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de Anda-Jáuregui G, Gómez-Romero L, Cañas S, Campos-Romero A, Alcántar-Fernández J, Cedro-Tanda A. COVID-19 reinfections in Mexico City: implications for public health. Front Public Health 2024; 11:1321283. [PMID: 38419814 PMCID: PMC10899476 DOI: 10.3389/fpubh.2023.1321283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 12/29/2023] [Indexed: 03/02/2024] Open
Abstract
Background Since its appearance, COVID-19 has immensely impacted our society. Public health measures, from the initial lockdowns to vaccination campaigns, have mitigated the crisis. However, SARS-CoV-2's persistence and evolving variants continue to pose global threats, increasing the risk of reinfections. Despite vaccination progress, understanding reinfections remains crucial for informed public health responses. Methods We collected available data on clinical and genomic information for SARS-CoV-2 samples from patients treated in Mexico City from 2020 epidemiological week 10 to 2023 epidemiological week 06 encompassing the whole public health emergency's period. To identify clinical data we utilized the SISVER (Respiratory Disease Epidemiological Surveillance System) database for SARS-CoV-2 patients who received medical attention in Mexico City. For genomic surveillance we analyzed genomic data previously uploaded to GISAID generated by Mexican institutions. We used these data sources to generate descriptors of case number, hospitalization, death and reinfection rates, and viral variant prevalence throughout the pandemic period. Findings The fraction of reinfected individuals in the COVID-19 infected population steadily increased as the pandemic progressed in Mexico City. Most reinfections occurred during the fifth wave (40%). This wave was characterized by the coexistence of multiple variants exceeding 80% prevalence; whereas all other waves showed a unique characteristic dominant variant (prevalence >95%). Shifts in symptom patient care type and severity were observed, 2.53% transitioned from hospitalized to ambulatory care type during reinfection and 0.597% showed the opposite behavior; also 7.23% showed a reduction in severity of symptoms and 6.05% displayed an increase in severity. Unvaccinated individuals accounted for the highest percentage of reinfections (41.6%), followed by vaccinated individuals (31.9%). Most reinfections occurred after the fourth wave, dominated by the Omicron variant; and after the vaccination campaign was already underway. Interpretation Our analysis suggests reduced infection severity in reinfections, evident through shifts in symptom severity and care patterns. Unvaccinated individuals accounted for most reinfections. While our study centers on Mexico City, its findings may hold implications for broader regions, contributing insights into reinfection dynamics.
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Affiliation(s)
- Guillermo de Anda-Jáuregui
- Instituto Nacional de Medicina Genómica, Mexico City, Mexico
- Investigadoras e Investigadoras por México, Consejo Nacional de Humanidades, Ciencias y Tecnologías, Mexico City, Mexico
- Centro de Ciencias de la Complejidad, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Laura Gómez-Romero
- Instituto Nacional de Medicina Genómica, Mexico City, Mexico
- Escuela de Medicina y Ciencias de la Salud, Tecnológico de Monterrey, Mexico City, Mexico
| | - Sofía Cañas
- Instituto Nacional de Medicina Genómica, Mexico City, Mexico
- Instituto Tecnológico de Estudios Superiores de Monterrey, Monterrey, Mexico
| | | | | | - Alberto Cedro-Tanda
- Núcleo B de Innovación en Medicina de Precisión, Instituto Nacional de Medicina Genómica, Mexico City, Mexico
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Arslan A, Sahbudak Bal Z, Erci E, Yıldırım Arslan S, Bilen NM, Avcu G, Çiçek C, Ozkinay F, Kurugol Z. SARS-CoV-2 reinfections in the pediatric cohort-a single-center experience. J Trop Pediatr 2023; 70:fmad049. [PMID: 38150674 DOI: 10.1093/tropej/fmad049] [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] [Indexed: 12/29/2023]
Abstract
BACKGROUND This study focused on timelines of infection episodes and dominant variants and aims to determine disease severity and outcome of pediatric patients with reinfection. MATERIALS AND METHODS This study retrospectively evaluated the medical records of the hospitalized patients and/or outpatients aged 0-18 with a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction between March 2020 and September 2022 at Ege University Children's Hospital. RESULTS Ninety-one pediatric patients reinfected with SARS-CoV-2 were included in the study. There was an underlying disease in 26.4% of the patients. The median time between the two infection episodes was 184 (90-662) days. There were 24 patients (26.3%) with the first infection in pre-Delta period; 17 (18.6%) of them were reinfected in Omicron BA.1 period, while 7 (7.6%) in Omicron BA.4/BA.5 period. Forty-five patients (49.4%) were infected initially in the Delta period; 35 patients (38.4%) were reinfected in the Omicron BA.1 period, while 10 patients (10.9%) were reinfected in the Omicron BA.4/BA.5 period. Twenty-two patients (24.1%) had the first infection in the Omicron BA.1 period and then reinfected in the Omicron BA.4/BA.5 period. Patients with reinfection more frequently displayed a symptom (84.6% vs. 94.5%, p = 0.03). The hospitalization rate significantly declined in reinfection (15.3% vs. 7.6%, p = 0.03). Severe disease, treatment needs and steroid use were decreased in reinfections without a significant difference (p > 0.05). Intensive care unit admission was not altered. CONCLUSION This study revealed that reinfections frequently develop in previously healthy children but do not cause more severe outcomes. The risk of symptomatic reinfections is still high due to the effect of the Omicron variant.
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Affiliation(s)
- Asli Arslan
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir 35040, Turkey
| | - Zumrut Sahbudak Bal
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir 35040, Turkey
| | - Ece Erci
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir 35040, Turkey
| | - Sema Yıldırım Arslan
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir 35040, Turkey
| | - Nimet Melis Bilen
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir 35040, Turkey
| | - Gülhadiye Avcu
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir 35040, Turkey
| | - Candan Çiçek
- Department of Microbiology, Faculty of Medicine, Ege University, Izmir 35040, Turkey
| | - Ferda Ozkinay
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir 35040, Turkey
| | - Zafer Kurugol
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir 35040, Turkey
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Wang Y, Liang J, Yang H, Zhu L, Hu J, Xiao L, Huang Y, Dong Y, Wu C, Zhang J, Zhou X. Epidemiological and clinical characteristics of COVID-19 reinfection during the epidemic period in Yangzhou city, Jiangsu province. Front Public Health 2023; 11:1256768. [PMID: 37780420 PMCID: PMC10535086 DOI: 10.3389/fpubh.2023.1256768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 08/22/2023] [Indexed: 10/03/2023] Open
Abstract
Background With the continuous progress of the epidemic of coronavirus disease 2019 (COVID-19) infection and the constant mutation of the virus strain, reinfection occurred in previously infected individuals and caused waves of the epidemic in many countries. Therefore, we aimed to explore the characteristics of COVID-19 reinfection during the epidemic period in Yangzhou and provide a scientific basis for assessing the COVID-19 situation and optimizing the allocation of medical resources. Methods We chose previously infected individuals of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reported locally in Yangzhou city from January 2020 to November 30, 2022. A telephone follow-up of cases was conducted from February to March 2023 to collect the COVID-19 reinfection information. We conducted a face-to-face survey on that who met the definition of reinfection to collect information on clinical symptoms, vaccination status of COVID-19, and so on. Data were analyzed using SPSS 19.0. Results Among the 999 eligible respondents (92.24% of all the participants), consisting of 42.28% males and 57.72% females, the reinfection incidence of females was significantly higher than that of male cases (χ2 = 5.197, P < 0.05); the ages of the respondents ranged from 1 to 91 years, with the mean age of 42.28 (standard deviation 22.73) years; the most of the sufferers were infected initially with Delta variant (56.88%), followed by the Omicron subvariants BA.1/BA.2 (39.52%). Among all the eligible respondents, 126 (12.61%) reported COVID-19 reinfection appearing during the epidemic period, and the intervals between infections were from 73 to 1,082 days. The earlier the initial infection occurred, the higher the reinfection incidence and the reinfection incidence was significantly increased when the interval was beyond 1 year (P < 0.01) .119 reinfection cases (94.4%) were symptomatic when the most common symptoms included fever (65.54%) and cough (61.34%); compared with the initial infection cases, the proportion of clinical symptoms in the reinfected cases was significantly higher (P < 0.01). The reinfection incidence of COVID-19 vaccination groups with different doses was statistically significant (P < 0.01). Fewer reinfections were observed among the respondents with three doses of COVID-19 vaccination compared to the respondents with two doses (χ2 = 14.595, P < 0.001) or without COVID-19 vaccination (χ2 =4.263, P = 0.039). Conclusion After the epidemic period of COVID-19, the reinfection incidence varied with different types of SARS-CoV-2 strains. The reinfection incidence was influenced by various factors such as virus characteristics, vaccination, epidemic prevention policies, and individual variations. As the SARS-CoV-2 continues to mutate, vaccination and appropriate personal protection have practical significance in reducing the risk of reinfection.
