Vaccination after developing long COVID: Impact on clinical presentation, viral persistence, and immune responses

BACKGROUND

Vaccination protects against severe COVID-19 manifestations. For those with post-COVID-19 conditions (PCC) or long COVID, the impact of COVID-19 vaccination on the evolution of symptoms, immune responses, and viral persistence is unclear.

METHODS

In this prospective observational cohort study, we evaluated the number of PCC symptoms, affected organ systems, and psychological well-being scores before and after patients with PCC received COVID-19 vaccination. We simultaneously evaluated biomarkers of systemic inflammation and levels of plasma cytokines/chemokines. We measured plasma and intracellular levels of SARS-CoV-2 antigens, and immunoreactivity to SARS-CoV-2 antigens in blood.

RESULTS

COVID-19 vaccination was associated with decreases in number of PCC symptoms (pre-vaccination: 6.56 ± 3.1 vs post-vaccination: 3.92 ± 4.02; P <0.001) and affected organ systems (pre-vaccination: 3.19 ± 1.04 vs post-vaccination: 1.89 ± 1.12; P <0.001), and increases in World Health Organization (WHO)-5 Well-Being Index Scores (pre-vaccination: 42.67 ± 22.76 vs post-vaccination: 56.15 ± 22.83; P <0.001). Patients with PCC also had significantly decreased levels of several pro-inflammatory plasma cytokines/chemokines after COVID-19 vaccination including sCD40L, GRO-⍺, macrophage inflammatory protein (MIP)-1⍺, interleukin (IL)-12p40, G-colony stimulating factor (CSF), M-CSF, IL-1β, and stem cell factor (SCF). PCC participants presented a certain level of immunoreactivity toward SARS-CoV-2, that was boosted with vaccination. SARS-CoV-2 S1 antigen persisted in the blood of PCC participants, mostly in non-classical monocytes, regardless of participants receiving vaccination.

CONCLUSIONS

Our study shows higher pro-inflammatory responses associated with PCC symptoms and brings forward a possible role for vaccination in mitigating PCC symptoms by decreasing systemic inflammation. We also observed persistence of viral products independent of vaccination that could be involved in perpetuating inflammation through non-classical monocytes.

Short communication: Accuracy of corpus luteum color flow Doppler ultrasonography to diagnose nonpregnancy in dairy cows on day 21 after insemination

The main objective of this study was to determine the accuracy of corpus luteum color flow Doppler ultrasonography (CLCFDU) to diagnose nonpregnant dairy cows 21 d after insemination. A secondary objective was to determine the accuracy of other indirect tests such as corpus luteum size and progesteronemia. Data from 1,632 Holstein cows (10 commercial herds) were used for the analysis in this prospective cohort study. The herds were visited weekly by a veterinarian and an animal health technician. During farm visits, cows were examined on d 21 after insemination using transrectal B-mode ultrasonography to quantify the presence and size of the corpus luteum. After identification of the corpus luteum, CLCFDU was performed and scored as D0, D1, D2, or D3 when 10% or less, between 11 and 30%, between 31 and 60%, or 61% or more of the corpus luteum surface was colored, respectively. A blood sample from coccygeal vessels was also collected to quantify progesteronemia. Farmers were blinded to these findings and no intervention was performed following examination. On d 32 after insemination, the cows were examined by the regular herd veterinarian using transrectal palpation and B-mode ultrasonography to determine whether the cows were pregnant or not (the reference test). Statistical analyses were conducted using 2 × 2 contingency tables. The apparent prevalence, sensitivity, specificity, positive predictive value, and negative predictive value of CLCFDU for predicting nonpregnancy were 22.0, 36.6, 99.0, 98.1, and 52.0%, respectively, when using D0 only as the diagnostic criterion; they were 47.2, 76.4, 94.8, 93.5, and 73.8%, respectively, for D0+D1 criteria. The same measures for cows with a corpus luteum <15 mm were 8.0, 11.7, 97.5, 86.9, and 43.4%, respectively, and they were 51.9, 67.4, 70.4, 76.6, and 60.0%, respectively, for progesteronemia <1 ng/mL. The measures of accuracy of CLCFDU to identify nonpregnant cows on d 21 after insemination were high, and the apparent prevalence varied depending on the diagnostic criteria used. The measures of accuracy of corpus luteum size (<15 mm) for the same purpose were high; however, apparent prevalence was low. The measures of accuracy of progesteronemia (<1 ng/mL) were low. In conclusion, CLCFDU had excellent accuracy to diagnose nonpregnancy in dairy cows on d 21 after insemination.

