1
|
Gao Y, Shen Q, Zang Y, Miao T, Yang M, Liu Y, Zheng X, Shen S, Wu W. COVID-19 vaccination and long COVID among 50 years older and above European: The role of chronic multimorbidity. Arch Gerontol Geriatr 2024; 126:105554. [PMID: 38971080 DOI: 10.1016/j.archger.2024.105554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 06/24/2024] [Accepted: 06/26/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND AND AIMS We aimed to explore the association between coronavirus disease-19 (COVID-19) vaccination and long COVID according to the status of chronic multimobidity. METHODS A total of 1913 participants were recruited in the cross-sectional study on the basis of the Survey of Health and Retirement in Europe. COVID-19 vaccination was defined as vaccination within the last 12 months. Chronic multimorbidity was defined as history of 2 + chronic disease. The study outcome was long COVID during the 12-month follow-up. Multivariable logistic models were performed to estimate the influence of chronic multimorbidity on the association of vaccination with long COVID. Net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were calculated. RESULTS Chronic multimorbidity significantly modified the association of COVID-19 vaccination with long COVID (Pinteraction = 0.024). The rates of study outcome were significantly lower among vaccinated participants in the chronic multimorbidity subgroup, but not in the other subgroup. Multivariable odds ratios (95 % confidence intervals) of study outcome for unvaccination vs. vaccination were 1.494 (1.013-2.203) in those with multimorbidity and 0.915 (0.654-1.280) in those without multimorbidity, respectively. Adding COVID-19 vaccination to a model containing conventional risk factors significantly improved risk reclassification for study outcome among those with chronic multimobidity (continuous NRI was 25.39 % [P = 0.002] and IDI was 0.42 % [P = 0.075]) CONCLUSION: An inverse association of COVID-19 vaccination with long COVID was found among participants with chronic multimorbidity, but not among those without chronic multimorbidity. Chronic multimorbidity might expand the influence of unvaccination on developing long COVID among European aged ≥50 years.
Collapse
Affiliation(s)
- Yumeng Gao
- Department of Acute Infectious Disease Control, The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University, Wuxi Center for Disease Control and Prevention, Wuxi, Jiangsu, 214023, China
| | - Qian Shen
- Department of Chronic Non-Communicable Disease Control, The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University, Wuxi Center for Disease Control and Prevention, Wuxi, Jiangsu, 214023, China
| | - Yuhan Zang
- Department of Health Promotion and Chronic Non-Communicable Disease Control, Wuzhong Center for Disease Control and Prevention, Suzhou, Jiangsu, 215000, China
| | - Tongtong Miao
- Department of Pharmacy, Nantong First People's Hospital, Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, 226006, China
| | - Man Yang
- Department of Chronic Non-Communicable Disease Control, The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University, Wuxi Center for Disease Control and Prevention, Wuxi, Jiangsu, 214023, China
| | - Yaqi Liu
- Department of Chronic Non-Communicable Disease Control, The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University, Wuxi Center for Disease Control and Prevention, Wuxi, Jiangsu, 214023, China
| | - Xiaowei Zheng
- Public Health Research Center and Department of Public Health and Preventive Medicine, Wuxi School of Medicine Jiangnan University, Wuxi, Jiangsu, 214122, China
| | - Suwen Shen
- Department of Chronic Non-Communicable Disease Control, The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University, Wuxi Center for Disease Control and Prevention, Wuxi, Jiangsu, 214023, China; Department of Medical Administration, Suzhou Industrial Park Medical and Health Management Center, Suzhou, Jiangsu, 215028, China.
| | - Wenyan Wu
- Center of Clinical Laboratory, The Fifth People's Hospital of Wuxi, Affiliated Hospital of Jiangnan University, Jiangnan University, Wuxi, Jiangsu, 214011, China.
| |
Collapse
|
2
|
Xu D, Xu Z. Machine learning applications in preventive healthcare: A systematic literature review on predictive analytics of disease comorbidity from multiple perspectives. Artif Intell Med 2024; 156:102950. [PMID: 39163727 DOI: 10.1016/j.artmed.2024.102950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 06/17/2024] [Accepted: 08/13/2024] [Indexed: 08/22/2024]
Abstract
Artificial intelligence is constantly revolutionizing biomedical research and healthcare management. Disease comorbidity is a major threat to the quality of life for susceptible groups, especially middle-aged and elderly patients. The presence of multiple chronic diseases makes precision diagnosis challenging to realize and imposes a heavy burden on the healthcare system and economy. Given an enormous amount of accumulated health data, machine learning techniques show their capability in handling this puzzle. The present study conducts a review to uncover current research efforts in applying these methods to understanding comorbidity mechanisms and making clinical predictions considering these complex patterns. A descriptive metadata analysis of 791 unique publications aims to capture the overall research progression between January 2012 and June 2023. To delve into comorbidity-focused research, 61 of these scientific papers are systematically assessed. Four predictive analytics of tasks are detected: disease comorbidity data extraction, clustering, network, and risk prediction. It is observed that some machine learning-driven applications address inherent data deficiencies in healthcare datasets and provide a model interpretation that identifies significant risk factors of comorbidity development. Based on insights, both technical and practical, gained from relevant literature, this study intends to guide future interests in comorbidity research and draw conclusions about chronic disease prevention and diagnosis with managerial implications.
Collapse
Affiliation(s)
- Duo Xu
- School of Economics and Management, Southeast University, Nanjing 211189, China.
| | - Zeshui Xu
- School of Economics and Management, Southeast University, Nanjing 211189, China; Business School, Sichuan University, Chengdu 610064, China.
| |
Collapse
|
3
|
van Dijk WJ, Haaksma ML, Mook-Kanamori DO, Visser LG, Numans ME, van Hylckama Vlieg A, Rosendaal FR, Kiefte-de Jong JC. Incidence, symptom clusters and determinants of post-acute COVID symptoms: a population-based surveillance in community-dwelling users of the COVID RADAR app. BMJ Open 2024; 14:e087235. [PMID: 39260850 PMCID: PMC11409358 DOI: 10.1136/bmjopen-2024-087235] [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: 09/13/2024] Open
Abstract
OBJECTIVES This study aims to describe the incidence, symptom clusters and determinants of post-acute COVID symptoms using data from the COVID RADAR app in the Netherlands. DESIGN Prospective cohort. SETTING General population in the Netherlands from April 2020 to February 2022. PARTICIPANTS A total of 1478 COVID RADAR app users, with data spanning 40 days before to 100 days after positive SARS-CoV-2 test. OUTCOME MEASURES Incidence and duration of 10 new symptoms that developed during acute infection, defined as 10 days prior and 10 days after positive test. Clustering of these post-acute COVID symptoms and associations between factors known in the acute phase and 100-day symptom persistence. RESULTS The most frequent post-acute symptoms were cough, loss of smell or taste and fatigue. At 100 days postinfection, 86 (8%) participants still experienced symptoms. Three post-acute COVID symptom clusters were identified: non-respiratory (headache and fatigue; 49% of participants with post-acute COVID symptoms); olfactory (15%) and respiratory (8%). Vaccination was associated with a lower risk of post-acute COVID symptoms 100 days after infection, although CIs were wide (OR: 0.5; 95% CI: 0.2 to 1.5), but not with non-respiratory symptoms (OR: 1.0; 95% CI: 0.3 to 4.4). Severe acute disease increased the risk of post-acute COVID symptoms (OR: 1.4; 95% CI: 1.2 to 1.5; per additional acute symptom). CONCLUSIONS In this cohort of infected community-dwelling app users, 5%-10% experienced post-acute COVID symptoms. The symptoms cluster in several distinct entities, which differ in incidence, patient characteristics and vaccination effects. This suggests multiple mechanisms underlying the development of post-acute COVID symptoms.
Collapse
Affiliation(s)
- Willian J van Dijk
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Miriam L Haaksma
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Dennis O Mook-Kanamori
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Leo G Visser
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
| | - Mattijs E Numans
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - A van Hylckama Vlieg
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Frits R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jessica C Kiefte-de Jong
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| |
Collapse
|
4
|
Islam Z, Yamamoto S, Mizoue T, Konishi M, Ohmagari N. Coffee and Green Tea Consumption With the Risk of COVID-19 Among the Vaccine Recipients in Japan: A Prospective Study. J Epidemiol 2024; 34:444-452. [PMID: 38346747 PMCID: PMC11330706 DOI: 10.2188/jea.je20230231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2024] Open
Abstract
BACKGROUND While coffee and green tea have been suggested to have immunoprotective effects, it remains elusive whether they can decrease the risk of coronavirus disease 2019 (COVID-19). OBJECTIVE We prospectively examined the associations of coffee and green tea consumption with the risk of COVID-19 among mRNA vaccine recipients during the epidemic of the Omicron variant. METHODS Participants were 2,110 staff (aged 18 to 76 years) of a large medical facility in Tokyo, who attended a serosurvey in June 2022, predominantly received ≥3 doses of vaccine, and were followed for COVID-19 until December 2022. Coffee and green tea consumption was ascertained via a questionnaire. COVID-19 was identified through the in-house registry. Cox proportional hazards model was used to estimate the hazard ratios (HRs) of COVID-19 across the categories of beverage consumption. RESULTS During 6 months of follow-up, 225 (10.6%) cases of COVID-19 were identified. Contrary to the expectation, higher consumption of coffee was associated with a significant increase in the risk of COVID-19; multivariable-adjusted HRs were 1.00 (reference), 0.92 (95% confidence interval [CI], 0.62-1.35), 1.48 (95% CI, 0.99-2.22), and 1.82 (95% CI, 1.20-2.76) for <1 cup/day, 1 cup/day, 2 cups/day, and ≥3 cups/day, respectively (P trend = 0.003). Green tea consumption was not significantly associated with the risk of COVID-19. The association with coffee was attenuated if serologically detected infection was added to the cases. CONCLUSION In a cohort of Japanese hospital staff who received COVID-19 vaccine, higher consumption of coffee was associated with an increased risk of COVID-19 during the epidemic of the Omicron variant. There was no evidence of a significant association between green tea consumption and COVID-19 risk.
Collapse
Affiliation(s)
- Zobida Islam
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine
| | - Shohei Yamamoto
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine
| | - Maki Konishi
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine
| | - Norio Ohmagari
- Center Hospital of the National Center for Global Health and Medicine
| |
Collapse
|
5
|
Wilpstra CD, Morrell S, Mirza NA, Ralph JL. Consequences of COVID-19 Vaccine Hesitancy Among Healthcare Providers During the First 10 Months of Vaccine Availability: Scoping Review. Can J Nurs Res 2024; 56:204-224. [PMID: 38693882 PMCID: PMC11308270 DOI: 10.1177/08445621241251711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2024] Open
Abstract
BACKGROUND Throughout the COVID-19 pandemic, healthcare providers (HCPs)-including nurses-have played important roles in the vaccination effort. It is expected that COVID-19 vaccine hesitancy among HCPs has numerous consequences; however, the scope of these consequences and their impacts on providers, patients, and the broader healthcare system remained unclear. PURPOSE To identify existing and emerging evidence to understand the state of knowledge of the consequences of COVID-19 vaccine hesitancy among HCPs. METHODS A scoping review was completed based upon the JBI scoping review methodology. The databases searched included OVID Medline, EBSCOhost CINAHL, ProQuest Nursing and Allied Health Source, ProQuest APA PsycInfo, and ProQuest Dissertations and Theses. The final literature search was completed on June 2, 2022. Studies were screened and retrieved based on predefined inclusion and exclusion criteria using Covidence reference management software. Data extraction followed criteria recommended in the JBI scoping review framework with additional relevant variables identified by the authors. RESULTS A total of 33 sources were included in the review. Consequences of HCP COVID-19 vaccine hesitancy were grouped under three themes and seven subthemes. Consequences affecting HCPs included health-related, psychosocial, and employment-related consequences. Consequences affecting patients pertained to COVID-19 vaccination communication and COVID-19 vaccination practices of HCPs. Consequences to the healthcare system involved consequences to coworkers and employment/attendance/staffing-related consequences. CONCLUSIONS Healthcare provider COVID-19 vaccine hesitancy was found to have numerous consequences. By understanding the scope and extent of these consequences, healthcare leaders, researchers, and HCPs can work together to protect providers, patients, and healthcare systems.
Collapse
Affiliation(s)
| | - Sherry Morrell
- Faculty of Nursing, University of Windsor, Windsor, Canada
| | | | - Jody L. Ralph
- Faculty of Nursing, University of Windsor, Windsor, Canada
| |
Collapse
|
6
|
Britton PN, Burrell R, Chapman E, Boyle J, Alexander S, Belessis Y, Dalby-Payne J, Knight K, Lau C, McMullan B, Milne B, Paull M, Nguyen J, Selvadurai H, Dale R, Baillie A. Post COVID-19 conditions in an Australian pediatric cohort, 3 months following a Delta outbreak. Pediatr Res 2024:10.1038/s41390-024-03492-x. [PMID: 39215197 DOI: 10.1038/s41390-024-03492-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 06/27/2024] [Accepted: 07/30/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Pediatric long COVID remains incompletely understood with scant Australian data available. We aimed to assess the impacts of the 2021 Delta variant of SARS-CoV-2 outbreak on symptoms and functioning 12 weeks post-acute infection in a cohort of children and adolescents. METHODS The parents/carers of 11,864 patients with PCR-confirmed SARS-CoV-2 were invited, via email or text message, to complete an online survey assessing symptoms and functional impairment. FINDINGS 1731 (17.6%) responded to the survey. 203 (11.7%) reported continued symptoms and/or functional impairment which were flagged for clinical review, all others reported recovery. Of the 169 subsequently clinically reviewed, 63 had already recovered (37.3%) and 17 had exacerbation of pre-existing condition(s) (10.1%); 63 (37.3%) were diagnosed with a Post COVID Condition (PCC). Of these, 21 (12.4%) were considered to have features compatible with the United Kingdom consensus cases definition for Long COVID. INTERPRETATION During an outbreak of SARS-CoV-2 an online questionnaire with subsequent clinical review revealed self-reported non-recovery at 12 weeks in a minority of cases, with a spectrum of features. Long COVID comprised only a subset of cases with self-reported non-recovery, and is infrequent in children and adolescents, but still comprises a likely significant burden that warrants attention. IMPACT Our study provides the only comprehensive estimate of the frequency and spectrum of post-COVID conditions in children from Australia. The high frequency of self-reported recovery, and low frequency of Long COVID compatible illness adds to the literature from other settings. Risk factors for post-COVID conditions in children are identified and include: age >11 year, and previous medical co-morbidity.
Collapse
Affiliation(s)
- Philip N Britton
- The Children's Hospital at Westmead Clinical School, Sydney Medical School, the University of Sydney, Westmead, NSW, Australia.
- Department of Infectious Diseases and Microbiology, the Children's Hospital at Westmead, Sydney Children's Hospitals Network, Westmead, NSW, Australia.
- Centre for Pediatric and Perinatal Infection Research, the Children's Hospital at Westmead, Sydney Children's Hospitals Network, Westmead, NSW, Australia.
| | - Rebecca Burrell
- The Children's Hospital at Westmead Clinical School, Sydney Medical School, the University of Sydney, Westmead, NSW, Australia
- Centre for Pediatric and Perinatal Infection Research, the Children's Hospital at Westmead, Sydney Children's Hospitals Network, Westmead, NSW, Australia
| | - Emily Chapman
- Integrated Care team, virtual KIDS- COVID-19 Outpatient Response Team, Sydney Children's Hospitals Network, Westmead, NSW, Australia
| | - Julia Boyle
- Matilda Centre for Research in Mental Health and Substance Use, the University of Sydney, Camperdown, NSW, Australia
| | - Shirley Alexander
- Weight Management Services, the Children's Hospital at Westmead, Sydney Children's Hospitals Network, Westmead, NSW, Australia
| | - Yvonne Belessis
- Department of Respiratory Medicine, Sydney Children's Hospital, Randwick, Sydney Children's Hospitals Network, Randwick, NSW, Australia
- School of Clinical Medicine, Faculty of Medicine and Health, the University of New South Wales, Sydney, NSW, Australia
| | - Jacqueline Dalby-Payne
- Department of General Medicine, the Children's Hospital at Westmead, Sydney Children's Hospital Network, Westmead, NSW, Australia
| | - Katherine Knight
- Department of Psychological Medicine, the Children's Hospital at Westmead, Sydney Children's Hospital Network, Westmead, NSW, Australia
| | - Christine Lau
- Integrated Care team, virtual KIDS- COVID-19 Outpatient Response Team, Sydney Children's Hospitals Network, Westmead, NSW, Australia
| | - Brendan McMullan
- School of Clinical Medicine, Faculty of Medicine and Health, the University of New South Wales, Sydney, NSW, Australia
- Department of Immunology and Infectious Diseases, Sydney Children's Hospital, Randwick, Sydney Children's Hospitals Network, Randwick, NSW, Australia
| | - Bronwyn Milne
- Department of Adolescent Medicine, the Children's Hospital at Westmead, Sydney Children's Hospital Network, Westmead, NSW, Australia
| | - Marilyn Paull
- Department of Adolescent Medicine, the Children's Hospital at Westmead, Sydney Children's Hospital Network, Westmead, NSW, Australia
| | - Jonathan Nguyen
- Integrated Care team, virtual KIDS- COVID-19 Outpatient Response Team, Sydney Children's Hospitals Network, Westmead, NSW, Australia
| | - Hiran Selvadurai
- The Children's Hospital at Westmead Clinical School, Sydney Medical School, the University of Sydney, Westmead, NSW, Australia
- Department of Respiratory Medicine, the Children's Hospital at Westmead, Sydney Children's Hospitals Network, Westmead, NSW, Australia
| | - Russell Dale
- The Children's Hospital at Westmead Clinical School, Sydney Medical School, the University of Sydney, Westmead, NSW, Australia
| | - Andrew Baillie
- The University of Sydney School of Health Sciences the University of Sydney, Camperdown, NSW, Australia
- Sydney Local Health District, the University of Sydney, Camperdown, NSW, Australia
| |
Collapse
|
7
|
Rothensteiner M, Leeb F, Götzinger F, Tebruegge M, Zacharasiewicz A. Long COVID in Children and Adolescents: A Critical Review. CHILDREN (BASEL, SWITZERLAND) 2024; 11:972. [PMID: 39201907 PMCID: PMC11352730 DOI: 10.3390/children11080972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Revised: 07/30/2024] [Accepted: 07/31/2024] [Indexed: 09/03/2024]
Abstract
(1) Background: Data on persisting symptoms after SARS-CoV-2 infection in children and adolescents are conflicting. Due to the absence of a clear pathophysiological correlate and a definitive diagnostic test, the diagnosis of Long COVID currently rests on consensus definitions only. This review aims to summarise the evidence regarding Long COVID in children and adolescents, incorporating the latest studies on this topic. (2) Methods: We designed a comprehensive search strategy to capture all relevant publications using Medline via the PubMed interface, with the initial literature search conducted in April 2023. To be included, publications had to present original data and include >50 participants with Long COVID symptoms aged between 0 and18 years. (3) Results: A total of 51 studies met the inclusion criteria, with most studies originating from Europe (n = 34; 66.7%), followed by the Americas (n = 8; 15.7%) and Asia (n = 7; 13.7%). Various study designs were employed, including retrospective, cross-sectional, prospective, or ambispective approaches. Study sizes varied significantly, with 18/51 studies having fewer than 500 participants. Many studies had methodological limitations: 23/51 (45.1%) studies did not include a control group without prior COVID-19 infection. Additionally, a considerable number of papers (33/51; 64.7%) did not include a clear definition of Long COVID. Other limitations included the lack of PCR- or serology-based confirmation of SARS-CoV-2 infection in the study group. Across different studies, there was high variability in the reported prevalence of Long COVID symptoms, ranging from 0.3% to 66.5%, with the majority of studies included in this review reporting prevalences of approximately 10-30%. Notably, the two studies with the highest prevalences also reported very high prevalences of Long COVID symptoms in the control group. There was a relatively consistent trend for Long COVID prevalence to decline substantially over time. The prevalence of Long COVID appeared to differ across different paediatric age groups, with teenagers being more commonly affected than younger children. Furthermore, data suggest that children and adolescents are less commonly affected by Long COVID compared to adults. In children and adolescents, Long COVID is associated with a very broad range of symptoms and signs affecting almost every organ system, with the respiratory, cardiovascular, and neuropsychiatric systems being most commonly affected. (4) Conclusions: The heterogeneity and limitations of published studies on Long COVID in children and adolescents complicate the interpretation of the existing data. Future studies should be rigorously designed to address unanswered questions regarding this complex disease.
