Rugby concussion to be studied in grassroots games for the first time by University of Essex

Reports and Proceedings

UNIVERSITY OF ESSEX

 

IMAGE: TWO COLCHESTER RUFC PLAYERS PRACTICE TACKLING view more 

CREDIT: THE UNIVERSITY OF ESSEX/EAST NEWS

Concussion in grassroots rugby will be investigated in a new cutting-edge technology trial which could transform player safety across the globe.   
    
For the first time the impact of collisions, head injuries and recovery time will be explored across an entire amateur season by researchers at the University of Essex working with wearable tech firm PhysiGo and Colchester Rugby Club’ 

The study comes as the devastating impact of repeated head trauma hits the headlines with some professional players - including England ace Steve Thompson and former Wales captain Ryan Jones – announcing they are suffering from early-onset dementia. 

The research team, from Essex’s School of Sport, Rehabilitation and Exercise Sciences, will record impacts and rotational forces experienced by players using wearable GPS units with embedded artificial intelligence.    
    
The devices combined with rigorous scientific testing will allow Dr Ben Jones to study the first team and youth side across all 22 games of their gruelling season.   
    
Dr Jones, a former England 7’s international who also played scrumhalf for Premiership Rugby sides Northampton Saints and Worcester Warriors, said: “This isn’t a case of trying to make the game soft or ruining it for the millions of people who enjoy it the world over, we just need to know more about its potential risks.   
    
“For years elite athletes have had the benefit of high-level analysis whereas the clubhouses that are the foundation of the game have been left behind.   
 
“Through this study, we can help improve safety and safeguard the sport for future generations.”   

Dr Ben Jones takes a baseline brain scan

CAPTION

A Colchester player takes part in a game of Where's Wally whilst his brain is scanned

CREDIT

University of Essex/East News

Over eight months, forwards and backs’ baseline brain activation will be monitored off-pitch using functional near-infrared spectroscopy combined with cognition testing.   
    
This will allow the team of sports scientists to see if and why key measures of cognition like brain oxygenation levels and differences in general blood flow are affected.    
    
The location and effect of persistent low-level impacts will also be assessed to understand if tackles, small collisions and bumps affect mental ability.   
 
Talks are also underway with governing bodies to introduce sensor-equipped head guards that will provide additional data on concussion risk. 
    
England and British and Irish Lions legend Rory Underwood MBE sits on PhysiGo’s Advisory board.  
 
He said:  “We are not looking to reduce the physicality of the game but use innovative ways of collecting data to gain a better awareness and understanding of the impact of the game.  
    
“This will provide coaches, medical and S&C staff, and players with better quality information and insight to enable better decision making when managing player welfare and "Return to Play" protocols.    

Dr Ben Jones interviews a player about their concussion history

CREDIT

University of Essex/East News

“The aim is to make the game as safe as possible for players, without losing the physical nature of the sport, to improve and prolong their playing career, at all levels.”   
   
Colchester Rugby Club, who play in the Regional 1 South East League, have welcomed the study and the data it will give them.   
 
Club Chairman Karl O’Brien said: “This research underlines our commitment to player welfare 
    
“We are a large community club with five senior men’s teams, in excess of 600 mini and youth players, an ever-growing number of girls and ladies' teams plus a newly formed LGBT squad of players and as always are fully committed to all of these players enjoying their rugby in a safe environment.   
    
“To be allowed to work with the excellent team from the University of Essex is absolutely fantastic for us all and we are proud to be helping people to enjoy the great game for many years to come as safely as possible.”    
    
PhysiGo is in close contact with World Rugby and is hopeful their equipment – which is designed to be affordable for small clubs – will be introduced in coming years.   
    
The work with Colchester and Essex comes after training research with Alton RFC, in Hampshire, Downlands College in Australia, and Cambridge University Hospital trust.   
    
Matt Baker, chief operating officer and co-founder of PhysiGo, said: “PhysiGo is committed to improving people’s health through AI-enabled wearables and it is especially important in contact sports like Rugby.    
    
“This kind of technology is being made available to elite clubs but we feel it is very important to work with grassroots like Colchester RFC and at a price that is inclusive to all.”   

