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The pandemic of coronavirus disease (COVID)-19 is a global threat, causing high mortality, especially in the elderly. The main symptoms and the primary cause of death are related to interstitial pneumonia. Viral entry also into myocardial cells mainly via the angiotensin converting enzyme type 2 (ACE2) receptor and excessive production of pro-inflammatory cytokines, however, also make the heart susceptible to injury. In addition to the immediate damage caused by the acute inflammatory response, the heart may also suffer from long-term consequences of COVID-19, potentially causing a post-pandemic increase in cardiac complications. Although the main cause of cardiac damage in COVID-19 remains coagulopathy with micro- (and to a lesser extent macro-) vascular occlusion, open questions remain about other possible modalities of cardiac dysfunction, such as direct infection of myocardial cells, effects of cytokines storm, and mechanisms related to enhanced coagulopathy. In this opinion paper, we focus on these lesser appreciated possibilities and propose experimental approaches that could provide a more comprehensive understanding of the cellular and molecular bases of cardiac injury in COVID-19 patients. We first discuss approaches to characterize cardiac damage caused by possible direct viral infection of cardiac cells, followed by formulating hypotheses on how to reproduce and investigate the hyperinflammatory and pro-thrombotic conditions observed in the heart of COVID-19 patients using experimental in vitro systems. Finally, we elaborate on strategies to discover novel pathology biomarkers using omics platforms. [ABSTRACT FROM AUTHOR]

The cardiovascular system is significantly affected in coronavirus disease-19 (COVID-19). Microvascular injury, endothelial dysfunction, and thrombosis resulting from viral infection or indirectly related to the intense systemic inflammatory and immune responses are characteristic features of severe COVID-19. Pre-existing cardiovascular disease and viral load are linked to myocardial injury and worse outcomes. The vascular response to cytokine production and the interaction between severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and angiotensin-converting enzyme 2 receptor may lead to a significant reduction in cardiac contractility and subsequent myocardial dysfunction. In addition, a considerable proportion of patients who have been infected with SARS-CoV-2 do not fully recover and continue to experience a large number of symptoms and post-acute complications in the absence of a detectable viral infection. This conditions often referred to as 'post-acute COVID-19' may have multiple causes. Viral reservoirs or lingering fragments of viral RNA or proteins contribute to the condition. Systemic inflammatory response to COVID-19 has the potential to increase myocardial fibrosis which in turn may impair cardiac remodelling. Here, we summarize the current knowledge of cardiovascular injury and post-acute sequelae of COVID-19. As the pandemic continues and new variants emerge, we can advance our knowledge of the underlying mechanisms only by integrating our understanding of the pathophysiology with the corresponding clinical findings. Identification of new biomarkers of cardiovascular complications, and development of effective treatments for COVID-19 infection are of crucial importance. [ABSTRACT FROM AUTHOR]

The coronavirus disease 2019 (COVID-19) pandemic has been as unprecedented as unexpected, affecting more than 105 million people worldwide as of 8 February 2020 and causing more than 2.3 million deaths according to the World Health Organization (WHO). Not only affecting the lungs but also provoking acute respiratory distress, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is able to infect multiple cell types including cardiac and vascular cells. Hence a significant proportion of infected patients develop cardiac events, such as arrhythmias and heart failure. Patients with cardiovascular comorbidities are at highest risk of cardiac death. To face the pandemic and limit its burden, health authorities have launched several fast-track calls for research projects aiming to develop rapid strategies to combat the disease, as well as longer-term projects to prepare for the future. Biomarkers have the possibility to aid in clinical decision-making and tailoring healthcare in order to improve patient quality of life. The biomarker potential of circulating RNAs has been recognized in several disease conditions, including cardiovascular disease. RNA biomarkers may be useful in the current COVID-19 situation. The discovery, validation, and marketing of novel biomarkers, including RNA biomarkers, require multi-centre studies by large and interdisciplinary collaborative networks, involving both the academia and the industry. Here, members of the EU-CardioRNA COST Action CA17129 summarize the current knowledge about the strain that COVID-19 places on the cardiovascular system and discuss how RNA biomarkers can aid to limit this burden. They present the benefits and challenges of the discovery of novel RNA biomarkers, the need for networking efforts, and the added value of artificial intelligence to achieve reliable advances. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic is an unprecedented healthcare emergency causing mortality and illness across the world. Although primarily affecting the lungs, the SARS-CoV-2 virus also affects the cardiovascular system. In addition to cardiac effects, e.g. myocarditis, arrhythmias, and myocardial damage, the vasculature is affected in COVID-19, both directly by the SARS-CoV-2 virus, and indirectly as a result of a systemic inflammatory cytokine storm. This includes the role of the vascular endothelium in the recruitment of inflammatory leucocytes where they contribute to tissue damage and cytokine release, which are key drivers of acute respiratory distress syndrome (ARDS), in disseminated intravascular coagulation, and cardiovascular complications in COVID-19. There is also evidence linking endothelial cells (ECs) to SARS-CoV-2 infection including: (i) the expression and function of its receptor angiotensin-converting enzyme 2 (ACE2) in the vasculature; (ii) the prevalence of a Kawasaki disease-like syndrome (vasculitis) in COVID-19; and (iii) evidence of EC infection with SARS-CoV-2 in patients with fatal COVID-19. Here, the Working Group on Atherosclerosis and Vascular Biology together with the Council of Basic Cardiovascular Science of the European Society of Cardiology provide a Position Statement on the importance of the endothelium in the underlying pathophysiology behind the clinical presentation in COVID-19 and identify key questions for future research to address. We propose that endothelial biomarkers and tests of function (e.g. flow-mediated dilatation) should be evaluated for their usefulness in the risk stratification of COVID-19 patients. A better understanding of the effects of SARS-CoV-2 on endothelial biology in both the micro- and macrovasculature is required, and endothelial function testing should be considered in the follow-up of convalescent COVID-19 patients for early detection of long-term cardiovascular complications. [ABSTRACT FROM AUTHOR]

