BackgroundThe COVID-19 pandemic is an unprecedented global public health crisis that continues to exert immense pressure on healthcare and related professional staff and services. The impact on staff wellbeing is likely to be influenced by a combination of modifiable and non-modifiable factors.ObjectivesThe aim of this study is to evaluate the effect of the COVID-19 pandemic on the self-reported wellbeing, resilience, and job satisfaction of National Health Service (NHS) and university staff working in the field of healthcare and medical research.MethodsWe conducted a cross sectional survey of NHS and UK university staff throughout the COVID-19 pandemic between May-November 2020. The anonymous and voluntary survey was disseminated through social media platforms, and via e-mail to members of professional and medical bodies. The data was analyzed using descriptive and regression (R) statistics.ResultsThe enjoyment of work and satisfaction outside of work was significantly negatively impacted by the COVID-19 pandemic for all of staff groups independent of other variables. Furthermore, married women reporting significantly lower wellbeing than married men (P = 0.028). Additionally, the wellbeing of single females was significantly lower than both married women and men (P = 0.017 and P < 0.0001, respectively). Gender differences were also found in satisfaction outside of work, with women reporting higher satisfaction than men before the COVID-19 pandemic (P = 0.0002).ConclusionOur study confirms that the enjoyment of work and general satisfaction of staff members has been significantly affected by the first wave of the COVID-19 pandemic. Interestingly, being married appears to be a protective factor for wellbeing and resilience but the effect may be reversed for life satisfaction outside work. Our survey highlights the critical need for further research to examine gender differences using a wider range of methods.

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Methods Retrospective analysis of new events among primary-APS (pAPS) patients followed for up to 15 years in three medical centres in Israel. Results Among 312 primary-APS patients 143 (46%) had new thrombotic event classified to three patterns: (1) Arterialassociated with heart valve disease (OR 7.24, hypertension (OR 3,, elevated anti B2-GPI IgM (OR 1.04, 95% C.I. 0.996-1.08), arterial thrombosis at presentation (OR 1.74 CI95% 0.992-3.26) and older age (41 vs. 34 years, p<0.001). ( 2) Venouslinked with venous thrombosis at presentation (OR 12.9, 95% C.I. 5.27-31.6, p<0.001), heart valve disease (OR 9.81 CI95% 1.82-52.9, p=0.018), aGAPSS (OR 1.15 CI95% 1.02-1.29) and younger age (31 vs. 36.5 years, p=0.001); (3) Combined pattern -associated with heart valve disease (OR 40.5 95% C.I. 7.7-212) and pulmonary embolism (OR 7.47 95% C.I. 1.96-28.5). A 4th variant 'the Breakthrough pattern' defined by rethrombosis despite prophylactic therapy was observed in 100/ 143(70%) patients and linked with heart valve disease (OR 8. 95% C.I. 2.43-26.3), venous thrombosis at presentation (OR 2.61 95% C.I. 1.47-4.66), leg ulcers (OR 12.2, 95% C.I. 1.4-107), hypertension (OR 1.99, 95% C.I. 0.92-4.34) and higher aGAPSS (OR 1.08, 95% C.I. 0.99-1.18). Conclusion In this real life observation, re-thrombosis was common among pAPS patients including in those recommended to receive prophylactic therapy. Different patterns of recurrence were identified and linked with presenting symptoms, specific serological markers, APS-manifestations and comorbidities. Studies that will address interventions to prevent recurrences of APS related events are needed.

Background/Aims Sjögren’s syndrome (SS) is an autoimmune rheumatic disease characterised by dryness resulting from chronic lymphocytic infiltration of the exocrine glands and extra glandular manifestations such as arthritis, anemia, and fatigue. The disease is more frequent in women aged 30-50. However, in rare cases, the disease starts in childhood, known as juvenile SS (jSS). Children have different clinical manifestations compared to adults, with dryness being less common, making the diagnosis very challenging. Our aim is to investigate in depth the immune cell profile of patients with jSS and their cytokine profile for better understanding of disease pathogenesis. Methods Peripheral blood was collected from a cohort of patients with jSS (n = 10) and age and sex-matched healthy controls (HC) (n = 10). None of the patients had received B-cell depletion therapy. Peripheral blood immune-phenotyping of 29 immune-cell subsets, including B and T cells, was performed using flow cytometry as we have reported previously for patients with adult-onset SS. Data were analyzed using multiple t-tests and compared with the adult SS immune phenotype. A panel of 15 serum cytokines associated with SS pathology were measured by Luminex, multiple t-tests were performed to detect statistically significant differences between jSS and HCs. Results Patients with jSS had an average age of 18 years (range 16-21) with an average age of disease onset at 14 years (range 12-18). 60% of patients had anti-Ro autoantibodies and 50% had anti-La autoantibodies. Patients with jSS had an altered immune profile compared to age-matched healthy controls (HCs) (mean age = 18 years, range 15-25). In the B cell compartment, jSS patients had higher frequencies of total CD19+ B cells (p = 0.0044), naïve B cells (CD19+IgD+CD27-) (p = 0.0183) and bm2 (CD19+IgD+CD38+) (p = 0.0490) whereas memory B cell subsets such as early bm5 (CD19+IgD-CD38+) and late bm5 (CD19+IgD-CD38-) were significantly reduced (p = 0.0249 and p = 0.0117, respectively). Interestingly, in the CD4+ T cell compartment, central memory T cells (CD4+CD27+CD45RA-) were significantly reduced (p = &lt;0.0001) but effector memory (CD4+CD27-CD45-) and effector memory-re-expressing-CD45RA (EMRA, CD4+CD27-CD45RA+) T-cell subsets were significantly elevated (p = 0.0171 and p = 0.0002 respectively). There was also a significant increase in CD8+CD25-CD127+ responders T cells (p = 0.0392) in jSS patients versus HCs. Serum cytokines levels of APRIL and CCL8 were significantly elevated in jSS. Conclusion This is the first pilot study investigating the immune profile of patients with jSS. In line with our previous studies in adults we detected elevated naïve and reduced frequencies of memory B cells, suggesting an immunological rationale for the use of similar therapies across age. However, we also found a specific dysregulation of the responder CD8+ T cell subpopulation in jSS versus HCs, which requires further investigation. Our cytokine data could indicate an ongoing dysregulation of the homeostasis of mature B-cells and activation of different immune cells. Disclosure L. Martin-Gutierrez: None. H. Peckham: None. A. Radziszewska: None. J. Peng: None. O. Nettey: None. E. Jury: None. C. Ciurtin: None.