Colchester RUFC players practice contact training

CREDIT

University of Essex/East News

Enhanced ocean oxygenation during Cenozoic warm periods

Earth’s past warm periods witnessed the shrinkage of the open ocean’s oxygen-deficient zones

Peer-Reviewed Publication

MAX PLANCK INSTITUTE FOR CHEMISTRY

 

IMAGE: STUDIES OF SEDIMENT CORES SHOW THAT OPEN OCEAN OXYGEN-DEFICIENT ZONES (IN RED) SHRANK DURING LONG WARM PERIODS IN THE PAST. view more 

CREDIT: A. AUDERSET, MPI FOR CHEMISTRY, PRODUCED WITH THE "OCEAN DATA VIEW" PROGRAM USING DATA FROM THE "WORLD OCEAN ATLAS (WOA18)".

When oxygen becomes scarce, life has a hard time. This is just as true for mountain regions above 7000 meters but also for bodies of water. For example, in tropical ocean regions off of West America and West Africa and in the northern Indian Ocean, only specialized microbes and organisms with a slow metabolism such as jellyfish can survive.

In the last 50 years, oxygen-deficient zones in the open ocean have increased. This poses major problems not only for marine ecosystems, but also for coastal inhabitants and countries that rely on fisheries as a source of food and income. Scientists have attributed this development to rising global temperatures: Less oxygen dissolves in warmer water, and the tropical ocean’s layers can become more stratified. But how will this development continue, and what happened in past warm periods?

A team led by Alexandra Auderset and Alfredo Martínez-García at the Max Planck Institute for Chemistry in Mainz has shown in a recent study that, in the open ocean, oxygen-deficient zones shrank during warm periods of the past.

The past oxygen content of the oceans can be read in sediments

The researchers read this finding from marine sediment archives. Drill cores can be used to determine past environmental conditions in a similar way to tree rings. Among other things, the sediment layers provide information about the oxygen content of the sea in the past. This is due to microorganisms such as foraminifera, which once lived on the sea surface and whose skeletons sank to the sea floor where they became part of the sediment. During their lifetime, these zooplankton absorbed chemical elements such as nitrogen, whose isotope ratio in turn depended on environmental conditions. Under oxygen-deficient conditions, bacterial denitrification occurs. In this process, the nutrient nitrate is chemically reduced to molecular nitrogen (N2) by bacteria. As they prefer to absorb light isotopes from the water instead of heavy ones, the ratio of light 14N shifts to heavy 15N in periods when the bacteria were active in the oceans. This changing isotopic signal, in turn, can be used to determine the extent of earlier oxygen-deficient zones.

The tropical Pacific Ocean was well oxygenated during past warm periods

Using nitrogen isotopes from foraminifera, the scientists from Mainz and Princeton University showed that denitrification of the water column in the eastern tropical North Pacific was greatly reduced during two warm phases of the Earth's modern era, the Cenozoic, about 16 and 50 million years ago.

"We had not expected this clear effect. From the correlation between high global temperatures and low denitrification rates, we conclude that the tropical Pacific’s oxygen-deficient zones shrank", says Auderset about the results, which were recently published in the journal Nature.

“It’s been a decades-long campaign to develop the methods that allowed for these findings”, says Daniel Sigman, Dusenbury Professor of Geological and Geophysical Sciences, whose group collaborated in the study. “And it turns out that even these first results are altering our view of the relationship between climate and the ocean’s oxygen conditions.”

It cannot, however, yet be precisely estimated what this means for the current expansion of the oxygen-deficient open ocean zones: “Unfortunately, it remains unclear whether our finding of shrinking marine oxygen-deficient zones is applicable to the coming decades or only to the much longer term", adds the paleoclimatologist Auderset. “This is because we don’t yet know whether short- or long-term processes were responsible for the change.”

Paleoclimate researchers Alexandra Auderset and Alfredo Martínez-García were able to deduce the oxygen content of the oceans in the past from the remains of microorganisms found in marine sediment. They determined the nitrogen isotope ratios in their laboratory, as part of a long-term collaboration with Daniel Sigman and his research group at Princeton University.

CREDIT

Simone Moretti, MPI for Chemistry

Searching for the cause

One leading possibility for the decline in oxygen-deficient zones under warming involves a reduction in the upwelling-fueled biological productivity of tropical surface waters. A decline in productivity could have occurred because winds weakened in the equatorial Pacific under warmer climate.

