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Chang JJY, Grimley SL, Tran BM, Deliyannis G, Tumpach C, Nguyen AN, Steinig E, Zhang J, Schröder J, Caly L, McAuley J, Wong SL, Waters SA, Stinear TP, Pitt ME, Purcell D, Vincan E, Coin LJ. Uncovering strain- and age-dependent innate immune responses to SARS-CoV-2 infection in air-liquid-interface cultured nasal epithelia. iScience 2024; 27:110009. [PMID: 38868206 PMCID: PMC11166695 DOI: 10.1016/j.isci.2024.110009] [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: 05/19/2023] [Revised: 04/03/2024] [Accepted: 05/14/2024] [Indexed: 06/14/2024] Open
Abstract
Continuous assessment of the impact of SARS-CoV-2 on the host at the cell-type level is crucial for understanding key mechanisms involved in host defense responses to viral infection. We investigated host response to ancestral-strain and Alpha-variant SARS-CoV-2 infections within air-liquid-interface human nasal epithelial cells from younger adults (26-32 Y) and older children (12-14 Y) using single-cell RNA-sequencing. Ciliated and secretory-ciliated cells formed the majority of highly infected cell-types, with the latter derived from ciliated lineages. Strong innate immune responses were observed across lowly infected and uninfected bystander cells and heightened in Alpha-infection. Alpha highly infected cells showed increased expression of protein-refolding genes compared with ancestral-strain-infected cells in children. Furthermore, oxidative phosphorylation-related genes were down-regulated in bystander cells versus infected and mock-control cells, underscoring the importance of these biological functions for viral replication. Overall, this study highlights the complexity of cell-type-, age- and viral strain-dependent host epithelial responses to SARS-CoV-2.
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Affiliation(s)
- Jessie J.-Y. Chang
- Department of Microbiology and Immunology, University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC 3000, Australia
| | - Samantha L. Grimley
- Department of Microbiology and Immunology, University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC 3000, Australia
| | - Bang M. Tran
- Department of Infectious Diseases, University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC 3000, Australia
| | - Georgia Deliyannis
- Department of Microbiology and Immunology, University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC 3000, Australia
| | - Carolin Tumpach
- Department of Infectious Diseases, University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC 3000, Australia
| | - An N.T. Nguyen
- Department of Microbiology and Immunology, University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC 3000, Australia
| | - Eike Steinig
- Department of Infectious Diseases, University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC 3000, Australia
- Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC 3000, Australia
| | - JianShu Zhang
- Department of Microbiology and Immunology, University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC 3000, Australia
| | - Jan Schröder
- Computational Sciences Initiative (CSI), The Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, VIC 3000, Australia
| | - Leon Caly
- Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC 3000, Australia
| | - Julie McAuley
- Department of Microbiology and Immunology, University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC 3000, Australia
| | - Sharon L. Wong
- Molecular and Integrative Cystic Fibrosis Research Centre, University of New South Wales, Sydney, NSW 2052, Australia
- School of Biomedical Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW 2052, Australia
| | - Shafagh A. Waters
- Molecular and Integrative Cystic Fibrosis Research Centre, University of New South Wales, Sydney, NSW 2052, Australia
- School of Biomedical Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW 2052, Australia
- Department of Respiratory Medicine, Sydney Children’s Hospital, Sydney, NSW 2031, Australia
| | - Timothy P. Stinear
- Department of Microbiology and Immunology, University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC 3000, Australia
| | - Miranda E. Pitt
- Department of Microbiology and Immunology, University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC 3000, Australia
- Australian Institute for Microbiology and Infection, University of Technology Sydney, Sydney, NSW 2007, Australia
| | - Damian Purcell
- Department of Microbiology and Immunology, University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC 3000, Australia
| | - Elizabeth Vincan
- Department of Infectious Diseases, University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC 3000, Australia
- Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC 3000, Australia
- Curtin Medical School, Curtin University, Perth, WA 6102, Australia
| | - Lachlan J.M. Coin
- Department of Microbiology and Immunology, University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC 3000, Australia
- Department of Clinical Pathology, University of Melbourne, Melbourne, VIC 3000, Australia
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2
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Tedjakusuma SN, Lester CA, Neuhaus ED, Dora EG, Gutierrez S, Braun MR, Tucker SN, Flitter BA. A Next-Generation Adenoviral Vaccine Elicits Mucosal and Systemic Immunogenicity and Reduces Viral Shedding after SARS-CoV-2 Challenge in Nonhuman Primates. Vaccines (Basel) 2024; 12:132. [PMID: 38400116 PMCID: PMC10893453 DOI: 10.3390/vaccines12020132] [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: 01/03/2024] [Revised: 01/20/2024] [Accepted: 01/24/2024] [Indexed: 02/25/2024] Open
Abstract
As new SARS-CoV-2 variants continue to emerge and impact communities worldwide, next-generation vaccines that enhance protective mucosal immunity may have a significant impact on productive infection and transmission. We have developed recombinant non-replicating adenovirus serotype 5 (rAd5) vaccines delivered by mucosal administration that express both target antigen and a novel molecular adjuvant within the same cell. Here, we describe the immunogenicity of three unique SARS-CoV-2 rAd5 vaccine candidates and their efficacy following viral challenge in non-human primates (NHPs). Intranasal immunization with rAd5 vaccines expressing Wuhan, or Beta variant spike alone, or Wuhan spike and nucleocapsid elicited strong antigen-specific serum IgG and IgA with neutralizing activity against multiple variants of concern (VOC). Robust cross-reactive mucosal IgA was detected after a single administration of rAd5, which showed strong neutralizing activity against multiple VOC. Additionally, mucosal rAd5 vaccination increased spike-specific IFN-γ producing circulating T-cells. Upon Beta variant SARS-CoV-2 challenge, all the vaccinated NHPs exhibited significant reductions in viral load and infectious particle shedding in both the nasal passages and lower airways. These findings demonstrate that mucosal rAd5 immunization is highly immunogenic, confers protective cross-reactive antibody responses in the circulation and mucosa, and reduces viral load and shedding after SARS-CoV-2 challenge.
