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Rodriguez-Idiazabal L, Quintana JM, Garcia-Asensio J, Legarreta MJ, Larrea N, Barrio I. Clinically meaningful phenotypes among SARS-CoV-2 reinfections: Informing prevention strategies for future pandemics. Prev Med 2025; 193:108259. [PMID: 40064450 DOI: 10.1016/j.ypmed.2025.108259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2024] [Revised: 03/04/2025] [Accepted: 03/05/2025] [Indexed: 03/16/2025]
Abstract
OBJECTIVE Rapidly phenotyping patients can inform public health action plans in new pandemics. This study aimed to derive meaningful SARS-CoV-2 reinfected patients' phenotypes based on easily-available patient data and explore key epidemiological factors of reinfections. METHODS We conducted a retrospective study of a cohort of SARS-CoV-2 reinfected adults from the Basque Country between January 1, 2021 and January 9, 2022. Phenotypes were defined in an unsupervised manner with clustering algorithms, incorporating variables like age, Charlson score, vaccination status and pre-existing treatments and comorbidities. Subsequently, clinical characteristics of phenotypes were compared, and their behavioral differences were evaluated through generalized additive models. Finally, their association with clinical outcomes was assessed. RESULTS Four phenotypes were identified, which subsequently had a direct relationship with the risk levels for severe COVID-19 outcomes. The highest-risk group, phenotype 4, consisted of older adults -76 years, [62-85] (Median, [Interquartile range])- with multiple comorbidities and extensive baseline medication use. Phenotype 3 was slightly younger -64 years, [58-77]- but presented very low Charlson scores and few comorbidities, representing an intermediate-risk group. Phenotypes 1 and 2 were younger and healthier adults with similar clinical profiles. However, phenotype 1 showed a less protective attitude, with a higher rate of unvaccinated patients and shorter time intervals between infections. CONCLUSIONS We were able to classify reinfected patients into four distinct groups based on easily available variables, and these phenotypes had a direct relationship with COVID-19 clinical outcomes. Thus, rapidly phenotyping infected individuals can serve as a preventive public health strategy during new pandemics.
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Affiliation(s)
- Lander Rodriguez-Idiazabal
- Department of Mathematics, University of the Basque Country UPV/EHU, Leioa, Basque Country, Spain; Applied Statistics Group, Basque Centre for Applied Mathematics (BCAM), Bilbao, Basque Country, Spain; Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Spain; Biosistemak Institute for Health Systems Research, Barakaldo, Basque Country, Spain.
| | - Jose M Quintana
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Spain; Biosistemak Institute for Health Systems Research, Barakaldo, Basque Country, Spain; Research Unit, Galdakao-Usansolo University Hospital, Osakidetza Basque Health Service, Galdakao, Basque Country, Spain; Health Service Research Network on Chronic Diseases (REDISSEC), Bilbao, Basque Country, Spain.
| | - Julia Garcia-Asensio
- Office of Healthcare Planning, Organization and Evaluation, Basque Government Department of Health, Basque Country, Spain.
| | - Maria Jose Legarreta
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Spain; Biosistemak Institute for Health Systems Research, Barakaldo, Basque Country, Spain; Research Unit, Galdakao-Usansolo University Hospital, Osakidetza Basque Health Service, Galdakao, Basque Country, Spain; Health Service Research Network on Chronic Diseases (REDISSEC), Bilbao, Basque Country, Spain.
| | - Nere Larrea
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Spain; Biosistemak Institute for Health Systems Research, Barakaldo, Basque Country, Spain; Research Unit, Galdakao-Usansolo University Hospital, Osakidetza Basque Health Service, Galdakao, Basque Country, Spain; Health Service Research Network on Chronic Diseases (REDISSEC), Bilbao, Basque Country, Spain.
| | - Irantzu Barrio
- Department of Mathematics, University of the Basque Country UPV/EHU, Leioa, Basque Country, Spain; Applied Statistics Group, Basque Centre for Applied Mathematics (BCAM), Bilbao, Basque Country, Spain.
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Kimotho J, Sein Y, Sayed S, Shah R, Mwai K, Saleh M, Wanjiku P, Mwacharo J, Nyagwange J, Karanja H, Kutima B, Gitonga JN, Mugo D, Karanu A, Moranga L, Oluoch V, Shah J, Mutiso J, Mburu A, Nneka Z, Betti P, Usyu Mutinda W, Issak Abdi A, Bejon P, Isabella Ochola-Oyier L, M.Warimwe G, Nduati EW, M. Ndungu F. Kinetics of naturally induced binding and neutralising anti-SARS-CoV-2 antibody levels and potencies among SARS-CoV-2 infected Kenyans with diverse grades of COVID-19 severity: an observational study. Wellcome Open Res 2024; 8:350. [PMID: 39640868 PMCID: PMC11617823 DOI: 10.12688/wellcomeopenres.19414.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2024] [Indexed: 12/07/2024] Open
Abstract
Background Given the low levels of coronavirus disease 2019 (COVID-19) vaccine coverage in sub-Saharan Africa (sSA), despite high levels of natural severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) exposures, strategies for extending the breadth and longevity of naturally acquired immunity are warranted. Designing such strategies will require a good understanding of naturally acquired immunity. Methods We measured whole-spike immunoglobulin G (IgG) and spike-receptor binding domain (RBD) total immunoglobulins (Igs) on 585 plasma samples collected longitudinally over five successive time points within six months of COVID-19 diagnosis in 309 COVID-19 patients. We measured antibody-neutralising potency against the wild-type (Wuhan) SARS-CoV-2 pseudovirus in a subset of 51 patients over three successive time points. Binding and neutralising antibody levels and potencies were then tested for correlations with COVID-19 severities. Results Rates of seroconversion increased from day 0 (day of PCR testing) to day 180 (six months) (63.6% to 100 %) and (69.3 % to 97%) for anti-spike-IgG and anti-spike-RBD binding Igs, respectively. Levels of these binding antibodies peaked at day 28 (p<0.01) and were subsequently maintained for six months without significant decay (p>0.99). Similarly, antibody-neutralising potencies peaked at day 28 (p<0.01) but declined by three-fold, six months after COVID-19 diagnosis (p<0.01). Binding antibody levels were highly correlated with neutralising antibody potencies at all the time points analysed (r>0.60, p<0.01). Levels and potencies of binding and neutralising antibodies increased with disease severity. Conclusions Most COVID-19 patients generated SARS-CoV-2 specific binding antibodies that remained stable in the first six months of infection. However, the respective neutralising antibodies decayed three-fold by month-six of COVID-19 diagnosis suggesting that they are short-lived, consistent with what has been observed elsewhere in the world. Thus, regular vaccination boosters are required to sustain the high levels of anti-SARS-CoV-2 naturally acquired neutralising antibody potencies in our population.
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Affiliation(s)
- John Kimotho
- KEMRI-Wellcome Trust Research Programme, KILIFI, Coast, 230-80108, Kenya
- Pwani University, KILIFI, 230-80108, Kenya
| | - Yiakon Sein
- KEMRI-Wellcome Trust Research Programme, KILIFI, Coast, 230-80108, Kenya
| | - Shahin Sayed
- Aga Khan University Hospital, 3rd Parklands Avenue, Nairobi, 30270 - 00100, Kenya
| | - Reena Shah
- Aga Khan University Hospital, 3rd Parklands Avenue, Nairobi, 30270 - 00100, Kenya
| | - Kennedy Mwai
- KEMRI-Wellcome Trust Research Programme, KILIFI, Coast, 230-80108, Kenya
| | - Mansoor Saleh
- Aga Khan University Hospital, 3rd Parklands Avenue, Nairobi, 30270 - 00100, Kenya
| | - Perpetual Wanjiku
- KEMRI-Wellcome Trust Research Programme, KILIFI, Coast, 230-80108, Kenya
| | - Jedidah Mwacharo
- KEMRI-Wellcome Trust Research Programme, KILIFI, Coast, 230-80108, Kenya
| | - James Nyagwange
- KEMRI-Wellcome Trust Research Programme, KILIFI, Coast, 230-80108, Kenya
| | - Henry Karanja
- KEMRI-Wellcome Trust Research Programme, KILIFI, Coast, 230-80108, Kenya
| | - Bernadette Kutima
- KEMRI-Wellcome Trust Research Programme, KILIFI, Coast, 230-80108, Kenya
| | - John N. Gitonga
- KEMRI-Wellcome Trust Research Programme, KILIFI, Coast, 230-80108, Kenya
| | - Daisy Mugo
- KEMRI-Wellcome Trust Research Programme, KILIFI, Coast, 230-80108, Kenya
| | - Ann Karanu
- Aga Khan University Hospital, 3rd Parklands Avenue, Nairobi, 30270 - 00100, Kenya
| | - Linda Moranga
- KEMRI-Wellcome Trust Research Programme, KILIFI, Coast, 230-80108, Kenya
| | - Viviane Oluoch
- Aga Khan University Hospital, 3rd Parklands Avenue, Nairobi, 30270 - 00100, Kenya
| | - Jasmit Shah
- Aga Khan University Hospital, 3rd Parklands Avenue, Nairobi, 30270 - 00100, Kenya
| | - Julius Mutiso
- Aga Khan University Hospital, 3rd Parklands Avenue, Nairobi, 30270 - 00100, Kenya
| | - Alfred Mburu
- Aga Khan University Hospital, 3rd Parklands Avenue, Nairobi, 30270 - 00100, Kenya
| | - Zaitun Nneka
- Aga Khan University Hospital, 3rd Parklands Avenue, Nairobi, 30270 - 00100, Kenya
| | - Peter Betti
- Aga Khan University Hospital, 3rd Parklands Avenue, Nairobi, 30270 - 00100, Kenya
| | | | - Abdirahman Issak Abdi
- KEMRI-Wellcome Trust Research Programme, KILIFI, Coast, 230-80108, Kenya
- Pwani University, KILIFI, 230-80108, Kenya
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Philip Bejon
- KEMRI-Wellcome Trust Research Programme, KILIFI, Coast, 230-80108, Kenya
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Lynette Isabella Ochola-Oyier
- KEMRI-Wellcome Trust Research Programme, KILIFI, Coast, 230-80108, Kenya
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - George M.Warimwe
- KEMRI-Wellcome Trust Research Programme, KILIFI, Coast, 230-80108, Kenya
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Eunice W. Nduati
- KEMRI-Wellcome Trust Research Programme, KILIFI, Coast, 230-80108, Kenya
- Pwani University, KILIFI, 230-80108, Kenya
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Francis M. Ndungu
- KEMRI-Wellcome Trust Research Programme, KILIFI, Coast, 230-80108, Kenya
- Pwani University, KILIFI, 230-80108, Kenya
- Aga Khan University Hospital, 3rd Parklands Avenue, Nairobi, 30270 - 00100, Kenya
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Division of Infectious Diseases, Department of Medicine Solna and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
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Shahriarirad S, Asmarian N, Shahriarirad R, Moghadami M, Askarian M, Hashemizadeh Fard Haghighi L, Javadi P, Sabetian G. High Post-Infection Protection after COVID-19 among Healthcare Workers: A Population-Level Observational Study. IRANIAN JOURNAL OF MEDICAL SCIENCES 2024; 49:247-258. [PMID: 38680224 PMCID: PMC11053253 DOI: 10.30476/ijms.2023.97708.2951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 04/04/2023] [Accepted: 05/04/2023] [Indexed: 05/01/2024]
Abstract
Background Even though a few years have passed since the coronavirus disease 2019 (COVID-19) outbreak, information regarding certain aspects of the disease, such as post-infection immunity, is still quite limited. This study aimed to evaluate post-infection protection and COVID-19 features among healthcare workers (HCWs), during three successive surges, as well as the rate of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfection, reactivation, re-positivity, and severity. Methods This cross-sectional population-level observational study was conducted from 20 April 2020 to 18 February 2021. The study population included all HCWs in public or private hospitals in Fars Province, Southern Iran. The infection rate was computed as the number of individuals with positive polymerase chain reaction (PCR) tests divided by the total number of person-days at risk. The re-infection was evaluated after 90 days. Results A total of 30,546 PCR tests were performed among HCWs, of which 13,749 (61.94% of total HCWs) were positive. Considering the applied 90-day threshold, there were 44 (31.2%) cases of reactivation and relapse, and 97 (68.8% of infected and 1.81% of total HCWs) cases of reinfection among 141 (2.64%) diagnosed cases who experienced a second episode of COVID-19. There was no significant difference in symptoms (P=0.65) or the necessity for ICU admission (P=0.25). The estimated protection against repeated infection after a previous SARS-CoV-2 infection was 94.8% (95% CI=93.6-95.7). Conclusion SARS-CoV-2 re-positivity, relapse, and reinfection were rare in the HCW population. After the first episode of infection, an estimated 94.8% protection against recurring infections was achieved. A preprint version of this manuscript is available at DOI:10.21203/rs.3.rs-772662/v1 (https://www.researchsquare.com/article/rs-772662/v1).
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Affiliation(s)
- Sepehr Shahriarirad
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Naeimehossadat Asmarian
- Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Shahriarirad
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohsen Moghadami
- Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehrdad Askarian
- Department of Community Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Parisa Javadi
- Department of Anesthesiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Golnar Sabetian
- Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Maniscalco L, Genovese D, Ravazzolo B, Vella G, Sparacia B, Vitale F, Matranga D, Amodio E. Low Risk of SARS-CoV-2 Reinfection for Fully or Boosted mRNA Vaccinated Subjects in Sicily: A Population-Based Study Using Real-World Data. Vaccines (Basel) 2023; 11:1757. [PMID: 38140163 PMCID: PMC10748171 DOI: 10.3390/vaccines11121757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 11/22/2023] [Accepted: 11/23/2023] [Indexed: 12/24/2023] Open
Abstract
Background: Reinfections occur as a response to natural infections wanes and novel strains of SARS-CoV-2 emerge. The present research explored the correlation between sex, age, COVID-19 vaccination, prior infection hospitalization, and SARS-CoV-2 reinfection in Sicily, Italy. Materials and Methods: A population-based retrospective cohort study was articulated using the vaccination flux from a regional registry and the Sicilian COVID-19 monitoring system of the Italian Institute of Health. Only adult Sicilians were included in the study, and hazard ratios were calculated using Cox regression. Results: Partial vaccination provided some protection (adj-HR: 0.92), when compared to unvaccinated individuals; furthermore, reinfection risk was reduced by full vaccination (adj-HR: 0.43), and the booster dose (adj-HR: 0.41). Males had a lower risk than females of reinfection with SARS-CoV-2 (adj-HR: 0.75). Reinfection with SARS-CoV-2 was diminished by hospitalization during the first infection (adj-HR: 0.78). Reinfection risk was higher among those aged 30-39 and 40-49 compared to those aged 18-29, whereas those aged 60-69, 70-79, and 80+ were statistically protected. Reinfection was significantly more frequent during the wild-type-Alpha, Delta, Delta-Omicron, and Omicron dominance/codominance waves compared to the wild type. Conclusions: This study establishes a solid base for comprehending the reinfection phenomenon in Sicily by pinpointing the most urgent policy hurdles and identifying some of the major factors. COVID-19 vaccination, one of the most effective public health tools, protects against reinfection, mostly caused by the Omicron strain. Elderly and hospitalized people's lower risk suggests stricter PPE use.
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Affiliation(s)
- Laura Maniscalco
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro” (PROMISE), University of Palermo, Via del Vespro 133, 90127 Palermo, Italy; (L.M.); (G.V.); (B.S.); (F.V.); (D.M.); (E.A.)
| | - Dario Genovese
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro” (PROMISE), University of Palermo, Via del Vespro 133, 90127 Palermo, Italy; (L.M.); (G.V.); (B.S.); (F.V.); (D.M.); (E.A.)
| | - Barbara Ravazzolo
- Unità Operativa Complessa di Epidemiologia Clinica con Registro Tumori, Azienda Ospedaliera Universitaria Policlinico “Paolo Giaccone”, 90127 Palermo, Italy;
| | - Giuseppe Vella
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro” (PROMISE), University of Palermo, Via del Vespro 133, 90127 Palermo, Italy; (L.M.); (G.V.); (B.S.); (F.V.); (D.M.); (E.A.)
| | - Benedetta Sparacia
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro” (PROMISE), University of Palermo, Via del Vespro 133, 90127 Palermo, Italy; (L.M.); (G.V.); (B.S.); (F.V.); (D.M.); (E.A.)
| | - Francesco Vitale
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro” (PROMISE), University of Palermo, Via del Vespro 133, 90127 Palermo, Italy; (L.M.); (G.V.); (B.S.); (F.V.); (D.M.); (E.A.)
- Unità Operativa Complessa di Epidemiologia Clinica con Registro Tumori, Azienda Ospedaliera Universitaria Policlinico “Paolo Giaccone”, 90127 Palermo, Italy;
| | - Domenica Matranga
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro” (PROMISE), University of Palermo, Via del Vespro 133, 90127 Palermo, Italy; (L.M.); (G.V.); (B.S.); (F.V.); (D.M.); (E.A.)
| | - Emanuele Amodio
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro” (PROMISE), University of Palermo, Via del Vespro 133, 90127 Palermo, Italy; (L.M.); (G.V.); (B.S.); (F.V.); (D.M.); (E.A.)
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Biswas RK, Afiaz A, Huq S, Farzana M, Kabir E. Public opinion on COVID-19 vaccine prioritization in Bangladesh: Who gets the vaccine and whom do you leave out? Vaccine 2023; 41:5018-5028. [PMID: 37407404 PMCID: PMC10272949 DOI: 10.1016/j.vaccine.2023.06.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 04/11/2023] [Accepted: 06/13/2023] [Indexed: 07/07/2023]
Abstract
One of the most challenging aspects of the COVID-19 pandemic is the inability to ensure equitable distribution of vaccines to fight the pandemic. Many governments around the globe had to prioritize and perform a triage in distributing the vaccines due to the limited supply as well as a lack of financial strength to acquire a sufficient number of vaccines in time. The present study assessed the public opinion in Bangladesh regarding vaccination prioritization strategy and its associated aspects. Due to the infectious nature of the viral transmission, the study used an online survey and collected a sample of 2291 respondents, distributed proportionally across sex, and income groups. Descriptive statistics and multinomial logistic regression modelling were utilized to conduct the analyses. The results emphasized unanimous preference of prioritized vaccination leaning towards the frontline workers, the severely sick and the elderly. However, the segregation across ethnicity was noted with no major preference among sexes or religion. The results reinforce the Bangladesh government's undertaken strategy of prioritization. However, the preference rankings varied across sociodemographic factors including self-assessed COVID-19 knowledge and income tiers, among others. The findings underline the necessity of improved risk communication strategies to ensure public confidence and conformity to vaccination efforts and their effective deployment across the country.
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Affiliation(s)
- Raaj Kishore Biswas
- Transport and Road Safety (TARS) Research Centre, School of Aviation, University of New South Wales, Australia; Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
| | - Awan Afiaz
- Institute of Statistical Research and Training, University of Dhaka, Dhaka, Bangladesh; Department of Biostatistics, University of Washington, Seattle, WA, United States.
| | - Samin Huq
- Child Health Research Foundation, Dhaka, Bangladesh; Global Health Workforce Network (GHWN), World Health Organization, Geneva, Switzerland.
| | - Maysha Farzana
- Department of Sociology, University of Dhaka, Dhaka, Bangladesh.
| | - Enamul Kabir
- School of Sciences, University of Southern Queensland, Toowoomba, Queensland, Australia; School of Mathematics, Physics, and Computing, University of Southern Queensland, Toowoomba, Queensland, Australia.
