2100034

The authors develop a color-based technique to differentiate between patients infected with SARS-CoV-2 and influenza A using a nucleic acid enzyme-gold nanoparticle (GNP) molecular test requiring minimal equipment. Conserved regions of the viral genomes are targeted, and two MNAzymes are created for each virus. When detecting SARS-CoV-2 positive patients, the clinical sensitivity is 90%, and the specificity is 100%. When detecting influenza A, the clinical sensitivity and specificity are 93% and 100%, respectively. The high clinical performance of the MNAzyme-GNP assay shows that it can be used to help clinicians choose effective treatments.

Syncope and silent hypoxemia in COVID-19: Implications for the autonomic field

Authors: Baker, Jacquie; Incognito, Anthony V.; Wilson, Richard J. A.; Raj, Satish R.

AUTONOMIC NEUROSCIENCE-BASIC & CLINICAL Volume: 235 Article Number: 102842

Reports of patients presenting with syncope and pre-syncope, as well as hypoxemia without symptoms of dyspnea (“silent hypoxemia”), have led researchers to speculate whether SARS-CoV-2 can alter autonomic nervous system function. We still do not know whether syncope and silent hypoxemia are more strongly associated with COVID-19 compared to any other viral infections that severely compromise gas exchange. Therefore, in this perspective the authors discuss these two intriguing clinical presentations, as they relate to autonomic nervous system function. In their discussion, they explore COVID-specific, as well as non-COVID specific mechanisms that may affect autonomic activity and potential therapeutic targets.

Antibody and cellular therapies for treatment of covid-19: a living systematic review and network meta-analysis

Authors: Siemieniuk, Reed A. C.; Bartoszko, Jessica J.; Martinez, Juan Pablo Diaz; Kum, Elena; Qasim, Anila; Zeraatkar, Dena; Izcovich, Ariel; Mangala, Sophia; Ge, Long; Han, Mi Ah; Agoritsas, Thomas; Arnold, Donald; Avila, Camila; Chu, Derek K.; Couban, Rachel; Cusano, Ellen; Darzi, Andrea J.; Devji, Tahira; Foroutan, Farid; Ghadimi, Maryam; Khamis, Assem; Lamontagne, Francois; Loeb, Mark; Miroshnychenko, Anna; Motaghi, Sharhzad; Murthy, Srinivas; Mustafa, Reem A.; Rada, Gabriel; Rochwerg, Bram; Switzer, Charlotte; Vandvik, Per O.; Vernooij, Robin W. M.; Wang, Ying; Yao, Liang; Guyatt, Gordon H.; Brignardello-Petersen, Romina

BMJ-BRITISH MEDICAL JOURNAL Volume: 374 Article Number: n2231

This review aims to evaluate the efficacy and safety of antiviral antibody therapies and blood products for the treatment of COVID-19. Data is sourced from WHO covid-19 database, a comprehensive multilingual source of global COVID-19 literature, and six Chinese databases (up to 21 July 2021). After duplicate data abstraction, the authors performed random effects Bayesian meta-analysis, including network meta-analysis for outcomes with sufficient data. In patients with non-severe COVID-19, casirivimab-imdevimab probably reduces hospitalisation; bamlanivimab-etesevimab, bamlanivimab, and sotrovimab may reduce hospitalisation. Convalescent plasma, IVIg, and other antibody and cellular interventions may not confer any meaningful benefit.

Rising through the pandemic: a scoping review of quality improvement in public health during the COVID-19 pandemic

Authors: Yin, X. Cindy; Pang, Michelle; Law, Madelyn P.; Guerra, Fiona; O'Sullivan, Tracey; Laxer, Rachel E.; Schwartz, Brian; Khan, Yasmin


The authors conducted a scoping review of literature published January 2020 - February 2021 and focused on the topic of QI at public health agencies during the COVID-19 pandemic. The literature indicates that QI-oriented activities are occurring at the organizational and program levels to enhance COVID-19 response. To optimize the benefits that QI approaches and methodologies may offer, it is important for public health agencies to focus on both widespread integration of QI as part of an organization's management philosophy and culture, as well as project-level activities at all stages of the emergency management cycle.


Reconstructing SARS-CoV-2 infection dynamics through the phylogenetic inference of unsampled sources of infection

Authors: Perera, Deshan; Perks, Ben; Potemkin, Michael; Liu, Andy; Gordon, Paul M. K.; Gill, M. John; Long, Quan; van Marle, Guido

PLOS ONE Volume: 16 Issue: 12 Article Number: e0261422

Modern phylogenetic tools that take into account asymptomatic or undiagnosed individuals can help guide public health responses. The authors fine-tuned established phylogenetic pipelines using published SARS-CoV-2 genomic data to examine reasonable estimate transmission networks with the inference of unsampled infection sources. They were able to observe the effects of preventive measures in Canada's "Atlantic bubble" and in populations such as New York State. The tools also inferred the cross-species disease transmission of SARS-CoV-2 transmission from humans to lions and tigers in New York City's Bronx Zoo. These phylogenetic tools offer a powerful approach in response to emerging infectious disease outbreaks.

Modelling COVID-19 transmission in a hemodialysis centre using simulation generated contacts matrices

Authors: Tofighi, Mohammadali; Asgary, Ali; Merchant, Asad A.; Shafiee, Mohammad Ali; Najafabadi, Mahdi M.; Nadri, Nazanin; Aarabi, Mehdi; Heffernan, Jane; Wu, Jianhong

PLOS ONE Volume: 16 Issue: 11 Article Number: e0259970

The authors used a combination of discrete event and agent-based simulation models, to study the operations of a typical large dialysis unit and generate contact matrices to examine outbreak scenarios. They present the details of the contact matrix generation process and demonstrate how the simulation calculates a micro-scale contact matrix comprising the number and duration of contacts at a micro-scale time step. They used the contacts matrix in an agent-based model to predict disease transmission under different scenarios. The results show that micro-simulation can be used to estimate contact matrices, which can be used effectively for disease modelling in dialysis.


Dried blood spot specimens for SARS-CoV-2 antibody testing: A multi-site, multi-assay comparison

Authors: Cholette, Francois; Mesa, Christine; Harris, Angela; Ellis, Hannah; Cachero, Karla; Lacap, Philip; Galipeau, Yannick; Langlois, Marc-Andre; Gingras, Anne-Claude; Yansouni, Cedric P.; Papenburg, Jesse; Cheng, Matthew P.; Chakraborty, Pranesh; Stein, Derek R.; Van Caeseele, Paul; Bartlett, Sofia; Krajden, Mel; Goldfarb, David; McGeer, Allison; Osiowy, Carla; Hankins, Catherine; Mazer, Bruce; Drebot, Michael; Kim, John

PLOS ONE Volume: 16 Issue: 12 Article Number: e0261003

The authors present test performance data from a well-characterized SARS-CoV-2 dried blood spot (DBS) panel sent to laboratories across Canada representing 10 commercial and 2 in-house developed tests for SARS-CoV-2 antibodies. Three commercial assays identified all positive and negative DBS correctly corresponding to a sensitivity, specificity, positive predictive value, and negative predictive value of 100%. Two in-house assays also performed equally well. In contrast, several commercial assays could not achieve a sensitivity greater than 40% or a negative predictive value greater than 60%. Their findings represent the foundation for future validation studies on DBS specimens.


Good Cholesterol Gone Bad? HDL and COVID-19

Authors: Kluck, George E. G.; Yoo, Jeong-Ah; Sakarya, Emmanuel H.; Trigatti, Bernardo L.

INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES Volume: 22 Issue: 19 Article Number: 10182

The authors review the role of HDL and SR-B1 in SARS-CoV-2-induced disease, and the advances in the understanding of HDL structure, properties, and function during SARS-CoV-2 infection and the COVID-19 disease. Some studies revealed that HDL binds to SARS-CoV-2 particles via the virus's spike protein and, under certain conditions, it facilitates SARS-CoV-2 binding to angiotensin-converting enzyme 2 (ACE2) and infection of host cells. Other studies, however, reported that HDL suppressed SARS-CoV-2 infection. In both cases, the ability of HDL to enhance or suppress virus infection appears to be dependent on the expression of the HDL receptor in the target cells.


COVID-19 Seroprevalence in Canada Modelling Waning and Boosting COVID-19 Immunity in Canada a Canadian Immunization Research Network Study

Authors: Dick, David W.; Childs, Lauren; Feng, Zhilan; Li, Jing; Roest, Gergely; Buckeridge, David L.; Ogden, Nick H.; Heffernan, Jane M.

VACCINES Volume: 10 Issue: 1 Article Number: 17

COVID-19 seroprevalence changes over time. The authors use an age-structured model including infection, vaccination and waning immunity to estimate the distribution of immunity to COVID-19 in the Canadian population. This is the first mathematical model to do so. They estimate that 60-80% of the Canadian population has some immunity to COVID-19 by late Summer 2021, depending on specific characteristics of the vaccine and the waning rate of immunity. Models results indicate that increased vaccination uptake in age groups 12-29, and booster doses in age group 50+ are needed to reduce the severity COVID-19 Fall 2021 resurgence.

Surveying the local public health response to COVID-19 in Canada: Study protocol

Authors: Plante, Charles; Bandara, Thilina; Littlejohns, Lori Baugh; Sandhu, Navdeep; Anh Pham; Neudorf, Cory

PLOS ONE Volume: 16 Issue: 11 Article Number: e0259590

The purpose of this paper is to report on a study that will collect retrospective information on the local public health response to COVID-19 throughout Canada between 2020 and 2021. The goal of the study is to develop and implement a study framework that will collect retrospective information on the local public health system response to the COVID-19 pandemic in Canada. The strengths of the study protocol include the engagement of Medical Health Officers/Medical Officers of Health as research partners and a robust integrated knowledge translation approach to further public health services and systems research in Canada.

Outcomes of SARS-CoV-2-Positive Youths Tested in Emergency Departments The Global PERN-COVID-19 Study

Authors: Funk, Anna L.; Florin, Todd A.; Kuppermann, Nathan; Tancredi, Daniel J.; Xie, Jianling; Kim, Kelly; Neuman, Mark, I; Ambroggio, Lilliam; Plint, Amy C.; Mintegi, Santiago; Klassen, Terry P.; Salvadori, Marina, I; Malley, Richard; Payne, Daniel C.; Simon, Norma-Jean; Yock-Corrales, Adriana; Nebhrajani, Jasmine R.; Chaudhari, Pradip P.; Breslin, Kristen A.; Finkelstein, Yaron; Campos, Carmen; Bergmann, Kelly R.; Bhatt, Maala; Ahmad, Fahd A.; Gardiner, Michael A.; Avva, Usha R.; Shah, Nipam P.; Sartori, Laura F.; Sabhaney, Vikram J.; Caperell, Kerry; Navanandan, Nidhya; Borland, Meredith L.; Morris, Claudia R.; Gangoiti, Iker; Pavlicich, Viviana; Kannikeswaran, Nirupama; Lunoe, Maren M.; Rino, Pedro B.; Kam, April J.; Cherry, Jonathan C.; Rogers, Alexander J.; Chong, Shu-Ling; Palumbo, Laura; Angelats, Carlos M.; Morrison, Andrea K.; Kwok, Maria Y.; Becker, Sarah M.; Dixon, Andrew C.; Poonai, Naveen; Eckerle, Michelle; Wassem, Muhammad; Dalziel, Stuart R.; Freedman, Stephen B.

JAMA NETWORK OPEN Volume: 5 Issue: 1 Article Number: e2142322

This study aimed to determine what proportion of SARS-CoV-2–positive youths tested in emergency departments experience severe outcomes (i.e., intensive interventions, severe organ impairment, or death) within 14 days? Among 3221 SARS-CoV-2–positive youths enrolled in the study, 3.3% had severe outcomes within 14 days. Across a subgroup of 2510 SARS-CoV-2–positive youths discharged home after testing, 0.5% had severe outcomes during the 2-week follow-up period. The findings of this study suggest that risk factors such as age, underlying chronic illness, and symptom duration may be useful for clinicians to consider when evaluating pediatric patients with SARS-CoV-2 infection.