Collapse
Affiliation(s)
- Maria Rothensteiner
- Department of Paediatrics and Adolescent Medicine, Klinik Ottakring, 1160 Vienna, Austria
| | - Franziska Leeb
- Department of Paediatrics and Adolescent Medicine, Medical University Vienna, 1090 Wien, Austria
| | - Florian Götzinger
- Department of Paediatrics and Adolescent Medicine, Klinik Ottakring, 1160 Vienna, Austria
| | - Marc Tebruegge
- Department of Paediatrics and Adolescent Medicine, Klinik Ottakring, 1160 Vienna, Austria
- Department of Paediatrics, Royal Children’s Hospital Melbourne, University of Melbourne, Melbourne, VIC 3052, Australia
- Department of Infection, Immunity & Inflammation, UCL Great Ormond Street Institute of Child Health, University College London, London WCN1 1EH, UK
| | - Angela Zacharasiewicz
- Department of Paediatrics and Adolescent Medicine, Klinik Ottakring, 1160 Vienna, Austria
| |
Collapse
|
8
|
Spiliopoulos L, Sørensen AIV, Bager P, Nielsen NM, Hansen JV, Koch A, Meder IK, Videbech P, Ethelberg S, Hviid A. Postacute symptoms 4 months after SARS-CoV-2 infection during the Omicron period: a nationwide Danish questionnaire study. Am J Epidemiol 2024; 193:1106-1114. [PMID: 37981717 PMCID: PMC11299024 DOI: 10.1093/aje/kwad225] [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: 10/28/2022] [Revised: 10/27/2023] [Accepted: 11/14/2023] [Indexed: 11/21/2023] Open
Abstract
Postacute symptoms are not uncommon after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with pre-Omicron variants. How the Omicron variant and coronavirus disease 2019 (COVID-19) booster vaccination influence the risk of postacute symptoms is less clear. We analyzed data from a nationwide Danish questionnaire study, EFTER-COVID, comprising 36 109 individuals aged ≥15 years who were tested between July 2021 and January 2022, to evaluate the associations of the Omicron variant and COVID-19 booster vaccination with postacute symptoms and new-onset general health problems 4 months after infection with SARS-CoV-2. Risk differences (RDs) were estimated by comparing Omicron cases with controls, comparing Omicron cases with Delta cases, and comparing Omicron cases vaccinated with 3 doses with those vaccinated with 2 doses, adjusting for age, sex, body mass index, self-reported chronic diseases, Charlson comorbidity index, health-care occupation, and vaccination status. Four months after testing for SARS-CoV-2 during the Omicron period, cases experienced substantial postacute symptoms and new-onset health problems in comparison with controls; the largest RD was observed for memory issues (RD = 7.4%; 95% CI, 6.4-8.3). However, risks were generally lower than those in the Delta period, particularly for dysosmia (RD = -15.0%; 95% CI, -17.0 to -13.2) and dysgeusia (RD = -11.2%; 95% CI, -13.2 to -9.5). Booster vaccination was associated with fewer postacute symptoms and new-onset health problems 4 months after Omicron infection as compared with 2 doses of COVID-19 vaccine.
Collapse
Affiliation(s)
- Lampros Spiliopoulos
- Department of Epidemiology Research, Statens Serum Institut, 2300 Copenhagen, Denmark
| | - Anna Irene Vedel Sørensen
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, 2300 Copenhagen, Denmark
| | - Peter Bager
- Department of Epidemiology Research, Statens Serum Institut, 2300 Copenhagen, Denmark
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, 2300 Copenhagen, Denmark
| | - Nete Munk Nielsen
- Department of Epidemiology Research, Statens Serum Institut, 2300 Copenhagen, Denmark
- Focused Research Unit in Neurology, Department of Neurology, Hospital of Southern Jutland, University of Southern Denmark, 6200 Aabenraa, Denmark
| | - Jørgen Vinsløv Hansen
- Department of Epidemiology Research, Statens Serum Institut, 2300 Copenhagen, Denmark
| | - Anders Koch
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, 2300 Copenhagen, Denmark
- Department of Infectious Diseases, Rigshospitalet University Hospital, 2100 Copenhagen, Denmark
- Global Health Section, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, 1014 Copenhagen, Denmark
| | - Inger Kristine Meder
- Department of Epidemiology Research, Statens Serum Institut, 2300 Copenhagen, Denmark
| | - Poul Videbech
- Centre for Neuropsychiatric Depression Research, Mental Health Centre Glostrup, 2600 Glostrup, Denmark
- Institute for Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Steen Ethelberg
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, 2300 Copenhagen, Denmark
- Global Health Section, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, 1014 Copenhagen, Denmark
| | - Anders Hviid
- Department of Epidemiology Research, Statens Serum Institut, 2300 Copenhagen, Denmark
- Pharmacovigilance Research Centre, Department of Drug Design and Pharmacology, University of Copenhagen, 2100 Copenhagen, Denmark
| |
Collapse
|
9
|
Saad-Roy CM, Morris SE, Boots M, Baker RE, Lewis BL, Farrar J, Marathe MV, Graham AL, Levin SA, Wagner CE, Metcalf CJE, Grenfell BT. Impact of waning immunity against SARS-CoV-2 severity exacerbated by vaccine hesitancy. PLoS Comput Biol 2024; 20:e1012211. [PMID: 39102402 PMCID: PMC11299835 DOI: 10.1371/journal.pcbi.1012211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 05/29/2024] [Indexed: 08/07/2024] Open
Abstract
The SARS-CoV-2 pandemic has generated a considerable number of infections and associated morbidity and mortality across the world. Recovery from these infections, combined with the onset of large-scale vaccination, have led to rapidly-changing population-level immunological landscapes. In turn, these complexities have highlighted a number of important unknowns related to the breadth and strength of immunity following recovery or vaccination. Using simple mathematical models, we investigate the medium-term impacts of waning immunity against severe disease on immuno-epidemiological dynamics. We find that uncertainties in the duration of severity-blocking immunity (imparted by either infection or vaccination) can lead to a large range of medium-term population-level outcomes (i.e. infection characteristics and immune landscapes). Furthermore, we show that epidemiological dynamics are sensitive to the strength and duration of underlying host immune responses; this implies that determining infection levels from hospitalizations requires accurate estimates of these immune parameters. More durable vaccines both reduce these uncertainties and alleviate the burden of SARS-CoV-2 in pessimistic outcomes. However, heterogeneity in vaccine uptake drastically changes immune landscapes toward larger fractions of individuals with waned severity-blocking immunity. In particular, if hesitancy is substantial, more robust vaccines have almost no effects on population-level immuno-epidemiology, even if vaccination rates are compensatorily high among vaccine-adopters. This pessimistic scenario for vaccination heterogeneity arises because those few individuals that are vaccine-adopters are so readily re-vaccinated that the duration of vaccinal immunity has no appreciable consequences on their immune status. Furthermore, we find that this effect is heightened if vaccine-hesitants have increased transmissibility (e.g. due to riskier behavior). Overall, our results illustrate the necessity to characterize both transmission-blocking and severity-blocking immune time scales. Our findings also underline the importance of developing robust next-generation vaccines with equitable mass vaccine deployment.
Collapse
Affiliation(s)
- Chadi M. Saad-Roy
- Miller Institute for Basic Research in Science, University of California, Berkeley, California, United States of America
- Department of Integrative Biology, University of California, Berkeley, California, United States of America
| | - Sinead E. Morris
- Department of Pathology and Cell Biology, Columbia University Medical Center, Columbia University, New York, New York, United States of America
| | - Mike Boots
- Department of Integrative Biology, University of California, Berkeley, California, United States of America
- Department of Biosciences, University of Exeter, Penryn, United Kingdom
| | - Rachel E. Baker
- Department of Epidemiology, Brown School of Public Health, Brown University, Providence, Rhode Island, United States of America
| | - Bryan L. Lewis
- Network Systems Science and Advanced Computing Division, Biocomplexity Institute, University of Virginia, Charlottesville, Virginia, United States of America
| | | | - Madhav V. Marathe
- Network Systems Science and Advanced Computing Division, Biocomplexity Institute, University of Virginia, Charlottesville, Virginia, United States of America
- Department of Computer Science, University of Virginia, Charlottesville, Virginia, United States of America
| | - Andrea L. Graham
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, New Jersey, United States of America
| | - Simon A. Levin
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, New Jersey, United States of America
| | | | - C. Jessica E. Metcalf
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, New Jersey, United States of America
- School of Public and International Affairs, Princeton University, Princeton, New Jersey, United States of America
| | - Bryan T. Grenfell
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, New Jersey, United States of America
- School of Public and International Affairs, Princeton University, Princeton, New Jersey, United States of America
| |
Collapse
|
10
|
Liao S, Teopiz KM, Kwan ATH, Le GH, Wong S, Ballum H, Rhee TG, Badulescu S, Cao B, Guo Z, Meshkat S, Phan L, Subramaniapillai M, Ho R, McIntyre RS. Relationship between anhedonia and psychosocial functioning in post-COVID-19 condition: a post-hoc analysis. Curr Med Res Opin 2024; 40:1407-1411. [PMID: 38954402 DOI: 10.1080/03007995.2024.2374510] [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: 02/21/2024] [Revised: 06/20/2024] [Accepted: 06/25/2024] [Indexed: 07/04/2024]
Abstract
BACKGROUND Post-COVID-19 condition (PCC), also known as "long COVID," is characterized by persistent symptoms, negatively affecting the well-being of individuals with PCC. Anhedonia (i.e. reduced capacity for pleasure) and compromised psychosocial functioning are notable symptoms in those with PCC. We aimed to provide insights to understand the effects of anhedonia and impaired psychosocial functioning of individuals with PCC. METHODS This post-hoc analysis used data from an 8-week, double-blind, randomized, placebo-controlled trial which evaluated vortioxetine for cognitive deficits in individuals with PCC (Clinicaltrials.gov Identifier: NCT05047952). A total of 147 eligible participants were randomly assigned to receive vortioxetine or matching placebo over eight weeks of double-blind treatment. Our study investigated the relationship between anhedonia, assessed by the Snaith-Hamilton Pleasure Scale (SHAPS), and psychosocial functioning, measured with the Post-COVID Functional Status (PCFS) scale. The analysis was conducted using a generalized linear model, with adjustments for relevant covariates such as age, sex, education, suspected versus confirmed COVID diagnosis, MDD diagnosis, and alcohol consumption. RESULTS Of the 147 participants, 143 participants had available baseline data for analysis. We observed that baseline PCFS score was statistically significantly positively correlated to baseline SHAPS score (β = 0.070, p = 0.045, 95% CI). DISCUSSIONS Our analysis revealed a significant relationship between measures of anhedonia and psychosocial functioning in adults with PCC. Strategies that aim to improve patient-reported outcomes with PCC need to prioritize the prevention and treatment of hedonic disturbances in patients experiencing PCC.
Collapse
Affiliation(s)
- Sonya Liao
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | - Kayla M Teopiz
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | - Angela T H Kwan
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Gia Han Le
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Sabrina Wong
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Hana Ballum
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | - Taeho Greg Rhee
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Sebastian Badulescu
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Bing Cao
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, P. R. China
| | - Ziji Guo
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | - Shakila Meshkat
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | - Lee Phan
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | | | - Roger Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, Singapore
- Division of Life Science (LIFS), Hong Kong University of Science and Technology, Hong Kong, Hong Kong
| | - Roger S McIntyre
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
11
|
Chidambaram V, Kumar A, Sadaf MI, Lu E, Al’Aref SJ, Tarun T, Galiatsatos P, Gulati M, Blumenthal RS, Leucker TM, Karakousis PC, Mehta JL. COVID-19 in the Initiation and Progression of Atherosclerosis: Pathophysiology During and Beyond the Acute Phase. JACC. ADVANCES 2024; 3:101107. [PMID: 39113913 PMCID: PMC11304887 DOI: 10.1016/j.jacadv.2024.101107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 04/24/2024] [Accepted: 06/01/2024] [Indexed: 08/10/2024]
Abstract
The incidence of atherosclerotic cardiovascular disease is increasing globally, especially in low- and middle-income countries, despite significant efforts to reduce traditional risk factors. Premature subclinical atherosclerosis has been documented in association with several viral infections. The magnitude of the recent COVID-19 pandemic has highlighted the need to understand the association between SARS-CoV-2 and atherosclerosis. This review examines various pathophysiological mechanisms, including endothelial dysfunction, platelet activation, and inflammatory and immune hyperactivation triggered by SARS-CoV-2 infection, with specific attention on their roles in initiating and promoting the progression of atherosclerotic lesions. Additionally, it addresses the various pathogenic mechanisms by which COVID-19 in the post-acute phase may contribute to the development of vascular disease. Understanding the overlap of these syndromes may enable novel therapeutic strategies. We further explore the need for guidelines for closer follow-up for the often-overlooked evidence of atherosclerotic cardiovascular disease among patients with recent COVID-19, particularly those with cardiometabolic risk factors.
Collapse
Affiliation(s)
- Vignesh Chidambaram
- Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Amudha Kumar
- Division of Cardiology, Department of Medicine, Loyola University Medical Center, Maywood, Illinois, USA
| | - Murrium I. Sadaf
- Division of Cardiovascular Medicine, Department of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Emily Lu
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Subhi J. Al’Aref
- Division of Cardiovascular Medicine, Department of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Tushar Tarun
- Division of Cardiovascular Medicine, Department of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Panagis Galiatsatos
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Martha Gulati
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Roger S. Blumenthal
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Thorsten M. Leucker
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Petros C. Karakousis
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jawahar L. Mehta
- Division of Cardiovascular Medicine, Department of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- Division of Cardiovascular Medicine, Central Arkansas Veterans Healthcare System, Little Rock, Arkansas, USA
| |
Collapse
|
12
|
Morioka S, Nikaido M, Tsuzuki S, Kutsuna S, Saito S, Hayakawa K, Sugiyama M, Ohmagari N. Epidemiology of post-COVID conditions beyond 3 years and factors associated with their persistence longer than 2 years: A cross-sectional study. J Infect Chemother 2024; 30:734-740. [PMID: 38350510 DOI: 10.1016/j.jiac.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 01/23/2024] [Accepted: 02/08/2024] [Indexed: 02/15/2024]
Abstract
OBJECTIVE This study aimed to investigate the epidemiology of post-coronavirus disease 2019 (COVID-19) conditions (PCCs) beyond 3 years and identify factors associated with their persistence longer than 2 years. STUDY DESIGN Cross-sectional questionnaire-based survey. METHODS We surveyed patients who had recovered from COVID-19 and visited our institution from February 2020 to November 2021. Demographic and clinical data and information on the presence and duration of PCCs were obtained. We identified factors associated with the persistence of PCCs longer than 2 years using multivariate linear regression analyses. RESULTS Among 935 patients surveyed, 407 completed the survey. Among them, 360 patients had mild disease in the acute phase. The proportions of participants with at least one symptom at 1, 2, and 3 years after symptom onset or COVID-19 diagnosis were 33.2%, 29.8%, and 5.7%, respectively. The numbers of participants with and without any residual symptoms 2 years after the onset of COVID-19 were 87 and 193, respectively. After multivariate adjustment, persistence of PCCs longer than 2 years was associated with lower body mass index, presence of any underlying medical conditions, and number of symptoms lasting for more than 1 month ≥ 5. CONCLUSIONS The prevalence of PCCs decreased 2 years after symptom onset or COVID-19 diagnosis. We also identified factors associated with PCC persistence longer than 2 years, which could help primary care physicians and patients with PCCs predict the duration of PCCs and better understand their natural history, thus reducing patients' anxiety about their duration.
Collapse
Affiliation(s)
- Shinichiro Morioka
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan; AMR Clinical Reference Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan; Emerging and Reemerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Sendai, Japan.
| | - Mio Nikaido
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Shinya Tsuzuki
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan; AMR Clinical Reference Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan; Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Satoshi Kutsuna
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan; Department of Infection Control, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Sho Saito
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Kayoko Hayakawa
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan; AMR Clinical Reference Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Masaya Sugiyama
- Department of Viral Pathogenesis and Controls, National Center for Global Health and Medicine, Ichikawa, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan; AMR Clinical Reference Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| |
Collapse
|
13
|
Theuri M, Ndombi EM, Thamaini P, Ogutu JO, Onsongo L, Madete JK, Ofula V, Gitau S, Mwangi G, Okemo P. Clinical characteristics, anti-SARS-CoV-2 IgG titers, and inflammatory markers in individuals with post-COVID-19 condition in Kenya: a cross-sectional study. PeerJ 2024; 12:e17723. [PMID: 39056056 PMCID: PMC11271650 DOI: 10.7717/peerj.17723] [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: 04/16/2024] [Accepted: 06/20/2024] [Indexed: 07/28/2024] Open
Abstract
Background Post-coronavirus disease 2019 (post-COVID-19) is associated with considerable morbidity and reduced quality of life. However, studies characterizing the post-COVID-19 condition in Kenya are limited. This study aimed to determine the prevalence of post-COVID-19 condition and determine the clinical characteristics, anti-SARS-CoV-2 IgG titers, and concentrations of inflammatory markers of individuals with post-COVID-19 condition in Kenya. Methods This descriptive cross-sectional study was conducted at the Kenyatta University Health Unit, Kenya. Demographic and clinical data were collected using a questionnaire. The serum levels of anti-SARS-CoV-2 antibodies, interleukin 6 (IL-6), and C-reactive protein (CRP) were quantified by enzyme-linked immunosorbent assays. Independent samples t-test was used to compare the anti-SARS-CoV-2 IgG, IL-6, and CRP levels between the participants with and without post-COVID-19 symptoms. The case definition for post-COVID-19 condition was persistence of acute COVID-19 symptoms or emergence of new symptoms 3 months after COVID-19 diagnosis, symptoms lasting for ≥2 months, and absence of any other etiological basis to explain the symptoms. Results A total of 189 volunteers were recruited in this study (median age: 21 years, range: 18-71 years; male, 49.2%). Forty participants reported having had at least one COVID-19 positive diagnosis in the past, of which 12 (30%) complained of post-COVID-19 symptoms. Significant differences in the number and duration of symptoms were observed between the individuals with and without post-COVID-19 symptoms (t-statistic = 2.87, p = 0.01; t-statistic = 2.39, p = 0.02, respectively). However, no significant differences in serum levels of anti-SARS-CoV-2 IgG, IL-6, and CRP were observed between the two groups (P = 0.08, 0.9, and 0.28, respectively). Conclusion These findings suggest that post-COVID-19 condition is a health concern even for a relatively young population in Kenya and globally. This condition requires more attention and well-designed studies to better define it and identify clinical chemistry markers that can be used for its diagnosis.
Collapse
Affiliation(s)
- Martin Theuri
- Department of Medical Laboratory Science, Kenyatta University, Nairobi, Kenya
| | - Eric M. Ndombi
- Department of Medical Microbiology and Parasitology, Kenyatta University, Nairobi, Kenya
| | - Peris Thamaini
- Department of Human Pathology, Kenyatta University, Nairobi, Kenya
| | - James Opiyo Ogutu
- Department of Medical Microbiology and Parasitology, Kenyatta University, Nairobi, Kenya
| | - Lister Onsongo
- Department of Community and Reproductive Health Nursing, Kenyatta University, Nairobi, Kenya
| | - June K. Madete
- Department of Electrical and Electronic Engineering, Kenyatta University, Nairobi, Kenya
| | - Victor Ofula
- Centre for Virus Research, kenya Medical Research Institute, Nairobi, Kenya
| | - Samuel Gitau
- Department of Pharmacology and Clinical Pharmacy, Kenyatta University, Nairobi, Kenya
| | - Gladys Mwangi
- Department of Pharmacology and Clinical Pharmacy, Kenyatta University, Nairobi, Kenya
| | - Paul Okemo
- Department of Biochemistry, Microbiology, and Biotechnology, Kenyatta University, Nairobi, Kenya
| |
Collapse
|
14
|
Orui M, Obara T, Ishikuro M, Noda A, Shinoda G, Murakami K, Nakamura T, Metoki H, Ogishima S, Izumi Y, Nakaya N, Hozawa A, Ishii T, Nagami F, Yamamoto M, Kuriyama S. How Healthy Lifestyle Habits Have Interacted with SARS-CoV-2 Infection and the Effectiveness of COVID-19 Vaccinations: Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. JMA J 2024; 7:353-363. [PMID: 39114619 PMCID: PMC11301014 DOI: 10.31662/jmaj.2024-0043] [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] [Received: 03/13/2024] [Accepted: 04/25/2024] [Indexed: 08/10/2024] Open
Abstract
Introduction To examine the interaction between lifestyle habits and the COVID-19 vaccinations for preventing SARS-CoV-2 infection, we analyzed 11,016 adult participants registered in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Methods Lifestyle variables, including regular exercise, smoking and drinking habits, sleep status, body mass index, and daily breakfast consumption, were assessed from 2014 to 2019 using baseline questionnaires. Information on SARS-CoV-2 infection and the COVID-19 vaccination were also collected from March 2020 to May 2023. The study period was divided into two in the postvaccination phase: the first period (the beginning of the vaccination program) and the second period (the fourth shot onward). Results In the Cox proportional-hazards model analysis, the five-time vaccinations group showed a significantly lower risk of SARS-CoV-2 infection adjusted age, sex, underlying health condition, and lifestyle variables (hazard ratio [HR] 0.81, 95% confidence interval [CI] 0.76-0.86). Logistic regression analysis revealed that a higher number of vaccinations was significantly associated with a low risk of SARS-CoV-2 infection regardless of lifestyle habits (three times in the first period: odds ratio [OR] 0.19, 95% CI 0.15-0.24; five times in the second period: OR 0.07, 95% CI 0.05-0.11 vs. none). Regarding lifestyle habits, the risk reduction in those who had sleep satisfaction (OR 0.12, 95% CI 0.08-0.18) was slightly larger than in those who had sleep dissatisfaction (OR 0.23, 95% CI 0.17-0.32) in the group with the highest number of vaccinations in the first period; however, this interaction was hardly confirmed in the second period when the number of infected cases significantly increased. Conclusions Our findings indicated that a higher number of COVID-19 vaccinations was associated with reduced risk of SARS-CoV-2 infection; otherwise, we may need to understand the advantages and limitations of a healthy lifestyle for preventing infection depending on the situation with vaccinations and infection spreading.