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Looi KH. Correlations of demographic factors and hygiene factors with face mask wearing during the COVID-19 pandemic and suggestion for future research: A cross-sectional study of adults in Malaysia. J Public Health Res 2023; 12:22799036231197192. [PMID: 37693740 PMCID: PMC10492497 DOI: 10.1177/22799036231197192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 07/30/2023] [Indexed: 09/12/2023] Open
Abstract
Background Despite the many touted benefits of community-wide face mask wearing, numerous communication campaigns and mandates, some people still refuse or fail to wear face masks in public settings. Hence, exposing themselves and others to the risk of infection by the severe acute respiratory syndrome coronavirus 2 and raise the potential for public healthcare systems to become overwhelmed once again. This study investigates demographic and hygiene factors related to propensity of face mask wearing in public settings. Design and methods The self-administered online questionnaire contained the independent variables (demographic and hygiene factors) and the outcome variable (frequency of face mask wearing). Participants were recruited through convenience and snowball sampling techniques. Seven hundred and eight responses were collected from Malaysian adults between May and June 2020. The demographic characteristics of participants, differences in the frequency of face mask wearing across demographic factors and hierarchical multiple regression were analyzed. Results The propensity of face mask wearing differs by gender. The hierarchical multiple regression revealed that being female, having personal protective equipment available and frequently washing hands were positively correlated with the frequency of face mask wearing. Moreover, the availability of personal protective equipment and the frequency of hand washing accounted for greater variation of the frequency of face mask wearing than gender. Conclusion Future studies should adopt established psychosocial models in conjunction with normative and cultural factors for a better understanding of underlying motivations to engage in preventive health behaviors to shape improved hygienic and societal precautionary protective behaviors in different contexts.
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Affiliation(s)
- Kim Hoe Looi
- School of Economics and Management, Xiamen University Malaysia, Bandar Sunsuria, Sepang, Selangor, Malaysia
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Gazit S, Saciuk Y, Perez G, Peretz A, Ben-Tov A, Stuart EA, Patalon T. Hybrid immunity against reinfection with SARS-CoV-2 following a previous SARS-CoV-2 infection and single dose of the BNT162b2 vaccine in children and adolescents: a target trial emulation. THE LANCET. MICROBE 2023; 4:e495-e505. [PMID: 37062294 PMCID: PMC10101759 DOI: 10.1016/s2666-5247(23)00103-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/05/2023] [Accepted: 03/07/2023] [Indexed: 04/18/2023]
Abstract
BACKGROUND Although most children and adolescents have had a previous SARS-CoV-2 infection and many continue to receive COVID-19 vaccinations, studies of the effectiveness of hybrid immunity against reinfection with the omicron (B.1.1.529) variant are scarce. We aimed to examine the effectiveness of vaccination in convalescent children and adolescents against reinfection with the delta (B.1.617.2) variant and the BA.1 and BA.2 and BA.4 and BA.5 omicron subvariants. METHODS This retrospective cohort study was devised to emulate a target randomised control trial using a retrospective dataset of anonymised health records of children (5-11 years old) and adolescents (12-16 years old) who were members of the Maccabi Healthcare Services, Israel. The design emulated 91 randomised trials by devising a series of multiple nested trials, compiling the results into a single dataset, and fitting Cox proportional hazards models to estimate adjusted hazard ratios (HRs) with 95% CIs of each measured outcome. The primary aim was to assess the protection from reinfection with the delta variant and the BA.1 and BA.2 and BA.4 and BA.5 omicron subvariants associated with hybrid immunity as a result of a previous SARS-CoV-2 infection followed by vaccination with the BNT162b2 (Pfizer-BioNTech) vaccine. FINDINGS Data from between from March 1, 2020, to July 31, 2022, for 163 812 individuals (120 721 children [59 404 girls and 61 317 boys], median age 8·0 years [IQR 6·7 to 10·2]; and 43 091 adolescents [21 239 girls and 21 852 boys], median age 13·5 years [12·6 to 14·8]) were included in at least one trial. A single dose of the BNT162b2 vaccine in convalescent children and adolescents confers statistically significant protection against the delta variant (78% [95% CI 72 to 83] in adolescents and 64% [3 to 87] in children) and the omicron BA.1 and BA.2 subvariants (54% [50 to 57] in adolescents and 71% [67 to 73] in children) compared with children who had a previous infection but were unvaccinated. However, the vaccine was not found to confer statistically significant protection against the BA.4 and BA.5 omicron subvariants in adolescents (8% [-18 to 29]) and children (12% [-6 to 27]). INTERPRETATION Decision makers in BA.4 and BA.5 dominant regions should re-examine whether convalescent individuals aged 5-16 years should receive the BNT162b2 vaccine to prevent future reinfection, especially in light of reports that show that most children and adolescents have already been infected with SARS-CoV-2. FUNDING None.
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Affiliation(s)
- Sivan Gazit
- Kahn Sagol Maccabi Research & Innovation Center, Maccabi Healthcare Services, Tel Aviv, Israel; Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel; Ben-Gurion University, Beersheba, Israel.
| | - Yaki Saciuk
- Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Galit Perez
- Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel; Ben-Gurion University, Beersheba, Israel
| | - Asaf Peretz
- Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Amir Ben-Tov
- Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Tal Patalon
- Kahn Sagol Maccabi Research & Innovation Center, Maccabi Healthcare Services, Tel Aviv, Israel; Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel
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Patalon T, Saciuk Y, Perez G, Peretz A, Ben-Tov A, Gazit S. Dynamics of Naturally Acquired Immunity Against Severe Acute Respiratory Syndrome Coronavirus 2 in Children and Adolescents. J Pediatr 2023; 257:113371. [PMID: 36870558 PMCID: PMC9981270 DOI: 10.1016/j.jpeds.2023.02.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 02/03/2023] [Accepted: 02/12/2023] [Indexed: 03/06/2023]
Abstract
OBJECTIVE To evaluate the duration of protection against reinfection conferred by a previous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children and adolescents. STUDY DESIGN We applied 2 complementary approaches: a matched test-negative, case-control design and a retrospective cohort design. A total of 458 959 unvaccinated individuals aged 5-18 years were included. The analyses focused on the period July 1, 2021, to December 13, 2021, a period of Delta variant dominance in Israel. We evaluated 3 SARS-CoV-2-related outcomes: documented polymerase chain reaction-confirmed infection or reinfection, symptomatic infection or reinfection, and SARS-CoV-2-related hospitalization or death. RESULTS Overall, children and adolescents who were previously infected acquired durable protection against reinfection with SARS-CoV-2 for at least 18 months. Importantly, no SARS-CoV-2-related deaths were recorded in either the SARS-CoV-2-naïve group or the previously infected group. The effectiveness of naturally acquired immunity against a recurrent infection reached 89.2% (95% CI, 84.7%-92.4%) at 3-6 months after the first infection and declined slightly to 82.5% (95% CI, 79.1%-85.3%) by 9-12 months after infection, with a slight nonsignificant waning trend seen up to 18 months after infection. Additionally, children aged 5-11 years exhibited no significant waning of naturally acquired protection throughout the outcome period, whereas waning protection in those aged 12-18 years was more prominent but still mild. CONCLUSIONS Children and adolescents who were previously infected with SARS-CoV-2 remain protected to a high degree for 18 months. Further research is needed to examine naturally acquired immunity against Omicron and newer emerging variants.
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Affiliation(s)
- Tal Patalon
- Kahn Sagol Maccabi Research & Innovation Center, Maccabi Healthcare Services, Tel Aviv, Israel; Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel.
| | - Yaki Saciuk
- Kahn Sagol Maccabi Research & Innovation Center, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Galit Perez
- Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel; Department of Health Policy and Management, School of Public Health, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Asaf Peretz
- Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Amir Ben-Tov
- Kahn Sagol Maccabi Research & Innovation Center, Maccabi Healthcare Services, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sivan Gazit
- Kahn Sagol Maccabi Research & Innovation Center, Maccabi Healthcare Services, Tel Aviv, Israel; Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel
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Polcz P, Tornai K, Juhász J, Cserey G, Surján G, Pándics T, Róka E, Vargha M, Reguly IZ, Csikász-Nagy A, Pongor S, Szederkényi G. Wastewater-based modeling, reconstruction, and prediction for COVID-19 outbreaks in Hungary caused by highly immune evasive variants. WATER RESEARCH 2023; 241:120098. [PMID: 37295226 DOI: 10.1016/j.watres.2023.120098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/16/2023] [Accepted: 05/17/2023] [Indexed: 06/12/2023]
Abstract
(MOTIVATION) Wastewater-based epidemiology (WBE) has emerged as a promising approach for monitoring the COVID-19 pandemic, since the measurement process is cost-effective and is exposed to fewer potential errors compared to other indicators like hospitalization data or the number of detected cases. Consequently, WBE was gradually becoming a key tool for epidemic surveillance and often the most reliable data source, as the intensity of clinical testing for COVID-19 drastically decreased by the third year of the pandemic. Recent results suggests that the model-based fusion of wastewater measurements with clinical data and other indicators is essential in future epidemic surveillance. (METHOD) In this work, we developed a wastewater-based compartmental epidemic model with a two-phase vaccination dynamics and immune evasion. We proposed a multi-step optimization-based data assimilation method for epidemic state reconstruction, parameter estimation, and prediction. The computations make use of the measured viral load in wastewater, the available clinical data (hospital occupancy, delivered vaccine doses, and deaths), the stringency index of the official social distancing rules, and other measures. The current state assessment and the estimation of the current transmission rate and immunity loss allow a plausible prediction of the future progression of the pandemic. (RESULTS) Qualitative and quantitative evaluations revealed that the contribution of wastewater data in our computational epidemiological framework makes predictions more reliable. Predictions suggest that at least half of the Hungarian population has lost immunity during the epidemic outbreak caused by the BA.1 and BA.2 subvariants of Omicron in the first half of 2022. We obtained a similar result for the outbreaks caused by the subvariant BA.5 in the second half of 2022. (APPLICABILITY) The proposed approach has been used to support COVID management in Hungary and could be customized for other countries as well.
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Affiliation(s)
- Péter Polcz
- National Laboratory for Health Security, Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Práter utca 85, Budapest, H-1083, Hungary.
| | - Kálmán Tornai
- National Laboratory for Health Security, Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Práter utca 85, Budapest, H-1083, Hungary
| | - János Juhász
- National Laboratory for Health Security, Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Práter utca 85, Budapest, H-1083, Hungary; Institute of Medical Microbiology, Semmelweis University, Üllői út 26, Budapest, H-1085, Hungary
| | - György Cserey
- National Laboratory for Health Security, Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Práter utca 85, Budapest, H-1083, Hungary
| | - György Surján
- Department of Public Health Laboratory, National Public Health Centre, Albert Flórián út 2-6, Budapest, H-1097, Hungary; Department of Digital Health Sciences, Semmelweis University, Üllői út 26, Budapest, H-1085, Hungary
| | - Tamás Pándics
- Department of Public Health Laboratory, National Public Health Centre, Albert Flórián út 2-6, Budapest, H-1097, Hungary; Department of Public Health Sciences, Faculty of Health Sciences, Semmelweis University, Vas utca 17, Budapest, H-1088, Hungary
| | - Eszter Róka
- Department of Public Health Laboratory, National Public Health Centre, Albert Flórián út 2-6, Budapest, H-1097, Hungary
| | - Márta Vargha
- Department of Public Health Laboratory, National Public Health Centre, Albert Flórián út 2-6, Budapest, H-1097, Hungary
| | - István Z Reguly
- National Laboratory for Health Security, Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Práter utca 85, Budapest, H-1083, Hungary
| | - Attila Csikász-Nagy
- National Laboratory for Health Security, Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Práter utca 85, Budapest, H-1083, Hungary
| | - Sándor Pongor
- National Laboratory for Health Security, Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Práter utca 85, Budapest, H-1083, Hungary
| | - Gábor Szederkényi
- National Laboratory for Health Security, Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Práter utca 85, Budapest, H-1083, Hungary
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10
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Albikawi ZF, Abuadas MH, Alalyani MM, Zahrani Y, Aqel E, Safi R. Fear and Stigma of COVID-19 Reinfection Scale (FSoCOVID-19RS): New Scale Development and Validation. Healthcare (Basel) 2023; 11:healthcare11101461. [PMID: 37239747 DOI: 10.3390/healthcare11101461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/15/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND The advent of COVID-19 and its impacts have prompted fear and stigma among people all across the world. Because of stigma, there was often a delay in diagnosis and treatment, which resulted in a poor prognosis. As a result, a reliable scale is required to measure the level of fear and stigma of COVID-19 reinfection. AIM To develop and validate a scale for determining the level of fear and stigma of COVID-19 reinfection. METHODS A cross-sectional study including 200 nursing-college students who had previously tested positive for COVID-19 was conducted. The scale's reliability was evaluated by external and internal consistency methods. Construct, convergent, and discriminant validity were evaluated using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). RESULTS The scale's mean score was 24.85 ± 11.35, and no floor or ceiling effects were detected. The scale items' reliability, measured by Cronbach's alpha coefficient if an item was deleted, ranged from 0.76 to 0.95, with a total score value of 0.86. The range of convergent validity coefficients was between 0.37 and 0.64. Pearson's correlation coefficients for test-retest validity ranged from 0.71 to 0.93, with a total score of 0.82. The coefficient of split-half correlation was 0.87, while the coefficient of reliability was 0.93. According to the factor analysis, two components had latent roots larger than 1. The rotated component matrix of the two factors revealed that all items had R values over 0.30, indicating that none of them should be excluded. In addition, CFA results revealed that χ2 = 3524, df = 1283, χ2/df ratio = 2.74, p < 0.001, GFI = 0.86, CFI = 0.92, AGFI = 0.88, and RMSEA = 0.05. The scale's convergent and discriminant validity was confirmed. CONCLUSIONS The 14-item, two-dimensional Fear and Stigma of COVID-19 Reinfection Scale (FSoCOVID-19 RS) was demonstrated to have reliable psychometric properties.
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Affiliation(s)
- Zainab Fatehi Albikawi
- Community and Psychiatric/Mental Health Nursing Department, Nursing College, King Khalid University, Khamis Mushait 39746, Saudi Arabia
| | - Mohammad Hamdi Abuadas
- Community and Psychiatric/Mental Health Nursing Department, Nursing College, King Khalid University, Khamis Mushait 39746, Saudi Arabia
| | - Mesheil M Alalyani
- Medical Surgical Nursing Department, Nursing College, King Khalid University, Khamis Mushait 39746, Saudi Arabia
| | - Yousef Zahrani
- Public Health Department, College of Applied Medical Sciences, King Khalid University, Khamis Mushait 62529, Saudi Arabia
| | - Emad Aqel
- Community and Psychiatric/Mental Health Nursing Department, Nursing College, King Khalid University, Khamis Mushait 39746, Saudi Arabia
| | - Raid Safi
- Basic Nursing Care Department, Nursing College, King Khalid University, Khamis Mushait 39746, Saudi Arabia
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11
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Mohta R, Prathapani S, Ghosh P. Jump-Drop Adjusted Prediction of Cumulative Infected Cases Using the Modified SIS Model. ANNALS OF DATA SCIENCE 2023:1-20. [PMID: 38625165 PMCID: PMC10184638 DOI: 10.1007/s40745-023-00467-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 01/18/2023] [Accepted: 03/21/2023] [Indexed: 04/17/2024]
Abstract
Accurate prediction of cumulative COVID-19 infected cases is essential for effectively managing the limited healthcare resources in India. Historically, epidemiological models have helped in controlling such epidemics. Models require accurate historical data to predict future outcomes. In our data, there were days exhibiting erratic, apparently anomalous jumps and drops in the number of daily reported COVID-19 infected cases that did not conform with the overall trend. Including those observations in the training data would most likely worsen model predictive accuracy. However, with existing epidemiological models it is not straightforward to determine, for a specific day, whether or not an outcome should be considered anomalous. In this work, we propose an algorithm to automatically identify anomalous 'jump' and 'drop' days, and then based upon the overall trend, the number of daily infected cases for those days is adjusted and the training data is amended using the adjusted observations. We applied the algorithm in conjunction with a recently proposed, modified Susceptible-Infected-Susceptible (SIS) model to demonstrate that prediction accuracy is improved after adjusting training data counts for apparent erratic anomalous jumps and drops.