Kisely S, Warren N, McMahon L, Dalais C, Henry I, Siskind D. Occurrence, prevention, and management of the psychological effects of emerging virus outbreaks on healthcare workers: rapid review and meta-analysis. BMA Survey Finds Doctors' Lives Still at Risk Despite Government Pledges on PPE. British Medical Association, 7 April 2020. https://www.bma.org.uk/bma-media-centre/ bma-survey-finds-doctors-lives-still-at-risk-despitegovernment-pledges-on-ppe (28 July 2020, date last accessed). [Extracted from the article]

The DESCARTES (Developing Education Science and Care for Renal Transplantation in European States) study group of the ERA-EDTA nicely summarized the evidence available until May 2020intheprognosis,managementandtreatmentofkidney transplant recipients with COVID-19 [12]. Accordingly,ameta-analysisoncomparativeeffectiveness of antihypertensive drugs in kidney transplant patients was published in the May issue by epidemiologists from Reggio Calabria in collaboration with colleagues from other ERA-EDTA member countries [11]. Young deceaseddonorkidneysshow a survival benefit over older donor kidneys in transplant recipients aged 20-50 years: a study by the ERA-EDTA Registry. [Extracted from the article]

Footnotes 1 The author belongs to the same institution as some of the Mishra et al. authors and has recently had a minor authorship role on another recently accepted paper. I would like to congratulate both sets of authors for fascinating and worthy articles. The eventual true outcomes are also plotted on the figure and although both lower intervals seem to be doing a good job, to my mind, the upper ARIMA interval is better than the one from Teh et al. [Extracted from the article]

Neither study, in the prior for HT ht , incorporates foreseeable effects such as step changes following interventions, the impact of improved testing on track-and-trace measures, or the expected decline in HT ht due to susceptible depletion. Both studies infer a time-varying reproduction number HT ht from summary data by constructing hierarchical Bayesian frameworks embodying HT ht as an intrinsic parameter. [Extracted from the article]

Wallinga and Lipsitch ([3]) derive HT ht , where HT ht is the moment generating function of the generation interval HT ht and HT ht is a I constant i growth rate. [Extracted from the article]

This is a function of a positive real variable , with (0) = I R i , and when I R i > 1 there is a unique value of I r i with ( I r i ) = 1. Thus, we specify the way in which the average number I R i of infections are distributed along the lifetime of the infection. REFERENCES 1 Kermack, W.O. & McKendrick, A.G. (1927) A contribution to the mathematical theory of epidemics. [Extracted from the article]

Alongside I R SB t sb i , the field of infectious disease dynamics has long considered instantaneous measures of growth, termed I r SB t sb i , a fundamental observed quantity from which I R SB t sb i is derived (Wallinga & Lipsitch, [5]). They find, however, that the data-smoothing assumptions necessary to estimate I r SB t sb i are similar to assumptions about the distribution of generation times necessary to estimate I R SB t sb i . The effective reproductive number, I R i , is an expression of how many infections are caused by each prevalent infection in the subsequent generation of transmission. [Extracted from the article]

The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has important implications for the safety of participants in clinical trials and the research staff caring for them and, consequently, for the trials themselves. Patients with heart failure may be at greater risk of infection with COVID-19 and the consequences might also be more serious, but they are also at risk of adverse outcomes if their clinical care is compromised. As physicians and clinical trialists, it is our responsibility to ensure safe and effective care is delivered to trial participants without affecting the integrity of the trial. The social contract with our patients demands no less. Many regulatory authorities from different world regions have issued guidance statements regarding the conduct of clinical trials during this COVID-19 crisis. However, international trials may benefit from expert guidance from a global panel of experts to supplement local advice and regulations, thereby enhancing the safety of participants and the integrity of the trial. Accordingly, the Heart Failure Association of the European Society of Cardiology on 21 and 22 March 2020 conducted web-based meetings with expert clinical trialists in Europe, North America, South America, Australia, and Asia. The main objectives of this Expert Position Paper are to highlight the challenges that this pandemic poses for the conduct of clinical trials in heart failure and to offer advice on how they might be overcome, with some practical examples. While this panel of experts are focused on heart failure clinical trials, these discussions and recommendations may apply to clinical trials in other therapeutic areas. [ABSTRACT FROM AUTHOR]