In the current study, the authors also found that during the two warm periods of the Cenozoic – the mid-Miocene climate optimum about 16 million years ago and the early Eocene climate optimum about 50 million years ago – the temperature difference between high and low latitudes was much smaller than at present. Both, the global warming and the weakening of high-to-low latitude temperature difference, should have worked to weaken tropical winds, reducing the upwelling of nutrient-rich deep seawater. This, in turn, would have resulted in lower biological productivity at the surface and less sinking of dead algal organic matter into the deep ocean, providing less fuel for the oxygen consumption that produces oxygen-deficient conditions. This chain of events can occur relatively quickly. Thus, if a similar change applies to human-driven global warming as well, then there could be a decline in the extent of open ocean oxygen deficiency in the coming decades.

Alternatively, the cause may lie in the Southern Ocean, thousands of kilometers away. During past prolonged warm periods, the exchange water between Southern Ocean surface waters and the deep ocean (“deep ocean overturning") may have accelerated, leading to higher oxygen in the ocean interior as a whole and thus shrinking the low-oxygen zones. If stronger Southern Ocean-driven deep ocean overturning was the main cause of the shrunken tropical oxygen-deficient zones, then this effect would take more than a hundred years at earliest to come into play.

“Both mechanisms probably play a role”, says Martínez-García, “The race is now on to figure out which mechanism is most important.”

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JOURNAL

Nature

DOI

10.1038/s41586-022-05017-0 

METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Enhanced ocean oxygenation during Cenozoic warm periods

ARTICLE PUBLICATION DATE

31-Aug-2022

SARS-CoV-2 can trigger chronic fatigue syndrome

Charité study provides evidence to support long-held suspicion

Peer-Reviewed Publication

CHARITÉ - UNIVERSITÄTSMEDIZIN BERLIN

 

IMAGE: ME/CFS IS CHARACTERIZED BY WEAKNESS AND/OR EXCESSIVE MUSCLE WEAKNESS FOLLOWING ACTIVITY. THIS DEVICE ENABLES RESEARCHERS TO MEASURE GRIP STRENGTH. view more 

CREDIT: © CHARITÉ | ANJA HAGEMANN

Since the beginning of the pandemic, SARS-CoV-2 has been suspected of causing chronic fatigue syndrome (ME/CFS). A well-controlled study conducted by a group of researchers from Charité – Universitätsmedizin Berlin and the Max Delbrück Center for Molecular Medicine (MDC) has now shown that, even after mild COVID-19, a subset of patients will develop symptoms which meet the diagnostic criteria for ME/CFS. Their findings also describe a second subset of post-COVID patients with similar symptoms. Differences in laboratory results between these groups may indicate differences in underlying mechanisms. The researchers’ findings have been published in Nature Communications*.

“Suspicions that COVID-19 might trigger ME/CFS initially arose as early as during the first wave of the pandemic,” says Prof. Dr. Carmen Scheibenbogen, Acting Director of Charité’s Institute of Medical Immunology on Campus Virchow-Klinikum. Prof. Scheibenbogen also oversees the work of the ‘Charité Fatigue Center’, which specializes in the diagnosis of ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome), a debilitating condition characterized by severe physical fatigue. The Center received its first requests from patients after SARS-CoV-2 infection as early as the summer of 2020. Since then, there has been accumulating evidence of a causal link between COVID-19 and ME/CFS, a disease which often causes severe physical impairments.

“Providing the scientific evidence to confirm these assumptions, however, is anything but a trivial task,” explains Prof. Scheibenbogen. She continues: “This is partly due to the paucity of research into ME/CFS and the fact that there are no universally accepted diagnostic criteria. Thanks to an extremely thorough diagnostic process and a comprehensive comparison with patients who developed ME/CFS following non-COVID-related infections, we have now been able to show that COVID-19 can trigger ME/CFS.”

