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Research indicates students of lower socioeconomic status (SES) are educationally disadvantaged. We sought to examine differences in paramedic student academic performance from counties with varying SES in the United States. Student performance data and SES data were combined for counties within the states of California, Mississippi, Louisiana, Texas and Virginia. Linear multiple regression modelling was performed to determine the relationship between income, high school graduation rate, poverty and food insecurity with first-attempt scores on the Fisdap Paramedic Readiness Exam (PRE) versions 3 and 4. Linear regression models indicated that there was a significant relationship between county-level income, poverty, graduation rate, food insecurity, and paramedic student academic performance. It remains unclear what type of relationship exists between individual SES and individual academic performance of paramedic students. These findings support the future collection of individual student level SES data in order to identify issues and mitigate impact on academic performance.

Multisystem Inflammatory Syndrome in Children (MIS-C) is a severe complication of SARS-CoV-2 infection characterized by multi-organ involvement and inflammation. Testing of cellular function ex vivo to understand the aberrant immune response in MIS-C is limited. Despite strong antibody production in MIS-C, SARS-CoV-2 nucleic acid testing can remain positive for 4-6 weeks after infection. Therefore, we hypothesized that dysfunctional cell-mediated antibody responses downstream of antibody production may be responsible for delayed clearance of viral products in MIS-C. In MIS-C, monocytes were hyperfunctional for phagocytosis and cytokine production, while natural killer (NK) cells were hypofunctional for both killing and cytokine production. The decreased NK cell cytotoxicity correlated with an NK exhaustion marker signature and systemic IL-6 levels. Potentially providing a therapeutic option, cellular engagers of CD16 and SARS-CoV-2 proteins were found to rescue NK cell function in vitro. Together, our results reveal dysregulation in antibody-mediated cellular responses unique to MIS-C that likely contribute to the immune pathology of this disease.