The hallmark of HIV-1 (HIV) infection is the progressive development of multicellular and systemic immune dysfunction, culminating in AIDS. Dendritic cells (DCs) play a pivotal role in HIV dissemination to CD4 + T cells, which are subsequently depleted by the virus leading to HIV disease progression. Type I interferons (IFNs) are critical for host defense during acute infection but contribute to chronic immune activation during the later stages of HIV disease. This persistent activation leads to immune cell exhaustion. HIV can activate type I IFN responses via several pathways, including the STING pathway, which is activated by, e.g., virus-derived oligonucleotides. Here, we investigated the underlying mechanisms creating HIV-mediated immune dysfunction and role of type I IFNs using a DC and T cell co-culture model. HIV exposure in the DC-T cell co-culture promoted the expansion of suppressive T cells with diminished proliferation and effector functions. The impairment required type I IFNs and subsequent IFNα/β receptor signaling, and our data indicate that this was initiated by HIV-derived ssDNA activation of IFI16/cGAS followed by STING signaling in the DCs. Targeting IFNAR1 with anifrolumab restored the immune functions of both DCs and T cells, as well as T cell proliferation and T cell effector functions, including their secretion of IL-2, IFNγ, and granzyme B. Our findings support that the immune impairments existing in untreated or antiretroviral therapy (ART) treated HIV-infected individuals are mediated, if not fully in part by type I IFN's negative effect on DC and T cells. Therapeutics targeting IFNα/β receptors, such as anifrolumab, hold potential as combination treatment alongside ART, to achieve a more complete immune restoration and contribute to improved quality of life among people living with HIV.

Immunoglobulin G subclass deficiencies (IgGSD) are associated with recurrent respiratory tract infections. Tools to identify patients with IgGSD who benefit from immunoglobulin G replacement therapy (IgGRT) are lacking. This crossover study evaluated the number of antibiotic-demanding infections on and after up to 18 mo off IgGRT in 28 patients with IgGSD. Pneumococcal antibodies against 21 serotypes were assessed using a multiplex assay. After 12 mo on IgGRT, the frequency of infections was reduced during the following 6 mo compared with the last 6 mo without IgGRT, indicating a delayed therapeutic effect. Low levels of pneumococcal serotype-specific antibodies and lower IgG2 levels were associated with the need to restart IgGRT. In conclusion, IgGRT effectively reduces bacterial infections in IgGSD, but the benefits may take at least a year to manifest. Pneumococcal antibody profiling and IgG2 levels may help identify patients needing long-term IgGRT.

SARS-CoV-2 infection remains a global health concern, with its impact on host immune responses not fully understood. In a case–control study, we examined how COVID-19 affects DNA methylation patterns in the upper respiratory airway of hospitalized individuals. DNA methylation arrays were performed on nasopharyngeal samples at inclusion/hospitalization and 6 weeks post-inclusion. We found a distinct DNA methylation pattern in COVID-19 patients compared to healthy controls, identifying 510,099 differentially methylated CpGs. Within the transcription start sites (TSSs) and gene body, COVID-19 patients displayed a higher number of genes/CpGs with elevated methylation levels. Enrichment analysis of TSS-methylated genes revealed effects of SARS-CoV-2 on genes associated with type I interferons, anti-viral and inflammatory responses, and immune functions. Some CpG methylations were transient, and normalized at group level by 6 weeks post-inclusion. Several IFN-regulated genes, including OAS1, OAS3, IFIT3, and MX1, were identified. Among the top regulators were IL17A and ERK1/2, both involved in inflammatory processes. Networks nodes included IGF1 and EGF, associated with processes including tissue repair and activation of immune responses. Overall, our data suggests that COVID-19 can impact the upper airway by modifying gene methylation patterns. This could have implications for conditioning of the airways, how individuals respond to future airway infections, and therapeutic interventions.

