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Article ; Online: Challenges and lessons in establishing human immune profiling cohort studies for pandemic response.

Logue, Jennifer K / Chu, Helen Y

2022 Volume 309, Issue 1, Page(s) 8–11

Abstract: Pandemics have devastating effects that can be mitigated with the existence of global infrastructure for pandemic preparedness along with the adaptation of existing research studies and establishment of biorepositories early in an outbreak. Observational ...

Abstract	Pandemics have devastating effects that can be mitigated with the existence of global infrastructure for pandemic preparedness along with the adaptation of existing research studies and establishment of biorepositories early in an outbreak. Observational cohort studies in place prior to a pandemic, that are rapidly scalable in response to emerging infectious diseases, are essential for both the early pandemic response and evaluation of its long-term effects. The ability to quickly collect and share samples from convalescent individuals is also critical for the development of vaccines and therapeutics. We provide a reflection on key lessons learned from establishing a longitudinal observational cohort study during the SARS-CoV-2 pandemic in order to provide guidance for future pandemic preparedness.
MeSH term(s)	COVID-19 ; Cohort Studies ; Disease Outbreaks ; Humans ; Observational Studies as Topic ; Pandemics/prevention & control ; SARS-CoV-2
Language	English
Publishing date	2022-06-30
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	391796-4
ISSN	1600-065X ; 0105-2896
ISSN (online)	1600-065X
ISSN	0105-2896
DOI	10.1111/imr.13110
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Article ; Online: The effects of the COVID-19 pandemic on community respiratory virus activity.

Chow, Eric J / Uyeki, Timothy M / Chu, Helen Y

Nature reviews. Microbiology

2022 Volume 21, Issue 3, Page(s) 195–210

Abstract: The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused substantial global morbidity and deaths, leading governments to turn to non-pharmaceutical interventions to slow down the spread of infection and lessen the burden on ... ...

Abstract	The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused substantial global morbidity and deaths, leading governments to turn to non-pharmaceutical interventions to slow down the spread of infection and lessen the burden on health care systems. These policies have evolved over the course of the COVID-19 pandemic, including after the availability of COVID-19 vaccines, with regional and country-level differences in their ongoing use. The COVID-19 pandemic has been associated with changes in respiratory virus infections worldwide, which have differed between virus types. Reductions in respiratory virus infections, including by influenza virus and respiratory syncytial virus, were most notable at the onset of the COVID-19 pandemic and continued in varying degrees through subsequent waves of SARS-CoV-2 infections. The decreases in community infection burden have resulted in reduced hospitalizations and deaths associated with non-SARS-CoV-2 respiratory infections. Respiratory virus evolution relies on the maintaining of a diverse genetic pool, but evidence of genetic bottlenecking brought on by case reduction during the COVID-19 pandemic has resulted in reduced genetic diversity of some respiratory viruses, including influenza virus. By describing the differences in these changes between viral species across different geographies over the course of the COVID-19 pandemic, we may better understand the complex factors involved in community co-circulation of respiratory viruses.
MeSH term(s)	Humans ; COVID-19/epidemiology ; COVID-19/prevention & control ; SARS-CoV-2 ; COVID-19 Vaccines ; Pandemics ; Viruses
Chemical Substances	COVID-19 Vaccines
Language	English
Publishing date	2022-10-17
Publishing country	England
Document type	Journal Article ; Review ; Research Support, N.I.H., Extramural
ZDB-ID	2139054-X
ISSN	1740-1534 ; 1740-1526
ISSN (online)	1740-1534
ISSN	1740-1526
DOI	10.1038/s41579-022-00807-9
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Article ; Online: Why Should We Advocate Maternal Immunization?

Boonyaratanakornkit, Jim / Chu, Helen Y

The Pediatric infectious disease journal

2019 Volume 38, Issue 6S Suppl 1, Page(s) S28–S32

Abstract: Maternal vaccination provides a method for protecting the pregnant woman, fetus and neonate during a period when there is increased susceptibility to infectious diseases. A dynamic state of immune tolerance during pregnancy and the need to develop ... ...