I congratulate Pellis and colleagues, and Dunbar and Held on their excellent papers describing a variety of mechanistic models of SARS-Cov-2 transmission, and more generally on their work to support policy formulation during the COVID-19 pandemic. Both papers address the difficulties of predicting and then evaluating the impact if non-pharmaceutical interventions (NPIs) against the transmission of severe respiratory pathogens. For example, models usually contain an underlying basic rate of transmissibility per unit time per infected individual, often denoted HT ht . [Extracted from the article]

The Bekker-Nielsen Dunbar and Held paper shows the importance of incorporating changes in population contacts into the description and prediction of disease spread. Formally, the two papers cannot be compared, since the Bekker-Nielsen Dunbar and Held paper aims at counterfactual inference about school closures (although estimation of Rt would be possible) while the Pellis et al. paper is a review and discussion of modelling/statistical COVID-related work, mainly in GB. Each paper contains many interesting points, for instance the Pellis et al. paper discusses the concept of Rc, the reproduction number of an infection in the presence of interventions but not accounting for the level of immunity of the population. [Extracted from the article]

We are witnessing an unparalleled pandemic caused by the novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) associated with coronavirus disease 2019 (COVID-19). Current data show that SARS-CoV-2 results in mild flu-like symptoms in the majority of healthy and young patients affected. Nevertheless, the severity of COVID-19 respiratory syndrome and the risk of adverse or catastrophic outcomes are increased in patients with pre-existing cardiovascular disease. Patients with adult congenital heart disease (ACHD)—by definition—have underlying cardiovascular disease. Many patients with ACHD are also afflicted with residual haemodynamic lesions such as valve dysfunction, diminished ventricular function, arrhythmias or cyanosis, have extracardiac comorbidities, and face additional challenges regarding pregnancy. Currently, there are emerging data of the effect of COVID-19 on ACHD patients, but many aspects, especially risk stratification and treatment considerations, remain unclear. In this article, we aim to discuss the broad impact of COVID-19 on ACHD patients, focusing specifically on pathophysiology, risk stratification for work, self-isolation, hospitalization, impact on pregnancy, psychosocial health, and longer-term implications for the provision of ACHD care. [ABSTRACT FROM AUTHOR]

But this reliance on an inherent transmission assumption can lead to challenges in interpretation, particularly in rapidly changing epidemics that take several generations of infection to settle to equilibrium. Understanding the extent of disease transmission - and how it changes over time - is a deceptively difficult problem, and these papers highlight some key considerations in how we should estimate and interpret COVID transmission dynamics. Even if we were to be omniscient, and see every contact and every transmission event, we would still have to make conceptual decisions about whether we are looking back at transmission that has already occurred, or predicting ongoing transmission from current infectious individuals, which is subject to right truncation. [Extracted from the article]

The solution lies in directly fitting spatially explicit epidemic models to incidence data, with the advantage of providing a flexible framework to incorporate spatio-temporal information at all scales. The two papers presenting methods for estimating local effective reproduction numbers, I R i SB I it i sb , are based on the renewal equation method applied to UK Local Authority Districts (LADs; Teh et al. and Mishra et al.). Spatial correlation of I R i SB I it i sb has the further advantage of pooling information from neighbouring LADs, allowing estimates for low-incidence LADs to be informed via spatial proximity. [Extracted from the article]

Ian Reynold's discussion contribution to papers in Session 3 of the Royal Statistical Society's Special Topic Meeting on COVID-19 transmission: 11 June 2021 I think that the presence of asymptomatic cases is a real problem for R. They affect both the numerator and the denominator of R. It is highly likely that age affects asymptotic cases with younger persons more likely to be so. We should ignore R and concentrate on tested cases, hospital admissions and deaths albeit a number of the latter are "with Covid" rather than "as a result of Covid". [Extracted from the article]

Several authors have mentioned the importance of allowing for the susceptible proportion of the population. Firstly, while we do know local vaccination numbers, accurate estimation of asymptomatic or mildly asymptomatic case-numbers is problematic, even with the availability of data from high-quality randomised prevalence surveys such as the REACT study (Riley et al., [1]). Peter J. Diggle's discussion contribution to the papers in Session 3 of the Royal Statistical Society's Special Topic Meeting on Covid-19 Transmission: 11 June 2021. [Extracted from the article]

The growth rate I r i , another widely used epidemic metric throughout the COVID-19 pandemic, represents the rate at which the epidemic is growing during the exponential phase of epidemic growth. The effective reproduction number I R i has been a headline epidemic metric since the onset of the COVID-19 pandemic. In fact within models, I r i and I R i are related via the generation time of the epidemic: the longer the generation time and higher the epidemic growth rate, higher the value of I R i . [Extracted from the article]