Collapse
Affiliation(s)
- Masatsugu Orui
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Taku Obara
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku University Hospital, Tohoku University, Sendai, Japan
| | - Mami Ishikuro
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Aoi Noda
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku University Hospital, Tohoku University, Sendai, Japan
| | - Genki Shinoda
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Keiko Murakami
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Tomohiro Nakamura
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Faculty of Data Science, Kyoto Women's University, Kyoto, Japan
| | - Hirohito Metoki
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Division of Public Health, Hygiene and Epidemiology, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Soichi Ogishima
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Advanced Research Center for Innovations in Next-Generation Medicine, Tohoku University, Sendai, Japan
| | - Yoko Izumi
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Naoki Nakaya
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Atsushi Hozawa
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Tadashi Ishii
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku University Hospital, Tohoku University, Sendai, Japan
| | - Fuji Nagami
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Masayuki Yamamoto
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Shinichi Kuriyama
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
| |
Collapse
|
15
|
Baumgarth N. Boosting immunity to protect from tickborne Lyme disease. THE LANCET. INFECTIOUS DISEASES 2024:S1473-3099(24)00412-2. [PMID: 39029480 DOI: 10.1016/s1473-3099(24)00412-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2024] [Accepted: 06/17/2024] [Indexed: 07/21/2024]
Affiliation(s)
- Nicole Baumgarth
- Johns Hopkins Bloomberg School of Public Health, Department of Molecular Microbiology and Immunology, Lyme and Tickborne Diseases Research and Education Institute. Baltimore, MD 21205, USA.
| |
Collapse
|
16
|
Matubu TA, Yende-Zuma N, Brummel SS, Stranix-Chibanda L, Ogwang LW, Dadabhai S, Atuhaire P, Chauwa F, Gadama L, Fernandez RE, Aizire J, Jackson JB, Tobian AAR, Taha TE, Fowler MG. SARS-CoV-2 seropositivity in African women living with HIV and their infants. BMC Infect Dis 2024; 24:693. [PMID: 38992577 PMCID: PMC11241888 DOI: 10.1186/s12879-024-09591-8] [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: 10/09/2023] [Accepted: 07/04/2024] [Indexed: 07/13/2024] Open
Abstract
BACKGROUND SARS-CoV-2 seropositivity data in women living with HIV (WLHIV), their infants and associated factors in this subpopulation remain limited. We retrospectively measured SARS-CoV-2 seropositivity from 07/2020-11/2021 among WLHIV and their children in the PROMOTE observational cohort in Uganda, Malawi, and Zimbabwe prior to widespread SARS-CoV-2 vaccination in those countries. METHODS Plasma stored during 3 waves of the COVID-19 pandemic in East/Southern Africa were tested for SARS-CoV-2 specific IgG antibodies (Ab) using serological assays that detect adaptive immune responses to SARS-CoV-2 spike protein. (EUROIMMUN, Mountain Lakes, New Jersey and Roche Diagnostics, Indianapolis, IN). Modified-Poisson regression models were used to calculate prevalence rate ratios (PRR) and 95% confidence intervals (CI) to identify sociodemographic and clinical risk factors. RESULTS PROMOTE samples from 918 mothers and 1237 children were analysed. Overall, maternal SARS-CoV-2 seropositivity was 60.1% (95% CI: 56.9 -63.3) and 41.5% (95%CI: 38.8 - 44.2) for children. Non-breastfeeding mothers had a 31% higher risk of SARS-CoV-2 seropositivity compared to breastfeeding mothers (aPRR=1.31, 95%CI: 1.08-1.59). WLHIV with undetectable viral load had a 10% increased risk of SARS-CoV-2 seropositivity (aPRR=1.10, 95%CI: 0.89-1.37). Moreover, those who were normotensive had 12% increased risk SARS-CoV-2 seropositivity (aPRR= 1.12, 95% CI: 0.68-1.85) compared to women with hypertension. Children between 2 and 5 years had a 19% reduced risk of SARS-CoV-2 seropositivity (aPRR=0.81, 95%CI: 0.64-1.02) when compared to younger children. Mother/infant SARS-CoV-2 serostatuses were discordant in 346/802 (43.1%) families tested: mothers+/children- in 72.3%; mothers-/children+ in 26.3%; child+/sibling+ concordance was 34.6%. CONCLUSIONS These SARS-CoV-2 seropositivity data indicate that by late 2021, about 60% of mothers and about 40% of children in a cohort of HIV-affected families in eastern/southern Africa had been infected with SARS-CoV-2. More mothers than their infants tested SARS-CoV-2+, likely due to a greater external exposure for mothers linked to daily routines/employment, and school closures. Breastfeeding was protective for mothers, likely because of higher likelihood of staying home with young children, and thus less exposure. Discordant results between children within the same families underscores the need to further understand transmission dynamics within households.
Collapse
Affiliation(s)
- Taguma A Matubu
- University of Zimbabwe Clinical Trials Research Centre, Harare, Zimbabwe.
| | - Nonhlanhla Yende-Zuma
- Biostatistics Research Unit, South African Medical Research Council, Durban, South Africa
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Sean S Brummel
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Lynda Stranix-Chibanda
- University of Zimbabwe Clinical Trials Research Centre, Harare, Zimbabwe
- Faculty of Medicine and Health Sciences, Child and Adolescent Health Unit, University of Zimbabwe, Harare, Zimbabwe
| | - Lillian Wambuzi Ogwang
- Makerere University-Johns Hopkins University (MU-JHU) Research Collaboration, Kampala, Uganda
| | - Sufia Dadabhai
- Johns Hopkins Bloomberg School of Public Health, Blantyre, Malawi
| | - Patience Atuhaire
- Makerere University-Johns Hopkins University (MU-JHU) Research Collaboration, Kampala, Uganda
| | - Felluna Chauwa
- Kamuzu University of Health Sciences-Johns Hopkins Research Project, Blantyre, Malawi
| | - Luis Gadama
- Kamuzu University of Health Sciences-Johns Hopkins Research Project, Blantyre, Malawi
| | | | - Jim Aizire
- Johns Hopkins Bloomberg School of Public Health, Blantyre, Malawi
| | | | | | - Taha E Taha
- Johns Hopkins Bloomberg School of Public Health, Blantyre, Malawi
| | | |
Collapse
|
17
|
Zang C, Hou Y, Schenck EJ, Xu Z, Zhang Y, Xu J, Bian J, Morozyuk D, Khullar D, Nordvig AS, Shenkman EA, Rothman RL, Block JP, Lyman K, Zhang Y, Varma J, Weiner MG, Carton TW, Wang F, Kaushal R. Identification of risk factors of Long COVID and predictive modeling in the RECOVER EHR cohorts. COMMUNICATIONS MEDICINE 2024; 4:130. [PMID: 38992068 PMCID: PMC11239808 DOI: 10.1038/s43856-024-00549-0] [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: 02/15/2023] [Accepted: 06/10/2024] [Indexed: 07/13/2024] Open
Abstract
BACKGROUND SARS-CoV-2-infected patients may develop new conditions in the period after the acute infection. These conditions, the post-acute sequelae of SARS-CoV-2 infection (PASC, or Long COVID), involve a diverse set of organ systems. Limited studies have investigated the predictability of Long COVID development and its associated risk factors. METHODS In this retrospective cohort study, we used electronic healthcare records from two large-scale PCORnet clinical research networks, INSIGHT (~1.4 million patients from New York) and OneFlorida+ (~0.7 million patients from Florida), to identify factors associated with having Long COVID, and to develop machine learning-based models for predicting Long COVID development. Both SARS-CoV-2-infected and non-infected adults were analysed during the period of March 2020 to November 2021. Factors associated with Long COVID risk were identified by removing background associations and correcting for multiple tests. RESULTS We observed complex association patterns between baseline factors and a variety of Long COVID conditions, and we highlight that severe acute SARS-CoV-2 infection, being underweight, and having baseline comorbidities (e.g., cancer and cirrhosis) are likely associated with increased risk of developing Long COVID. Several Long COVID conditions, e.g., dementia, malnutrition, chronic obstructive pulmonary disease, heart failure, PASC diagnosis U099, and acute kidney failure are well predicted (C-index > 0.8). Moderately predictable conditions include atelectasis, pulmonary embolism, diabetes, pulmonary fibrosis, and thromboembolic disease (C-index 0.7-0.8). Less predictable conditions include fatigue, anxiety, sleep disorders, and depression (C-index around 0.6). CONCLUSIONS This observational study suggests that association patterns between investigated factors and Long COVID are complex, and the predictability of different Long COVID conditions varies. However, machine learning-based predictive models can help in identifying patients who are at risk of developing a variety of Long COVID conditions.
Collapse
Affiliation(s)
- Chengxi Zang
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
| | - Yu Hou
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
| | - Edward J Schenck
- Division of Pulmonary and Critical Care Medicine, Weill Cornell Department of Medicine, New York, NY, USA
| | - Zhenxing Xu
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
| | - Yongkang Zhang
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
| | - Jie Xu
- Department of Health Outcomes Biomedical Informatics, University of Florida, Gainesville, FL, USA
| | - Jiang Bian
- Department of Health Outcomes Biomedical Informatics, University of Florida, Gainesville, FL, USA
| | - Dmitry Morozyuk
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
| | - Dhruv Khullar
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
| | - Anna S Nordvig
- Department of Neurology, Weill Cornell Medicine, New York, NY, USA
| | - Elizabeth A Shenkman
- Department of Health Outcomes Biomedical Informatics, University of Florida, Gainesville, FL, USA
| | - Russell L Rothman
- Center for Health Services Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jason P Block
- Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, MA, USA
| | - Kristin Lyman
- Louisiana Public Health Institute, New Orleans, LA, USA
| | - Yiye Zhang
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
| | - Jay Varma
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
| | - Mark G Weiner
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
| | | | - Fei Wang
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA.
| | - Rainu Kaushal
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
| |
Collapse
|
18
|
Malambo W, Chanda D, Besa L, Engamba D, Mwiinga L, Mwitumwa M, Matibula P, Naik N, Sivile S, Agolory S, Auld A, Mulenga L, Hines JZ, Fwoloshi S. Clinical characteristics and factors associated with long COVID among post-acute COVID-19 clinic patients in Zambia, August 2020 to January 2023: A cross-sectional and longitudinal study design. PLoS One 2024; 19:e0306131. [PMID: 38954717 PMCID: PMC11219000 DOI: 10.1371/journal.pone.0306131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 06/11/2024] [Indexed: 07/04/2024] Open
Abstract
INTRODUCTION A number of seroprevalence studies in Zambia document the extent of spread of acute SARS-CoV-2 infection, yet knowledge gaps still exist on symptoms and conditions that continue or develop after acute COVID-19 (long COVID). This is an important gap given the estimated prevalence of long COVID in other African countries. We assessed factors associated with long COVID at the initial visit to a post-acute COVID-19 (PAC-19) clinic and longitudinally among a cohort of patients with ≥2 review visits. METHODS We implemented a cross-sectional and longitudinal analysis of PAC-19 clinic patients from Aug-2020 to Jan-2023. The study outcome was long COVID; defined as the presence of new, relapsing, or persistent COVID-19 symptoms that interfere with the ability to function at home or work. Explanatory variables were demographic and clinical characteristics of patients which included sex, age group, presence of new onset medical conditions, presence of pre-existing comorbidities, vaccination status and acute COVID-19 episode details. We fitted logistic and mixed effects regression models to assess for associated factors and considered statistical significance at p<0.05. RESULTS Out of a total 1,359 PAC-19 clinic patients in the cross-sectional analysis, 548 (40.3%) patients with ≥2 PAC-19 clinic visits were in the longitudinal analysis. Patients' median age was 53 (interquartile range [IQR]: 41-63) years, 919 (67.6%) were hospitalized for acute COVID-19, and of whom 686 (74.6%) had severe acute COVID-19. Overall, 377 (27.7%) PAC-19 clinic patients had long COVID. Patients with hospital length of stay ≥15 days (adjusted odds ratio [aOR]: 5.37; 95% confidence interval [95% CI]: 2.99-10.0), severe acute COVID-19 (aOR: 3.22; 95% CI: 1.68-6.73), and comorbidities (aOR:1.50; 95% CI: 1.02-2.21) had significantly higher chance of long COVID. Longitudinally, long COVID prevalence significantly (p<0.001) declined from 75.4% at the initial PAC-19 visit to 26.0% by the final visit. The median follow-up time was 7 (IQR: 4-12) weeks. CONCLUSION Factors associated with long COVID in Zambia were consistent both cross-sectionally at the initial visit to PAC-19 clinics and longitudinally across subsequent review visits. This highlights the importance of ongoing monitoring and tailored interventions for patients with comorbidities and severe COVID-19 to mitigate the long-term impacts of COVID-19.
Collapse
Affiliation(s)
- Warren Malambo
- Division of Global HIV and TB, U.S. Centers for Disease Control and Prevention, Global Health Center, Lusaka, Zambia
| | - Duncan Chanda
- Department of Internal Medicine, University Teaching Hospital Adult and Emergency Hospital, Lusaka, Zambia
- Ministry of Health, Lusaka, Zambia
| | | | - Daniella Engamba
- Department of Internal Medicine, University Teaching Hospital Adult and Emergency Hospital, Lusaka, Zambia
- Ministry of Health, Lusaka, Zambia
| | - Linos Mwiinga
- Division of Global HIV and TB, U.S. Centers for Disease Control and Prevention, Global Health Center, Lusaka, Zambia
| | - Mundia Mwitumwa
- Department of Internal Medicine, University Teaching Hospital Adult and Emergency Hospital, Lusaka, Zambia
| | - Peter Matibula
- Department of Internal Medicine, University Teaching Hospital Adult and Emergency Hospital, Lusaka, Zambia
| | - Neil Naik
- Department of Internal Medicine, University Teaching Hospital Adult and Emergency Hospital, Lusaka, Zambia
| | - Suilanji Sivile
- Department of Internal Medicine, University Teaching Hospital Adult and Emergency Hospital, Lusaka, Zambia
- Ministry of Health, Lusaka, Zambia
| | - Simon Agolory
- Division of Global HIV and TB, U.S. Centers for Disease Control and Prevention, Global Health Center, Lusaka, Zambia
| | - Andrew Auld
- Division of Global HIV and TB, U.S. Centers for Disease Control and Prevention, Global Health Center, Lusaka, Zambia
| | | | - Jonas Z. Hines
- Division of Global HIV and TB, U.S. Centers for Disease Control and Prevention, Global Health Center, Lusaka, Zambia
| | - Sombo Fwoloshi
- Department of Internal Medicine, University Teaching Hospital Adult and Emergency Hospital, Lusaka, Zambia
- Ministry of Health, Lusaka, Zambia
| |
Collapse
|
19
|
Lubarsky D, Clark DE, Crum K, Karpinos A, Austin ED, Soslow JH. Quantifying the impact of post-acute sequelae of coronavirus on the cardiopulmonary endurance of athletes. Pulm Circ 2024; 14:e12413. [PMID: 39022309 PMCID: PMC11252491 DOI: 10.1002/pul2.12413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 06/24/2024] [Accepted: 07/05/2024] [Indexed: 07/20/2024] Open
Abstract
Post-acute sequelae of Coronavirus (PASC), or Long COVID, has emerged as a critical health concern. The clinical manifestations of PASC have been described, but studies have not quantified the cardiopulmonary effects. The goal of this study was to quantify PASC cardiopulmonary changes among endurance athletes. Endurance athletes were recruited via social media; 45 met inclusion criteria, 32 had PASC and 13 were asymptomatic at 3 months (control). Comprehensive interviews were conducted to assess: cardiopulmonary symptoms at 3 months; quantitative and qualitative changes in cardiovascular endurance; exercise hours per week at baseline and 3 months; and Modified Oslo, Dyspnea, and EQ-5D-5L scales. All collected data was based on self-reported symptoms. Wilcoxon rank sum compared PASC with control to distinguish the effects of PASC vs effects of COVID infection/lockdown. PASC subjects were more likely to be female (Table). The most common 3-month symptoms in PASC were fatigue and shortness of breath. Based on self-reported data, subjects endorsed a median decrease of 27% in cardiopulmonary endurance levels compared with 0% in controls (p = 0.0019). PASC subjects exercised less hours and had worse self-reported health as compared with controls. PASC subjects also had significantly worse Modified Oslo, Dyspnea, and EQ-5D-5L scores. Of the 32 PASC patients, 10 (31%) reported a complete inability to engage in any cardiovascular endurance exercise at 3 months. PASC leads to a significant, quantifiable decrease in cardiopulmonary health and endurance.
Collapse
Affiliation(s)
- Daniel Lubarsky
- Department of PediatricsMonroe Carell Jr. Children's Hospital at Vanderbilt, and Vanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Daniel E. Clark
- Department of PediatricsStanford University School of MedicineStanfordCaliforniaUSA
| | - Kimberly Crum
- Department of PediatricsMonroe Carell Jr. Children's Hospital at Vanderbilt, and Vanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Ashley Karpinos
- Department of Internal Medicine and Sports MedicineVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Eric D. Austin
- Department of PediatricsMonroe Carell Jr. Children's Hospital at Vanderbilt, and Vanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Jonathan H. Soslow
- Department of PediatricsMonroe Carell Jr. Children's Hospital at Vanderbilt, and Vanderbilt University Medical CenterNashvilleTennesseeUSA
| |
Collapse
|
20
|
Shao HH, Yin RX. Pathogenic mechanisms of cardiovascular damage in COVID-19. Mol Med 2024; 30:92. [PMID: 38898389 PMCID: PMC11186295 DOI: 10.1186/s10020-024-00855-2] [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: 03/09/2024] [Accepted: 06/07/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND COVID-19 is a new infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS CoV-2). Since the outbreak in December 2019, it has caused an unprecedented world pandemic, leading to a global human health crisis. Although SARS CoV-2 mainly affects the lungs, causing interstitial pneumonia and severe acute respiratory distress syndrome, a number of patients often have extensive clinical manifestations, such as gastrointestinal symptoms, cardiovascular damage and renal dysfunction. PURPOSE This review article discusses the pathogenic mechanisms of cardiovascular damage in COVID-19 patients and provides some useful suggestions for future clinical diagnosis, treatment and prevention. METHODS An English-language literature search was conducted in PubMed and Web of Science databases up to 12th April, 2024 for the terms "COVID-19", "SARS CoV-2", "cardiovascular damage", "myocardial injury", "myocarditis", "hypertension", "arrhythmia", "heart failure" and "coronary heart disease", especially update articles in 2023 and 2024. Salient medical literatures regarding the cardiovascular damage of COVID-19 were selected, extracted and synthesized. RESULTS The most common cardiovascular damage was myocarditis and pericarditis, hypertension, arrhythmia, myocardial injury and heart failure, coronary heart disease, stress cardiomyopathy, ischemic stroke, blood coagulation abnormalities, and dyslipidemia. Two important pathogenic mechanisms of the cardiovascular damage may be direct viral cytotoxicity as well as indirect hyperimmune responses of the body to SARS CoV-2 infection. CONCLUSIONS Cardiovascular damage in COVID-19 patients is common and portends a worse prognosis. Although the underlying pathophysiological mechanisms of cardiovascular damage related to COVID-19 are not completely clear, two important pathogenic mechanisms of cardiovascular damage may be the direct damage of the SARSCoV-2 infection and the indirect hyperimmune responses.
Collapse
Affiliation(s)
- Hong-Hua Shao
- Department of Infectious Diseases, HIV/AIDS Clinical Treatment Center of Guangxi (Nanning), The Fourth People's Hospital of Nanning, No. 1 Erli, Changgang Road, Nanning, Guangxi, 530023, People's Republic of China
| | - Rui-Xing Yin
- Department of Infectious Diseases, HIV/AIDS Clinical Treatment Center of Guangxi (Nanning), The Fourth People's Hospital of Nanning, No. 1 Erli, Changgang Road, Nanning, Guangxi, 530023, People's Republic of China.