Governing the Access to COVID-19 Tools Accelerator: towards greater participation, transparency, and accountability

Authors: Moon, Suerie; Armstrong, Jana; Hutler, Brian; Upshur, Ross; Katz, Rachel; Atuire, Caesar; Bhan, Anant; Emanuel, Ezekiel; Faden, Ruth; Ghimire, Prakash; Greco, Dirceu; Ho, Calvin W. L.; Kochhar, Sonali; Schaefer, G. Owen; Shamsi-Gooshki, Ehsan; Singh, Jerome Amir; Smith, Maxwell J.; Wolff, Jonathan

LANCET Volume: 399 Issue: 10323 Page: 487-494

The Access to COVID-19 Tools Accelerator (ACT-A) is a multistakeholder initiative quickly constructed in the early months of the COVID-19 pandemic to respond to a catastrophic breakdown in global cooperation. The authors traced the evolution of ACT-A's governance through publicly available documents and analysed it against three principles embedded in the founding mission statement of ACT-A: participation, transparency, and accountability. They found three challenges to realising these principles. First, the roles of the various organisations in ACT-A decision-making are unclear. Second, the absence of a clearly defined decision-making body. Third, the nearly indiscernible role of governments in ACT-A.


Importance of non-pharmaceutical interventions in the COVID-19 vaccination era: A case study of the Seychelles

Authors: Vilches, Thomas N.; Sah, Pratha; Abdollahi, Elaheh; Moghadas, Seyed M.; Galvani, Alison P.

JOURNAL OF GLOBAL HEALTH Volume: 11 Article Number: 03104

With various non-pharmaceutical interventions (NPIs) in place and mounting vaccination coverage, the Seychelles suppressed COVID-19 incidence to an average of 42 daily cases from January 1 to April 15, 2021. Despite the high vaccination coverage, the country experienced a surge of COVID-19 infections soon after most NPIs were lifted in mid-April. The authors found that adoption of NPIs had been instrumental in reducing COVID-19 incidence from January to April 2021. Without NPIs, the model projected that the country would have experienced a significant early outbreak despite the rapidity of vaccination rollout. Their analysis shows that easing NPIs prematurely risks a COVID-19 resurgence.


Modelling the impact of travel restrictions on COVID-19 cases in Newfoundland and Labrador

Authors: Amy Hurford, Proton Rahman, J. Concepción Loredo-Osti

Royal Society Open Science

The authors predicted possible outbreaks over nine weeks, with and without the travel restrictions. Their results suggest that the travel restrictions reduced the mean number of clinical COVID-19 cases in NL by 92%. Without the travel restrictions, there is a substantial risk of very large outbreaks. They show how the NL COVID-19 outbreak could have unfolded had the travel restrictions not been implemented. Both physical distancing and travel restrictions affect the local dynamics of the epidemic. Their modelling shows that the travel restrictions are a plausible reason for the few reported COVID-19 cases in NL after 4 May.


Examining the impact of the early stages of the COVID-19 pandemic period on youth cannabis use: adjusted annual changes between the pre-COVID and initial COVID-lockdown waves of the COMPASS study

Authors: Scott T. Leatherdale, Richard E. Bélanger, Rabi Joël Gansaonré, Karen A. Patte, Margaret deGroh, Ying Jiang, Slim Haddad

BMC Public Health

This paper examined the effect of the early stages of the COVID-19 pandemic period on youth cannabis use in the context of a natural experiment. Results show that monthly, weekly, and daily cannabis use increased across all waves; however, the expected increases from the pre-COVID-19 wave (2019) to the initial COVID-19 period wave (2020) were lesser relative to the changes seen across the 2018 to 2019 waves. Data from May to July 2020 identified that the majority of youth who use cannabis did not report increased cannabis use due to COVID-19 or using cannabis to cope with COVID-19.


In vitro efficacy of topical ophthalmic antiseptics against SARS-CoV-2

Authors: Tina Felfeli, Samantha B Kasloff, Jay Krishnan, Sherif R El-Defrawy, Tony Mazzulli and Todd A Cutts

BMJ Open Ophthalmology

This study evaluated the virucidal efficacy and contact times for commonly used ophthalmic concentrations of povidone-iodine (PVI) and chlorhexidine gluconate (CHX) against SARS-CoV-2. It demonstrated that PVI at commonly used ophthalmic concentration of 5% has greater virucidal activity than CHX against SARS-CoV-2 in inoculated suspensions, with CHX proving to be ineffective at full concentration of 0.1% even after 30 min of contact time. These findings are in keeping with previous findings which have shown the efficacy of PVI in managing upper respiratory tract infections and suggested the use of PVI on the sinonasal and oral mucosa against the transmission of SARS-CoV-2.


Heterologous immunization with Covishield and Pfizer vaccines against SARS-CoV-2 elicits a robust humoral immune response

Authors: Ali Toloue Ostadgavahi, Ryan Booth, Gary Sisson, Nichole McMullen, Michelle Warhuus, Peter Robertson, Matthew Miller, Wanda C Allen, May El Sherif, Robert Brownlie, Darryl Falzarano and Christopher D Richardson

The Journal of Infection in Developing Countries VOL 15 NO 05

The authors characterize the neutralizing antibodies produced in two subjects who received combination immunizations against SARS-CoV-2. Both subjects exhibited increased levels of isotype IgG and IgM antibodies directed against the entire spike protein following immunizations. These antibodies also exhibited increased reactivity with the receptor binding domain in the spike protein and neutralized the infectivity of a replicating pseudovirus. Neutralizing antibodies against the pseudovirus in the 2 subjects approached levels in the convalescent positive control. These results firmly validate the value of the Pfizer-BioNTech vaccine in boosting immunity following initial Covishield inoculation.

A single dose of the SARS-CoV-2 vaccine BNT162b2 elicits Fc-mediated antibody effector functions and T cell responses

Authors: Alexandra Tauzin, Manon Nayrac, Mehdi Benlarbi, Shang Yu Gong, Romain Gasser, Guillaume Beaudoin-Bussières, Nathalie Brassard, Annemarie Laumaea, Dani Vézina, Jérémie Prévost, Sai Priya Anand, Catherine Bourassa, Gabrielle Gendron-Lepage, Halima Medjahed, Guillaume Goyette, Julia Niessl, OlivierTastet, Laurie Gokool, Chantal Morrisseau, Pascale Arlotto, Leonidas Stamatatos, Andrew T. McGuire, Catherine Larochelle, Pradeep Uchil, Maolin Lu, Walther Mothes, Gaston De Serres, Sandrine Moreira, Michel Roger, Jonathan Richard, Valérie Martel-Laferrière, Ralf Duerr, Cécile Tremblay, Daniel E. Kaufmann, Andrés Finzi

Cell Host & Microbe

To assess the mechanisms contributing to protection, the authors analyzed humoral and T cell responses three weeks after a single BNT162b2 dose. They observed weak neutralizing activity elicited in SARS-CoV-2 naive individuals but strong anti-receptor binding domain and spike antibodies with Fc-mediated effector functions. In previously infected individuals, a single dose boosted all humoral and T cell responses, with strong correlations between T helper and antibody immunity. Their results highlight the potential role of Fc-mediated effector functions and T cell responses in vaccine efficacy. They also provide support for spacing doses to vaccinate more individuals in conditions of vaccine scarcity.

Development and assessment of a hospital admissions-based syndromic surveillance system for COVID-19 in Ontario, Canada: ACES Pandemic Tracker

Authors: Nicholas Papadomanolakis-Pakis, Allison Maier, Adam van Dijk, Nancy VanStone and Kieran Michael Moore

BMC Public Health

This study aimed to describe the development and effectiveness of a real-time public health syndromic surveillance system as an early warning system and to provide situational awareness in response to the COVID-19 pandemic. The authors collected data on syndromes of interest (SOI) that may be related to COVID-19. They found a strong correlation between suspected COVID-19 (including SOI) hospital admissions and confirmed COVID-19 admissions and a stronger correlation between suspected COVID-19 (excluding SOI) admissions and confirmed COVID-19 admissions. Laboratory-confirmed COVID-19 hospital admissions lagged in reporting by 3 days compared with suspected COVID-19 admissions when SOI were excluded.

COVID-19 infection among international travellers: a prospective analysis

Authors: Meaghan Lunney, Paul E Ronksley, Robert G Weaver, Lianne Barnieh, Norman Blue, Marc T Avey, Elizabeth Rolland-Harris, Faisal M Khan, Jack X Q Pang, Ellen Rafferty, Tayler D Scory, Lawrence W Svenson, Rachel Rodin and Marcello Tonelli

BMJ Open

This report estimates the risk of COVID-19 importation and secondary transmission associated with a modified quarantine programme in Canada. All participants were required to receive a PCR COVID-19 test on arrival. If positive, participants were required to remain in quarantine for 14 days. If negative, participants could leave quarantine but were required to have a second test 6 or 7 days after arrival. 21.5 per 1000 international travellers tested positive for COVID-19. Most (69%) tested positive on arrival and 31% tested positive during follow-up. These findings suggest the need for ongoing vigilance in travellers testing negative on arrival.


CRISPR/Cas12a-mediated gold nanoparticle aggregation for colorimetric detection of SARS-CoV-2

Authors: Yiren Cao, Jinjun Wu, Bo Pang, Hongquan Zhang and X. Chris Le

Chemical Communications

CRISPR/Cas systems have been playing a special role in the detection of SARS-CoV-2. In this study, the authors report a colorimetric assay that incorporates reverse transcription loop-mediated isothermal amplification and the trans-cleavage activity of CRISPR/Cas12a to facilitate sequence-dependent aggregation of gold nanoparticles, thus achieving isothermal and visualized detection of nucleic acids. The trans-cleavage activity of the target-activated CRISPR/Cas12a liberated an RNA crosslinker from a molecular transducer, which facilitated the assembly of gold nanoparticles. Integration of the molecular transducer with isothermal amplification and CRISPR/Cas12a resulted in visual detection of the N gene and E gene of SARS-CoV-2 in 45 min.

Development and validation of an automated emergency department-based syndromic surveillance system to enhance public health surveillance in Yukon: a lower-resourced and remote setting

Authors: Etran Bouchouar, Benjamin M. Hetman and Brendan Hanley

BMC Public Health

An automated low-cost and low-resources Emergency Department syndromic surveillance system (ED-SyS) was developed and validated using data from visits between October 1, 2018, to April 30, 2019. Six syndromes were originally identified for the ED-SyS, with an additional syndrome added to assist in detecting cases of COVID-19. As expected, no records were flagged for COVID-19 from the dataset. The development and validation of automated ED-SyS in lower-resourced settings can be achieved without sophisticated platforms, intensive resources, time or costs. Validation is an important step for measuring the accuracy of syndromic surveillance, and ensuring it performs adequately in a local context.

Identification of a High-Frequency Intrahost SARS-CoV-2 Spike Variant with Enhanced Cytopathic and Fusogenic Effects

Authors: Lynda Rocheleau, Geneviève Laroche, Kathy Fu, Corina M. Stewart, Abdulhamid O. Mohamud, Marceline Côté, Patrick M. Giguère, Marc-André Langlois and Martin Pelchat


The authors profiled the intrasample genetic diversity of SARS-CoV-2 variants, using high-throughput sequencing data sets from 15,289 infected individuals and infected cell lines. Despite high mutational background, they identified recurrent intragenetic variable positions in the samples analyzed, including several positions at the end of the gene encoding the viral spike (S) protein. They observed a truncated S protein that undergoes increased processing and increased syncytium formation, presumably due to escaping M protein retention in intracellular compartments. Their findings suggest the emergence of a high-frequency viral sublineage that is not horizontally transmitted but potentially involved in intrahost disease cytopathic effects.


COVID-19 international border surveillance at Toronto’s Pearson Airport: a cohort study

Authors: Vivek Goel, David Bulir, Eric De Prophetis, Munaza Jamil, Laura C Rosella, Dominik Mertz, Cheryl Regehr and Marek Smieja

BMJ Open

The primary objective was to estimate the positivity rate of air travellers coming to Toronto in September and October 2020, on arrival and on day 7 and day 14. The secondary objectives were to estimate the degree of risk based on country of origin and to assess knowledge and attitudes towards COVID-19 control measures and subjective well-being during the quarantine period. Participants were passengers arriving on international flights. Of all passengers enrolled, 1.5% tested positive. Of these, 67% were identified on arrival, 27% on day 7, and 6% on day 14. Average well-being score declined between arrival and day 7.


Primary care teams’ experiences of delivering mental health care during the COVID-19 pandemic: a qualitative study

Authors: Rachelle Ashcroft, Catherine Donnelly, Maya Dancey, Sandeep Gill, Simon Lam, Toula Kourgiantakis, Keith Adamson, David Verrilli, Lisa Dolovich, Anne Kirvan, Kavita Mehta, Deepy Sur & Judith Belle Brown

BMC Fam Pract

This study describes the impact of the COVID-19 pandemic on primary care teams’ delivery of mental health care in Ontario. From the outset of the COVID-19 pandemic, primary care quickly responded to the rising mental health care demands of their patients. Despite the numerous challenges they faced with the rapid transition to virtual care, primary care teams have persevered. It is essential that policy and decision-makers take note of the toll that these demands have placed on providers. There is an immediate need to enhance primary care’s capacity for mental health care for the duration of the pandemic and beyond.