As part of this study, experts from Charité’s Post-COVID Network examined 42 individuals who presented at the Center with persistent, severe fatigue and impaired day-to-day functioning six months after their SARS-CoV-2 infection. Most of the study participants were unable to perform light work for more than two to four hours a day; some were unable to work and struggled to look after themselves. Only three out of the 42 patients examined needed hospital care during their initial (acute) SARS-CoV-2 infection, but none required oxygen. 32 of the patients met the WHO classification of mild COVID-19, meaning they did not develop pneumonia, but had fairly severe symptoms including fever, cough, muscle pain and joint pain for between one and two weeks. As all of the participants’ infections occurred during the first wave of the pandemic, none of them had been vaccinated. At Charité, all of the individuals concerned were examined by an interdisciplinary team of neurologists, immunologists, rheumatologists, cardiologists, endocrinologists and pulmonologists with many years’ experience in the diagnosis of ME/CFS. For comparison, the researchers then examined 19 age- and gender-matched individuals who had developed ME/CFS following a similar period of illness due to a non-COVID-related infection.

The researchers used the ‘Canadian Consensus Criteria’ to establish a diagnosis of ME/CFS. “In addition to having been scientifically developed, this catalog of criteria has been proven as a reliable diagnostic tool for chronic fatigue syndrome in clinical practice,” explains the study’s other co-lead, Dr. Judith Bellmann-Strobl, who heads the multidisciplinary outpatient department at the Experimental and Clinical Research Center (ECRC), a facility jointly operated by Charité and the MDC. According to the Canadian Consensus Criteria, approximately half of the post-COVID patients examined met the diagnostic criteria for ME/CFS. While the other half presented with similar symptoms, their post-exertional malaise was milder and only lasted for a few hours. In contrast, ME/CFS patients reported post-exertional malaise which persisted into the following day. Summarizing the researchers’ findings, Dr. Bellman-Strobl says: “We can therefore distinguish between two groups of post-COVID patients with severely impaired physical functioning.”

In addition to collating data on symptoms, the researchers also determined various laboratory parameters. They then compared these with hand grip strength, which was reduced in the majority of the participants examined. “We furthermore found that individuals with milder exertional intolerance had reduced hand grip strength if they had elevated levels of the cytokine interleukin 8. In these cases, reduced muscular strength may be caused by a persistent inflammatory response,” says Prof. Scheibenbogen. “In the ME/CFS group, however, hand grip strength was correlated with the hormone NT-proBNP, which can be released by muscle cells when oxygen supply is insufficient. This suggests that, in these individuals, muscle weakness may be caused by an impaired blood supply.” According to the researchers’ preliminary observations, the two groups may also be distinguishable in terms of disease progression. “In many people whose symptoms are indicative of ME/CFS but who do not meet diagnostic criteria, symptoms appear to improve over time,” explains Prof. Scheibenbogen.

These new findings may help researchers to develop specific treatments for post-COVID syndrome (‘Long Covid’) and ME/CFS. “Our data also provide further evidence that ME/CFS is not a psychosomatic disorder but a severe physical disease which can be measured and diagnosed using objective methods,” emphasizes Prof. Scheibenbogen. “Unfortunately, current treatments for ME/CFS are purely symptomatic in nature. I would therefore urge even young people to protect themselves against SARS-CoV-2 by getting vaccinated and wearing an FFP2 mask.”

*Kedor C et al. Post COVID-19 Chronic Fatigue Syndrome following the first pandemic wave in Germany and biomarkers associated with symptom severity results from a prospective observational study. Nat Comm 2022 Aug 30. doi: 10.1038/s41467-022-32507-6

About ME/CFS
ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome) is a severe disease which is usually triggered by an infection and often develops into a chronic condition. The hallmark of the condition is post-exertional malaise: a severe exacerbation in the severity of symptoms following even mild physical or mental exertion. Post-exertional malaise can occur immediately after exertion or after a delay of hours or the following day and will last at least until the next day, but may persist for longer. In addition to fatigue and physical weakness, it is also frequently associated with headache or muscle pain, as well as neurocognitive, immunological symptoms and symptoms of autonomic nervous system dysfunction. Before the pandemic, prevalence estimates for ME/CFS in the general public were approximately 0.3 percent. Experts assume that the COVID-19 pandemic will result in a significant increase in the number of people affected by ME/CFS. Until now, viruses known to trigger ME/CFS have included the Epstein-Barr virus, the Dengue virus and enteroviruses, among others. Cases of ME/CFS have also been reported in individuals infected with the first SARS coronavirus during 2002/2003. ME/CFS should be distinguished from post-infectious fatigue, which is associated with a large number of infectious diseases and can persist for weeks and even months.