- Department of Cardiology, Institute of Cardiovascular Diseases, The First Affiliated Hospital, Guangxi Medical University, 6 Shuangyong Road, Nanning, Guangxi, 530021, People's Republic of China.
| |
Collapse
|
21
|
Hamlin RE, Blish CA. Challenges and opportunities in long COVID research. Immunity 2024; 57:1195-1214. [PMID: 38865966 PMCID: PMC11210969 DOI: 10.1016/j.immuni.2024.05.010] [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: 01/02/2024] [Revised: 04/19/2024] [Accepted: 05/10/2024] [Indexed: 06/14/2024]
Abstract
Long COVID (LC) is a condition in which patients do not fully recover from the initial SARS-CoV-2 infection but rather have persistent or new symptoms for months to years following the infection. Ongoing research efforts are investigating the pathophysiologic mechanisms of LC and exploring preventative and therapeutic treatment approaches for patients. As a burgeoning area of investigation, LC research can be structured to be more inclusive, innovative, and effective. In this perspective, we highlight opportunities for patient engagement and diverse research expertise, as well as the challenges of developing definitions and reproducible studies. Our intention is to provide a foundation for collaboration and progress in understanding the biomarkers and mechanisms driving LC.
Collapse
Affiliation(s)
| | - Catherine A Blish
- Department of Medicine, Stanford University, Stanford, CA, USA; Chan Zuckerberg Biohub, San Francisco, CA, USA.
| |
Collapse
|
22
|
Rudroff T. Long COVID in Brain Health Research: A Call to Action. Brain Sci 2024; 14:587. [PMID: 38928587 PMCID: PMC11201626 DOI: 10.3390/brainsci14060587] [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: 05/22/2024] [Revised: 06/03/2024] [Accepted: 06/07/2024] [Indexed: 06/28/2024] Open
Abstract
The COVID-19 pandemic has brought attention to the long-term consequences of the virus, particularly the persistent symptoms that characterize long COVID. This syndrome, which can last for months after the initial infection, includes a range of neurological and neuropsychiatric manifestations that have significant implications for brain health and dementia research. This review explores the current understanding of long COVID's cognitive, neurological, and psychiatric symptoms and their potential impact on brain stimulation and neuroimaging studies. It argues that researchers must adapt their study designs and screening processes to account for the confounding effects of long COVID and ensure the accuracy and reliability of their findings. To advance the understanding of this condition and its long-term effects on brain health, the review proposes a series of strategies, including the development of standardized screening tools, the investigation of underlying mechanisms, and the identification of risk factors and protective factors. It also emphasizes the importance of collaborative research efforts and international data sharing platforms in accelerating the pace of discovery and developing targeted interventions for individuals with long COVID. As the prevalence of this condition continues to grow, it is imperative that the neuroscience community comes together to address this challenge and support those affected by long COVID.
Collapse
Affiliation(s)
- Thorsten Rudroff
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA 52242, USA;
- Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA
| |
Collapse
|
23
|
Abstract
Soon after the outbreak of coronavirus disease 2019 (COVID-19), unexplained sustained fatigue, cognitive disturbance, and muscle ache/weakness were reported in patients who had recovered from acute COVID-19 infection. This abnormal condition has been recognized as "long COVID (postacute sequelae of COVID-19 [PASC])" with a prevalence estimated to be from 10 to 20% of convalescent patients. Although the pathophysiology of PASC has been studied, the exact mechanism remains obscure. Microclots in circulation can represent one of the possible causes of PASC. Although hypercoagulability and thrombosis are critical mechanisms of acute COVID-19, recent studies have reported that thromboinflammation continues in some patients, even after the virus has cleared. Viral spike proteins and RNA can be detected months after patients have recovered, findings that may be responsible for persistent thromboinflammation and the development of microclots. Despite this theory, long-term results of anticoagulation, antiplatelet therapy, and vascular endothelial protection are inconsistent, and could not always show beneficial treatment effects. In summary, PASC reflects a heterogeneous condition, and microclots cannot explain all the presenting symptoms. After clarification of the pathomechanisms of each symptom, a symptom- or biomarker-based stratified approach should be considered for future studies.
Collapse
Affiliation(s)
- Toshiaki Iba
- Department of Emergency and Disaster Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Jean M Connors
- Division of Hematology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jerrold H Levy
- Department of Anesthesiology, Critical Care, and Surgery, Duke University School of Medicine, Durham, North Carolina
| |
Collapse
|
24
|
Kozłowski P, Leszczyńska A, Ciepiela O. Long COVID Definition, Symptoms, Risk Factors, Epidemiology and Autoimmunity: A Narrative Review. AMERICAN JOURNAL OF MEDICINE OPEN 2024; 11:100068. [PMID: 39034937 PMCID: PMC11256271 DOI: 10.1016/j.ajmo.2024.100068] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 01/29/2024] [Accepted: 02/01/2024] [Indexed: 07/23/2024]
Abstract
The virus called SARS-CoV-2 emerged in 2019 and quickly spread worldwide, causing COVID-19. It has greatly impacted on everyday life, healthcare systems, and the global economy. In order to save as many lives as possible, precautions such as social distancing, quarantine, and testing policies were implemented, and effective vaccines were developed. A growing amount of data collected worldwide allowed the characterization of this new disease, which turned out to be more complex than other common respiratory tract infections. An increasing number of convalescents presented with a variety of nonspecific symptoms emerging after the acute infection. This possible new global health problem was identified and labelled as long COVID. Since then, a great effort has been made by clinicians and the scientific community to understand the underlying mechanisms and to develop preventive measures and effective treatment. The role of autoimmunity induced by SARS-CoV-2 infection in the development of long COVID is discussed in this review. We aim to deliver a description of several conditions with an autoimmune background observed in COVID-19 convalescents, including Guillain-Barré syndrome, antiphospholipid syndrome and related thrombosis, and Kawasaki disease highlighting a relationship between SARS-CoV-2 infection and the development of autoimmunity. However, further studies are required to determine its true clinical significance.
Collapse
Affiliation(s)
- Paweł Kozłowski
- Central Laboratory, University Clinical Centre of the Medical University of Warsaw, Warsaw, Poland
| | - Aleksandra Leszczyńska
- Central Laboratory, University Clinical Centre of the Medical University of Warsaw, Warsaw, Poland
| | - Olga Ciepiela
- Central Laboratory, University Clinical Centre of the Medical University of Warsaw, Warsaw, Poland
- Department of Laboratory Medicine, Medical University of Warsaw, Warsaw, Poland
| |
Collapse
|
25
|
Kutsuna S, Onozuka D, Asano K, Matsunami K, Matsuoka T. Cross-sectional surveillance study of long COVID in Toyonaka city, Osaka prefecture, Japan. J Infect Chemother 2024; 30:511-515. [PMID: 38103867 DOI: 10.1016/j.jiac.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 10/11/2023] [Accepted: 12/10/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND As the COVID-19 epidemic continues, concerns about long-term health impacts, specifically long COVID, persist. While the prevalence and symptomatology of long COVID have been explored in various global contexts, large-scale cohort studies in Japan remain limited, especially after the advent of the Omicron variant. METHODS In this observational study, 4,047 residents with a history of COVID-19 living in Toyonaka City, Osaka Prefecture, were assessed for long COVID symptoms using the VOICE mobile application and a paper survey. Respondents provided demographic and health information, as well as information regarding COVID-19 infection and subsequent symptoms. A Cox proportional hazard regression model was used to estimate the multivariable-adjusted hazard ratios and 95 % confidence intervals for overall morbidity of long COVID symptoms. RESULTS The survey found that 5.2 % of participants reported the persistence of one or more symptoms at 30 days post-onset. Fatigue was the most commonly reported symptom (1.75 %), followed by hair loss (1.41 %), and cough (1.28 %). Factors associated with an increased risk of experiencing long COVID symptoms included BMI, severe illness during the acute phase, and infection with certain COVID-19 variant strains, including Alpha, Delta, and Omicron. However, the incidence rate of long COVID appears to be decreasing with the dominance of the Omicron variant. CONCLUSIONS This large-scale study from Toyonaka City suggests a 5.2 % prevalence rate for persistent COVID-19 symptoms 4 weeks post-infection, potentially indicating a lower prevalence of long COVID in Japanese populations after the rise of the Omicron variant.
Collapse
Affiliation(s)
- Satoshi Kutsuna
- Department of Infection Control and Prevention, Graduate School of Medicine, Faculty of Medicine, Osaka University, Osaka, Japan.
| | - Daisuke Onozuka
- Department of Oral Microbe Control, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Kento Asano
- Academic Clinical Research Center, Department of Medical Innovation, Osaka University Hospital, Osaka, Japan
| | | | | |
Collapse
|
26
|
Petrakis V, Rafailidis P, Terzi I, Dragoumani I, Markatou F, Papanas N, Vradelis S, Gouveri E, Panopoulou M, Papazoglou D, Periklis P. The prevalence of long COVID-19 syndrome in hospitalized patients with COVID-19 pneumonia. LE INFEZIONI IN MEDICINA 2024; 32:202-212. [PMID: 38827835 PMCID: PMC11142409 DOI: 10.53854/liim-3202-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 04/14/2024] [Indexed: 06/05/2024]
Abstract
Introduction Long COVID affects millions of individuals worldwide with a wide range of persistent symptoms. Pathogenesis, prevalence and clinical approach of this syndrome remain not well characterized.The aim of the study is the estimation of prevalence of long-COVID and identification of possible risk factors. Patients and Methods This is an observational prospective study including COVID-19 patients hospitalized at the Department of Infectious Diseases of the University General Hospital of Alexandroupolis (Greece). Eligible COVID-19 patients were interviewed and examined 6, 12 and 18 months after COVID-19 symptoms onset and hospital discharge in order to evaluate the prevalence and consequences of long-COVID symptoms. Results A total number of 995 patients were included. The median age at discharge was 55 years and 53% of patients were retired. The majority was males (57%). Vaccination against SARS-CoV-2 was completed in 52% (n=517) COVID-19 patients. More than 40% of COVID-19 patients had at least one symptom at 18 months after hospitalization. Intravenous antiviral 0treatment with remdesivir and complete vaccination status were found to lead to lower rates of Long-COVID. Conclusions More studies in larger patient cohorts are needed in order to identify the underlying biological mechanisms of long-COVID and create effective interventions for prevention and treatment.
Collapse
Affiliation(s)
- Vasileios Petrakis
- Department of Infectious Diseases, 2 University Department of Internal Medicine, University General Hospital Alexandroupolis, Democritus University of Thrace, Alexandroupolis,
Greece
| | - Petros Rafailidis
- Department of Infectious Diseases, 2 University Department of Internal Medicine, University General Hospital Alexandroupolis, Democritus University of Thrace, Alexandroupolis,
Greece
| | - Irene Terzi
- Department of Infectious Diseases, 2 University Department of Internal Medicine, University General Hospital Alexandroupolis, Democritus University of Thrace, Alexandroupolis,
Greece
| | - Ioulia Dragoumani
- Department of Infectious Diseases, 2 University Department of Internal Medicine, University General Hospital Alexandroupolis, Democritus University of Thrace, Alexandroupolis,
Greece
| | - Filothei Markatou
- Department of Infectious Diseases, 2 University Department of Internal Medicine, University General Hospital Alexandroupolis, Democritus University of Thrace, Alexandroupolis,
Greece
| | - Nikolaos Papanas
- Department of Infectious Diseases, 2 University Department of Internal Medicine, University General Hospital Alexandroupolis, Democritus University of Thrace, Alexandroupolis,
Greece
| | - Stergios Vradelis
- Department of Infectious Diseases, 2 University Department of Internal Medicine, University General Hospital Alexandroupolis, Democritus University of Thrace, Alexandroupolis,
Greece
| | - Evanthia Gouveri
- Department of Infectious Diseases, 2 University Department of Internal Medicine, University General Hospital Alexandroupolis, Democritus University of Thrace, Alexandroupolis,
Greece
| | - Maria Panopoulou
- University Laboratory Department, University General Hospital Alexandroupolis, Democritus University of Thrace, Alexandroupolis,
Greece
| | - Dimitrios Papazoglou
- Department of Infectious Diseases, 2 University Department of Internal Medicine, University General Hospital Alexandroupolis, Democritus University of Thrace, Alexandroupolis,
Greece
| | - Panagopoulos Periklis
- Department of Infectious Diseases, 2 University Department of Internal Medicine, University General Hospital Alexandroupolis, Democritus University of Thrace, Alexandroupolis,
Greece
| |
Collapse
|
27
|
Wang Y, Su B, Xie J, Garcia-Rizo C, Prieto-Alhambra D. Long-term risk of psychiatric disorder and psychotropic prescription after SARS-CoV-2 infection among UK general population. Nat Hum Behav 2024; 8:1076-1087. [PMID: 38514769 PMCID: PMC11199144 DOI: 10.1038/s41562-024-01853-4] [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: 10/13/2022] [Accepted: 02/28/2024] [Indexed: 03/23/2024]
Abstract
Despite evidence indicating increased risk of psychiatric issues among COVID-19 survivors, questions persist about long-term mental health outcomes and the protective effect of vaccination. Using UK Biobank data, three cohorts were constructed: SARS-CoV-2 infection (n = 26,101), contemporary control with no evidence of infection (n = 380,337) and historical control predating the pandemic (n = 390,621). Compared with contemporary controls, infected participants had higher subsequent risks of incident mental health at 1 year (hazard ratio (HR): 1.54, 95% CI 1.42-1.67; P = 1.70 × 10-24; difference in incidence rate: 27.36, 95% CI 21.16-34.10 per 1,000 person-years), including psychotic, mood, anxiety, alcohol use and sleep disorders, and prescriptions for antipsychotics, antidepressants, benzodiazepines, mood stabilizers and opioids. Risks were higher for hospitalized individuals (2.17, 1.70-2.78; P = 5.80 × 10-10) than those not hospitalized (1.41, 1.30-1.53; P = 1.46 × 10-16), and were reduced in fully vaccinated people (0.97, 0.80-1.19; P = 0.799) compared with non-vaccinated or partially vaccinated individuals (1.64, 1.49-1.79; P = 4.95 × 10-26). Breakthrough infections showed similar risk of psychiatric diagnosis (0.91, 0.78-1.07; P = 0.278) but increased prescription risk (1.42, 1.00-2.02; P = 0.053) compared with uninfected controls. Early identification and treatment of psychiatric disorders in COVID-19 survivors, especially those severely affected or unvaccinated, should be a priority in the management of long COVID. With the accumulation of breakthrough infections in the post-pandemic era, the findings highlight the need for continued optimization of strategies to foster resilience and prevent escalation of subclinical mental health symptoms to severe disorders.
Collapse
Affiliation(s)
- Yunhe Wang
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Binbin Su
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China
| | - Junqing Xie
- Centre for Statistics in Medicine and NIHR Biomedical Research Centre Oxford, NDORMS, University of Oxford, Oxford, UK.
- Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, China.
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China.
| | - Clemente Garcia-Rizo
- Barcelona Clinic Schizophrenia Unit, Hospital Clínic de Barcelona, Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB), Barcelona, Spain
- CIBERSAM, ISCIII, Madrid, Spain
- Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - Daniel Prieto-Alhambra
- Centre for Statistics in Medicine and NIHR Biomedical Research Centre Oxford, NDORMS, University of Oxford, Oxford, UK
- Medical Informatics, Erasmus Medical Center University, Rotterdam, the Netherlands
| |
Collapse
|
28
|
Liu M, Ma R, Cao X, Zhang H, Zhou S, Jiang W, Jiang Y, Sun J, Yang Q, Li X, Sun Y, Shi L, Wang M, Song X, Chen F, Zhang X, Wei H, Yu S, Zhu D, Ba L, Cao Z, Xiao X, Wei X, Lin Z, Chen F, Shan C, Wang G, Ye J, Qu S, Zhao C, Wang Z, Li H, Liu F, Cui X, Ye S, Liu Z, Xu Y, Cai X, Huang W, Zhang R, Zhao Y, Yu G, Shi G, Lu M, Shen Y, Zhao Y, Pei J, Xie S, Yu L, Liu Y, Gu S, Yang Y, Cheng L, liu J. Incidence and prognosis of olfactory and gustatory dysfunctions related to SARS-CoV-2 Omicron strain infection in China: A national multicenter survey of 35,566 individuals. World J Otorhinolaryngol Head Neck Surg 2024; 10:113-120. [PMID: 38855290 PMCID: PMC11156687 DOI: 10.1002/wjo2.167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 10/27/2023] [Accepted: 02/15/2024] [Indexed: 06/11/2024] Open
Abstract
Objective This cross-sectional study aimed to determine the epidemiology of olfactory and gustatory dysfunctions related to COVID-19 in China. Methods This study was conducted by 45 tertiary Grade-A hospitals in China. Online and offline questionnaire data were obtained from patients infected with COVID-19 between December 28, 2022, and February 21, 2023. The collected information included basic demographics, medical history, smoking and drinking history, vaccination history, changes in olfactory and gustatory functions before and after infection, and other postinfection symptoms, as well as the duration and improvement status of olfactory and gustatory disorders. Results Complete questionnaires were obtained from 35,566 subjects. The overall incidence of olfactory and taste dysfunction was 67.75%. Being female or being a cigarette smoker increased the likelihood of developing olfactory and taste dysfunction. Having received four doses of the vaccine or having good oral health or being a alcohol drinker decreased the risk of such dysfunction. Before infection, the average olfactory and taste VAS scores were 8.41 and 8.51, respectively; after infection, they decreased to 3.69 and 4.29 and recovered to 5.83 and 6.55 by the time of the survey. The median duration of dysosmia and dysgeusia was 15 and 12 days, respectively, with 0.5% of patients having symptoms lasting for more than 28 days. The overall self-reported improvement rate was 59.16%. Recovery was higher in males, never smokers, those who received two or three vaccine doses, and those that had never experienced dental health issues, or chronic accompanying symptoms. Conclusions The incidence of dysosmia and dysgeusia following infection with the SARS-CoV-2 virus is high in China. Incidence and prognosis are influenced by several factors, including sex, SARS-CoV-2 vaccination, history of head-facial trauma, nasal and oral health status, smoking and drinking history, and the persistence of accompanying symptoms.
