Epidemiology of sleep and sleep disorders in The Netherlands.

Sleep Disorders Medicine

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has had a tremendous impact on health services; hundreds of thousands of healthcare workers (HCWs) have died from coronavirus disease 2019 (COVID-19). The introduction of the BNT162b2 mRNA vaccine in Italy provided recipients with significant protection against COVID-19 within one to two weeks after the administration of the second of the two recommended doses. While the vaccine induces a robust T cell response, the protective role of factors and pathways other than those related to memory B cell responses to specific SARS-CoV-2 antigens remains unclear. This retrospective study aimed to evaluate the determinants of serological protection in a group of vaccinated HCWs (n = 793) by evaluating circulating levels of antiviral spike receptor-binding domain (S-RBD) antibodies during the nine-month period following vaccination. We found that 99.5% of the HCWs who received the two doses of the BNT162b2 vaccine developed protective antibodies that were maintained at detectable levels for as long as 250 days after the second dose of the vaccine. Multivariate analysis was performed on anti-S-RBD titers in a subgroup of participants (n = 173) that were evaluated twice during this period. The results of this analysis reveal that the antibody titer observed at the second time point was significantly related to the magnitude of the primary response, the time that had elapsed between the first and the second evaluation, and a previous history of SARS-CoV-2 infection. Of importance is the finding that despite waning antibody titers following vaccination, none of the study participants contracted severe COVID-19 during the observational period.

/pdf/reduced-titers-of-circulating-anti-sars-cov-2-antibodies-and-1pxe5kyv.pdf

Reduced Titers of Circulating Anti-SARS-CoV-2 Antibodies and Risk of COVID-19 Infection in Healthcare Workers during the Nine Months after Immunization with the BNT162b2 mRNA Vaccine

Tragically, the United States (US) surpassed one million documented deaths due to the coronavirus disease 2019 (COVID-19) pandemic. A convincing association between unhealthy lifestyle behaviors and poorer outcomes associated with COVID-19 infection has already been demonstrated and communicated by the Centers for Disease Control and Prevention in public health messaging. The US is experiencing not a pandemic, but a syndemic, specifically an unhealthy lifestyle behaviors-chronic diseases-COVID-19 syndemic. This syndemic has almost certainly significantly contributed to the more than one million deaths the United States has experienced during the pandemic. Decades of a high prevalence of unhealthy lifestyle behaviors laid the foundation for our current unfortunate situation by increasing vulnerability to a novel virus, especially among subgroups who have been historically marginalized. As such, a major pathway to defeating this syndemic is through the promotion of healthy living behaviors for all. Now is the time for action appropriate to meet the demands of a syndemic and a new path forward to a healthier and more equitable future. 

http://www.amjmed.com/article/S0002934322004958/pdf

Mapping One Million COVID-19 Deaths and Unhealthy Lifestyle Behaviors in the United States: Recognizing the Syndemic Pattern and Taking Action

Coronavirus disease 2019 (COVID-19) has become a new public health crisis threatening the world. Dysregulated immune responses are the most striking pathophysiological features of patients with severe COVID-19, which can result in multiple-organ failure and death. The cytochrome P450 (CYP) system is the most important drug metabolizing enzyme family, which plays a significant role in the metabolism of endogenous or exogenous substances. Endogenous CYPs participate in the biosynthesis or catabolism of endogenous substances, including steroids, vitamins, eicosanoids, and fatty acids, whilst xenobiotic CYPs are associated with the metabolism of environmental toxins, drugs, and carcinogens. CYP expression and activity are greatly affected by immune response. However, changes in CYP expression and/or function in COVID-19 and their impact on COVID-19 pathophysiology and the metabolism of therapeutic agents in COVID-19, remain unclear. In this analysis, we review current evidence predominantly in the following areas: firstly, the possible changes in CYP expression and/or function in COVID-19; secondly, the effects of CYPs on the metabolism of arachidonic acid, vitamins, and steroid hormones in COVID-19; and thirdly, the effects of CYPs on the metabolism of therapeutic COVID-19 drugs.

/pdf/the-role-of-cytochrome-p450-enzymes-in-covid-19-pathogenesis-14oxq1u0.pdf

The Role of Cytochrome P450 Enzymes in COVID-19 Pathogenesis and Therapy

Sleep disorders and COVID-19.

Normal and abnormal movements in sleep have been a source of both great academic interest and clinical confusion. Nocturnal head banging (jactatio capitis nocturna) was one of the earliest-described sleep-related movement disorders, having first been mentioned in 1811. Since Manoia’s initial classification of abnormal movements in sleep as a separate category of sleep disturbances 90 years ago, a lot of progress has been made in the field. Several investigators have contributed to our understanding of these phenomena, which include rhythmic movements in sleep, hypnic jerks, propriospinal myoclonus, periodic limb movements in sleep, catathrenia, and phasic muscle movements in rapid eye movement (REM) sleep. This chapter provides a brief chronological account of discoveries and research in the field of sleep-related movement disorders.

Sudhansu Chokroverty

Papers

Sleep disorders and COVID-19.

Movement Disorders in Sleep

COVID-19: A 21st Century Cataclysmic Pandemic

Chapter 1 – Polysomnographic Recording Technique

Chapter 9 – Uncommon, Atypical, and Often Unrecognized PSG Patterns