Treatment of ME/CFS at Charité
Charité currently operates a total of eleven special outpatient clinics which are dedicated to the diagnosis and treatment of people with persistent symptoms following SARS-CoV-2 infection. Spread across different departments and institutes, these clinics form part of the Post-COVID Network, which enables them to work closely together in addition to providing a range of treatments based on the patients’ cardinal symptoms. The Network also comprises the Charité Fatigue Center, the key point of contact for individuals who experience persistent severe fatigue, difficulty concentrating and exertional intolerance six months or more after contracting COVID-19. Patients with ME/CFS also have access to an interdisciplinary care which is offered as part of the CFS_CARE project and includes a specially developed rehabilitation program.

About this study
The data underpinning the published article were generated using the Pa-COVID-19 platform. Pa-COVID-19 is a prospective patient registry for patients with COVID-19 at Charité. The aim of the registry is to collate comprehensive clinical and molecular data on patients with COVID-19 in order to identify individual risk factors for severe disease, as well as prognostic biomarkers and treatment targets. The protocol for the study is available here.

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JOURNAL

Nature Communications

DOI

10.1038/s41467-022-32507-6 

ARTICLE TITLE

A prospective observational study of post-COVID-19 chronic fatigue syndrome following the first pandemic wave in Germany and biomarkers associated with symptom severity

Previous variants of SARS-CoV-2 provide protection against Omicron BA.5 infection

Vaccinated people who were infected by the first Omicron subvariants have four times greater protection than vaccinated people who were not infected. These results are part of a study that will be published today in the prestigious journal NEJM.

Peer-Reviewed Publication

INSTITUTO DE MEDICINA MOLECULAR

 

IMAGE: ILLUSTRATION OF SARS-COV-2 VIRUSES, RESPONSIBLE FOR COVID-19 DISEASE view more 

CREDIT: HELENA PINHEIRO, IMM

Vaccinated people who were infected by the first Omicron subvariants have four times greater protection than vaccinated people who were not infected. These results are part of a study that will be published today in the prestigious scientific journal New England Journal of Medicine*.

The study published now was led by Luís Graça, group leader at the Instituto de Medicina Molecular João Lobo Antunes (iMM) and Full Professor at the Faculty of Medicine of the University of Lisbon, and by Manuel Carmo Gomes, Associate Professor with Aggregation at the Faculty of Sciences of the University of Lisbon (Ciências ULisboa). Both researchers are members of the Technical Commission on Vaccination against COVID-19 (CTVC) of the Direção Geral de Saúde (DGS).

This is one of the first studies worldwide to analyze the probability of becoming infected with the subvariant currently in circulation in vaccinated people, by estimating the degree of protection conferred by infections with previous variants and using real-world data.

“Vaccinated people who were infected by Omicron subvariants BA.1 and BA.2 have a protection against infection with subvariant BA.5, in circulation since June, about four times greater than vaccinated people who were not infected at any time. ”, starts explaining Luís Graça, co-leader of the study. “Infections in 2020 and 2021 that occurred through infection with earlier variants of the SARS-CoV-2 virus (ancestral lineage, Alpha and Delta variants) also confer protection against infection for the more recent Omicron variant, although this protection is not as high as that of individuals infected with the BA.1 and BA.2 variants, at the beginning of 2022”, reinforces Luís Graça.

“These results are very important because the adapted vaccines that are in clinical development and evaluation are based on the BA.1 subvariant of the virus, which was a dominant variant in infections in January and February 2022. Until now, it was not known what degree of protection this subvariant provides against the subvariant that is currently in circulation. These results show that this protection is very significant and allows us to anticipate the benefit of the adapted”, adds Luís Graça on the relevance of the study.

To carry out this study, the researchers had access to the registry of COVID-19 cases at Portugal’s national level. “We used the Portuguese national registry of COVID-19 cases to obtain information on all cases of SARS-CoV-2 infections in the population over 12 years of age residing in Portugal. The virus variant of each infection was determined considering the date of infection and the dominant variant at that time. We considered the infections caused by the first variants of Omicron BA.1 and BA.2 together”, explains Manuel Carmo Gomes. “With these data, we analyzed the probability of a person that was previously infected to be reinfected with the current variant, which allowed us to calculate the percentage of protection provided by previous infections”, explains João Malato, PhD student in Luís Graça’s group and first author of the study.