Abstract	Maternal vaccination provides a method for protecting the pregnant woman, fetus and neonate during a period when there is increased susceptibility to infectious diseases. A dynamic state of immune tolerance during pregnancy and the need to develop adaptive memory to a new foreign antigen-rich environment lead to windows of vulnerability to infection for the mother and neonate, respectively. Passive transfer of humoral immunity through the placenta and breast milk from the mother can bridge the gap in immunity for the neonate. Studies on boosting this natural process of antibody transfer have led to the recommendation for administering inactivated influenza, diphtheria, tetanus toxoid and acellular pertussis vaccines during pregnancy. Several new maternal vaccine candidates are on the horizon.
MeSH term(s)	Diphtheria/prevention & control ; Diphtheria-Tetanus-acellular Pertussis Vaccines/administration & dosage ; Diphtheria-Tetanus-acellular Pertussis Vaccines/immunology ; Female ; Humans ; Immunity, Maternally-Acquired ; Immunization/methods ; Immunization/standards ; Infant, Newborn ; Influenza Vaccines/administration & dosage ; Influenza Vaccines/immunology ; Influenza, Human/prevention & control ; Milk, Human/immunology ; Mothers ; Pregnancy ; Pregnancy Complications, Infectious/prevention & control ; Pregnant Women ; Tetanus Toxoid/administration & dosage ; Tetanus Toxoid/immunology ; Whooping Cough/prevention & control
Chemical Substances	Diphtheria-Tetanus-acellular Pertussis Vaccines ; Influenza Vaccines ; Tetanus Toxoid
Language	English
Publishing date	2019-06-13
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	392481-6
ISSN	1532-0987 ; 0891-3668
ISSN (online)	1532-0987
ISSN	0891-3668
DOI	10.1097/INF.0000000000002312
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Article ; Online: RSV, Antibodies and the Developing World.

Murray, Alastair / Chu, Helen Y

The Pediatric infectious disease journal

2019 Volume 38, Issue 6S Suppl 1, Page(s) S24–S27

Abstract: Respiratory syncytial virus remains a major cause of infantile respiratory illness globally. Infants in the developing world experience the highest burden of mortality and morbidity. Risk factors associated with respiratory syncytial virus infection and ... ...

Abstract	Respiratory syncytial virus remains a major cause of infantile respiratory illness globally. Infants in the developing world experience the highest burden of mortality and morbidity. Risk factors associated with respiratory syncytial virus infection and progression to severe disease include household crowding, preterm birth and low birth weight. Maternally-derived antibody has a role in protection of infants through transplacental antibody transfer and breast milk antibody. Promising prevention strategies that are under development include vaccination during pregnancy and monoclonal antibody administration at birth.
MeSH term(s)	Antibodies, Viral/immunology ; Developing Countries/statistics & numerical data ; Female ; Global Health ; Humans ; Immunity, Maternally-Acquired ; Infant ; Infant, Newborn ; Milk, Human/immunology ; Pregnancy ; Respiratory Syncytial Virus Infections/epidemiology ; Respiratory Syncytial Virus Infections/prevention & control ; Respiratory Syncytial Virus, Human/immunology ; Respiratory Syncytial Virus, Human/pathogenicity ; Vaccination
Chemical Substances	Antibodies, Viral
Language	English
Publishing date	2019-06-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	392481-6
ISSN	1532-0987 ; 0891-3668
ISSN (online)	1532-0987
ISSN	0891-3668
DOI	10.1097/INF.0000000000002333
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Article ; Online: Factors and Challenges in Understanding SARS-CoV-2 RNA Levels, Symptoms, and Transmissibility-Reply.

Chung, Erin / Hughes, James P / Chu, Helen Y

JAMA pediatrics

2021 Volume 175, Issue 12, Page(s) 1293–1294

MeSH term(s)	COVID-19 ; Humans ; RNA, Viral/genetics ; SARS-CoV-2
Chemical Substances	RNA, Viral
Language	English
Publishing date	2021-09-20
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	2701223-2
ISSN	2168-6211 ; 2168-6203
ISSN (online)	2168-6211
ISSN	2168-6203
DOI	10.1001/jamapediatrics.2021.3579
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Article ; Online: Respiratory Virus Infection During Pregnancy: Does It Matter?

Englund, Janet A / Chu, Helen Y

The Journal of infectious diseases

2018 Volume 218, Issue 4, Page(s) 512–515

MeSH term(s)	Cross-Sectional Studies ; Female ; Humans ; Pregnancy ; Respiratory Syncytial Virus Infections ; Respiratory Syncytial Virus, Human
Keywords	covid19
Language	English
Publishing date	2018-05-05
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	3019-3
ISSN	1537-6613 ; 0022-1899
ISSN (online)	1537-6613
ISSN	0022-1899
DOI	10.1093/infdis/jiy169
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Article ; Online: Chapter 3 Immunobiological aspects of vaccines in pregnancy: Maternal perspective

Chu, Helen Y. / Marchant, Arnaud

Maternal Immunization

Abstract: Abstract Immunization during pregnancy is an efficient strategy to protect both the mother and the newborn infant against infectious pathogens. Pregnant women have an increased susceptibility to severe infections caused by some pathogens, but the ... ...