Any assessment of the quality of I R i SB I t i sb estimates would thus involve a decision on the timescale at which the reproduction number is considered and what exactly I R i SB I t i sb represents and whether models agree that this is being estimated. For example, consider the following discrete-time branching process model, initialised with some starting number of infectious individuals I I i SB I 0 i sb , a mean reproduction number I R i and over-dispersion I k i : I I i SB I t i sb ~ Poisson ( SB I t i sb ). By definition of the instantaneous reproduction number I R i SB I t i sb is the average number of new infections caused by infectious individuals at time I t i (weighted by their infectiousness). [Extracted from the article]

For example, in recruiting participants randomly from those registered for healthcare in England, the REACT-1 design attempts to reduce the impact of temporal variation when making growth rate estimates (Riley et al., [4]). REACT is a program of studies separated into REACT-1 (Riley et al., [4]) that collects self-administered nose and throat swabs (Riley et al., [4]) and REACT-2 that collects self-administered lateral-flow antibody tests (Ward et al., [6]). In addition to growth rates, population surveys of infection provide estimates of prevalence at national and regional scales that can be easily understood as measures of individual risk: measured swab-positivity is easily translated into odds of infection. [Extracted from the article]

However, I do believe the excessive focus on HT ht was highly unhelpful in early 2020. This comment expands on the excellent presentation by Parag, Thompson and Donnelly on the differences between reproduction number HT ht and epidemic growth rates HT ht . Later on, however, the problem becomes much less acute, because HT ht is lower and the precise timing of interventions less relevant, and because the generation time distribution is better informed. [Extracted from the article]

Let HT ht denote observed log-transformed incidence at each of I n i locations HT ht and I m i times HT ht . Empirical statistical modelling of the kind suggested here is arguably a better choice when the epidemic is subject to a complex combination of formal (policy-driven) and informal (behaviourally responsive) changes over space and time, and when the objective is to build a general-purpose, spatially refined, real-time surveillance system, in which a disease-agnostic model can be fitted to a range of important health outcomes using disease-specific covariates and their associated parameter estimates. [Extracted from the article]

The basic reproduction number HT ht can be defined in several different sensible ways for non-homogeneously-mixing models such as models with households, and some of these approaches could be translated to HT ht . For instance, can conditions be found under which HT ht is invariably underestimated or overestimated? ESTIMATION AND MODELS There are two prevalent views as to how to estimate HT ht or any other reproduction number. [Extracted from the article]

Background The National Institutes of Health (NIH) mobilized more than $4 billion in extramural funding for the COVID-19 pandemic. Assessing the research output from this effort is crucial to understanding how the scientific community leveraged federal funding and responded to this public health crisis. Methods NIH-funded COVID-19 grants awarded between January 2020 and December 2021 were identified from NIH Research Portfolio Online Reporting Tools Expenditures and Results using the "COVID-19 Response" filter. PubMed identifications of publications under these grants were collected and the NIH iCite tool was used to determine citation counts and focus (eg, clinical, animal). iCite and the NIH's LitCOVID database were used to identify publications directly related to COVID-19. Publication titles and Medical Subject Heading terms were used as inputs to a machine learning–based model built to identify common topics/themes within the publications. Results and Conclusions We evaluated 2401 grants that resulted in 14 654 publications. The majority of these papers were published in peer-reviewed journals, though 483 were published to preprint servers. In total, 2764 (19%) papers were directly related to COVID-19 and generated 252 029 citations. These papers were mostly clinically focused (62%), followed by cell/molecular (32%), and animal focused (6%). Roughly 60% of preprint publications were cell/molecular-focused, compared with 26% of nonpreprint publications. The machine learning–based model identified the top 3 research topics to be clinical trials and outcomes research (8.5% of papers), coronavirus-related heart and lung damage (7.3%), and COVID-19 transmission/epidemiology (7.2%). This study provides key insights regarding how researchers leveraged federal funding to study the COVID-19 pandemic during its initial phase. [ABSTRACT FROM AUTHOR]

The spread of COVID-19 in Peru resulted in the declaration of a national health emergency, in which Indigenous peoples were identified as being particularly vulnerable due to their pre-existing poor health indicators and disadvantaged social conditions. The aim of this paper is to examine how the Peruvian government responded to the health and food needs of the Shawi and Ashaninka Indigenous peoples of Peru during the first 18 months of the pandemic (March 2020–August 2021). This study uses both official policy documents and real-world experiences to evaluate policy responses in terms of their immediate impact and their longer-term sustainability and contribution to the improvement of health, well-being and justice for Indigenous communities. Four health and food security responses were evaluated: the Amazon Health Plan and Indigenous Command; food aid; cash aid; and COVID-19 vaccination. We employed the Multidimensional Injustice Framework to analyse the justice implications of the design and implementation of responses. Data collection included 71 interviews with government officials (n  = 7), Indigenous leaders (n  = 31) and community members (n  = 33). The results show how national and regional governments released policies to address the health and food needs of Indigenous peoples directly or indirectly, as part of a broader focus on vulnerable people. However, justice implications were not sufficiently addressed in the design or implementation of the responses. On the distributive dimension, Indigenous communities were prioritized to receive health goods and services, nevertheless, the distribution had shortcomings that impeded their collection and Indigenous food systems and livelihoods were largely overlooked. On the procedural dimension, Indigenous representatives were included to provide culturally sensitive feedback on health interventions, but without funding, and furthermore, the community members had only passive participation. This paper points out the importance of considering and addressing justice implications for more effective and fairer health and food policy responses to current and future health crises. [ABSTRACT FROM AUTHOR]