Collapse
Affiliation(s)
- Meng‐Fan Liu
- Graduate School of Beijing University of Chinese MedicineBeijingChina
- Department of Otorhinolaryngology Head and Neck SurgeryChina‐Japan Friendship HospitalBeijingChina
| | - Rui‐Xia Ma
- Department of Otorhinolaryngology Head and Neck SurgeryThe First People′s Hospital of YinchuanYinchuanChina
| | - Xian‐Bao Cao
- Department of OtorhinolaryngologyThe First People′s Hospital of Yunnan ProvinceKunmingChina
| | - Hua Zhang
- Department of OtorhinolaryngologyThe First Affiliated Hospital of Xinjiang Medical UniversityUrumqiChina
| | - Shui‐Hong Zhou
- Department of Otorhinolaryngology Head and Neck SurgeryThe First Affiliated Hospital of Zhejiang University School of MedicineHangzhouChina
| | - Wei‐Hong Jiang
- Department of Otorhinolaryngology Head and Neck SurgeryXiangya Hospital Central South UniversityChangshaChina
| | - Yan Jiang
- Department of Otorhinolaryngology Head and Neck SurgeryThe Affiliated Hospital of Qingdao UniversityQingdaoChina
| | - Jing‐Wu Sun
- Department of Otorhinolaryngology Head and Neck SurgeryThe First Affiliated Hospital of USTCHefeiChina
| | - Qin‐Tai Yang
- Department of Otorhinolaryngology Head and Neck SurgeryThe Third Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Xue‐Zhong Li
- Department of Otorhinolaryngology Head and Neck SurgeryQilu Hospital of Shandong UniversityJinanChina
| | - Ya‐Nan Sun
- Department of Otorhinolaryngology Head and Neck SurgeryThe Second Affiliated Hospital of Harbin Medical UniversityHarbinChina
| | - Li Shi
- Department of Otolaryngology, The Second Hospital of Shandong UniversityShandong UniversityJinanChina
| | - Min Wang
- Department of Otorhinolaryngology Head and Neck SurgeryPeking University People′s HospitalBeijingChina
| | - Xi‐Cheng Song
- Department of Otorhinolaryngology Head and Neck Surgery, Yantai Yuhuangding HospitalQingdao UniversityYantaiChina
| | - Fu‐Quan Chen
- Department of Otorhinolaryngology Head and Neck Surgery, Xijing HospitalThe Fourth Military Medical UniversityXi′anChina
| | - Xiao‐Shu Zhang
- Gansu Provincial Center for Disease Control and PreventionLanzhouChina
| | - Hong‐Quan Wei
- Department of Otorhinolaryngology Head and Neck SurgeryThe First Affiliated Hospital of China Medical UniversityShenyangChina
| | - Shao‐Qing Yu
- Department of Otorhinolaryngology Head and Neck Surgery, Tongji HospitalTongji Medical UniversityShanghaiChina
| | - Dong‐Dong Zhu
- Department of Otorhinolaryngology Head and Neck SurgeryChina‐Japan Union Hospital of Jilin UniversityChangchunChina
| | - Luo Ba
- Department of Otorhinolaryngology Head and Neck SurgeryXizang Autonomous Region People′s HospitalLasaChina
| | - Zhi‐Wei Cao
- Department of Otorhinolaryngology Head and Neck SurgeryShengjing Hospital of China Medical UniversityShenyangChina
| | - Xu‐Ping Xiao
- Department of Otorhinolaryngology Head and Neck SurgeryHunan Provincial People′s HospitalChangshaChina
| | - Xin Wei
- Department of Otorhinolaryngology Head and Neck SurgeryHainan General HospitalHaikouChina
| | - Zhi‐Hong Lin
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Affiliated Hospital, College of MedicineZhejiang UniversityHangzhouChina
| | - Feng‐Hong Chen
- Department of Otorhinolaryngology, The First Affiliated HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Chun‐Guang Shan
- Department of Otorhinolaryngology Head and Neck SurgeryThe Second Hospital of Hebei Medical UniversityShijiazhuangChina
| | - Guang‐Ke Wang
- Department of Otorhinolaryngology Head and Neck SurgeryHenan Provincial People′s HospitalZhengzhouChina
| | - Jing Ye
- Department of Otorhinolaryngology Head and Neck SurgeryThe First Affiliated Hospital of Nanchang UniversityNanchangChina
| | - Shen‐Hong Qu
- Department of Otorhinolaryngology Head and Neck SurgeryGuangxi Zhuang Autonomous Region People′s HospitalNanningChina
| | - Chang‐Qing Zhao
- Department of Otorhinolaryngology Head and Neck SurgeryShanxi Medical University Affiliated Second HospitalTaiyuanChina
| | - Zhen‐Lin Wang
- Department of Otorhinolaryngology Head and Neck Surgery, XuanWu HospitalCapital Medical UniversityBeijingChina
| | - Hua‐Bin Li
- Department of Otorhinolaryngology Head and Neck Surgery, Eye, Ear, Nose and Throat Hospital, Shanghai Medical CollegeFudan UniversityShanghaiChina
| | - Feng Liu
- Department of Otorhinolaryngology Head and Neck Surgery, West China HospitalSichuan UniversityChengduChina
| | - Xiao‐Bo Cui
- Department of Otorhinolaryngology Head and Neck SurgeryAffiliated Hospital of Inner Mongolia Medical UniversityHohhotChina
| | - Sheng‐Nan Ye
- Department of Otorhinolaryngology Head and Neck SurgeryThe First Affiliated Hospital of Fujian Medical UniversityFuzhouChina
| | - Zheng Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Yu Xu
- Department of Otorhinolaryngology Head and Neck SurgeryRenmin Hospital of Wuhan UniversityWuhanChina
| | - Xiao Cai
- Department of Otorhinolaryngology Head and Neck SurgeryQinghai Provincial People′s HospitalXiningChina
| | - Wei Huang
- Department of Otorhinolaryngology Head and Neck SurgeryTianjin Huanhu HospitalTianjinChina
| | - Ru‐Xin Zhang
- Department of Otorhinolaryngology Head and Neck SurgeryHuadong Hospital Affiliated to Fudan UniversityShanghaiChina
| | - Yu‐Lin Zhao
- Department of Otorhinolaryngology Head and Neck SurgeryThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
| | - Guo‐Dong Yu
- Department of Otorhinolaryngology Head and Neck SurgeryAffiliated Hospital of Guizhou Medical UniversityGuiyangChina
| | - Guang‐Gang Shi
- Department of Otorhinolaryngology Head and Neck Surgery, Shandong Provincial HospitalAffiliated to Shandong First Medical UniversityJinanChina
| | - Mei‐Ping Lu
- Department of Otorhinolaryngology & Clinical Allergy Center, The First Affiliated HospitalNanjing Medical UniversityNanjingChina
| | - Yang Shen
- Department of Otorhinolaryngology Head and Neck SurgeryThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Yu‐Tong Zhao
- Department of Otorhinolaryngology Head and Neck SurgeryThe First People′s Hospital of YinchuanYinchuanChina
| | - Jia‐Hong Pei
- Department of OtorhinolaryngologyThe First People′s Hospital of Yunnan ProvinceKunmingChina
| | - Shao‐Bing Xie
- Department of Otorhinolaryngology Head and Neck SurgeryXiangya Hospital Central South UniversityChangshaChina
| | - Long‐Gang Yu
- Department of Otorhinolaryngology Head and Neck SurgeryThe Affiliated Hospital of Qingdao UniversityQingdaoChina
| | - Ye‐Hai Liu
- Department of Otorhinolaryngology Head and Neck SurgeryThe First Affiliated Hospital of Anhui Medical UniversityHefeiChina
| | - Shao‐Wei Gu
- Department of Otorhinolaryngology Head and Neck SurgeryQilu Hospital of Shandong UniversityJinanChina
| | - Yu‐Cheng Yang
- Department of Otorhinolaryngology Head and Neck SurgeryThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Lei Cheng
- Department of Otorhinolaryngology & Clinical Allergy Center, The First Affiliated HospitalNanjing Medical UniversityNanjingChina
| | - Jian‐Feng liu
- Department of Otorhinolaryngology Head and Neck SurgeryChina‐Japan Friendship HospitalBeijingChina
| |
Collapse
|
29
|
Sbierski-Kind J, Schlickeiser S, Feldmann S, Ober V, Grüner E, Pleimelding C, Gilberg L, Brand I, Weigl N, Ahmed MIM, Ibarra G, Ruzicka M, Benesch C, Pernpruner A, Valdinoci E, Hoelscher M, Adorjan K, Stubbe HC, Pritsch M, Seybold U, Roider J. Persistent immune abnormalities discriminate post-COVID syndrome from convalescence. Infection 2024; 52:1087-1097. [PMID: 38326527 PMCID: PMC11142964 DOI: 10.1007/s15010-023-02164-y] [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: 11/13/2023] [Accepted: 12/19/2023] [Indexed: 02/09/2024]
Abstract
BACKGROUND Innate lymphoid cells (ILCs) are key organizers of tissue immune responses and regulate tissue development, repair, and pathology. Persistent clinical sequelae beyond 12 weeks following acute COVID-19 disease, named post-COVID syndrome (PCS), are increasingly recognized in convalescent individuals. ILCs have been associated with the severity of COVID-19 symptoms but their role in the development of PCS remains poorly defined. METHODS AND RESULTS Here, we used multiparametric immune phenotyping, finding expanded circulating ILC precursors (ILCPs) and concurrent decreased group 2 innate lymphoid cells (ILC2s) in PCS patients compared to well-matched convalescent control groups at > 3 months after infection or healthy controls. Patients with PCS showed elevated expression of chemokines and cytokines associated with trafficking of immune cells (CCL19/MIP-3b, FLT3-ligand), endothelial inflammation and repair (CXCL1, EGF, RANTES, IL-1RA, PDGF-AA). CONCLUSION These results define immunological parameters associated with PCS and might help find biomarkers and disease-relevant therapeutic strategies.
Collapse
Affiliation(s)
- Julia Sbierski-Kind
- Department of Medicine IV, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
- Department of Internal Medicine IV, Division of Diabetology, Endocrinology and Nephrology, University Hospital, Eberhard-Karls-Universität Tübingen, Tübingen, Germany
- The M3 Research Center, University Clinic Tübingen (UKT), Medical Faculty, Otfried-Müllerstr. 37, Tübingen, Germany
| | - Stephan Schlickeiser
- Charité, Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität Zu Berlin, Institute of Medical Immunology, Augustenburger Platz 1, 13353, Berlin, Germany
- Berlin Institute of Health (BIH) at Charité, Universitätsmedizin Berlin, BIH Center for Regenerative Therapies (BCRT), Charitéplatz 1, 10117, Berlin, Germany
| | - Svenja Feldmann
- Department of Infectious Diseases, Department of Medicine IV, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Veronica Ober
- Department of Infectious Diseases, Department of Medicine IV, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Eva Grüner
- Department of Infectious Diseases, Department of Medicine IV, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Claire Pleimelding
- Department of Infectious Diseases, Department of Medicine IV, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Leonard Gilberg
- Department of Infectious Diseases, Department of Medicine IV, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Isabel Brand
- German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany
| | - Nikolas Weigl
- Department of Medicine IV, Division of Clinical Pharmacology, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Mohamed I M Ahmed
- German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Gerardo Ibarra
- The M3 Research Center, University Clinic Tübingen (UKT), Medical Faculty, Otfried-Müllerstr. 37, Tübingen, Germany
- COVID-19 Registry of the LMU Munich (CORKUM), University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Michael Ruzicka
- COVID-19 Registry of the LMU Munich (CORKUM), University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
- Department of Medicine III, LMU University Hospital, LMU Munich, Munich, Germany
| | - Christopher Benesch
- COVID-19 Registry of the LMU Munich (CORKUM), University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
- Department of Medicine II, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Anna Pernpruner
- COVID-19 Registry of the LMU Munich (CORKUM), University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
- Department of Medicine II, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Elisabeth Valdinoci
- COVID-19 Registry of the LMU Munich (CORKUM), University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
- Department of Medicine II, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Michael Hoelscher
- German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Kristina Adorjan
- COVID-19 Registry of the LMU Munich (CORKUM), University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Hans Christian Stubbe
- German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany
- COVID-19 Registry of the LMU Munich (CORKUM), University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
- Department of Medicine II, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Michael Pritsch
- German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Ulrich Seybold
- Department of Infectious Diseases, Department of Medicine IV, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Julia Roider
- Department of Infectious Diseases, Department of Medicine IV, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany.
- German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany.
| |
Collapse
|
30
|
Henderson AD, Butler-Cole BFC, Tazare J, Tomlinson LA, Marks M, Jit M, Briggs A, Lin LY, Carlile O, Bates C, Parry J, Bacon SCJ, Dillingham I, Dennison WA, Costello RE, Wei Y, Walker AJ, Hulme W, Goldacre B, Mehrkar A, MacKenna B, Herrett E, Eggo RM. Clinical coding of long COVID in primary care 2020-2023 in a cohort of 19 million adults: an OpenSAFELY analysis. EClinicalMedicine 2024; 72:102638. [PMID: 38800803 PMCID: PMC11127160 DOI: 10.1016/j.eclinm.2024.102638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 04/10/2024] [Accepted: 04/29/2024] [Indexed: 05/29/2024] Open
Abstract
Background Long COVID is the patient-coined term for the persistent symptoms of COVID-19 illness for weeks, months or years following the acute infection. There is a large burden of long COVID globally from self-reported data, but the epidemiology, causes and treatments remain poorly understood. Primary care is used to help identify and treat patients with long COVID and therefore Electronic Health Records (EHRs) of past COVID-19 patients could be used to help fill these knowledge gaps. We aimed to describe the incidence and differences in demographic and clinical characteristics in recorded long COVID in primary care records in England. Methods With the approval of NHS England we used routine clinical data from over 19 million adults in England linked to SARS-COV-2 test result, hospitalisation and vaccination data to describe trends in the recording of 16 clinical codes related to long COVID between November 2020 and January 2023. Using OpenSAFELY, we calculated rates per 100,000 person-years and plotted how these changed over time. We compared crude and adjusted (for age, sex, 9 NHS regions of England, and the dominant variant circulating) rates of recorded long COVID in patient records between different key demographic and vaccination characteristics using negative binomial models. Findings We identified a total of 55,465 people recorded to have long COVID over the study period, which included 20,025 diagnoses codes and 35,440 codes for further assessment. The incidence of new long COVID records increased steadily over 2021, and declined over 2022. The overall rate per 100,000 person-years was 177.5 cases in women (95% CI: 175.5-179) and 100.5 in men (99.5-102). The majority of those with a long COVID record did not have a recorded positive SARS-COV-2 test 12 or more weeks before the long COVID record. Interpretation In this descriptive study, EHR recorded long COVID was very low between 2020 and 2023, and incident records of long COVID declined over 2022. Using EHR diagnostic or referral codes unfortunately has major limitations in identifying and ascertaining true cases and timing of long COVID. Funding This research was supported by the National Institute for Health and Care Research (NIHR) (OpenPROMPT: COV-LT2-0073).
Collapse
Affiliation(s)
| | - Ben FC. Butler-Cole
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX2 6GG, UK
| | - John Tazare
- London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Laurie A. Tomlinson
- London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Michael Marks
- London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Mark Jit
- London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Andrew Briggs
- London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Liang-Yu Lin
- London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Oliver Carlile
- London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Chris Bates
- TPP, TPP House, 129 Low Lane, Horsforth, Leeds LS18 5PX, UK
| | - John Parry
- TPP, TPP House, 129 Low Lane, Horsforth, Leeds LS18 5PX, UK
| | - Sebastian CJ. Bacon
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX2 6GG, UK
| | - Iain Dillingham
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX2 6GG, UK
| | | | - Ruth E. Costello
- London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Yinghui Wei
- Centre for Mathematical Sciences, School of Engineering, Computing and Mathematics, University of Plymouth, Plymouth, UK
| | - Alex J. Walker
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX2 6GG, UK
| | - William Hulme
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX2 6GG, UK
| | - Ben Goldacre
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX2 6GG, UK
| | - Amir Mehrkar
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX2 6GG, UK
| | - Brian MacKenna
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX2 6GG, UK
| | - Emily Herrett
- London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Rosalind M. Eggo
- London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| |
Collapse
|
31
|
Herbert C, Wang B, Lin H, Yan Y, Hafer N, Pretz C, Stamegna P, Wright C, Suvarna T, Harman E, Schrader S, Nowak C, Kheterpal V, Orvek E, Wong S, Zai A, Barton B, Gerber BS, Lemon SC, Filippaios A, Gibson L, Greene S, Colubri A, Achenbach C, Murphy R, Heetderks W, Manabe YC, O’Connor L, Fahey N, Luzuriaga K, Broach J, Roth K, McManus DD, Soni A. Performance of and Severe Acute Respiratory Syndrome Coronavirus 2 Diagnostics Based on Symptom Onset and Close Contact Exposure: An Analysis From the Test Us at Home Prospective Cohort Study. Open Forum Infect Dis 2024; 11:ofae304. [PMID: 38911947 PMCID: PMC11191649 DOI: 10.1093/ofid/ofae304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 05/29/2024] [Indexed: 06/25/2024] Open
Abstract
Background Understanding changes in diagnostic performance after symptom onset and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure within different populations is crucial to guide the use of diagnostics for SARS-CoV-2. Methods The Test Us at Home study was a longitudinal cohort study that enrolled individuals across the United States between October 2021 and February 2022. Participants performed paired antigen-detection rapid diagnostic tests (Ag-RDTs) and reverse-transcriptase polymerase chain reaction (RT-PCR) tests at home every 48 hours for 15 days and self-reported symptoms and known coronavirus disease 2019 exposures immediately before testing. The percent positivity for Ag-RDTs and RT-PCR tests was calculated each day after symptom onset and exposure and stratified by vaccination status, variant, age category, and sex. Results The highest percent positivity occurred 2 days after symptom onset (RT-PCR, 91.2%; Ag-RDT, 71.1%) and 6 days after exposure (RT-PCR, 91.8%; Ag-RDT, 86.2%). RT-PCR and Ag-RDT performance did not differ by vaccination status, variant, age category, or sex. The percent positivity for Ag-RDTs was lower among exposed, asymptomatic than among symptomatic individuals (37.5% (95% confidence interval [CI], 13.7%-69.4%) vs 90.3% (75.1%-96.7%). Cumulatively, Ag-RDTs detected 84.9% (95% CI, 78.2%-89.8%) of infections within 4 days of symptom onset. For exposed participants, Ag-RDTs detected 94.0% (95% CI, 86.7%-97.4%) of RT-PCR-confirmed infections within 6 days of exposure. Conclusions The percent positivity for Ag-RDTs and RT-PCR tests was highest 2 days after symptom onset and 6 days after exposure, and performance increased with serial testing. The percent positivity of Ag-RDTs was lowest among asymptomatic individuals but did not differ by sex, variant, vaccination status, or age category.
Collapse
Affiliation(s)
- Carly Herbert
- Program in Digital Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- University of Massachusetts Center for Clinical and Translational Science, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Biqi Wang
- Program in Digital Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Division of Health System Science, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Honghuang Lin
- Program in Digital Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Division of Health System Science, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Yi Yan
- Division of Microbiology, OHT7 Office of Product Evaluation and Quality, Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Nathaniel Hafer
- University of Massachusetts Center for Clinical and Translational Science, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Program in Molecular Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Caitlin Pretz
- Program in Digital Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Pamela Stamegna
- Program in Digital Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Colton Wright
- Program in Digital Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | | | | | | | | | | | - Elizabeth Orvek
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Steven Wong
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Adrian Zai
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Bruce Barton
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Ben S Gerber
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Stephenie C Lemon
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Andreas Filippaios
- Program in Digital Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Laura Gibson
- Division of Infectious Disease, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Sharone Greene
- Division of Infectious Disease, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Andres Colubri
- Department of Microbiology and Physiological Systems, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Chad Achenbach
- Division of Infectious Disease, Department of Medicine, Havey Institute for Global Health, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Robert Murphy
- Division of Infectious Disease, Department of Medicine, Havey Institute for Global Health, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - William Heetderks
- National Institute of Biomedical Imaging and Bioengineering, NIH, via contract with Kelly Services, Bethesda, Maryland, USA
| | - Yukari C Manabe
- Division of Infectious Disease, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Laurel O’Connor
- Department of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Nisha Fahey
- Program in Digital Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Department of Pediatrics, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Katherine Luzuriaga
- University of Massachusetts Center for Clinical and Translational Science, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Program in Molecular Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - John Broach
- University of Massachusetts Center for Clinical and Translational Science, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Department of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Kristian Roth
- Division of Microbiology, OHT7 Office of Product Evaluation and Quality, Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - David D McManus
- Program in Digital Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Division of Health System Science, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Division of Cardiology, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Apurv Soni
- Program in Digital Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Division of Health System Science, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| |
Collapse
|
32
|
Fisher KA, Mazor KM, Epstein MM, Goldthwait L, Abu Ghazaleh H, Zhou Y, Crawford S, Marathe J, Linas BP. Long COVID awareness and receipt of medical care: a survey among populations at risk for disparities. Front Public Health 2024; 12:1360341. [PMID: 38873310 PMCID: PMC11173587 DOI: 10.3389/fpubh.2024.1360341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 05/08/2024] [Indexed: 06/15/2024] Open
Abstract
Introduction The COVID-19 pandemic has been characterized by disparities in disease burden and medical care provision. Whether these disparities extend to long COVID awareness and receipt of medical care is unknown. We aimed to characterize awareness of long COVID and receipt of medical care for long COVID symptoms among populations who experience disparities in the United States (US). Methods We conducted a cross-sectional survey among a national sample of US adults between January 26-February 5, 2023. We surveyed approximately 2,800 adults drawn from the Ipsos probability-based KnowledgePanel® who identify as White, Black, or Hispanic, with over-sampling of Black, Hispanic, and Spanish-proficient adults. Awareness of long COVID was assessed with the question, "Have you heard of long COVID? This is also referred to as post-COVID, Long-haul COVID, Post-acute COVID-19, or Chronic COVID." Respondents reporting COVID-19 symptoms lasting longer than 1 month were classified as having long COVID and asked about receipt of medical care. Results Of the 2,828 respondents, the mean age was 50.4 years, 52.8% were female, 40.2% identified as Hispanic, 29.8% as Black, and 26.7% as White. 18% completed the survey in Spanish. Overall, 62.5% had heard of long COVID. On multivariate analysis, long COVID awareness was lower among respondents who identified as Black (OR 0.64; 95% CI 0.51, 0.81), Hispanic and completed the survey in English (OR 0.59; 95% CI 0.46, 0.76), and Hispanic and completed the survey in Spanish (OR 0.31, 95% C.I. 0.23, 0.41), compared to White respondents (overall p < 0.001). Long COVID awareness was also associated with educational attainment, higher income, having health insurance, prior history of COVID-19 infection, and COVID-19 vaccination. Among those reporting symptoms consistent with long COVID (n = 272), 26.8% received medical care. Older age, longer symptom duration and greater symptom impact were associated with receipt of medical care for long COVID symptoms. Of those who received care, most (77.8%) rated it as less than excellent on a 5-point scale. Discussion This survey reveals limited awareness of long COVID and marked disparities in awareness according to race, ethnicity, and language. Targeted public health campaigns are needed to raise awareness.