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Affiliation(s)
- Yin Wang
- Yangzhou Center for Disease Control and Prevention, Yangzhou, Jiangsu, China
| | - Jie Liang
- Yangzhou Center for Disease Control and Prevention, Yangzhou, Jiangsu, China
| | - Huimin Yang
- Yangzhou Center for Disease Control and Prevention, Yangzhou, Jiangsu, China
| | - Liguo Zhu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Jianli Hu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Lishun Xiao
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Yao Huang
- Yangzhou Center for Disease Control and Prevention, Yangzhou, Jiangsu, China
| | - Yuying Dong
- Yangzhou Center for Disease Control and Prevention, Yangzhou, Jiangsu, China
| | - Cheng Wu
- Yangzhou Center for Disease Control and Prevention, Yangzhou, Jiangsu, China
| | - Jun Zhang
- Yangzhou Center for Disease Control and Prevention, Yangzhou, Jiangsu, China
| | - Xin Zhou
- Yangzhou Center for Disease Control and Prevention, Yangzhou, Jiangsu, China
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Qamar MA, Afzal SS, Dhillon RA, Sajid MI, Sarfraz Z, Sarfraz A, Narmeen M, Irfan O, Cherrez-Ojeda I, Bin Sarwar Zubairi A. A global systematic review and meta-analysis on the emerging evidence on risk factors, clinical characteristics, and prognosis of multisystem inflammatory syndrome in adults (MIS-A). Ann Med Surg (Lond) 2023; 85:4463-4475. [PMID: 37663717 PMCID: PMC10473365 DOI: 10.1097/ms9.0000000000000732] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 04/18/2023] [Indexed: 09/05/2023] Open
Abstract
Background The multisystem inflammatory syndrome in adults (MIS-A) has emerged, similar to those in children associated with SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) [multisystem inflammatory syndrome in children (MIS-C)]. This review aimed to analyze the risk factors, clinical course, and prognosis of MIS-A. Methods A comprehensive literature search was conducted using several databases for cases reporting MIS-A from 1 December 2019 till 9 September 2021. The case definitions used to identify potential cases were those recommended by the World Health Organization, Center for Disease Control, and individual country/physician classification. The meta-analysis was performed using Comprehensive Meta-Analysis (CMA) 2.2.027 and Review Manager (RevMan) 5.4.1, employing 95% confidence intervals (CI). Results Seventy studies were assessed for full-text eligibility, out of which 37 were included. The mean age of the study population was 32.52±10.29 years. The most common symptoms were fever (89.8%, 95% CI: 77.7-95.7%) and diarrhea (49%, 95% CI: 35.4-62.7%). Ventricular tachycardia (57.1%, 95% CI: 43.1-70.1%) was the most common electro-cardiac abnormality. The most common inflammatory marker was elevated C-reactive protein (89.8%, 95% CI: 77.7-95.7%). Abnormal echocardiogram was the most common imaging test result (commonly, ventricular dysfunction and arrhythmias), while steroids were the most administered treatment. Severe cases had a higher need for vasopressor and inotropic support and antibiotic therapy compared to the non-severe cases. One death was reported due to cardiovascular failure. Conclusion Our collated findings will help clinicians identify the typical presenting symptoms and optimal management of MIS-A. Further research is required to understand the long-term prognosis and the correlation between coronavirus disease 2019 (COVID-19) and MIS-A to understand its pathogenesis and clinical spectrum.
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Affiliation(s)
| | | | | | - Mir Ibrahim Sajid
- Orthopaedic Trauma Service, Florida Orthopaedic Institute, Tampa, Florida, USA
| | - Zouina Sarfraz
- Research and Publications, Fatima Jinnah Medical University, Lahore, Pakistan
| | - Azza Sarfraz
- Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Mehek Narmeen
- Dr. Ruth K. M. Pfau Civil Hospital, Karachi, Pakistan
| | - Omar Irfan
- Section of Pulmonary and Critical Care Medicine, Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Ivan Cherrez-Ojeda
- Allergy, Immunology and Pulmonology, Universidad Espíritu Santo, Samborondón, Ecuador
| | - Ali Bin Sarwar Zubairi
- Section of Pulmonary and Critical Care Medicine, Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
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Pecoraro V, Pirotti T, Trenti T. Evidence of SARS-CoV-2 reinfection: analysis of 35,000 subjects and overview of systematic reviews. Clin Exp Med 2023; 23:1213-1224. [PMID: 36289100 PMCID: PMC9607758 DOI: 10.1007/s10238-022-00922-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 10/11/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Reinfection by SARS-CoV-2 is a rare but possible event. We evaluated the prevalence of reinfections in the Province of Modena and performed an overview of systematic reviews to summarize the current knowledge. METHODS We applied big data analysis and retrospectively analysed the results of oro- or naso-pharyngeal swab results tested for molecular research of viral RNA of SARS-CoV-2 between 1 January 2021 and 30 June 2021 at a single center. We selected individuals with samples sequence of positive, negative and then positive results. Between first and second positive result we considered a time interval of 90 days to be sure of a reinfection. We also performed a search for and evaluation of systematic reviews reporting SARS-CoV-2 reinfection rates. Main information was collected and the methodological quality of each review was assessed, according to A Measurement Tool to Assess systematic Reviews (AMSTAR). RESULTS Initial positive results were revealed in more than 35,000 (20%) subjects; most (28%) were aged 30-49 years old. Reinfection was reported in 1,258 (3.5%); most (33%) were aged 30-49 years old. Reinfection rates according to vaccinated or non-vaccinated subjects were 0.6% vs 1.1% (p < 0.0001). Nine systematic reviews were identified and confirmed that SARS-CoV-2 reinfection rate is a rare event. AMSTAR revealed very low-moderate levels of quality among selected systematic reviews. CONCLUSIONS There is a real, albeit rare risk of SARS-CoV-2 reinfection. Big data analysis enabled accurate estimates of the reinfection rates. Nevertheless, a standardized approach to identify and report reinfection cases should be developed.
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Affiliation(s)
- Valentina Pecoraro
- Department of Laboratory Medicine and Pathology, Azienda USL of Modena, Modena, Italy
| | - Tommaso Pirotti
- Department of Laboratory Medicine and Pathology, Azienda USL of Modena, Modena, Italy
| | - Tommaso Trenti
- Department of Laboratory Medicine and Pathology, Azienda USL of Modena, Modena, Italy
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Cegolon L, Magnano G, Negro C, Larese Filon F. SARS-CoV-2 Reinfections in Health-Care Workers, 1 March 2020-31 January 2023. Viruses 2023; 15:1551. [PMID: 37515237 PMCID: PMC10384331 DOI: 10.3390/v15071551] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/05/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
Objective: To study SARS-CoV-2 reinfections in health-care workers (HCWs) of the University Health Agency Giuliano-Isontina (ASUGI), covering the provinces of Trieste and Gorizia (northeastern Italy) routinely screened for SARS-CoV-2 via nasopharyngeal swab. Design: Cohort study of HCWs (N = 8205) followed since the start of the pandemic (1 March 2020) through 31 January 2023. The risk of reinfection during the Omicron transmission period (after 30 November 2021) among HCWs previously infected by SARS-CoV-2 was estimated based on days since last dose of COVID-19 vaccine received, adjusting for age, sex, job task, workplace, number of doses of COVID-19 vaccines and number of swab tests performed. In the crude as well as adjusted incidence rate analysis, reinfections occurring 15+ days after a first dose of COVID-19 vaccine or 8+ days following a second or more dose were counted. Results: In a highly vaccinated population, during the entire study period (1 March 2020-31 January 2023) 5253 HCWs incurred at least one SARS-CoV-2 infection, 4262 HCWs were infected only once, and 1091 were reinfected. Reinfections almost entirely (99.1% = 1071/1091) occurred after 30 November 2021, peaking in July 2022 (N = 161). Six hundred eighty-three reinfections followed a pre-Omicron primary event against 408 reinfections following an Omicron event. Reinfections during the Omicron transmission period occurred a mean of 400 ± 220 days after primary SARS-CoV-2 infection; 512 ± 205 days following a pre-Omicron primary event, as opposed to 218 ± 74 days after an Omicron primary infection. Thirty-four hospitalizations were observed, all before the Omicron wave, following 18 (0.4%) primary SARS-CoV-2 infections and 16 (1.5%) reinfections. By excluding events occurring <15 days after a first dose or <8 days after a further dose of COVID-19 vaccine, 605 reinfections followed a pre-Omicron primary event (raw incidence = 1.4 × 1000 person-days) against 404 after a primary Omicron infection (raw incidence = 0.3 × 1000 person-days). Apart from nurse aids (slightly enhanced biological risk) and academic HCWs (remarkably lower risk with pre-Omicron primary events), the effect of occupation in terms of job task and workplace was marginal. Furthermore, whilst the risk of reinfection was lower in males and HCWs < 60 years old following a pre-Omicron primary infection, HCWs aged 30-50 were more likely to be infected after an Omicron primary event. Regardless of timeline of primary SARS-CoV-2 event, the risk of reinfection decreased with higher number of doses of COVID-19 vaccines, being lowest after the second booster. In particular, VE was 16% for one dose, 51% for two doses, 76% for the booster and 92% for the second booster with a pre-Omicron primary SARS-CoV-2 event. The latter figures increased to 72%, 59%, 74% and 93%, respectively, with Omicron primary infections. Conclusions: SARS-CoV-2 reinfections were frequent during the Omicron transmission period, though featured by mild or no symptoms. Whilst the impact of occupation on biological risk was relatively marginal, COVID-19 vaccination had the strongest protective effect against reinfection, with a 93% VE by second booster following an Omicron primary infection.