“This study demonstrates, in the period of time analysed, that previous infection in vaccinated people (the so-called hybrid immunity) continues to confer for the variants that are known for their ability to evade the immune response, such as the subvariant currently dominant”, emphasizes Válter Fonseca, co-author of this study. and coordinator of the CTVC of the DGS.

 

This work was carried out at the iMM and the Centro de Estatística e Aplicações da Universidade de Lisboa from the Faculty of Sciences of the University of Lisbon, in collaboration with the DGS. This work was funded by the European Union Horizon 2020 Research and Innovation program, the Fundação para a Ciência e a Tecnologia (FCT, Portugal), and the National Institute of Health.

 

*João Malato, Ruy M. Ribeiro, Pedro Pinto Leite, Pedro Casaca, Eugénia Fernandes, Carlos Antunes, Válter R. Fonseca, Manuel Carmo Gomes, Luis Graça (2022) Risk of BA.5 infection in individuals exposed to prior SARS-CoV-2 variants. NEJM. DOI: https://doi.org/10.1101/2022.07.27.22277602

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JOURNAL

New England Journal of Medicine

DOI

10.1101/2022.07.27.22277602 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Risk of BA.5 infection in individuals exposed to prior SARS-CoV-2 variants

ARTICLE PUBLICATION DATE

31-Aug-2022

Risk of children orphaned from COVID-19 highest in poorest countries

In poorest countries, each COVID-19 death estimated to result in 1.56 orphans – vs 0.09 orphans in high-GDP countries

Peer-Reviewed Publication

PLOS

 

IMAGE: A VISUALIZATION OF THE COVID-19 VIRUS. view more 

CREDIT: FUSION MEDICAL ANIMATION, UNSPLASH, CC0 (HTTPS://CREATIVECOMMONS.ORG/PUBLICDOMAIN/ZERO/1.0/)

The risk of children being orphaned per COVID-19 death is highest in the poorest countries and those where people of reproductive age have the highest rates of non-communicable diseases, according to a new study published this week in the open-access journal PLOS Global Public Health by Callum Lowe of Australian National University and colleagues.

Due to the higher COVID-19 mortality risk among adults than children, and the propensity of the SARS-CoV-2 virus to quickly spread throughout a household, there is the possibility that children will survive a COVID-19 infection while their parents or caregivers will not. In this study, the researchers used a previously developed COVID-19 orphanhood calculator to predict the total orphans per COVID-19 death for 139 countries. The calculator integrated information on fertility rates and pandemic mortality by age and sex. Information on other factors, including vaccine coverage and sociodemographics was also available at the country level.

The team found that the risk of orphaned children (those who have lost at least one of their parents or caregivers) was much higher in countries below median GDP per capita (1.56 orphans per COVID-19 death) compared to countries above median GDP (0.09 orphans per death). The increased risk of orphans was specifically associated with greater poverty prevalence (B = 2.32, p<0.01), lower GDP per capita (B = -0.23, p<0.05), and a higher proportion of people with non-communicative diseases who are between the ages of 15 and 49 (B = 1.46, p<0.0001). In almost all global regions, it was also associated with lower vaccination coverage.

The authors conclude that due to pre-existing health and vaccine coverage inequity, more children will suffer the loss of their parents due to COVID-19 in poorer countries.

The authors add: “COVID-19 has spread to almost every country on the globe, but the risk of children being orphaned due to COVID-19 is higher in poorer countries. Inequity in access to COVID-19 vaccines will bolster this issue further.”

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In your coverage please use this URL to provide access to the freely available article in PLOS Global Public Health: https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0000317

Citation: Lowe C, Rachmawati L, Richardson A, Kelly M (2022) COVID-19 orphans—Global patterns associated with the hidden pandemic. PLOS Glob Public Health 2(8): e0000317. https://doi.org/10.1371/journal.pgph.0000317

Author Countries: Australia, Indonesia

Funding: The authors received no specific funding for this work.

