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Background: Levels of plasma SARS-CoV-2 nucleocapsid (N) antigen may be an important biomarker in patients with COVID-19 and enhance our understanding of the pathogenesis of COVID-19. Objective: To evaluate whether levels of plasma antigen can predict short-term clinical outcomes and identify clinical and viral factors associated with plasma antigen levels in hospitalized patients with SARS-CoV-2. Design: Cross-sectional study of baseline plasma antigen level from 2540 participants enrolled in the TICO (Therapeutics for Inpatients With COVID-19) platform trial from August 2020 to November 2021, with additional data on day 5 outcome and time to discharge. Setting: 114 centers in 10 countries. Participants: Adults hospitalized for acute SARS-CoV-2 infection with 12 days or less of symptoms. Measurements: Baseline plasma viral N antigen level was measured at a central laboratory. Delta variant status was determined from baseline nasal swabs using reverse transcriptase polymerase chain reaction. Associations between baseline patient characteristics and viral factors and baseline plasma antigen levels were assessed using both unadjusted and multivariable modeling. Association between elevated baseline antigen level of 1000 ng/L or greater and outcomes, including worsening of ordinal pulmonary scale at day 5 and time to hospital discharge, were evaluated using logistic regression and Fine-Gray regression models, respectively. Results: Plasma antigen was below the level of quantification in 5% of participants at enrollment, and 1000 ng/L or greater in 57%. Baseline pulmonary severity of illness was strongly associated with plasma antigen level, with mean plasma antigen level 3.10-fold higher among those requiring noninvasive ventilation or high-flow nasal cannula compared with room air (95% CI, 2.22 to 4.34). Plasma antigen level was higher in those who lacked antispike antibodies (6.42 fold; CI, 5.37 to 7.66) and in those with the Delta variant (1.73 fold; CI, 1.41 to 2.13). Additional factors associated with higher baseline antigen level included male sex, shorter time since hospital admission, decreased days of remdesivir, and renal impairment. In contrast, race, ethnicity, body mass index, and immunocompromising conditions were not associated with plasma antigen levels. Plasma antigen level of 1000 ng/L or greater was associated with a markedly higher odds of worsened pulmonary status at day 5 (odds ratio, 5.06 [CI, 3.41 to 7.50]) and longer time to hospital discharge (median, 7 vs. 4 days; subhazard ratio, 0.51 [CI, 0.45 to 0.57]), with subhazard ratios similar across all levels of baseline pulmonary severity. Limitations: Plasma samples were drawn at enrollment, not hospital presentation. No point-of-care test to measure plasma antigen is currently available. Conclusion: Elevated plasma antigen is highly associated with both severity of pulmonary illness and clinically important patient outcomes. Multiple clinical and viral factors are associated with plasma antigen level at presentation. These data support a potential role of ongoing viral replication in the pathogenesis of SARS-CoV-2 in hospitalized patients.

The COVID-19 pandemic led to nationwide lockdowns and rigid measures of social distancing in Denmark. Such a situation provides the unique opportunity to study interruptions in training routines and scrutinise the significance of physical attendance, face-to-face interactions and collective engagement for sport and leisure-time physical activity. Drawing on Randall Collins’ micro-sociological theory of ‘Interaction Ritual Chains’, this article focuses on CrossFit–an activity, which is not only known for members’ high-intensity workouts but also for a tight-knit community. Specifically, we explored how CrossFitters in Denmark made sense of and experienced the changes of their leisure practices throughout the COVID-19 pandemic. Semi-structured interviews with 20 CrossFitters recruited from different CrossFit boxes showed that not only activity levels but also emotional energy and group solidarity dropped considerably during COVID-19 as members lacked interactions within the CrossFit boxes which had been crucial for their participation before the pandemic. Notably, new training situations, specifically online workouts, could not replace the highly successful interaction rituals in the CrossFit box, which stresses the significance of face-to-face interactions for continuous leisure-time physical activity. In so doing, this article contributes to discussions about whether online workouts and digitally mediated communities can complement or replace physical training.

