Aspirin Use Is Associated With Decreased Mechanical Ventilation, Intensive Care Unit Admission, and In-Hospital Mortality in Hospitalized Patients With Coronavirus Disease 2019

BACKGROUND

Coronavirus disease-2019 (COVID-19) is associated with hypercoagulability and increased thrombotic risk in critically ill patients. To our knowledge, no studies have evaluated whether aspirin use is associated with reduced risk of mechanical ventilation, intensive care unit (ICU) admission, and in-hospital mortality.

METHODS

A retrospective, observational cohort study of adult patients admitted with COVID-19 to multiple hospitals in the United States between March 2020 and July 2020 was performed. The primary outcome was the need for mechanical ventilation. Secondary outcomes were ICU admission and in-hospital mortality. Adjusted hazard ratios (HRs) for study outcomes were calculated using Cox-proportional hazards models after adjustment for the effects of demographics and comorbid conditions.

RESULTS

Four hundred twelve patients were included in the study. Three hundred fourteen patients (76.3%) did not receive aspirin, while 98 patients (23.7%) received aspirin within 24 hours of admission or 7 days before admission. Aspirin use had a crude association with less mechanical ventilation (35.7% aspirin versus 48.4% nonaspirin, P = .03) and ICU admission (38.8% aspirin versus 51.0% nonaspirin, P = .04), but no crude association with in-hospital mortality (26.5% aspirin versus 23.2% nonaspirin, P = .51). After adjusting for 8 confounding variables, aspirin use was independently associated with decreased risk of mechanical ventilation (adjusted HR, 0.56, 95% confidence interval [CI], 0.37-0.85, P = .007), ICU admission (adjusted HR, 0.57, 95% CI, 0.38-0.85, P = .005), and in-hospital mortality (adjusted HR, 0.53, 95% CI, 0.31-0.90, P = .02). There were no differences in major bleeding (P = .69) or overt thrombosis (P = .82) between aspirin users and nonaspirin users.

CONCLUSIONS

Aspirin use may be associated with improved outcomes in hospitalized COVID-19 patients. However, a sufficiently powered randomized controlled trial is needed to assess whether a causal relationship exists between aspirin use and reduced lung injury and mortality in COVID-19 patients.

A genomic gene encoding the b5 rabbit immunoglobulin kappa constant region: implications for latent allotype phenomenon

We previously reported that domestic rabbits of five immunoglobulin kappa allotype strains (b4v, b4, b5, b6, and b9) harbor at least two DNA sequences that hybridize strongly to kappa constant region probes in Southern blots. One of these sequences ("type A") has been identified as encoding the constant region of the kappa 2 isotype, an immunoglobulin chain that most rabbits express only at low levels, if at all. We identified the second sequence--for rabbits of the b4 allotype--as encoding the nominal b4 kappa chain (or kappa 1 isotype), but for rabbits of other allotypes no definite identification for this "type B" sequence could be made. Here we suggest that the type B sequence in rabbits of the other domestic allotypes also encodes the nominal kappa 1 immunoglobulin chain. We show this directly for the b5 allotype; a type B sequence cloned from b5 DNA has been found to contain an apparently functional gene encoding the b5 constant region sequence. Indirect arguments suggest the corresponding conclusion for the b4v, b6, and b9 allotypes. We have considered the implications of these results for the phenomenon of "latent allotype" expression.

Characterization of mutations that lie in the promoter-regulatory region for glnA, the structural gene encoding glutamine synthetase

In enteric bacteria products of nitrogen regulatory genes ntrA, ntrB and ntrC are known to regulate transcription both positively and negatively at glnA, the structural gene encoding glutamine synthetase [L-glutamate:ammonia-ligase (ADP-forming), EC 6.3.1.2]. We have characterized two types of cis-acting mutations in the glnA promoter-regulatory region. One type, which we have called promoter Up [glnAp (Up)], elevates transcription of glnA to high levels without need for ntr-mediated activation but leaves expression sensitive to ntr-mediated repression. The other type renders glnA transcription insensitive to repression but leaves it normally responsive to activation. Properties of the two types of promoter-regulatory mutations suggest that sites for ntr-mediated activation of glnA transcription are functionally distinct from sites for ntr-mediated repression.

Cultured Kaposi's sarcoma tumor cells fail to stimulate T cell proliferation

Prior to the AIDS epidemic, Kaposi's sarcoma (KS) was a rare neoplasm. However, in the context of immunosuppression, cutaneous KS lesions more frequently develop and express various surface molecules recognized by T cells such as intercellular adhesion molecule-1 (ICAM-1; CD54) and HLA-DR. The KS tumor cells are thought to arise locally from endothelial cells via a transdifferentiation process. To determine if KS tumor cells can stimulate resting T cell proliferation, we asked whether the tumor cells express the critically important T cell costimulatory molecules B7-1 (CD-80) and B7-2 (CD-86). In contrast to cytokine-activated endothelial cells, which were induced to express B7-1, but not B7-2 and could function in bacteria-derived superantigen-driven T cell proliferation, four different KS tumor cell lines failed to express either B7-1 or B7-2 and were unable to stimulate allogeneic T cell proliferation upon addition of bacteria-derived superantigen. These results suggest that KS tumor cells behave differently in their response to cytokines compared with endothelial cells and may be able to evade the local immune response by not expressing costimulatory molecules necessary for T cell proliferation.

