Between 10%-26% of COVID patients develop Post COVID condition (PCC). The complex interaction between autoimmunity and SARS-CoV-2 is emerging as an important challenge and an opportunity to improve diagnosis and treatment of immune mediated chronic illnesses. In a retrospective cohort study using electronic health records from a Massachusetts group medical practice, we identified 38,327 patients with a COVID-19 diagnosis and 1,143 with a PCC diagnosis from 1/1/2020 to 6/25/2023. We investigated the hypotheses that auto-immune diseases-1) increase risk of developing PCC; 2) were more likely to develop after COVID-19; and 3) medical utilization would be higher in patients with a PCC diagnosis. We compared COVID-19 patients with and without a PCC diagnosis. We evaluated demographics, PCC symptoms, pre-infection comorbidities, autoimmune diseases pre- and post- SARS-CoV-2 infection, and medical utilization. Females were more likely to have a PCC diagnosis (63%, p = 0.012). High BMI (> 30), pre-infection chronic respiratory disease, and "any post-infection autoimmune disease" were also associated with PCC diagnosis, OR= 1.25, (95% CI: 1.11, 1.41); OR=1.64, (95% CI: 1.45, 1.86), OR=1.57, (95% CI: 1.10, 2.24), respectively. Pre-infection, psoriasis OR=1.41 (95% CI: 1.04, 1.91) and rheumatoid arthritis OR=1.64, (95% CI: 1.00, 2.69) were more likely to be observed in patients with a PCC diagnosis. Post-infection, Sjögren's syndrome, OR=4.05 (95% CI: 1.94, 8.49) was more likely among PCC diagnosed patients and rheumatoid arthritis OR=3.18 (95% CI: 0.99, 10.46) may also be more prevalent. We observed approximately one more day of medical utilization per month among patients with a PCC diagnosis (p < 0.001). We confirm PCC diagnosis is more prevalent among women, patients with high BMI and chronic respiratory disease. Our findings support emerging evidence that pre-existing autoimmune diseases may increase risk of PCC, SARS-CoV-2 may increase the risk of new onset autoimmune disease, and medical utilization is higher among patients with PCC.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has had a global impact, underscoring the importance of personal protective equipment (PPE). Use of N95s reduces the risk of airborne infection; however, in the absence of equitable designs, health care workers (HCWs) who do not fit the average White male head and face are at an increased risk of airborne infectious diseases.

Primary: Feasibility of a mixed-method study, with a sample size of 100, 50% of participants self-identifying as non-White and having at least one characteristic of interest. Secondary: (1) Generate quantitative evidence on N95 fit using a PortaCount fit test, (2) describe participant-reported feelings on fit and breathability, and (3) evaluate the impacts of the pandemic on a HCW's physical and mental well-being.

This was a mixed-method prospective pilot and feasibility study. Quantitative fit was assessed using a TSI PortaCount test and measurements of bizygomatic breadth and Menton-Sellion length. A survey was administered to collect sociodemographic information, HCWs' assessment of N95 fit, comfort, and the impact of PPE-related challenges on well-being.

This study was limited by a small sample size, as COVID-19 pandemic restrictions prevented adequate recruitment to detect differences between groups. We describe key findings that should inform analyses of the impact of gender and ethnicity on N95 respirator fit. Following a study amendment to increase eligible sites, 37 of the 41 (90.2%) approached HCWs consented to participate. Compared to other HCWs, non-White females had the lowest mean fit factor. Differences in Menton-Sellion length and bizygomatic breadth were observed between males, females, and White and non-White HCWs. Most HCWs reported physical discomfort and negative impacts on their psychological well-being.

We identified gender and ethnicity as key factors in the fit of N95s. Differences in gender, ethnicity, and anthropometric measures must be considered in respirator designs.

Presenteeism-defined as continuing to work during an illness-poses a public health risk in the workplace and is especially hazardous within health care institutions where vulnerable patients may be exposed to nosocomial infections. Understanding the frequency and characteristics of health care personnel (HCP) who report presenteeism while ill with COVID-19 may help mitigate SARS-CoV-2 spread in hospitals and other health care institutions.

To determine the frequency of presenteeism among HCP with symptomatic COVID-19, and to evaluate the demographic, occupational, and clinical factors associated with it.

