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Why have some territories performed better than others in the fight against COVID‐19? This paper uses a novel dataset on excess mortality, trust and political polarization for 165 European regions to explore the role of social and political divisions in the remarkable regional differences in excess mortality during the first wave of the COVID‐19 pandemic. First, we investigate whether regions characterized by a low social and political trust witnessed a higher excess mortality. Second, we argue that it is not only levels, but also polarization in trust among citizens – in particular, between government supporters and non‐supporters – that matters for understanding why people in some regions have adopted more pro‐healthy behaviour. Third, we explore the partisan make‐up of regional parliaments and the relationship between political division – or what we refer to as 'uncooperative politics'. We hypothesize that the ideological positioning – in particular those that lean more populist – and ideological polarization among political parties is also linked to higher mortality. Accounting for a host of potential confounders, we find robust support that regions with lower levels of both social and political trust are associated with higher excess mortality, along with citizen polarization in institutional trust in some models. On the ideological make‐up of regional parliaments, we find that, ceteris paribus, those that lean more 'tan' on the 'GAL‐TAN' spectrum yielded higher excess mortality. Moreover, although we find limited evidence of elite polarization driving excess deaths on the left‐right or GAL‐TAN spectrums, partisan differences on the attitudes towards the European Union demonstrated significantly higher deaths, which we argue proxies for (anti)populism. Overall, we find that both lower citizen‐level trust and populist elite‐level ideological characteristics of regional parliaments are associated with higher excess mortality in European regions during the first wave of the pandemic. [ABSTRACT FROM AUTHOR]

Sweden has been considered both pioneer and pariah in regard to its approach to the novel coronavirus SARS-CoV-2 and its pandemic disease, COVID-19. While much of Europe went into economic hibernation and rigid lockdown in the first wave of novel coronavirus infections in the spring of 2020, Sweden kept its borders, bars, restaurants, schools, gyms etc. open. Organised children’s sporting arrangements were also encouraged, on the basis that socialising and physical activity outweighed the risks posed by COVID-19 to children. Public transportation could still be freely used. Masks were not worn. This paper examines the often controversial tenets of the Swedish public health response to COVID-19, and how widely it has appealed to public health experts and officials in Europe and beyond. Debates within the country are also discussed. What it shows is that, despite rising levels of infection in a second wave in Europe and concessions that it might have even failed, the Swedish model is being adopted by stealth and admired from afar. [ABSTRACT FROM AUTHOR]

Acromegaly embraces typical complications of a pituitary tumor as well as GH (growth hormone) and IGF1 (insulin-like growth factor) excess-related cardio-metabolic and oncologic conditions; and associated medical, surgical treatment or even radiotherapy issues. We point out a few particular aspects concerning acromegaly issues amid COVID-19 pandemic. The review includes only full length, English published papers. One of the most important complications of long standing, untreated or un-responsive to therapy acromegaly is related to respiratory and otorhinolaryngology issues like sleep apnea; this becomes an important aspect causing pulmonary complications in patients with active coronavirus infection. In subjects who are not going through a COVID-19 infection, but they had a prior diagnostic of acromegaly, two main aspects of medical and surgical practice were noted: a massive reduction of surgical volume during the first year of pandemic, mostly during peak months of high infection rate in general population and the introduction of tele (digital) health care systems, of different protocols and various platforms mostly depending of medical center, rather than country or even continent related protocols. Associated central adrenal insufficiency requires a particular attention if COVID-19 positive. The data directly targeting the endocrinologists amid pandemic are very limited. ACROCOVID is a 2021 study that was internationally conducted based on a questionnaire that was applied to 84 endocrinologists (67% of them in Europe); 33% of acromegalic individuals had a delay on procedure because of insufficient COVID-19 assays and 54% of them due to inefficient provision for neurosurgery. Secondary diabetes mellitus (with a potential worsening in some patients due to pasireotide LAR) is at high risk for COVID-19 infection; the level of glycated hemoglobin A1c seems a good predictor at onset of infectious disease. Acromegaly might associate osteoporosis; coronavirus infection aggravates bone loss due to oxidative stress, inflammatory status, cytokine release, immobilization, glucocorticoid use. Acromegaly field concerning pandemic changes represents a complex, still ongoing matter involving both patients and multidisciplinary practitioners. [ABSTRACT FROM AUTHOR]

How do political parties respond to external shocks? Using an original survey of political parties across Europe conducted in June 2020 and Chapel Hill Expert Survey (CHES) data on partisan ideological positioning, we argue that the pre‐existing ideological stances of Europe's political parties shaped their response to emerging Covid‐19 policy issues, including the tension between economic normalization and containment, legal versus voluntary enforcement and the role of science in policymaking. We find that party ideology powerfully predicts how parties, both in government and in opposition, responded to the pandemic. [ABSTRACT FROM AUTHOR]

Severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) caused outbreaks of the pandemic starting from the end of 2019 and, despite ongoing vaccination campaigns, still influences health services and economic factors globally. Understanding immune protection elicited by natural infection is of critical importance for public health policy. This knowledge is instrumental to set scientific parameters for the release of "immunity pass" adopted with different criteria across Europe and other countries and to provide guidelines for the vaccination of COVID-19 recovered patients. Here, we characterized the humoral response triggered by SARS-CoV-2 natural infection by analyzing serum samples from 94 COVID-19 convalescent patients with three serological platforms, including live virus neutralization, pseudovirus neutralization, and ELISA. We found that neutralization potency varies greatly across individuals, is significantly higher in severe patients compared with mild ones, and correlates with both Spike and receptor-binding domain (RBD) recognition. We also show that RBD-targeting antibodies consistently represent only a modest proportion of Spike-specific IgG, suggesting broad specificity of the humoral response in naturally infected individuals. Collectively, this study contributes to the characterization of the humoral immune response in the context of natural SARS-CoV-2 infection, highlighting its variability in terms of neutralization activity, with implications for immune protection in COVID-19 recovered patients. [ABSTRACT FROM AUTHOR]

In the first months of the COVID-19 pandemic in Europe, many patients were treated in hospitals using mechanical ventilation. However, due to a shortage of ICU ventilators, hospitals worldwide needed to deploy anesthesia machines for ICU ventilation (which is off-label use). A joint guidance was written to apply anesthesia machines for long-term ventilation. The goal of this research is to retrospectively evaluate the differences in measurable ventilation parameters between the ICU ventilator and the anesthesia machine as used for COVID-19 patients. In this study, we included 32 patients treated in March and April 2020, who had more than 3 days of mechanical ventilation, either in the regular ICU with ICU ventilators (Hamilton S1), or in the temporary emergency ICU with anesthetic ventilators (Aisys, GE). The data acquired during regular clinical treatment was collected from the Patient Data Management Systems. Available ventilation parameters (pressures and volumes: PEEP, Ppeak, Pinsp, Vtidal), monitored parameters EtCO2, SpO2, derived compliance C, and resistance R were processed and analyzed. A sub-analysis was performed to compare closed-loop ventilation (INTELLiVENT-ASV) to other ventilation modes. The results showed no major differences in the compared parameters, except for Pinsp. PEEP was reduced over time in the with Hamilton treated patients. This is most likely attributed to changing clinical protocol as more clinical experience and literature became available. A comparison of compliance between the 2 ventilators could not be made due to variances in the measurement of compliance. Closed loop ventilation could be used in 79% of the time, resulting in more stable EtCO2. From the analysis it can be concluded that the off-label usage of the anesthetic ventilator in our hospital did not result in differences in ventilation parameters compared to the ICU treatment in the first 4 days of ventilation. [ABSTRACT FROM AUTHOR]