Detection of SARS-CoV-2 in wastewater in Halifax, Nova Scotia, Canada, using four RT-qPCR assays

Authors: D Kain, NM Stall, A McGeer, G Evans, V Allen and J Johnstone


This note reports preliminary findings from a study that is tracking SARS-CoV-2 in wastewater, with a specific focus on the use of four reverse transcriptase quantitative PCR (RT-qPCR) assays for detecting the virus in wastewater. The authors were able to detect the virus in wastewater samples during the initial rise of cases in the Halifax region. Levels of the targeted SARS-CoV-2 gene fragments increased and fell in response to reported cases of COVID-19. The CDC N1 and E RT-qPCR assays demonstrated greater relative sensitivity than the CDC N2 and N3 assays for detection of SARS-CoV-2 in raw sewage samples.


Low yield of SARS-CoV-2 Asymptomatic Routine Screen Testing, Despite High Community Incidence

Authors: D Kain, NM Stall, A McGeer, G Evans, V Allen and J Johnstone

Infect Control Hosp Epidemiol Published Jun 24, 2021

This study investigates the percent positivity of routine asymptomatic screen testing in nursing-home staff during periods of both low and high SARS-CoV-2 incidence. It shows that, during times of low SARS-CoV-2 incidence, the yield of routine asymptomatic screen testing is very low. In times of high SARS-CoV-2 incidence, positivity rose only to a peak of 0.36% in contrast to the rise in percent positivity observed in symptomatic individuals. The findings demonstrate that outside an outbreak or high-risk contact setting, the pretest probability of routine asymptomatic SARS-CoV-2 screen testing remains low, even in settings with high SARS-CoV-2 incidence.


COVID-19 Experiences, PPE, and Health Concerns in Toronto, Canada Bicycle Delivery Workers: Cross-sectional Pilot Survey

Authors: M Anne Harris and Tracy L Kirkham

Annals of Work Exposures and Health

To pilot recruitment methods for bicycle delivery workers in Toronto and to assess workers’ experiences with COVID-19 and personal protective equipment (PPE). No participants reported a diagnosis of COVID-19. However, four participants indicated experiencing symptoms. Most participants reported they used PPE, especially masks and/or respirators (97.1%) and 71.4% of participants indicated their employer provided them with PPE (masks or gloves). Participants expressed concern about precarious work and uncertainty about their own COVID-19 exposure risk. Given the essential role of bicycle delivery workers in deliveries during the COVID-19 pandemic, further work is needed to characterize exposures and risks in this population.

Centenarians and extremely old people living with frailty can elicit durable SARS-CoV-2 spike specific IgG antibodies with virus neutralization functions following virus infection as determined by serological study

Authors: Mary K. Foley, Samuel D. Searle, Ali Toloue, Ryan Booth, Alec Falkenham, Darryl Falzarano, Salvatore Rubino, Magen E. Francis, Mara McNeil, Christopher Richardson, Jason LeBlanc, Sharon Oldford, Volker Gerdts, Melissa K. Andrew, Shelly A. McNeil, Barry Clarke, Kenneth Rockwood, David J. Kelvin and Alyson A. Kelvin


The authors investigated the development of humoral immunity in centenarians following a SARS-CoV-2 outbreak in a long-term care facility. All individuals had a Clinical Frailty scale score ≥5 and were of extreme older age or were centenarians. Six women with a median age of 98.8 years tested positive for SARS-CoV-2. Anti-spike IgG antibody titers were the highest titers observed in our cohort with all IgG positive individuals having virus neutralization ability. Additionally, 5 out of the 6 positive participants had a robust IgA anti-SARS-CoV-2 response. In all 5, antibodies were detected after 60 days from initial diagnosis.


Antibody epitopes in vaccine-induced immune thrombotic thrombocytopenia

Authors: Angela Huynh, John G Kelton, Donald M Arnold, Mercy Daka and Ishac Nazy


Vaccine-induced immune thrombotic thrombocytopaenia (VITT) is a rare adverse effect of COVID-19 adenoviral vector vaccines. VITT resembles heparin-induced thrombocytopaenia (HIT) in that it is associated with platelet-activating antibodies against platelet factor 4 (PF4). The authors sought to determine the binding site on PF4 of antibodies from patients with VITT. They found that the binding of anti-PF4 antibodies from these patients was restricted to eight surface amino acids on PF4, located within the heparin-binding site, and that the binding was inhibited by heparin. Their data indicate that VITT antibodies can mimic the effect of heparin by binding to a similar site on PF4.

Optimal COVID-19 quarantine and testing strategies

Authors: Wells, Chad R.; Townsend, Jeffrey P.; Pandey, Abhishek; Moghadas, Seyed M.; Krieger, Gary; Singer, Burton; McDonald, Robert H.; Fitzpatrick, Meagan C.; Galvani, Alison P.

NATURE COMMUNICATIONS Volume: 12 Issue: 1 Article Number: 356 Published: JAN 7, 2021

The researchers developed a mathematical model to determine if the timing of testing for COVID-19, could reduce the duration of a quarantine period below the standard 14 days. They illustrate that appropriately timed testing can make shorter quarantines effective. Testing on exit (or entry and exit) can reduce the duration of a 14-day quarantine by 50%, while testing on entry shortens quarantine by at most one day.

A real-world test of their theory applied to offshore oil rig employees confirmed the model’s results. They concluded that safely reducing the necessary duration of quarantine could lessen the economic impacts of the pandemic.


COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Authors: Abdukahil, Sheryl Ann; Abe, Ryuzo; Abel, Laurent; Absil, Lara; Acker, Andrew; Adachi, Shingo; Adam, Elisabeth; Adriao, Diana; Ainscough, Kate; Hssain, Ali Ait; Tamlihat et al,

INFECTION Early Access: JUN 2021

The ISARIC prospective multinational observational study recruited 60,109 laboratory-confirmed COVID-19 patients from 43 countries to evaluate relationships of age and sex to published case definitions and most commonly reported symptoms. Results: ‘typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most frequently reported; 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds.

These symptoms were reported less frequently in children ≤ 18 years (85%), older adults ≥ 70 years: (90%), and women 90% vs men (93%) The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years confusion.


Experiences of self-care during the COVID-19 pandemic among individuals with rheumatoid arthritis: A qualitative study

Authors: Leese, Jenny; Backman, Catherine L.; Ma, Jasmin K.; Koehn, Cheryl; Hoens, Alison M.; English, Kelly; Davidson, Eileen; McQuitty, Shanon; Gavin, James; Adams, Jo; Therrien, Stephanie; Li, Linda C.


This study explored the impact of COVID-19 pandemic on self-care of individuals living with rheumatoid arthritis (RA). Participants (aged 27-73 years; 23 females) in British Columbia, Canada were interviewed on three themes: (1) Adapting to maintain self-care at home; some participants reported improved self-care. (2) Managing emotions such as keeping perspective; participants reported letting go and maintaining self-control. (3) Changing to remote communication with health professionals; participants indicated that positive relations were maintained and grew.

The findings reveal opportunities to further examine remote consultations to optimize RA patient engagement and self-care. These opportunities may also apply in other chronic illnesses.


Optimizing planning and design of COVID-19 drive-through mass vaccination clinics by simulation

Authors: Asgary, Ali; Najafabadi, Mahdi M.; Wendel, Sarah K.; Resnick-Ault, Daniel; Zane, Richard D.; Wu, Jianhong


Drive-through clinics have been widely adopted for COVID-19 vaccination. The authors used AnyLogic simulation software to illustrate how the design of mass vaccination drive throughs could be optimized. Simulations exposed the potential for avoidable bottlenecks, overflows, and queueing; they also clarified staffing requirements. Simulation results informed the target number of vaccinations and necessary processing times for different drive through station set ups and clinic formats.

The authors concluded that modern simulation tools with advanced visual and analytical capabilities could be very useful for effective planning, design, and operations management of mass vaccination facilities.


A scoping review of global vaccine certificate solutions for COVID-19

Authors: Mithani, Salima S.; Bota, A. Brianne; Zhu, David T.; Wilson, Kumanan


As the vaccines are now becoming increasingly available, measures such as vaccine certificates are being investigated and implemented around the world. The authors reviewed digital solutions for vaccine certificates, evaluating them based on purpose and use case, technological architecture, security and privacy measures, and ethical and legal implications. Technology emerged as the most dominant theme followed by ethics, travel, legal concerns, public policy, and scientific concerns. The reviewers identified eight vaccine certificate models. These models are being considered in 11 countries and are in place in 5 others.


A disproportionate epidemic: COVID-19 cases and deaths among essential workers in Toronto, Canada

Authors: Rao, Amrita; Ma, Huiting; Moloney, Gary; Kwong, Jeffrey C.; Juni, Peter; Sander, Beate; Kustra, Rafal; Baral, Stefan D.; Mishra, Sharmistha

ANNALS OF EPIDEMIOLOGY Volume: 63 Page: 63-67 Published: NOV 2021

Shelter-in-place mandates and closure of nonessential businesses have been central to COVID-19 response strategies in Canada. However, half of the working population are in essential occupations that do not allow for remote work. The writers compared per-capita rates of COVID-19 cases and deaths from January 23, 2020, to January 24, 2021, across neighborhoods in Toronto by proportion of the population working in essential services. The findings -- cumulative per-capita rates of COVID-19 cases and deaths were 3.3-fold and 2.5-fold higher, respectively, in neighborhoods with the highest concentrations of essential workers. The results highlight the need for active intervention strategies targeting essential workers.


A longitudinal dataset of incidence and intervention policy impacts regarding the COVID-19 pandemic in Canadian provinces

Authors: Keshteli, Ammar Hassanzadeh; Allen, Dana; Anjum, Afia; Patel, Yashvi; Sivakumaran, Aadhavya; Tian, Siyang; Wang, Fei; Wang, Hao; Lewis, Mark A.; Greiner, Russell; Wishart, David S.

DATA IN BRIEF Volume: 38 Article Number: 107381 Published: OCT 2021

Provincial governments across Canada have experimented with widely varying policies in order to limit the burden of COVID-19. The effectiveness of these policies has been difficult to ascertain due to the lack of a publicly available, high-quality dataset on interventions and outcomes. The paper addresses this gap by providing a Canadian-specific data set encompassing sociodemographic, climatic, mobility, and health system information for all 10 Canadian provinces. In addition, the dataset includes longitudinal data on the daily number of COVID-19 cases, deaths, and the constantly changing intervention policies that have been implemented.


Feasibility and Acceptability of Remote Physical Exercise Programs to Prevent Mobility Loss in Pre-Disabled Older Adults during Isolation Periods Such as the COVID-19 Pandemic

Authors: Buckinx, F.; Aubertin-Leheudre, M.; Daoust, R.; Hegg, S.; Martel, D.; Martel-Thibault, M.; Sirois, Marie-Josee


This study aimed to assess the feasibility and acceptability of remote physical exercise (PE) to prevent mobility loss among pre-disabled older adults. Participants followed a 12-week PE remote program in Zoom supervised groups (Web-Ex group) or phone-supervised individual booklet-based home-program (Booklet group). The total rate of adherence was 82.5% in the Web-Ex group and 85.8% in the Booklet group. The level of satisfaction 60% for Web-ex group and for 37.9% for Booklet group. Remote physical exercise via web technology or booklets with regular and personalized follow-up was proven feasible and acceptable among pre-disabled seniors.


Continuity of routine immunization programs in Canada during the COVID-19 pandemic

Authors: Sell, Hannah; Assi, Ali; Driedger, S. Michelle; Dube, Eve; Gagneur, Arnaud; Meyer, Samantha B.; Robinson, Joan; Sadarangani, Manish; Tunis, Matthew; MacDonald, Shannon E.

VACCINE Volume: 39 Issue: 39 Page: 5532-5537 Published: SEP 15, 2021

The pandemic interrupted routine immunization appointments for infants, children, adults, and older adults. The study assessed provinces and territories (P/Ts) strategies to assist the public, school programs, and maternal/prenatal programs to catch-up on missed doses and continue delivering routine immunization programs. After the initial lockdown period, all routine programs continued with adaptations. Catch-up measures included appointment rebooking and making additional clinics and/or providers available. Major challenges included staff shortages, PPE shortages, limited infrastructure, public health restrictions, and public vaccine hesitancy. The writers concluded that further research is needed to determine the measurable impact of the pandemic on routine vaccine coverage levels.