Background Since the release of the first global hepatitis elimination targets in 2016, and until the COVID-19 pandemic started in early 2020, many countries and territories were making progress toward hepatitis C virus (HCV) elimination. This study aims to evaluate HCV burden in 2020, and forecast HCV burden by 2030 given current trends. Methods This analysis includes a literature review, Delphi process, and mathematical modelling to estimate HCV prevalence (viraemic infection, defined as HCV RNA-positive cases) and the cascade of care among people of all ages (age =0 years from birth) for the period between Jan 1, 2015, and Dec 31, 2030. Epidemiological data were collected from published sources and grey literature (including government reports and personal communications) and were validated among country and territory experts. A Markov model was used to forecast disease burden and cascade of care from 1950 to 2050 for countries and territories with data. Model outcomes were extracted from 2015 to 2030 to calculate population-weighted regional averages, which were used for countries or territories without data. Regional and global estimates of HCV prevalence, cascade of care, and disease burden were calculated based on 235 countries and territories. Findings Models were built for 110 countries or territories: 83 were approved by local experts and 27 were based on published data alone. Using data from these models, plus population-weighted regional averages for countries and territories without models (n=125), we estimated a global prevalence of viraemic HCV infection of 0.7% (95% UI 0.7-0.9), corresponding to 56.8 million (95% UI 55.2-67.8) infections, on Jan 1, 2020. This number represents a decrease of 6.8 million viraemic infections from a 2015 (beginning of year) prevalence estimate of 63.6 million (61.8-75.8) infections (0.9% [0.8-1.0] prevalence). By the end of 2020, an estimated 12.9 million (12.5-15.4) people were living with a diagnosed viraemic infection. In 2020, an estimated 641 000 (623 000-765 000) patients initiated treatment. Interpretation At the beginning of 2020, there were an estimated 56.8 million viraemic HCV infections globally. Although this number represents a decrease from 2015, our forecasts suggest we are not currently on track to achieve global elimination targets by 2030. As countries recover from COVID-19, these findings can help refocus efforts aimed at HCV elimination. Copyright (C) 2022 Elsevier Ltd. All rights reserved. This analysis was funded by a grant from the John C Martin Foundation (2019-G024) through the Polaris Observatory for low-income and middleincome countries. Grants for analyses in high-income countries and territories were provided by Gilead Sciences (IN-US-987-5808) and AbbVie (4200907861). ZeShan Foundation (2021-0101-1-CDA-HEP-10) supported country and regional analyses in Asia and The Hepatitis Fund supported country and regional analyses in Africa. We thank the Epidemiological Research Group on the Burden of Viral Hepatitis and Measures for its Elimination (grant number 19HC1001; led by JT) funded by the Ministry of Health, Labour and Welfare of Japan. We thank the contributors included in the appendix (pp 2-3), who contributed to the country or territory analyses but did not meet authorship requirements. John C Martin Foundation [2019-G024]; Gilead Sciences [IN-US-987-5808]; AbbVie [4200907861]; ZeShan Foundation [2021-0101-1-CDA-HEP-10]; The Hepatitis Fund; Ministry of Health, Labour and Welfare of Japan [19HC1001]

Pro-environmental behavior, a form of prosocial behavior that ultimately benefits all humanity, is essential for addressing climate change. This review presents pro-environmental behavior in a social dilemma framework describing how non-aligned interests in nested groups (e.g. smaller groups with interests opposing the interests of a superordinate group entailing the smaller groups) and unequal opportunities (e.g. differential access to resources) constitute barriers to pro-environmental behavior. We then summarize recent literature on three ways in which these barriers could be addressed. Specifically, we review how individual and conflicting interests might be overcome and benefits for the collective can be achieved by (1) collective action and global identities, (2) applying insights from another global crisis, the COVID-19 pandemic, and (3) a shift to research methods that consider the nested structure of and unequal opportunities within global crises as well as high-impact actions. Taken together, these approaches might foster one form of prosociality, pro-environmental behavior, that is desperately needed in the pursuit of sustainability.

AbstractThe various interventions that governments took in the first wave of the Covid-19 outbreak impacted people severely. Given the low satisfaction with the government performance in Austria compared to Denmark, though both governments set out with a suppression strategy early on and were able to lower infection rates, we analyse the changes in civil, political and social citizenship and the governmental communicative practices during the first Covid response phase from March to August 2020. Employing a case-oriented qualitative comparison, we find that a combination of factors explains the different degree of satisfaction. In Austria, there was a combination of politics of fear, extensive and authoritarian regulations of civil citizenship, political citizenship was challenged and social citizenship undermined. In Denmark, an engaging and caring communicative strategy was employed, political citizenship was maintained and civil citizenship was curtailed less obstructively and was less policed. Social citizenship also was upheld for larger groups.

Reflecting on a methodological experiment, we discuss the use of computational techniques in anthropology. The experiment was based on a collaborative effort by a team of ethnographers to produce an archive on the digitalisation of everyday life that took place during the COVID-19 pandemic. We describe how online ethnographic data collection took place using digitally mediated interviews, participant observation in virtual events, and mobile ethnography. We analyse the consequences of online ethnography for establishing rapport and present steps taken to create an infrastructure for navigating ethnographic material comprising more than 3000 pages of text generated by multiple ethnographers.