The use of simulation training as a teaching method to support vocational learning is growing in popularity within VET. However, there is scarce research on how students experience and make use of simulation training. Therefore, this study explores how VET students experience and reflect on simulation training as a method for learning vocational knowledge and skills. The empirical material is based on 27 group interviews with VET students (n = 43) from two different vocational education programmes at two upper secondary schools from 2019 to 2022. The researchers followed one class of students from the Natural Resource Use Programme and two classes from the Vehicle and Transport Programme. Drawing upon practice theory, the results discuss how and in what ways VET students value simulation training. Simulation training is only one part of students' learning, and the results show how they handle the differences between using the simulator to learn how to drive or driving an authentic machine. Students emphasise the lack of fidelity and difficulties enacting an embodied practice but also stress that the simulator places unreasonable demands on them as learners.

The hallmark of HIV-1 infection is the progressive development of multicellular and systemic immune dysfunction, culminating in AIDS. Dendritic cells (DCs) play a pivotal role in HIV dissemination to CD4+ T cells, which are subsequently depleted by the virus leading to HIV disease progression. Type I interferons (IFNs) are critical for host defense during acute infection but contribute to chronic immune activation during the later stages of HIV disease. This persistent activation leads to immune cell exhaustion. HIV-1 can activate type I IFN responses via several pathways, including the STING pathway, which is activated by e.g., virus-derived oligonucleotides. Here, we investigated the underlying mechanisms creating HIV-1-mediated immune dysfunction and role of type I IFNs using a DC and T cell co-culture model. HIV-1 exposure in the DC-T cell co-culture promoted the expansion of suppressive T cells with diminished proliferation and effector functions. The impairment required type I IFNs and subsequent IFN-alfa/beta; receptor signaling, initiated by HIV-derived ssDNA activation of IFI16/cGAS followed by STING signaling in the DCs. Targeting IFNAR1 with Anifrolumab restored the immune functions of both DCs and T cells, as well as T cell proliferation and T cell effector functions, including their secretion of IL-2, IFN-alpha;, and granzyme B. Our findings support that the immune impairments existing in untreated or antiretroviral therapy (ART) treated HIV-infected individuals are mediated, if not fully in part by type I IFNs negative effect on DC and T cells. Therapeutics targeting IFN-alpha/beta; receptors, such as Anifrolumab, hold potential as combination treatment alongside ART, to achieve a more complete immune restoration and contribute to improved quality of life among people living with HIV. ### Competing Interest Statement The authors have declared no competing interest.

Individuals with chronic lymphocytic leukemia (CLL) face increased risk of severe COVID-19. This study from Sweden, a country with few mandatory restrictions at the onset of the pandemic, used 10 nationwide registers to compare risks of severe COVID-19 outcomes of PCR-verified SARS-CoV-2 infections through February 2023 in individuals with vs without CLL. From a population of 8,275,839 (6,653 CLL) individuals born 1930-2003, 2,088,163 first infections (1,289 CLL) were included. The 90-day all-cause mortality rate and adjusted relative risk (aRR [95% CI]) for individuals with CLL vs the general population was 24.8% (1.95 [1.58-2.41)) during Wild-type, 17.2% (2.38 [1.58-3.57)) during Alpha, 4.1% (0.71 [0.24-2.08]) during Delta, and 12.6% (1.49 [1.24-1.78]) during Omicron. Their mortality during Omicron was 0.6% (<65 years), 5.4% (65-74 years), and 19.7% (>75 years). Small molecule inhibitors (1.56 [1.03-2.37]) and corticosteroid usage (1.45 [1.04-2.02]) was associated with increased mortality. Next, we analyzed the all-cause mortality in the capital (Stockholm), widely affected by SARS-CoV-2 at the onset of the pandemic. Mortality in individuals with CLL increased by 55% during the first 6 months of 2020 vs 2019 and age- and sex aRR by June 30 was 1.53 [1.09-2.15] for individuals with CLL (P=.02) and 1.29 [1.25-1.33] for the general population (P<.001). Collectively, a significantly increased risk of severe COVID-19 and death was observed among individuals with CLL in Sweden, particularly at the onset of the pandemic when few national protective measures were introduced, but also after Omicron emerged, emphasizing the need for a more pro-active pandemic strategy for CLL.