Low-Income Asian Americans: High Levels Of Food Insecurity And Low Participation In The CalFresh Nutrition Program

Little is known about food insecurity and the extent of Supplemental Nutrition Assistance Program (SNAP) participation in the heterogeneous Asian American population. Using California Health Interview Survey data from the period 2011-20, we examined both issues among low-income Asian American adults from six origin groups: Chinese, Filipino, Japanese, Korean, South Asian, and Vietnamese. We found high and varied levels of overall food insecurity, with the highest burden among Filipino adults (40 percent). Food insecurity by severity was also heterogenous; very low food security affected 2 percent of Chinese adults but 9 percent and 10 percent of Filipino and Japanese adults, respectively. Participation in CalFresh (California-implemented SNAP) ranged from 11 percent and 12 percent among Korean and Chinese adults, respectively, to 20 percent among Vietnamese adults. Compared with English-proficient low-income Asian American adults, those with limited English proficiency were no less likely to participate in CalFresh, possibly reflecting language assistance required by California law and provided by community-based organizations. These results underscore the importance of collecting and reporting disaggregated data by Asian origin group that could inform targeted outreach and interventions.

Expression of cell surface adhesion molecules on the epithelium of Organ-cultured skin

Human neonatal foreskin was maintained in organ culture under serum-free, growth-factor-free conditions or in the presence of a combination of growth factors that are known to stimulate keratinocyte proliferation in monolayer culture. Previously, we have shown that normal histology is maintained when growth-factor-free conditions are used but that the epithelium undergoes a hyperproliferative response and invades the dermis in the presence of the exogenous growth factors. In the present study, the tissue was examined by immunofluorescence for expression of alpha 6 and beta 4 integrin components and for E-cadherin. Under growth factor-free conditions, both alpha 6 and beta 4 were localized to the basal surface of epithelial cells in contact with the basement membrane. In contrast, both epitopes were diffusely distributed throughout the basal epithelium in the presence of growth factors. E-cadherin expression was rapidly lost from the tissue in organ culture. This occurred in both the presence and absence of exogenous growth factors. On the basis of these immunochemical results, we conclude that the same changes in alpha 6 and beta 4 expression that are seen in rapidly proliferating keratinocytes and squamous epithelial cell tumors can be seen in the epidermis of organ-cultured skin when it is maintained in the presence of epithelial growth factors. The observed loss of E-cadherin, in contrast, appears to be a consequence of incubation in organ culture.

Comparative toxicities of commonly used agricultural insecticides to four honey bee species (Hymenoptera: Apidae) in Vietnam

Beekeeping for honey production is a vital economic activity in Vietnam, significantly contributing to the nation's agricultural exports and poverty alleviation. However, the widespread use of pesticides, compounded by insufficient regulations, poses serious challenges to the industry and threatens bee health. This study examined the oral toxicities of five commonly used agricultural insecticides including bifenthrin, imidacloprid, thiacloprid, thiamethoxam, and chlorantraniliprole, on four honey bee species prevalent in Vietnam: the Asian honey bee (Apis cerana), the European honey bee (A. mellifera), the giant honey bee (A. dorsata), and the red dwarf honey bee (A. florea). Our results indicated significant variability in toxicity among the pesticides and honey bee species, with the managed species A. cerana showing the highest tolerance across all tested insecticides. In contrast, the wild species A. dorsata and A. florea were significantly more sensitive. These findings highlight the need to develop a pesticide risk assessment and improve pesticide regulations that consider the impacts on a broader range of honey bee species beyond A. mellifera.

A Latent Class Analysis of COVID-19 Vaccine Attitudes and Beliefs: Results from a Community Survey Conducted Via the Chicagoland Community Engagement Alliance (CEAL) Program

BACKGROUND

In the U.S., responses to the rollout of COVID-19 vaccine varied widely, with contrasting perceptions of the vaccine. We aimed to characterize distinct groups of respondents regarding COVID-19 vaccine perceptions.

METHODS

Data came from the 2021-2023 Common Survey (n = 852), collected in Chicago using a community-based participatory approach focusing on communities with low COVID-19 vaccination. Participants answered eight questions about vaccine-related perceptions. We conducted a latent class analysis in R.