This paper draws on diverse psychological, behavioural and numerical literature to understand some of the challenges we all face in making sense of large-scale phenomena and use this to create a road map for HCI responses. This body of knowledge offers tools and principles that can help HCI researchers deliver value now, but also highlights challenges for future HCI research. The paper is framed by looking at patterns and information that highlight some of the common misunderstandings that arise—not just for politicians and the general public but also for many in the academic community. This paper does not have all the answers to this, but we hope it provides some and, perhaps more importantly, raises questions that we need to address as scientific and technical communities. [ABSTRACT FROM AUTHOR]

Competing risks data are commonly encountered in randomized clinical trials and observational studies. This paper considers the situation where the ending statuses of competing events have different clinical interpretations and/or are of simultaneous interest. In clinical trials, often more than one competing event has meaningful clinical interpretations even though the trial effects of different events could be different or even opposite to each other. In this paper, we develop estimation procedures and inferential properties for the joint use of multiple cumulative incidence functions (CIFs). Additionally, by incorporating longitudinal marker information, we develop estimation and inference procedures for weighted CIFs and related metrics. The proposed methods are applied to a COVID‐19 in‐patient treatment clinical trial, where the outcomes of COVID‐19 hospitalization are either death or discharge from the hospital, two competing events with completely different clinical implications. [ABSTRACT FROM AUTHOR]

This paper examines the relationship between policy compliance, the emergence of alternate epistemes and authorities in online spaces, and the decline of trust and legitimacy in democratic institutions. Drawing on insights from public policy, regulation theory, and political theory, the paper critically engages with scholarship on "policy-takers" to illuminate the tensions of compliance and legitimacy in liberal states. It proposes a compliance--legitimacy matrix that identifies the features of policy compliance--including consent, legitimacy, expertise, and trust--and their relationship to the disaggregation of policy knowledge. The article applies this framework to a case study of social media posts that respond to policy information during the management of the Covid-19 pandemic in Australia. Through analysis of these posts, the study reveals the distrust in "the science" and experts advocated by government and the calls from skeptic groups for noncompliance with public health measures. The paper argues that public policy faces an epistemic crisis of public confidence, with significant downstream consequences for compliance with public policy initiatives that has been brought on both by the failures of states to cultivate trust in science and the government. The compliance--legitimacy matrix offers a useful tool for policymakers to anticipate and address objections from policy-takers and to preempt and diffuse their fears. [ABSTRACT FROM AUTHOR]

Transformative innovation policy (TIP) implies not only new directionality for innovation policy but also rethinking its means and scope. This requires further investigation into the role of horizontal and cross-sectoral policy programmes that may be relevant for upscaling innovation and destabilising regimes. This paper studies the national implementation, in Finland, of the European Union (EU) programme for COVID-19 recovery, the Recovery and Resilience Facility (RRF), as an example of a cross-sectoral policy programme. It is of interest, because the EU has set certain conditions related to sustainability transitions for the RRF. Using a transformative policy mix approach, the paper finds that the Finnish RRF Programme lists many policy measures that can be regarded as having a transformative intent. These include upscaling innovative sustainability niches and destabilising existing practices. Yet, we also found that there is a risk that cross-sectoral programmes fail to find overall transformative visions and fund multiple potentially competing technological pathways instead. [ABSTRACT FROM AUTHOR]

This paper explores Covid-19-related corruption in Bangladesh. Specifically, we analyse the issue of Covid-19-related corruption in the health sector of Bangladesh. We also explore how denial strategies adapted by government officials have worsened the problem. Using Cohen's notion of denial strategies (Cohen 2001. States of Denial. Cambridge: Polity), we analyse media reports during the pandemic that highlighted Covid-19-related corruption occurring in the Bangladeshi health sector. Our analyses reveal that the Covid-19 pandemic has given rise to a new wave of corruption, particularly in the procurement of testing kits and personal protective equipment (PPE), as well as the issuance of false Covid-19 certificates. We call for an in-depth investigation of Covid-19-related corruption in Bangladesh and other developing countries that follows similar social, contextual and cultural values via interviews with policymakers and health professionals. Our paper extends the ongoing debate on Covid-19-related corruption and its impacts on public health sectors. [ABSTRACT FROM AUTHOR]

The severe acute respiratory syndrome coronavirus 2 virus has, up to the time of this article, resulted in >770 million cases of COVID-19 illness worldwide, and approximately 7 million deaths, including >1.1 million in the United States. Although defined as a respiratory virus, early in the pandemic, it became apparent that considerable numbers of people recovering from COVID-19 illness experienced persistence or new onset of multi-system health problems, including neurologic and cognitive and behavioral health concerns. Persistent multi-system health problems are defined as Post-COVID-19 Condition (PCC), Post-Acute Sequelae of COVID-19, or Long COVID. A significant number of those with PCC report cognitive problems. This paper reviews the current state of scientific knowledge on persisting cognitive symptoms in adults following COVID-19 illness. A brief history is provided of the emergence of concerns about persisting cognitive problems following COVID-19 illness and the definition of PCC. Methodologic factors that complicate clear understanding of PCC are reviewed. The review then examines research on patterns of cognitive impairment that have been found, factors that may contribute to increased risk, behavioral health variables, and interventions being used to ameliorate persisting symptoms. Finally, recommendations are made about ways neuropsychologists can improve the quality of existing research. [ABSTRACT FROM AUTHOR]