Background/Objectives: One of the risk groups during the COVID-19 pandemic was people with predominantly antibody deficiencies (PADs) that have a compromised immune system. In the absence of evidence and clinical experience, there were challenges for patients in their daily life and for staff in counseling during this time. Therefore, the aim of this study was to explore the experiences of PAD patients and nurses during the COVID-19 pandemic. Methods: Focus group interviews with patients (n = 12) and nurses (n = 12) were performed separately, which were then analyzed using content analysis. Results: The daily life of PAD patients was affected during the pandemic, with concerns about becoming seriously ill. Social isolation and adherence to recommendations by the majority of the Swedish population resulted in patients feeling infectiously healthier during this period. The rapid transition of specialist care to telemedicine care encounters was an important measure taken to address patients’ concerns and questions according to both patients and nurses. In addition, patients expressed a need for a coordinated care plan to facilitate access to integrated care. Conclusions: The high level of trust for authorities in Sweden was related to the high compliance with the recommendations, which reduced the spread of the infection. The role of specialized care is an important support for PAD patients, which was particularly evident during the pandemic. Information transfer to a specific risk group, such as people with PADs, is important and can usefully be coordinated by their specialist clinic. Telemedicine meetings are an important complement for people with PADs and need to be further elaborated. Also, there is a need to clarify how to better coordinate primary and specialized care.

BACKGROUND:It is thought that patients with inborn errors of immunity (IEI) are more susceptible to severe coronavirus disease 2019 (COVID-19) than the general population, but a quantification of this potential risk is largely missing. OBJECTIVE:We assessed the impact of COVID-19 on patients with IEI. METHODS:A nationwide cohort study was performed to estimate the relative risk (RR) for hospitalization, intensive care, and death within 30 days after a positive severe acute respiratory syndrome coronavirus 2 test result in an IEI population (n = 2392) compared to the general population (n = 8,270,705) using data from Swedish national registries. Three time periods were studied: the prevaccination period, and the Alpha/Delta and Omicron periods. Adjustment was made for demographics, income, comorbidities, and vaccination status. RESULTS:During the prevaccination period, 25.2% of the IEI population was hospitalized, compared to 17.5% and 5.2% during the Alpha/Delta and Omicron periods, respectively. For the 3 time periods, the adjusted RR [95% confidence interval] for hospitalization in the IEI population compared to the general population was 3.1 [2.1-4.2], 3.5 [2.4-4.8], and 4.3 [2.5-6.7], respectively. The respective values for intensive care after COVID-19 were 5.6 [2.6-10.8], 4.7 [1.7-10.1], and 4.7 [1.7-10.1] for the 3 periods. Five patients (0.6%) in the IEI population died within 30 days of a positive PCR test result compared to 18,773 (0.2%) in the general population during the 3 study periods. CONCLUSION:Patients with IEI had a 3 to 4 times higher risk for hospitalization and a 5 times higher risk for intensive care during COVID-19 compared to the general population.