This is an observational cohort study that uses data from the Preventing Emerging Infections Through Vaccine Effectiveness Testing (PREVENT) project: a test-negative, case-control vaccine effectiveness study that enrolled HCP who had COVID-19 symptoms at 24 academic medical centers from December 2020 through April 2024.

Exposures include demographic, occupational, and clinical characteristics of participants.

Having confirmed symptomatic COVID-19 infection and reporting presenteeism; overall frequency of presenteeism through the study period and the association of the exposure characteristics with presenteeism, adjusting for confounders using 3 multivariable models. Presenteeism was defined as HCP who did not stop working during their illness, but the study did not differentiate whether they continued working remotely.

A total of 3721 HCP were included in the analysis (2842 [76.4%] aged 18-49 years; 2993 [80.4%] female; 278 [7.5%] Asian, 406 [10.9%] Black, and 2912 [78.3%] White). Overall, 293 (7.9%) reported presenteeism during the study period, and the frequency of presenteeism increased each year of the study period (from 1 of 73 [1.4%] in 2020 to 16 of 105 [15.2%] in 2024). Presenteeism was associated with HCP who have minimal patient contact (adjusted odds ratio [aOR], 3.73; 95% CI, 2.39-4.37), a graduate or professional degree (aOR, 1.90; 95% CI, 1.45-2.50), and income over $100 000 (aOR, 1.74; 95% CI, 1.12-2.69).

In this observational cohort study of 3721 HCP, there was an increasing frequency of presenteeism from 2020 through 2024, and job role and socioeconomic factors were associated. More studies are needed to understand the rationale behind the decision to continue working and the exact causes of presenteeism's rising incidence among HCP with COVID-19.

Since the Supreme Court's 2022 decision in Dobbs v Jackson Women's Health Organization, state legislatures have enacted laws severely restricting abortion. Facility case studies have reported post-Dobbs increases in patient volume and gestational length at abortion.

To understand changes from before to after the Dobbs decision in the overall volume of callers and gestational length of their pregnancies at a large, regional abortion fund.

This cross-sectional study used data from monthly caller records (June 2016-June 2024) from the District of Columbia Abortion Fund (DCAF) using interrupted time series analyses with segmented regression. DCAF serves the Washington, DC, area, which is unique in its absence of gestational restrictions, service availability, and proximity to states with post-Dobbs restrictions. Data were analyzed from November 2024 through August 2025.

Time in months, with change points and discontinuities after the Dobbs decision. To contextualize trends, change points and discontinuities were examined at the onset of the COVID-19 pandemic, the enactment of a 6-week abortion ban in Texas, and the enactment of a 12-week ban in North Carolina.

Overall call volume and gestational length of callers, measured dichotomously (first trimester vs ≥13 weeks) and continuously (weeks' gestation).

Among 43 351 DCAF caller records, 31% had pregnancies at 13 weeks' gestation or greater. After the Dobbs decision, there was a sudden and substantial reversal of a prior 6-year trend of increasing call volume, as indicated by both an immediate drop (from 721 to 663 callers per month; coefficient, -10.7% [95% CI, -16.8% to -4.7%]), and a continued decrease over the subsequent year (coefficient, -12.7% [95% CI, -13.6% to -11.6%] per month). Concurrently, there was a sharp increase in the proportion of callers whose pregnancies were at 13 weeks' gestation or later, from approximately 22% just before Dobbs to 32% the month after the Dobbs decision (odds ratio [OR], 1.61 [95% CI, 1.39 to 1.87]); this increase continued (OR per month, 1.07 [95% CI, 1.06 to 1.09]), reaching a peak of 53% per year post-Dobbs. Both trends reversed after the enactment of North Carolina's 12-week ban.

In this cross-sectional study of caller records at a large abortion fund, there were immediate and lasting changes in the volume and gestational length of callers following the Dobbs decision, suggesting differential redistribution of access or care-seeking by trimester and/or delays in presentation for care.

The objective of this study is to answer the question "What is the most common and severe type of nasal discharge in patients with chronic rhinosinusitis (CRS) at baseline as measured by patient-reported outcomes?".

Two independent reviewers evaluated studies for inclusion, extracted data from included studies, and performed critical appraisal of studies. Data on the four Sino-Nasal Outcome Test 22 (SNOT22) discharge questions, demographic, and comorbidity data was collected. Meta-analysis of single means and proportions was performed for demographic, comorbidity, severity, and prevalence data.