Collapse
Affiliation(s)
- Kimberly A. Fisher
- Division of Health Systems Science, Department of Medicine, UMass Chan Medical School, Worcester, MA, United States
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, UMass Chan Medical School, Worcester, MA, United States
| | - Kathleen M. Mazor
- Division of Health Systems Science, Department of Medicine, UMass Chan Medical School, Worcester, MA, United States
| | - Mara M. Epstein
- Division of Health Systems Science, Department of Medicine, UMass Chan Medical School, Worcester, MA, United States
| | - Lydia Goldthwait
- Division of Health Systems Science, Department of Medicine, UMass Chan Medical School, Worcester, MA, United States
| | - Hiba Abu Ghazaleh
- Division of Health Systems Science, Department of Medicine, UMass Chan Medical School, Worcester, MA, United States
| | - Yanhua Zhou
- Division of Health Systems Science, Department of Medicine, UMass Chan Medical School, Worcester, MA, United States
| | - Sybil Crawford
- Tan Chingfen Graduate School of Nursing, UMass Chan Medical School, Worcester, MA, United States
| | - Jai Marathe
- Boston Medical Center, Boston, MA, United States
- Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, MA, United States
| | - Benjamin P. Linas
- Boston Medical Center, Boston, MA, United States
- Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, MA, United States
- Boston University School of Public Health, Boston, MA, United States
| |
Collapse
|
33
|
Malden DE, Liu ILA, Qian L, Sy LS, Lewin BJ, Asamura DT, Ryan DS, Bezi C, Williams JTB, Kaiser R, Daley MF, Nelson JC, McClure DL, Zerbo O, Henninger ML, Fuller CC, Weintraub ES, Saydah S, Tartof SY. Post-COVID conditions following COVID-19 vaccination: a retrospective matched cohort study of patients with SARS-CoV-2 infection. Nat Commun 2024; 15:4101. [PMID: 38778026 PMCID: PMC11111703 DOI: 10.1038/s41467-024-48022-9] [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: 10/16/2023] [Accepted: 04/18/2024] [Indexed: 05/25/2024] Open
Abstract
COVID-19 vaccinations protect against severe illness and death, but associations with post-COVID conditions (PCC) are less clear. We aimed to evaluate the association between prior COVID-19 vaccination and new-onset PCC among individuals with SARS-CoV-2 infection across eight large healthcare systems in the United States. This retrospective matched cohort study used electronic health records (EHR) from patients with SARS-CoV-2 positive tests during March 2021-February 2022. Vaccinated and unvaccinated COVID-19 cases were matched on location, test date, severity of acute infection, age, and sex. Vaccination status was ascertained using EHR and integrated data on externally administered vaccines. Adjusted relative risks (RRs) were obtained from Poisson regression. PCC was defined as a new diagnosis in one of 13 PCC categories 30 days to 6 months following a positive SARS-CoV-2 test. The study included 161,531 vaccinated COVID-19 cases and 161,531 matched unvaccinated cases. Compared to unvaccinated cases, vaccinated cases had a similar or lower risk of all PCC categories except mental health disorders (RR: 1.06, 95% CI: 1.02-1.10). Vaccination was associated with ≥10% lower risk of sensory (RR: 0.90, 0.86-0.95), circulatory (RR: 0.88, 0.83-0.94), blood and hematologic (RR: 0.79, 0.71-0.89), skin and subcutaneous (RR: 0.69, 0.66-0.72), and non-specific COVID-19 related disorders (RR: 0.53, 0.51-0.56). In general, associations were stronger at younger ages but mostly persisted regardless of SARS-CoV-2 variant period, receipt of ≥3 vs. 1-2 vaccine doses, or time since vaccination. Pre-infection vaccination was associated with reduced risk of several PCC outcomes and hence may decrease the long-term consequences of COVID-19.
Collapse
Affiliation(s)
- Debbie E Malden
- Kaiser Permanente Southern California, Department of Research & Evaluation, Pasadena, USA.
| | - In-Lu Amy Liu
- Kaiser Permanente Southern California, Department of Research & Evaluation, Pasadena, USA
| | - Lei Qian
- Kaiser Permanente Southern California, Department of Research & Evaluation, Pasadena, USA
| | - Lina S Sy
- Kaiser Permanente Southern California, Department of Research & Evaluation, Pasadena, USA
| | - Bruno J Lewin
- Kaiser Permanente Southern California, Department of Research & Evaluation, Pasadena, USA
- Kaiser Permanente Bernard J. Tyson School of Medicine, Department of Clinical Science, Pasadena, USA
| | - Dawn T Asamura
- Kaiser Permanente Southern California, Department of Research & Evaluation, Pasadena, USA
| | - Denison S Ryan
- Kaiser Permanente Southern California, Department of Research & Evaluation, Pasadena, USA
| | - Cassandra Bezi
- Kaiser Permanente Southern California, Department of Research & Evaluation, Pasadena, USA
| | - Joshua T B Williams
- Denver Health, Ambulatory Care Services & Center for Health Systems Research, Denver, USA
| | | | - Matthew F Daley
- Kaiser Permanente Colorado, Institute for Health Research, Aurora, USA
| | - Jennifer C Nelson
- Kaiser Permanente Washington Health Research Institute (KPWHRI), Seattle, USA
| | | | - Ousseny Zerbo
- Kaiser Permanente Northern California, Division of Research, Vaccine Study Center, Oakland, USA
| | | | | | - Eric S Weintraub
- Centers for Disease Control and Prevention, Immunization Safety Office, Atlanta, GA, USA
| | - Sharon Saydah
- Centers for Disease Control and Prevention, Immunization Safety Office, Atlanta, GA, USA
| | - Sara Y Tartof
- Kaiser Permanente Southern California, Department of Research & Evaluation, Pasadena, USA
- Kaiser Permanente Bernard J. Tyson School of Medicine, Department of Health Systems Science, Pasadena, USA
| |
Collapse
|
34
|
Xie J, Mothe B, Alcalde Herraiz M, Li C, Xu Y, Jödicke AM, Gao Y, Wang Y, Feng S, Wei J, Chen Z, Hong S, Wu Y, Su B, Zheng X, Cohet C, Ali R, Wareham N, Alhambra DP. Relationship between HLA genetic variations, COVID-19 vaccine antibody response, and risk of breakthrough outcomes. Nat Commun 2024; 15:4031. [PMID: 38740772 DOI: 10.1038/s41467-024-48339-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 04/29/2024] [Indexed: 05/16/2024] Open
Abstract
The rapid global distribution of COVID-19 vaccines, with over a billion doses administered, has been unprecedented. However, in comparison to most identified clinical determinants, the implications of individual genetic factors on antibody responses post-COVID-19 vaccination for breakthrough outcomes remain elusive. Here, we conducted a population-based study including 357,806 vaccinated participants with high-resolution HLA genotyping data, and a subset of 175,000 with antibody serology test results. We confirmed prior findings that single nucleotide polymorphisms associated with antibody response are predominantly located in the Major Histocompatibility Complex region, with the expansive HLA-DQB1*06 gene alleles linked to improved antibody responses. However, our results did not support the claim that this mutation alone can significantly reduce COVID-19 risk in the general population. In addition, we discovered and validated six HLA alleles (A*03:01, C*16:01, DQA1*01:02, DQA1*01:01, DRB3*01:01, and DPB1*10:01) that independently influence antibody responses and demonstrated a combined effect across HLA genes on the risk of breakthrough COVID-19 outcomes. Lastly, we estimated that COVID-19 vaccine-induced antibody positivity provides approximately 20% protection against infection and 50% protection against severity. These findings have immediate implications for functional studies on HLA molecules and can inform future personalised vaccination strategies.
Collapse
Affiliation(s)
- Junqing Xie
- Centre for Statistics in Medicine and NIHR Biomedical Research Centre Oxford, NDORMS, University of Oxford, Oxford, UK
| | - Beatriz Mothe
- Infectious Diseases Department, IrsiCaixa AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Marta Alcalde Herraiz
- Centre for Statistics in Medicine and NIHR Biomedical Research Centre Oxford, NDORMS, University of Oxford, Oxford, UK
| | - Chunxiao Li
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Yu Xu
- Cambridge Baker Systems Genomics Initiative, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, UK
| | - Annika M Jödicke
- Centre for Statistics in Medicine and NIHR Biomedical Research Centre Oxford, NDORMS, University of Oxford, Oxford, UK
| | - Yaqing Gao
- Nuffield Department of Population Health, Big Data Institute, University of Oxford, Oxford, UK
| | - Yunhe Wang
- Nuffield Department of Population Health, Big Data Institute, University of Oxford, Oxford, UK
| | - Shuo Feng
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
| | - Jia Wei
- Nuffield Department of Medicine, Big Data Institute, University of Oxford, Oxford, UK
| | - Zhuoyao Chen
- Centre for Medicines Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Shenda Hong
- National Institute of Health Data Science, Peking University, Beijing, China
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
| | - Yeda Wu
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
| | - Binbin Su
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China
| | - Xiaoying Zheng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China
| | - Catherine Cohet
- Real-World Evidence Workstream, Data Analytics and Methods Task Force, European Medicines Agency, Amsterdam, Noord-Holland, The Netherlands
| | - Raghib Ali
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, UK
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Nick Wareham
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Daniel Prieto Alhambra
- Centre for Statistics in Medicine and NIHR Biomedical Research Centre Oxford, NDORMS, University of Oxford, Oxford, UK.
- Department of Medical Informatics, Erasmus University Medical Centre, Rotterdam, The Netherlands.
| |
Collapse
|
35
|
Lupi L, Vitiello A, Parolin C, Calistri A, Garzino-Demo A. The Potential Role of Viral Persistence in the Post-Acute Sequelae of SARS-CoV-2 Infection (PASC). Pathogens 2024; 13:388. [PMID: 38787240 PMCID: PMC11123686 DOI: 10.3390/pathogens13050388] [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: 04/06/2024] [Revised: 04/26/2024] [Accepted: 05/06/2024] [Indexed: 05/25/2024] Open
Abstract
The infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated not only with the development of acute disease but also with long-term symptoms or post-acute sequelae of SARS-CoV-2 (PASC). Multiple lines of evidence support that some viral antigens and RNA can persist for up to 15 months in multiple organs in the body, often after apparent clearance from the upper respiratory system, possibly leading to the persistence of symptoms. Activation of the immune system to viral antigens is observed for a prolonged time, providing indirect evidence of the persistence of viral elements after acute infection. In the gastrointestinal tract, the persistence of some antigens could stimulate the immune system, shaping the local microbiota with potential systemic effects. All of these interactions need to be investigated, taking into account predisposing factors, multiplicity of pathogenic mechanisms, and stratifying populations of vulnerable individuals, particularly women, children, and immunocompromised individuals, where SARS-CoV-2 may present additional challenges.
Collapse
Affiliation(s)
- Lorenzo Lupi
- Department of Molecular Medicine, University of Padova, 35121 Padova, Italy; (L.L.); (A.V.); (C.P.); (A.C.)
| | - Adriana Vitiello
- Department of Molecular Medicine, University of Padova, 35121 Padova, Italy; (L.L.); (A.V.); (C.P.); (A.C.)
| | - Cristina Parolin
- Department of Molecular Medicine, University of Padova, 35121 Padova, Italy; (L.L.); (A.V.); (C.P.); (A.C.)
| | - Arianna Calistri
- Department of Molecular Medicine, University of Padova, 35121 Padova, Italy; (L.L.); (A.V.); (C.P.); (A.C.)
| | - Alfredo Garzino-Demo
- Department of Molecular Medicine, University of Padova, 35121 Padova, Italy; (L.L.); (A.V.); (C.P.); (A.C.)
- Department of Microbial Pathogenesis, School of Dentistry, University of Maryland, Baltimore, MD 21201, USA
- Department of Microbiology and Immunology, School of Medicine, University of Maryland, Baltimore, MD 21201, USA
| |
Collapse
|
36
|
Galiero R, Loffredo G, Simeon V, Caturano A, Vetrano E, Medicamento G, Alfano M, Beccia D, Brin C, Colantuoni S, Di Salvo J, Epifani R, Nevola R, Marfella R, Sardu C, Coppola C, Scarano F, Maggi P, Calabrese C, De Lucia Sposito P, Rescigno C, Sbreglia C, Fraganza F, Parrella R, Romano A, Calabria G, Polverino B, Pagano A, Numis F, Bologna C, Nunziata M, Esposito V, Coppola N, Maturo N, Nasti R, Di Micco P, Perrella A, Adinolfi LE, Chiodini P, Di Domenico M, Rinaldi L, Sasso FC. Impact of liver fibrosis on COVID-19 in-hospital mortality in Southern Italy. PLoS One 2024; 19:e0296495. [PMID: 38713731 DOI: 10.1371/journal.pone.0296495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 12/14/2023] [Indexed: 05/09/2024] Open
Abstract
BACKGROUND & AIMS SARS-Cov-2 infection manifests as a wide spectrum of clinical presentation and even now, despite the global spread of the vaccine, contagiousness is still elevated. The aim of the study was the evaluation of the impact of liver fibrosis assessed by FIB-4 and liver impairment, assessed by cytolysis indices, on intrahospital mortality in COVID-19 subjects. METHODS This is a retrospective observational cohort study, which involved 23 COVID Hospital Units in Campania Region, Italy. Exposure variables were collected during hospital admission and at discharge. According to FIB-4 values, we subdivided the overall population in three groups (FIB-4<1.45; 1.453.25), respectively group 1,2,3. RESULTS At the end of the study, 938 individuals had complete discharged/dead data. At admission, 428 patients were in group 1 (45.6%), 387 in group 2 (41.3%) and 123 in group 3 (13.1%). Among them, 758 (81%) subjects were discharged, while the remaining 180 (19%) individuals died. Multivariable Cox's regression model showed a significant association between mortality risk and severity of FIB-4 stages (group 3 vs group 1, HR 2.12, 95%CI 1.38-3.28, p<0.001). Moreover, Kaplan-Meier analysis described a progressive and statistically significant difference (p<0.001 Log-rank test) in mortality according to FIB-4 groups. Among discharged subjects, 507 showed a FIB-4<1.45 (66.9%, group 1), 182 a value 1.453.25 (9.0%, group 3). Among dead subjects, 42 showed a FIB-4<1.45 (23.3%, group 1), 62 a value 1.453.25 (42.3%, group 3). CONCLUSIONS FIB-4 value is significantly associated with intrahospital mortality of COVID-19 patients. During hospitalization, particularly in patients with worse outcomes, COVID-19 seems to increase the risk of acute progression of liver damage.
Collapse
Affiliation(s)
- Raffaele Galiero
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giuseppe Loffredo
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Vittorio Simeon
- Medical Statistics Unit, Department of Physical and Mental Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Alfredo Caturano
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Erica Vetrano
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giulia Medicamento
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Maria Alfano
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Domenico Beccia
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Chiara Brin
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Sara Colantuoni
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Jessica Di Salvo
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Raffaella Epifani
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Riccardo Nevola
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
- Ospedale Evangelico Betania, Naples, Italy
| | - Raffaele Marfella
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Celestino Sardu
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Carmine Coppola
- Hepatology Unit, Internal Medicine, Area Stabiese Hospital, Naples, Italy
| | - Ferdinando Scarano
- COVID Center "S. Anna e SS. Madonna della Neve" Hospital, Boscotrecase, Italy
| | - Paolo Maggi
- U.O.C. Infectious and Tropical diseases, S. Anna e S. Sebastiano Hospital, Caserta, Italy
| | - Cecilia Calabrese
- Pneumologia Vanvitelli Department of Translational Medical Sciences, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | | | - Carolina Rescigno
- U.O.C. Infectious Diseases and Neurology, Cotugno Hospital, Naples, Italy
| | - Costanza Sbreglia
- U.O.C. Infectious Diseases of the Elderly, Cotugno Hospital, Naples, Italy
| | | | - Roberto Parrella
- U.O.C. Respiratory Infectious Diseases, Cotugno Hospital, Naples, Italy
| | | | - Giosuele Calabria
- IXth Division of Infectious Diseases and Interventional Ultrasound, Cotugno Hospital, Naples, Italy
| | | | - Antonio Pagano
- Emergency and Acceptance Unit, "Santa Maria delle Grazie" Hospital, Pozzuoli, Italy
| | - Fabio Numis
- Emergency and Acceptance Unit, "Santa Maria delle Grazie" Hospital, Pozzuoli, Italy
| | | | | | - Vincenzo Esposito
- IVth Division of Immunodeficiency and Gender Infectious Diseases, Cotugno Hospital, Naples, Italy
| | - Nicola Coppola
- Department of Mental Health and Public Medicine, Centro COVID A.O.U. Vanvitelli, Naples, Italy
| | - Nicola Maturo
- U.O.S.D. Infectious Diseases Emergency and Acceptance, Cotugno Hospital, Naples, Italy
| | - Rodolfo Nasti
- Emergency Division, A.O.R.N. "Antonio Cardarelli", Naples, Italy
| | - Pierpaolo Di Micco
- Department of Internal Medicine, Fatebenefratelli Hospital of Naples, Naples, Italy
| | | | - Luigi Elio Adinolfi
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Paolo Chiodini
- Medical Statistics Unit, Department of Physical and Mental Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Marina Di Domenico
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Luca Rinaldi
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Ferdinando Carlo Sasso
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| |
Collapse
|
37
|
Kobashi Y, Yoshida M, Saito H, Yoshimura H, Nonaka S, Yamamoto C, Zhao T, Tsubokura M. Understanding Reasons for Vaccination Hesitancy and Implementing Effective Countermeasures: An Online Survey of Individuals Unvaccinated against COVID-19. Vaccines (Basel) 2024; 12:499. [PMID: 38793750 PMCID: PMC11125705 DOI: 10.3390/vaccines12050499] [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: 03/01/2024] [Revised: 04/26/2024] [Accepted: 04/30/2024] [Indexed: 05/26/2024] Open
Abstract
This online survey of unvaccinated people living in Japan aimed to identify the reasons for declining vaccination and to develop effective countermeasures. We conducted a hierarchical class analysis to classify participants, examine factors influencing their classification, and provide the information they needed about coronavirus disease 2019 (COVID-19) and trusted sources of COVID-19 information for each group. A total of 262 participants were classified into three groups: Group 1 with no specific reason (28 participants, 10.69%); Group 2 with clear concerns about trust in the vaccine (85 participants, 32.44%), and Group 3 with attitudinal barriers, such as distrust of the vaccine and complacency towards COVID-19, and structural barriers, such as vaccination appointments (149 participants, 56.87%). For each group, females tended to be classified in Group 2 more than Group 1 (Odds ratio (OR) [95% confidential intervals (95%CI)] = 1.64 (0.63 to 2.66), p = 0.001) and in Group 3 more than Group 1 (OR [95%CI] = 1.16 (0.19 to 2.12), p = 0.019). The information that the participants wanted to know about COVID-19 was different among each group (Safety: p < 0.001, Efficacy: p < 0.001, Genetic effects: p < 0.001). Those who did not receive the COVID-19 vaccine also had lower influenza vaccination coverage (8.02%). Additionally, 38 participants (14.50%) were subject to social disadvantages because they had not received the COVID-19 vaccine. Countermeasures should be carefully tailored according to the target population, reasons for hesitancy, and specific context. The findings of this study may help develop individualized countermeasures to address vaccine hesitancy.
Collapse
Affiliation(s)
- Yurie Kobashi
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Fukushima 960-1295, Japan; (Y.K.); (M.Y.); (H.S.); (H.Y.); (C.Y.); (T.Z.)
- Department of Internal Medicine, Serireikai Group Hirata Central Hospital, Ishikawa Country, Fukushima 963-8202, Japan
| | - Makoto Yoshida
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Fukushima 960-1295, Japan; (Y.K.); (M.Y.); (H.S.); (H.Y.); (C.Y.); (T.Z.)
- Faculty of Medicine, Teikyo University School of Medicine, Itabashi-ku, Tokyo 173-8605, Japan
| | - Hiroaki Saito
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Fukushima 960-1295, Japan; (Y.K.); (M.Y.); (H.S.); (H.Y.); (C.Y.); (T.Z.)
- Department of Internal Medicine, Soma Central Hospital, Soma, Fukushima 976-0016, Japan
| | - Hiroki Yoshimura
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Fukushima 960-1295, Japan; (Y.K.); (M.Y.); (H.S.); (H.Y.); (C.Y.); (T.Z.)
- School of Medicine, Hiroshima University, Hiroshima 739-8511, Japan
| | - Saori Nonaka
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Fukushima 960-1295, Japan; (Y.K.); (M.Y.); (H.S.); (H.Y.); (C.Y.); (T.Z.)
| | - Chika Yamamoto
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Fukushima 960-1295, Japan; (Y.K.); (M.Y.); (H.S.); (H.Y.); (C.Y.); (T.Z.)
| | - Tianchen Zhao
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Fukushima 960-1295, Japan; (Y.K.); (M.Y.); (H.S.); (H.Y.); (C.Y.); (T.Z.)
| | - Masaharu Tsubokura
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Fukushima 960-1295, Japan; (Y.K.); (M.Y.); (H.S.); (H.Y.); (C.Y.); (T.Z.)