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Affiliation(s)
- Rashi Mohta
- Department of Mathematics, Indian Institute of Technology Guwahati, Guwahati, Assam India
| | - Sravya Prathapani
- Department of Mathematics, Indian Institute of Technology Guwahati, Guwahati, Assam India
| | - Palash Ghosh
- Department of Mathematics, Indian Institute of Technology Guwahati, Guwahati, Assam India
- Jyoti and Bhupat Mehta School of Health Sciences and Technology, Indian Institute of Technology Guwahati, Guwahati, Assam India
- Centre for Quantitative Medicine, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
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12
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Iannizzi C, Chai KL, Piechotta V, Valk SJ, Kimber C, Monsef I, Wood EM, Lamikanra AA, Roberts DJ, McQuilten Z, So-Osman C, Jindal A, Cryns N, Estcourt LJ, Kreuzberger N, Skoetz N. Convalescent plasma for people with COVID-19: a living systematic review. Cochrane Database Syst Rev 2023; 5:CD013600. [PMID: 37162745 PMCID: PMC10171886 DOI: 10.1002/14651858.cd013600.pub6] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
BACKGROUND Convalescent plasma may reduce mortality in patients with viral respiratory diseases, and is being investigated as a potential therapy for coronavirus disease 2019 (COVID-19). A thorough understanding of the current body of evidence regarding benefits and risks of this intervention is required. OBJECTIVES To assess the effectiveness and safety of convalescent plasma transfusion in the treatment of people with COVID-19; and to maintain the currency of the evidence using a living systematic review approach. SEARCH METHODS To identify completed and ongoing studies, we searched the World Health Organization (WHO) COVID-19 Global literature on coronavirus disease Research Database, MEDLINE, Embase, Cochrane COVID-19 Study Register, and the Epistemonikos COVID-19 L*OVE Platform. We searched monthly until 03 March 2022. SELECTION CRITERIA We included randomised controlled trials (RCTs) evaluating convalescent plasma for COVID-19, irrespective of disease severity, age, gender or ethnicity. We excluded studies that included populations with other coronavirus diseases (severe acute respiratory syndrome (SARS) or Middle East respiratory syndrome (MERS)), as well as studies evaluating standard immunoglobulin. DATA COLLECTION AND ANALYSIS We followed standard Cochrane methodology. To assess bias in included studies we used RoB 2. We used the GRADE approach to rate the certainty of evidence for the following outcomes: all-cause mortality at up to day 28, worsening and improvement of clinical status (for individuals with moderate to severe disease), hospital admission or death, COVID-19 symptoms resolution (for individuals with mild disease), quality of life, grade 3 or 4 adverse events, and serious adverse events. MAIN RESULTS In this fourth review update version, we included 33 RCTs with 24,861 participants, of whom 11,432 received convalescent plasma. Of these, nine studies are single-centre studies and 24 are multi-centre studies. Fourteen studies took place in America, eight in Europe, three in South-East Asia, two in Africa, two in western Pacific and three in eastern Mediterranean regions and one in multiple regions. We identified a further 49 ongoing studies evaluating convalescent plasma, and 33 studies reporting as being completed. Individuals with a confirmed diagnosis of COVID-19 and moderate to severe disease 29 RCTs investigated the use of convalescent plasma for 22,728 participants with moderate to severe disease. 23 RCTs with 22,020 participants compared convalescent plasma to placebo or standard care alone, five compared to standard plasma and one compared to human immunoglobulin. We evaluate subgroups on detection of antibodies detection, symptom onset, country income groups and several co-morbidities in the full text. Convalescent plasma versus placebo or standard care alone Convalescent plasma does not reduce all-cause mortality at up to day 28 (risk ratio (RR) 0.98, 95% confidence interval (CI) 0.92 to 1.03; 220 per 1000; 21 RCTs, 19,021 participants; high-certainty evidence). It has little to no impact on need for invasive mechanical ventilation, or death (RR 1.03, 95% CI 0.97 to 1.11; 296 per 1000; 6 RCTs, 14,477 participants; high-certainty evidence) and has no impact on whether participants are discharged from hospital (RR 1.00, 95% CI 0.97 to 1.02; 665 per 1000; 6 RCTs, 12,721 participants; high-certainty evidence). Convalescent plasma may have little to no impact on quality of life (MD 1.00, 95% CI -2.14 to 4.14; 1 RCT, 483 participants; low-certainty evidence). Convalescent plasma may have little to no impact on the risk of grades 3 and 4 adverse events (RR 1.17, 95% CI 0.96 to 1.42; 212 per 1000; 6 RCTs, 2392 participants; low-certainty evidence). It has probably little to no effect on the risk of serious adverse events (RR 1.14, 95% CI 0.91 to 1.44; 135 per 1000; 6 RCTs, 3901 participants; moderate-certainty evidence). Convalescent plasma versus standard plasma We are uncertain whether convalescent plasma reduces or increases all-cause mortality at up to day 28 (RR 0.73, 95% CI 0.45 to 1.19; 129 per 1000; 4 RCTs, 484 participants; very low-certainty evidence). We are uncertain whether convalescent plasma reduces or increases the need for invasive mechanical ventilation, or death (RR 5.59, 95% CI 0.29 to 108.38; 311 per 1000; 1 study, 34 participants; very low-certainty evidence) and whether it reduces or increases the risk of serious adverse events (RR 0.80, 95% CI 0.55 to 1.15; 236 per 1000; 3 RCTs, 327 participants; very low-certainty evidence). We did not identify any study reporting other key outcomes. Convalescent plasma versus human immunoglobulin Convalescent plasma may have little to no effect on all-cause mortality at up to day 28 (RR 1.07, 95% CI 0.76 to 1.50; 464 per 1000; 1 study, 190 participants; low-certainty evidence). We did not identify any study reporting other key outcomes. Individuals with a confirmed diagnosis of SARS-CoV-2 infection and mild disease We identified two RCTs reporting on 536 participants, comparing convalescent plasma to placebo or standard care alone, and two RCTs reporting on 1597 participants with mild disease, comparing convalescent plasma to standard plasma. Convalescent plasma versus placebo or standard care alone We are uncertain whether convalescent plasma reduces all-cause mortality at up to day 28 (odds ratio (OR) 0.36, 95% CI 0.09 to 1.46; 8 per 1000; 2 RCTs, 536 participants; very low-certainty evidence). It may have little to no effect on admission to hospital or death within 28 days (RR 1.05, 95% CI 0.60 to 1.84; 117 per 1000; 1 RCT, 376 participants; low-certainty evidence), on time to COVID-19 symptom resolution (hazard ratio (HR) 1.05, 95% CI 0.85 to 1.30; 483 per 1000; 1 RCT, 376 participants; low-certainty evidence), on the risk of grades 3 and 4 adverse events (RR 1.29, 95% CI 0.75 to 2.19; 144 per 1000; 1 RCT, 376 participants; low-certainty evidence) and the risk of serious adverse events (RR 1.14, 95% CI 0.66 to 1.94; 133 per 1000; 1 RCT, 376 participants; low-certainty evidence). We did not identify any study reporting other key outcomes. Convalescent plasma versus standard plasma We are uncertain whether convalescent plasma reduces all-cause mortality at up to day 28 (OR 0.30, 95% CI 0.05 to 1.75; 2 per 1000; 2 RCTs, 1597 participants; very low-certainty evidence). It probably reduces admission to hospital or death within 28 days (RR 0.49, 95% CI 0.31 to 0.75; 36 per 1000; 2 RCTs, 1595 participants; moderate-certainty evidence). Convalescent plasma may have little to no effect on initial symptom resolution at up to day 28 (RR 1.12, 95% CI 0.98 to 1.27; 1 RCT, 416 participants; low-certainty evidence). We did not identify any study reporting other key outcomes. This is a living systematic review. We search monthly for new evidence and update the review when we identify relevant new evidence. AUTHORS' CONCLUSIONS For the comparison of convalescent plasma versus placebo or standard care alone, our certainty in the evidence that convalescent plasma for individuals with moderate to severe disease does not reduce mortality and has little to no impact on clinical improvement or worsening is high. It probably has little to no effect on SAEs. For individuals with mild disease, we have very-low to low certainty evidence for most primary outcomes and moderate certainty for hospital admission or death. There are 49 ongoing studies, and 33 studies reported as complete in a trials registry. Publication of ongoing studies might resolve some of the uncertainties around convalescent plasma therapy for people with asymptomatic or mild disease.
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Affiliation(s)
- Claire Iannizzi
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Khai Li Chai
- Transfusion Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Vanessa Piechotta
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Sarah J Valk
- Jon J van Rood Center for Clinical Transfusion Research, Sanquin/Leiden University Medical Center, Leiden, Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands
| | - Catherine Kimber
- Systematic Review Initiative, NHS Blood and Transplant, Oxford, UK
| | - Ina Monsef
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Erica M Wood
- Transfusion Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | | | - David J Roberts
- Systematic Review Initiative, NHS Blood and Transplant, Oxford, UK
| | - Zoe McQuilten
- Transfusion Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Cynthia So-Osman
- Sanquin Blood Bank, Amsterdam, Netherlands
- Erasmus Medical Centre, Rotterdam, Netherlands
| | - Aikaj Jindal
- Department of Transfusion Medicine, SPS Hospitals, Ludhiana (Punjab), India
| | - Nora Cryns
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Lise J Estcourt
- Haematology/Transfusion Medicine, NHS Blood and Transplant, Oxford, UK
| | - Nina Kreuzberger
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Nicole Skoetz
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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13
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Iannizzi C, Chai KL, Piechotta V, Valk SJ, Kimber C, Monsef I, Wood EM, Lamikanra AA, Roberts DJ, McQuilten Z, So-Osman C, Jindal A, Cryns N, Estcourt LJ, Kreuzberger N, Skoetz N. Convalescent plasma for people with COVID-19: a living systematic review. Cochrane Database Syst Rev 2023; 2:CD013600. [PMID: 36734509 PMCID: PMC9891348 DOI: 10.1002/14651858.cd013600.pub5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Convalescent plasma may reduce mortality in patients with viral respiratory diseases, and is being investigated as a potential therapy for coronavirus disease 2019 (COVID-19). A thorough understanding of the current body of evidence regarding benefits and risks of this intervention is required. OBJECTIVES To assess the effectiveness and safety of convalescent plasma transfusion in the treatment of people with COVID-19; and to maintain the currency of the evidence using a living systematic review approach. SEARCH METHODS To identify completed and ongoing studies, we searched the World Health Organization (WHO) COVID-19 Global literature on coronavirus disease Research Database, MEDLINE, Embase, Cochrane COVID-19 Study Register, and the Epistemonikos COVID-19 L*OVE Platform. We searched monthly until 03 March 2022. SELECTION CRITERIA We included randomised controlled trials (RCTs) evaluating convalescent plasma for COVID-19, irrespective of disease severity, age, gender or ethnicity. We excluded studies that included populations with other coronavirus diseases (severe acute respiratory syndrome (SARS) or Middle East respiratory syndrome (MERS)), as well as studies evaluating standard immunoglobulin. DATA COLLECTION AND ANALYSIS We followed standard Cochrane methodology. To assess bias in included studies we used RoB 2. We used the GRADE approach to rate the certainty of evidence for the following outcomes: all-cause mortality at up to day 28, worsening and improvement of clinical status (for individuals with moderate to severe disease), hospital admission or death, COVID-19 symptoms resolution (for individuals with mild disease), quality of life, grade 3 or 4 adverse events, and serious adverse events. MAIN RESULTS In this fourth review update version, we included 33 RCTs with 24,861 participants, of whom 11,432 received convalescent plasma. Of these, nine studies are single-centre studies and 24 are multi-centre studies. Fourteen studies took place in America, eight in Europe, three in South-East Asia, two in Africa, two in western Pacific and three in eastern Mediterranean regions and one in multiple regions. We identified a further 49 ongoing studies evaluating convalescent plasma, and 33 studies reporting as being completed. Individuals with a confirmed diagnosis of COVID-19 and moderate to severe disease 29 RCTs investigated the use of convalescent plasma for 22,728 participants with moderate to severe disease. 23 RCTs with 22,020 participants compared convalescent plasma to placebo or standard care alone, five compared to standard plasma and one compared to human immunoglobulin. We evaluate subgroups on detection of antibodies detection, symptom onset, country income groups and several co-morbidities in the full text. Convalescent plasma versus placebo or standard care alone Convalescent plasma does not reduce all-cause mortality at up to day 28 (risk ratio (RR) 0.98, 95% confidence interval (CI) 0.92 to 1.03; 220 per 1000; 21 RCTs, 19,021 participants; high-certainty evidence). It has little to no impact on need for invasive mechanical ventilation, or death (RR 1.03, 95% CI 0.97 to 1.11; 296 per 1000; 6 RCTs, 14,477 participants; high-certainty evidence) and has no impact on whether participants are discharged from hospital (RR 1.00, 95% CI 0.97 to 1.02; 665 per 1000; 6 RCTs, 12,721 participants; high-certainty evidence). Convalescent plasma may have little to no impact on quality of life (MD 1.00, 95% CI -2.14 to 4.14; 1 RCT, 483 participants; low-certainty evidence). Convalescent plasma may have little to no impact on the risk of grades 3 and 4 adverse events (RR 1.17, 95% CI 0.96 to 1.42; 212 per 1000; 6 RCTs, 2392 participants; low-certainty evidence). It has probably little to no effect on the risk of serious adverse events (RR 1.14, 95% CI 0.91 to 1.44; 135 per 1000; 6 RCTs, 3901 participants; moderate-certainty evidence). Convalescent plasma versus standard plasma We are uncertain whether convalescent plasma reduces or increases all-cause mortality at up to day 28 (RR 0.73, 95% CI 0.45 to 1.19; 129 per 1000; 4 RCTs, 484 participants; very low-certainty evidence). We are uncertain whether convalescent plasma reduces or increases the need for invasive mechanical ventilation, or death (RR 5.59, 95% CI 0.29 to 108.38; 311 per 1000; 1 study, 34 participants; very low-certainty evidence) and whether it reduces or increases the risk of serious adverse events (RR 0.80, 95% CI 0.55 to 1.15; 236 per 1000; 3 RCTs, 327 participants; very low-certainty evidence). We did not identify any study reporting other key outcomes. Convalescent plasma versus human immunoglobulin Convalescent plasma may have little to no effect on all-cause mortality at up to day 28 (RR 1.07, 95% CI 0.76 to 1.50; 464 per 1000; 1 study, 190 participants; low-certainty evidence). We did not identify any study reporting other key outcomes. Individuals with a confirmed diagnosis of SARS-CoV-2 infection and mild disease We identified two RCTs reporting on 536 participants, comparing convalescent plasma to placebo or standard care alone, and two RCTs reporting on 1597 participants with mild disease, comparing convalescent plasma to standard plasma. Convalescent plasma versus placebo or standard care alone We are uncertain whether convalescent plasma reduces all-cause mortality at up to day 28 (odds ratio (OR) 0.36, 95% CI 0.09 to 1.46; 8 per 1000; 2 RCTs, 536 participants; very low-certainty evidence). It may have little to no effect on admission to hospital or death within 28 days (RR 1.05, 95% CI 0.60 to 1.84; 117 per 1000; 1 RCT, 376 participants; low-certainty evidence), on time to COVID-19 symptom resolution (hazard ratio (HR) 1.05, 95% CI 0.85 to 1.30; 483 per 1000; 1 RCT, 376 participants; low-certainty evidence), on the risk of grades 3 and 4 adverse events (RR 1.29, 95% CI 0.75 to 2.19; 144 per 1000; 1 RCT, 376 participants; low-certainty evidence) and the risk of serious adverse events (RR 1.14, 95% CI 0.66 to 1.94; 133 per 1000; 1 RCT, 376 participants; low-certainty evidence). We did not identify any study reporting other key outcomes. Convalescent plasma versus standard plasma We are uncertain whether convalescent plasma reduces all-cause mortality at up to day 28 (OR 0.30, 95% CI 0.05 to 1.75; 2 per 1000; 2 RCTs, 1597 participants; very low-certainty evidence). It probably reduces admission to hospital or death within 28 days (RR 0.49, 95% CI 0.31 to 0.75; 36 per 1000; 2 RCTs, 1595 participants; moderate-certainty evidence). Convalescent plasma may have little to no effect on initial symptom resolution at up to day 28 (RR 1.12, 95% CI 0.98 to 1.27; 1 RCT, 416 participants; low-certainty evidence). We did not identify any study reporting other key outcomes. This is a living systematic review. We search monthly for new evidence and update the review when we identify relevant new evidence. AUTHORS' CONCLUSIONS For the comparison of convalescent plasma versus placebo or standard care alone, our certainty in the evidence that convalescent plasma for individuals with moderate to severe disease does not reduce mortality and has little to no impact on clinical improvement or worsening is high. It probably has little to no effect on SAEs. For individuals with mild disease, we have low certainty evidence for our primary outcomes. There are 49 ongoing studies, and 33 studies reported as complete in a trials registry. Publication of ongoing studies might resolve some of the uncertainties around convalescent plasma therapy for people with asymptomatic or mild disease.
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Affiliation(s)
- Claire Iannizzi
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Khai Li Chai
- Transfusion Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Vanessa Piechotta
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Sarah J Valk
- Jon J van Rood Center for Clinical Transfusion Research, Sanquin/Leiden University Medical Center, Leiden, Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands
| | - Catherine Kimber
- Systematic Review Initiative, NHS Blood and Transplant, Oxford, UK
| | - Ina Monsef
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Erica M Wood
- Transfusion Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | | | - David J Roberts
- Systematic Review Initiative, NHS Blood and Transplant, Oxford, UK
| | - Zoe McQuilten
- Transfusion Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Cynthia So-Osman
- Sanquin Blood Bank, Amsterdam, Netherlands
- Erasmus Medical Centre, Rotterdam, Netherlands
| | - Aikaj Jindal
- Department of Transfusion Medicine, SPS Hospitals, Ludhiana (Punjab), India
| | - Nora Cryns
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Lise J Estcourt
- Haematology/Transfusion Medicine, NHS Blood and Transplant, Oxford, UK
| | - Nina Kreuzberger
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Nicole Skoetz
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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14
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Kimber C, Valk SJ, Chai KL, Piechotta V, Iannizzi C, Monsef I, Wood EM, Lamikanra AA, Roberts DJ, McQuilten Z, So-Osman C, Estcourt LJ, Skoetz N. Hyperimmune immunoglobulin for people with COVID-19. Cochrane Database Syst Rev 2023; 1:CD015167. [PMID: 36700518 PMCID: PMC9887673 DOI: 10.1002/14651858.cd015167.pub2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Hyperimmune immunoglobulin (hIVIG) contains polyclonal antibodies, which can be prepared from large amounts of pooled convalescent plasma or prepared from animal sources through immunisation. They are being investigated as a potential therapy for coronavirus disease 2019 (COVID-19). This review was previously part of a parent review addressing convalescent plasma and hIVIG for people with COVID-19 and was split to address hIVIG and convalescent plasma separately. OBJECTIVES To assess the benefits and harms of hIVIG therapy for the treatment of people with COVID-19, and to maintain the currency of the evidence using a living systematic review approach. SEARCH METHODS To identify completed and ongoing studies, we searched the World Health Organization (WHO) COVID-19 Research Database, the Cochrane COVID-19 Study Register, the Epistemonikos COVID-19 L*OVE Platform and Medline and Embase from 1 January 2019 onwards. We carried out searches on 31 March 2022. SELECTION CRITERIA We included randomised controlled trials (RCTs) that evaluated hIVIG for COVID-19, irrespective of disease severity, age, gender or ethnicity. We excluded studies that included populations with other coronavirus diseases (severe acute respiratory syndrome (SARS) or Middle East respiratory syndrome (MERS)), as well as studies that evaluated standard immunoglobulin. DATA COLLECTION AND ANALYSIS We followed standard Cochrane methodology. To assess bias in included studies, we used RoB 2. We rated the certainty of evidence, using the GRADE approach, for the following outcomes: all-cause mortality, improvement and worsening of clinical status (for individuals with moderate to severe disease), quality of life, adverse events, and serious adverse events. MAIN RESULTS We included five RCTs with 947 participants, of whom 688 received hIVIG prepared from humans, 18 received heterologous swine glyco-humanised polyclonal antibody, and 241 received equine-derived processed and purified F(ab')2 fragments. All participants were hospitalised with moderate-to-severe disease, most participants were not vaccinated (only 12 participants were vaccinated). The studies were conducted before or during the emergence of several SARS-CoV-2 variants of concern. There are no data for people with COVID-19 with no symptoms (asymptomatic) or people with mild COVID-19. We identified a further 10 ongoing studies evaluating hIVIG. Benefits of hIVIG prepared from humans We included data on one RCT (579 participants) that assessed the benefits and harms of hIVIG 0.4 g/kg compared to saline placebo. hIVIG may have little to no impact on all-cause mortality at 28 days (risk ratio (RR) 0.79, 95% confidence interval (CI) 0.43 to 1.44; absolute effect 77 per 1000 with placebo versus 61 per 1000 (33 to 111) with hIVIG; low-certainty evidence). The evidence is very uncertain about the effect on worsening of clinical status at day 7 (RR 0.85, 95% CI 0.58 to 1.23; very low-certainty evidence). It probably has little to no impact on improvement of clinical status on day 28 (RR 1.02, 95% CI 0.97 to 1.08; moderate-certainty evidence). We did not identify any studies that reported quality-of-life outcomes, so we do not know if hIVIG has any impact on quality of life. Harms of hIVIG prepared from humans hIVIG may have little to no impact on adverse events at any grade on day 1 (RR 0.98, 95% CI 0.81 to 1.18; 431 per 1000; 1 study 579 participants; low-certainty evidence). Patients receiving hIVIG probably experience more adverse events at grade 3-4 severity than patients who receive placebo (RR 4.09, 95% CI 1.39 to 12.01; moderate-certainty evidence). hIVIG may have little to no impact on the composite outcome of serious adverse events or death up to day 28 (RR 0.72, 95% CI 0.45 to 1.14; moderate-certainty evidence). We also identified additional results on the benefits and harms of other dose ranges of hIVIG, not included in the summary of findings table, but summarised in additional tables. Benefits of animal-derived polyclonal antibodies We included data on one RCT (241 participants) to assess the benefits and harms of receptor-binding domain-specific polyclonal F(ab´)2 fragments of equine antibodies (EpAbs) compared to saline placebo. EpAbs may reduce all-cause mortality at 28 days (RR 0.60, 95% CI 0.26 to 1.37; absolute effect 114 per 1000 with placebo versus 68 per 1000 (30 to 156) ; low-certainty evidence). EpAbs may reduce worsening of clinical status up to day 28 (RR 0.67, 95% CI 0.38 to 1.18; absolute effect 203 per 1000 with placebo versus 136 per 1000 (77 to 240); low-certainty evidence). It may have some effect on improvement of clinical status on day 28 (RR 1.06, 95% CI 0.96 to 1.17; low-certainty evidence). We did not identify any studies that reported quality-of-life outcomes, so we do not know if EpAbs have any impact on quality of life. Harms of animal-derived polyclonal antibodies EpAbs may have little to no impact on the number of adverse events at any grade up to 28 days (RR 0.99, 95% CI 0.74 to 1.31; low-certainty evidence). Adverse events at grade 3-4 severity were not reported. Individuals receiving EpAbs may experience fewer serious adverse events than patients receiving placebo (RR 0.67, 95% CI 0.38 to 1.19; low-certainty evidence). We also identified additional results on the benefits and harms of other animal-derived polyclonal antibody doses, not included in the summary of findings table, but summarised in additional tables. AUTHORS' CONCLUSIONS We included data from five RCTs that evaluated hIVIG compared to standard therapy, with participants with moderate-to-severe disease. As the studies evaluated different preparations (from humans or from various animals) and doses, we could not pool them. hIVIG prepared from humans may have little to no impact on mortality, and clinical improvement and worsening. hIVIG may increase grade 3-4 adverse events. Studies did not evaluate quality of life. RBD-specific polyclonal F(ab´)2 fragments of equine antibodies may reduce mortality and serious adverse events, and may reduce clinical worsening. However, the studies were conducted before or during the emergence of several SARS-CoV-2 variants of concern and prior to widespread vaccine rollout. As no studies evaluated hIVIG for participants with asymptomatic infection or mild disease, benefits for these individuals remains uncertain. This is a living systematic review. We search monthly for new evidence and update the review when we identify relevant new evidence.