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Affiliation(s)
- Luca Cegolon
- Department of Medical, Surgical & Health Sciences, University of Trieste, 34129 Trieste, Italy
- Occupational Medicine Unit, University Health Agency Giuliano-Isontina (ASUGI), 34129 Trieste, Italy
| | - Greta Magnano
- Department of Medical, Surgical & Health Sciences, University of Trieste, 34129 Trieste, Italy
| | - Corrado Negro
- Department of Medical, Surgical & Health Sciences, University of Trieste, 34129 Trieste, Italy
- Occupational Medicine Unit, University Health Agency Giuliano-Isontina (ASUGI), 34129 Trieste, Italy
| | - Francesca Larese Filon
- Department of Medical, Surgical & Health Sciences, University of Trieste, 34129 Trieste, Italy
- Occupational Medicine Unit, University Health Agency Giuliano-Isontina (ASUGI), 34129 Trieste, Italy
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Ukwishaka J, Ndayishimiye Y, Destine E, Danwang C, Kirakoya-Samadoulougou F. Global prevalence of coronavirus disease 2019 reinfection: a systematic review and meta-analysis. BMC Public Health 2023; 23:778. [PMID: 37118717 PMCID: PMC10140730 DOI: 10.1186/s12889-023-15626-7] [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: 12/29/2022] [Accepted: 04/07/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND In December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged with a high transmissibility rate and resulted in numerous negative impacts on global life. Preventive measures such as face masks, social distancing, and vaccination helped control the pandemic. Nonetheless, the emergence of SARS-CoV-2 variants, such as Omega and Delta, as well as coronavirus disease 2019 (COVID-19) reinfection, raise additional concerns. Therefore, this study aimed to determine the overall prevalence of reinfection on global and regional scales. METHODS A systematic search was conducted across three databases, PubMed, Scopus, and ProQuest Central, including all articles pertaining to COVID-19 reinfection without language restriction. After critical appraisal and qualitative synthesis of the identified relevant articles, a meta-analysis considering random effects was used to pool the studies. RESULTS We included 52 studies conducted between 2019 and 2022, with a total sample size of 3,623,655 patients. The overall prevalence of COVID-19 reinfection was 4.2% (95% confidence interval [CI]: 3.7-4.8%; n = 52), with high heterogeneity between studies. Africa had the highest prevalence of 4.7% (95% CI: 1.9-7.5%; n = 3), whereas Oceania and America had lower estimates of 0.3% (95% CI: 0.2-0.4%; n = 1) and 1% (95% CI: 0.8-1.3%; n = 7), respectively. The prevalence of reinfection in Europe and Asia was 1.2% (95% CI: 0.8-1.5%; n = 8) and 3.8% (95% CI: 3.4-4.3%; n = 43), respectively. Studies that used a combined type of specimen had the highest prevalence of 7.6% (95% CI: 5.8-9.5%; n = 15) compared with those that used oropharyngeal or nasopharyngeal swabs only that had lower estimates of 6.7% (95% CI: 4.8-8.5%; n = 8), and 3.4% (95% CI: 2.8-4.0%; n = 12) respectively. CONCLUSION COVID-19 reinfection occurs with varying prevalence worldwide, with the highest occurring in Africa. Therefore, preventive measures, including vaccination, should be emphasized to ensure control of the pandemic.
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Affiliation(s)
- Joyeuse Ukwishaka
- Maternal Child and Community Health Division, Rwanda Bio-Medical Center, Kigali, Rwanda.
- IntraHealth International, Kigali, Rwanda.
- Centre de Recherche en Epidémiologie, Biostatistique et Recherche Clinique, Ecole de Santé Publique, Université Libre de Bruxelles, Brussels, Belgium.
| | - Yves Ndayishimiye
- Centre de Recherche en Epidémiologie, Biostatistique et Recherche Clinique, Ecole de Santé Publique, Université Libre de Bruxelles, Brussels, Belgium
| | - Esmeralda Destine
- Centre de Recherche en Epidémiologie, Biostatistique et Recherche Clinique, Ecole de Santé Publique, Université Libre de Bruxelles, Brussels, Belgium
| | | | - Fati Kirakoya-Samadoulougou
- Centre de Recherche en Epidémiologie, Biostatistique et Recherche Clinique, Ecole de Santé Publique, Université Libre de Bruxelles, Brussels, Belgium
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Nguyen NN, Nguyen YN, Hoang VT, Million M, Gautret P. SARS-CoV-2 Reinfection and Severity of the Disease: A Systematic Review and Meta-Analysis. Viruses 2023; 15:v15040967. [PMID: 37112949 PMCID: PMC10145185 DOI: 10.3390/v15040967] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/04/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Abstract
Since the discovery of SARS-CoV-2, changes in genotype and reinfection with different variants have been observed in COVID-19-recovered patients, raising questions around the clinical pattern and severity of primary infection and reinfection. In this systematic review, we summarize the results of 23 studies addressing SARS-CoV-2 reinfections. A total of 23,231 reinfected patients were included, with pooled estimated reinfection rates ranging from 0.1 to 6.8%. Reinfections were more prevalent during the Omicron variant period. The mean age of reinfected patients was 38.0 ± 6. years and females were predominant among reinfected patients (M/F = 0.8). The most common symptoms during the first and second infection were fever (41.1%), cough (35.7% and 44.6%), myalgia (34.5% and 33.3%), fatigue (23.8% and 25.6%), and headaches (24.4% and 21.4%). No significant differences of clinical pattern were observed between primary infection and reinfection. No significant differences in the severity of infection were observed between primary infection and reinfection. Being female, being a patient with comorbidities, lacking anti-nucleocapsid IgG after the first infection, being infected during the Delta and Omicron wave, and being unvaccinated were associated with a higher risk of reinfection. Conflicting age-related findings were found in two studies. Reinfection with SARS-CoV-2 suggests that natural immunity is not long-lasting in COVID-19 patients.