BACKGROUND:Data on the outcomes of COVID-19 in people living with HIV (PLHIV), specifically in relation to vaccination status, are lacking during the Omicron era. METHODS:This nationwide registry-based study included all resident in Sweden ≥18 years with a positive SARS-CoV-2 PCR test during January 2021-February 2023. We estimated adjusted odds ratios (adjOR) for COVID-19 hospitalisation and severe COVID-19 (ICU admission and 90-day mortality), categorised by SARS-CoV-2 vaccination status (0-1, 2, and ≥3 doses), and HIV-status. Analyses were then categorised by time periods of pre-Omicron, Omicron during public testing, and Omicron after public testing. RESULTS:1348 PLHIV and 1 669 389 people without HIV (PWoH) were included. PLHIV were older, more migrant (65 vs. 22%) and male (59 vs. 46%). Of PLHIV, 96% were on antiretroviral treatment and 94% virally suppressed. AdjORs of COVID-19 hospitalisation were similar irrespective of HIV-status, controlled for demographics, calendar month of infection, comorbidities, and income. PLHIV were more likely to be hospitalised than PWoH during Omicron and public testing (adjOR 2.3, 95% CI 1.1-4.2), but not after public testing. The odds of severe COVID-19 were three times higher in PLHIV compared to PWoH vaccinated with 2 doses (adjOR 3.2, 95% CI 1.3-6.9), but not when vaccinated with ≥3 doses (adjOR 0.7, 95% CI 0.2-1.6). Migrant and low nadir CD4+ T-cells were associated with higher odds of hospitalisation in unvaccinated PLHIV. CONCLUSIONS:This nationwide study, including mostly well-treated PLHIV, highlights the importance of vaccination with booster dose/s for effective protection against severe COVID-19 in PLHIV.KEY POINTPeople living with HIV compared to people without HIV did not have higher odds of COVID-19 hospitalisation irrespective of SARS-CoV-2 vaccination status (0-1 dose, 2 doses, ≥3 doses) when adjusting for known risk factors including comorbidities and socioeconomic status.

Introduction Due to disease- and treatment-related immune defects, patients with chronic lymphocytic leukemia (CLL) have an increased risk of severe disease and death from COVID-19, as well as impaired responses to SARS-CoV-2 vaccination. Thus, we performed a retrospective nationwide analysis on the risk of severe disease and death in individuals with CLL compared to matched controls without CLL in Sweden during the first 3 years of the COVID-19 pandemic in Sweden, using multiple national and population-based registers. The impact of vaccination status and specific CLL directed therapies on outcome, during different phases of the pandemic was also studied. Methods We conducted a nationwide cohort study considering all SARS-CoV-2 infection episodes (>90 days between positive PCR tests) from individuals born 1930-2003, residing in Sweden from 1 February 2020 to 31 March 2023. Data from multiple nationwide registers with high coverage (including, but not limited to, the Total Population Register, the National Cause of Death Register, the National Vaccination Register and the INCA CLL register) were used. An infection episode was classified as exposed to CLL when a CLL diagnosis was registered any time before and up until 90 days after the positive PCR test. Each exposed episode was matched to an unexposed episode using a combination of exact and propensity score-based matching without replacement. Exact matching included age category, sex, born in Sweden, residential region, infection episode number, calendar month of positive PCR test, and SARS-CoV-2 variant. Propensity score matching included calendar week, age, and more detailed information on region of birth and residential region. Primary outcome was 90-day all-cause mortality, and secondary outcomes were 90-day COVID-19 mortality, COVID-19 hospital admission and ICU admission. Standardized mean difference (SMD) was used to assess balance before and after matching. Risk ratios (RRs) adjusted for matching factors as well as income quartile, education level, COVID-19 vaccination status, and comorbidities (based on prescription drug use) were calculated using modified Poisson regression with confidence intervals (CIs) derived from a sandwich variance estimator. Results From a population of 8,275,839 individuals (6,653 with CLL, 8,269,186 without CLL), 2,088,163 first infection episodes (1,289 CLL, 2,086,874 no CLL) and 140,041 subsequent infection episodes (83 CLL, 139,958 no CLL) were identified. From these, 1,369 episodes from individuals with CLL were matched to the same number of controls. The matching removed substantial differences observed in age, sex, region of birth, and SARS-CoV-2 variant. After matching, SMD values >0.1 were only observed for education level, immunosuppressive drug use, and COVID-19 vaccination status. The 90-day all-cause mortality was 15% (n=199) in individuals with CLL and 8% (n=113) in controls, of which 63% (n=126) and 47% (n=53) had a COVID-19 diagnosis as main cause of death. The adjusted RR (95% CI) was 1.71 (1.38-2.11) for CLL compared with controls. The 90-day all-cause mortality rate in CLL was 25% (64/258) for Wild-type, 12% (23/194) for Alpha/Delta, and 12% (112/916) for Omicron. The adjusted RRs (95% CIs) for Wild-type, Alpha/Delta, and Omicron were 1.79 (1.26-2.54), 2.17 (1.08-4.33), and 1.59 (1.19-2.12). The adjusted RR (95% CI) was 1.64 (1.21-2.24) for unvaccinated, 1.57 (1.17-2.10) for >2 doses, 1.59 (1.16-2.18) for >3 doses, and 1.97 (1.21-3.20) for >4 doses. The adjusted RR (95% CI) was 2.41 (1.79-3.24) when restricting analyses to 90-day COVID-19 mortality. Risks were also significantly increased for COVID-19 hospital admission and ICU admission. When including all 2,228,204 episodes, the adjusted RR (95% CI) was 1.68 (1.48-1.90), similar to the matched cohort analysis. Conclusions SARS-CoV-2 infected individuals with CLL had a 2.4 times higher 90-day all-cause mortality, COVID-19 hospital and ICU admission compared with matched controls. This increased risk remained throughout different SARS-CoV-2 variant periods, reinforcing the importance of sustained efforts to protect this frail patient population from infection also during the endemic phase of COVID-19. However, the consistent RR of death compared to controls through different vaccination statuses indicates a benefit in protection from death in individuals with CLL similar to that seen in controls.