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Affiliation(s)
- Catherine Kimber
- Systematic Review Initiative, NHS Blood and Transplant, Oxford, UK
| | - Sarah J Valk
- Jon J van Rood Center for Clinical Transfusion Research, Sanquin/Leiden University Medical Center, Leiden, Netherlands
| | - Khai Li Chai
- Transfusion Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Vanessa Piechotta
- Cochrane Haematology, Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Claire Iannizzi
- Cochrane Haematology, Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ina Monsef
- Cochrane Haematology, Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Erica M Wood
- Transfusion Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | | | - David J Roberts
- Systematic Review Initiative, NHS Blood and Transplant, Oxford, UK
| | - Zoe McQuilten
- Transfusion Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Cynthia So-Osman
- Erasmus Medical Centre, Rotterdam, Netherlands
- Unit Transfusion Medicine, Sanquin Blood Supply Foundation, Amsterdam, Netherlands
| | - Lise J Estcourt
- Haematology/Transfusion Medicine, NHS Blood and Transplant, Oxford, UK
| | - Nicole Skoetz
- Cochrane Haematology, Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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15
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Findlater L, Trickey A, Jones HE, Trindall A, Taylor-Phillips S, Mulchandani R, EDSAB-HOME Investigators, Oliver I, Wyllie D. Association of Results of Four Lateral Flow Antibody Tests with Subsequent SARS-CoV-2 Infection. Microbiol Spectr 2022; 10:e0246822. [PMID: 36135374 PMCID: PMC9602656 DOI: 10.1128/spectrum.02468-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 09/06/2022] [Indexed: 01/04/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine coverage remains incomplete, being only 15% in low-income countries. Rapid point-of-care tests predicting SARS-CoV-2 infection susceptibility in the unvaccinated may assist in risk management and vaccine prioritization. We conducted a prospective cohort study in 2,826 participants working in hospitals and Fire and Police services in England, UK, during the pandemic (ISRCTN5660922). Plasma taken at recruitment in June 2020 was tested using four lateral flow immunoassay (LFIA) devices and two laboratory immunoassays detecting antibodies against SARS-CoV-2 (UK Rapid Test Consortium's AbC-19 rapid test, OrientGene COVID IgG/IgM rapid test cassette, SureScreen COVID-19 rapid test cassette, and Biomerica COVID-19 IgG/IgM rapid test; Roche N and Euroimmun S laboratory assays). We monitored participants for microbiologically confirmed SARS-CoV-2 infection for 200 days. We estimated associations between test results at baseline and subsequent infection, using Poisson regression models adjusted for baseline demographic risk factors for SARS-CoV-2 exposure. Positive IgG results on each of the four LFIAs were associated with lower rates of subsequent infection with adjusted incidence rate ratios (aIRRs) of 0.00 (95% confidence interval, 0.00 to 0.01), 0.03 (0.02 to 0.05), 0.07 (0.05 to 0.10), and 0.09 (0.07 to 0.12), respectively. The protective association was strongest for AbC-19 and SureScreen. The aIRR for the laboratory Roche N antibody assay at the manufacturer-recommended threshold was similar to those of the two best performing LFIAs at 0.03 (0.01 to 0.10). Lateral flow devices measuring SARS-CoV-2 IgG predicted disease risk in unvaccinated individuals over a 200-day follow-up. The association of some LFIAs with subsequent infection was similar to laboratory immunoassays. IMPORTANCE Previous research has demonstrated an association between the detection of antibodies to SARS-CoV-2 following natural infection and protection from subsequent symptomatic SARS-CoV-2 infection. Lateral flow immunoassays (LFIAs) detecting anti-SARS-CoV-2 IgG are a cheap, readily deployed technology that has been used on a large scale in population screening programs, yet no studies have investigated whether LFIA results are associated with subsequent SARS-CoV-2 infection. In a prospective cohort study of 2,826 United Kingdom key workers, we found positivity in lateral flow test results had a strong negative association with subsequent SARS-CoV-2 infection within 200 days in an unvaccinated population. Positivity on more-specific but less-sensitive tests was associated with a markedly decreased rate of disease; protection associated with testing positive using more sensitive devices detecting lower levels of anti-SARS-CoV-2 IgG was more modest. Lateral flow tests with high specificity may have a role in estimation of SARS-CoV-2 disease risk in unvaccinated populations.
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Affiliation(s)
- Lucy Findlater
- UK Health Security Agency, Cambridge, United Kingdom
- National Institute of Health Research Health Protection Research Unit on Behavioural Science and Evaluation at the University of Bristol, Bristol, United Kingdom
| | - Adam Trickey
- Population Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Hayley E. Jones
- National Institute of Health Research Health Protection Research Unit on Behavioural Science and Evaluation at the University of Bristol, Bristol, United Kingdom
- Population Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Amy Trindall
- UK Health Security Agency, Cambridge, United Kingdom
| | | | | | - EDSAB-HOME Investigators
- UK Health Security Agency, Cambridge, United Kingdom
- National Institute of Health Research Health Protection Research Unit on Behavioural Science and Evaluation at the University of Bristol, Bristol, United Kingdom
- Population Health Sciences, University of Bristol, Bristol, United Kingdom
- University of Warwick, Coventry, United Kingdom
| | - Isabel Oliver
- UK Health Security Agency, Cambridge, United Kingdom
- National Institute of Health Research Health Protection Research Unit on Behavioural Science and Evaluation at the University of Bristol, Bristol, United Kingdom
| | - David Wyllie
- UK Health Security Agency, Cambridge, United Kingdom
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16
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Costa Silva RCM, Bandeira-Melo C, Paula Neto HA, Vale AM, Travassos LH. COVID-19 diverse outcomes: Aggravated reinfection, type I interferons and antibodies. Med Hypotheses 2022; 167:110943. [PMID: 36105250 PMCID: PMC9461281 DOI: 10.1016/j.mehy.2022.110943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 06/29/2022] [Accepted: 06/30/2022] [Indexed: 12/04/2022]
Abstract
SARS-CoV-2 infection intrigued medicine with diverse outcomes ranging from asymptomatic to severe acute respiratory syndrome (SARS) and death. After more than two years of pandemic, reports of reinfection concern researchers and physicists. Here, we will discuss potential mechanisms that can explain reinfections, including the aggravated ones. The major topics of this hypothesis paper are the disbalance between interferon and antibodies responses, HLA heterogeneity among the affected population, and increased proportion of cytotoxic CD4+ T cells polarization in relation to T follicular cells (Tfh) subtypes. These features affect antibody levels and hamper the humoral immunity necessary to prevent or minimize the viral burden in the case of reinfections.
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Affiliation(s)
- Rafael Cardoso Maciel Costa Silva
- Laboratório de Imunoreceptores e Sinalização, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Christianne Bandeira-Melo
- Laboratório de Inflamação, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Heitor Afonso Paula Neto
- Laboratório de Alvos Moleculares, Faculdade de Farmácia, Departamento de Biotecnologia Farmacêutica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - André Macedo Vale
- Laboratório de Biologia de Linfócitos, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Leonardo Holanda Travassos
- Laboratório de Imunoreceptores e Sinalização, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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17
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Kumar V, Kumar S, Sharma PC. Recent advances in the vaccine development for the prophylaxis of SARS Covid-19. Int Immunopharmacol 2022; 111:109175. [PMID: 35994853 PMCID: PMC9381430 DOI: 10.1016/j.intimp.2022.109175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 08/08/2022] [Accepted: 08/14/2022] [Indexed: 12/14/2022]
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-caused Coronavirus Disease 2019 (COVID-19) is currently a global pandemic that has wreaked havoc on public health, lives, and the global economy. The present COVID-19 outbreak has put pressure on the scientific community to develop medications and vaccinations to combat COVID-19. However, according to highly optimistic forecasts, we could not have a COVID-19 vaccine until September 2020. This is due to the fact that a successful COVID-19 vaccine will necessitate a careful validation of effectiveness and adverse reactivity given that the target vaccine population includes high-risk people over 60, particularly those with severe co-morbid conditions, frontline healthcare professionals, and those involved in essential industrial sectors. For passive immunization, which is being considered for Covid-19, there are several platforms for vaccine development, each with its own advantages and disadvantages. The COVID-19 pandemic, which is arguably the deadliest in the last 100 years after the Spanish flu, necessitates a swift assessment of the various approaches for their ability to incite protective immunity and safety to prevent unintended immune potentiation, which is crucial to the pathogenesis of this virus. Considering the pandemic's high fatality rate and rapid spread, an efficient vaccination is critical for its management. As a result, academia, industry, and government are collaborating in unprecedented ways to create and test a wide range of vaccinations. In this review, we summarize the Covid-19 vaccine development initiatives, recent trends, difficulties, comparison between traditional vaccines development and Covid-19 vaccines development also listed the approved/authorized, phase-3 and pre-clinical trials Covid-19 vaccines in different countries.
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Affiliation(s)
- Vipul Kumar
- Department of Pharmaceutical Chemistry, Delhi Institute of Pharmaceutical Sciences and Research (DIPSAR), Delhi Pharmaceutical Sciences and Research University, New Delhi 110017, India
| | - Sahil Kumar
- Department of Pharmaceutical Chemistry, Delhi Institute of Pharmaceutical Sciences and Research (DIPSAR), Delhi Pharmaceutical Sciences and Research University, New Delhi 110017, India.
| | - Prabodh Chander Sharma
- Department of Pharmaceutical Chemistry, School of Pharmaceutical Sciences, Delhi Pharmaceutical Sciences and Research University, New Delhi 110017, India
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18
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Burbano Lombana DA, Zino L, Butail S, Caroppo E, Jiang ZP, Rizzo A, Porfiri M. Activity-driven network modeling and control of the spread of two concurrent epidemic strains. APPLIED NETWORK SCIENCE 2022; 7:66. [PMID: 36186912 PMCID: PMC9514203 DOI: 10.1007/s41109-022-00507-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023]
Abstract
The emergency generated by the current COVID-19 pandemic has claimed millions of lives worldwide. There have been multiple waves across the globe that emerged as a result of new variants, due to arising from unavoidable mutations. The existing network toolbox to study epidemic spreading cannot be readily adapted to the study of multiple, coexisting strains. In this context, particularly lacking are models that could elucidate re-infection with the same strain or a different strain-phenomena that we are seeing experiencing more and more with COVID-19. Here, we establish a novel mathematical model to study the simultaneous spreading of two strains over a class of temporal networks. We build on the classical susceptible-exposed-infectious-removed model, by incorporating additional states that account for infections and re-infections with multiple strains. The temporal network is based on the activity-driven network paradigm, which has emerged as a model of choice to study dynamic processes that unfold at a time scale comparable to the network evolution. We draw analytical insight from the dynamics of the stochastic network systems through a mean-field approach, which allows for characterizing the onset of different behavioral phenotypes (non-epidemic, epidemic, and endemic). To demonstrate the practical use of the model, we examine an intermittent stay-at-home containment strategy, in which a fraction of the population is randomly required to isolate for a fixed period of time.
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Affiliation(s)
- Daniel Alberto Burbano Lombana
- Center for Urban Science and Progress, Tandon School of Engineering, New York University, 370 Jay Street, Brooklyn, NY 11201 USA
- Department of Mechanical and Aerospace Engineering, Tandon School of Engineering, New York University, Six MetroTech Center, Brooklyn, NY 11201 USA
- Department of Electrical and Computer Engineering, Rutgers University, 94 Brett Rd, Piscataway, NJ 08854 USA
| | - Lorenzo Zino
- Engineering and Technology Institute Groningen, University of Groningen, Nijenborgh 4, 9747 AG Groningen, The Netherlands
| | - Sachit Butail
- Department of Mechanical Engineering, Northern Illinois University, DeKalb, IL 60115 USA
| | - Emanuele Caroppo
- Department of Mental Health, Local Health Unit Roma 2, 00159 Rome, Italy
- University Research Center He.R.A., Universitá Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Zhong-Ping Jiang
- Department of Electrical and Computer Engineering, Tandon School of Engineering, New York University, 370 Jay Street, Brooklyn, NY 11201 USA
| | - Alessandro Rizzo
- Department of Electronics and Telecommunications, Politecnico di Torino, Corso Duca Degli Abruzzi, 24, 10129 Turin, Italy
- Institute for Invention, Innovation and Entrepreneurship, Tandon School of Engineering, New York University, Six MetroTech Center, Brooklyn, NY 11201 USA
| | - Maurizio Porfiri
- Center for Urban Science and Progress, Tandon School of Engineering, New York University, 370 Jay Street, Brooklyn, NY 11201 USA
- Department of Mechanical and Aerospace Engineering, Tandon School of Engineering, New York University, Six MetroTech Center, Brooklyn, NY 11201 USA
- Department of Biomedical Engineering, Tandon School of Engineering, New York University, Six MetroTech Center, Brooklyn, NY 11201 USA
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19
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El-Menyar A, Khan NA, Mekkodathil A, Rizoli S, Consunji R, Elmenyar E, Galwankar S, Al-Thani H. A quick scoping review of the first year of vaccination against the COVID-19 pandemic: Do we need more shots or time? Medicine (Baltimore) 2022; 101:e30609. [PMID: 36123868 PMCID: PMC9477714 DOI: 10.1097/md.0000000000030609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 08/16/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The emergence of new severe acute respiratory syndrome coronavirus 2 variants, along with the waning of vaccine-induced immunity, has increased breakthrough infections and urged booster jabs and debates. In the short term, the administration of booster doses has been reported to be safe and enhance severe acute respiratory syndrome coronavirus 2-specific neutralizing antibody levels. However, the effects of these doses on the pandemic trajectory and herd immunity are unclear. There is insufficient evidence that a third booster shot of the coronavirus disease 2019 (COVID-19) vaccine maintains longer immunity and covers new viral variants. The lack of sufficient evidence, combined with the fact that millions of people have not yet received 1 or 2 jabs of the COVID-19 vaccine, has raised concerns regarding the call for booster vaccinations. METHODS We conducted a quick scoping review to explore the literature on the need for a booster COVID-19 vaccination from January 1, 2021, to April 30, 2022. RESULTS Sixty-one relevant publications were identified, of which 17 were related to waning immunity after 2 doses of the vaccine among the general population or healthcare workers, 19 were related to the third or booster dose of vaccination after the second dose among the general population or healthcare workers, and 25 were related to booster dose among immunocompromised patient. CONCLUSIONS Initially, the need for a booster dose was equivocal; however, several studies demonstrated the benefit of the booster dose over time. Adequate scientific information is required regarding the administration of booster doses to the general population as well as the high-risk individuals.
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Affiliation(s)
- Ayman El-Menyar
- Department of Surgery, Trauma and Vascular Surgery Clinical Research, Hamad Medical Corporation, Qatar
- Clinical Medicine, Weill Cornell Medical College, Doha, Qatar
| | - Naushad Ahmad Khan
- Department of Surgery, Trauma and Vascular Surgery Clinical Research, Hamad Medical Corporation, Qatar
| | - Ahammed Mekkodathil
- Department of Surgery, Trauma and Vascular Surgery Clinical Research, Hamad Medical Corporation, Qatar
| | - Sandro Rizoli
- Department of Surgery, Trauma Surgery, Hamad Medical Corporation, Qatar
| | - Rafael Consunji
- Department of Surgery, Trauma Surgery, Hamad Medical Corporation, Qatar
| | | | - Sagar Galwankar
- Department of Emergency Medicine, Sarasota Memorial Hospital, Sarasota, FL
| | - Hassan Al-Thani
- Department of Surgery, Trauma Surgery, Hamad Medical Corporation, Qatar
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20
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Ferguson EA, Brum E, Chowdhury A, Chowdhury S, Kundegorski M, Mahmud AS, Purno N, Sania A, Steenson R, Tasneem M, Hampson K. Modelling how face masks and symptoms-based quarantine synergistically and cost-effectively reduce SARS-CoV-2 transmission in Bangladesh. Epidemics 2022; 40:100592. [PMID: 35738153 PMCID: PMC9192122 DOI: 10.1016/j.epidem.2022.100592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 04/22/2022] [Accepted: 06/10/2022] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Non-pharmaceutical interventions (NPIs) used to limit SARS-CoV-2 transmission vary in their feasibility, appropriateness and effectiveness in different contexts. In Bangladesh a national lockdown implemented in March 2020 exacerbated poverty and was untenable long-term. A resurgence in 2021 warranted renewed NPIs. We sought to identify NPIs that were feasible in this context and explore potential synergies between interventions. METHODS We developed an SEIR model for Dhaka District, parameterised from literature values and calibrated to data from Bangladesh. We discussed scenarios and parameterisations with policymakers with the aid of an interactive app. These discussions guided modelling of lockdown and two post-lockdown measures considered feasible to deliver; symptoms-based household quarantining and compulsory mask-wearing. We compared NPI scenarios on deaths, hospitalisations relative to capacity, working days lost, and cost-effectiveness. RESULTS Lockdowns alone were predicted to delay the first epidemic peak but could not prevent overwhelming of the health service and were costly in lost working days. Impacts of post-lockdown interventions depended heavily on compliance. Assuming 80% compliance, symptoms-based household quarantining alone could not prevent hospitalisations exceeding capacity, whilst mask-wearing prevented overwhelming health services and was cost-effective given masks of high filtration efficiency. Combining masks with quarantine increased their impact. Recalibration to surging cases in 2021 suggested potential for a further wave in 2021, dependent on uncertainties in case reporting and immunity. CONCLUSIONS Masks and symptoms-based household quarantining synergistically prevent transmission, and are cost-effective in Bangladesh. Our interactive app was valuable in supporting decision-making, with mask-wearing being mandated early, and community teams being deployed to support quarantining across Dhaka. These measures likely contributed to averting the worst public health impacts, but delivering an effective response with consistent compliance across the population has been challenging. In the event of a further resurgence, concurrent messaging to increase compliance with both mask-wearing and quarantine is recommended.