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Affiliation(s)
| | | | | | | | | | | | | | - Becca A. Flitter
- Vaxart, Inc., South San Francisco, CA 94080, USA; (S.N.T.); (C.A.L.); (E.D.N.); (E.G.D.); (S.G.); (M.R.B.); (S.N.T.)
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3
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Wiedenmann M, Ipekci AM, Araujo-Chaveron L, Prajapati N, Lam YT, Alam MI, L'Huillier AG, Zhelyazkov I, Heron L, Low N, Goutaki M. SARS-CoV-2 variants of concern in children and adolescents with COVID-19: a systematic review. BMJ Open 2023; 13:e072280. [PMID: 37813543 PMCID: PMC10565293 DOI: 10.1136/bmjopen-2023-072280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 09/04/2023] [Indexed: 10/13/2023] Open
Abstract
OBJECTIVES Infections by SARS-CoV-2 variants of concern (VOCs) might affect children and adolescents differently than earlier viral lineages. We aimed to address five questions about SARS-CoV-2 VOC infections in children and adolescents: (1) symptoms and severity, (2) risk factors for severe disease, (3) the risk of infection, (4) the risk of transmission and (5) long-term consequences following a VOC infection. DESIGN Systematic review. DATA SOURCES The COVID-19 Open Access Project database was searched up to 1 March 2022 and PubMed was searched up to 9 May 2022. ELIGIBILITY CRITERIA We included observational studies about Alpha, Beta, Gamma, Delta and Omicron VOCs among ≤18-year-olds. We included studies in English, German, French, Greek, Italian, Spanish and Turkish. DATA EXTRACTION AND SYNTHESIS Two reviewers extracted and verified the data and assessed the risk of bias. We descriptively synthesised the data and assessed the risks of bias at the outcome level. RESULTS We included 53 articles. Most children with any VOC infection presented with mild disease, with more severe disease being described with the Delta or the Gamma VOC. Diabetes and obesity were reported as risk factors for severe disease during the whole pandemic period. The risk of becoming infected with a SARS-CoV-2 VOC seemed to increase with age, while in daycare settings the risk of onward transmission of VOCs was higher for younger than older children or partially vaccinated adults. Long-term symptoms following an infection with a VOC were described in <5% of children and adolescents. CONCLUSION Overall patterns of SARS-CoV-2 VOC infections in children and adolescents are similar to those of earlier lineages. Comparisons between different pandemic periods, countries and age groups should be improved with complete reporting of relevant contextual factors, including VOCs, vaccination status of study participants and the risk of exposure of the population to SARS-CoV-2. PROSPERO REGISTRATION NUMBER CRD42022295207.