Assessment of the American Heart Association's "Life's simple 7" score in French-speaking adults from Québec

BACKGROUND AND AIMS

The "Life's Simple 7" (LS7) metrics were developed by the American Heart Association (AHA) to assess and promote cardiovascular health in the American population. The purpose of this study was to assess the overall cardiovascular health of French-speaking adults from the Province of Quebec using the LS7 score.

METHODS AND RESULTS

A total of 777 age and sex-representative participants of five different administrative regions in the Province of Quebec (387 men and 390 women; mean age ± SEM: 41.9 ± 0.1 years) were included in these analyses. Metrics of the LS7 score (smoking, physical activity, diet, body mass index, blood pressure, fasting total cholesterol and blood glucose) were analysed to generate a final score ranging from 0 to 7. Only 0.5% of participants met all criteria for ideal cardiovascular health. The diet metric showed the lowest prevalence of "ideal" scores (4.8%) whereas not smoking was the metric with the highest prevalence (88.1%). Women had a higher LS7 score than men, while age and education level (negative and positive association, respectively; p < 0.0001) were also associated with the LS7 score.

CONCLUSION

Consistent with studies conducted among other populations, very few French-speaking adults from the Province of Quebec achieve an ideal cardiovascular health. These data indicate that further public health efforts aimed at promoting the LS7 metrics, focusing primarily on diet, are urgently needed. Specific groups, including older adults and those with lower levels of education, should be targeted when developing cardiovascular health promotion interventions.

Glycaemic control and self-management behaviours in Type 2 diabetes: results from a 1-year longitudinal cohort study

AIM

To better understand the associations between changes in self-management behaviours and glycaemic control.

METHODS

We conducted a prospective observational study of 295 adult patients with Type 2 diabetes evaluated at baseline, 6 and 12 months. Four self-management behaviours were evaluated using the Summary of Diabetes Self-Care Activities instrument, which assesses healthy diet, physical activity, medication taking and self-monitoring of blood glucose. Using hierarchical linear regression models, we tested whether changes in self-management behaviours were associated with short-term (6-month) or long-term (12-month) changes in glycaemic control, after controlling for demographic and clinical characteristics.

RESULTS

Improved diet was associated with a decrease in HbA1c level, both at 6 and 12 months. Improved medication taking was associated with short-term improvement in glycaemic control, while increased self-monitoring of blood glucose frequency was associated with a 12-month improvement in HbA1c . Completely stopping exercise after being physically active at baseline was associated with a rise in HbA1c level at 6-month follow-up. Interaction analysis indicated that a healthy diet benefitted all participant subgroups, but that medication taking was associated with glycaemic control only for participants living in poverty and more strongly for those with lower educational levels. Finally, a higher self-monitoring of blood glucose frequency was associated with better glycaemic control only in insulin-treated participants.

CONCLUSIONS

Even after adjusting for potential confounders (including baseline HbA1c ), increased frequency of healthy diet, medication taking and self-monitoring of blood glucose were associated with improved HbA1c levels. These self-management behaviours should be regularly monitored to identify patients at risk of deterioration in glycaemic control. Barriers to optimum self-management should be removed, particularly among socio-economically disadvantaged populations.