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Affiliation(s)
- Nhu Ngoc Nguyen
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
- IHU-Méditerranée Infection, Marseille, France
| | | | - Van Thuan Hoang
- Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam
| | - Matthieu Million
- IHU-Méditerranée Infection, Marseille, France
- Aix Marseille Univ, IRD, AP-HM, MEPHI, Marseille, France
| | - Philippe Gautret
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
- IHU-Méditerranée Infection, Marseille, France
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Mizrahi Reuveni M, Kertes J, Shapiro Ben David S, Shahar A, Shamir-Stein N, Rosen K, Liran O, Bar-Yishay M, Adler L. Risk Stratification Model for Severe COVID-19 Disease: A Retrospective Cohort Study. Biomedicines 2023; 11:biomedicines11030767. [PMID: 36979745 PMCID: PMC10045652 DOI: 10.3390/biomedicines11030767] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 02/19/2023] [Accepted: 02/26/2023] [Indexed: 03/06/2023] Open
Abstract
Background: Risk stratification models have been developed to identify patients that are at a higher risk of COVID-19 infection and severe illness. Objectives To develop and implement a scoring tool to identify COVID-19 patients that are at risk for severe illness during the Omicron wave. Methods: This is a retrospective cohort study that was conducted in Israel’s second-largest healthcare maintenance organization. All patients with a new episode of COVID-19 between 26 November 2021 and 18 January 2022 were included. A model was developed to predict severe illness (COVID-19-related hospitalization or death) based on one-third of the study population (the train group). The model was then applied to the remaining two-thirds of the study population (the test group). Risk score sensitivity, specificity, and positive predictive value rates, and receiver operating characteristics (ROC) were calculated to describe the performance of the model. Results: A total of 409,693 patients were diagnosed with COVID-19 over the two-month study period, of which 0.4% had severe illness. Factors that were associated with severe disease were age (age > 75, OR-70.4, 95% confidence interval [CI] 42.8–115.9), immunosuppression (OR-4.8, 95% CI 3.4–6.7), and pregnancy (5 months or more, OR-82.9, 95% CI 53–129.6). Factors that were associated with a reduced risk for severe disease were vaccination status (patients vaccinated in the previous six months OR-0.6, 95% CI 0.4–0.8) and a prior episode of COVID-19 (OR-0.3, 95% CI 0.2–0.5). According to the model, patients who were in the 10th percentile of the risk severity score were considered at an increased risk for severe disease. The model accuracy was 88.7%. Conclusions: This model has allowed us to prioritize patients requiring closer follow-up by their physicians and outreach services, as well as identify those that are most likely to benefit from anti-viral treatment during the fifth wave of infection in Israel, dominated by the Omicron variant.
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Affiliation(s)
| | - Jennifer Kertes
- Health Division, Maccabi Healthcare Services, Tel Aviv 6812509, Israel
| | - Shirley Shapiro Ben David
- Health Division, Maccabi Healthcare Services, Tel Aviv 6812509, Israel
- Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Arnon Shahar
- Health Division, Maccabi Healthcare Services, Tel Aviv 6812509, Israel
| | | | - Keren Rosen
- Health Division, Maccabi Healthcare Services, Tel Aviv 6812509, Israel
| | - Ori Liran
- Health Division, Maccabi Healthcare Services, Tel Aviv 6812509, Israel
| | - Mattan Bar-Yishay
- Health Division, Maccabi Healthcare Services, Tel Aviv 6812509, Israel
| | - Limor Adler
- Health Division, Maccabi Healthcare Services, Tel Aviv 6812509, Israel
- Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Correspondence:
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10
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The COVID-19 Vaccination Coverage in ICU Patients with Severe COVID-19 Infection in a Country with Low Vaccination Coverage-A National Retrospective Analysis. J Clin Med 2023; 12:jcm12051749. [PMID: 36902535 PMCID: PMC10003614 DOI: 10.3390/jcm12051749] [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: 01/12/2023] [Revised: 02/18/2023] [Accepted: 02/20/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Romania is one of the European countries with low COVID-19 vaccination coverage. The main goal of this study was to describe the COVID-19 vaccination status in patients admitted to Romanian ICUs with a severe COVID-19 infection. The study describes the patients' characteristics according to their vaccination status and evaluates the association between vaccination status and ICU mortality. METHODS This retrospective, observational, multicenter study included patients with confirmed vaccination status admitted to Romanian ICUs from January 2021 to March 2022. RESULTS Two thousand, two hundred and twenty-two patients with confirmed vaccination status were included. Five point one three percent of patients were vaccinated with two vaccine doses and one point seventeen percent of patients were vaccinated with one vaccine dose. The vaccinated patients showed a higher rate of comorbidities but had similar clinical characteristics at ICU admission and lower mortality rates compared to non-vaccinated patients. Vaccinated status and higher Glasgow Coma Scale at ICU admission were independently associated with ICU survival. Ischemic heart disease, chronic kidney disease, higher SOFA score at ICU admission and the need for mechanical ventilation in ICU were independently associated with ICU mortality. CONCLUSION Lower rates of ICU admission were observed in fully vaccinated patients even in a country with low vaccination coverage. The ICU mortality was lower for fully vaccinated patients compared to non-vaccinated patients. The benefit of vaccination on ICU survival could be more important in patients with associated comorbidities.
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11
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Deng J, Ma Y, Liu Q, Du M, Liu M, Liu J. Severity and Outcomes of SARS-CoV-2 Reinfection Compared with Primary Infection: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3335. [PMID: 36834029 PMCID: PMC9961977 DOI: 10.3390/ijerph20043335] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/09/2023] [Accepted: 02/13/2023] [Indexed: 06/01/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfection has brought new challenges to the global prevention and control of coronavirus disease 2019 (COVID-19) pandemic; however, current studies suggest that there is still great uncertainty about the risk of severe COVID-19 and poor outcomes after SARS-CoV-2 reinfection. Random-effects inverse-variance models were used to evaluate the pooled prevalence (PP) and its 95% confidence interval (CI) of severity, outcomes and symptoms of reinfection. Random-effects were used to estimate the pooled odds ratios (OR) and its 95%CI of severity and outcomes between reinfections and primary infections. Nineteen studies involving a total of 34,375 cases of SARS-CoV-2 reinfection and 5,264,720 cases of SARS-CoV-2 primary infection were included in this meta-analysis. Among those SARS-CoV-2 reinfection cases, 41.77% (95%CI, 19.23-64.31%) were asymptomatic, and 51.83% (95%CI, 23.90-79.76%) were symptomatic, only 0.58% (95%CI, 0.031-1.14%) manifested as severe illness, and 0.04% (95%CI, 0.009-0.078%) manifested as critical illness. The PPs for SARS-CoV-2 reinfection-related hospitalization, admission to ICU, and death were, respectively, 15.48% (95%CI, 11.98-18.97%), 3.58% (95%CI, 0.39-6.77%), 2.96% (95%CI, 1.25-4.67%). Compared with SARS-CoV-2 primary infection cases, reinfection cases were more likely to present with mild illness (OR = 7.01, 95%CI, 5.83-8.44), and the risk of severe illness was reduced by 86% (OR = 0.14, 95%CI, 0.11-0.16). Primary infection provided some protection against reinfection and reduces the risk of symptomatic infection and severe illness. Reinfection did not contribute to extra risk of hospitalization, ICU, or death. It is suggested to scientifically understand the risk of reinfection of SARS-CoV-2, strengthen public health education, maintain healthy habits, and reduce the risk of reinfection.
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Affiliation(s)
- Jie Deng
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Yirui Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Qiao Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Min Du
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Min Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
- Institute for Global Health and Development, Peking University, Beijing 100871, China
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12
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COVID-19 Clinical Features and Outcomes in Elderly Patients during Six Pandemic Waves. J Clin Med 2022; 11:jcm11226803. [PMID: 36431282 PMCID: PMC9692444 DOI: 10.3390/jcm11226803] [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: 10/27/2022] [Revised: 11/12/2022] [Accepted: 11/15/2022] [Indexed: 11/19/2022] Open
Abstract
Many elderly patients with severe SARS-CoV-2 infections and COVID-19 infections are admitted to intensive care units. Age was previously identified as an independent risk factor for death and contributed to the greater severity of COVID-19. The elderly may have diminished lung functions, poor reactions to artificial ventilation, and compromised immune systems. However, it is yet uncertain how each pandemic wave and the predominant SARS-CoV-2 strains contribute to varying results and how patient groups such as the elderly are impacted. Comparing six COVID-19 pandemic waves, the objective of this study was to examine the variation in case severity, symptomatology, ICU hospitalizations, and mortality among SARS-CoV-2-infected elderly individuals. The study followed a retrospective design, including 60 eligible patients older than 70 years in each of the six pandemic wave groups, after matching them by the number of comorbidities and gender. SARS-CoV-2 infection during the first, third, and fourth pandemic waves had a significantly higher risk of mortality for hospitalized patients. Confusion and dyspnea at admission were significant risk factors for ICU admission in elderly patients (β = 1.92, respectively β = 3.65). The laboratory parameters identified decreased lymphocytes (β = 2.11), elevated IL-6 (β = 1.96), and procalcitonin (β = 2.46) as the most significant risk factors. The third and fourth COVID-19 waves had considerably more severe infections (31.7% and 26.7%) than the sixth wave (13.3%). Median ICU stay and percentage of patients receiving oxygen support also differed across pandemic waves. However, mortality rates between the six pandemic waves were similar. The average length of hospitalization varied dramatically among the six pandemic waves. Although senior patients are more likely to have worse COVID-19 outcomes after hospitalization, this risk is mitigated by the greater prevalence of comorbidities and frailty among the elderly. The six pandemic waves that were specifically evaluated did not reveal considerably disproportionate variations in terms of patient mortality; however, during the fourth pandemic wave, there were likely more hospitalized patients with severe COVID-19 in Romania. It is probable that certain circulating SARS-CoV-2 strains were more infectious, resulting in an increase in infections and a strain on healthcare systems, which might explain the variations found in our research.