This paper estimates the dynamic effect of vaccination on mortality from COVID-19 using weekly data from 26 European Union countries during 2021. Our analysis relies on the double machine learning method to control for multiple confounders, including nonpharmaceutical interventions, climate variables, mobility factors, variants of concern, country- and week-specific shocks. In our baseline specification, we show that a 10 percentage point increase in cumulative doses per hundred inhabitants averts 5.08 COVID-19 deaths per million inhabitants at the eight-week horizon and 26.41 deaths in the eight-week time window considered. The average reduction in mortality in this window is close to 50%. Further estimates reveal that the effect of doses administered to adults aged 18–59 does not statistically differ from that of doses received by people aged 60 and over. Finally, vaccine-specific estimates document that mRNA-1273 (Moderna) and Vaxzevria (AstraZeneca) are more cost-effective in saving lives than Comirnaty (Pfizer), while we are unable to demonstrate any effect of Ad26.COV2.S (Johnson & Johnson). [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has triggered several changes in countries' health purchasing arrangements to accompany the adjustments in service delivery in order to meet the urgent and additional demands for COVID-19-related services. However, evidence on how these adjustments have played out in low- and middle-income countries is scarce. This paper provides a synthesis of a multi-country study of the adjustments in purchasing arrangements for the COVID-19 health sector response in eight middle-income countries (Armenia, Cameroon, Ghana, Kenya, Nigeria, Philippines, Romania and Ukraine). We use secondary data assembled by country teams, as well as applied thematic analysis to examine the adjustments made to funding arrangements, benefits packages, provider payments, contracting, information management systems and governance arrangements as well as related implementation challenges. Our findings show that all countries in the study adjusted their health purchasing arrangements to varying degrees. While the majority of countries expanded their benefit packages and several adjusted payment methods to provide selected COVID-19 services, only half could provide these services free of charge. Many countries also streamlined their processes for contracting and accrediting health providers, thereby reducing administrative hurdles. In conclusion, it was important for the countries to adjust their health purchasing arrangements so that they could adequately respond to the COVID-19 pandemic, but in some countries financing challenges resulted in issues with equity and access. However, it is uncertain whether these adjustments can and will be sustained over time, even where they have potential to contribute to making purchasing more strategic to improve efficiency, quality and equitable access in the long run. [ABSTRACT FROM AUTHOR]

The Covid-19 pandemic is the most recent—and most severe—crisis to face the microfinance/financial inclusion sector, but it was far from the first. From its earliest years, crises have appeared throughout the modern history of microfinance, and the responses they engendered have included some of the most significant reforms and innovations in the sector. In this paper, we describe selected historical crises—Peru in the 1980s, Grameen in the 1990s, and Andhra Pradesh and others in the 2007–2010 period—through their legacy and impact on the sector's activities and priorities. We then examine some of the pressures on institutions during the pandemic, through interview data with MFI leaders from the Sentinel Project conducted during 2021–22. We argue that the resilience of the sector to the unprecedented pressures of the pandemic can be traced to many of these historical post-crisis reforms—and consider what this means for future crisis responses. [ABSTRACT FROM AUTHOR]

Motivation A patient's disease phenotype can be driven and determined by specific groups of cells whose marker genes are either unknown or can only be detected at late-stage using conventional bulk assays such as RNA-Seq technology. Recent advances in single-cell RNA sequencing (scRNA-seq) enable gene expression profiling in cell-level resolution, and therefore have the potential to identify those cells driving the disease phenotype even while the number of these cells is small. However, most existing methods rely heavily on accurate cell type detection, and the number of available annotated samples is usually too small for training deep learning predictive models. Results Here, we propose the method ScRAT for phenotype prediction using scRNA-seq data. To train ScRAT with a limited number of samples of different phenotypes, such as coronavirus disease (COVID) and non-COVID, ScRAT first applies a mixup module to increase the number of training samples. A multi-head attention mechanism is employed to learn the most informative cells for each phenotype without relying on a given cell type annotation. Using three public COVID datasets, we show that ScRAT outperforms other phenotype prediction methods. The performance edge of ScRAT over its competitors increases as the number of training samples decreases, indicating the efficacy of our sample mixup. Critical cell types detected based on high-attention cells also support novel findings in the original papers and the recent literature. This suggests that ScRAT overcomes the challenge of missing marker genes and limited sample number with great potential revealing novel molecular mechanisms and/or therapies. Availability and implementation The code of our proposed method ScRAT is published at https://github.com/yuzhenmao/ScRAT. [ABSTRACT FROM AUTHOR]