BackgroundImmunoglobulin G subclass deficiencies (IgGsd) comprise a wide clinical spectrum from no symptoms to repeated respiratory infections and risk for the development of lung damage. Our aims were to investigate whether the immunological phenotype of IgGsd patients on and off immunoglobulin replacement therapy (IgRT) was reflected in the clinical features of IgGsd.MethodThirty patients with IgGsd were included in this prospective study of 18 months of IgRT, followed by 7-18 months of IgRT discontinuation. Blood samples were collected when patients were on and off IgRT and compared with samples from 34 cross-sectional healthy controls. An in-depth lymphocyte phenotyping was performed by flow cytometry and plasma levels of immune checkpoints were assessed.ResultsIgG3 subclass deficiency was most common. Patients with IgGsd had decreased levels of activated T cells and B cells and plasma levels of negative immune checkpoint molecules correlated negatively with T cell and B cell activation. The decreased T cell activation level was unaffected by IgRT, while the B cell activation was partly restored. Of note, decreased levels of activated regulatory T cells (Tregs) were found in IgGsd patients and was partly restored during IgRT. The profile of comorbidities did not associate with Treg levels.DiscussionIgGsd is associated with decreased B cell and T cell activation including Tregs, and increased plasma levels of negative immune checkpoint molecules. The consequence of reduced activated Tregs in IgGsd remains unclear. Decreased immune cell activation was partly restored during IgRT, demonstrating that IgRT may contribute to improved immune function in patients with IgGsd.

This study investigates the formation of VET teaching practice when using simulation as a teaching method to support students' vocational learning at upper secondary schools in Sweden. The study is based on repeated interviews with twelve VET teachers from two schools over the course of three years. Drawing upon practice theory, the findings show that the use of simulators brought about both new knowledge and new relationships in teaching practice, as well as side effects such as dependency on other relatings outside the school. A new practice for vocational learning emerged, which required rearrangement of teachers’ work, roles and relatings.