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13
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Cai J, Zhou J. How many asymptomatic cases were unconfirmed in the US COVID-19 pandemic? The evidence from a serological survey. CHAOS, SOLITONS, AND FRACTALS 2022; 164:112630. [PMID: 36091638 PMCID: PMC9444511 DOI: 10.1016/j.chaos.2022.112630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 07/10/2022] [Accepted: 08/25/2022] [Indexed: 06/15/2023]
Abstract
A serological survey from CDC revealed more than 10% of individuals in America probably resolving or past infection with SARS-CoV-2 at the end of 2020, which illustrated there were massive unconfirmed asymptomatic infected people by contrast with the reported cases numbers. Asymptomatic patients as one of the crucial reasons for the COVID-19 pandemic being tough to contain, estimating the number of unconfirmed ones including the active infected and having cured in this population, is of great guiding significance for formulating epidemic prevention and control policies. This paper proposes a varying coefficient Susceptible-Infected-Removed-Susceptible (vSIRS) model to obtain the time series data of the unconfirmed asymptomatic infected numbers. Moreover, due to the time-varying coefficients, we can effectively track the situation changes of the COVID-19 intervened by related policy support and medical care level through this epidemiological model. A novel two-stage approach with a programming problem is correspondingly developed to accomplish the estimation of the unknown parameters in the vSIRS model. Subsequently, by leveraging seroprevalence data, daily reported cases data, and other clinical information, we apply the vSIRS model to analyze the evolution of COVID-19 in America. The modeling results show millions of active asymptomatic infected individuals were unconfirmed during the autumn and winter of 2020, which was a momentous factor for driving American COVID-19 pandemic.
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Affiliation(s)
- Junyang Cai
- School of Management, Shanghai University, Shanghai 200444, China
| | - Jian Zhou
- School of Management, Shanghai University, Shanghai 200444, China
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14
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Almadhi M, Alsayyad AS, Conroy R, Atkin S, Awadhi AA, Al-Tawfiq JA, AlQahtani M. Epidemiological assessment of SARS-CoV-2 reinfection. Int J Infect Dis 2022; 123:9-16. [PMID: 35931371 PMCID: PMC9345650 DOI: 10.1016/j.ijid.2022.07.075] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/29/2022] [Accepted: 07/29/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES SARS-CoV-2 vaccination has been shown to reduce infection severity; however, the reinfection frequency among unvaccinated, partially vaccinated, and fully vaccinated individuals remains unclear. This study aims to elucidate the rates of and factors associated with such occurrences. METHODS This retrospective epidemiological report included 1362 COVID-19 reinfection cases in Bahrain between April 2020 and July 2021. We analyzed differences in disease severity and reinfection characteristics among various vaccination statuses: fully vaccinated, interrupted vaccination, one-dose vaccination, postreinfection vaccination, and unvaccinated. RESULTS Reinfection cases increased from zero per month in April-June 2020 to a sharp peak of 579 in May 2021. A significantly larger proportion of reinfected individuals were male (60.3%, P <0.0001). Reinfection episodes were highest among those 30-39 years of age (29.7%). The fewest reinfection episodes occurred at 3-6 months after the first infection (20.6%) and most occurred ≥9 months after the initial infection (46.4%). Most individuals were asymptomatic during both episodes (35.7%). Reinfection disease severity was mild, with vaccinated patients less likely to have symptomatic reinfection (odds ratio 0.71, P = 0.004). Only 6.6% of reinfected patients required hospitalization. One death was recorded; the patient belonged to the unvaccinated group. CONCLUSION Vaccine-induced immunity and previous infection with or without vaccination were effective in reducing reinfection disease severity.
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Affiliation(s)
- Marwa Almadhi
- National Taskforce for Combating the Coronavirus (COVID-19), Supreme health council, Manama, Bahrain,University of Manchester, Manchester, UK
| | - Adel Salman Alsayyad
- Department of Family and Community Medicine, Arabian Gulf University, Manama, Bahrain
| | - Ronan Conroy
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Stephen Atkin
- Royal College of Surgeons in Ireland, Busaiteen, Bahrain
| | - Abdulla Al Awadhi
- National Taskforce for Combating the Coronavirus (COVID-19), Supreme health council, Manama, Bahrain,Bahrain Defence Force Hospital, Riffa, Bahrain
| | - Jaffar A. Al-Tawfiq
- Infectious Disease Unit, Specialty Internal Medicine, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia,Division of Infectious Diseases, Indiana University School of Medicine, Indianapolis, Indiana, USA,Division of Infectious Diseases, Johns Hopkins University, Baltimore, Maryland, USA
| | - Manaf AlQahtani
- National Taskforce for Combating the Coronavirus (COVID-19), Supreme health council, Manama, Bahrain,Royal College of Surgeons in Ireland, Busaiteen, Bahrain,Bahrain Defence Force Hospital, Riffa, Bahrain,Corresponding author: Manaf AlQahtani, AlSayh Muharraq 15503, Phone: +973 3976 6000
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15
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Zalewska M, Fus W, Konka A, Wystyrk K, Bochenek A, Botor H, Fronczek M, Zembala-John J, Adamek B. An Immune Response to Heterologous ChAdOx1/BNT162b2 Vaccination against COVID-19: Evaluation of the anti-RBD Specific IgG Antibodies Titers and Interferon Gamma Release Assay (IGRA) Test Results. Vaccines (Basel) 2022; 10:vaccines10091546. [PMID: 36146624 PMCID: PMC9506411 DOI: 10.3390/vaccines10091546] [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: 08/12/2022] [Revised: 09/08/2022] [Accepted: 09/14/2022] [Indexed: 11/20/2022] Open
Abstract
This study aimed to assess the magnitude of anti-SARS-CoV-2 immunoglobulin G (IgG) titers and Interferon-Gamma Release Assay (IGRA) test results following administration of booster BNT162b2 in 48 ChAd-primed participants (vaccination schedule: ChAd/ChAd/BNT). Whole blood samples were collected: first, before and second, 21 days after the booster dose. The IgG level was measured using chemiluminescent immunoassay; the intensity of the T-cell response—IFNγ concentration—was assessed using IGRA test. At 21 days after the booster, all subjects achieved reactive/positive anti-SARS-CoV-2 IgG, and IGRA test results showed a significant increase compared to the results before booster administration. We compared the results before and after the booster between participants with and without prior history of COVID-19. The IFNγ concentrations in both cohorts were higher in convalescents (both before booster and 21 days after). The IgG titers were subtly lower in COVID-19 convalescents than in naïve but without statistical significance. Data on cell-mediated immunity are scarce, especially with regard to the general population. A better understanding of the complexity of the immune response to SARS-CoV-2 could contribute to developing more effective vaccination strategies.