Since the inception of the novel coronavirus, immense research efforts have been made to understand how several economic indicators, including food security, would be affected. With India racing behind the United States in terms of daily infection rate and being a country with challenging food security issues, it is important to investigate how the presence of the pandemic has influenced the dynamics of food prices in the country. This paper considers seven price series from 167 markets across the five regions in India as well as the growth rate of COVID-19 infection. The paper uses a time-varying autoregressive model to investigate the nonlinear dynamics of food prices in relation to the pandemic in India. The resultant models reveal strong asymmetric properties with shock-inflicted persistence, which appear not to converge over the simulation period. Moreover, in terms of the location of the burden of the pandemic impact, we find a food product divide. [ABSTRACT FROM AUTHOR]

Background: In 2020, SARS-CoV-2 and the COVID-19 pandemic had a huge impact on the access to and provision of ART treatments. Gradually, knowledge of the virus and its transmission has become available, allowing ART activities to resume. Still, questions on the impact of the virus on human gametes and fertility remain.Objective and Rationale: This article summarizes published data, aiming to clarify the impact of SARS-CoV-2 and the COVID-19 disease on human fertility and assisted reproduction, as well as the impact of vaccination, and from this, provide answers to questions that are relevant for people contemplating pregnancy and for health care professionals.Search Methods: PUBMED/MEDLINE and the WHO COVID-19 database were searched from inception to 5 October 2022 with search terms focusing on 'SARS-CoV-2' and gametes, embryos, reproductive function, fertility and ART. Non-English studies and papers published prior to 2020 were excluded, as well as reviews and non-peer reviewed publications. Full papers were assessed for relevance and quality, where feasible.Outcomes: From the 148 papers included, the following observations were made. The SARS-CoV-2-binding proteins, angiotensin-converting enzyme 2 (ACE2) and type II transmembrane serine protease (TMPRSS2), are expressed in the testis, but co-expression remains to be proven. There is some evidence of SARS-CoV-2 RNA in the ejaculate of COVID-19 patients with severe disease, but not in those with mild/moderate disease. SARS-CoV-2 infection can impair spermatogenesis, but this seems to resolve after one spermatogenic cycle. Testosterone levels seem to be lower during and after COVID-19, but long-term data are lacking; disease severity may be associated with testosterone levels. COVID-19 cannot be considered a sexually transmitted disease. There is no co-expression of ACE2 and TMPRSS2 in the myometrium, uterus, ovaries or fallopian tubes. Oocytes seem to have the receptors and protease machinery to be susceptible to SARS-CoV-2 infection; however, viral RNA in oocytes has not been detected so far. Women contemplating pregnancy following COVID-19 may benefit from screening for thyroid dysfunction. There is a possible (transient) impact of COVID-19 on menstrual patterns. Embryos, and particularly late blastocysts, seem to have the machinery to be susceptible to SARS-CoV-2 infection. Most studies have not reported a significant impact of COVID-19 on ovarian reserve, ovarian function or follicular fluid parameters. Previous asymptomatic or mild SARS-CoV-2 infection in females does not seem to negatively affect laboratory and clinical outcomes of ART. There are no data on the minimum required interval, if any, between COVID-19 recovery and ART. There is no evidence of a negative effect of SARS-CoV-2 vaccination on semen parameters or spermatogenesis, ovarian function, ovarian reserve or folliculogenesis. A transient effect on the menstrual cycle has been documented. Despite concerns, cross reactivity between anti-SARS-CoV-2 spike protein antibodies and Syncytin-1, an essential protein in human implantation, is absent. There is no influence of mRNA SARS-CoV-2 vaccine on patients' performance during their immediate subsequent ART cycle. Pregnancy rates post-vaccination are similar to those in unvaccinated patients.Wider Implications: This review highlights existing knowledge on the impact of SARS-CoV-2 infection or COVID-19 on fertility and assisted reproduction, but also identifies gaps and offers suggestions for future research. The knowledge presented should help to provide evidence-based advice for practitioners and couples contemplating pregnancy alike, facilitating informed decision-making in an environment of significant emotional turmoil. [ABSTRACT FROM AUTHOR]

