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Longitudinal analyses of the innate immune system, including the earliest time points, are essential to understand the immunopathogenesis and clinical course of coronavirus disease (COVID-19). Here, we performed a detailed characterization of natural killer (NK) cells in 205 patients (403 samples; days 2 to 41 after symptom onset) from four independent cohorts using single-cell transcriptomics and proteomics together with functional studies. We found elevated interferon (IFN)-α plasma levels in early severe COVD-19 alongside increased NK cell expression of IFN-stimulated genes (ISGs) and genes involved in IFN-α signaling, while upregulation of tumor necrosis factor (TNF)-induced genes was observed in moderate diseases. NK cells exert anti-SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) activity but are functionally impaired in severe COVID-19. Further, NK cell dysfunction may be relevant for the development of fibrotic lung disease in severe COVID-19, as NK cells exhibited impaired anti-fibrotic activity. Our study indicates preferential IFN-α and TNF responses in severe and moderate COVID-19, respectively, and associates a prolonged IFN-α-induced NK cell response with poorer disease outcome., Competing Interests: Declaration of interests P.-A.K. and F.I.S. are cofounders and shareholders of Dioscure Therapeutics SE. F.I.S. is a consultant and shareholder of IFM Therapeutics. J.R.H. is founder and board member of Isoplexis and PACT Pharma. J.D.G. declares contracted research with Gilead, Lilly, and Regeneron. K.H., J.M.J., and A.J.B. work at Quanterix Corporation. All other authors declare no competing interests., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Hypertension and diabetes mellitus are leading health concerns in the United States. Despite a disproportionate burden of both conditions among African Americans, it is estimated that 44% of diabetes cases and one quarter of hypertension cases within this population are undiagnosed. Lack of awareness of the risk of these conditions may hinder preventive efforts and the adoption of positive lifestyle changes. Based on the findings from a pilot study to develop and standardize uniform screening forms for hypertension and diabetes, this article reports on the perceived risk versus actual risk of developing these conditions among primarily African American participants using a community-based screening tool. Each form assessed both perceived and actual risk of diabetes and hypertension, respectively. A total of 265 hypertension and 225 diabetes screening forms were randomly selected from eight sites across the country. The risk perception of the overall study sample was similar to its actual risk for developing either condition. However, a significant proportion of individuals who scored at high risk for diabetes or hypertension were unaware of their risk for these conditions. These results suggest the need for developing culturally relevant interventions, public health education, and policies that address the risk misperceptions among this group.

Of 3,816 homosexual men examined in five sexually transmitted disease clinics in the United States, 6.1% had hepatitis B surface antigen, 52.4% had antibody to hepatitis B surface antigen, and 3.0% of the men who had no other indicator of infection with hepatitis B virus (HBV) had antibody to hepatitis B core antigen. The rate of seropositivity for HBV indicated by the presence of one or more of these serologic markers was 61.5%; seropositivity was significantly related to the duration of regular homosexual activity and to the number of nonsteady male sexual contacts in the four months before the patients were interviewed. Anal-genital intercourse, oral-anal intercourse, and rectal douching were significantly related to evidence of HBV infection, but oral-oral contact and oral-genital contact were not. Trauma to the rectal mucosa is a feature common to the practices that were significantly related to seropositivity for HBV.

Gonorrhea is the most frequently reported communicable disease in the United States. In response to rapidly rising rates in the late 1960s, the Public Health Service instituted a gonorrhea control programme. An important component of the programme is the screening of women for gonococcal infections. We use a time series intervention model to estimate the initial increase in reporting of cases in women associated with the control programme. From the middle 1970s to the middle 1980s, a regular seasonal pattern in the data is conspicuous. We use a second time series model to quantify the seasonal variation during this period and to construct forecasts.