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21
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Churiso G, Diriba K, Girma H, Tafere S. Laboratory Findings in Different Disease Status of COVID-19 Admitted Patients at Dilla University Referral Hospital Treatment Center, South Ethiopia. Infect Drug Resist 2022; 15:4307-4320. [PMID: 35965852 PMCID: PMC9373995 DOI: 10.2147/idr.s370907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 08/01/2022] [Indexed: 01/09/2023] Open
Abstract
Background Millions were infected and many were dying because of the coronavirus disease 2019, since its emergence. The patients experience asymptomatic, mild, moderate, severe and critical disease with varying signs and symptoms. Decreased lymphocytes and abnormal liver and renal function tests are common among COVID-19 patients. Severe and critical cases show higher number of white blood cells, and neutrophils. However, studies showed different laboratory findings in different disease status. Therefore, this study investigated laboratory findings of COVID-19 admitted patients at Dilla University Referral Hospital treatment center, South Ethiopia. Methods A retrospective study design was conducted on 220 patients confirmed by real time polymerase chain reaction, and admitted to Dilla University Referral Hospital treatment center from September 2020 to July 2021. Data were collected from the patients’ record, and analyzed by GraphPad Prism version 8.0.1.244 software. Descriptive statistics were used to analyze the frequency while independent t-test was used to compare means of each parameter for each disease status. Results Of the 220 study cases, 120 (54.5%) were severe, 89 (40.5%) were moderate and 11 (5.0%) were mild. One hundred forty (71.1%) of the 197 laboratory tested cases, 87 (77.7%) of severe, and 49 (64.5%) of the moderate cases had neutrophils above normal range. However, 134 (68.0%) of them, 82 (73.2%) of severe and 49 (64.5%) of moderate cases showed decreased lymphocyte level. Most of the cases showed an increased level of aspartate transaminase, alanine transaminase, alkaline phosphatase, total bilirubin, and total calcium. There was statistically significant mean neutrophils (p=0.04), number of white blood cells (p= 0.02), and creatinine level (p=0.00) difference between severe and mild cases. Conclusion Most of the severe COVID-19 patients showed increased neutrophils, liver function tests; and decreased lymphocytes; suggesting higher inflammation and lymphopenia. Therefore, patients with severe and critical disease status require close follow-up.
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Affiliation(s)
- Gemechu Churiso
- Department of Medical Laboratory Sciences, Dilla University, Dilla, Ethiopia
| | - Kuma Diriba
- Department of Medical Laboratory Sciences, Dilla University, Dilla, Ethiopia
| | - Henok Girma
- Ohio State University, Global One Health Initiative, Dilla, Ethiopia
| | - Soressa Tafere
- COVID-19 Treatment Center, Dilla University, Dilla, Ethiopia
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22
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Fast and noninvasive electronic nose for sniffing out COVID-19 based on exhaled breath-print recognition. NPJ Digit Med 2022; 5:115. [PMID: 35974062 PMCID: PMC9379872 DOI: 10.1038/s41746-022-00661-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 07/22/2022] [Indexed: 12/25/2022] Open
Abstract
The reverse transcription-quantitative polymerase chain reaction (RT-qPCR) approach has been widely used to detect the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, instead of using it alone, clinicians often prefer to diagnose the coronavirus disease 2019 (COVID-19) by utilizing a combination of clinical signs and symptoms, laboratory test, imaging measurement (e.g., chest computed tomography scan), and multivariable clinical prediction models, including the electronic nose. Here, we report on the development and use of a low cost, noninvasive method to rapidly sniff out COVID-19 based on a portable electronic nose (GeNose C19) integrating an array of metal oxide semiconductor gas sensors, optimized feature extraction, and machine learning models. This approach was evaluated in profiling tests involving a total of 615 breath samples composed of 333 positive and 282 negative samples. The samples were obtained from 43 positive and 40 negative COVID-19 patients, respectively, and confirmed with RT-qPCR at two hospitals located in the Special Region of Yogyakarta, Indonesia. Four different machine learning algorithms (i.e., linear discriminant analysis, support vector machine, stacked multilayer perceptron, and deep neural network) were utilized to identify the top-performing pattern recognition methods and to obtain a high system detection accuracy (88–95%), sensitivity (86–94%), and specificity (88–95%) levels from the testing datasets. Our results suggest that GeNose C19 can be considered a highly potential breathalyzer for fast COVID-19 screening.
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23
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Otunuga OM. Analysis of multi-strain infection of vaccinated and recovered population through epidemic model: Application to COVID-19. PLoS One 2022; 17:e0271446. [PMID: 35905113 PMCID: PMC9337708 DOI: 10.1371/journal.pone.0271446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 06/30/2022] [Indexed: 11/19/2022] Open
Abstract
In this work, an innovative multi-strain SV EAIR epidemic model is developed for the study of the spread of a multi-strain infectious disease in a population infected by mutations of the disease. The population is assumed to be completely susceptible to n different variants of the disease, and those who are vaccinated and recovered from a specific strain k (k ≤ n) are immune to previous and present strains j = 1, 2, ⋯, k, but can still be infected by newer emerging strains j = k + 1, k + 2, ⋯, n. The model is designed to simulate the emergence and dissemination of viral strains. All the equilibrium points of the system are calculated and the conditions for existence and global stability of these points are investigated and used to answer the question as to whether it is possible for the population to have an endemic with more than one strain. An interesting result that shows that a strain with a reproduction number greater than one can still die out on the long run if a newer emerging strain has a greater reproduction number is verified numerically. The effect of vaccines on the population is also analyzed and a bound for the herd immunity threshold is calculated. The validity of the work done is verified through numerical simulations by applying the proposed model and strategy to analyze the multi-strains of the COVID-19 virus, in particular, the Delta and the Omicron variants, in the United State.
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24
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Kullmann T, Drozgyik A. Reinfection, recontamination and revaccination for SARS-CoV-2. World J Methodol 2022; 12:258-263. [PMID: 36159102 PMCID: PMC9350730 DOI: 10.5662/wjm.v12.i4.258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/22/2022] [Accepted: 07/11/2022] [Indexed: 02/06/2023] Open
Abstract
The reports on coronavirus disease 2019 (COVID-19) describe the pandemic in waves. Similar to the ocean’s waves, the frequency and amplitude of the number of new cases and the number of deaths were globally quite regular; nevertheless, they showed important regional irregularities and the direction of spread has been generally rather unpredictable for COVID-19. One of the major reasons for the repeated outbreaks is the mutating capacity of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that allows the virus to infect persons who have natural immunity or have been vaccinated. Vaccination began in vast campaigns from the second year of the pandemic that was supposed to decrease the magnitude of the waves. Although it reduced the complications, the expected attenuation of the disease expansion has not yet been met. This paper provides a short overview of the most recent data on the rate of reinfection in vaccinated and non-vaccinated individuals. It points out that testing positive for a second time for SARS-CoV-2 does not necessarily mean a reinfection; it can also be interpreted as recontamination. The symptom free outcome as well as the rapid reconversion of the polymerase chain reaction test may help to determine the difference between reinfection and recontamination. Awareness of this phenomenon may be valuable in times of human resource difficulties. The available evidence may suggest that the protective value of a prior infection could be better considered for vaccine distribution in the future.
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Affiliation(s)
- Tamás Kullmann
- Department of Medical Emergencies, Petz Aladár Hospital, Győr 9024, Hungary
| | - András Drozgyik
- Department of Surgery, Petz Aladár Hospital, Győr 9024, Hungary
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25
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Batchi-Bouyou AL, Djontu JC, Vouvoungui JC, Mfoutou Mapanguy CC, Lobaloba Ingoba L, Mougany JS, Boumpoutou KR, Diafouka-kietela S, Ampa R, Ntoumi F. Assessment of neutralizing antibody responses after natural SARS-CoV-2 infection and vaccination in congolese individuals. BMC Infect Dis 2022; 22:610. [PMID: 35831798 PMCID: PMC9277981 DOI: 10.1186/s12879-022-07593-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 06/13/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Assessing immune responses after vaccination is part of the evaluation package of vaccine effectiveness in the real world. Regarding SARS-CoV-2, neutralizing antibody levels has been shown to be a good indicator of antibody immune response boosting. So far, limited data have been reported from Africa including in Central Africa. The objective of this study was to provide data on anti-S1 spike total IgG and neutralizing antibodies in vaccinated and non-vaccinated including naturally infected Congolese population during B.1.214.1 and B.1.617.2 variant waves. METHODS Recruited patients were divided into 4 groups: (1) Naturally infected by the B.1.214.1 variant on January 2021 and followed up until September 2021. These patients have been vaccinated at month 07 and then followed up for 2 months post vaccination; (2) Naturally infected by the B.1.617.2 variant from June 2021; (3) unvaccinated SARS-CoV-2 individuals with no history of prior SARS-CoV-2 infection; (4) fully vaccinated individuals with sinopharm/BBIP-CorV or Janssen/Ad26.COV2.S. SARS-CoV-2 was detected by qRT-PCR and sequenced using Next-Generation Sequencing. ELISA method was used for detecting IgG, and neutralizing Antibody against SARS-CoV-2 antigens using commercial neutralizing assay. RESULTS Individuals infected by the B.1214.1 variant elicited consistently high IgG titers at 02, 03 and 06 months. Two months post vaccination with BBIP-CorV, participants showed a significant increase by × 2.5 fold (p < 0.0001) of total IgG and X1.5 fold for neutralizing antibody capacity. This study showed that natural infection with B1.617.2 (delta) variant was more immunogenic compared to those being infected with B1.214.2 variant. We found a significantly higher concentration in anti-SARS-CoV-2 IgG (p < 0.0002) and antibodies neutralization capacity (P < 0.0001) in fully vaccinated compared to unvaccinated participants. Two months post vaccination, individuals who received Janssen/Ad26.COV2.S presented higher (p = 0.01) total IgG to spike protein compared to BBIP-CorV. CONCLUSION Both natural infection and vaccination with BBIP-CorV and Janssen/Ad26.COV2.S induced antibody response in Congolese population. In addition, Janssen/Ad26.COV2.S was more immunogenic than Sinopharm/BBIP-CorV. There is a need to investigate the duration of these antibodies both in previously infected and naive vaccinated Congolese to allow public heath stakeholders to make evidence-based decision on vaccine schedule for the Congolese population.
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Affiliation(s)
- Armel Landry Batchi-Bouyou
- Fondation Congolaise pour la Recherche Médicale (FCRM), Villa D6, Campus OMS, Djoué, Brazzaville, Republic of Congo
- Faculty of Sciences and Techniques, University Marien Ngouabi, Brazzaville, Republic of Congo
| | - Jean Claude Djontu
- Fondation Congolaise pour la Recherche Médicale (FCRM), Villa D6, Campus OMS, Djoué, Brazzaville, Republic of Congo
| | | | - Claujens Chastel Mfoutou Mapanguy
- Fondation Congolaise pour la Recherche Médicale (FCRM), Villa D6, Campus OMS, Djoué, Brazzaville, Republic of Congo
- Faculty of Sciences and Techniques, University Marien Ngouabi, Brazzaville, Republic of Congo
| | - Line Lobaloba Ingoba
- Fondation Congolaise pour la Recherche Médicale (FCRM), Villa D6, Campus OMS, Djoué, Brazzaville, Republic of Congo
- Faculty of Sciences and Techniques, University Marien Ngouabi, Brazzaville, Republic of Congo
| | - Jiré Séphora Mougany
- Fondation Congolaise pour la Recherche Médicale (FCRM), Villa D6, Campus OMS, Djoué, Brazzaville, Republic of Congo
- Faculty of Sciences and Techniques, University Marien Ngouabi, Brazzaville, Republic of Congo
| | - Kamal Rauchelvy Boumpoutou
- Fondation Congolaise pour la Recherche Médicale (FCRM), Villa D6, Campus OMS, Djoué, Brazzaville, Republic of Congo
| | - Steve Diafouka-kietela
- Fondation Congolaise pour la Recherche Médicale (FCRM), Villa D6, Campus OMS, Djoué, Brazzaville, Republic of Congo
| | - Raoul Ampa
- Faculty of Sciences and Techniques, University Marien Ngouabi, Brazzaville, Republic of Congo
| | - Francine Ntoumi
- Fondation Congolaise pour la Recherche Médicale (FCRM), Villa D6, Campus OMS, Djoué, Brazzaville, Republic of Congo
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
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26
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Chivese T, Matizanadzo JT, Musa OAH, Hindy G, Furuya-Kanamori L, Islam N, Al-Shebly R, Shalaby R, Habibullah M, Al-Marwani TA, Hourani RF, Nawaz AD, Haider MZ, Emara MM, Cyprian F, Doi SAR. The prevalence of adaptive immunity to COVID-19 and reinfection after recovery - a comprehensive systematic review and meta-analysis. Pathog Glob Health 2022; 116:269-281. [PMID: 35099367 PMCID: PMC9248963 DOI: 10.1080/20477724.2022.2029301] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
This study aims to estimate the prevalence and longevity of detectable SARS-CoV-2 antibodies and T and B memory cells after recovery. In addition, the prevalence of COVID-19 reinfection and the preventive efficacy of previous infection with SARS-CoV-2 were investigated. A synthesis of existing research was conducted. The Cochrane Library, the China Academic Journals Full Text Database, PubMed, and Scopus, and preprint servers were searched for studies conducted between 1 January 2020 to 1 April 2021. Included studies were assessed for methodological quality and pooled estimates of relevant outcomes were obtained in a meta-analysis using a bias adjusted synthesis method. Proportions were synthesized with the Freeman-Tukey double arcsine transformation and binary outcomes using the odds ratio (OR). Heterogeneity was assessed using the I2 and Cochran's Q statistics and publication bias was assessed using Doi plots. Fifty-four studies from 18 countries, with around 12,000,000 individuals, followed up to 8 months after recovery, were included. At 6-8 months after recovery, the prevalence of SARS-CoV-2 specific immunological memory remained high; IgG - 90.4% (95%CI 72.2-99.9, I2 = 89.0%), CD4+ - 91.7% (95%CI 78.2-97.1y), and memory B cells 80.6% (95%CI 65.0-90.2) and the pooled prevalence of reinfection was 0.2% (95%CI 0.0-0.7, I2 = 98.8). Individuals previously infected with SARS-CoV-2 had an 81% reduction in odds of a reinfection (OR 0.19, 95% CI 0.1-0.3, I2 = 90.5%). Around 90% of recovered individuals had evidence of immunological memory to SARS-CoV-2, at 6-8 months after recovery and had a low risk of reinfection.RegistrationPROSPERO: CRD42020201234.
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Affiliation(s)
- Tawanda Chivese
- Department of Population Medicine, College of Medicine, Qu Health, Qatar University, Doha, Qatar,CONTACT Tawanda Chivese ; Department of Population Medicine, College of Medicine, Qu Health, Qatar University, Doha, Qatar
| | - Joshua T. Matizanadzo
- Department of Public Health and Primary Care, Brighton and Sussex Medical School, UK
| | - Omran A. H. Musa
- Department of Population Medicine, College of Medicine, Qu Health, Qatar University, Doha, Qatar
| | - George Hindy
- Department of Population Medicine, College of Medicine, Qu Health, Qatar University, Doha, Qatar
| | - Luis Furuya-Kanamori
- UQ Centre for Clinical Research, The University of Queensland, Herston, Australia
| | - Nazmul Islam
- Department of Public Health, Qu Health, Qatar University, Doha, Qatar
| | - Rafal Al-Shebly
- Department of Population Medicine, College of Medicine, Qu Health, Qatar University, Doha, Qatar
| | - Rana Shalaby
- Department of Population Medicine, College of Medicine, Qu Health, Qatar University, Doha, Qatar
| | - Mohammad Habibullah
- Department of Population Medicine, College of Medicine, Qu Health, Qatar University, Doha, Qatar
| | - Talal A. Al-Marwani
- Department of Population Medicine, College of Medicine, Qu Health, Qatar University, Doha, Qatar
| | - Rizeq F. Hourani
- Department of Population Medicine, College of Medicine, Qu Health, Qatar University, Doha, Qatar
| | - Ahmed D. Nawaz
- Department of Population Medicine, College of Medicine, Qu Health, Qatar University, Doha, Qatar
| | - Mohammad Z. Haider
- Department of Population Medicine, College of Medicine, Qu Health, Qatar University, Doha, Qatar
| | - Mohamed M. Emara
- Immunology Section, Basic Medical Sciences Department, College of Medicine, Qu Health, Qatar University, Doha, Qatar,Microbiology Section, Biomedical and Pharmaceutical Research Unit, Qu Health, Qatar University, Doha, Qatar
| | - Farhan Cyprian
- Immunology Section, Basic Medical Sciences Department, College of Medicine, Qu Health, Qatar University, Doha, Qatar
| | - Suhail A. R. Doi
- Department of Population Medicine, College of Medicine, Qu Health, Qatar University, Doha, Qatar
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27
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Yuguero O, Companys M, Guzmán M, Maciel R, Llobet C, López A, Olles R, Pujol V, Ruiz MJ, Saura M, Vidal C, Godoy P. Epidemiological and clinical characteristics of SARS-CoV-2 reinfections in a Spanish region. SAGE Open Med 2022; 10:20503121221108556. [PMID: 35784672 PMCID: PMC9244920 DOI: 10.1177/20503121221108556] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 06/04/2022] [Indexed: 11/15/2022] Open
Abstract
Objective: We aimed to assess the prevalence and clinical characteristics of SARS-CoV-2 reinfections in a Spanish region. Methods: This is a retrospective observational study in all patients with SARS-CoV-2 infections in the Lleida health region from 1 March to 30 November 2020. Reinfections were classified as patients with positive SARS-CoV-2 PCR tests separated by at least 90 days plus a negative test result between both infection episodes. Primary and secondary outcomes: The primary outcome was the percentage of SARS-CoV-2 reinfections among all SARS-CoV-2 infections detected during our study period. Secondary outcomes were the clinical and sociodemographic characteristics of patients with SARS-CoV-2 reinfections. Results: Of the 27,758 patients diagnosed with SARS-CoV-2 infection in the study period, 14 were identified as coronavirus reinfection (0.050%). Of the reinfected sample, 12 patients (85.7%) were women. The median age was 41.5 years. Two patients died in the second coronavirus episode. Conclusion: The reinfection rate of SARS-CoV-2 in the Spanish region Lleida was relatively low during the observational period in 2020 (less than 1%). These data are in line with the notion that previous SARS-CoV-2 infections may offer a significant protection by so called natural immunity.
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Affiliation(s)
- Oriol Yuguero
- ER LAB, Biomedical Research Institute of Lleida (IRBLleida), Lleida, Spain
- Faculty of Medicine, University of Lleida, Lleida, Spain
| | - Maria Companys
- ER LAB, Biomedical Research Institute of Lleida (IRBLleida), Lleida, Spain
| | - Marianela Guzmán
- ER LAB, Biomedical Research Institute of Lleida (IRBLleida), Lleida, Spain
| | - Rita Maciel
- ER LAB, Biomedical Research Institute of Lleida (IRBLleida), Lleida, Spain
| | - Cecília Llobet
- ER LAB, Biomedical Research Institute of Lleida (IRBLleida), Lleida, Spain
| | - Aurora López
- ER LAB, Biomedical Research Institute of Lleida (IRBLleida), Lleida, Spain
| | - Rebeca Olles
- ER LAB, Biomedical Research Institute of Lleida (IRBLleida), Lleida, Spain
| | - Violant Pujol
- ER LAB, Biomedical Research Institute of Lleida (IRBLleida), Lleida, Spain
| | - Maria José Ruiz
- ER LAB, Biomedical Research Institute of Lleida (IRBLleida), Lleida, Spain
| | - Mireia Saura
- ER LAB, Biomedical Research Institute of Lleida (IRBLleida), Lleida, Spain
| | - Carmel Vidal
- ER LAB, Biomedical Research Institute of Lleida (IRBLleida), Lleida, Spain
| | - Pere Godoy
- Faculty of Medicine, University of Lleida, Lleida, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
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28
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Shalash AO, Toth I, Skwarczynski M. The potential of developing a protective peptide-based vaccines against SARS-CoV-2. Drug Dev Res 2022; 83:1251-1256. [PMID: 35751566 PMCID: PMC9349783 DOI: 10.1002/ddr.21969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/20/2022] [Accepted: 06/14/2022] [Indexed: 12/11/2022]
Abstract
COVID‐19 pandemic has been the deadliest infectious disease outbreak since Spanish flu. The emerging variant lineages, decay of neutralizing antibodies, and occur of reinfections require the development of highly protective and safe vaccines. As currently approved COVID‐19 vaccines that utilize virus‐related genetic material are less than ideal, other vaccine types have been also widely investigated. Among them, peptide‐based vaccines hold great promise in countering COVID‐19 as they may overcome most of the shortcomings of RNA/DNA and protein vaccines. Two basic types of potential peptide vaccines can be developed. The first type are those which rely on cytotoxic T‐cell (CTL) responses to kill infected host cells and stop the replication via employing CTL‐epitopes as vaccine antigens. The second type of peptide vaccines are those that rely on B‐cell peptide epitopes to trigger humoral response via generating SARS‐CoV‐2‐specific antibodies to neutralize and/or opsonize the virus. We propose that combining both cellular and humoral immune responses would be highly protective. Here we discuss opportunities and challenges in the development of an effective and safe peptide‐based vaccine against COVID‐19.