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Affiliation(s)
- Margarethe Wiedenmann
- Medical Service Unit, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Aziz Mert Ipekci
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Lucia Araujo-Chaveron
- EHESP French School of Public Health, Rennes, France
- Emerging Disease Epidemiology Unit, Insitut Pasteur, Paris, France
| | - Nirmala Prajapati
- Université Paris-Saclay, Gif-sur-Yvette, France
- Exposome and Heredity Team, Institut national de la santé et de la recherche médicale, Paris, France
| | - Yin Ting Lam
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | | | - Arnaud G L'Huillier
- Département de pédiatrie, gynécologie et obstétrique, HUG, Geneve, Switzerland
| | | | - Leonie Heron
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Nicola Low
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Myrofora Goutaki
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
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4
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Volz E. Fitness, growth and transmissibility of SARS-CoV-2 genetic variants. Nat Rev Genet 2023; 24:724-734. [PMID: 37328556 DOI: 10.1038/s41576-023-00610-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2023] [Indexed: 06/18/2023]
Abstract
The massive scale of the global SARS-CoV-2 sequencing effort created new opportunities and challenges for understanding SARS-CoV-2 evolution. Rapid detection and assessment of new variants has become one of the principal objectives of genomic surveillance of SARS-CoV-2. Because of the pace and scale of sequencing, new strategies have been developed for characterizing fitness and transmissibility of emerging variants. In this Review, I discuss a wide range of approaches that have been rapidly developed in response to the public health threat posed by emerging variants, ranging from new applications of classic population genetics models to contemporary synthesis of epidemiological models and phylodynamic analysis. Many of these approaches can be adapted to other pathogens and will have increasing relevance as large-scale pathogen sequencing becomes a regular feature of many public health systems.
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Affiliation(s)
- Erik Volz
- Department of Infectious Disease Epidemiology, MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK.
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5
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Zak AJ, Hoang T, Yee CM, Rizvi SM, Prabhu P, Wen F. Pseudotyping Improves the Yield of Functional SARS-CoV-2 Virus-like Particles (VLPs) as Tools for Vaccine and Therapeutic Development. Int J Mol Sci 2023; 24:14622. [PMID: 37834067 PMCID: PMC10572262 DOI: 10.3390/ijms241914622] [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: 08/14/2023] [Revised: 09/08/2023] [Accepted: 09/16/2023] [Indexed: 10/15/2023] Open
Abstract
Virus-like particles (VLPs) have been proposed as an attractive tool in SARS-CoV-2 vaccine development, both as (1) a vaccine candidate with high immunogenicity and low reactogenicity and (2) a substitute for live virus in functional and neutralization assays. Though multiple SARS-CoV-2 VLP designs have already been explored in Sf9 insect cells, a key parameter ensuring VLPs are a viable platform is the VLP spike yield (i.e., spike protein content in VLP), which has largely been unreported. In this study, we show that the common strategy of producing SARS-CoV-2 VLPs by expressing spike protein in combination with the native coronavirus membrane and/or envelope protein forms VLPs, but at a critically low spike yield (~0.04-0.08 mg/L). In contrast, fusing the spike ectodomain to the influenza HA transmembrane domain and cytoplasmic tail and co-expressing M1 increased VLP spike yield to ~0.4 mg/L. More importantly, this increased yield translated to a greater VLP spike antigen density (~96 spike monomers/VLP) that more closely resembles that of native SARS-CoV-2 virus (~72-144 Spike monomers/virion). Pseudotyping further allowed for production of functional alpha (B.1.1.7), beta (B.1.351), delta (B.1.617.2), and omicron (B.1.1.529) SARS-CoV-2 VLPs that bound to the target ACE2 receptor. Finally, we demonstrated the utility of pseudotyped VLPs to test neutralizing antibody activity using a simple, acellular ELISA-based assay performed at biosafety level 1 (BSL-1). Taken together, this study highlights the advantage of pseudotyping over native SARS-CoV-2 VLP designs in achieving higher VLP spike yield and demonstrates the usefulness of pseudotyped VLPs as a surrogate for live virus in vaccine and therapeutic development against SARS-CoV-2 variants.
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Affiliation(s)
| | | | | | | | | | - Fei Wen
- Department of Chemical Engineering, University of Michigan, Ann Arbor, MI 48109, USA (P.P.)
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6
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Fryer HR, Golubchik T, Hall M, Fraser C, Hinch R, Ferretti L, Thomson L, Nurtay A, Pellis L, House T, MacIntyre-Cockett G, Trebes A, Buck D, Piazza P, Green A, Lonie LJ, Smith D, Bashton M, Crown M, Nelson A, McCann CM, Adnan Tariq M, Elstob CJ, Nunes Dos Santos R, Richards Z, Xhang X, Hawley J, Lee MR, Carrillo-Barragan P, Chapman I, Harthern-Flint S, Bonsall D, Lythgoe KA. Viral burden is associated with age, vaccination, and viral variant in a population-representative study of SARS-CoV-2 that accounts for time-since-infection-related sampling bias. PLoS Pathog 2023; 19:e1011461. [PMID: 37578971 PMCID: PMC10449197 DOI: 10.1371/journal.ppat.1011461] [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: 12/16/2022] [Revised: 08/24/2023] [Accepted: 06/05/2023] [Indexed: 08/16/2023] Open
Abstract
In this study, we evaluated the impact of viral variant, in addition to other variables, on within-host viral burden, by analysing cycle threshold (Ct) values derived from nose and throat swabs, collected as part of the UK COVID-19 Infection Survey. Because viral burden distributions determined from community survey data can be biased due to the impact of variant epidemiology on the time-since-infection of samples, we developed a method to explicitly adjust observed Ct value distributions to account for the expected bias. By analysing the adjusted Ct values using partial least squares regression, we found that among unvaccinated individuals with no known prior exposure, viral burden was 44% lower among Alpha variant infections, compared to those with the predecessor strain, B.1.177. Vaccination reduced viral burden by 67%, and among vaccinated individuals, viral burden was 286% higher among Delta variant, compared to Alpha variant, infections. In addition, viral burden increased by 17% for every 10-year age increment of the infected individual. In summary, within-host viral burden increases with age, is reduced by vaccination, and is influenced by the interplay of vaccination status and viral variant.