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Affiliation(s)
- Marzena Zalewska
- Department of Medical and Molecular Biology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, H. Jordana 19, 41-808 Zabrze, Poland
- Correspondence:
| | - Wiktoria Fus
- Silesian Park of Medical Technology Kardio-Med Silesia, M. Curie-Skłodowskiej 10C, 41-800 Zabrze, Poland
| | - Adam Konka
- Silesian Park of Medical Technology Kardio-Med Silesia, M. Curie-Skłodowskiej 10C, 41-800 Zabrze, Poland
| | - Karolina Wystyrk
- Silesian Park of Medical Technology Kardio-Med Silesia, M. Curie-Skłodowskiej 10C, 41-800 Zabrze, Poland
| | - Aneta Bochenek
- Silesian Park of Medical Technology Kardio-Med Silesia, M. Curie-Skłodowskiej 10C, 41-800 Zabrze, Poland
| | - Hanna Botor
- Acellmed Ltd., M. Curie-Skłodowskiej 10C, 41-800 Zabrze, Poland
| | - Martyna Fronczek
- Silesian Park of Medical Technology Kardio-Med Silesia, M. Curie-Skłodowskiej 10C, 41-800 Zabrze, Poland
- Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, H. Jordana 38, 41-808 Zabrze, Poland
| | - Joanna Zembala-John
- Silesian Park of Medical Technology Kardio-Med Silesia, M. Curie-Skłodowskiej 10C, 41-800 Zabrze, Poland
- Department of Medicine and Environmental Epidemiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, H. Jordana 19, 41-808 Zabrze, Poland
- Silesian Center for Heart Diseases in Zabrze, M. Curie—Skłodowskiej 9, 41-800 Zabrze, Poland
| | - Brygida Adamek
- Department of Basic Medical Sciences, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, Piekarska 18, 41-902 Bytom, Poland
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16
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DiIorio M, Kennedy K, Liew JW, Putman MS, Sirotich E, Sattui SE, Foster G, Harrison C, Larché MJ, Levine M, Moni TT, Thabane L, Bhana S, Costello W, Grainger R, Machado PM, Robinson PC, Sufka P, Wallace ZS, Yazdany J, Gore-Massy M, Howard RA, Kodhek MA, Lalonde N, Tomasella LA, Wallace J, Akpabio A, Alpízar-Rodríguez D, Beesley RP, Berenbaum F, Bulina I, Chock EY, Conway R, Duarte-García A, Duff E, Gheita TA, Graef ER, Hsieh E, El Kibbi L, Liew DF, Lo C, Nudel M, Singh AD, Singh JA, Singh N, Ugarte-Gil MF, Hausmann JS, Simard JF, Sparks JA. Prolonged COVID-19 symptom duration in people with systemic autoimmune rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance Vaccine Survey. RMD Open 2022; 8:e002587. [PMID: 36104117 PMCID: PMC9475962 DOI: 10.1136/rmdopen-2022-002587] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 08/26/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE We investigated prolonged COVID-19 symptom duration, defined as lasting 28 days or longer, among people with systemic autoimmune rheumatic diseases (SARDs). METHODS We analysed data from the COVID-19 Global Rheumatology Alliance Vaccine Survey (2 April 2021-15 October 2021) to identify people with SARDs reporting test-confirmed COVID-19. Participants reported COVID-19 severity and symptom duration, sociodemographics and clinical characteristics. We reported the proportion experiencing prolonged symptom duration and investigated associations with baseline characteristics using logistic regression. RESULTS We identified 441 respondents with SARDs and COVID-19 (mean age 48.2 years, 83.7% female, 39.5% rheumatoid arthritis). The median COVID-19 symptom duration was 15 days (IQR 7, 25). Overall, 107 (24.2%) respondents had prolonged symptom duration (≥28 days); 42/429 (9.8%) reported symptoms lasting ≥90 days. Factors associated with higher odds of prolonged symptom duration included: hospitalisation for COVID-19 vs not hospitalised and mild acute symptoms (age-adjusted OR (aOR) 6.49, 95% CI 3.03 to 14.1), comorbidity count (aOR 1.11 per comorbidity, 95% CI 1.02 to 1.21) and osteoarthritis (aOR 2.11, 95% CI 1.01 to 4.27). COVID-19 onset in 2021 vs June 2020 or earlier was associated with lower odds of prolonged symptom duration (aOR 0.42, 95% CI 0.21 to 0.81). CONCLUSION Most people with SARDs had complete symptom resolution by day 15 after COVID-19 onset. However, about 1 in 4 experienced COVID-19 symptom duration 28 days or longer; 1 in 10 experienced symptoms 90 days or longer. Future studies are needed to investigate the possible relationships between immunomodulating medications, SARD type/flare, vaccine doses and novel viral variants with prolonged COVID-19 symptoms and other postacute sequelae of COVID-19 among people with SARDs.
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Affiliation(s)
- Michael DiIorio
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Kevin Kennedy
- Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Jean W Liew
- Section of Rheumatology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Michael S Putman
- Division of Rheumatology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Emily Sirotich
- Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Sebastian E Sattui
- Division of Rheumatology and Clinical Immunology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Gary Foster
- Department of Health Research Methods, Evidence and Impact (HEI); Medicine, McMaster University, Hamilton, Ontario, Canada
| | | | - Maggie J Larché
- Divisions of Clinical Immunology and Allergy/Rheumatology, McMaster University Department of Medicine, Hamilton, Ontario, Canada
| | - Mitchell Levine
- Department of Health Research Methods, Evidence and Impact (HEI), McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Tarin T Moni
- Department of Biochemistry & Biomedical Sciences, McMaster University Faculty of Science, Hamilton, Ontario, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence and Impact (HEI), McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Suleman Bhana
- Rheumatology, Crystal Run Healthcare, Middletown, New York, USA
| | - Wendy Costello
- N/A, Irish Children's Arthritis Network (iCAN), Tipperary, Ireland
| | - Rebecca Grainger
- Department of Medicine, University of Otago Wellington, Wellington, New Zealand
| | - Pedro M Machado
- MRC Centre for Neuromuscular Diseases, University College London, London, UK
- Rheumatology, University College London Centre for Rheumatology, London, UK
| | - Philip C Robinson
- Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
- Metro North Hospital & Health Service, Royal Brisbane and Woman's Hospital Health Service District, Herston, Queensland, Australia
| | - Paul Sufka
- Rheumatology, HealthPartners, St Paul, Minnesota, USA
| | - Zachary S Wallace
- Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Clinical Epidemiology Program and Rheumatology Unit, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Jinoos Yazdany
- Medicine/Rheumatology, University of California, San Francisco, California, USA
| | | | | | | | - Nadine Lalonde
- Patient Board, Covid-19 Global Rheumatology Alliance, London, Ontario, Canada
| | | | - John Wallace
- Rheumatology, Autoinflammatory UK, Edinburgh, UK
| | - Akpabio Akpabio
- Internal Medicine, University of Uyo Teaching Hospital, Uyo, Nigeria
| | | | - Richard P Beesley
- Juvenile Arthritis Research, European Network for Childhood Arthritis (ENCA), Tonbridge, UK
| | | | - Inita Bulina
- Rheumatology, Paul Stradins Clinical University Hospital, Riga, Latvia
| | - Eugenia Yupei Chock
- Section of Rheumatology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Richard Conway
- Department of Rheumatology, Saint James's Hospital, Dublin, Ireland
| | | | - Eimear Duff
- Rheumatology, Saint James's Hospital, Dublin, Ireland
| | - Tamer A Gheita
- Rheumatology and Clinical Immunology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Elizabeth R Graef
- Rheumatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Evelyn Hsieh
- Division of Rheumatology, Yale School of Medicine, New Haven, Connecticut, USA
- Rheumatology, VA Connecticut Healthcare System-West Haven Campus, West Haven, Connecticut, USA
| | - Lina El Kibbi
- Internal Medicine Department, Division of Rheumatology, Specialized Medical Center Hospital, Riyadh, Saudi Arabia
| | - David Fl Liew
- Rheumatology, Austin Health, Heidelberg West, Victoria, Australia
- Clinical Pharmacology and Therapeutics, Austin Health, Heidelberg, Victoria, Australia
| | - Chieh Lo
- Rheumatology, I-Shou University College of Medicine, Yanchau Sheng, Taiwan
| | - Michal Nudel
- N/A, The Israeli Association for RMDs patients "Mifrakim Tz'eirim", Haifa, Israel
| | - Aman Dev Singh
- Department of Community Medicine, Government Medical College Amritsar, Amritsar, Punjab, India
- Rajindra Hospital Patiala, Patiala, Punjab, India
| | - Jasvinder A Singh
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Medicine Service, Birmingham Veterans Affairs Medical Center, Birmingham, Alabama, USA
| | - Namrata Singh
- Medicine, Division of Rheumatology, University of Washington, Seattle, Washington, USA
| | - Manuel F Ugarte-Gil
- School of Medicine, Universidad Cientifica del Sur, Lima, Peru
- Rheumatology, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima, Peru
| | - Jonathan S Hausmann
- Rheumatology, Boston Children's Hospital, Boston, Massachusetts, USA
- Division of Rheumatology and Clinical Immunology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Julia F Simard
- Epidemiology and Population Health and Department of Medicine, Division of Immunology & Rheumatology, Stanford School of Medicine, Stanford, California, USA
- Department of Medicine, Clinical Epidemiology Unit, Sweden
| | - Jeffrey A Sparks
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, Massachusetts, USA
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Kotov I, Saenko V, Borisova N, Kolesnikov A, Kondrasheva L, Tivanova E, Khafizov K, Akimkin V. Effective Approaches to Study the Genetic Variability of SARS-CoV-2. Viruses 2022; 14:v14091855. [PMID: 36146662 PMCID: PMC9504788 DOI: 10.3390/v14091855] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 08/18/2022] [Accepted: 08/19/2022] [Indexed: 11/16/2022] Open
Abstract
Significant efforts are being made in many countries around the world to respond to the COVID-19 pandemic by developing diagnostic reagent kits, identifying infected people, determining treatment methods, and finally producing effective vaccines. However, novel coronavirus variants may potentially reduce the effectiveness of all these efforts, demonstrating increased transmissibility and abated response to therapy or vaccines, as well as the possibility of false negative results in diagnostic procedures based on nucleic acid amplification methods. Since the end of 2020, several variants of concern have been discovered around the world. When information about a new, potentially more dangerous strain of pathogen appears, it is crucial to determine the moment of its emergence in a region. Eventually, that permits taking timely measures and minimizing new risks associated with the spreading of the virus. Therefore, numerous nations have made tremendous efforts to identify and trace these virus variants, which necessitates serious technological processes to sequence a large number of viral genomes. Here, we report on our experience as one of the primary laboratories involved in monitoring SARS-CoV-2 variants in Russia. We discuss the various approaches used, describe effective protocols, and outline a potential technique combining several methods to increase the ability to trace genetic variants while minimizing financial and labor costs.
