Faculty Bibliography

IMPORTANCE/UNASSIGNED:A substantial number of individuals worldwide experience long COVID, or post-COVID condition. Other postviral and autoimmune conditions have a female predominance, but whether the same is true for long COVID, especially within different subgroups, is uncertain. OBJECTIVE/UNASSIGNED:To evaluate sex differences in the risk of developing long COVID among adults with SARS-CoV-2 infection. DESIGN, SETTING, AND PARTICIPANTS/UNASSIGNED:This cohort study used data from the National Institutes of Health (NIH) Researching COVID to Enhance Recovery (RECOVER)-Adult cohort, which consists of individuals enrolled in and prospectively followed up at 83 sites in 33 US states plus Washington, DC, and Puerto Rico. Data were examined from all participants enrolled between October 29, 2021, and July 5, 2024, who had a qualifying study visit 6 months or more after their initial SARS-CoV-2 infection. EXPOSURE/UNASSIGNED:Self-reported sex (male, female) assigned at birth. MAIN OUTCOMES AND MEASURES/UNASSIGNED:Development of long COVID, measured using a self-reported symptom-based questionnaire and scoring guideline at the first study visit that occurred at least 6 months after infection. Propensity score matching was used to estimate risk ratios (RRs) and risk differences (95% CIs). The full model included demographic and clinical characteristics and social determinants of health, and the reduced model included only age, race, and ethnicity. RESULTS/UNASSIGNED:Among 12 276 participants who had experienced SARS-CoV-2 infection (8969 [73%] female; mean [SD] age at infection, 46 [15] years), female sex was associated with higher risk of long COVID in the primary full (RR, 1.31; 95% CI, 1.06-1.62) and reduced (RR, 1.44; 95% CI, 1.17-1.77) models. This finding was observed across all age groups except 18 to 39 years (RR, 1.04; 95% CI, 0.72-1.49). Female sex was associated with significantly higher overall long COVID risk when the analysis was restricted to nonpregnant participants (RR, 1.50; 95%: CI, 1.27-1.77). Among participants aged 40 to 54 years, the risk ratio was 1.42 (95% CI, 0.99-2.03) in menopausal female participants and 1.45 (95% CI, 1.15-1.83) in nonmenopausal female participants compared with male participants. CONCLUSIONS AND RELEVANCE/UNASSIGNED:In this prospective cohort study of the NIH RECOVER-Adult cohort, female sex was associated with an increased risk of long COVID compared with male sex, and this association was age, pregnancy, and menopausal status dependent. These findings highlight the need to identify biological mechanisms contributing to sex specificity to facilitate risk stratification, targeted drug development, and improved management of long COVID.

BACKGROUND/UNASSIGNED:In patients with inflammatory bowel disease (IBD) who need intestinal resection, prior data suggest that earlier surgical intervention may be associated with improved outcomes. However, surgery is often deferred for additional trials of advanced therapies, which potentially shifts patients from a fit to a frail preoperative state. OBJECTIVES/UNASSIGNED:This study aimed to evaluate clinical changes that occur in the year prior to intestinal resection in patients with IBD. DESIGN/UNASSIGNED:Retrospective cohort study. METHODS/UNASSIGNED:This was a multi-hospital retrospective study of patients ⩾18 years old who underwent initial IBD-related intestinal resection between January 1, 2018 and May 31, 2023. Clinical characteristics and radiographical skeletal muscle mass were compared using the Wilcoxon Signed-Rank test for continuous variables and McNemar's test for categorical variables. RESULTS/UNASSIGNED: = 0.06). CONCLUSION/UNASSIGNED:In the 6-12 months prior to an IBD-related intestinal resection, as compared to the month prior, individuals were less likely to be malnourished, have an infection, or need hospitalization for IBD. This suggests that minimizing delays to surgery may lead to improved outcomes.

BACKGROUND AND STUDY AIMS/UNASSIGNED:Gastroenterologists are prone to endoscopy-related musculoskeletal injuries (ERI). Current interventions lack real-time monitoring and feedback. ErgoGenius, a novel artificial intelligence computer-vision tool, addresses this gap by providing continuous posture assessment and feedback without wearable motion trackers. The aim of this study was to determine the feasibility of ErgoGenius, its accuracy compared with human appraisers, and its ability to detect abnormal posture. METHODS/UNASSIGNED:-test was used to compare REBA scores between bed positions. RESULTS/UNASSIGNED:= 0.006). CONCLUSIONS/UNASSIGNED:ErgoGenius was successfully deployed to detect abnormal postures related to changes in bed position and quantify ERI risk. It performed at par with human appraisers. This tool shows promise in enhancing ergonomic practices among gastroenterologists and trainees, potentially leading to better health outcomes and reduced injury.

BACKGROUND:Despite reports indicating that polyps proximal to the splenic flexure have higher rates of metachronous colorectal adenocarcinoma (CRC), the role of adenoma location on surveillance recommendations remains unclear. This study aimed to analyze the association between index polyp location and post-colonoscopy CRC among participants of the Minnesota Colon Cancer Control Study (MCCCS). METHODS:The MCCCS randomized 46,551 patients 50-80 years to usual care, annual, or biennial screening with fecal occult-blood testing (FOBT). Screening was performed between 1976-1992. Positive FOBT was followed by colonoscopy. We analyzed participants whose colonoscopy revealed at least one adenoma. Patients were divided into those with at least one lesion proximal to the splenic flexure and those without. RESULTS:Of 2,295 patients, 815 had proximal adenomas. The majority were men; mean age =62 years at randomization, and 69 years at index polyp. There was a high rate of advanced adenomas: 44% ≥1 polyp ≥1 cm, 35% with villous histology, and 5% high grade dysplasia. At 20 years, 87 patients had a CRC diagnosis, and the estimated cumulative incidence of CRC was 4.3%. Proximal adenomas had a higher risk of developing a post-colonoscopy CRC (SHR=1.63, 95% CI=1.05-2.53, P=0.03), which was attenuated after adjusting for polyp multiplicity in sensitivity analyses (SHR=1.56, 95% CI=0.96-2.53, P=0.07). CONCLUSION/CONCLUSIONS:Although patients with proximal adenomas were found to have higher hazards of post-colonoscopy CRC, adjusting for polyp multiplicity attenuated the strength of association. Further research is warranted to determine whether polyp location should be factored in the determination of appropriate surveillance intervals.

INTRODUCTION/BACKGROUND:Risk factors for serrated polyps (SPs) are not well understood. METHODS:Multivariable analyses of data from a multicenter colonoscopy-based study estimated odds ratios for having either a sessile serrated lesion or traditional serrated adenoma according to participant characteristics. RESULTS:Six thousand seventy-eighty participants were included in the analyses (565 with either a sessile serrated lesion or traditional serrated adenoma). White race was associated with a higher risk of SPs compared with Black race (adjusted odds ratio 4.64, 95% confidence interval 1.89-11.41). Obesity and current smoking were also associated with a higher risk of SPs. DISCUSSION/CONCLUSIONS:White race, smoking, and obesity are risk factors for precancerous SPs.