Purpose Common variable immunodeficiency (CVID) is a primary antibody deficiency that commonly manifests as recurrent infections. Many CVID patients also suffer from immune dysregulation, an inflammatory condition characterized by polyclonal lymphocytic tissue infiltration and associated with increased morbidity and mortality. The genetic cause is unknown in most CVID patients and epigenetic alterations may contribute to the broad range of clinical manifestations. MicroRNAs are small non-coding RNAs that are involved in epigenetic modulation and may contribute to the clinical phenotype in CVID. Methods Here, we determined the circulating microRNAome and plasma inflammatory proteins of a cohort of CVID patients with various levels of immune dysregulation and compared them to healthy controls. A set of deregulated microRNAs was validated by qPCR and correlated to inflammatory proteins and clinical findings. Results Levels of microRNA-34a correlated with 11 proteins such as CXCL9, TNF, and IL10, which were predicted to be biologically connected. Moreover, there was a negative correlation between mir-34 levels and the number of naïve CD4 T cells in CVID. Conclusion Collectively, our data show that microRNAs correlate with the inflammatory response in CVID. Further investigations are needed to elucidate the role of miRNAs in the development of CVID-related immune dysregulation.

Abstract Immunoglobulin G subclass deficiencies (IgGsd) comprise a wide clinical spectrum from no symptoms to repeated respiratory infections and risk for the development of lung damage. In Sweden, immunoglobulin replacement therapy (IgRT) is considered in IgGsd patients with a high burden of infections. Our aims were to characterize immunological parameters in IgGsd on and off IgRT, and to identify factors that can predict the need of IgRT in IgGsd. Thirty-five patients with IgGsd were included in this prospective study and followed up to 36 months, when on and off IgRT. We analyzed possible associations between need of continuous IgRT and levels of immunoglobulins, IgG-subclasses, 21 serotype-specific pneumococcal antibodies, complement function and other factors that may predispose for a severe clinical course or increased exposure to airway pathogens. In-depth lymphocyte phenotyping was performed when on and off IgRT and compared to 34 healthy controls. Seventeen of the patients needed continuous IgRT. The prevalence of protective levels of serotype-specific antibodies was lower in IgGsd with need of IgRT. T cell and B cell subsets were similar irrespective of the need of IgRT. A combination of factors including age, autoimmunity, lung disease, fatigue, and a profession associated with increased risk of infections could predict the need of IgRT. In conclusion comorbidities due to dysregulated immunsystem in combination with low IgG subclass levels and presence of low levels of serotype specific IgGs, have a higher impact on the need of IgRT than aberrations in T cell and B cell subsets.

This article is centred on the tendency to align education for newly arrived students with migration policy. Drawing on an in-depth analysis of interviews with four adult migrant students, we aim to investigate how the participants’ experiences of studying and how they imagine their future intersect with their immigration status. The interviews were conducted when they were first studying a language introduction programme, and then three years later. We focus on the participants’ narratives about transitions within the education system and later into the labour market. Using Sara Ahmed’s approach to the orientation of subjects in time and space, the analysis shows that all students expressed a desire to “be in line,” meaning finishing their studies and finding employment. Students with temporary and conditional residence permits were directed towards specific vocational tracks and sectors of the labour market. Migrant students are a heterogenous group and, based on the findings presented, we argue that immigration status constitutes a crucial part of this heterogeneity, influencing how students imagine their future in a new society.

It is argued that the use of high-fidelity simulators is educationally effective, since students are able to work more independently and can better control their learning. Therefore, simulations can be used as a teaching method to facilitate and ease teachers’ work situations. This raises questions as to whether teachers’ professional bodies are a bounded physicality, or whether we can understand teachers’ professional bodies in practice in terms of enactments? This article analyses and discusses the enactment of VET teachers’ professional bodies in the context of vocational and simulation-based training. The empirical material is based on ethnographic observations in three classes in two different vocational education programmes at two upper secondary schools in Sweden. Three different cases are presented and analysed as examples of how VET teachers’ professional bodies are enacted. Guided by a practice theory perspective (Schatzki, T. R. Social practices: a Wittgensteinian approach to human activity and the social (1996), Schatzki, T. R. The site of the social: A philosophical account of the constitution of social life and change (2002), Schatzki, T. R. & Natter, W. Sociocultural bodies, bodies sociopolitical. In T. R.Schatzki & W. Natter (Eds.), The social and political body (1996), the study shows that VET teachers’ professional bodies are enacted in multiples, distributed, and delegated in an interplay between the teachers, the students, the simulator, and its material set-up. In these enactments of professional bodies, VET teachers embody both a teacher identity and a previous vocational identity, which they perform simultaneously depending on the educational situation.