Few Canadian children and youth were meeting the 24-hour movement behaviour guidelines 6-months into the COVID-19 pandemic: Follow-up from a national study

Authors: Moore, Sarah A.; Faulkner, Guy; Rhodes, Ryan E.; Vanderloo, Leigh M.; Ferguson, Leah J.; Guerrero, Michelle D.; Brussoni, Mariana; Mitra, Raktim; O'Reilly, Norm; Spence, John C.; Chulak-Bozzer, Tala; Tremblay, Mark S.

APPLIED PHYSIOLOGY NUTRITION AND METABOLISM Volume: 46 Issue: 10 Page: 1225-1240 Published: OCT 2021

This study assessed movement behaviours in Canadian children and youth 6 months into the pandemic compared with the start-up. The survey assessed changes in movement behaviours -- physical activity and play, sedentary behaviours, and sleep -- from before the pandemic to October 2020. During the second wave, 4.5% of children and 1.9% of youth met the movement guidelines (3.1% overall). Whereas, during the first wave, 4.8% of children and 0.6% of youth were meeting combined guidelines (2.6% overall). This study demonstrates the ongoing challenges to engage children and youth in healthy movement during the pandemic.


Organizational factors associated with health worker protection during the COVID-19 pandemic in four provinces of South Africa

Authors: Zungu, Muzimkhulu; Voyi, Kuku; Mlangeni, Nosimilo; Moodley, Saiendhra Vasudevan; Ramodike, Jonathan; Claassen, Nico; Wilcox, Elizabeth; Thunzi, Nkululeko; Yassi, Annalee; Spiegel, Jerry; Malotle, Molebogeng

BMC HEALTH SERVICES RESEARCH Volume: 21 Issue: 1 Article Number: 1080 Published: OCT 11, 2021

This study assessed how South Africa protected its health workers from infection in 45 hospitals. A semi-structured questionnaire and a qualitative observational risk assessment was undertaken. The writers found that all of the health facilities had COVID-19 plans but no comprehensive occupational health and safety plan for health workers. None of the facilities had an acceptable HealthWISE compliance score (>= 75%) due to poor ventilation and inadequate administrative control measures. While the supply of personal protective equipment was adequate, it was often worn improperly. The analysis showed that hospitals with higher compliance scores had significantly lower infection rates.


Aging, Social Distancing, and COVID-19 Risk: Who is more Vulnerable and Why?

Authors: Faraji, Jamshid; Metz, Gerlinde A. S.

AGING AND DISEASE Volume: 12 Issue: 7 Page: 1624-1643 Published: OCT 2021

The authors examined alternatives to social isolation during pandemics. They offer insights to new social relationship strategies that would help build resilience in our aging population during pandemics. The moderating role of personalized social relationships has the potential to: influence stress resilience; reduce the wear and tear of chronic stress; and reduce vulnerability to infection and adverse health outcomes. The authors concluded that gaining a more in depth understanding of how social support mechanisms enhance resilience to stress and promote mental and physical health will enable development of new preventive strategies for future generations.


Neuroimmune multi-hit perspective of coronaviral infection

Authors: Hayley, Shawn; Sun, Hongyu

JOURNAL OF NEUROINFLAMMATION Volume: 18 Issue: 1 Article Number: 231 Published: OCT 13, 2021

Over one’s life, environmental stressors such as microbial infections, chemical toxicants, and psychological stressors can ultimately shape central nervous system (CNS) functioning and contribute to its eventual breakdown. This review assessed the COVID-19 pandemic through the lens of a multi-hit framework impacting the brain. The writers identify emerging evidence suggesting the possibility of microglial or other inflammatory factors as potentially contributing to neurodegenerative illnesses. They also identify evidence of psychosocial stress contributing to a substantial upswing in depression, anxiety and eating disorders. In coming years, the aforementioned may be matched by a spike in dementia, motor and cognitive neurodegenerative diseases.


Acute Hypoxemic Respiratory Failure in Children at the Start of COVID-19 Outbreak: A Nationwide Experience

Authors: Lopez-Fernandez, Yolanda M.; Martinez-de-Azagra, Amelia; Gonzalez-Gomez, Jose M.; Perez-Caballero Macarron, Cesar; Garcia-Gonzalez, Maria; Parrilla-Parrilla, Julio; Minambres-Rodriguez, Maria; Madurga-Revilla, Paula; Gomez-Zamora, Ana; Rodriguez-Campoy, Patricia; Mayordomo-Colunga, Juan; Butragueno-Laiseca, Laura; Nunez-Borrero, Rocio; Gonzalez-Martin, Jesus M.; Slutsky, Arthur S.; Villar, Jesus

JOURNAL OF CLINICAL MEDICINE Volume: 10 Issue: 19 Article Number: 4301 Published: OCT 2021

This observational study compared the physiological characteristics, respiratory management, and outcomes of children with acute hypoxemic respiratory failure (AHRF) with those affected by COVID-19. All non-COVID-19 patients ultimately experienced severe pediatric acute respiratory distress syndrome. Conversely, a small proportion of the COVID-19 group had mild or moderate pediatric acute respiratory distress syndrome. Conclusions: Children with AHRF due to COVID-19 had fewer comorbidities and better oxygen supply than patients with non-COVID-19 AHRF. In this study, progression to severe pediatric acute respiratory distress syndrome was rarely observed in children with COVID-19.


Syndromic surveillance using monthly aggregate health systems information data: methods with application to COVID-19 in Liberia

Authors: Fulcher, Isabel R.; Boley, Emma Jean; Gopaluni, Anuraag; Varney, Prince F.; Barnhart, Dale A.; Kulikowski, Nichole; Mugunga, Jean-Claude; Murray, Megan; Law, Michael R.; Hedt-Gauthier, Bethany

INTERNATIONAL JOURNAL OF EPIDEMIOLOGY Volume: 50 Issue: 4 Page: 1091-1102 Published: AUG, 2021

In Liberia, proactive measures to inform local public health responses to the pandemic have been hindered by limited access to COVID-19 diagnostic tests and testing infrastructure. The researchers developed surveillance tools to analyse aggregated health facility data on COVID-19-related indicators in seven low- and middle-income countries (LMICs), including Liberia.

Conclusions: Syndromic surveillance can be used to monitor health facility catchment areas for spikes in specific symptoms which may indicate COVID-19 circulation. The developed methods coupled with existing infrastructure for routine health data systems can be used to monitor a variety of indicators and other infectious diseases with epidemic potential.


Estimated impact of COVID-19 on preventive care service delivery: an observational cohort study

Authors: Laing, Scott; Johnston, Sharon

BMC HEALTH SERVICES RESEARCH Volume: 21 Issue: 1 Article Number: 1107 Published: OCT 16, 2021

COVID-19 caused significant healthcare service disruptions. This study assessed preventive care screening rates at three primary care clinics in Ottawa, Ontario.

Results: Screenings decreased in all three areas: cervical cancer 7.5%; colorectal cancer 8.1%, and type 2 diabetes 4.5%. These decreases equate to 288,000 cervical cancer, 326,000 colorectal cancer, and 274,000 type 2 diabetes screenings. Nationally the deficits potentially triple. Virtual care and reopening measures have not restored services. Electronic medical record data could be employed to improve screening via panel management.


SARS-CoV-2 Nonstructural Protein 1 Inhibits the Interferon Response by Causing Depletion of Key Host Signaling Factors

Authors: Kumar, Anil; Ishida, Ray; Strilets, Tania; Cole, Jamie; Lopez-Orozco, Joaquin; Fayad, Nawell; Felix-Lopez, Alberto; Elaish, Mohamed; Evseev, Danyel; Magor, Katharine E.; Mahal, Lara K.; Nagata, Les P.; Evans, David H.; Hobman, Tom C.

JOURNAL OF VIROLOGY Volume: 95 Issue: 13 Article Number: e00266-21 Published: JUL 2021

Earlier studies have shown that several SARS-CoV-2 proteins can provoke the interferon (IFN) response, but the mechanisms employed to do so are not well understood. This study describes two novel mechanisms by which SARS-CoV-2 blocks the IFN pathway. In the absence of other viral proteins, non-structural protein 1 (NSP1) or nucleocapsid in proteins was able to block IFN induction, and inhibit IFN signaling. Mapping studies suggest that NSP1 prevents IFN induction in part by blocking IRF3 phosphorylation. In addition, NSP1-induced depletion of Tyk2 and STAT2 dampened ISG induction. This data provides new insights into how SARS-CoV-2 successfully evades the IFN system to establish infection.


Nodosome Inhibition as a Novel Broad-Spectrum Antiviral Strategy against Arboviruses, Enteroviruses, and SARS-CoV-2

Authors: Limonta, Daniel; Dyna-Dagman, Lovely; Branton, William; Mancinelli, Valeria; Makio, Tadashi; Wozniak, Richard W.; Power, Christopher; Hobman, Tom C.

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY Volume: 65 Issue: 8 Article Number: e00491-21 Published: AUG 2021

In the present report, researchers describe two small molecules with broad-spectrum antiviral activity. These drugs block the formation of the nodosome. A drug that targets NOD2 was shown to have potent broad-spectrum antiviral activity against other flaviviruses, alphaviruses, enteroviruses, and SARS-CoV-2. Another drug that inhibits receptor-interacting serine/threonine protein kinase 2 (RIPK2), also decreased the replication of these pathogenic RNA viruses. The broad-spectrum action of nodosome-targeting drugs is mediated in part by the enhancement of the interferon response. Together, these results suggest that further preclinical investigation of nodosome inhibitors as potential broad-spectrum antivirals is warranted.


Construction of a Non-infectious SARS-CoV-2 Replicon for Antiviral-Drug Testing and Gene Function Studies

Authors: Hai Trong Nguyen; Falzarano, Darryl; Gerdts, Volker; Liu, Qiang

JOURNAL OF VIROLOGY Volume: 95 Issue: 18 Article Number: e00687-21 Published: SEP, 2021

This study involved development a SARS-CoV-2 replicon system with a sensitive and easily quantifiable reporter. Unlike studies involving infectious SARS-CoV-2 virus that must be performed in a biosafety level 3 (BSL3) facility, the replicon is non-infectious and can be safely used in BSL2 laboratories. The study illustrated that remdesivir, a U.S. Food and Drug Administration-approved antiviral drug, significantly inhibited the replication of the replicon, providing proof of principle for the application of the replicon as a useful tool for developing antivirals. The replicon will serve as a valuable tool for testing antiviral drugs and studying SARS-CoV-2 biology.


From nobody's clapping for us to bad moms: COVID-19 and the circle of childcare in Canada

Authors: Smith, Julia


This paper adopted a circle of care framework to determine how COVID-19 affected three childcare sectors -- paid childcare educators, unpaid childcare workers (mostly mothers), and other paid work. Educators reported that their safety was not prioritized, and their contributions undervalued. Mothers lost income due to care demands and struggled to access necessities; some reported increased personal insecurity, guilt, and distress. The researchers concluded that the childcare policy in British Columbia failed to recognize these impacts. The writers recommended pandemic recovery and preparedness policies that promote gender equality and consider all sectors of childcare.


Guidance for the design and reporting of studies evaluating the clinical performance of tests for present or past SARS-CoV-2 infection

Authors: Doust, Jenny A.; Bell, Katy J. L.; Leeflang, Mariska M. G.; Dinnes, Jacqueline; Lord, Sally J.; Mallett, Sue; van de Wijgert, Janneke H. H. M.; Sandberg, Sverre; Adeli, Khosrow; Deeks, Jonathan J.; Bossuyt, Patrick M.; Horvath, Andrea R.

BMJ-BRITISH MEDICAL JOURNAL Volume: 372 Article Number: n568 Published: MAR 29, 2021

The authors reviewed over 1700 preprints and peer reviewed journal articles evaluating tests for SARS-CoV-2 infection. Numerous methodological issues were identified including high risk of bias and difficulties applying the results in practice. The authors propose guidance to improve the conduct and interpretation of these studies. This includes: principles for future research; purpose of the test; study population selection; reference standard, test timing; critical considerations for design, reporting, and interpretation of diagnostic accuracy studies; clinical performance; and test limitations. This will assist publishers and peer reviewers assess the studies, and support clinicians and policy makers in their decision making.