A total of 53 studies (n = 6584) were included for analysis. Postnasal drip (PND) was the most severe symptom (2.6, 95%CI: 2.2-3) and most prevalent (80.7%, 95%CI: 53.0-97.7). Patients without nasal polyps had a higher PND score than those with polyps (2.56 vs 2.40, 95%CI: 0.1-0.2). However, patients with polyps reported higher symptom scores for need to blow nose, runny nose, and thick nasal discharge (all p < 0.0001).

CRS patients experience PND at a higher prevalence and severity at baseline than the other three forms of nasal discharge captured by the SNOT22. Polyp status influences differing symptoms of nasal drainage. Comorbid asthma or allergies are associated with more severe PND and total SNOT22 scores.

Partisanship is a factor behind COVID-19 vaccine hesitancy in USA. A growing body of research indicates that conservative Republicans demonstrate greater vaccine hesitancy than their liberal Democratic counterparts. Importantly, older adults tend to be more conservative yet exhibit less vaccine hesitancy overall. Accordingly, this study investigates age as a moderating factor in early vaccine attitudes, addressing a gap in the current literature. Leveraging protection motivation theory and data from the Collaborative Multiracial Post-Election Survey (N = 15 000), our analysis suggests that the relationship between partisanship and COVID-19 vaccine hesitancy is conditioned by age, as measured both continuously and categorically through generational cohorts. Our primary contribution is the finding of no partisanship effect on the oldest cohort of Americans in the earliest days of COVID-19 vaccine implementation. For adults from the Silent Generation, partisanship has no systematic effect on COVID-19 vaccine hesitancy. Furthermore, for younger partisans, vaccination attitudes are more closely tied to political identity than previously known. Our findings uncover generational diversity and provide novel insight into vaccine hesitancy across age and partisanship. Examining age interactions is crucial since age is a major risk factor for many infectious diseases worldwide. Understanding this relationship is essential to ensure that vaccine campaigns are targeted in the most effective way. We present an important contribution that is intersectional in nature, furthering research in both health behavior and politics.

Being obese considerably elevates the risk of both obstructive sleep apnea syndrome (OSAS) and mortality. Although body mass index (BMI) is a common measure, it neglects visceral adiposity, a critical factor in the development of cardiometabolic and respiratory dysfunction. By integrating waist circumference and height, the body roundness index (BRI) delivers a more accurate evaluation of central fat distribution, potentially improving the prediction of OSAS and mortality.

We analyzed data from 13,854 US adults aged ≥20 years from the NHANES 2005-2008 and 2015-2018 cycles. Using multivariable logistic and Cox regression models, along with restricted cubic spline and subgroup analyses, the connections of BRI and BMI with OSAS and all-cause mortality were examined, and ROC curves were employed to compare predictive performance.

Both BRI and BMI were significantly associated with increased OSAS risk, with stronger associations observed for BRI (adjusted odds ratio [OR] = 3.060, 95% confidence interval [CI]: 2.880-3.251, p < 0.001) than for BMI (adjusted OR = 1.573, 95% CI: 1.535-1.612, p < 0.001). In OSAS patients, BRI was positively associated with all-cause mortality (adjusted hazard ratio [HR] = 1.087, 95% CI: 1.036-1.141, p < 0.001; Q4 vs. Q1: HR = 1.423, 95% CI: 1.073-1.887, p = 0.014), while BMI showed an inverse crude association that became marginally positive after adjustment (adjusted HR = 1.021, 95% CI: 1.001-1.040, p = 0.038; Q4 vs. Q1: HR = 1.378, 95% CI: 0.966-1.964, p = 0.037). BRI demonstrated superior predictive value for mortality (area under the curve [AUC] = 0.610) compared to BMI (AUC = 0.521; p < 0.001), despite comparable performance for OSAS prediction (BRI AUC = 0.793 vs. BMI AUC = 0.790; p = 0.236).

BRI and BMI showed comparable ability to predict OSAS risk; however, BRI demonstrated superior value in mortality stratification, emphasizing its clinical significance for assessing visceral fat-related prognosis. Because OSAS was identified using a validated questionnaire rather than polysomnography, minor classification errors may exist, warranting cautious interpretation of the findings.