Background: There has been a large influx of COVID-19 seroprevalence studies, but comparability between the seroprevalence estimates has been an issue because of heterogeneities in testing platforms and study methodology. One potential source of heterogeneity is the response or participation rate.Methods: We conducted a review of participation rates (PR) in SARS-CoV-2 seroprevalence studies collected by SeroTracker and examined their effect on the validity of study conclusions. PR was calculated as the count of participants for whom the investigators had collected a valid sample, divided by the number of people invited to participate in the study. A multivariable beta generalized linear model with logit link was fitted to determine if the PR of international household and community-based seroprevalence studies was associated with the factors of interest, from 1 December 2019 to 10 March 2021.Results: We identified 90 papers based on screening and were able to calculate the PR for 35 out of 90 papers (39%), with a median PR of 70% and an interquartile range of 40.92; 61% of the studies did not report PR.Conclusions: Many SARS-CoV-2 seroprevalence studies do not report PR. It is unclear what the median PR rate would be had a larger portion not had limitations in reporting. Low participation rates indicate limited representativeness of results. Non-probabilistic sampling frames were associated with higher participation rates but may be less representative. Standardized definitions of participation rate and data reporting necessary for the PR calculations are essential for understanding the representativeness of seroprevalence estimates in the population of interest. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has struck businesses across the globe with unprecedented impacts. The world economy has been hit hard and firms have experienced a myriad of challenges, but these challenges have been heterogeneous across firms. This paper examines one important dimension of this heterogeneity: the differential effect of the pandemic on women-led and men-led businesses. The paper exploits a unique sample of close to 40,000 mainly formal businesses from 49 countries covering the months between April and September 2020. The findings show that women-led micro-businesses, women-led businesses in the hospitality industry, and women-led businesses in countries more severely affected by the COVID-19 shock were disproportionately hit compared with businesses led by men. At the same time, women-led micro-firms were markedly more likely to report increasing the use of digital platforms, but less likely to invest in software, equipment, or digital solutions. Finally, the findings also show that women-led businesses were less likely to have received some form of public support although they have been hit harder in some domains. In a crisis of the magnitude of the COVID-19 pandemic, evidence tracing the impact of the shock in a timely fashion is desperately needed to help inform the design of policy interventions. This real-time glimpse into women-led businesses fills this need for robust and policy-relevant evidence, and due to the large country coverage of the data, it is possible to identify patterns that extend beyond any one country, region, or sector, but at the cost of some granularity for testing more complex economic theories. [ABSTRACT FROM AUTHOR]

The coronavirus disease 2019 (Covid-19) pandemic has forced us to reconsider the relationship between public and private research and development (R&D). The policy issue is whether, over the next years, governments' only negotiating position on vaccines and biomedical technologies will be to sign one purchase contract after another and transfer value from taxpayers to investors in pharmaceutical companies. Knowledge and technologies that are crucial to Covid-19 messenger ribonucleic acid vaccine development and production were created with the R&D and financial contribution of governments. Patents filed by pharma companies do not protect the public interest arising from such earlier research. The paper offers a case study on the privatization of knowledge created in the first place by R&D in the public sector or supported by public funds and eventually being appropriated by pharmaceutical corporations. The privatization of knowledge is a more general mechanism, relevant in all industries where patents protect corporate R&D which in turn is supported by government direct or indirect subsidies. [ABSTRACT FROM AUTHOR]

Recent literature on indicators as technology of global governance has shown the power of numbers in shaping knowledge and policy priorities. But not all indicators have powerful effects; some remain invisible. Are such indicators an obverse of powerful indicators? Are the same process of indirect exercise of power to indirectly achieve social and economic effects at work? This paper explores the case of Sustainable Development Goal (SDG) indicator 3.d.1 for the target to build national capacity for pandemic preparedness (target 3d) as a case study of invisible indicators. This indicator has had little traction, despite its relevance in the context of the Coronavirus disease 2019 (COVID-19) pandemic. The paper explores the reasons that explain this paradox through the framework of epistemic infrastructures. It argues that the indicator--the State Party Self-Assessment Report (SPAR) score--was an inconvenient tool for the powerful actors in the global health community as it turned out to be an extremely poor predictor of COVID-19 response performance. It would have exposed not only the failings of the powerful countries that lead the policy agenda for pandemic preparedness but also the legitimacy of their expertise and the paradigm of global health security as an approach to governing health risks. The analysis highlights the tight relationship between power and the use of indicators in global governance. While indicators are increasingly used by powerful actors to reframe policy narratives, the indicator of pandemic preparedness has been kept invisible to maintain their existing framing. It thus illustrates the resilience of power structures in epistemic infrastructures. [ABSTRACT FROM AUTHOR]

Creative and cultural workers (CCWs) concentrate in large cities due to the livelihood opportunities they facilitate. Synchronously, cities have experienced the highest rate of Covid-19 infections. Focusing on the case study of Milan, the paper explores the criticalities of the sector and the impact of the pandemic using qualitative interviews and digital ethnography. It highlights how C-19 has exacerbated the effects of neoliberalism on CCWs, illuminating their precarious working conditions but paradoxically providing time and focus for workers to collectively organise. This paper captures CCWs use of the city to make their precarious working conditions visible in response to the unsustainable demands of neoliberalism. It also engages with the need for re-futuring contemporary understanding of the creative city, questioning the value of agglomeration economies and creative city policies, especially if workers' rights and livelihoods do not become central to the future local policy agenda. [ABSTRACT FROM AUTHOR]

This research explores how central-city shopping districts could be transformed to support a post-Covid lifestyle, where people re-embrace community, local streets and walking while relying more on online shopping. By reviewing metropolitan/city development plans since the 1980s and mapping changes of retail provisions, urban environment and pedestrian movements in Melbourne's Hoddle Grid in the twenty-first century, this paper shows that planning policies focusing on people-centred experiences in the central-city shopping district helped to improve retail resilience. This paper thus adds insights to understanding the relentless retail landscape changes and has implications for central-city retail planning in the post-Covid era. [ABSTRACT FROM AUTHOR]