Cultural contexts during a pandemic: a qualitative description of cultural factors that shape protective behaviours in the Chinese Canadian community

Authors: Lee, Charlotte T.; Kanji, Rahim; Wang, Angel H.; Mamuji, Aaida; Rozdilsky, Jack; Chu, Terri

BMC PUBLIC HEALTH Volume: 21 Issue: 1 Article Number: 1897 Published: OCT 20, 2021

This study examined how cultural factors shaped protective health behaviours in the Chinese Canadian community in Toronto, Canada. Factors such as collectivism, information seeking behaviour, symbolism of masks, and previous experience with SARS drove early adoption of personal protective behaviours in the community during the first wave of COVID-19. These behaviours preceded the first nation-wide lockdown in Canada that included physical distancing, mask use, and self-quarantine. These findings have implications for the development of future public health interventions and campaigns targeting personal protective behaviours in this population and other ethnic minority populations with similar characteristics.


Remote cognitive and behavioral assessment: Report of the Alzheimer Society of Canada Task Force on dementia care best practices for COVID-19

Authors: Geddes, Maiya R.; O'Connell, Megan E.; Fisk, John D.; Gauthier, Serge; Camicioli, Richard; Ismail, Zahinoor

ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING Volume: 12 Issue: 1 Article Number: e12111 Published: September 22, 2020

Despite the urgent need for remote neurobehavioral assessment of individuals with cognitive impairment, guidance is lacking. The paper provides a multi-dimensional framework for remotely assessing cognitive, functional, behavioral, and physical aspects of people with cognitive impairment.

Remote assessment was found to be acceptable to patients and caregivers. Similarly, informed consent, informant history, and attention to privacy and autonomy are paramount. A range of screening and domain-specific instruments are available for telephone or video assessment of cognition, function, and behavior. Aspects of the remote dementia-focused neurological examination can be performed reliably. Some neuropsychological tests administered by videoconferencing require further development.


Assessment of the Burden of SARS-CoV-2 Variants of Concern Among Essential Workers in the Greater Toronto Area, Canada

Authors: Chagla, Zain; Ma, Huiting; Sander, Beate; Baral, Stefan D.; Moloney, Gary; Mishra, Sharmistha

JAMA NETWORK OPEN Volume: 4 Issue: 10 Published: OCT 19, 2021

Towards the end of 2020, variants of concern (VOCs) of SARS-CoV-2 emerged replacing the wildtype. The study assessed the impact of these VOCs on two of the most populous neighborhoods in the City of Toronto and Region of Peel, characterized by a larger proportion of frontline essential workers, and higher density contact networks. Study results identified a rapid mirroring of wildtype epidemics, suggesting an association between essential work, income, and COVID-19 burden, that may be magnified by more transmissible variants. Reducing SARS-CoV-2 transmission and the associated morbidity and mortality necessitates tailored and equitable intervention strategies including vaccine prioritization and outreach services.


Resistance of SARS-CoV-2 beta and gamma variants to plasma collected from Canadian blood donors during the spring of 2020

Authors: Drews, Steven J.; Abe, Kento T.; Hu, Queenie; Samson, Reuben; Gingras, Anne-Claude; Colwill, Karen; Rathod, Bhavisha; Wang, Jenny; Fazel-Zarandi, Mahya; Yi, Qi-Long; Robinson, Alyssia; Wood, Heidi; Tuite, Ashleigh; Fisman, David; Evans, David H.; Lin, Yi-Chan J.; O'Brien, Sheila F.

TRANSFUSION Early Access: OCT 18, 2021

This pilot study assessed the ability of plasma collected from Canadian blood donors in the first wave of the SARS-CoV-2 pandemic to neutralize later SARS-CoV-2 variants of concern (VOCs).

Selected plasma specimens were assessed for neutralization against VOCs using pseudotyped lentivirus inhibition assays as well as a plaque reduction neutralization test 50% (PRNT50). The preliminary data from research results justifies limiting the use of first wave plasma products in upcoming clinical trials. However, the results should not be used to speculate on general trends in the immunity of Canadian blood donors to SARS-CoV-2.


Cancer Treatment During COVID-19: A Qualitative Analysis of Patient-Perceived Risks and Experiences with Virtual Care

Authors: Lesley, Gotlib Conn; Tahmasebi, Houman; Meti, Nicholas; Wright, Frances C.; Thawer, Alia; Cheung, Matthew; Singh, Simron

JOURNAL OF PATIENT EXPERIENCE Volume: 8 Article Number: 23743735211039328 Published: AUG 31, 2021

As the pandemic evolved, most cancer centers shifted from in-person to virtual cancer care. This study assessed cancer patient-perceived COVID-19 risks and the perceived value of virtual care. Focus groups found that most participants worried more about treatment delays than they did about COVID-19 infection. Most participants accepted virtual care for some appointment types; however, preference for in-person care was found to sustain the humanistic and therapeutic aspects of cancer care that many participants valued. Nuances in the appropriateness and adequacy of virtual cancer care still need exploration. Preserving the humanistic aspects of care is of paramount importance.


Is talk cheap? Correspondence between self-attributions about changes in drinking and longitudinal changes in drinking during the coronavirus disease 2019 pandemic

Authors: Minhas, Meenu; Belisario, Kyla; Gonzalez-Roz, Alba; Halladay, Jillian; Morris, Vanessa; Keough, Matthew; Murphy, James; MacKillop, James


This study examined changes in drinking behaviour during the pandemic, namely increases/decreases/no change, and the magnitude of changes. Self-reporting about changes in drinking largely paralleled changes in weekly drinking days (DD). Individuals' who self-reported increases in drinking exhibited significant increases; they also showed significant increases in depression and post-traumatic stress disorder symptoms. Individuals' who self-reported decreases exhibited significant decreases; and individuals who self-reported no change showed nonsignificant changes. Conclusions: Self-reporting closely corresponds with longitudinal changes in drinking. These findings support the validity of self-attributions in population-level surveys, particularly in young adults.


Does COVID-19 influence the sympathetic regulation of blood pressure?

Authors: Petterson, Jennifer L.; McPhee, Breanna N.; Wu, Yanlin; O'Brien, Myles W.


This study explored autonomic nerve system dysfunction and systemic haemodynamics (blood flow) in young, otherwise healthy adults recently infected with SARS-CoV-2 (COV+). Muscle sympathetic nerve activity (MSNA), heart rate variability (HRV) and systemic haemodynamics were measured. The COV+ participants exhibited higher resting MSNA burst frequency (in bursts per minute), burst incidence (in bursts per 100 heartbeats) and total MSNA activity (as total burst area per minute) compared with control subjects. Both groups had similar resting heart rate, systolic and diastolic blood pressure. These research outcomes may have implications for the development of neurocardiovascular conditions resulting from SARS-CoV-2 infection.


Children's Sleep During COVID-19: How Sleep Influences Surviving and Thriving in Families

Authors: MacKenzie, Nicole E.; Keys, Elizabeth; Hall, Wendy A.; Gruber, Reut; Smith, Isabel M.; Constantin, Evelyn; Godbout, Roger; Stremler, Robyn; Reid, Graham J.; Hanlon-Dearman, Ana; Brown, Cary A.; Shea, Sarah; Weiss, Shelly K.; Ipsiroglu, Osman; Witmans, Manisha; Chambers, Christine T.; Andreou, Pantelis; Begum, Esmot; Corkum, Penny

JOURNAL OF PEDIATRIC PSYCHOLOGY Volume: 46 Issue: 9 Page: 1051-1062 Published: OCT, 2021

The researchers studied sleep changes during the first wave of the pandemic in children who had previously been identified as having sleep problems.

Participating families had previously taken part in the Better Nights, Better Days (BNBD) randomized controlled trial. Approximately 40% of parents perceived their child's sleep had worsened due to increased screen time, anxiety, and decreased exercise. Findings from semi-structured interviews highlighted the effect of disrupted routines on sleep and stress, and that stress reciprocally influenced children's and parents' sleep. It was concluded that eHealth interventions, such as BNBD with modifications that address the COVID-19 context, could help families address these challenges.


Self-rated mental health among sexual health service clients during the first months of the COVID-19 pandemic, British Columbia, Canada

Authors: Salway, Travis; Ablona, Aidan; Chang, Hsiu-Ju; Watt, Sarah; Worthington, Catherine; Grace, Daniel; Wong, Jason; Ogilvie, Gina; Grennan, Troy; Gilbert, Mark

PREVENTIVE MEDICINE Volume: 153 Article Number: 106789 Published: DEC, 2021

The research team investigated self-reported mental health among sexual health clients from March-May 2020, using a survey of HIV-testing and sexual health service clients from British Columbia, Canada. Over half (55%) reported their mental health as poor at the beginning of the COVID-19 pandemic, more than double that of the general Canadian population in the same period (22%). Acknowledging that this burden of poor mental health that is likely to persist in the coming years, the researchers propose that sexual health clinics should ease access to mental health supports as a low barrier point of primary care contact.


Perfectionistic Cognitions Pre-Pandemic Predict Greater Anxiety Symptoms During the Pandemic Among Emerging Adults: A Two-Wave Cross-Lagged Study

Authors: Molnar, Danielle S.; Methot-Jones, Tabitha; Moore, Jessy; O'Leary, Deborah D.; Wade, Terrance J.


This study examined the associations between perfectionistic cognitions, anxiety, and depression pre-pandemic to during the pandemic in a sample of emerging adults. Results demonstrated that perfectionistic cognitions decreased; anxiety increased; and depressive symptoms did not change pre-pandemic or during the pandemic. These results support assertions that individuals with heightened levels of perfectionism are at an increased risk for poorer mental health during the pandemic. These findings underscore the importance of assessing perfectionistic cognitions for the prevention and treatment of anxiety symptoms among emerging adults during and post-pandemic.


A pre-pandemic COVID-19 assessment of the costs of prevention and control interventions for healthcare associated infections in medical and surgical wards in Quebec

Authors: Tchouaket Nguemeleu, Eric; Robins, Stephanie; Boivin, Sandra; Sia, Drissa; Kilpatrick, Kelley; Dubreuil, Bruno; Larouche, Catherine; Parisien, Natasha; Letourneau, Josiane

ANTIMICROBIAL RESISTANCE AND INFECTION CONTROL Volume: 10 Issue: 1 Article Number: 150 Published: OCT 21, 2021

This study examined in two Quebec hospitals the economic costs and benefits of clinical best practices (CBPs) for: category i) handwashing, screening, hygiene and sanitation of surfaces and equipment; category ii) donning and removing personal protective equipment. Conclusions: The median costs for category 1) actions were low, from 20 cents to $4.1 per action; for category ii) 76 cents per action. This study supplies evidence-based arguments supporting the allocation of resources to infection prevention and control practices that directly affect the safety of patients, healthcare workers and the public. Further research of costing clinical best care practices is recommended.


Multicenter Postimplementation Assessment of the Positive Predictive Value of SARS-CoV-2 Antigen-Based Point-of-Care Tests Used for Screening of Asymptomatic Continuing Care Staff

Authors: Jamil N. Kanji, Dustin T. Proctor, William Stokes, Byron M. Berenger, James Silvius, Graham Tipples, A. Mark Joffe, Allison A. Venner

The authors evaluated the positive predictive value (PPV) of two antigen-based point-of-care tests, Abbott Panbio and BD Veritor, used in the asymptomatic screening of SARS-CoV-2 among health care workers at continuing care sites across Alberta, Canada. On-site testing occurred on a weekly or twice-weekly basis. Positive tests were confirmed with a real-time reverse transcriptase PCR reference method. It resulted in a very low detection rate and a high rate of detection of false positives: 0.12% tests were positive, 0.05% were confirmed as true positives. Use of the Veritor and Panbio resulted in PPVs of 23.4 and 70.0%, respectively.


Child and family factors associated with child mental health and well-being during COVID-19 (Euro Child Adolsc Psych Jul 24, 2021)

Brae Anne McArthur, Nicole Racine, Sheila McDonald, Suzanne Tough & Sheri Madigan

European Child & Adolescent Psychiatry (2021)

This study identified the most salient child and family factors associated with children’s mental health and well-being during the COVID-19 pandemic, after controlling for pre-pandemic mental health. It included 846 mother–child dyads (child age 9–11). After controlling for pre-pandemic anxiety, connectedness to caregivers, child sleep, and child screen time predicted child COVID-19 anxiety symptoms. After controlling for pre-pandemic depression, connectedness to caregivers and screen time predicted child COVID-19 depressive symptoms. After controlling for covariates, connectedness to caregivers predicted child COVID-19 happiness. Fostering parent–child connections and promoting healthy device and sleep habits are factors to consider in post-pandemic mental health recovery planning.