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JOURNAL

PLOS Global Public Health

DOI

10.1371/journal.pgph.0000317 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

COVID-19 orphans—Global patterns associated with the hidden pandemic

ARTICLE PUBLICATION DATE

31-Aug-2022

COVID-19’s elevated toll on mental health varied across the globe: uOttawa review

Mental health problems remained elevated over the pandemic as meta-analysis reveals North Americans suffered increased anxiety, depression & PTSD while Latin America and Europe fell into the thralls of insomnia

Peer-Reviewed Publication

UNIVERSITY OF OTTAWA

 

IMAGE: DR. JUDE MARY CÉNAT, DIRECTOR OF THE V-TRAC LAB AND AN ASSOCIATE PROFESSOR IN THE FACULTY OF SOCIAL SCIENCE’S SCHOOL OF PSYCHOLOGY, WHOSE MENTAL HEALTH RESEARCH HAS ALSO FOCUSED ON BLACK HEALTH. view more 

CREDIT: UNIVERSITY OF OTTAWA

A meta-analysis review by researchers from the University of Ottawa has confirmed elevated but differing mental health distress levels across the globe over the course of the COVID-19 pandemic.

The Vulnerability, Trauma, Resilience and Culture Research Laboratory (V-TRaC) directed by Dr. Jude Mary Cénat screened 18,070 published articles to include 64 longitudinal studies in the systematic review, which offered a clear picture of the evolution of the effect of the pandemic on global mental health.

Published in the Journal of Affective Disorders, researchers found:

• Symptoms of anxiety, depression, and Post Traumatic Stress Disorder (PTSD) were highest in North America compared to Europe, Asia and Latin America.
• Psychological distress and insomnia were more prevalent in Latin America and Europe.
• Symptoms of poor mental health – PTSD, psychological distress, suicidal ideations, loneliness, and substance use – remained elevated over the pandemic.
• An overall decrease in anxiety and depression between the start of the pandemic through to September 2021, with these symptoms reaching their peak in May 2020.

“This meta-analysis reveals how the evolution of mental health problems is related to the evolution of the pandemic as well as the social, economic and health problems that accompany it. This study confirms that globally, the mental health of populations has been affected by the COVID-19 pandemic,” says Dr. Cénat, Director of the V-TRaC lab and an Associate Professor in the Faculty of Social Science’s School of Psychology, whose mental health research has also focused on Black health. 

“Future studies should systematically report data on gender, age groups, education level, ethnicity, sexual orientation, and migration status to allow for better comparison. They will also help identify groups that are more at risk of experiencing mental health problems. Additional studies also need to be conducted in certain parts of the world such as India, Africa, the Middle East, and the Caribbean, to better understand the long-term impacts of the COVID-19 pandemic on the mental health of diverse populations.”

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JOURNAL

Journal of Affective Disorders

DOI

10.1016/j.jad.2022.07.011 

METHOD OF RESEARCH

Meta-analysis

SUBJECT OF RESEARCH

People

ARTICLE TITLE

The global evolution of mental health problems during the COVID-19 pandemic: A systematic review and meta-analysis of longitudinal studies

ARTICLE PUBLICATION DATE

15-Oct-2022

Increased use of telehealth for opioid use disorder services during COVID-19 pandemic associated with reduced risk of overdose

Study findings support value of expanding use of telehealth services for opioid use disorder-related care

Peer-Reviewed Publication

NIH/NATIONAL INSTITUTE ON DRUG ABUSE

The expansion of telehealth services during the COVID-19 pandemic was associated with individuals staying in treatment longer and reducing their risk of medically treated overdose, according to a new study.

Published today in JAMA Psychiatry, this study was a collaborative effort led by researchers at the National Center for Injury Prevention and Control, a part of the Centers for Disease Control and Prevention (CDC); the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health (NIH); and the Centers for Medicare & Medicaid Services (CMS).

In this national study, researchers analyzed data among 175,778 Medicare beneficiaries from September 2018 to February 2021. The analysis examined the receipt of telehealth services, medications for opioid use disorder (MOUD), and experiencing a medically treated overdose among individuals with opioid use disorder (OUD) starting a new episode of care prior to the pandemic compared to those during the pandemic. 

“Strategies to increase access to care and MOUD receipt and retention are urgently needed, and the results of this study add to the growing research documenting the benefits of expanding the use of telehealth services for people with OUD,” said lead author Christopher M. Jones, Pharm.D., Dr.P.H., acting director of the National Center for Injury Prevention and Control at the CDC. “The findings from this collaborative study also highlight the importance of working across agencies to identify successful approaches to address the escalating overdose crisis.”