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Affiliation(s)
- Ivan Kotov
- FSBI Central Research Institute for Epidemiology of the Federal Service for Surveillance of Consumer Rights Protection and Human Wellbeing, 111123 Moscow, Russia
- Moscow Institute of Physics and Technology, National Research University, 115184 Dolgoprudny, Russia
| | - Valeriia Saenko
- FSBI Central Research Institute for Epidemiology of the Federal Service for Surveillance of Consumer Rights Protection and Human Wellbeing, 111123 Moscow, Russia
| | - Nadezhda Borisova
- FSBI Central Research Institute for Epidemiology of the Federal Service for Surveillance of Consumer Rights Protection and Human Wellbeing, 111123 Moscow, Russia
| | - Anton Kolesnikov
- FSBI Central Research Institute for Epidemiology of the Federal Service for Surveillance of Consumer Rights Protection and Human Wellbeing, 111123 Moscow, Russia
| | - Larisa Kondrasheva
- FSBI Central Research Institute for Epidemiology of the Federal Service for Surveillance of Consumer Rights Protection and Human Wellbeing, 111123 Moscow, Russia
| | - Elena Tivanova
- FSBI Central Research Institute for Epidemiology of the Federal Service for Surveillance of Consumer Rights Protection and Human Wellbeing, 111123 Moscow, Russia
| | - Kamil Khafizov
- FSBI Central Research Institute for Epidemiology of the Federal Service for Surveillance of Consumer Rights Protection and Human Wellbeing, 111123 Moscow, Russia
- Correspondence:
| | - Vasily Akimkin
- FSBI Central Research Institute for Epidemiology of the Federal Service for Surveillance of Consumer Rights Protection and Human Wellbeing, 111123 Moscow, Russia
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18
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Ren X, Zhou J, Guo J, Hao C, Zheng M, Zhang R, Huang Q, Yao X, Li R, Jin Y. Reinfection in patients with COVID-19: a systematic review. Glob Health Res Policy 2022; 7:12. [PMID: 35488305 PMCID: PMC9051013 DOI: 10.1186/s41256-022-00245-3] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 04/03/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND With the continuation of the COVID-19 pandemic, some COVID-19 patients have become reinfected with the virus. Viral gene sequencing has found that some of these patients were reinfected by the different and others by same strains. This has raised concerns about the effectiveness of immunity after infection and the reliability of vaccines. To this end, we conducted a systematic review to assess the characteristics of patients with reinfection and possible causes. METHODS A systematic search was conducted across eight databases: PubMed, Embase, Web of Science, The Cochrane Library, CNKI, WanFang, VIP and SinoMed from December 1, 2019 to September 1, 2021. The quality of included studies were assessed using JBI critical appraisal tools and Newcastle-Ottawa Scale. RESULTS This study included 50 studies from 20 countries. There were 118 cases of reinfection. Twenty-five patients were reported to have at least one complication. The shortest duration between the first infection and reinfection was 19 days and the longest was 293 days. During the first infection and reinfection, cough (51.6% and 43.9%) and fever (50% and 30.3%) were the most common symptoms respectively. Nine patients recovered, seven patients died, and five patients were hospitalized, but 97 patients' prognosis were unknown. B.1 is the most common variant strain at the first infection. B.1.1.7, B.1.128 and B.1.351 were the most common variant strains at reinfection. Thirty-three patients were infected by different strains and 9 patients were reported as being infected with the same strain. CONCLUSIONS Our research shows that it is possible for rehabilitated patients to be reinfected by SARS-COV-2. To date, the causes and risk factors of COVID-19 reinfection are not fully understood. For patients with reinfection, the diagnosis and management should be consistent with the treatment of the first infection. The public, including rehabilitated patients, should be fully vaccinated, wear masks in public places, and pay attention to maintaining social distance to avoid reinfection with the virus.
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Affiliation(s)
- Xiangying Ren
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
- College of Nursing and Health, Henan University, Kaifeng, Henan China
| | - Jie Zhou
- School of Nursing, Wuhan University, Wuhan, China
| | - Jing Guo
- Department of Acupuncture Rehabilitation, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Chunmei Hao
- The First Clinical College of Wuhan University, Wuhan, Hubei China
| | - Mengxue Zheng
- The First Clinical College of Wuhan University, Wuhan, Hubei China
| | - Rong Zhang
- Department of Neurotumor Disease Diagnosis and Treatment Center, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Qiao Huang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xiaomei Yao
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON Canada
- Center for Clinical Practice Guideline Conduction and Evaluation, Children’s Hospital of Fudan University, Shanghai, China
| | - Ruiling Li
- College of Nursing and Health, Henan University, Kaifeng, Henan China
| | - Yinghui Jin
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
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Nunhofer V, Weidner L, Hoeggerl AD, Zimmermann G, Badstuber N, Grabmer C, Jungbauer C, Lindlbauer N, Held N, Pascariuc M, Ortner T, Rohde E, Laner-Plamberger S. Persistence of Naturally Acquired and Functional SARS-CoV-2 Antibodies in Blood Donors One Year after Infection. Viruses 2022; 14:v14030637. [PMID: 35337044 PMCID: PMC8953712 DOI: 10.3390/v14030637] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 03/14/2022] [Accepted: 03/17/2022] [Indexed: 12/18/2022] Open
Abstract
The developmental course of antibodies produced after a SARS-CoV-2 infection has been insufficiently investigated so far. Therefore, the aim of this study was to investigate the dynamics of SARS-CoV-2 antibody levels against the viral nucleocapsid- and spike-protein among Austrian blood donors as a representative group of a supposedly healthy population within the first year after a SARS-CoV-2 infection. The impact of age, sex, vaccination status, AB0-blood group and awareness about the infection was evaluated. Our study shows that the level of anti-N antibodies is declining, while anti-S antibody levels remain stable. Antibodies detected were functional in vitro. Age, sex and blood group do not influence antibody dynamics. However, blood group AB shows significantly lower antibody levels and in vitro functionality compared to other blood groups. Our data reveal that one out of five individuals was not aware of a previous SARS-CoV-2 infection and that the disease course neither affects the level of antibody production nor the in vitro functionality. We also found that 14% of participants show persisting COVID-19-related symptoms for up to nine months. Our results provide valuable insights into the dynamics of the immune response after a SARS-CoV-2 infection in a representative cohort of adult blood donors in Central Europe.
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Affiliation(s)
- Verena Nunhofer
- Department for Transfusion Medicine, University Hospital of Salzburg (SALK), Paracelsus Medical University (PMU) Salzburg, Müllner-Hauptstraße 48, 5020 Salzburg, Austria; (V.N.); (A.D.H.); (C.G.); (N.L.); (N.H.); (M.P.); (E.R.)
| | - Lisa Weidner
- Austrian Red Cross, Blood Service for Vienna, Lower Austria and Burgenland, Wiedner Hauptstraße 32, 1040 Vienna, Austria; (L.W.); (C.J.)
| | - Alexandra Domnica Hoeggerl
- Department for Transfusion Medicine, University Hospital of Salzburg (SALK), Paracelsus Medical University (PMU) Salzburg, Müllner-Hauptstraße 48, 5020 Salzburg, Austria; (V.N.); (A.D.H.); (C.G.); (N.L.); (N.H.); (M.P.); (E.R.)
| | - Georg Zimmermann
- Team Biostatistics and Big Medical Data, IDA Lab Salzburg, PMU Salzburg, Strubergasse 16, 5020 Salzburg, Austria;
- Research and Innovation Management, PMU Salzburg, Strubergasse 16, 5020 Salzburg, Austria
| | - Natalie Badstuber
- Department of Psychological Assessment, Institute of Psychology, Paris-Lodron-University of Salzburg, 5020 Salzburg, Austria; (N.B.); (T.O.)
| | - Christoph Grabmer
- Department for Transfusion Medicine, University Hospital of Salzburg (SALK), Paracelsus Medical University (PMU) Salzburg, Müllner-Hauptstraße 48, 5020 Salzburg, Austria; (V.N.); (A.D.H.); (C.G.); (N.L.); (N.H.); (M.P.); (E.R.)