Coroners' records on suicide mortality in Montréal: limitations and implications in suicide prevention strategies

INTRODUCTION

In Montréal, the characteristics of suicide cases may vary between different areas. The information collected by coroners during their investigations of suicides could be used to support local suicide-prevention planning actions.

METHODS

This study analyzes all coroners' records on suicide in Montréal from 2007 to 2009 to (1) determine the usefulness of the data available; (2) develop a profile of cases; (3) examine local differences by comparing two areas, one with the highest suicide rate and the other with the lowest.

RESULTS

The data collected revealed the lack of a systematic, standardized procedure for recording information about deaths by suicide. The rates of missing data varied, but were very high for antecedents of suicide attempts and recent events that could have precipitated the suicide. We observed differences in the characteristics of suicide cases according to area of residence.

CONCLUSION

By adopting a standardized procedure for collecting information on cases of suicide, coroners could provide local decision makers with a more accurate portrait of the people who die by suicide in their area. Local adjustments may improve suicide prevention strategies.

Coroners' records on suicide mortality in Montréal: limitations and implications in suicide prevention strategies

Introduction

In Montréal, the characteristics of suicide cases may vary between different areas. The information collected by coroners during their investigations of suicides could be used to support local suicide-prevention planning actions.

Methods

This study analyzes all coroners' records on suicide in Montréal from 2007 to 2009 to 1. determine the usefulness of the data available; 2. develop a profile of cases; 3. examine local differences by comparing two areas, one with the highest suicide rate and the other with the lowest.

Results

The data collected revealed the lack of a systematic, standardized procedure for recording information about deaths by suicide. The rates of missing data varied, but were very high for antecedents of suicide attempts and recent events that could have precipitated the suicide. We observed differences in the characteristics of suicide cases according to area of residence.

Conclusion

By adopting a standardized procedure for collecting information on cases of suicide, coroners could provide local decision makers with a more accurate portrait of the people who die by suicide in their area. Local adjustments may improve suicide-prevention strategies.

The structural integrity of glial scar tissue associated with a chronic spinal cord lesion can be altered by transplanted fetal spinal cord tissue

The potential for fetal spinal cord (FSC) tissue transplants to modify an established glial scar or to restrict the reformation of a scar following surgical manipulation of a chronic lesion site was studied in the injured rat spinal cord. Six to eight weeks after preparation of a hemisection lesion cavity, glial scar tissue was left intact in one group, whereas in a second group it was excised prior to transplantation of a suspension of FSC tissue. From the first group, examination of serial sections through the graft-host interface that had been immunoreacted for glial fibrillary acidic protein (GFAP) demonstrated that in many cases the glial scar no longer was a continuous wall separating the two tissues. Quantitation of the area occupied by these discrete gaps in the scar provided an Index of Fusion, indicating the extent of direct contact between the transplant and host spinal cord. In some animals this constituted as much as 60% of the interface, while in others there were no breaks in the scar (0% fusion). Reinjury of the spinal cord lead to a rapid astrocytic response culminating in the reestablishment of a dense matrix of glial cells and processes covered by a basal lamina. This reformed scar effectively isolated the spinal cord from the external environment of the cavity. When FSC tissue was transplanted after first removing scar tissue the continuity of reformed glial scarring at the graft-host interface was altered. Distinct gaps in the scar appeared randomly along the interface. The mean Index of Fusion for animals receiving a moderate reinjury (removal of scar tissue only) was not as high as for those animals in which a more severe reinjury (expansion of the cavity by 0.5 mm) was performed before transplantation. The extent of graft-host fusion was not significantly improved when scar tissue was removed prior to transplantation. These findings support the hypothesis that the presence of FSC tissue will have an effect on the persistence of glial scar tissue in a chronic lesion site as well as limit the extent to which a new scar is formed in response to a second injury to the spinal cord.