Repeat virological and serological profiles in hospitalized patients initially tested by nasopharyngeal RT-PCR for SARS-CoV-2

Noah Reich,Christopher F. Lowe,David Puddicombe,Nancy Matic,Jesse Greiner,Janet Simons,Victor Leung,Terry Chu,Hiten Naik,Nick Myles,Laura Burns,Marc G. Romney,Gordon Ritchie,Sylvie Champagne,Kent Dooley,Inna Sekirov,Aleksandra Stefanovic

Wide ranges of false-negative real-time polymerase chain reaction (PCR) tests for SARS-CoV-2 have been reported depending on clinical presentation, the timing of testing, specimens tested, testing method, and reference standard used. This study estimated the frequency of discordance between initial nasopharyngeal (NP) PCR and repeat NP sampling PCR and/or serology in acutely ill patients admitted to the hospital. Panel diagnosis was further utilized. Discordance was a rare occurrence. The percent agreement between initial and repeat PCR was 96.7%. It was 98.9% between initial PCR and serology. There were 3.1% discordant cases, 1.4% true cases tested negative on initial PCR.


SARS-CoV-2 Nonstructural Protein 1 Inhibits the Interferon Response by Causing Depletion of Key Host Signaling Factors

Authors: Kumar, Anil; Ishida, Ray; Strilets, Tania; Cole, Jamie; Lopez-Orozco, Joaquin; Fayad, Nawell; Felix-Lopez, Alberto; Elaish, Mohamed; Evseev, Danyel; Magor, Katharine E.; Mahal, Lara K.; Nagata, Les P.; Evans, David H.; Hobman, Tom C.

JOURNAL OF VIROLOGY Volume: 95 Issue: 13 Article Number: e00266-21

This study describes two mechanisms by which SARS-CoV-2 blocks the interferon (IFN) pathway to establish infection. Type I IFNs and IFN-stimulated genes (ISGs) were poorly induced during SARS-CoV-2 infection, and once infection was established, cells were highly resistant to ectopic induction of IFNs and ISGs. Levels of two key IFN signaling pathway components, Tyk2 and STAT2, were significantly lower in SARS-CoV-2-infected cells. Expression of nonstructural protein 1 (NSP1) or nucleocapsid in the absence of other viral proteins was sufficient to block IFN induction, but only NSP1 was able to inhibit IFN signaling. Mapping studies suggest that NSP1 prevents IFN induction in part by blocking IRF3 phosphorylation. NSP1-induced depletion of Tyk2 and STAT2 dampened ISG induction.


Construction of a Noninfectious SARS-CoV-2 Replicon for Antiviral-Drug Testing and Gene Function Studies

Authors: Hai Trong Nguyen; Falzarano, Darryl; Gerdts, Volker; Liu, Qiang

JOURNAL OF VIROLOGY Volume: 95 Issue: 18 Article Number: e00687-21

The authors constructed a noninfectious and biosafety level 2 (BSL2)-compatible SARS-CoV-2 replicon in a bacterial artificial chromosomal (BAC) vector by reverse genetics. Upon transfecting the SARS-CoV-2 replicon BAC plasmid DNA into Vero E6 cells, the replicon replication was demonstrated. Deleting nonstructural protein 15 or mutating its catalytic sites significantly reduced replicon replication, whereas providing the nucleocapsid protein in trans-enhanced replicon replication. This study showed that the antiviral drug remdesivir significantly inhibited the replicon replication. This study established a sensitive and BSL2-compatible reporter system in a single BAC plasmid for investigating the functions of SARS-CoV-2 proteins in viral replication and evaluating antiviral compounds.


A small number of early introductions seeded widespread transmission of SARS-CoV-2 in Quebec, Canada

Authors: Murall, Carmen Lia; Fournier, Eric; Galvez, Jose Hector; N'Guessan, Arnaud; Reiling, Sarah J.; Quirion, Pierre-Olivier; Naderi, Sana; Roy, Anne-Marie; Chen, Shu-Huang; Stretenowich, Paul; Bourgey, Mathieu; Bujold, David; Gregoire, Romain; Lepage, Pierre; St-Cyr, Janick; Willet, Patrick; Dion, Rejean; Charest, Hugues; Lathrop, Mark; Roger, Michel; Bourque, Guillaume; Ragoussis, Jiannis; Shapiro, B. Jesse; Moreira, Sandrine

GENOME MEDICINE Volume: 13 Issue: 1 Article Number: 169

By combining phylogenetic and phylodynamic analyses with epidemiological data, the authors investigated the arrival of SARS-CoV-2 to Quebec. They estimated approximately 600 independent introduction events into Quebec, the majority of which happened from spring break until 2 weeks after the Canadian border closed for non-essential travel. Most of the introductions were inferred to have originated from Europe via the Americas, which is consistent with common spring break and “snowbird” destinations. Fewer than 100 viral introductions arrived during spring break, of which 7–12 led to the largest transmission lineages of the first wave (accounting for 52–75% of all sequenced infections).


Mechanistic insights into COVID-19 by global analysis of the SARS-CoV-2 3CL(pro) substrate degradome

Authors: Pablos, Isabel; Machado, Yoan; de Jesus, Hugo C. Ramos; Mohamud, Yasir; Kappelhoff, Reinhild; Lindskog, Cecilia; Vlok, Marli; Bell, Peter A.; Butler, Georgina S.; Grin, Peter M.; Cao, Quynh T.; Nguyen, Jenny P.; Solis, Nestor; Abbina, Srinivas; Rut, Wioletta; Vederas, John C.; Szekely, Laszlo; Szakos, Attila; Drag, Marcin; Kizhakkedathu, Jayachandran N.; Mossman, Karen; Hirota, Jeremy A.; Jan, Eric; Luo, Honglin; Banerjee, Arinjay; Overall, Christopher M.

CELL REPORTS Volume: 37 Issue: 4 Article Number: 109892

The viral protease (3CL(pro)) is indispensable for SARS-CoV-2 replication. This study delineates the human protein substrate landscape of 3CL(pro). It identified more than 100 substrates in human lung and kidney cells supported by analyses of SARS-CoV-2-infected cells. It shows that 3CL(pro) targets the Hippo pathway, including inactivation of MAP4K5, and key effectors of transcription, mRNA processing, and translation. In post-mortem COVID-19 lung samples, NDP52 rarely colocalizes with galectin-8, unlike in healthy lungs. The 3CL(pro) substrate degradome establishes a foundational substrate atlas to accelerate exploration of SARSCoV-2 pathology and drug design.


Evaluation of the relative virulence of novel SARS-CoV-2 variants: a retrospective cohort study in Ontario, Canada

Authors: Fisman, David N.; Tuite, Ashleigh R.

CANADIAN MEDICAL ASSOCIATION JOURNAL Volume: 193 Issue: 42 Page: E1619-E1625

Using a retrospective cohort of people in Ontario who tested positive for SARS-CoV-2 and were screened for variants of concern (VOCs) between February and June 2021, this study evaluated the virulence of these VOCs, i.e., those with the N501Y mutation (Alpha, Beta and Gamma variants) and then the Delta variant compared with non-VOC SARS-CoV-2 strains. Compared with non-VOC strains, the adjusted elevation in risk associated with N501Y-positive variants was 52% for hospitalization, 89% for ICU admission and 51% for death. For the Delta variant, it was 108% for hospitalization, 235% for ICU admission and 133% for death.


Incidence and Outcomes of Acute Kidney Injury in Patients Admitted to Hospital With COVID-19: A Retrospective Cohort Study

Authors: Pitre, Tyler; Dong, Angela (Hong Tian); Jones, Aaron; Kapralik, Jessica; Cui, Sonya; Mah, Jasmine; Helmeczi, Wryan; Su, Johnny; Patel, Vivek; Zia, Zaka; Mallender, Michael; Tang, Xinxin; Webb, Cooper; Patro, Nivedh; Junek, Mats; MyLinh, Duong; Ho, Terence; Beauchamp, Marla K.; Costa, Andrew P.; Kruisselbrink, Rebecca; Tsang, Jennifer L. Y.; Walsh, Michael

CANADIAN JOURNAL OF KIDNEY HEALTH AND DISEASE Volume: 8 Article Number: 20543581211027759

This study determined the incidence of acute kidney injury (AKI) in 815 patients with COVID-19 admitted to medicine and ICU wards between March 4, 2020, and April 23, 2021, its association with in-hospital mortality, and disease severity. The authors staged AKI based on the KDIGO system. A total of 439 patients developed AKI (57.6% presented with AKI, and 42.4% developed AKI in-hospital). The odds of ICU admission, mechanical ventilation, and death increased as the AKI stage worsened. Stage 3 AKI that occurred during hospitalization increased the odds of death. Stage 3 AKI that occurred prior to hospitalization carried an increased odd of death.


Psychological and Demographic Determinants of Substance Use and Mental Health During the COVID-19 Pandemic (Front Public Health Jun 25, 2021)

Fatima Mougharbel, Hugues Sampasa-Kanyinga, Brandon Heidinger, Kim Corace, Hayley A. Hamilton, Gary S. Goldfield

Frontiers in Public Health, 25 June 2021

This study examined whether sociodemographic and COVID-19-related worries are associated with combinations of alcohol consumption and comorbid psychological distress variables among a Canadian sample of adults who participated in a survey in May 2020. Four multivariate ordinal logistic regression models were used to estimate the odds of binge drinking, increased alcohol consumption during the pandemic, and psychological distress. It identified several demographic and COVID-related worries for increased odds of alcohol intake and co-morbid psychological distress during the COVID-19 pandemic, including identifying as a woman, high income groups, being divorced, separated or widowed, and experiencing financial worries and COVID illness worries.


On testing for infections during epidemics, with application to Covid-19 in Ontario, Canada (Infect Dis Model Jul 22, 2021)

Jerald F.Lawless, Ping Yan

Infectious Disease Modelling

Volume 6, 2021, Pages 930-941

The authors provide statistical models for studying testing and ascertainment rates, and illustrate them on public data on testing and case counts in Ontario, Canada. They observed that per capita testing rates have consistently varied approximately two-fold across regions at any given time, whereas confirmed case rates varied by factors of 20 or more. Their results show that there is a moderate negative association between testing and confirmed case rates across regions. Since January 2021 this association has eased, but regions with the highest confirmed case rates still tend to have lower testing rates. Exceptions are often for regional public health units with smaller populations.


Children's Sleep During COVID-19: How Sleep Influences Surviving and Thriving in Families

Authors: MacKenzie, Nicole E.; Keys, Elizabeth; Hall, Wendy A.; Gruber, Reut; Smith, Isabel M.; Constantin, Evelyn; Godbout, Roger; Stremler, Robyn; Reid, Graham J.; Hanlon-Dearman, Ana; Brown, Cary A.; Shea, Sarah; Weiss, Shelly K.; Ipsiroglu, Osman; Witmans, Manisha; Chambers, Christine T.; Andreou, Pantelis; Begum, Esmot; Corkum, Penny

JOURNAL OF PEDIATRIC PSYCHOLOGY Volume: 46 Issue: 9 Page: 1051-1062

This study aimed to characterize sleep changes during the COVID-19 pandemic in children who had previously been identified as having sleep problems, identify factors contributing to sleep changes due to COVID-19 safety measures, and understand parents’ and children’s needs to support sleep during the pandemic. Results show that the sleep of many Canadian children was affected by the first wave of the pandemic, with the disruption of routines influencing children’s sleep. Forty percent of parents perceived their child’s sleep quality worsened during the pandemic and attributed it to increased screen time, anxiety, and decreased exercise. eHealth interventions could help families address these challenges.


Assessment of the Burden of SARS-CoV-2 Variants of Concern Among Essential Workers in the Greater Toronto Area, Canada

Authors: Chagla, Zain; Ma, Huiting; Sander, Beate; Baral, Stefan D.; Moloney, Gary; Mishra, Sharmistha

JAMA NETWORK OPEN Volume: 4 Issue: 10

The authors created a retrospective cohort of neighborhoods in the City of Toronto and Region of Peel, two of the most populous and most affected per capita regions of Ontario, stratified by income and essential work status, and noted the emergence of variants of concern (VOC) through this population. Their findings suggest that VOCs of SARS-CoV-2, similar to wildtype SARS-CoV-2, are disproportionately associated with neighborhoods with lower income and a higher proportion of essential workers. This association may be magnified by more transmissible variants. Reducing SARS-CoV-2 transmission and the associated morbidity and mortality necessitates tailored and equitable intervention strategies including vaccine prioritization and outreach services.