| | - Christof Jungbauer
- Austrian Red Cross, Blood Service for Vienna, Lower Austria and Burgenland, Wiedner Hauptstraße 32, 1040 Vienna, Austria; (L.W.); (C.J.)
| | - Nadja Lindlbauer
- Department for Transfusion Medicine, University Hospital of Salzburg (SALK), Paracelsus Medical University (PMU) Salzburg, Müllner-Hauptstraße 48, 5020 Salzburg, Austria; (V.N.); (A.D.H.); (C.G.); (N.L.); (N.H.); (M.P.); (E.R.)
| | - Nina Held
- Department for Transfusion Medicine, University Hospital of Salzburg (SALK), Paracelsus Medical University (PMU) Salzburg, Müllner-Hauptstraße 48, 5020 Salzburg, Austria; (V.N.); (A.D.H.); (C.G.); (N.L.); (N.H.); (M.P.); (E.R.)
| | - Monica Pascariuc
- Department for Transfusion Medicine, University Hospital of Salzburg (SALK), Paracelsus Medical University (PMU) Salzburg, Müllner-Hauptstraße 48, 5020 Salzburg, Austria; (V.N.); (A.D.H.); (C.G.); (N.L.); (N.H.); (M.P.); (E.R.)
| | - Tuulia Ortner
- Department of Psychological Assessment, Institute of Psychology, Paris-Lodron-University of Salzburg, 5020 Salzburg, Austria; (N.B.); (T.O.)
| | - Eva Rohde
- Department for Transfusion Medicine, University Hospital of Salzburg (SALK), Paracelsus Medical University (PMU) Salzburg, Müllner-Hauptstraße 48, 5020 Salzburg, Austria; (V.N.); (A.D.H.); (C.G.); (N.L.); (N.H.); (M.P.); (E.R.)
- Spinal Cord Injury and Tissue Regeneration Centre Salzburg, PMU Salzburg, Strubergasse 21, 5020 Salzburg, Austria
| | - Sandra Laner-Plamberger
- Department for Transfusion Medicine, University Hospital of Salzburg (SALK), Paracelsus Medical University (PMU) Salzburg, Müllner-Hauptstraße 48, 5020 Salzburg, Austria; (V.N.); (A.D.H.); (C.G.); (N.L.); (N.H.); (M.P.); (E.R.)
- Spinal Cord Injury and Tissue Regeneration Centre Salzburg, PMU Salzburg, Strubergasse 21, 5020 Salzburg, Austria
- Correspondence:
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Hurtado IC, Hurtado JS, Valencia SL, Pinzón EM, Guzmán AR, Lesmes MC. Reinfection by SARS CoV2 in Valle Del Cauca, Colombia: A Descriptive Retrospective Study. INQUIRY: THE JOURNAL OF HEALTH CARE ORGANIZATION, PROVISION, AND FINANCING 2022; 59:469580221096528. [PMID: 35574692 PMCID: PMC9109169 DOI: 10.1177/00469580221096528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Introduction: In coronavirus cases, reinfection has been associated with short-term immunity and genetic changes in viruses which allow them to escape from immune response, viral genotyping is required to make the precise diagnosis of reinfection, but the suspicion occurs in patients with more than 90 days between the tests and total improvement between them. We made a descriptive retrospective study with the cases of reinfection in Valle del Cauca, Colombia. Results: We found up to June 30, 3249 cases with suspected reinfection, 1.1% of all cases. During the first infection episode, 68% of the patients had symptoms, while at the moment of reinfection, the percentage was 73.4%. 55% of the analyzed cases had symptoms in both infection episodes, hospitalization of reinfection cases was 2% during the first episode and 2.2% in the second one. Conclusion: the reinfection percentage was low, as well as the hospitalization and ICU cases. These results allow to define that in terms of the provision of healthcare services, reinfection defined in this study, does not generate any differences in care required vs the first episode.
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Arif A, Chavarria Y, Qamar MA, Tebha SS, Butt M, Qamar K, Yosufi A. New-Onset Refractory Status Epilepticus Secondary to COVID-19 Infection in Adults: A Systematic Review. Neuropsychiatr Dis Treat 2022; 18:1951-1961. [PMID: 36065386 PMCID: PMC9440723 DOI: 10.2147/ndt.s381018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 08/20/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND New-onset refractory status epilepticus (NORSE) has been reported in the scientific literature as a phenomenon associated with the COVID-19 infection. Given the resurgence of the newer variants of COVID-19 added with its multi-system manifestations, this project was conducted to study the clinical picture of NORSE secondary to COVID-19 infection. METHODS Three electronic databases were searched using an extensive search strategy from November 2019 to December 2021. Patients reporting NORSE secondary to COVID-19 were included in this review. The status epilepticus severity score (STESS) was calculated by the study authors for individual patients. Statistical analysis was performed using SPSS version 26 with a p-value <0.05 as statistically significant. RESULTS After screening, 12 patients were included in this study with a mean age of 61.6 ± 19.0-year olds. The most common type of status epilepticus reported in our study population was non-convulsive status epilepticus (NCSE) (7 out of 12 patients, 58.3%). The linear regression model revealed that STESS scores were significantly influenced by patients' age (p = 0.004) and intra-hospital occurrence (IHO) of status epilepticus (p = 0.026). Overall, 8 patients (66.7%) were discharged without complications. CONCLUSION Given the observed association of STESS with the aging population and IHO of status epilepticus, special attention is due to the caretakers of this population, while further studies are needed to further build upon this review.
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Affiliation(s)
- Aabiya Arif
- Medical School, Ziauddin University, Karachi, Sindh, Pakistan
| | - Yeny Chavarria
- Department of Neurology, University of California, Irvine, CA, USA
| | | | - Sameer Saleem Tebha
- Department of Neurosurgery and Neurology, Jinnah Medical and Dental College, Karachi, Sindh, Pakistan
| | - Mehwish Butt
- Department of Neurosurgery and Neurology, Jinnah Medical and Dental College, Karachi, Sindh, Pakistan
| | - Khulud Qamar
- Department of Medicine, Dow Medical College, Karachi, Sindh, Pakistan
| | - Abubakr Yosufi
- Medical School, Kabul University of Medical Sciences, Kabul, Afghanistan
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22
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Phan PH, Nguyen DT, Dao NH, Nguyen HTT, Vu AV, Hoang ST, Nguyen LV, Cao TV, Tran DM. Case Report: Successful Treatment of a Child With COVID-19 Reinfection-Induced Fulminant Myocarditis by Cytokine-Adsorbing oXiris® Hemofilter Continuous Veno-Venous Hemofiltration and Extracorporeal Membrane Oxygenation. Front Pediatr 2022; 10:946547. [PMID: 35903158 PMCID: PMC9315247 DOI: 10.3389/fped.2022.946547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 06/15/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Indirect cardiomyocyte damage-related hyperinflammatory response is one of the key mechanisms in COVID-19-induced fulminant myocarditis. In addition to the clinical benefit of using cytokines absorption hemofiltration, the effectiveness of instituting veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support for cardiac compromise has been reported. However, current literature enunciates a paucity of available data on the effectiveness of these novel modalities. CASE PRESENTATION We reported a 9-year-old boy with recurrent COVID-19 infection-causing fulminant myocarditis, who was treated successfully by using novel modalities of oXiris ® hemofilter continuous venovenous hemofiltration (CVVH) and VA-ECMO. The patient made a full recovery without any sequelae. CONCLUSION We conclude that the novel highly-absorptive hemofilter CVVH and VA-ECMO may be effective treatment modalities in managing SARS-CoV-2-induced fulminant myocarditis. Our report highlights the need for further well-designed investigations to confirm this extrapolation.
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Affiliation(s)
- Phuc H Phan
- Pediatric COVID-19 Intensive Care Unit, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Dung T Nguyen
- Pediatric COVID-19 Intensive Care Unit, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Nam H Dao
- Pediatric COVID-19 Intensive Care Unit, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Ha T T Nguyen
- Pediatric COVID-19 Intensive Care Unit, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - An V Vu
- Pediatric COVID-19 Intensive Care Unit, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Son T Hoang
- Cardiovascular Center, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Lam V Nguyen
- Pediatric COVID-19 Intensive Care Unit, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Tung V Cao
- Pediatric COVID-19 Intensive Care Unit, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Dien M Tran
- Pediatric COVID-19 Intensive Care Unit, Vietnam National Children's Hospital, Hanoi, Vietnam
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