Abstract	Abstract Immunization during pregnancy is an efficient strategy to protect both the mother and the newborn infant against infectious pathogens. Pregnant women have an increased susceptibility to severe infections caused by some pathogens, but the mechanisms involved remain poorly understood. Pregnancy is associated with dynamic changes in maternal immune system that are critical for tolerance of the fetus. These changes could also play an important role in shaping maternal immune components that are transferred to the newborn infant following natural infection or vaccination to prevent infectious diseases in early life. As the momentum for maternal immunization is growing, there is a need to increase our understanding of the immunobiology of maternal immunization in order to better prevent infectious diseases in the pregnant women and the young infant.
Keywords	covid19
Publisher	Elsevier; PMC
Document type	Article ; Online
DOI	10.1016/b978-0-12-814582-1.00003-6
Database	COVID19

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Article ; Online: Care-seeking correlates of acute respiratory illness among sheltered adults experiencing homelessness in Seattle, WA, 2019: a community-based cross-sectional study.

Rogers, Julia H / Hawes, Stephen E / Wolf, Caitlin R / Hughes, James P / Englund, Janet A / Starita, Lea M / Chu, Helen Y

Frontiers in public health

2023 Volume 11, Page(s) 1090148

Abstract: Objective: Multifarious barriers to accessing healthcare services among people experiencing homelessness (PEH) lead to delays in seeking care for acute infections, including those caused by respiratory viruses. PEH are at high risk of acute respiratory ... ...

Abstract	Objective: Multifarious barriers to accessing healthcare services among people experiencing homelessness (PEH) lead to delays in seeking care for acute infections, including those caused by respiratory viruses. PEH are at high risk of acute respiratory illness (ARI)-related complications, especially in shelter settings that may facilitate virus spread, yet data characterizing healthcare utilization for ARI episodes among sheltered PEH remained limited. Methods: We conducted a cross-sectional study of viral respiratory infection among adult residents at two homeless shelters in Seattle, Washington between January and May 2019. We assessed factors associated with seeking medical care for ARI via self-report. We collected illness questionnaires and nasal swabs were tested for respiratory viruses by reverse transcription quantitative real-time PCR (RT-qPCR). Results: We observed 825 encounters from 649 unique participants; 241 (29.2%) encounters reported seeking healthcare for their ARI episode. Seasonal influenza vaccine receipt (adjusted prevalence ratio [aPR] 1.39, 95% CI 1.02-1.88), having health insurance (aPR 2.77, 95% CI 1.27-6.02), chronic lung conditions (aPR 1.55, 95% CI 1.12-2.15), and experiencing influenza-like-illness symptoms (aPR 1.63, 95% CI 1.20 - 2.20) were associated with increased likelihood of seeking care. Smoking (aPR 0.65, 95% CI 0.45-0.92) was associated with decreased likelihood of seeking care. Discussion: Findings suggest that care seeking for viral respiratory illness among PEH may be supported by prior engagement with primary healthcare services. Strategies to increase healthcare utilization may lead to earlier detection of respiratory viruses.
MeSH term(s)	Humans ; Adult ; Respiratory Tract Infections/epidemiology ; Cross-Sectional Studies ; Washington/epidemiology ; Virus Diseases ; Viruses ; Ill-Housed Persons ; Patient Acceptance of Health Care
Language	English
Publishing date	2023-06-20
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2711781-9
ISSN	2296-2565 ; 2296-2565
ISSN (online)	2296-2565
ISSN	2296-2565
DOI	10.3389/fpubh.2023.1090148
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Article ; Online: Burden of long COVID among adults experiencing sheltered homelessness: a longitudinal cohort study in King County, WA between September 2020-April 2022.

Cox, Sarah N / Scott, Emily M / Rogers, Julia H / Chow, Eric J / Wasse, Jessica K / Carone, Marco / Hughes, James P / Chu, Helen Y

BMC public health

2023 Volume 23, Issue 1, Page(s) 1079

Abstract: Background: People experiencing homelessness (PEH) are at increased risk for acquiring SARS-CoV-2, but the burden of long COVID in this population is unknown.: Methods: We conducted a matched prospective cohort study to assess the prevalence, ... ...