Asthma is the most common chronic health condition affecting children in Aotearoa New Zealand, with Māori and Pacific children disproportionately burdened by high morbidity and inequitable care. Despite clinical guidelines and growing research, inconsistencies in diagnosis, treatment adherence, and education persist. This scoping review identifies and maps literature on care models, service delivery, education and support strategies, and experiences of children, young people, and their family/whānau in asthma care and management for those under 18 in Aotearoa New Zealand.

This scoping review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. We searched MEDLINE, CINAHL, Scopus, PsychINFO, and grey literature for articles published between 2014 and 2024 on asthma care for children under 18 in Aotearoa New Zealand. Eligible articles from health or community settings were thematically analysed using conventional content analysis.

Twenty-one articles met inclusion criteria, including qualitative, quantitative, mixed-methods, and policy or guideline documents. Thematic analysis revealed four interconnected themes: (1) medications and adherence, (2) education and health literacy, (3) children and whānau experiences, and (4) culture and beliefs. Findings reflect persistent inequities in asthma outcomes and care access, especially for Māori and Pacific children and highlight opportunities to strengthen culturally safe and family/whānau-centred care to improve asthma care, treatment and its management.

This review identifies key gaps in asthma care for children in Aotearoa New Zealand and calls for more responsive, culturally grounded models to improve asthma outcomes across diverse settings.

In 2021, the National Institutes of Health launched a multi-centre observational study on long Covid: Researching COVID to Enhance Recovery (RECOVER). Six Boston academic medical centres joined community partners to become the Boston COVID Recovery Cohort (BCRC), a consortium of RECOVER sites. Our consortium developed a community engagement model, and this manuscript shares lessons and recommendations.

The BCRC Community Partnership Table, which included community partners, senior equity leaders, academic researchers and health system collaborators, co-developed a charter to advance research, community education, clinical care, social support and institutional and policy change goals. BCRC engaged patients, providers, caregivers and legislators via multiple communication channels.

The BCRC Community Partnership Table faced several challenges: working within a novel, evolving pandemic; structural barriers to successful community engagement; perspectives on trustworthiness of research; and working across multiple organisations with distinct structures, resources and goals. There were also successes: leaders who were invested in community engagement; a focus on inclusive network building; co-production; flexible communication channels; a shift to centring communities and patients; and connection with the legislature to support broader policy impacts.

To inform future community engagement models, we recommend the following: (1) healthcare research funders should build in time and resources for community engagement; (2) study consortia should include community engagement specialists in decision-making positions from the outset; and (3) community members should have prominent roles leading research engagement efforts.

Engagement models can enhance the equity impact of long Covid research. Reflections and recommendations in this paper can inform future efforts.

The project included community leaders, community-based organisations, people with long Covid, and those caring for people with long Covid. Community leaders, community-based organisations and people with long Covid are included in every aspect of the network. They inform decision-making, play a key role in network leadership and are also all represented within the authorship team.

There is contradicting information regarding the effect of COVID-19 on mortality in African settings. Knowledge of the complete direct and indirect burden of COVID-19 on mortality is heavily reliant on the availability of a population-based surveillance system. Here we provide robust data on the effect of COVID-19 on mortality trends in a rural, coastal, Kenyan community.

A historical cohort study using data from the Kaloleni Rabai Health and Demographic Surveillance System was conducted with special focus on two discernible time periods representing the pre-COVID-19 (2018-2019) and COVID-19 (2020-2021) periods. Mortality rates were estimated as the total number of deaths divided by the person-time (years) at risk, accounting for attrition, and calculated separately for the two periods. A cox proportional hazards model was used to estimate the impact of COVID-19 on mortality.

1191 deaths occurred between 2018 and 2021. There was no significant change in overall mortality rates between pre-COVID-19 and COVID-19 periods (3.7 and 3.6 per 1000 person years at risk respectively, p = 0.74). Older age was significantly associated with mortality (a_HR: 1.05, 95% CI: 1.05-1.06; p < 0.001). However, an interaction term between age and time-period appeared to reverse this association (a_HR: 0.99, 95% CI: 0.99-1.00; p < 0.001).

Our findings suggest that although overall COVID-19 did not directly impact mortality rates within this rural population, the onset of the pandemic did appear to reverse and/or attenuate the impact of several risk factors on mortality. It is possible that COVID-19 brought health and wellness into sharp focus, making people more vigilant about their health, hygiene and associated preventive measures.