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Affiliation(s)
- Ahmed O Shalash
- School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, Queensland, Australia
| | - Istvan Toth
- School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, Queensland, Australia.,School of Pharmacy, The University of Queensland, Woolloongabba, Queensland, Australia
| | - Mariusz Skwarczynski
- School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, Queensland, Australia
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29
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Abstract
Recurrent updates in non-pharmaceutical interventions (NPIs) aim to control successive waves of the coronavirus disease 2019 (COVID-19) but are often met with low adherence by the public. This study evaluated the effectiveness of gathering restrictions and quarantine policies based on a modified Susceptible-Exposed-Infectious-Hospitalized-Recovered (SEIHR) model by incorporating cross-boundary travellers with or without quarantine to study the transmission dynamics of COVID-19 with data spanning a nine-month period during 2020 in Hong Kong. The asymptotic stability of equilibria reveals that the model exhibits the phenomenon of backward bifurcation, which in this study is a co-existence between a stable disease-free equilibrium (DFE) and an endemic equilibrium (EE). Even if the basic reproduction number ([Formula: see text]) is less than unity, this disease cannot be eliminated. The effect of each parameter on the overall dynamics was assessed using Partial Rank Correlation Coefficients (PRCCs). Transmission rates (i.e., [Formula: see text] and [Formula: see text]), effective contact ratio [Formula: see text] between symptomatic individuals and quarantined people, and transfer rate [Formula: see text] related to infection during quarantine were identified to be the most sensitive parameters. The effective contact ratios between the infectors and susceptible individuals in late July were found to be over twice as high as that in March of 2020, reflecting pandemic fatigue and the potential existence of infection during quarantine.
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30
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Saldaña F, Velasco-Hernández JX. Modeling the COVID-19 pandemic: a primer and overview of mathematical epidemiology. SEMA JOURNAL 2022. [PMCID: PMC8318333 DOI: 10.1007/s40324-021-00260-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Since the start of the still ongoing COVID-19 pandemic, there have been many modeling efforts to assess several issues of importance to public health. In this work, we review the theory behind some important mathematical models that have been used to answer questions raised by the development of the pandemic. We start revisiting the basic properties of simple Kermack-McKendrick type models. Then, we discuss extensions of such models and important epidemiological quantities applied to investigate the role of heterogeneity in disease transmission e.g. mixing functions and superspreading events, the impact of non-pharmaceutical interventions in the control of the pandemic, vaccine deployment, herd-immunity, viral evolution and the possibility of vaccine escape. From the perspective of mathematical epidemiology, we highlight the important properties, findings, and, of course, deficiencies, that all these models have.
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Affiliation(s)
- Fernando Saldaña
- Instituto de Matemáticas, Universidad Nacional Autónoma de México, Campus Juriquilla, 76230, Quéretaro, Mexico
| | - Jorge X. Velasco-Hernández
- Instituto de Matemáticas, Universidad Nacional Autónoma de México, Campus Juriquilla, 76230, Quéretaro, Mexico
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31
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Arslan Y, Akgul F, Sevim B, Varol ZS, Tekin S. Re-infection in COVID-19: Do we exaggerate our worries? Eur J Clin Invest 2022; 52:e13767. [PMID: 35306659 PMCID: PMC9111805 DOI: 10.1111/eci.13767] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/22/2022] [Accepted: 03/06/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Protective long-term immunity following coronavirus disease 2019 (COVID-19) is unclear. The study evaluated the relationship between the vaccination status and risk factors in the re-infection of patients with a diagnosis of COVID-19 who reported to the Public Health Management System in a province in south-eastern Turkey. METHODS Patients with positive results for the severe acute respiratory syndrome coronavirus 2 by the real-time reverse transcription polymerase chain reaction (RT-PCR) test in respiratory samples were defined as confirmed cases. Reinfection was diagnosed in cases with COVID-19 real-time RT-PCR positivity, with or without COVID-19-like symptoms, in at least 90 days after the first infection/disease. RESULTS A total of 58 811 patients with the diagnosis of COVID-19 from March 11, 2020, to August 31, 2021, were included in the study. Re-infection was detected in 421 (0.7%) of all patients. The mean age of the cases was 38.0±16.0 years, and 51% of them were female. Eight (2.0%) of the cases resulted in death due to re-infection. No hospitalization or mortality was observed in fully vaccinated patients. Additionally, none of the mortal cases had completed the vaccination schedule. CONCLUSIONS We are concerned that the re-infection rates and mortality may increase due to new variant strains. Vaccination is the greatest weapon against progression to critical illness in re-infections, even with existing mutations. Therefore, it is important for those without a full vaccination schedule to be vaccinated, even if they have been previously infected.
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Affiliation(s)
- Yusuf Arslan
- Department of Infectious Diseases and Clinical Microbiology, Batman Training and Research Hospital, Batman, Turkey
| | - Fethiye Akgul
- Department of Infectious Diseases and Clinical Microbiology, Batman Training and Research Hospital, Batman, Turkey
| | - Bunyamin Sevim
- Batman Provincial Health Directorate, TR Ministry of Health, Batman, Turkey
| | - Zeynep Sedef Varol
- Public Health Department, Division of Epidemiology, School of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Suda Tekin
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Koç University, Istanbul, Turkey
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Soleimanian S, Alyasin S, Sepahi N, Ghahramani Z, Kanannejad Z, Yaghobi R, Karimi MH. An Update on Protective Effectiveness of Immune Responses After Recovery From COVID-19. Front Immunol 2022; 13:884879. [PMID: 35669767 PMCID: PMC9163347 DOI: 10.3389/fimmu.2022.884879] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 04/20/2022] [Indexed: 12/22/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exhibits variable immunity responses among hosts based on symptom severity. Whether immunity in recovered individuals is effective for avoiding reinfection is poorly understood. Determination of immune memory status against SARS-CoV-2 helps identify reinfection risk and vaccine efficacy. Hence, after recovery from COVID-19, evaluation of protective effectiveness and durable immunity of prior disease could be significant. Recent reports described the dynamics of SARS-CoV-2 -specific humoral and cellular responses for more than six months in convalescent SARS-CoV-2 individuals. Given the current evidence, NK cell subpopulations, especially the memory-like NK cell subset, indicate a significant role in determining COVID-19 severity. Still, the information on the long-term NK cell immunity conferred by SARS-CoV-2 infection is scant. The evidence from vaccine clinical trials and observational studies indicates that hybrid natural/vaccine immunity to SARS-CoV-2 seems to be notably potent protection. We suggested the combination of plasma therapy from recovered donors and vaccination could be effective. This focused review aims to update the current information regarding immune correlates of COVID-19 recovery to understand better the probability of reinfection in COVID-19 infected cases that may serve as guides for ongoing vaccine strategy improvement.
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Affiliation(s)
- Saeede Soleimanian
- Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Soheila Alyasin
- Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Allergy and Clinical Immunology, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Najmeh Sepahi
- Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Ghahramani
- Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Kanannejad
- Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ramin Yaghobi
- Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Gazit S, Shlezinger R, Perez G, Lotan R, Peretz A, Ben-Tov A, Herzel E, Alapi H, Cohen D, Muhsen K, Chodick G, Patalon T. The Incidence of SARS-CoV-2 Reinfection in Persons With Naturally Acquired Immunity With and Without Subsequent Receipt of a Single Dose of BNT162b2 Vaccine : A Retrospective Cohort Study. Ann Intern Med 2022; 175:674-681. [PMID: 35157493 PMCID: PMC8855786 DOI: 10.7326/m21-4130] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND There is insufficient evidence regarding the magnitude and durability of protection conferred by a combined effect of naturally acquired immunity after SARS-CoV-2 infection and vaccine-induced immunity. OBJECTIVE To compare the incidence rate of SARS-CoV-2 reinfection in previously infected persons to that of previously infected persons who subsequently received a single dose of BNT162b2 messenger RNA vaccine. DESIGN A retrospective cohort study emulating a randomized controlled target trial through a series of nested trials. SETTING Nationally centralized database of Maccabi Healthcare Services, Israel. PARTICIPANTS Persons with documented SARS-CoV-2 infection who did not receive subsequent SARS-CoV-2 vaccination were compared with persons with documented SARS-CoV-2 infection who received a single dose of the BNT162b2 vaccine at least 3 months after infection. INTERVENTION Forty-one randomized controlled trials were emulated, in which 107 413 Maccabi Healthcare Services' members aged 16 years and older were eligible for at least 1 trial. MEASUREMENTS SARS-CoV-2-related outcomes of infection, symptomatic disease, hospitalization, and death, between 2 March and 13 December 2021. RESULTS A statistically significant decreased risk (hazard ratio, 0.18 [95% CI, 0.15 to 0.20]) for reinfection was found among persons who were previously infected and then vaccinated versus those who were previously infected but remained unvaccinated. In addition, there was a decreased risk for symptomatic disease (hazard ratio, 0.24 [CI, 0.20 to 0.29]) among previously infected and vaccinated persons compared with those who were not vaccinated after infection. No COVID-19-related mortality cases were found. LIMITATION Hybrid protection against non-Delta variants could not be inferred. CONCLUSION Persons previously infected with SARS-CoV-2 gained additional protection against reinfection and COVID-19 from a subsequent single dose of the BNT162b2 vaccine. Nonetheless, even without a subsequent vaccination, reinfection appeared relatively rare. PRIMARY FUNDING SOURCE None.
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Affiliation(s)
- Sivan Gazit
- Kahn Sagol Maccabi (KSM) Research & Innovation Center and Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel (S.G., T.P.)
| | - Roei Shlezinger
- Kahn Sagol Maccabi (KSM) Research & Innovation Center, Maccabi Healthcare Services, Tel Aviv, Israel (R.S.)
| | - Galit Perez
- Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel (G.P., R.L., E.H., H.A.)
| | - Roni Lotan
- Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel (G.P., R.L., E.H., H.A.)
| | - Asaf Peretz
- Kahn Sagol Maccabi (KSM) Research & Innovation Center, Maccabi Healthcare Services, Tel Aviv, and Internal Medicine COVID-19 Ward, Samson Assuta Ashdod University Hospital, Ashdod, Israel (A.P.)
| | - Amir Ben-Tov
- Kahn Sagol Maccabi (KSM) Research & Innovation Center, Maccabi Healthcare Services, and Sackler Faculty of Medicine, School of Public Health, Tel Aviv University, Tel Aviv, Israel (A.B.)
| | - Esma Herzel
- Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel (G.P., R.L., E.H., H.A.)
| | - Hillel Alapi
- Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel (G.P., R.L., E.H., H.A.)
| | - Dani Cohen
- Sackler Faculty of Medicine, School of Public Health, Tel Aviv University, Tel Aviv, Israel (D.C., K.M.)
| | - Khitam Muhsen
- Sackler Faculty of Medicine, School of Public Health, Tel Aviv University, Tel Aviv, Israel (D.C., K.M.)
| | - Gabriel Chodick
- Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, and Sackler Faculty of Medicine, School of Public Health, Tel Aviv University, Tel Aviv, Israel (G.C.)
| | - Tal Patalon
- Kahn Sagol Maccabi (KSM) Research & Innovation Center and Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel (S.G., T.P.)
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Gazit S, Shlezinger R, Perez G, Lotan R, Peretz A, Ben-Tov A, Herzel E, Alapi H, Cohen D, Muhsen K, Chodick G, Patalon T. SARS-CoV-2 Naturally Acquired Immunity vs. Vaccine-induced Immunity, Reinfections versus Breakthrough Infections: a Retrospective Cohort Study. Clin Infect Dis 2022; 75:e545-e551. [PMID: 35380632 PMCID: PMC9047157 DOI: 10.1093/cid/ciac262] [Citation(s) in RCA: 87] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Indexed: 01/01/2023] Open
Abstract
Background Waning of protection against infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) conferred by 2 doses of the BNT162b2 vaccine begins shortly after inoculation and becomes substantial within 4 months. With that, the impact of prior infection on incident SARS-CoV-2 reinfection is unclear. Therefore, we examined the long-term protection of naturally acquired immunity (protection conferred by previous infection) compared to vaccine-induced immunity. Methods A retrospective observational study of 124 500 persons, compared 2 groups: (1) SARS-CoV-2-naive individuals who received a 2-dose regimen of the BioNTech/Pfizer mRNA BNT162b2 vaccine, and (2) previously infected individuals who have not been vaccinated. Two multivariate logistic regression models were applied, evaluating four SARS-CoV-2-related outcomes—infection, symptomatic disease (coronavirus disease 2019 [COVID-19]), hospitalization, and death—between 1 June and 14 August 2021, when the Delta variant was dominant in Israel. Results SARS-CoV-2-naive vaccinees had a 13.06-fold (95% confidence interval [CI], 8.08–21.11) increased risk for breakthrough infection with the Delta variant compared to unvaccinated-previously-infected individuals, when the first event (infection or vaccination) occurred during January and February of 2021. The increased risk was significant for symptomatic disease as well. When allowing the infection to occur at any time between March 2020 and February 2021, evidence of waning naturally acquired immunity was demonstrated, although SARS-CoV-2 naive vaccinees still had a 5.96-fold (95% CI: 4.85–7.33) increased risk for breakthrough infection and a 7.13-fold (95% CI: 5.51–9.21) increased risk for symptomatic disease. Conclusions Naturally acquired immunity confers stronger protection against infection and symptomatic disease caused by the Delta variant of SARS-CoV-2, compared to the BNT162b2 2-dose vaccine-indued immunity.
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Affiliation(s)
- Sivan Gazit
- Kahn Sagol Maccabi (KSM) Research & Innovation Center, Maccabi Healthcare Services, Tel Aviv, 68125, Israel.,Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Israel
| | - Roei Shlezinger
- Kahn Sagol Maccabi (KSM) Research & Innovation Center, Maccabi Healthcare Services, Tel Aviv, 68125, Israel
| | - Galit Perez
- Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Israel
| | - Roni Lotan
- Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Israel
| | - Asaf Peretz
- Kahn Sagol Maccabi (KSM) Research & Innovation Center, Maccabi Healthcare Services, Tel Aviv, 68125, Israel.,Internal Medicine COVID-19 Ward, Samson Assuta Ashdod University Hospital, Ashdod Israel
| | - Amir Ben-Tov
- Kahn Sagol Maccabi (KSM) Research & Innovation Center, Maccabi Healthcare Services, Tel Aviv, 68125, Israel.,Sackler Faculty of Medicine, School of Public Health, Tel Aviv University, Tel Aviv, Israel
| | - Esma Herzel
- Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Israel
| | - Hillel Alapi
- Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Israel
| | - Dani Cohen
- Sackler Faculty of Medicine, School of Public Health, Tel Aviv University, Tel Aviv, Israel
| | - Khitam Muhsen
- Sackler Faculty of Medicine, School of Public Health, Tel Aviv University, Tel Aviv, Israel
| | - Gabriel Chodick
- Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Israel.,Sackler Faculty of Medicine, School of Public Health, Tel Aviv University, Tel Aviv, Israel
| | - Tal Patalon
- Kahn Sagol Maccabi (KSM) Research & Innovation Center, Maccabi Healthcare Services, Tel Aviv, 68125, Israel.,Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Israel
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Mohamed K, Rzymski P, Islam MS, Makuku R, Mushtaq A, Khan A, Ivanovska M, Makka SA, Hashem F, Marquez L, Cseprekal O, Filgueiras IS, Fonseca DLM, Mickael E, Ling I, Arero AG, Cuschieri S, Minakova K, Rodríguez‐Román E, Abarikwu SO, Faten A, Grancini G, Cabral‐Marques O, Rezaei N. COVID-19 vaccinations: The unknowns, challenges, and hopes. J Med Virol 2022; 94:1336-1349. [PMID: 34845731 PMCID: PMC9015467 DOI: 10.1002/jmv.27487] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/26/2021] [Accepted: 11/28/2021] [Indexed: 12/25/2022]
Abstract
The entire world has been suffering from the coronavirus disease 2019 (COVID-19) pandemic since March 11, 2020. More than a year later, the COVID-19 vaccination brought hope to control this viral pandemic. Here, we review the unknowns of the COVID-19 vaccination, such as its longevity, asymptomatic spread, long-term side effects, and its efficacy on immunocompromised patients. In addition, we discuss challenges associated with the COVID-19 vaccination, such as the global access and distribution of vaccine doses, adherence to hygiene guidelines after vaccination, the emergence of novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants, and vaccine resistance. Despite all these challenges and the fact that the end of the COVID-19 pandemic is still unclear, vaccines have brought great hope for the world, with several reports indicating a significant decline in the risk of COVID19-related infection and hospitalizations.