- Department of Internal Medicine, Serireikai Group Hirata Central Hospital, Ishikawa Country, Fukushima 963-8202, Japan
- Research Center for Community Health, Minamisoma Municipal General Hospital, Minamisoma, Fukushima 975-0033, Japan
- General Incorporated Association for Comprehensive Disaster Health Management Research Institute, Minato-ku, Tokyo 108-0074, Japan
| |
Collapse
|
38
|
Saheb Sharif-Askari F, Ali Hussain Alsayed H, Saheb Sharif-Askari N, Saddik B, Al Sayed Hussain A, Halwani R. Risk factors and early preventive measures for long COVID in non-hospitalized patients: analysis of a large cohort in the United Arab Emirates. Public Health 2024; 230:198-206. [PMID: 38574425 DOI: 10.1016/j.puhe.2024.02.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 02/07/2024] [Accepted: 02/29/2024] [Indexed: 04/06/2024]
Abstract
OBJECTIVES Long COVID is characterized by persistent symptoms lasting for 4 weeks or more following the acute infection with SARS-CoV-2. Risk factors for long COVID and the impact of pre-COVID vaccination and treatment during acute COVID-19 remain uncertain. This study aimed to investigate patient-specific factors associated with long COVID in a large cohort of non-hospitalized adult patients with mild to moderate COVID-19 in Dubai. STUDY DESIGN Cohort study. METHODS The study included 28,375 non-hospitalized adult patients diagnosed with mild to moderate COVID-19 between January 1, 2021, and September 31, 2022, in Dubai, who were followed up for 90 days. The presence of long COVID symptoms was documented by physicians during patient visits to the family medicine department. Furthermore, long COVID-related risk factors were collected and analyzed, including patient demographics, comorbidities, pre-COVID vaccination status, and the COVID-related treatments received during the acute phase of the illness. Cox proportional hazard models were applied for the statistical analysis. RESULTS Among the cohort, 2.8% of patients experienced long COVID symptoms during the 90-day follow-up. Patients with long COVID tended to be younger, female, and of Caucasian race. Common symptoms included fatigue, muscle pain, respiratory symptoms, abdominal and neurological symptoms, allergic reactions, skin rashes, and hair loss. Risk factors for long COVID were identified as diabetes mellitus, asthma, and Vitamin D deficiency. Females and Caucasians had a higher risk of long COVID during the pre-Omicron period compared to the Omicron period. Pre-COVID vaccination was associated with a reduced risk of long COVID in all patient subgroups. Treatment with favipiravir or sotrovimab during the acute phase of COVID-19 was linked to a decreased risk of long COVID, although favipiravir showed limited effectiveness in the high-risk group. CONCLUSION This study contributes to the existing knowledge by identifying risk factors for long COVID among non-hospitalized patients and emphasizing the potential benefits of pre-COVID vaccination and timely treatment.
Collapse
Affiliation(s)
- Fatemeh Saheb Sharif-Askari
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates; Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
| | - Hawra Ali Hussain Alsayed
- Department of Pharmacy, Rashid Hospital, Dubai Academic Health Corporation, Dubai, United Arab Emirates
| | - Narjes Saheb Sharif-Askari
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates; Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Basema Saddik
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates; Department of Family and Community Medicine, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates; School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Ali Al Sayed Hussain
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
| | - Rabih Halwani
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates; Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates; Prince Abdullah Ben Khaled Celiac Disease Chair, Department of Pediatrics, Faculty of Medicine, King Saud University, Saudi Arabia.
| |
Collapse
|
39
|
Huh K, Kim YE, Bae GH, Moon JY, Kang JM, Lee J, Bae JW, Peck KR, Jung J. Vaccination and the risk of post-acute sequelae after COVID-19 in the Omicron-predominant period. Clin Microbiol Infect 2024; 30:666-673. [PMID: 38331252 DOI: 10.1016/j.cmi.2024.01.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 02/10/2024]
Abstract
OBJECTIVES To assess the association of primary and third doses of vaccination with the risk of post-acute sequelae of COVID-19. METHODS This retrospective cohort study utilized a combined database of nationwide health care claims data, COVID-19 patient registry, and vaccination records from South Korea. Individuals diagnosed with COVID-19 in the Omicron variant-dominant period of January-March 2022 were tracked for 30-120 days post-infection. The exposure of interest was the receipt of primary and third doses of the SARS-CoV-2 vaccine. The occurrence of 26 specific conditions in eight domains was compared using Cox regression with inverse probability of treatment weighting. RESULTS This study included 394 773 unvaccinated individuals and 7 604 081 individuals receiving ≥2 doses of vaccine. Compared with unvaccinated individuals, vaccination with at least two doses was associated with a reduced risk (adjusted hazard ratio; 95% CI) of several conditions, including ischaemic heart disease (0.73; 0.57-0.94), heart failure (0.55; 0.48-0.63), cardiac dysrhythmia (0.72; 0.61-0.85), cardiac arrest (0.41; 0.33-0.51), pulmonary embolism (0.66; 0.52-0.84), venous thromboembolism (0.54; 0.44-0.66), acute renal failure (0.56; 0.46-0.67), new dialysis (0.45; 0.34-0.59), chronic obstructive pulmonary disease (0.74; 0.65-0.84), acute pancreatitis (0.64; 0.51-0.80), and diabetes (0.82; 0.71-0.95). The risks of heart failure, cardiac dysrhythmias, cardiac arrest, pulmonary embolism, and new dialysis were lower in those who were vaccinated with three doses compared with those who were vaccinated with two doses. DISCUSSION Vaccination was associated with a decreased risk of post-acute sequelae of COVID-19, suggesting its potential role in mitigating the indirect impacts of COVID-19.
Collapse
Affiliation(s)
- Kyungmin Huh
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Young-Eun Kim
- Department of Bigdata Strategy, National Health Insurance Service, Wonju, South Korea
| | - Gi Hwan Bae
- Artificial Intelligence and Big-Data Convergence Center, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea
| | - Jong Youn Moon
- Department of Preventive Medicine, Gachon University College of Medicine, Incheon, South Korea; Center for Public Healthcare, Gachon University Gil Medical Center, Incheon, South Korea
| | - Ji-Man Kang
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, South Korea; Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, South Korea
| | - Jacob Lee
- Division of Infectious Disease, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, South Korea
| | - Jang-Whan Bae
- Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, South Korea; Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju, South Korea
| | - Kyong Ran Peck
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jaehun Jung
- Artificial Intelligence and Big-Data Convergence Center, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea; Department of Preventive Medicine, Gachon University College of Medicine, Incheon, South Korea.
| |
Collapse
|
40
|
Asplin P, Keeling MJ, Mancy R, Hill EM. Epidemiological and health economic implications of symptom propagation in respiratory pathogens: A mathematical modelling investigation. PLoS Comput Biol 2024; 20:e1012096. [PMID: 38701066 PMCID: PMC11095726 DOI: 10.1371/journal.pcbi.1012096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 05/15/2024] [Accepted: 04/19/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Respiratory pathogens inflict a substantial burden on public health and the economy. Although the severity of symptoms caused by these pathogens can vary from asymptomatic to fatal, the factors that determine symptom severity are not fully understood. Correlations in symptoms between infector-infectee pairs, for which evidence is accumulating, can generate large-scale clusters of severe infections that could be devastating to those most at risk, whilst also conceivably leading to chains of mild or asymptomatic infections that generate widespread immunity with minimal cost to public health. Although this effect could be harnessed to amplify the impact of interventions that reduce symptom severity, the mechanistic representation of symptom propagation within mathematical and health economic modelling of respiratory diseases is understudied. METHODS AND FINDINGS We propose a novel framework for incorporating different levels of symptom propagation into models of infectious disease transmission via a single parameter, α. Varying α tunes the model from having no symptom propagation (α = 0, as typically assumed) to one where symptoms always propagate (α = 1). For parameters corresponding to three respiratory pathogens-seasonal influenza, pandemic influenza and SARS-CoV-2-we explored how symptom propagation impacted the relative epidemiological and health-economic performance of three interventions, conceptualised as vaccines with different actions: symptom-attenuating (labelled SA), infection-blocking (IB) and infection-blocking admitting only mild breakthrough infections (IB_MB). In the absence of interventions, with fixed underlying epidemiological parameters, stronger symptom propagation increased the proportion of cases that were severe. For SA and IB_MB, interventions were more effective at reducing prevalence (all infections and severe cases) for higher strengths of symptom propagation. For IB, symptom propagation had no impact on effectiveness, and for seasonal influenza this intervention type was more effective than SA at reducing severe infections for all strengths of symptom propagation. For pandemic influenza and SARS-CoV-2, at low intervention uptake, SA was more effective than IB for all levels of symptom propagation; for high uptake, SA only became more effective under strong symptom propagation. Health economic assessments found that, for SA-type interventions, the amount one could spend on control whilst maintaining a cost-effective intervention (termed threshold unit intervention cost) was very sensitive to the strength of symptom propagation. CONCLUSIONS Overall, the preferred intervention type depended on the combination of the strength of symptom propagation and uptake. Given the importance of determining robust public health responses, we highlight the need to gather further data on symptom propagation, with our modelling framework acting as a template for future analysis.
Collapse
Affiliation(s)
- Phoebe Asplin
- EPSRC & MRC Centre for Doctoral Training in Mathematics for Real-World Systems, University of Warwick, Coventry, United Kingdom
- Mathematics Institute, University of Warwick, Coventry, United Kingdom
- The Zeeman Institute for Systems Biology & Infectious Disease Epidemiology Research, University of Warwick, Coventry, United Kingdom
| | - Matt J. Keeling
- Mathematics Institute, University of Warwick, Coventry, United Kingdom
- The Zeeman Institute for Systems Biology & Infectious Disease Epidemiology Research, University of Warwick, Coventry, United Kingdom
- School of Life Sciences, University of Warwick, Coventry, United Kingdom
| | - Rebecca Mancy
- School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, United Kingdom
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom
| | - Edward M. Hill
- Mathematics Institute, University of Warwick, Coventry, United Kingdom
- The Zeeman Institute for Systems Biology & Infectious Disease Epidemiology Research, University of Warwick, Coventry, United Kingdom
| |
Collapse
|
41
|
Al Awaidy S, Khamis F, Al Ghafri T, Badahdah A. Support for Mandatory COVID-19 Vaccines for 5- to 11-Year-Old Children: Cross-sectional study of Omani mothers. Sultan Qaboos Univ Med J 2024; 24:229-234. [PMID: 38828250 PMCID: PMC11139360 DOI: 10.18295/squmj.1.2024.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 12/20/2023] [Accepted: 01/18/2024] [Indexed: 06/05/2024] Open
Abstract
Objectives This study aimed to investigate the variables that influenced a sample of Omani mothers' support for mandatory COVID-19 vaccines for children. The vaccination against COVID-19 averted millions of fatalities during the COVID-19 pandemic. Nevertheless, a considerable number of parents and caregivers opposed mandating COVID-19 vaccines for children. Methods This cross-sectional study was conducted at several healthcare facilities in Oman using a structured questionnaire between February and March 2022. Univariable and multivariable logistic regression models were used to analyse the data. Results A total of 700 Omani mothers (response rate = 73.4%) who had children aged 5-11 years old were included. The median age of the mothers was 38 ± 5.19 years. The results of multivariable logistic regression were generally consistent with those of the univariable analysis except for age (odds ratio [OR] = 1.06, 95% confidence interval [CI]: 0.58-1.93; P = 0.86) and income (OR = 1.09, 95% CI: 0.58-2.03; P = 0.79). Mothers who were vaccine hesitant (OR = 9.82, 95% CI: 5.27-18.28; P <0.001), tested positive for COVID-19 (OR = 3.25, 95% CI: 1.80-5.86; P <0.001) and had one or two doses of COVID-19 vaccines (OR = 5.41, 95% CI: 2.92-10.03; P <0.001) were more likely to refuse mandating COVID-19 vaccines for children 5-11 years old. Conclusion Mothers who were vaccine hesitant, tested positive for COVID-19 and had one or two doses of COVID-19 vaccines were more likely to oppose mandatory COVID-19 vaccines for young children. The findings should aid public health authorities in designing future childhood vaccine literacy programmes with specific attention to some subgroups in Oman to help reduce opposition to vaccines in future pandemics among mothers.
Collapse
Affiliation(s)
| | - Faryal Khamis
- Department of Medicine, The Royal Hospital, Muscat, Oman
| | - Thamra Al Ghafri
- Directorate General of Health Services, Ministry of Health, Muscat, Oman
| | - Abdallah Badahdah
- School of Psychology, Sociology and Rural Studies, South Dakota State University, Brookings, USA
| |
Collapse
|
42
|
Patel NJ, Wang X, Lin M, Kowalski EN, Cook CE, Vanni KMM, Guzzo K, Qian G, Bade KJ, Saavedra A, Venkat R, Srivatsan S, Williams ZK, Hanberg JS, Kawano Y, Schiff AE, Sparks JA, Wallace ZS. Factors Associated With an Electronic Health Record-Based Definition of Postacute Sequelae of COVID-19 in Patients With Systemic Autoimmune Rheumatic Disease. J Rheumatol 2024; 51:529-537. [PMID: 38428964 PMCID: PMC11065568 DOI: 10.3899/jrheum.2023-1092] [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] [Accepted: 02/12/2024] [Indexed: 03/03/2024]
Abstract
OBJECTIVE Many individuals with rheumatic disease are at higher risk for severe acute coronavirus disease 2019 (COVID-19). We aimed to evaluate risk factors for postacute sequelae of COVID-19 (PASC) using an electronic health record (EHR)-based definition. METHODS We identified patients with prevalent rheumatic diseases and COVID-19 within the Mass General Brigham healthcare system. PASC was defined by the International Classification of Diseases, 10th revision (ICD-10) codes, relevant labs, vital signs, and medications at least 30 days following the first COVID-19 infection. Patients were followed until the earliest of incident PASC, repeat COVID-19 infection, 1 year of follow-up, death, or February 19, 2023. We used multivariable Cox regression to estimate the association of baseline characteristics with PASC risk. RESULTS Among 2459 patients (76.37% female, mean age 57.4 years), the most common incident PASC manifestations were cough (14.56%), dyspnea (12.36%), constipation (11.39%), and fatigue (10.70%). Serious manifestations including acute coronary disease (4.43%), thromboembolism (3.09%), hypoxemia (3.09%), stroke (1.75%), and myocarditis (0.12%) were rare. The Delta wave (adjusted hazard ratio [aHR] 0.63, 95% CI 0.49-0.82) and Omicron era (aHR 0.50, 95% CI 0.41-0.62) were associated with lower risk of PASC than the early pandemic period (March 2020-June 2021). Age, obesity, comorbidity burden, race, and hospitalization for acute COVID-19 infection were associated with greater risk of PASC. Glucocorticoid (GC) use (aHR 1.19, 95% CI 1.05-1.34 compared to no use) was associated with greater risk of PASC. CONCLUSION Among patients with rheumatic diseases, following their first COVID-19 infection, we found a decreased risk of PASC over calendar time using an EHR-based definition. Aside from GCs, no specific immunomodulatory medications were associated with increased risk, and risk factors were otherwise similar to those seen in the general population.
Collapse
Affiliation(s)
- Naomi J Patel
- N.J. Patel, MD, MPH, Z.S. Wallace, MD, MSc, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, and Harvard Medical School, and Rheumatology and Allergy Clinical Epidemiology Research Center, Mongan Institute, Department of Medicine, Massachusetts General Hospital
| | - Xiaosong Wang
- X. Wang, MS, E.N. Kowalski, BS, K.M.M. Vanni, BA, G. Qian, BA&Sc, K.J. Bade, BS, A. Saavedra, BA, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital
| | - Miao Lin
- M. Lin, MS, C.E. Cook, MPH, K. Guzzo, BA, S. Srivatsan, BS, Z.K. Williams, BS, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, and Rheumatology and Allergy Clinical Epidemiology Research Center, Mongan Institute, Department of Medicine, Massachusetts General Hospital
| | - Emily N Kowalski
- X. Wang, MS, E.N. Kowalski, BS, K.M.M. Vanni, BA, G. Qian, BA&Sc, K.J. Bade, BS, A. Saavedra, BA, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital
| | - Claire E Cook
- M. Lin, MS, C.E. Cook, MPH, K. Guzzo, BA, S. Srivatsan, BS, Z.K. Williams, BS, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, and Rheumatology and Allergy Clinical Epidemiology Research Center, Mongan Institute, Department of Medicine, Massachusetts General Hospital
| | - Kathleen M M Vanni
- X. Wang, MS, E.N. Kowalski, BS, K.M.M. Vanni, BA, G. Qian, BA&Sc, K.J. Bade, BS, A. Saavedra, BA, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital
| | - Krishan Guzzo
- M. Lin, MS, C.E. Cook, MPH, K. Guzzo, BA, S. Srivatsan, BS, Z.K. Williams, BS, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, and Rheumatology and Allergy Clinical Epidemiology Research Center, Mongan Institute, Department of Medicine, Massachusetts General Hospital
| | - Grace Qian
- X. Wang, MS, E.N. Kowalski, BS, K.M.M. Vanni, BA, G. Qian, BA&Sc, K.J. Bade, BS, A. Saavedra, BA, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital
| | - Katarina J Bade
- X. Wang, MS, E.N. Kowalski, BS, K.M.M. Vanni, BA, G. Qian, BA&Sc, K.J. Bade, BS, A. Saavedra, BA, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital
| | - Alene Saavedra
- X. Wang, MS, E.N. Kowalski, BS, K.M.M. Vanni, BA, G. Qian, BA&Sc, K.J. Bade, BS, A. Saavedra, BA, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital
| | | | - Shruthi Srivatsan
- M. Lin, MS, C.E. Cook, MPH, K. Guzzo, BA, S. Srivatsan, BS, Z.K. Williams, BS, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, and Rheumatology and Allergy Clinical Epidemiology Research Center, Mongan Institute, Department of Medicine, Massachusetts General Hospital
| | - Zachary K Williams
- M. Lin, MS, C.E. Cook, MPH, K. Guzzo, BA, S. Srivatsan, BS, Z.K. Williams, BS, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, and Rheumatology and Allergy Clinical Epidemiology Research Center, Mongan Institute, Department of Medicine, Massachusetts General Hospital
| | - Jennifer S Hanberg
- J.S. Hanberg, MD, Y. Kawano, MD, J.A. Sparks, MD, MMSc, Harvard Medical School, and Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital
| | - Yumeko Kawano
- J.S. Hanberg, MD, Y. Kawano, MD, J.A. Sparks, MD, MMSc, Harvard Medical School, and Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital
| | - Abigail E Schiff
- A.E. Schiff, MD, PhD, Harvard Medical School, and Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Jeffrey A Sparks
- J.S. Hanberg, MD, Y. Kawano, MD, J.A. Sparks, MD, MMSc, Harvard Medical School, and Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital
| | - Zachary S Wallace
- N.J. Patel, MD, MPH, Z.S. Wallace, MD, MSc, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, and Harvard Medical School, and Rheumatology and Allergy Clinical Epidemiology Research Center, Mongan Institute, Department of Medicine, Massachusetts General Hospital;
| |
Collapse
|
43
|
Moneshwaran S, Macrin D, Kanagathara N. An unprecedented global challenge, emerging trends and innovations in the fight against COVID-19: A comprehensive review. Int J Biol Macromol 2024; 267:131324. [PMID: 38574936 DOI: 10.1016/j.ijbiomac.2024.131324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 03/30/2024] [Accepted: 03/30/2024] [Indexed: 04/06/2024]
Abstract
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a highly contagious and dangerous virus that caused the global COVID-19 pandemic in early 2020. It primarily affects the respiratory system, leading to severe illness and high rates of mortality worldwide. The virus enters the body by binding to a receptor called ACE2, which is present in specific cells of the lungs known as type 2 alveolar epithelial cells. Numerous studies have investigated the consequences of SARS-CoV-2 infection, revealing various impacts on the body. This review provides an overview of SARS-CoV-2, including its structure and how it infects cells. It also examines the different variants of concern, such as Alpha, Beta, Gamma, Delta, and the more recent Omicron variant, discussing their characteristics and the level of damage they cause. The usage of drugs to treat COVID-19 is another aspect that has been covered and compares the effectiveness and use of antiviral drugs in the treatment and its potential benefits in COVID-19 treatment. Furthermore, this review explores the consequences and abnormalities associated with SARS-CoV-2 infection, including its impact on various organs and systems in the body. And also discussing the different COVID-19 vaccines available and their effectiveness in preventing infection and reducing the severity of illness. The current review ensures the recent update of the COVID research with expert's knowledge, collection of numerous data from reliable sources and methodologies as well as update of findings based on reviews. This review also provided clear contextual explanations to aid the interpretation and application of the results. The main motto and limitation of this manuscript are to address the computational methods of drug discovery against the rapidly evolving SARS-CoV-2 virus, which has been discussed. Additionally, current computational approaches which are cost effective and can able to predict the therapeutic agents for the treatment against the virus have also been discussed.