Abstract	Background: People experiencing homelessness (PEH) are at increased risk for acquiring SARS-CoV-2, but the burden of long COVID in this population is unknown. Methods: We conducted a matched prospective cohort study to assess the prevalence, characteristics, and impact of long COVID among sheltered PEH in Seattle, WA between September 2020-April 2022. Adults ≥ 18 years, residing across nine homeless shelters with active respiratory virus surveillance, were eligible to complete in-person baseline surveys and interval follow-up phone surveys. We included a subset of 22 COVID-19-positive cases who tested positive or inconclusive for SARS-CoV-2 and 44 COVID-19-negative controls who tested negative for SARS-CoV-2, frequency matched on age and sex. Among controls, 22 were positive and 22 were negative for one of 27 other respiratory virus pathogens. To assess the impact of COVID-19 on the risk of symptom presence at follow-up (day 30-225 post-enrollment test), we performed log-linear regression with robust standard errors, adjusting for confounding by shelter site and demographic variables determined a priori. Results: Of 53 eligible COVID-19 cases, 22 (42%) completed ≥ 1 follow-up survey. While five (23%) cases reported ≥ 1 symptom at baseline, this increased to 77% (10/13) between day 30-59 and 33% (4/12) day 90 + . The most commonly reported symptoms day 30 + were fatigue (27%) and rhinorrhea (27%), with 8 (36%) reporting symptoms that interfered with or prevented daily activities. Four (33%) symptomatic cases reported receiving medical care outside of a medical provider at an isolation facility. Of 44 controls, 12 (27%) reported any symptoms day 90 + . Risk of any symptoms at follow-up was 5.4 times higher among COVID-19 cases compared to controls (95% CI: 2.7-10.5). Conclusions: Shelter residents reported a high prevalence of symptoms 30 + days after their SARS-CoV-2 detection, though few accessed medical care for persistent illness. The impact of COVID-19 extends beyond acute illness and may exacerbate existing challenges that marginalized populations face in maintaining their health and wellbeing.
MeSH term(s)	Humans ; Adult ; COVID-19/epidemiology ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; Longitudinal Studies ; Prospective Studies ; Ill-Housed Persons
Language	English
Publishing date	2023-06-06
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2041338-5
ISSN	1471-2458 ; 1471-2458
ISSN (online)	1471-2458
ISSN	1471-2458
DOI	10.1186/s12889-023-16026-7
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Article ; Online: Nausea, Vomiting, and Diarrhea Are Common in Community-Acquired Acute Viral Respiratory Illness.

Newman, Kira L / Wolf, Caitlin R / Logue, Jennifer K / Englund, Janet A / Boeckh, Michael / Chu, Helen Y

Digestive diseases and sciences

2023 Volume 68, Issue 8, Page(s) 3383–3389

Abstract: Background: Gastrointestinal (GI) symptoms are recognized sequelae of acute respiratory illness (ARI), but their prevalence is not well documented. Our study aim was to assess the incidence of GI symptoms in community ARI cases for persons of all ages ... ...

Abstract	Background: Gastrointestinal (GI) symptoms are recognized sequelae of acute respiratory illness (ARI), but their prevalence is not well documented. Our study aim was to assess the incidence of GI symptoms in community ARI cases for persons of all ages and their association with clinical outcomes. Methods: We collected mid-nasal swabs, clinical, and symptom data from Seattle-area individuals during the 2018-2019 winter season as part of a large-scale prospective community surveillance study. Swabs were tested by polymerase chain reaction (PCR) for 26 respiratory pathogens. Likelihood of GI symptoms given demographic, clinical, and microbiological covariates were analyzed with Fisher's exact, Wilcoxon-rank-sum, and t-tests and multivariable logistic regression. Results: In 3183 ARI episodes, 29.4% had GI symptoms (n = 937). GI symptoms were significantly associated with pathogen detection, illness interfering with daily life, seeking care for the illness, and greater symptom burden (all p < 0.05). Controlling for age, > 3 symptoms, and month, influenza (p < 0.001), human metapneumovirus (p = 0.004), and enterovirus D68 (p = 0.05) were significantly more likely to be associated with GI symptoms than episodes with no pathogen detected. Seasonal coronaviruses (p = 0.005) and rhinovirus (p = 0.04) were significantly less likely to be associated with GI symptoms. Conclusion: In this community-surveillance study of ARI, GI symptoms were common and associated with illness severity and respiratory pathogen detection. GI symptoms did not track with known GI tropism, suggesting GI symptoms may be nonspecific rather than pathogen-mediated. Patients presenting with GI and respiratory symptoms should have respiratory virus testing, even if the respiratory symptom is not the primary concern.
MeSH term(s)	Humans ; Infant ; Respiratory Tract Infections/diagnosis ; Respiratory Tract Infections/epidemiology ; Prospective Studies ; Virus Diseases/diagnosis ; Virus Diseases/epidemiology ; Nausea ; Gastrointestinal Diseases/diagnosis ; Gastrointestinal Diseases/epidemiology ; Diarrhea/diagnosis ; Diarrhea/epidemiology ; Vomiting
Language	English
Publishing date	2023-06-03
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	304250-9
ISSN	1573-2568 ; 0163-2116
ISSN (online)	1573-2568
ISSN	0163-2116
DOI	10.1007/s10620-023-07976-4
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