IntroductionAfter more than two years the Coronavirus disease-19 (COVID-19) pandemic continues to burden healthcare systems and economies worldwide, and it is evident that the effects on the immune system can persist for months post-infection. The activity of myeloid cells such as monocytes and dendritic cells (DC) is essential for correct mobilization of the innate and adaptive responses to a pathogen. Impaired levels and responses of monocytes and DC to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is likely to be a driving force behind the immune dysregulation that characterizes severe COVID-19.MethodsHere, we followed a cohort of COVID-19 patients hospitalized during the early waves of the pandemic for 6-7 months. The levels and phenotypes of circulating monocyte and DC subsets were assessed to determine both the early and long-term effects of the SARS-CoV-2 infection.ResultsWe found increased monocyte levels that persisted for 6-7 months, mostly attributed to elevated levels of classical monocytes. Myeloid derived suppressor cells were also elevated over this period. While most DC subsets recovered from an initial decrease, we found elevated levels of cDC2/cDC3 at the 6-7 month timepoint. Analysis of functional markers on monocytes and DC revealed sustained reduction in program death ligand 1 (PD-L1) expression but increased CD86 expression across almost all cell types examined. Finally, C-reactive protein (CRP) correlated positively to the levels of intermediate monocytes and negatively to the recovery of DC subsets.ConclusionBy exploring the myeloid compartments, we show here that alterations in the immune landscape remain more than 6 months after severe COVID-19, which could be indicative of ongoing healing and/or persistence of viral antigens.

In public discourse, the social inclusion of migrants is often regarded as a challenge demanding migrants to increase their engagement in adapting to the new host country. Such imaginaries commonly declare migrants as being unwilling to acquire language skills and specific cultural values. In parallel, formal education is often proposed as the single most important remedy to inclusion, which generally solely implies labor market participation. However, there is a range of other, often neglected, practices that migrants themselves regard as important for their social inclusion in society. This article aims to analyze what practices are assigned meaning by newly arrived migrants in Sweden on their path toward social inclusion in the country. This is a longitudinal interview study with 19 newly arrived adult migrants that were interviewed on two occasions, three years apart. Drawing on a sociocultural perspective, we understand social inclusion as an ongoing process by which individuals become members of different communities. The result shows that important for social inclusion is access to valuable relationships and close social ties. These relations are important in all communities in which the migrants participate. The analysis illustrates three different communities, outside of formal education and employment, that migrants ascribe meaning to concerning language learning and social inclusion. These communities are sports, internships, and civil society engagements. Through its longitudinal design, this study also illustrates how migrants’ narratives and their meanings shift with time and how migrants relate to these communities over time.

The differing roles of the pentameric (p) and monomeric (m) C-reactive protein (CRP) isoforms in viral diseases are not fully understood, which was apparent during the COVID-19 pandemic regarding the clinical course of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Herein, we investigated the predictive value of the pCRP and mCRP isoforms for COVID-19 severity in hospitalized patients and evaluated how the levels of the protein isoforms changed over time during and after acute illness. This study utilized samples from a well-characterized cohort of Swedish patients with SARS-CoV-2 infection, the majority of whom had known risk factors for severe COVID-19 and required hospitalization. The levels of pCRP were significantly raised in patients with severe COVID-19 and in contrast to mCRP the levels were significantly associated with disease severity. Additionally, the pCRP levels remained elevated for at least six weeks post inclusion, which was longer compared to the two weeks for mCRP. Our data indicates a low level of inflammation lasting for at least six weeks following COVID-19, which might indicate that the disease has an adverse effect on the immune system even after the viral infection is resolved. It is also clear that the current standard method of testing pCRP levels upon hospitalization is a useful marker for predicting disease severity and mCRP testing would not add any clinical relevance for patients with COVID-19.