Impact of temperature on the affinity of SARS-CoV-2 Spike glycoprotein for host ACE2

Authors: Prevost, Jeremie; Richard, Jonathan; Gasser, Romain; Ding, Shilei; Fage, Clement; Anand, Sai Priya; Adam, Damien; Vergara, Natasha Gupta; Tauzin, Alexandra; Benlarbi, Mehdi; Gong, Shang Yu; Goyette, Guillaume; Prive, Anik; Moreira, Sandrine; Charest, Hugues; Roger, Michel; Mothes, Walther; Pazgier, Marzena; Brochiero, Emmanuelle; Boivin, Guy; Abrams, Cameron F.; Schon, Arne; Finzi, Andres

JOURNAL OF BIOLOGICAL CHEMISTRY Volume: 297 Issue: 4 Article Number: 101151

Temperature has been suggested to play a role on the viability and transmissibility of SARS-CoV-2. The receptor-binding domain (RBD) of the Spike glycoprotein is known to bind to its host receptor angiotensin-converting enzyme 2 (ACE2) to initiate viral fusion. The authors observed a significant and stepwise increase in RBD-ACE2 affinity at low temperatures, resulting in slower dissociation kinetics. This translated into enhanced interaction of the full Spike glycoprotein with the ACE2 receptor and higher viral attachment at low temperatures. The RBD N501Y mutation, present in emerging variants of concern, bypassed this requirement. The data suggests the hypothesis that the acquisition of N501Y reflects an adaptation to warmer climates.


Cross-reactivity of antibodies from non-hospitalized COVID-19 positive individuals against the native, B.1.351, B.1.617.2, and P.1 SARS-CoV-2 spike proteins

Authors: Jodaylami, Maryam Hojjat; Djaileb, Abdelhadi; Ricard, Pierre; Lavallee, Etienne; Cellier-Goethebeur, Stella; Parker, Megan-Faye; Coutu, Julien; Stuible, Matthew; Gervais, Christian; Durocher, Yves; Desautels, Florence; Cayer, Marie-Pierre; de Grandmont, Marie Joelle; Rochette, Samuel; Brouard, Danny; Trottier, Sylvie; Boudreau, Denis; Pelletier, Joelle N.; Masson, Jean-Francois

SCIENTIFIC REPORTS Volume: 11 Issue: 1 Article Number: 21601

This study aimed at characterizing the cross-reactivity of antibodies against SARS-CoV-2 variants of concern (VOCs) to understand the humoral response of non-hospitalized individuals previously infected with SARS-CoV-2 before the emergence of VOCs. Antibody levels and pseudo-neutralization of the ectodomain of SARS-CoV-2 spike protein/human ACE-2 receptor interaction were analyzed. The authors observed a sustained humoral response against SARS-CoV-2 spike proteins among non-hospitalized Canadian adults. This response inhibited the interaction between the spike proteins from the different VOCs and ACE-2 receptor for >= 16 weeks post-diagnosis. Sera from vaccinated individuals had higher antibody levels and more efficiently inhibited the spike-ACE-2 interactions showing the effectiveness of vaccination.


Statins and SARS-CoV-2 Infection: Results of a Population-Based Prospective Cohort Study of 469 749 Adults From 2 Canadian Provinces

Authors: McAlister, Finlay A.; Wang, Ting; Wang, Xuesong; Chu, Anna; Goodman, Shaun G.; van Diepen, Sean; Jackevicius, Cynthia A.; Kaul, Padma; Udell, Jacob; Ko, Dennis T.; Kwong, Jeffrey C.; Austin, Peter C.; Lee, Douglas S.

JOURNAL OF THE AMERICAN HEART ASSOCIATION Volume: 10 Issue: 21 Article Number: e022330

Studies have suggested that statin users have a lower risk of dying with COVID-19. The authors tested this hypothesis in a cohort of adults in Ontario and Alberta. They compared adults using statins with nonusers. Compared with nonusers, patients taking statins exhibit the same risk of testing positive for SARS-CoV-2 and those younger than 75 years exhibit similar outcomes within 30 days of a positive test. Patients older than 75 years with a positive SARS-CoV-2 test and who were taking statins had more emergency department visits and hospitalizations but exhibited lower 30-day all-cause mortality risk.


A metagenomics workflow for SARS-CoV-2 identification, co-pathogen detection, and overall diversity

Authors: Castaneda-Mogollon, Daniel; Kamaliddin, Claire; Oberding, Lisa; Liu, Yan; Mohon, Abu Naser; Faridi, Rehan Mujeeb; Khan, Faisal; Pillai, Dylan R.

JOURNAL OF CLINICAL VIROLOGY Volume: 145 Article Number: 105025

The authors developed a metagenomics workflow that detects SARS-CoV-2 variants of concern (VOC) and co-pathogens triggering respiratory symptoms. The diversity analysis showed a shift in the DNA-metagenome by symptomatology status and anatomical swabbing site. While 31 co-pathogens were identified in SARSCoV-2 infected patients, no significant increase in pathogen or associated reads were noted when compared to SARS-CoV-2 negative patients. The Alpha SARS-CoV-2 VOC and 2 variants of interest (Zeta) were successfully identified for the first time using a clinical metagenomics approach. The diversity analysis suggested a complex set of microorganisms with different genomic abundance profiles in SARS-CoV-2 infected patients compared to healthy controls.


Variant-specific interventions to slow down replacement and prevent outbreaks

Authors: Majeed, Bushra; Tosato, Marco; Wu, Jianhong

MATHEMATICAL BIOSCIENCES Volume: 343 Article Number: 108703

Emergency and establishment of variants of concern (VOC) impose significant challenges for the COVID19 pandemic control. Here, the authors developed a mathematical model and utilized it to examine the impact of non-pharmaceutical interventions, including the COVID-test and whole-genome sequencing test capacity and contact tracing and quarantine strength, on the VOC-induced epidemic wave. They point out the undesirable and unexpected effect of lukewarm tracing and quarantine that can potentially increase the VOC-cases at the outbreak peak time, and they demonstrate the significance of strain-specific interventions to prevent a VOC-induced outbreak, or to mitigate the epidemic wave when this outbreak is unavoidable.


Sex- and age-specific regulation of ACE2: Insights into severe COVID-19 susceptibility

Authors: Viveiros, Anissa; Gheblawi, Mahmoud; Aujla, Preetinder K.; Sosnowski, Deanna K.; Seubert, John M.; Kassiri, Zamaneh; Oudit, Gavin Y.


Aged males disproportionately succumb to increased COVID-19 severity, hospitalization, and mortality compared to females. Angiotensin-converting enzyme 2 (ACE2) and transmembrane protease, serine 2 (TMPRSS2) facilitate SARS-CoV-2 viral entry and may have sexually dimorphic regulation. As viral load dictates disease severity, the authors investigated the expression, protein levels, and activity of ACE2 and TMPRSS2. Their data reveal that aged males have elevated ACE2 in both mice and humans across organs. They report the first comparative study comprehensively investigating the impact of sex and age in murine and human levels of ACE2 and TMPRSS2, to begin to elucidate the sex bias in COVID-19 severity.


A vesicular stomatitis virus-based prime-boost vaccination strategy induces potent and protective neutralizing antibodies against SARS-CoV-2

Authors: Kim, Gyoung Nyoun; Choi, Jung-ah; Wu, Kunyu; Saeedian, Nasrin; Yang, Eunji; Park, Hayan; Woo, Sun-Je; Lim, Gippeum; Kim, Seong-Gyu; Eo, Su-Kyeong; Jeong, Hoe Won; Kim, Taewoo; Chang, Jae-Hyung; Seo, Sang Hwan; Kim, Na Hyung; Choi, Eunsil; Choo, Seungho; Lee, Sangkyun; Winterborn, Andrew; Li, Yue; Parham, Kate; Donovan, Justin M.; Fenton, Brock; Dikeakos, Jimmy D.; Dekaban, Gregory A.; Haeryfar, S. M. Mansour; Troyer, Ryan M.; Arts, Eric J.; Barr, Stephen D.; Song, Manki; Kang, C. Yong

PLOS PATHOGENS Volume: 17 Issue: 12 Article Number: e1010092

With new variants of concern starting to dominate the human pandemic, new derivatives of the current vaccines may be necessary for continued protection from SARS-CoV-2 infection. The authors have developed a vaccine that uses a safe vesicular stomatitis virus-based delivery vehicle to present a key SARS-CoV-2 protein to our immune system in order to train it to recognize and prevent SARS-CoV-2 infection. Their vaccine completely protected vaccinated animals from SARS-CoV-2 infection and significantly reduced lung damage, a major hallmark of COVID-19.


Functional recovery following hospitalisation of patients diagnosed with COVID-19: a protocol for a longitudinal cohort study

Authors: Reid, Julie C.; Costa, Andrew P.; Duong, MyLinh; Ho, Terence; Kruisselbrink, Rebecca; Raina, Parminder; Kirkwood, Renata; Jones, Aaron; Corriveau, Sophie; Griffith, Lauren E.; Haider, Shariq; Marcucci, Maura; Markle-Reid, Maureen; Morrison, Hope; Raghavan, Natya; Schumacher, Connie; Vrkljan, Brenda; Junek, Mats; Martin, Leslie; Patel, Ameen; Girolametto, Carla; Pitre, Tyler; Beauchamp, Marla K.

BMJ OPEN Volume: 11 Issue: 12 Article Number: e053021

The primary aim of the Coronavirus Registry Functional Recovery (COREG-FR) study is to understand the trajectory of functional recovery among individuals hospitalised for COVID-19 that will guide clinical care and optimal management of serious COVID-19 illness and recovery. COREG-FR will follow participants from admission to hospital as an inpatient, to hospital discharge, and at 3-month, 6-month, 9-month and up to 12-month post-hospital discharge. The primary outcome is the Activity Measure for Post-Acute Care mobility scale measured at all time points. COREG-FR ( is designed as a data platform for future studies evaluating COVID-19 recovery.


The Quality of SARS-CoV-2-Specific T Cell Functions Differs in Patients with Mild/Moderate versus Severe Disease, and T Cells Expressing Coinhibitory Receptors Are Highly Activated

Authors: Shahbaz, Shima; Xu, Lai; Sligl, Wendy; Osman, Mohammed; Bozorgmehr, Najmeh; Mashhouri, Siavash; Redmond, Desiree; Rosero, Eliana Perez; Walker, John; Elahi, Shokrollah

JOURNAL OF IMMUNOLOGY Volume: 207 Issue: 4 Page: 1099-1111

The authors studied the effector functions of SARS-CoV-2-reactive T cells expressing coinhibitory receptors and examined the immunogenicity of SARS-CoV-2 peptide pools in regard to effector T cell responses in COVID-19 patients. Analyzing patients with mild, moderate, and severe disease, they observed that coinhibitory receptors were upregulated on both CD4(+) and CD8(+) T cells. The expression of coinhibitory receptors on T cells recognizing SARS-CoV-2 peptide pools was associated with increased frequencies of cytokine-producing T cells. Their data refute the concept of pathological T cell exhaustion in COVID-19 patients and demonstrate that T cells may either play a protective or detrimental role.


SARS-CoV-2-Reactive Mucosal B Cells in the Upper Respiratory Tract of Uninfected Individuals

Authors: Liu, Yanling; Budylowski, Patrick; Dong, Shilan; Li, Zhijie; Goroshko, Sofiya; Leung, Leslie Y. T.; Grunebaum, Eyal; Campisi, Paolo; Propst, Evan J.; Wolter, Nikolas E.; Rini, James M.; Zia, Amin; Ostrowski, Mario; Ehrhardt, Gotz R. A.

JOURNAL OF IMMUNOLOGY Volume: 207 Issue: 10 Page: 2581-2588

The authors report the identification of SARS-CoV-2-reactive B cells in human tonsillar tissue obtained from children who were negative for COVID-19 prior to the pandemic and the generation of mAbs recognizing the SARS-CoV-2 Spike protein from these B cells. These Abs showed reduced binding to Spike proteins of SARS-CoV-2 variants and did not recognize Spike proteins of endemic coronaviruses, but subsets reacted with commensal microbiota and exhibited SARS-CoV-2-neutralizing potential. Their study demonstrates pre-existing SARS-CoV-2-reactive Abs in various B cell populations that may lead to the rapid engagement of the pathogen and contribute to prevent manifestations of symptomatic or severe disease.


Canadian parents' perceptions of COVID-19 vaccination and intention to vaccinate their children: Results from a cross-sectional national survey

Authors: Humble, Robin M.; Sell, Hannah; Dube, Eve; MacDonald, Noni E.; Robinson, Joan; Driedger, S. Michelle; Sadarangani, Manish; Meyer, Samantha B.; Wilson, Sarah; Benzies, Karen M.; Lemaire-Paquette, Samuel; MacDonald, Shannon E.