Collapse
Affiliation(s)
- S Moneshwaran
- Department of Bioinformatics, Saveetha School of Engineering, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Thandalam, Chennai 602 105, India
| | - D Macrin
- Department of Bioinformatics, Saveetha School of Engineering, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Thandalam, Chennai 602 105, India
| | - N Kanagathara
- Department of Physics, Saveetha School of Engineering, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Thandalam, Chennai 602 105, India.
| |
Collapse
|
44
|
Drury RE, Camara S, Chelysheva I, Bibi S, Sanders K, Felle S, Emary K, Phillips D, Voysey M, Ferreira DM, Klenerman P, Gilbert SC, Lambe T, Pollard AJ, O'Connor D. Multi-omics analysis reveals COVID-19 vaccine induced attenuation of inflammatory responses during breakthrough disease. Nat Commun 2024; 15:3402. [PMID: 38649734 PMCID: PMC11035709 DOI: 10.1038/s41467-024-47463-6] [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: 06/18/2023] [Accepted: 04/02/2024] [Indexed: 04/25/2024] Open
Abstract
The immune mechanisms mediating COVID-19 vaccine attenuation of COVID-19 remain undescribed. We conducted comprehensive analyses detailing immune responses to SARS-CoV-2 virus in blood post-vaccination with ChAdOx1 nCoV-19 or a placebo. Samples from randomised placebo-controlled trials (NCT04324606 and NCT04400838) were taken at baseline, onset of COVID-19-like symptoms, and 7 days later, confirming COVID-19 using nucleic amplification test (NAAT test) via real-time PCR (RT-PCR). Serum cytokines were measured with multiplexed immunoassays. The transcriptome was analysed with long, short and small RNA sequencing. We found attenuation of RNA inflammatory signatures in ChAdOx1 nCoV-19 compared with placebo vaccinees and reduced levels of serum proteins associated with COVID-19 severity. KREMEN1, a putative alternative SARS-CoV-2 receptor, was downregulated in placebo compared with ChAdOx1 nCoV-19 vaccinees. Vaccination ameliorates reductions in cell counts across leukocyte populations and platelets noted at COVID-19 onset, without inducing potentially deleterious Th2-skewed immune responses. Multi-omics integration links a global reduction in miRNA expression at COVID-19 onset to increased pro-inflammatory responses at the mRNA level. This study reveals insights into the role of COVID-19 vaccines in mitigating disease severity by abrogating pro-inflammatory responses associated with severe COVID-19, affirming vaccine-mediated benefit in breakthrough infection, and highlighting the importance of clinically relevant endpoints in vaccine evaluation.
Collapse
Affiliation(s)
- Ruth E Drury
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Susana Camara
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Irina Chelysheva
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Sagida Bibi
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Katherine Sanders
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Salle Felle
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Katherine Emary
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Daniel Phillips
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Merryn Voysey
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Daniela M Ferreira
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Paul Klenerman
- NIHR Oxford Biomedical Research Centre, Oxford, UK
- Peter Medawar Building for Pathogen Research, Nuffield Dept. of Clinical Medicine, University of Oxford, Oxford, UK
- Translational Gastroenterology Unit, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Sarah C Gilbert
- NIHR Oxford Biomedical Research Centre, Oxford, UK
- Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Chinese Academy of Medical Science (CAMS) Oxford Institute, University of Oxford, Oxford, UK
| | - Teresa Lambe
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
- Chinese Academy of Medical Science (CAMS) Oxford Institute, University of Oxford, Oxford, UK
| | - Andrew J Pollard
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Daniel O'Connor
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK.
- NIHR Oxford Biomedical Research Centre, Oxford, UK.
| |
Collapse
|
45
|
Hsieh KH, Chao CH, Cheng YL, Lai YC, Chuang YC, Wang JR, Chang SY, Hung YP, Chen YMA, Liu WL, Chuang WJ, Yeh TM. Enhancement of NETosis by ACE2-cross-reactive anti-SARS-CoV-2 RBD antibodies in patients with COVID-19. J Biomed Sci 2024; 31:39. [PMID: 38637878 PMCID: PMC11027296 DOI: 10.1186/s12929-024-01026-5] [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: 12/07/2023] [Accepted: 03/26/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND High levels of neutrophil extracellular trap (NET) formation or NETosis and autoantibodies are related to poor prognosis and disease severity of COVID-19 patients. Human angiotensin-converting enzyme 2 (ACE2) cross-reactive anti-severe acute respiratory syndrome coronavirus 2 spike protein receptor-binding domain (SARS-CoV-2 RBD) antibodies (CR Abs) have been reported as one of the sources of anti-ACE2 autoantibodies. However, the pathological implications of CR Abs in NET formation remain unknown. METHODS In this study, we first assessed the presence of CR Abs in the sera of COVID-19 patients with different severity by serological analysis. Sera and purified IgG from CR Abs positive COVID-19 patients as well as a mouse monoclonal Ab (mAb 127) that can recognize both ACE2 and the RBD were tested for their influence on NETosis and the possible mechanisms involved were studied. RESULTS An association between CR Abs levels and the severity of COVID-19 in 120 patients was found. The CR Abs-positive sera and IgG from severe COVID-19 patients and mAb 127 significantly activated human leukocytes and triggered NETosis, in the presence of RBD. This NETosis, triggered by the coexistence of CR Abs and RBD, activated thrombus-related cells but was abolished when the interaction between CR Abs and ACE2 or Fc receptors was disrupted. We also revealed that CR Abs-induced NETosis was suppressed in the presence of recombinant ACE2 or the Src family kinase inhibitor, dasatinib. Furthermore, we found that COVID-19 vaccination not only reduced COVID-19 severity but also prevented the production of CR Abs after SARS-CoV-2 infection. CONCLUSIONS Our findings provide possible pathogenic effects of CR Abs in exacerbating COVID-19 by enhancing NETosis, highlighting ACE2 and dasatinib as potential treatments, and supporting the benefit of vaccination in reducing disease severity and CR Abs production in COVID-19 patients.
Collapse
Affiliation(s)
- Kun-Han Hsieh
- Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chiao-Hsuan Chao
- Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Medical Laboratory and Regenerative Medicine, MacKay Medical College, New Taipei, Taiwan
| | - Yi-Ling Cheng
- Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yen-Chung Lai
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA, 92037, USA
- Division of Infectious Diseases, Department of Medicine, University of California, San Diego, La Jolla, CA, 92037, USA
| | - Yung-Chun Chuang
- Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Leadgene Biomedical, Inc, Tainan, Taiwan
- Department of Biomedical Sciences, Chung Shan Medical University, Taichung, Taiwan
| | - Jen-Ren Wang
- Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Diseases and Vaccinology, National Institute of Infectious National Health Research Institutes, Tainan, Taiwan
- Center of Infectious Disease and Signaling Research, National Cheng Kung University, Tainan, Taiwan
| | - Sui-Yuan Chang
- Department of Clinical Laboratory Sciences and Medical Biotechnology, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Yuan-Pin Hung
- Department of Internal Medicine, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan
- Department of Internal Medicine, National Cheng Kung University, Medical College and Hospital, Tainan, Taiwan
| | - Yi-Ming Arthur Chen
- Laboratory of Important Infectious Diseases and Cancer, Department of Medicine, School of Medicine, Fu Jen Catholic University, New Taipei City, 242, Taiwan
- School of Medicine, Fu Jen Catholic University, New Taipei City, 242, Taiwan
- Diseases and Vaccinology, National Institute of Infectious National Health Research Institutes, Miaoli County, 350, Taiwan
| | - Wei-Lun Liu
- School of Medicine, Fu Jen Catholic University, New Taipei City, 242, Taiwan
- Department of Critical Care Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, 243, Taiwan
- Data Science Center, College of Medicine, Fu Jen Catholic University, New Taipei City, 242, Taiwan
| | - Woei-Jer Chuang
- Department of Biochemistry and Molecular Biology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Trai-Ming Yeh
- Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
- Center of Infectious Disease and Signaling Research, National Cheng Kung University, Tainan, Taiwan.
| |
Collapse
|
46
|
Majumder MAA, Bharatha A, Kumar S, Chatterjee M, Gupta S, Harewood H, Singh K, Johnson WMS, Rajasundaram A, Dutta SB, Prasad SV, Rahman S, Kabir R, Parsa AD, Gaur U, Rabbi AMF, Krishnamurthy K, Mohammad S, Chode V, Haque M, Campbell MH. Self-reported side effects of COVID-19 vaccines among health professions students in India. PeerJ 2024; 12:e17083. [PMID: 38590705 PMCID: PMC11000642 DOI: 10.7717/peerj.17083] [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: 09/28/2023] [Accepted: 02/19/2024] [Indexed: 04/10/2024] Open
Abstract
Studies focusing on the safety and common side effects of vaccines play a crucial role in enhancing public acceptance of vaccination. Research is scarce regarding the usage of COVID-19 vaccines and the side effects experienced by health professions students in India and other countries. This study aimed to document self-reported side effects associated with COVID-19 vaccination among medical and dental students of six medical and dental colleges and teaching hospitals in four states (Tamil Nadu, Madhya Pradesh, Gujarat, and West Bengal) of India. A cross-sectional survey using purposive sampling of medical and dental students was conducted from 26 April to 26 May 2021. Data was collected using a Google Forms questionnaire capturing information regarding receiving COVID-19 vaccines, side effects and symptoms, onset and duration of symptoms, use of treatment to alleviate symptoms, awareness of haematologic risks associated with vaccination, and side effects from previous (non-COVID-19) vaccinations. The majority (94.5%) of participants received both doses of the Covishield/AstraZeneca COVID-19 vaccine. Among participants (n = 492), 45.3% (n = 223) reported one or more side effects. The most frequently reported side effects were soreness of the injected arm (80.3%), tiredness (78.5%), fever (71.3%), headache (64.1%), and hypersomnia (58.7%). The two most common severe symptoms were fever (14.8%) and headache (13%). Most side effects appeared on the day of vaccination: soreness of the injection site (57%), fever (43.1%), and tiredness (42.6%). Most reported symptoms persisted for one to three days-soreness of the injection site (53%), fever (47.1%), and headache (42.6%). Logistic regression showed that women were almost 85% less likely to report side effects. The study's findings corroborate the safety of the Covishield/AstraZeneca vaccine's first dose, evidenced by the relatively minor and transient nature of the side effects. However, the study underscores the necessity for ongoing research to assess the long-term impacts of COVID-19 vaccines, especially in the context of booster doses, thereby contributing to the global understanding of vaccine safety and efficacy.
Collapse
Affiliation(s)
- Md Anwarul Azim Majumder
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
- Public Health Foundation of Bangladesh, Dhaka, Bangladesh
| | - Ambadasu Bharatha
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | | | - Madhuri Chatterjee
- Shri Ramkrishna Institute of Medical Science, Durgapur, West Bengal, India
| | - Subir Gupta
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - Heather Harewood
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - Keerti Singh
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - WMS Johnson
- Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India
| | | | - Sudeshna Banerjee Dutta
- Department of Medical Surgical Nursing (Critical care nursing), Shri Anand Institute of Nursing, Rajkot, Gujarat, India
| | | | - Sayeeda Rahman
- American University of Integrative Sciences (AUIS), Bridgetown, Barbados
| | - Russell Kabir
- Anglia Ruskin University, Chelmsford, Essex, United Kingdom
| | | | - Uma Gaur
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | | | - Kandamaran Krishnamurthy
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - Shegufta Mohammad
- Health Education Department, Empower Me First College, Geneva, Switzerland
| | | | - Mainul Haque
- National Defence University of Malaysia, Kuala Lumpur, Malaysia
| | - Michael H. Campbell
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| |
Collapse
|
47
|
MacCallum-Bridges C, Hirschtick JL, Patel A, Orellana RC, Elliott MR, Fleischer NL. The impact of COVID-19 vaccination prior to SARS-CoV-2 infection on prevalence of long COVID among a population-based probability sample of Michiganders, 2020-2022. Ann Epidemiol 2024; 92:17-24. [PMID: 38382771 DOI: 10.1016/j.annepidem.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 02/16/2024] [Accepted: 02/17/2024] [Indexed: 02/23/2024]
Abstract
PURPOSE To estimate the association between COVID-19 vaccination status at the time of COVID-19 onset and long COVID prevalence. METHODS We used data from the Michigan COVID-19 Recovery Surveillance Study, a population-based probability sample of adults with COVID-19 (n = 4695). We considered 30-day and 90-day long COVID (illness duration ≥30 or ≥90 days, respectively), using Poisson regression to estimate prevalence ratios (PRs) comparing vaccinated (completed an initial series ≥14 days before COVID-19 onset) to unvaccinated individuals (received 0 doses before COVID-19 onset), accounting for differences in age, sex, race and ethnicity, education, employment, health insurance, and rurality/urbanicity. The full unvaccinated comparison group was further divided into historic and concurrent comparison groups based on timing of COVID-19 onset relative to vaccine availability. We used inverse probability of treatment weights to account for sociodemographic differences between groups. RESULTS Compared to the full unvaccinated comparison group, the adjusted prevalence of 30-day and 90-day long COVID were lower among vaccinated individuals [PR30-day= 0.57(95%CI:0.49,0.66); PR90-day= 0.42(95%CI:0.34,0.53)]. Estimates were consistent across comparison groups (full, historic, and concurrent). CONCLUSIONS Long COVID prevalence was 40-60% lower among adults vaccinated (vs. unvaccinated) prior to their COVID-19 onset. COVID-19 vaccination may be an important tool to reduce the burden of long COVID.
Collapse
Affiliation(s)
- Colleen MacCallum-Bridges
- University of Michigan Department of Epidemiology, 1415 Washington Heights, Ann Arbor, MI 48109, United States.
| | - Jana L Hirschtick
- University of Michigan Department of Epidemiology, 1415 Washington Heights, Ann Arbor, MI 48109, United States
| | - Akash Patel
- University of Michigan Department of Epidemiology, 1415 Washington Heights, Ann Arbor, MI 48109, United States
| | - Robert C Orellana
- CDC Foundation., 600 Peachtree Street NE #1000, Atlanta, GA 30308, United States; Michigan Department of Health and Human Services, 333 South Grand Avenue, Lansing, MI 48933, United States
| | - Michael R Elliott
- University of Michigan Department of Biostatistics, 1415 Washington Heights, Ann Arbor, MI 48109, United States; University of Michigan Survey Research Center, 426 Thompson Street, Ann Arbor, MI 48104, United States
| | - Nancy L Fleischer
- University of Michigan Department of Epidemiology, 1415 Washington Heights, Ann Arbor, MI 48109, United States
| |
Collapse
|
48
|
Fan Q, Hu W, Han X, Henderson SL, Geng Y. Understanding and mitigating negative affect in preventive health behaviors: Evidence from the COVID-19 vaccination process. J Health Psychol 2024:13591053241242526. [PMID: 38561913 DOI: 10.1177/13591053241242526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
The study investigated the willingness for vaccine uptake during the COVID-19 pandemic (April-June 2021), and explored the effect of both mindfulness and health education in managing negative affect post-vaccination. In study 1, a sample of 468 Chinese college students completed a one-time survey, assessing loneliness, stress, medical fear, and vaccination likelihood. Results showed that medical fear mediated the relationship between loneliness, stress and vaccination likelihood. In study 2, 70 college students were randomly assigned to one of three intervention conditions (mindfulness, health education, and control) during vaccination. Participants in mindfulness group showed lower negative affect scores than the control group post-intervention (p = 0.019). However, no significant difference was reported between health education with the other two conditions. As such, medical fear would be an important factor to target for improving the likelihood of vaccine uptake. Furthermore, a short mindfulness intervention was effective to improve experience of vaccination through mitigating negative affect.
Collapse
Affiliation(s)
- Qianqian Fan
- School of Education, Zhengzhou University, Zhengzhou, China
| | - Wanying Hu
- School of Education, Zhengzhou University, Zhengzhou, China
| | - Xinxin Han
- School of Education, Zhengzhou University, Zhengzhou, China
| | | | - Yaoguo Geng
- School of Physical Education (Main Campus), Zhengzhou University, Zhengzhou, China
| |
Collapse
|
49
|
Szanyi J, Howe S, Blakely T. The importance of reporting accurate estimates of long COVID prevalence. Lancet 2024; 403:1136-1137. [PMID: 38521555 DOI: 10.1016/s0140-6736(23)01120-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 05/26/2023] [Indexed: 03/25/2024]
Affiliation(s)
- Joshua Szanyi
- Population Interventions Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3053, Australia.
| | - Samantha Howe
- Population Interventions Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3053, Australia
| | - Tony Blakely
- Population Interventions Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3053, Australia
| |
Collapse
|
50
|
Inoue W, Kimura Y, Okamoto S, Nogimori T, Sakaguchi-Mikami A, Yamamoto T, Tsunetsugu-Yokota Y. SARS-CoV-2-Specific Immune Responses in Vaccination and Infection during the Pandemic in 2020-2022. Viruses 2024; 16:446. [PMID: 38543812 PMCID: PMC10974545 DOI: 10.3390/v16030446] [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: 02/01/2024] [Revised: 03/10/2024] [Accepted: 03/11/2024] [Indexed: 05/23/2024] Open
Abstract
To gain insight into how immunity develops against SARS-CoV-2 from 2020 to 2022, we analyzed the immune response of a small group of university staff and students who were either infected or vaccinated. We investigated the levels of receptor-binding domain (RBD)-specific and nucleocapsid (N)-specific IgG and IgA antibodies in serum and saliva samples taken early (around 10 days after infection or vaccination) and later (around 1 month later), as well as N-specific T-cell responses. One patient who had been infected in 2020 developed serum RBD and N-specific IgG antibodies, but declined eight months later, then mRNA vaccination in 2021 produced a higher level of anti-RBD IgG than natural infection. In the vaccination of naïve individuals, vaccines induced anti-RBD IgG, but it declined after six months. A third vaccination boosted the IgG level again, albeit to a lower level than after the second. In 2022, when the Omicron variant became dominant, familial transmission occurred among vaccinated people. In infected individuals, the levels of serum anti-RBD IgG antibodies increased later, while anti-N IgG peaked earlier. The N-specific activated T cells expressing IFN γ or CD107a were detected only early. Although SARS-CoV-2-specific salivary IgA was undetectable, two individuals showed a temporary peak in RBD- and N-specific IgA antibodies in their saliva on the second day after infection. Our study, despite having a small sample size, revealed that SARS-CoV-2 infection triggers the expected immune responses against acute viral infections. Moreover, our findings suggest that the temporary mucosal immune responses induced early during infection may provide better protection than the currently available intramuscular vaccines.
Collapse
Affiliation(s)
- Wakana Inoue
- Department of Medical Technology, School of Health Sciences and Graduate School of Medical Technology, Tokyo University of Technology, Tokyo 144-8535, Japan; (W.I.); (Y.K.); (S.O.); (A.S.-M.)
| | - Yuta Kimura
- Department of Medical Technology, School of Health Sciences and Graduate School of Medical Technology, Tokyo University of Technology, Tokyo 144-8535, Japan; (W.I.); (Y.K.); (S.O.); (A.S.-M.)
| | - Shion Okamoto
- Department of Medical Technology, School of Health Sciences and Graduate School of Medical Technology, Tokyo University of Technology, Tokyo 144-8535, Japan; (W.I.); (Y.K.); (S.O.); (A.S.-M.)
| | - Takuto Nogimori
- Laboratory of Precision Immunology, Center for Intractable Diseases and ImmunoGenomics, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka 567-0085, Japan; (T.N.); (T.Y.)
| | - Akane Sakaguchi-Mikami
- Department of Medical Technology, School of Health Sciences and Graduate School of Medical Technology, Tokyo University of Technology, Tokyo 144-8535, Japan; (W.I.); (Y.K.); (S.O.); (A.S.-M.)
| | - Takuya Yamamoto
- Laboratory of Precision Immunology, Center for Intractable Diseases and ImmunoGenomics, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka 567-0085, Japan; (T.N.); (T.Y.)
- Laboratory of Aging and Immune Regulation, Graduate School of Pharmaceutical Sciences, Osaka University, Osaka 565-0871, Japan
- Department of Virology and Immunology, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Yasuko Tsunetsugu-Yokota
- Department of Medical Technology, School of Health Sciences and Graduate School of Medical Technology, Tokyo University of Technology, Tokyo 144-8535, Japan; (W.I.); (Y.K.); (S.O.); (A.S.-M.)
- Laboratory of Precision Immunology, Center for Intractable Diseases and ImmunoGenomics, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka 567-0085, Japan; (T.N.); (T.Y.)
- Research Institute, The World New Prosperity (WNP), Tokyo 169-0075, Japan
| |
Collapse
|