A glycosylation mutation affects cell fate in chimeras of Dictyostelium discoideum

Prestalk and prespore cells form a simple pattern in the pseudoplasmodium of the cellular slime mold Dictyostelium discoideum. Prestalk cells are distinguished from prespore cells by a low level of expression of a glycoantigen on their surfaces and by reduced intercellular cohesion. We examined the possible significance of these differences, using the modB mutation, which eliminates this glycoantigen genetically, leading to reduced intercellular cohesion, modB mutant cells were allowed to develop together with normal cells to form chimeric slugs. Mutant cells labeled by feeding with fluorescent bacteria were highly enriched in the prestalk cell zone at the anterior end of the slug. In contrast, normal cells, if in a minority, were concentrated in the rear part of the prespore cell zone. Immunoblot analysis and cell-by-cell double-label immunofluorescence of these mixtures showed that mutant cells underproduced several prespore cell markers. Mutant cells tended not to form spores in chimeras unless they exceeded a threshold proportion of ca. 30%. However, mutant cells showed no tendency to produce excess prestalk cells when allowed to develop alone. These findings are most simply explained by postulating that reduced glycoantigen expression and intercellular adhesion encourage a more anterior cell localization, which in turn causes differentiation into a prestalk cell. Since normal prestalk cells also show reduced glycoantigen expression and intercellular adhesion, this suggests that a similar mechanism may contribute to pattern formation during normal development.

Regeneration of adult dorsal root axons into transplants of embryonic spinal cord

Transplants of the embryonic rat spinal cord survive and differentiate in the spinal cords of adult and newborn host rats. Very little is known about the extent to which these homotopic transplants can provide an environment for regeneration of adult host axons that normally terminate in the spinal cord. We have used horseradish peroxidase injury filling and transganglionic transport methods to determine whether transected dorsal roots regenerate into fetal spinal cord tissue grafted into the spinal cords of adult rats. Additional transplants were examined for the presence of calcitonin gene-related peptide-like immunoreactivity, which in the normal dorsal horn is derived exclusively from primary afferent axons. Host animals had one side of the L4-5 spinal cord resected and replaced by a transplant of E14 or E15 spinal cord. Adjacent dorsal roots were sectioned and juxtaposed to the graft. The dorsal roots and their projections into the transplants were then labeled 2-9 months later. The tracing methods that used transport or diffusion of horseradish peroxidase demonstrated that severed host dorsal root axons had regenerated and grown into the transplants. In addition, some donor and host neurons had extended their axons into the periphery to at least the midthigh level as indicated by retrograde labeling following application of tracer to the sciatic nerve. Primary afferent axons immunoreactive for calcitonin gene-related peptide were among those that regenerated into transplants, and the projections shown by this immunocytochemical method exceeded those demonstrated by the horseradish peroxidase tracing techniques. Growth of the host dorsal roots into transplants indicates that fetal spinal cord tissue permits regeneration of adult axotomized neurons that would otherwise be aborted at the dorsal root/spinal cord junction. This transplantation model should therefore prove useful in studying the enhancement and specificity of the regrowth of axons that normally terminate in the spinal cord.

Temporal relationship between the appearance of vimentin and neural tube development

Intermediate filaments of the vimentin type that were initially identified within mesodermally derived cells have recently been demonstrated within several immature cell types derived from neuroectoderm, such as astroblasts and early stage neuroblasts. The objective of the present study was to determine the earliest developmental stage at which vimentin could be detected in the mouse neural tube. Vimentin was not detectable in the newly formed neural tube in E8 embryos. In the E9 neural tube the first positively labeled processes were observed in the ventrolateral region of the cervical neural tube with the processes having the distribution and appearance of those of radial glial cells. Between E9 and E10 there was a significant increase in the vimentin content of the neural tube as labeled filamentous bundles were observed throughout the ventricular cell layer and in the forming mantle layer. The distribution of labeled filaments in the E11 neural tube was similar to that of the E10 tissue although staining intensity was greater in the mantle layer in the E11 tissue. This work identifies the temporal relationship between the appearance of vimentin and neural tube development.