VACCINE Volume: 39 Issue: 52 Page: 7669-7676

This cross-sectional national survey aimed to assess parents’ perceptions and intentions regarding COVID-19 vaccination for their children. Sixty-three percent of parents intended to vaccinate their children against COVID19. Those employed part-time (compared to full-time) had lower intention to vaccinate their children, while those who spoke languages other than English, French, or Indigenous languages were less likely to have low intention. Low vaccination intention was also associated with children not receiving influenza vaccine pre-pandemic, parents having low intention to vaccinate themselves against COVID19, believing COVID-19 vaccination is unnecessary or unsafe, and opposing COVID-19 vaccine use in children without prior testing.


CTN 328: immunogenicity outcomes in people living with HIV in Canada following vaccination for COVID-19 (HIV-COV): protocol for an observational cohort study

Authors: Costiniuk, Cecilia T.; Singer, Joel; Langlois, Marc-Andre; Kulic, Iva; Needham, Judy; Burchell, Ann; Jenabian, Mohammad-Ali; Walmsley, Sharon; Ostrowski, Mario; Kovacs, Colin; Tan, Darrell; Harris, Marianne; Hull, Mark; Brumme, Zabrina; Brockman, Mark; Margolese, Shari; Mandarino, Enrico; Angel, Jonathan B.; Routy, Jean-Pierre; Anis, Aslam H.; Cooper, Curtis

BMJ OPEN Volume: 11 Issue: 12 Article Number: e054208

This observational Canadian cohort study about COVID-19 vaccine use in people living with HIV (PLWH) aims to inform the design of future COVID-19 clinical trials, dosing strategies to improve immune responses and guideline development for PLWH. Participants will attend five visits: prevaccination; 1 month following the first vaccine dose; and at 3, 6 and 12 months following the second vaccine dose. The primary end point will be the percentage of PLWH with COVID-19-specific antibodies at 6 months following the second vaccine dose. Humoral and cell-mediated immune responses, and the interplay between T cell phenotypes and inflammatory markers, will be described.


Impact of the COVID-19 pandemic on Canadian Armed Forces Veterans who live with chronic pain

Authors: Choiniere, Manon; Page, M. Gabrielle; Lacasse, Anais; Dassieu, Lise; Thompson, James M.; Janelle-Montcalm, Audree; Dorais, Marc; Nguefack, Hermine Lore Nguena; Hudspith, Maria; Moor, Gregg; Sutton, Kathryn

JOURNAL OF MILITARY VETERAN AND FAMILY HEALTH Volume: 7 Page: 92-105 Supplement: 2 Special Issue: SI

This study compared the impact of the pandemic and public health measures on Canadian Veterans and non-Veterans who live with chronic pain. Two thirds of Veterans (67.1%) reported worsened pain since pandemic onset, and 44.7% experienced moderate to severe psychological distress. This was comparable to the non-Veteran group (63.2%), and no differences were found between female and male Veterans. Percentages of participants reporting changes in pharmacological pain treatments because of the pandemic were similar in CAF Veterans (14.9%) and non-Veterans (13.3%). Over 50% of Veterans modified their physical/psychological pain treatments due to the pandemic, compared with 45.3% of non-Veterans.


Background incidence rates of hospitalisations and emergency department visits for thromboembolic and coagulation disorders in Ontario, Canada for COVID-19 vaccine safety assessment: a population-based retrospective observational study

Authors: Nasreen, Sharifa; Calzavara, Andrew J.; Sundaram, Maria E.; MacDonald, Shannon E.; Righolt, Christiaan H.; Pai, Menaka; Field, Thalia S.; Zhou, Lily W.; Wilson, Sarah E.; Kwong, Jeffrey C.

BMJ OPEN Volume: 11 Issue: 12 Article Number: e052019

The objective of this population-based retrospective observational study was to estimate background rates of selected thromboembolic and coagulation disorders in Ontario, Canada, to help contextualise observed events of these potential adverse events of special interest and to detect potential safety signals related to COVID-19 vaccines. The authors used health administrative databases and searched records of hospitalisations and emergency department visits to identify cases. Primary outcome measures were incidence rates of ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, deep vein thrombosis, pulmonary embolism, idiopathic thrombocytopaenia, disseminated intravascular coagulation and cerebral venous thrombosis during five prepandemic years (2015–2019) and 2020.


ACE2, TMPRSS2, and L-SIGN Expression in Placentae From HIV-Positive Pregnancies Exposed to Antiretroviral Therapy-Implications for SARS-CoV-2 Placental Infection

Authors: Kala, Smriti; Meteleva, Ksenia; Serghides, Lena

JOURNAL OF INFECTIOUS DISEASES Volume: 224 Page: S631-S641 Supplement: 6

The authors compared mRNA levels of SARS-CoV-2 cell-entry mediators ACE2, TMPRSS2, and L-SIGN by quantitative polymerase chain reaction in placentae from pregnant women with HIV (WHIV) on protease inhibitor (PI)-based ART, from WHIV on non-PI-based ART, and from HIV-uninfected women. They identified pregnant women of black race and WHIV on PI-based ART to have relatively lower expression of placental ACE2 than those of white race and HIV-uninfected women. This may potentially contribute to altered susceptibility to COVID-19 in these women, favorably by reduced viral entry or detrimentally by loss of ACE2 protection against hyperinflammation.


Biases in Evaluating the Safety and Effectiveness of Drugs for the Treatment of COVID-19: Designing Real-World Evidence Studies

Authors: Renoux, Christel; Azoulay, Laurent; Suissa, Samy

AMERICAN JOURNAL OF EPIDEMIOLOGY Volume: 190 Issue: 8 Page: 1452-1456

A growing number of observational studies in which the effects of certain drugs were evaluated have been conducted, including several in which researchers assessed whether hydroxychloroquine improved outcomes in SARS-CoV-2-infected individuals and whether renin-angiotensin-aldosterone system inhibitors have detrimental effects. In the present article, the authors review and illustrate how immortal time bias and selection bias were present in several of these studies. Understanding these biases and how they can be avoided may prove important for future observational studies assessing the effectiveness and safety of potentially promising drugs during the coronavirus 19 pandemic.


Structural analysis of receptor binding domain mutations in SARS-CoV-2 variants of concern that modulate ACE2 and antibody binding

Authors: Mannar, Dhiraj; Saville, James W.; Zhu, Xing; Srivastava, Shanti S.; Berezuk, Alison M.; Zhou, Steven; Tuttle, Katharine S.; Kim, Andrew; Li, Wei; Dimitrov, Dimiter S.; Subramaniam, Sriram

CELL REPORTS Volume: 37 Issue: 12 Article Number: 110156

The SARS-CoV-2 Beta and Gamma variants of concern (VoCs) include a mutation (N501Y) found in the Alpha variant that enhances affinity of the spike protein for its ACE2 receptor. Additional mutations are found in these variants that appear to promote antibody evasion. Epsilon variants lack the N501Y mutation yet exhibit antibody evasion. The authors have engineered spike proteins to express these mutations either in isolation or in different combinations. Their findings suggest that the emergence of new SARS-CoV-2 variant spikes can be rationalized as the result of mutations that confer increased ACE2 affinity, increased antibody evasion, or both.


Acute Care Visits for Eating Disorders Among Children and Adolescents After the Onset of the COVID-19 Pandemic

Authors: Toulany, Alene; Kurdyak, Paul; Guttmann, Astrid; Stukel, Therese A.; Fu, Longdi; Strauss, Rachel; Fiksenbaum, Lisa; Saunders, Natasha R.

JOURNAL OF ADOLESCENT HEALTH Volume: 70 Issue: 1 Page: 42-47 Article Number: 110156

This study compares the rates of emergency department visits and hospitalizations for eating disorders among all children and adolescents aged 3-17 years, residing in Ontario, Canada, before and during the first 10 months of the COVID-19 pandemic. Acute care visits for eating disorders increased immediately after the onset of the pandemic. They observed a 66% and 37% increase in risk for emergency department visit and hospitalization, respectively. Acute care visits for pediatric eating disorders increased significantly after the onset of COVID-19 pandemic and remained well above expected levels during the first 10 months of the pandemic.


Association of pre-existing comorbidities with mortality and disease severity among 167,500 individuals with COVID-19 in Canada: A population-based cohort study

Authors: Ge, Erjia; Li, Yanhong; Wu, Shishi; Candido, Elisa; Wei, Xiaolin

PLOS ONE Volume: 16 Issue: 10 Article Number: e0258154

This study aimed to examine the associations of comorbidities with mortality and disease severity in individuals with COVID-19 diagnosed in 2020 in Ontario. The authors found that solid organ transplant, dementia, chronic kidney disease, severe mental illness, cardiovascular disease, hypertension, chronic obstructive pulmonary disease, cancer, diabetes, rheumatoid arthritis, HIV, and asthma were associated with mortality or severity. Their study highlights that the number of comorbidities was a strong risk factor for deaths and severe outcomes among younger individuals with COVID-19. This suggests that in addition of prioritizing by age, vaccination priority groups should also include younger population with multiple comorbidities.


Serum and cerebrospinal fluid biomarker profiles in acute SARS-CoV-2-associated neurological syndromes

Authors: Paterson, Ross W.; Benjamin, Laura A.; Mehta, Puja R.; Brown, Rachel L.; Athauda, Dilan; Ashton, Nicholas J.; Leckey, Claire A.; Ziff, Oliver J.; Heaney, Judith; Heslegrave, Amanda J.; Benedet, Andrea L.; Blennow, Kaj; Checkley, Anna M.; Houlihan, Catherine F.; Mummery, Catherine J.; Lunn, Michael P.; Manji, Hadi; Zandi, Michael S.; Keddie, Stephen; Chou, Michael; Changaradil, Deepthi Vinayan; Solomon, Tom; Keshavan, Ashvini; Barker, Suzanne; Jager, Hans Rolf; Carletti, Francesco; Simister, Robert; Werring, David J.; Spyer, Moira J.; Nastouli, Eleni; Gauthier, Serge; Rosa-Neto, Pedro; Zetterberg, Henrik; Schott, Jonathan M.

BRAIN COMMUNICATIONS Volume: 3 Issue: 3 Article Number: fcab099

The authors collected serum and cerebrospinal fluid (CSF) from COVID-19 patients to analyse damage to the nervous system caused by the SARS-CoV-2. They characterized neurological syndromes involving the peripheral nervous system (PNS) and central nervous system (CNS), and measured biomarkers of neuronal damage and neuroinflammation. They detected increased concentrations of neurofilament light in the CSF of those with CNS inflammation, compared to those with encephalopathy, peripheral syndromes and controls. Serum neurofilament light levels were elevated across patients hospitalized with COVID-19. Their findings suggest serum neurofilament light elevation in the non-neurological patients may reflect PNS damage in response to severe illness.


Involvement of the ACE2/Ang-(1-7)/MasR Axis in Pulmonary Fibrosis: Implications for COVID-19

Authors: Morganstein, Taylor; Haidar, Zahraa; Trivlidis, Joshua; Azuelos, Ilan; Huang, Megan Jiaxin; Eidelman, David H.; Baglole, Carolyn J.

INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES Volume: 22 Issue: 23 Article Number: 12955

Pulmonary fibrosis is a chronic disease. The ACE2/Ang-(1-7)/MasR axis is of interest in pulmonary fibrosis due to evidence of its anti-fibrotic action. Scientific evidence supports that inhibition of ACE2 causes enhanced fibrosis. ACE2 is also the primary receptor that facilitates the entry of SARS-CoV-2. One of the potential complications in people who recover from COVID-19 is pulmonary fibrosis. This review aimed to characterize the ACE2-Ang-(1-7)-MasR Axis in the context of pulmonary fibrosis with an emphasis on risk factors, including the SARS-CoV-2 virus and exposure to environmental toxicants. It emphasizes the necessity for further research on each factor and its interplay.


Consequences of the COVID-19 Pandemic on Children's Mental Health: A Meta-Analysis

Authors: Bussieres, Eve-Line; Malboeuf-Hurtubise, Catherine; Meilleur, A.; Mastine, Trinity; Herault, Elodie; Chadi, Nicholas; Montreuil, Marjorie; Genereux, Melissa; Camden, Chantal

FRONTIERS IN PSYCHIATRY Volume: 12 Article Number: 691659

This review explored the impacts of the COVID-19 pandemic on the mental health of children aged 5-13 years-old, while highlighting the specific difficulties experienced by children with neurodevelopmental issues or chronic health conditions. Studies suggest that children's mental health was generally negatively impacted during the COVID-19 pandemic. COVID-19 lockdown measures were associated with negative general mental health outcomes among children, but of small magnitude. Sleep habits were also changed, as sleep duration significantly increased in children. Results did not differ between children from the general population and those from clinical populations. Effect sizes were larger in European versus Asian countries.


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.