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Affiliation(s)
- Kawthar Mohamed
- School of Medicine, Tehran University of Medical SciencesTehranIran
- Universal Scientific Education and Research Network (USERN)ManamaBahrain
| | - Piotr Rzymski
- Department of Environmental MedicinePoznań University of Medical SciencesPoznańPoland
- Universal Scientific Education and Research Network (USERN)PoznańPoland
| | - Md Shahidul Islam
- Department of Tissue Engineering and Applied Cell SciencesSchool of Advanced Technologies in Medicine, Tehran University of Medical SciencesTehranIran
- Universal Scientific Education and Research Network (USERN)DhakaBangladesh
| | - Rangarirai Makuku
- School of Medicine, Tehran University of Medical SciencesTehranIran
- Universal Scientific Education and Research Network (USERN)HarareZimbabwe
| | - Ayesha Mushtaq
- International Higher School of Medicine, International University of KyrgyzstanBishkekKyrgyzstan
- Universal Scientific Education and Research Network (USERN)BishkekKyrgyzstan
| | - Amjad Khan
- Department of PharmacyQuaid‐i‐Azam UniversityIslamabadPakistan
- Universal Scientific Education and Research Network (USERN)IslamabadPakistan
| | - Mariya Ivanovska
- Department of Microbiology and ImmunologyResearch Center, Medical UniversityPlovdivBulgaria
- Universal Scientific Education and Research Network (USERN)PlovdivBulgaria
| | - Sara A. Makka
- Neuroscience Research Center, Faculty of Medical SciencesLebanese UniversityBeirutLebanon
- Universal Scientific Education and Research Network (USERN)BeirutLebanon
| | - Fareeda Hashem
- School of Medicine, Tehran University of Medical SciencesTehranIran
- Universal Scientific Education and Research Network (USERN)ManamaBahrain
| | - Leander Marquez
- College of Social Sciences and PhilosophyUniversity of the Philippines DilimanQuezon CityPhilippines
- Universal Scientific Education and Research Network (USERN)Quezon CityPhilippines
| | - Orsolya Cseprekal
- Department of Transplantation and SurgerySemmelweis UniversityBudapestHungary
- Universal Scientific Education and Research Network (USERN)BudapestHungary
| | - Igor Salerno Filgueiras
- Department of ImmunologyInstitute of Biomedical Sciences, University of São PauloSão PauloBrazil
- Universal Scientific Education and Research Network (USERN)São PauloBrazil
| | - Dennyson Leandro M. Fonseca
- Universal Scientific Education and Research Network (USERN)São PauloBrazil
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical SciencesUniversity of São PauloSão PauloBrazil
| | - Essouma Mickael
- Department of Rheumatology and Physical Medicine, Erasme HospitalUniversité Libre de BruxellesBrusselsBelgium
- Universal Scientific Education and Research Network (USERN)YaoundéCameroon
| | - Irene Ling
- School of Science, Monash University MalasiaJalan Lagoon SelatanDarul EhsanSelangorMalaysia
- Universal Scientific Education and Research Network (USERN)Darul EhsanSelangorMalaysia
| | - Amanuel Godana Arero
- School of Medicine, Tehran University of Medical SciencesTehranIran
- Universal Scientific Education and Research Network (USERN)Addis AbabaEthiopia
| | - Sarah Cuschieri
- Faculty of Medicine and SurgeryUniversity of MaltaMsidaMalta
- Universal Scientific Education and Research Network (USERN)VallettaMalta
| | - Kseniia Minakova
- National Technical University "Kharkiv Polytechnic Institute"KharkivUkraine
- Universal Scientific Education and Research Network (USERN)KyivUkraine
| | - Eduardo Rodríguez‐Román
- Center for Microbiology and Cell BiologyInstituto Venezolano de Investigaciones CientíficasCaracasVenezuela
- Universal Scientific Education and Research Network (USERN)CaracasVenezuela
| | - Sunny O. Abarikwu
- Department of BiochemistryUniversity of Port HarcourtChobaNigeria
- Universal Scientific Education and Research Network (USERN)ChobaNigeria
| | - Attig‐Bahar Faten
- Tunisia Polytechnic SchoolUniversity of CarthageTunisTunisia
- Universal Scientific Education and Research Network (USERN)TunisTunisia
| | - Giulia Grancini
- Department of ChemistryPhysical Chemistry Unit, University of PaviaPaviaItaly
- Universal Scientific Education and Research Network (USERN)PaviaItaly
| | - Otavio Cabral‐Marques
- Department of ImmunologyInstitute of Biomedical Sciences, University of São PauloSão PauloBrazil
- Universal Scientific Education and Research Network (USERN)São PauloBrazil
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical SciencesUniversity of São PauloSão PauloBrazil
| | - Nima Rezaei
- School of Medicine, Tehran University of Medical SciencesTehranIran
- Research Center for Immunodeficiencies, Children's Medical CenterTehran University of Medical SciencesTehranIran
- Universal Scientific Education and Research Network (USERN)TehranIran
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Akpan GE, Bawo L, Amo-Addae M, Kennedy J, Wesseh CS, Whesseh F, Adewuyi P, Sanvee-Blebo L, Babalola J, Sesay HWW, Yeabah TO, Jackson D, Shannon F, Umeokonkwo CD, Nyenswah AW, Macauley J, Jallah W. COVID-19 reinfection in Liberia: Implication for improving disease surveillance. PLoS One 2022; 17:e0265768. [PMID: 35324956 PMCID: PMC8947140 DOI: 10.1371/journal.pone.0265768] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 03/07/2022] [Indexed: 11/18/2022] Open
Abstract
COVID-19 remains a serious disruption to human health, social, and economic existence. Reinfection with the virus intensifies fears and raises more questions among countries, with few documented reports. This study investigated cases of COVID-19 reinfection using patients’ laboratory test results between March 2020 and July 2021 in Liberia. Data obtained from Liberia’s Ministry of Health COVID-19 surveillance was analyzed in Excel 365 and ArcGIS Pro 2.8.2. Results showed that with a median interval of 200 days (Range: 99–415), 13 out of 5,459 cases were identified and characterized as reinfection in three counties during the country’s third wave of the outbreak. Eighty-six percent of the COVID-19 reinfection cases occurred in Montserrado County within high clusters, which accounted for over 80% of the randomly distributed cases in Liberia. More cases of reinfection occurred among international travelers within populations with high community transmissions. This study suggests the need for continued public education and surveillance to encourage longer-term COVID-19 preventive practices even after recovery.
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Affiliation(s)
- Godwin E. Akpan
- Division of Field Epidemiology Training Program, African Field Epidemiology Network, Monrovia, Liberia
- * E-mail:
| | - Luke Bawo
- Department of Planning, Research and Development, Ministry of Health, Monrovia, Liberia
| | - Maame Amo-Addae
- Division of Field Epidemiology Training Program, African Field Epidemiology Network, Monrovia, Liberia
| | - Jallah Kennedy
- Office of the Executive Director, Roads To Health (Roads to Rural and Vulnerable Population Health), Galloway, New Jersey, United States of America
| | - C. Sanford Wesseh
- Department of Planning, Research and Development, Ministry of Health, Monrovia, Liberia
| | - Faith Whesseh
- Division of Field Epidemiology Training Program, African Field Epidemiology Network, Monrovia, Liberia
| | - Peter Adewuyi
- Division of Field Epidemiology Training Program, African Field Epidemiology Network, Monrovia, Liberia
| | - Lily Sanvee-Blebo
- Division of Field Epidemiology Training Program, African Field Epidemiology Network, Monrovia, Liberia
| | - Joseph Babalola
- Division of Field Epidemiology Training Program, African Field Epidemiology Network, Monrovia, Liberia
| | - Himiede W. W. Sesay
- Division of Field Epidemiology Training Program, African Field Epidemiology Network, Monrovia, Liberia
| | - Trokon O. Yeabah
- Division of Infectious Disease and Epidemiology, National Public Health Institute of Liberia, Monrovia, Liberia
| | - Dikena Jackson
- Department of Planning, Research and Development, Ministry of Health, Monrovia, Liberia
| | - Fulton Shannon
- Department of Planning, Research and Development, Ministry of Health, Monrovia, Liberia
| | - Chukwuma David Umeokonkwo
- Division of Field Epidemiology Training Program, African Field Epidemiology Network, Monrovia, Liberia
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | - Abraham W. Nyenswah
- Division of Infectious Disease and Epidemiology, National Public Health Institute of Liberia, Monrovia, Liberia
| | - Jane Macauley
- Office of the Director General, National Public Health Institute of Liberia, Monrovia, Liberia
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Massonnaud CR, Roux J, Colizza V, Crépey P. Evaluating COVID-19 Booster Vaccination Strategies in a Partially Vaccinated Population: A Modeling Study. Vaccines (Basel) 2022; 10:479. [PMID: 35335111 PMCID: PMC8952850 DOI: 10.3390/vaccines10030479] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/15/2022] [Accepted: 03/17/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Several countries are implementing COVID-19 booster vaccination campaigns. The objective of this study was to model the impact of different primary and booster vaccination strategies. METHODS We used a compartmental model fitted to hospital admission data in France to analyze the impact of primary and booster vaccination strategies on morbidity and mortality, assuming waning of immunity and various levels of virus transmissibility during winter. RESULTS Strategies prioritizing primary vaccinations were systematically more effective than strategies prioritizing boosters. Regarding booster strategies targeting different age groups, their effectiveness varied with immunity and virus transmissibility levels. If the waning of immunity affects all adults, people aged 30 to 49 years should be boosted in priority, even for low transmissibility levels. CONCLUSIONS Increasing the primary vaccination coverage should remain a priority. If a plateau has been reached, boosting the immunity of younger adults could be the most effective strategy, especially if SARS-CoV-2 transmissibility is high.
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Affiliation(s)
- Clément R. Massonnaud
- RSMS—U 1309, ARENES—UMR 6051, EHESP, CNRS, Inserm, Université de Rennes, 35043 Rennes, France; (C.R.M.); (J.R.)
- Biostatistics Unit, University Hospital Charles Nicolle, 76000 Rouen, France
| | - Jonathan Roux
- RSMS—U 1309, ARENES—UMR 6051, EHESP, CNRS, Inserm, Université de Rennes, 35043 Rennes, France; (C.R.M.); (J.R.)
| | - Vittoria Colizza
- Institut National de la Santé Et de la Recherche Médicale (INSERM), Institut Pierre Louis d’Épidémiologie et de Santé Publique (IPLESP), Sorbonne Université, 75014 Paris, France;
| | - Pascal Crépey
- RSMS—U 1309, ARENES—UMR 6051, EHESP, CNRS, Inserm, Université de Rennes, 35043 Rennes, France; (C.R.M.); (J.R.)
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Cooper I, Mondal A, Antonopoulos CG, Mishra A. Dynamical analysis of the infection status in diverse communities due to COVID-19 using a modified SIR model. NONLINEAR DYNAMICS 2022; 109:19-32. [PMID: 35340759 PMCID: PMC8933770 DOI: 10.1007/s11071-022-07347-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 03/05/2022] [Indexed: 06/14/2023]
Abstract
In this article, we model and study the spread of COVID-19 in Germany, Japan, India and highly impacted states in India, i.e., in Delhi, Maharashtra, West Bengal, Kerala and Karnataka. We consider recorded data published in Worldometers and COVID-19 India websites from April 2020 to July 2021, including periods of interest where these countries and states were hit severely by the pandemic. Our methodology is based on the classic susceptible-infected-removed (SIR) model and can track the evolution of infections in communities, i.e., in countries, states or groups of individuals, where we (a) allow for the susceptible and infected populations to be reset at times where surges, outbreaks or secondary waves appear in the recorded data sets, (b) consider the parameters in the SIR model that represent the effective transmission and recovery rates to be functions of time and (c) estimate the number of deaths by combining the model solutions with the recorded data sets to approximate them between consecutive surges, outbreaks or secondary waves, providing a more accurate estimate. We report on the status of the current infections in these countries and states, and the infections and deaths in India and Japan. Our model can adapt to the recorded data and can be used to explain them and importantly, to forecast the number of infected, recovered, removed and dead individuals, as well as it can estimate the effective infection and recovery rates as functions of time, assuming an outbreak occurs at a given time. The latter information can be used to forecast the future basic reproduction number and together with the forecast on the number of infected and dead individuals, our approach can further be used to suggest the implementation of intervention strategies and mitigation policies to keep at bay the number of infected and dead individuals. This, in conjunction with the implementation of vaccination programs worldwide, can help reduce significantly the impact of the spread around the world and improve the wellbeing of people.
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Affiliation(s)
- Ian Cooper
- School of Physics, The University of Sydney, Sydney, Australia
| | - Argha Mondal
- Department of Mathematics, Sidho-Kanho-Birsha University, Purulia, West Bengal 723104 India
- Department of Mathematical Sciences, University of Essex, Wivenhoe Park, Colchester, UK
| | - Chris G. Antonopoulos
- Department of Mathematical Sciences, University of Essex, Wivenhoe Park, Colchester, UK
| | - Arindam Mishra
- Division of Dynamics, Technical University of Lodz, Stefanowskiego 1/15, 90-924 Lodz, Poland
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Manica M, Pancheri S, Poletti P, Giovanazzi G, Guzzetta G, Trentini F, Marziano V, Ajelli M, Grazia Zuccali M, Benetollo PP, Merler S, Ferro A. Risk of Symptomatic Infection During a Second Coronavirus Disease 2019 Wave in Severe Acute Respiratory Syndrome Coronavirus 2-Seropositive Individuals. Clin Infect Dis 2022; 74:893-896. [PMID: 34134145 PMCID: PMC8406865 DOI: 10.1093/cid/ciab556] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Indexed: 02/06/2023] Open
Abstract
We analyzed 221 coronavirus disease 2019 cases identified between June 2020 and January 2021 in 6074 individuals screened for immunoglobulin G antibodies in May 2020, representing 77% of residents of 5 Italian municipalities. The relative risk of developing symptomatic infection in seropositive participants was 0.055 (95% confidence interval, .014-.220).
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Affiliation(s)
- Mattia Manica
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy
| | - Serena Pancheri
- Department of Prevention, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
| | - Piero Poletti
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy
| | - Giulia Giovanazzi
- Department of Prevention, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
| | - Giorgio Guzzetta
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy
| | - Filippo Trentini
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy
| | | | - Marco Ajelli
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health, Bloomington, Indiana, USA
- Laboratory for the Modeling of Biological and Socio-technical Systems, Northeastern University, Boston, Massachusetts, USA
| | - Maria Grazia Zuccali
- Department of Prevention, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
| | - Pier Paolo Benetollo
- Department of Prevention, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
| | - Stefano Merler
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy
| | - Antonio Ferro
- Department of Prevention, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
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Churiso G, Diriba K, Girma H, Tafere S. Clinical Features and Time to Recovery of Admitted COVID-19 Cases at Dilla University Referral Hospital Treatment Center, South Ethiopia. Infect Drug Resist 2022; 15:795-806. [PMID: 35281575 PMCID: PMC8904438 DOI: 10.2147/idr.s356606] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 02/15/2022] [Indexed: 12/23/2022] Open
Abstract
Background Since coronavirus disease 2019 emergence, millions were infected and many were dying because of the virus. Clinical features and time to recovery of admitted clients vary across settings. Therefore showing clinical features and recovery time from COVID-19 in a different setting is necessary to design appropriate treatment and preventive measures. So, this study attempted to investigate the clinical features and time to recovery of admitted clients to Dilla University Referral Hospital treatment center, Ethiopia. Methods A retrospective study design was conducted in 220 patients confirmed by real time polymerase chain reaction and admitted to Dilla University Referral Hospital treatment center from September 2020 to July 2021. Data were collected from the patients' record. Data entry was done by an Epi-Info version 7.2.1.0 and analyzed by Statistical Package for the Social Sciences version 25 software. Descriptive statistics were used for clinical features, and median time to recovery was computed by using Kaplan-Meier. Results Common clinical features were cough 209 (95%), shortness of breath 153 (69.5%), fever 133 (60.5%), headache 75 (34.1%), easy fatigue 68 (30.9%), joint pain 56 (25.5%), tachypnea 197 (89.5%), hypoxia 95 (43.2%), and tachycardia 83 (37.7%). The overall median recovery time for admitted cases was 5 days. There was significant difference between recovery probability of severe and moderate cases, severe and mild cases (p=0.00), who had normal body temperature and hypothermic (p=0.05), who had normal breathing rate and bradypnea patients (p= 0.014). Conclusion COVID-19 patients frequently show cough, shortness of breath, fever, headache, easy fatigue and joint pain. Median time to recovery was 5 days. Having a normal body temperature, normal breathing rate, and severe disease status had statistically significant association with median recovery time. So, close follow up is required for client admitted with severe disease.
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Affiliation(s)
- Gemechu Churiso
- Department of Medical Laboratory Sciences, Dilla University, Dilla, Ethiopia
| | - Kuma Diriba
- Department of Medical Laboratory Sciences, Dilla University, Dilla, Ethiopia
| | - Henok Girma
- Ohio State University, Global One Health Initiative, Dilla, Ethiopia
| | - Soressa Tafere
- COVID-19 Treatment Center, Dilla University, Dilla, Ethiopia
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Bechmann N, Barthel A, Schedl A, Herzig S, Varga Z, Gebhard C, Mayr M, Hantel C, Beuschlein F, Wolfrum C, Perakakis N, Poston L, Andoniadou CL, Siow R, Gainetdinov RR, Dotan A, Shoenfeld Y, Mingrone G, Bornstein SR. Sexual dimorphism in COVID-19: potential clinical and public health implications. Lancet Diabetes Endocrinol 2022; 10:221-230. [PMID: 35114136 PMCID: PMC8803381 DOI: 10.1016/s2213-8587(21)00346-6] [Citation(s) in RCA: 79] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 11/16/2021] [Accepted: 12/03/2021] [Indexed: 01/19/2023]
Abstract
Current evidence suggests that severity and mortality of COVID-19 is higher in men than in women, whereas women might be at increased risk of COVID-19 reinfection and development of long COVID. Differences between sexes have been observed in other infectious diseases and in the response to vaccines. Sex-specific expression patterns of proteins mediating virus binding and entry, and divergent reactions of the immune and endocrine system, in particular the hypothalamic-pituitary-adrenal axis, in response to acute stress might explain the higher severity of COVID-19 in men. In this Personal View, we discuss how sex hormones, comorbidities, and the sex chromosome complement influence these mechanisms in the context of COVID-19. Due to its role in the severity and progression of SARS-CoV-2 infections, we argue that sexual dimorphism has potential implications for disease treatment, public health measures, and follow-up of patients predisposed to the development of long COVID. We suggest that sex differences could be considered in future pandemic surveillance and treatment of patients with COVID-19 to help to achieve better disease stratification and improved outcomes.
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Affiliation(s)
- Nicole Bechmann
- Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Andreas Barthel
- Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; Medicover Bochum, Bochum, Germany
| | - Andreas Schedl
- Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; Université Côte d'Azur, INSERM, CNRS, iBV, Nice, France
| | - Stephan Herzig
- Institute for Diabetes and Cancer (IDC), Helmholtz Center Munich, Joint Heidelberg-IDC Translational Diabetes Program Inner Medicine I, Neuherberg, Germany
| | - Zsuzsanna Varga
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Catherine Gebhard
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland; Center for Molecular Cardiology, University of Zurich, Zurich, Switzerland
| | - Manuel Mayr
- Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; King's British Heart Foundation Centre of Research Excellence, School of Cardiovascular Medicine and Sciences, King's College London, London, UK
| | - Constanze Hantel
- Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich (USZ) and University of Zurich (UZH), Zurich, Switzerland
| | - Felix Beuschlein
- Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich (USZ) and University of Zurich (UZH), Zurich, Switzerland; Department for Endocrinology, Medizinische Klinik und Poliklinik IV, Ludwig-Maximilians-University, Munich, Germany
| | - Christian Wolfrum
- Institute of Food, Nutrition and Health, ETH Zürich, Schwerzenbach, Switzerland
| | - Nikolaos Perakakis
- Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Lucilla Poston
- Division of Women's Health, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Cynthia L Andoniadou
- Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; Centre for Craniofacial and Regenerative Biology, Faculty of Dental, Oral, and Craniofacial Sciences, King's College London, London, UK
| | - Richard Siow
- King's British Heart Foundation Centre of Research Excellence, School of Cardiovascular Medicine and Sciences, King's College London, London, UK; Vascular Biology and Inflammation Section, School of Cardiovascular Medicine and Sciences, King's College London, London, UK
| | - Raul R Gainetdinov
- Institute of Translational Biomedicine and St Petersburg University Hospital, St Petersburg State University, St Petersburg, Russia
| | - Arad Dotan
- The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Ramat Gan, Israel
| | - Yehuda Shoenfeld
- The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Ramat Gan, Israel; Ariel University, Ariel, Israel
| | - Geltrude Mingrone
- Department of Diabetes, School of Life Course Science and Medicine, King's College London, London, UK; Fondazione Policlinico Universitario Agostino Gemelli Istituto Di Ricovero e Cura a Carattere Scientifico, Rome, Italy; Department of Internal Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Stefan R Bornstein
- Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; Department of Diabetes, School of Life Course Science and Medicine, King's College London, London, UK.