RESULTS

The sample included 623 female participants (73.1%), 482 Black participants (56.6%), 259 Hispanic/Latino(a) participants (30.4%), 26 Asian participants (3.1%), and 261 participants with a college degree (30.6%). In a four-class model, Class 1 (skeptic) included 153 participants (18.0%) with low confidence in vaccine safety, effectiveness, and potential to get life back to normal. Class 2 (uncertain) included 163 participants (19.1%) who mostly indicated uncertainty. Class 3 (support with concerns) included 266 participants (31.2%) who recognized many vaccine benefits but also had concerns about its rapid development and "not being studied in people like me." Class 4 (pro-vaccine) included 270 participants (31.7%) with high confidence in vaccine safety and effectiveness and social approval of vaccination. Interestingly, both the skeptic and pro-vaccine groups had somewhat similar agreement with the statement "not enough information on COVID vaccine interaction." Class assignments varied by sociodemographic characteristics. Socioeconomic hardships were associated with a lower likelihood of being in the "pro-vaccine" group.

CONCLUSIONS

Given the distinct classes of vaccine beliefs, tailored public health messaging is needed to enhance vaccine confidence and uptake.

Activation of interleukin-2 receptor alpha expression by extracellular HTLV-I Tax1 protein: a potential role in HTLV-I pathogenesis

The Tax1 protein of human T cell leukemia/lymphoma virus type I (HTLV-I) has been shown to stimulate the proliferation of human lymphocytes. Here we report that lymphocyte proliferation can be induced at extracellular Tax1 concentrations as low as 25 pM. The proliferative response induced by extracellular Tax1 is accompanied by an activation of endogenous interleukin-2 receptor alpha-chain (IL-2R alpha) expression in human lymphocytes. Functional activation of IL-2R alpha expression in peripheral blood lymphocytes treated with Tax1 was demonstrated using an [125I]IL-2-binding assay. In addition, an enzyme-linked immunosorbent assay demonstrated that soluble IL-2R alpha in the medium of IL-2- and Tax1-treated cells was over 13-fold greater than in the medium of control treated cells. Overexpression of IL-2R alpha is a common clinical feature of some patients with adult T-cell leukemia (ATL) and tropical spastic paraparesis/HTLV-I-associated myopathy (TSP/HAM). The ability of extracellular Tax1 protein to activate expression of IL-2R alpha in both infected and uninfected lymphocytes may contribute to the abnormal lymphocyte proliferation observed in both ATL and TSP/HAM.

Immunoreactive calmodulin in supernatant fraction of platelet homogenates from humans, guinea pigs, rats, and rabbits

Immunoreactive Calmodulin (CM) was measured in the supernatant fraction of homogenates of platelets obtained from humans, rats, guinea pigs and rabbits, using a commercial RIA kit. The levels (microgram/g wet weight of platelets) of immunoreactive CM were 6.8 +/- 0.5, 6.9 +/- 0.4, 8.6 +/- 1.8 and 9.7 +/- 3.1 (mean +/- SEM) for rat, human, rabbit and guinea pig, respectively. There was no statistically significant difference in values between these four species. The refractoriness of rat platelets to aggregate to certain agonists such as platelet activating factor (PAF) cannot be explained on differences in amount of immunoreactive CM.

Selective alterations in gene expression for NMDA receptor subunits in prefrontal cortex of schizophrenics

NMDA receptor antagonists can induce a schizophrenia-like psychosis, but the role of NMDA receptors in the pathophysiology of schizophrenia remains unclear. Expression patterns of mRNAs for five NMDA receptor subunits (NR1/NR2A-D) were determined by in situ hybridization in prefrontal, parieto-temporal, and cerebellar cortex of brains from schizophrenics and from neuroleptic-treated and nonmedicated controls. In the cerebral cortex of both schizophrenics and controls, mRNAs for NR1, NR2A, NR2B, and NR2D subunits were preferentially expressed in layers II/III, Va, and VIa, with much higher levels in the prefrontal than in the parieto-temporal cortex. Levels of mRNA for the NR2C subunit were very low overall. By contrast, the cerebellar cortex of both schizophrenics and controls contained very high levels of NR2C subunit mRNA, whereas levels for the other subunit mRNAs were very low, except NR1, for which levels were moderate. Significant alterations in the schizophrenic cohort were confined to the prefrontal cortex. Here there was a shift in the relative proportions of mRNAs for the NR2 subunit family, with a 53% relative increase in expression of the NR2D subunit mRNA. No comparable changes were found in neuroleptic-treated or untreated controls. These findings indicate regional heterogeneity of NMDA receptor subunit expression in human cerebral and cerebellar cortex. In schizophrenics, the alterations in expression of NR2 subunit mRNA in prefrontal cortex are potential indicators of deficits in NMDA receptor-mediated neurotransmission accompanying functional hypoactivity of the frontal lobes.