Interferons make up a key first-line defense against viral pathogens. Although Type I interferons (alpha/beta) have been used for years to treat hepatitis and other viral infections, systemic toxicity has limited their uptake. Interferon lambda, a Type III interferon, drives a similar antiviral response to interferon alpha/beta but uses a different receptor with a much more limited tissue distribution. Trials in hepatitis B and C infections have shown that interferon lambda has similar antiviral activity but a better side effect profile than Type I interferons. Pre-clinical studies have shown that interferon lambda is highly effective in respiratory viral infections as a preventative or therapeutic approach with no risk of promoting the cytokine storm syndrome. We evaluated peginterferon lambda in ambulatory patients with mild-moderate COVID-19 and will present initial study results. 
 

Endothelial injury as a consequence of SARS-CoV-2 infection leads to a dysregulated host inflammatory response and activation of coagulation pathways. Macro- and micro-vascular thrombosis contributes to morbidity, organ failure and death. Therapeutic anticoagulation may improve clinical outcomes in patients with COVID-19 through anti-thrombotic, anti-inflammatory, and anti-viral activities of heparins.
 

The talk will provide a short outline of respiratory oscillometry and its potential utility for identification of early graft function following lung transplant and prognosis in disease severity in chronic lung disease.

PLENARY SESSION III

Many patients worldwide are waiting for procedures delayed by the focus of resources on COVID-19. Waiting may cause anxiety, which can manifest physically and worsen other aspects of mental health. This study aimed to synthesize published research on the impact of waiting, determinants of impact, and strategies to support mental health among wait-listed patients and caregivers. We conducted a scoping review. We searched MEDLINE, EMBASE, CINAHL, SCOPUS, AMED, PsychInfo, Sociological Abstracts, the Cochrane Library, and Joanna Briggs Database from 2010 to July 8, 2020 for studies about mental health and waiting for procedures. We included 51 studies published from 2010 to 2019 in 19 countries that focused on organ transplant (60.8%), surgery (21.6%) or cancer diagnosis/treatment (13.7%). Most patients reported anxiety, depression and poor quality of life, which deteriorated with increasing wait time. Few studies involved caregivers (15.7%), who had similar depression and greater anxiety compared with patients. The impact of waiting on mental health was greater among women and new immigrants, and those of younger age, lower socioeconomic status, or with less-positive coping ability or longer wait times. Lack of provider communication about wait times eroded trust in the healthcare system. Six studies evaluated educational strategies to develop coping skills: 2 studies reduced depression (2 did not), 1 study reduced anxiety (2 did not) and 2 studies improved quality of life (2 did not). In contrast, patients desired acknowledgement of concerns by providers, peer support, and periodic communication about waitlist position, prioritization criteria, and anticipated procedure date. Findings highlight the need to support mental health among wait-listed patients and caregivers during the current pandemic and beyond using strategies they recommended. Ongoing research should explore how to optimize the impact of those strategies for diverse patients and caregivers.

Supporting stakeholders with timely evidence has a direct and immediate impact on their decision-making and population health in the short-and long-term. 
This talk will provide an overview of a suite of COVID-19 models developed by the COVID-19 Modeling Collaborative, that have supported Ontario decision-making to date with a focus on Ontario’s acute care system, including predicting ICU occupancy, medication and PPE demand as well as estimating adverse health outcomes from restricting elective surgeries during the first wave.