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Reynolds SL, Kaufman HW, Meyer WA, Bush C, Cohen O, Cronin K, Kabelac C, Leonard S, Anderson S, Petkov V, Lowy D, Sharpless N, Penberthy L. Duration of Protection Against SARS-CoV-2 Reinfection and Associated Risk of Reinfection Assessed with Real-World Data. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022. [PMID: 35233580 PMCID: PMC8887071 DOI: 10.1101/2022.02.25.22271515] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
IMPORTANCE Better understanding of the protective duration of prior SARS-CoV-2 infection against reinfection is needed. OBJECTIVE Primary: To assess the durability of immunity to SARS-CoV-2 reinfection among initially unvaccinated individuals with previous SARS-CoV-2 infection. Secondary: Evaluate the crude SARS-CoV-2 reinfection rate and associated characteristics. DESIGN AND SETTING Retrospective observational study of HealthVerity data among 144,678,382 individuals, during the pandemic era through April 2021. PARTICIPANTS Individuals studied had SARS-CoV-2 molecular diagnostic or antibody index test results from February 29 through December 9, 2020, with ≥365 days of pre-index continuous closed medical enrollment, claims, or electronic health record activity. MAIN OUTCOMES AND MEASURES Rates of reinfection among index-positive individuals were compared to rates of infection among index-negative individuals. Factors associated with reinfection were evaluated using multivariable logistic regression. For both objectives, the outcome was a subsequent positive molecular diagnostic test result. RESULTS Among 22,786,982 individuals with index SARS-CoV-2 laboratory test data (2,023,341 index positive), the crude rate of reinfection during follow-up was significantly lower (9.89/1,000-person years) than that of primary infection (78.39/1,000 person years). Consistent with prior findings, the risk of reinfection among index-positive individuals was 87% lower than the risk of infection among index-negative individuals (hazard ratio, 0.13; 95% CI, 0.13, 0.13). The cumulative incidence of reinfection among index-positive individuals and infection among index-negative individuals was 0.85% (95% CI: 0.82%, 0.88%) and 6.2% (95% CI: 6.1%, 6.3%), respectively, over follow-up of 375 days. The duration of protection against reinfection was stable over the median 5 months and up to 1-year follow-up interval. Factors associated with an increased reinfection risk included older age, comorbid immunologic conditions, and living in congregate care settings; healthcare workers had a decreased reinfection risk. CONCLUSIONS AND RELEVANCE This large US population-based study demonstrates that SARS-CoV-2 reinfection is uncommon among individuals with laboratory evidence of a previous infection. Protection from SARS-CoV-2 reinfection is stable up to one year. Reinfection risk was primarily associated with age 85+ years, comorbid immunologic conditions and living in congregate care settings; healthcare workers demonstrated a decreased reinfection risk. These findings suggest that infection induced immunity is durable for variants circulating prior to Delta. KEY POINTS Question: How long does prior SARS-CoV-2 infection provide protection against SARS-CoV-2 reinfection?Finding: Among >22 million individuals tested February 2020 through April 2021, the relative risk of reinfection among those with prior infection was 87% lower than the risk of infection among individuals without prior infection. This protection was durable for up to a year. Factors associated with increased likelihood of reinfection included older age (85+ years), comorbid immunologic conditions, and living in congregate care settings; healthcare workers had lower risk.Meaning: Prior SARS-CoV-2 infection provides a durable, high relative degree of protection against reinfection.
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Developing an Effective Peptide-Based Vaccine for COVID-19: Preliminary Studies in Mice Models. Viruses 2022; 14:v14030449. [PMID: 35336856 PMCID: PMC8954996 DOI: 10.3390/v14030449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 02/12/2022] [Accepted: 02/21/2022] [Indexed: 02/06/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) has caused massive health and economic disasters worldwide. Although several vaccines have effectively slowed the spread of the virus, their long-term protection and effectiveness against viral variants are still uncertain. To address these potential shortcomings, this study proposes a peptide-based vaccine to prevent COVID-19. A total of 15 B cell epitopes of the wild-type severe acute respiratory coronavirus 2 (SARS-CoV-2) spike (S) protein were selected, and their HLA affinities predicted in silico. Peptides were divided into two groups and tested in C57BL/6 mice with either QS21 or Al(OH)3 as the adjuvant. Our results demonstrated that the peptide-based vaccine stimulated high and durable antibody responses in mice, with the T and B cell responses differing based on the type of adjuvant employed. Using epitope mapping, we showed that our peptide-based vaccine produced antibody patterns similar to those in COVID-19 convalescent individuals. Moreover, plasma from vaccinated mice and recovered COVID-19 humans had the same neutralizing activity when tested with a pseudo particle assay. Our data indicate that this adjuvant peptide-based vaccine can generate sustainable and effective B and T cell responses. Thus, we believe that our peptide-based vaccine can be a safe and effective vaccine against COVID-19, particularly because of the flexibility of including new peptides to prevent emerging SARS-CoV-2 variants and avoiding unwanted autoimmune responses.
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Lin L, Zhao Y, Chen B, He D. Multiple COVID-19 Waves and Vaccination Effectiveness in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2282. [PMID: 35206474 PMCID: PMC8871705 DOI: 10.3390/ijerph19042282] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 02/10/2022] [Accepted: 02/15/2022] [Indexed: 01/27/2023]
Abstract
(1) Background: The coronavirus 2019 (COVID-19) pandemic has caused multiple waves of cases and deaths in the United States (US). The wild strain, the Alpha variant (B.1.1.7) and the Delta variant (B.1.617.2) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were the principal culprits behind these waves. To mitigate the pandemic, the vaccination campaign was started in January 2021. While the vaccine efficacy is less than 1, breakthrough infections were reported. This work aims to examine the effects of the vaccination across 50 US states and the District of Columbia. (2) Methods: Based on the classic Susceptible-Exposed-Infectious-Recovered (SEIR) model, we add a delay class between infectious and death, a death class and a vaccinated class. We compare two special cases of our new model to simulate the effects of the vaccination. The first case expounds the vaccinated individuals with full protection or not, compared to the second case where all vaccinated individuals have the same level of protection. (3) Results: Through fitting the two approaches to reported COVID-19 deaths in all 50 US states and the District of Columbia, we found that these two approaches are equivalent. We calculate that the death toll could be 1.67-3.33 fold in most states if the vaccine was not available. The median and mean infection fatality ratio are estimated to be approximately 0.6 and 0.7%. (4) Conclusions: The two approaches we compared were equivalent in evaluating the effectiveness of the vaccination campaign in the US. In addition, the effect of the vaccination campaign was significant, with a large number of deaths averted.
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Affiliation(s)
| | | | | | - Daihai He
- Department of Applied Mathematics, The Hong Kong Polytechnic University, Hong Kong, China; (L.L.); (Y.Z.); (B.C.)
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Natarajan H, Xu S, Crowley AR, Butler SE, Weiner JA, Bloch EM, Littlefield K, Benner SE, Shrestha R, Ajayi O, Wieland-Alter W, Sullivan D, Shoham S, Quinn TC, Casadevall A, Pekosz A, Redd AD, Tobian AAR, Connor RI, Wright PF, Ackerman ME. Antibody attributes that predict the neutralization and effector function of polyclonal responses to SARS-CoV-2. BMC Immunol 2022; 23:7. [PMID: 35172720 PMCID: PMC8851712 DOI: 10.1186/s12865-022-00480-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 02/07/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND While antibodies can provide significant protection from SARS-CoV-2 infection and disease sequelae, the specific attributes of the humoral response that contribute to immunity are incompletely defined. METHODS We employ machine learning to relate characteristics of the polyclonal antibody response raised by natural infection to diverse antibody effector functions and neutralization potency with the goal of generating both accurate predictions of each activity based on antibody response profiles as well as insights into antibody mechanisms of action. RESULTS To this end, antibody-mediated phagocytosis, cytotoxicity, complement deposition, and neutralization were accurately predicted from biophysical antibody profiles in both discovery and validation cohorts. These models identified SARS-CoV-2-specific IgM as a key predictor of neutralization activity whose mechanistic relevance was supported experimentally by depletion. CONCLUSIONS Validated models of how different aspects of the humoral response relate to antiviral antibody activities suggest desirable attributes to recapitulate by vaccination or other antibody-based interventions.
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Affiliation(s)
- Harini Natarajan
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, NH, USA
| | - Shiwei Xu
- Program in Quantitative Biological Sciences, Dartmouth College, Hanover, NH, USA
| | - Andrew R Crowley
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, NH, USA
| | - Savannah E Butler
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, NH, USA
| | - Joshua A Weiner
- Thayer School of Engineering, Dartmouth College, 14 Engineering Drive, Hanover, NH, 03755, USA
| | - Evan M Bloch
- Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Kirsten Littlefield
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sarah E Benner
- Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Ruchee Shrestha
- Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Olivia Ajayi
- Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Wendy Wieland-Alter
- Department of Pediatrics, Geisel School of Medicine at Dartmouth, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - David Sullivan
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Shmuel Shoham
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Thomas C Quinn
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Arturo Casadevall
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Andrew Pekosz
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Andrew D Redd
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Aaron A R Tobian
- Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Ruth I Connor
- Department of Pediatrics, Geisel School of Medicine at Dartmouth, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Peter F Wright
- Department of Pediatrics, Geisel School of Medicine at Dartmouth, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Margaret E Ackerman
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, NH, USA.
- Program in Quantitative Biological Sciences, Dartmouth College, Hanover, NH, USA.
- Thayer School of Engineering, Dartmouth College, 14 Engineering Drive, Hanover, NH, 03755, USA.
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Rahman S, Rahman MM, Miah M, Begum MN, Sarmin M, Mahfuz M, Hossain ME, Rahman MZ, Chisti MJ, Ahmed T, Arifeen SE, Rahman M. COVID-19 reinfections among naturally infected and vaccinated individuals. Sci Rep 2022; 12:1438. [PMID: 35082344 PMCID: PMC8792012 DOI: 10.1038/s41598-022-05325-5] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 01/03/2022] [Indexed: 12/17/2022] Open
Abstract
The protection against emerging SARS-CoV-2 variants by pre-existing antibodies elicited due to the current vaccination or natural infection is a global concern. We aimed to investigate the rate of SARS-CoV-2 infection and its clinical features among infection-naïve, infected, vaccinated, and post-infection-vaccinated individuals. A cohort was designed among icddr,b staff registered for COVID-19 testing by real-time reverse transcriptase-polymerase chain reaction (rRT-PCR). Reinfection cases were confirmed by whole-genome sequencing. From 19 March 2020 to 31 March 2021, 1644 (mean age, 38.4 years and 57% male) participants were enrolled; where 1080 (65.7%) were tested negative and added to the negative cohort. The positive cohort included 750 positive patients (564 from baseline and 186 from negative cohort follow-up), of whom 27.6% were hospitalized and 2.5% died. Among hospitalized patients, 45.9% had severe to critical disease and 42.5% required oxygen support. Hypertension and diabetes mellitus were found significantly higher among the hospitalised patients compared to out-patients; risk ratio 1.3 and 1.6 respectively. The risk of infection among positive cohort was 80.2% lower than negative cohort (95% CI 72.6-85.7%; p < 0.001). Genome sequences showed that genetically distinct SARS-CoV-2 strains were responsible for reinfections. Naturally infected populations were less likely to be reinfected by SARS-CoV-2 than the infection-naïve and vaccinated individuals. Although, reinfected individuals did not suffer severe disease, a remarkable proportion of naturally infected or vaccinated individuals were (re)-infected by the emerging variants.
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Affiliation(s)
- Sezanur Rahman
- Virology Laboratory, Infectious Diseases Division, icddr,b: International Centre for Diarrhoeal Disease Research, Bangladesh, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - M Mahfuzur Rahman
- Virology Laboratory, Infectious Diseases Division, icddr,b: International Centre for Diarrhoeal Disease Research, Bangladesh, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Mojnu Miah
- Virology Laboratory, Infectious Diseases Division, icddr,b: International Centre for Diarrhoeal Disease Research, Bangladesh, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Mst Noorjahan Begum
- Virology Laboratory, Infectious Diseases Division, icddr,b: International Centre for Diarrhoeal Disease Research, Bangladesh, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Monira Sarmin
- Nutrition and Clinical Services Division, icddr,b: International Centre for Diarrhoeal Disease Research, Bangladesh, Mohakhali, Dhaka, 1212, Bangladesh
| | - Mustafa Mahfuz
- Nutrition and Clinical Services Division, icddr,b: International Centre for Diarrhoeal Disease Research, Bangladesh, Mohakhali, Dhaka, 1212, Bangladesh
| | - Mohammad Enayet Hossain
- Virology Laboratory, Infectious Diseases Division, icddr,b: International Centre for Diarrhoeal Disease Research, Bangladesh, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Mohammed Ziaur Rahman
- Virology Laboratory, Infectious Diseases Division, icddr,b: International Centre for Diarrhoeal Disease Research, Bangladesh, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Mohammod Jobayer Chisti
- Nutrition and Clinical Services Division, icddr,b: International Centre for Diarrhoeal Disease Research, Bangladesh, Mohakhali, Dhaka, 1212, Bangladesh
| | - Tahmeed Ahmed
- Nutrition and Clinical Services Division, icddr,b: International Centre for Diarrhoeal Disease Research, Bangladesh, Mohakhali, Dhaka, 1212, Bangladesh
| | - Shams El Arifeen
- Maternal and Child Health Division, icddr,b: International Centre for Diarrhoeal Disease Research, Bangladesh, Mohakhali, Dhaka, 1212, Bangladesh
| | - Mustafizur Rahman
- Virology Laboratory, Infectious Diseases Division, icddr,b: International Centre for Diarrhoeal Disease Research, Bangladesh, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh.
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Mao Y, Wang W, Ma J, Wu S, Sun F. Reinfection rates among patients previously infected by SARS-CoV-2: systematic review and meta-analysis. Chin Med J (Engl) 2022; 135:145-152. [PMID: 34908003 PMCID: PMC8769121 DOI: 10.1097/cm9.0000000000001892] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Asymptomatic or symptomatic infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can be followed by reinfection. The protection conferred by prior infection among coronavirus disease 2019 (COVID-19) patients is unclear. We assessed the incidence of SARS-CoV-2 reinfection and the protection effect of previous infection against reinfection. METHODS We searched PubMed, EMBASE, Cochrane, Scopus, Web of Science, and ClinicalTrials.gov for publications up until the end date of May 1, 2021. The reinfection rate of recovered patients and the protection against reinfection were analyzed using meta-analysis. RESULTS Overall, 19 studies of 1096 reinfection patients were included. The pooled reinfection rate was 0.65% (95% confidence interval [CI] 0.39-0.98%). The symptomatic reinfection rate was a bit lower (0.37% [95% CI 0.11-0.78%], I2 = 99%). The reinfection rate was much higher in high-risk populations (1.59% [95% CI 0.30-3.88%], I2 = 90%). The protection against reinfection and symptomatic reinfection was similar (87.02% [95% CI 83.22-89.96%] and 87.17% [95% CI 83.09-90.26%], respectively). CONCLUSIONS The rate of reinfection with SARS-CoV-2 is relatively low. The protection against SARS-CoV-2 after natural infection is comparable to that estimated for vaccine efficacy. These data may help guide public health measures and vaccination strategies in response to the COVID-19 pandemic. High-quality clinical studies are needed to establish the relevant risk factors in recovered patients.
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Affiliation(s)
- Yinjun Mao
- Department of Pharmacy, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350005, China
| | - Weiwei Wang
- National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China
| | - Jun Ma
- Institute of Basic Medical Sciences, Peking University Health Science Center, Beijing 100191, China
| | - Shanshan Wu
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Disease, Beijing Digestive Disease Center, Beijing Key Laboratory for Precancerous Lesion of Digestive Disease, Beijing, 100050, China
| | - Feng Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing 100191, China
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Lee J, Cho K, Kook H, Kang S, Lee Y, Lee J. The Different Immune Responses by Age Are due to the Ability of the Fetal Immune System to Secrete Primal Immunoglobulins Responding to Unexperienced Antigens. Int J Biol Sci 2022; 18:617-636. [PMID: 35002513 PMCID: PMC8741860 DOI: 10.7150/ijbs.67203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 11/15/2021] [Indexed: 12/23/2022] Open
Abstract
Among numerous studies on coronavirus 2019 (COVID-19), we noted that the infection and mortality rates of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) increased with age and that fetuses known to be particularly susceptible to infection were better protected despite various mutations. Hence, we established the hypothesis that a new immune system exists that forms before birth and decreases with aging. Methods: To prove this hypothesis, we established new ex-vivo culture conditions simulating the critical environmental factors of fetal stem cells (FSCs) in early pregnancy. Then, we analyzed the components from FSCs cultivated newly developed ex-vivo culture conditions and compared them from FSCs cultured in a normal condition. Results: We demonstrated that immunoglobulin M (IgM), a natural antibody (NAb) produced only in early B-1 cells, immunoglobulins (Igs) including IgG3, which has a wide range of antigen-binding capacity and affinity, complement proteins, and antiviral proteins are induced in FSCs only cultured in newly developed ex-vivo culture conditions. Particularly we confirmed that their extracellular vesicles (EVs) contained NAbs, Igs, various complement proteins, and antiviral proteins, as well as human leukocyte antigen G (HLA-G), responsible for immune tolerance. Conclusion: Our results suggest that FSCs in early pregnancy can form an independent immune system responding to unlearned antigens as a self-defense mechanism before establishing mature immune systems. Moreover, we propose the possibility of new solutions to cope with various infectious diseases based on the factors in NAbs-containing EVs, especially not causing unnecessary immune reaction due to HLA-G.
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Affiliation(s)
- Jangho Lee
- R&D Center of Stemmedicare Ltd, Seoul, 06095, Republic of Korea
| | - Kyoungshik Cho
- R&D Center of Stemmedicare Ltd, Seoul, 06095, Republic of Korea
| | - Hyejin Kook
- R&D Center of Stemmedicare Ltd, Seoul, 06095, Republic of Korea
| | - Suman Kang
- R&D Center of Stemmedicare Ltd, Seoul, 06095, Republic of Korea
| | - Yunsung Lee
- R&D Center of Stemmedicare Ltd, Seoul, 06095, Republic of Korea
| | - Jiwon Lee
- R&D Center of Stemmedicare Ltd, Seoul, 06095, Republic of Korea
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Nationwide assessment of energy costs and policies to limit airborne infection risks in U.S. schools. JOURNAL OF BUILDING ENGINEERING 2022; 45:103533. [PMCID: PMC8556188 DOI: 10.1016/j.jobe.2021.103533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 10/01/2021] [Accepted: 10/26/2021] [Indexed: 06/12/2023]
Abstract
Practices such as improved ventilation and air filtration are being considered by schools to reduce the transmission of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) that causes the pandemic of coronavirus disease 2019 (COVID-19). Improved ventilation may significantly increase the energy cost of heating, ventilation, and air conditioning (HVAC), exacerbating financial challenges schools face amidst the worst pandemic in decades. This study evaluated HVAC energy costs for reducing COVID-19 airborne infection risks in 111,485 public and private schools in the U.S. to support decision-makings. The average annual HVAC energy cost to maintain the infection risk below 1% for the schools in the U.S. is estimated at $20.1 per square meter or $308.4 per capita with improved ventilation and air filtration, where the private schools have higher costs than the public schools on average. The cost could be reduced by adopting partial online learning. It was also found that additional cost to control infection risk with increased ventilation and air filtration is significantly lower for PK-5 schools than that for middle and high schools, indicating the possibility of remaining in-person instructions for PK-5 schools with necessary governmental assistance. Analyses of school HVAC energy costs to reduce airborne infection risks under different intervention scenarios provide important operational guidelines, financial implications, and policy insights for schools, community stakeholders, and policymakers to keep schools safe during the ongoing pandemic and improve preparedness for epidemics projected in the future.
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Reinfection and Breakthrough Infection of SARS-CoV-2: An Emerging Challenge That Is Threatening Our World. INFECTIOUS DISEASES & IMMUNITY 2022. [PMID: 37521155 PMCID: PMC8772053 DOI: 10.1097/id9.0000000000000027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The pandemic of coronavirus disease 2019 has threatened humans for more than one and a half years. In particular, viral mutation like delta strain has led to third- or fourth-wave transmission among the countries in Asia, Europe, and North America. Although large-scale vaccination has been carried out in many countries, the incidence of reinfection and vaccine-past breakthrough infection is becoming an emerging challenge to humans worldwide. The related mechanisms underlying the reinfection and breakthrough infection remain unknown. In this review, we summarized the challenge and related reasons for severe acute respiratory syndrome coronavirus 2 reinfection and breakthrough infection. Simultaneously, we addressed some critical contents of the study in future.
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