Among the key findings from this study:

• Data analyzed from two groups of Medicare beneficiaries, one group initiating an episode of OUD-related care before the COVID-19 pandemic and one initiating care during the COVID-19 pandemic, and found that those in the COVID-19 pandemic group were more likely to receive OUD-related telehealth services compared to the pre-pandemic group (19.6% compared to 0.6%) and were more likely to receive MOUD (12.6% compared to 10.8%).
   
• Among the COVID-19 pandemic group, receipt of OUD-related telehealth services was associated with significantly better MOUD treatment retention and lower risk of medically treated overdose compared to those not receiving OUD-related telehealth services, lending support for permanently implementing access to telehealth services.

“The expansion of telehealth services for people with substance use disorders during the pandemic has helped to address barriers to accessing medical care for addiction throughout the country that have long existed,” said Wilson Compton, M.D., M.P.E, deputy director of the National Institute on Drug Abuse and senior author of the study. “Telehealth is a valuable service and when coupled with medications for opioid use disorder can be lifesaving. This study adds to the evidence showing that expanded access to these services could have a longer-term positive impact if continued.”

Although the study did find that receiving OUD-related telehealth services was generally associated with beneficial outcomes, the study also determined some groups were less likely to receive these services, including non-Hispanic black persons and those living in the South. These outcomes underscore the need for future efforts to focus on eliminating the digital divide and reducing underlying inequities in access to care and services.

“The COVID-19 pandemic was an unexpected shock to the US healthcare system, which consequently offered a unique opportunity to investigate the impact of healthcare delivery methods on health outcomes among those who were newly diagnosed with OUD. The findings showed that telehealth improved the receipt and retention of MOUD, suggesting that this method of healthcare delivery may address common barriers to OUD-related treatment such as transportation and perceived stigma associated with OUD,” said lead analyst Carla Shoff, Ph.D., social science research analyst at CMS.

This study serves as a supportive resource towards maintaining access to telehealth services for patients with OUD as it demonstrates that Medicare beneficiaries and providers used the new flexibilities related to telehealth services during the COVID-19 pandemic and that these services were associated with positive impacts on patient outcomes such as MOUD treatment receipt, retention, and risk for medically treated overdose.  

Find Treatment for Substance Use Disorder, including Opioid Use Disorder 

If you or someone close to you needs help for a substance use disorder, talk to your doctor or call SAMHSA’s National Helpline at 1-800-662-HELP or go to SAMHSA’s Behavioral Health Treatment Services. 

Additional Resources: 

• Local health centers for substance abuse 
• Buprenorphine Treatment Practitioner  

• Opioid Treatment Program Directory 
• Decisions in Recovery: Treatment for Opioid Use Disorder (Handbook) 

If you have questions about any medicines, call the U.S. Department of Health and Human Services Poison Help Hotline at 1-800-222-1222. 

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

CDC works 24/7 protecting America’s health, safety and security. Whether disease start at home or abroad, are curable or preventable, chronic or acute, or from human activity or deliberate attack, CDC responds to America’s most pressing health threats. CDC is headquartered in Atlanta and has experts located throughout the United States and the world.

About the National Institute on Drug Abuse (NIDA): NIDA is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports most of the world’s research on the health aspects of drug use and addiction. The Institute carries out a large variety of programs to inform policy, improve practice, and advance addiction science. For more information about NIDA and its programs, visit www.nida.nih.gov.

About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.
NIH…Turning Discovery Into Health®

About the Centers for Medicare & Medicaid Services (CMS): CMS provides health coverage to nearly 150 million people through Medicare, Medicaid, the Children’s Health Insurance Program, and the Health Insurance Marketplace. A component of the U.S. Department of Health and Human Services, CMS serves the public as a trusted partner and steward, dedicated to advancing health equity, expanding coverage, and improving health outcomes.

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JOURNAL

JAMA Psychiatry

DOI

10.1001/jamapsychiatry.2022.2284 

METHOD OF RESEARCH

Data/statistical analysis

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Receipt of Telehealth Services, Receipt and Retention of Medications for Opioid Use Disorder, and Medically Treated Overdose Among Medicare Beneficiaries Before and During the COVID-19 Pandemic

ARTICLE PUBLICATION DATE

31-Aug-2022