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Affiliation(s)
- Helen R. Fryer
- Big Data Institute, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Oxford, United Kingdom
| | - Tanya Golubchik
- Big Data Institute, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Oxford, United Kingdom
- Sydney Infectious Diseases Institute (Sydney ID), School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Matthew Hall
- Big Data Institute, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Oxford, United Kingdom
| | - Christophe Fraser
- Big Data Institute, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Oxford, United Kingdom
- Pandemic Sciences Institute, University of Oxford, Old Road Campus, Oxford, United Kingdom
| | - Robert Hinch
- Big Data Institute, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Oxford, United Kingdom
| | - Luca Ferretti
- Big Data Institute, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Oxford, United Kingdom
- Pandemic Sciences Institute, University of Oxford, Old Road Campus, Oxford, United Kingdom
| | - Laura Thomson
- Big Data Institute, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Oxford, United Kingdom
| | - Anel Nurtay
- Big Data Institute, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Oxford, United Kingdom
| | - Lorenzo Pellis
- Department of Mathematics, University of Manchester, Manchester, United Kingdom
- The Alan Turing Institute, London, United Kingdom
| | - Thomas House
- Department of Mathematics, University of Manchester, Manchester, United Kingdom
| | | | - Amy Trebes
- Wellcome Centre for Human Genetics, Oxford, United Kingdom
| | - David Buck
- Wellcome Centre for Human Genetics, Oxford, United Kingdom
| | - Paolo Piazza
- Wellcome Centre for Human Genetics, Oxford, United Kingdom
| | - Angie Green
- Wellcome Centre for Human Genetics, Oxford, United Kingdom
| | - Lorne J Lonie
- Wellcome Centre for Human Genetics, Oxford, United Kingdom
| | - Darren Smith
- The Hub for Biotechnology in the Built Environment, Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Matthew Bashton
- The Hub for Biotechnology in the Built Environment, Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Matthew Crown
- The Hub for Biotechnology in the Built Environment, Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Andrew Nelson
- Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Clare M. McCann
- Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Mohammed Adnan Tariq
- Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Claire J. Elstob
- Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Rui Nunes Dos Santos
- Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Zack Richards
- Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Xin Xhang
- Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Joseph Hawley
- Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Mark R. Lee
- Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Priscilla Carrillo-Barragan
- Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Isobel Chapman
- Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Sarah Harthern-Flint
- Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | | | - David Bonsall
- Pandemic Sciences Institute, University of Oxford, Old Road Campus, Oxford, United Kingdom
- Wellcome Centre for Human Genetics, Oxford, United Kingdom
| | - Katrina A. Lythgoe
- Big Data Institute, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Oxford, United Kingdom
- Pandemic Sciences Institute, University of Oxford, Old Road Campus, Oxford, United Kingdom
- Department of Biology, University of Oxford, Oxford, United Kingdom
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7
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Ward JL, Harwood R, Kenny S, Cruz J, Clark M, Davis PJ, Draper ES, Hargreaves D, Ladhani SN, Gent N, Williams HE, Luyt K, Turner S, Whittaker E, Bottle A, Fraser LK, Viner RM. Pediatric Hospitalizations and ICU Admissions Due to COVID-19 and Pediatric Inflammatory Multisystem Syndrome Temporally Associated With SARS-CoV-2 in England. JAMA Pediatr 2023; 177:2807910. [PMID: 37523172 PMCID: PMC10391354 DOI: 10.1001/jamapediatrics.2023.2357] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 04/02/2023] [Indexed: 08/01/2023]
Abstract
Importance Investigating how the risk of serious illness after SARS-CoV-2 infection in children and adolescents has changed as new variants have emerged is essential to inform public health interventions and clinical guidance. Objective To examine risk factors associated with hospitalization for COVID-19 or pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) among children and adolescents during the first 2 years of the COVID-19 pandemic and change in risk factors over time. Design, Setting, and Participants This population-level analysis of hospitalizations after SARS-CoV-2 infection in England among children and adolescents aged 0 to 17 years was conducted from February 1, 2020, to January 31, 2022. National data on hospital activity were linked with data on SARS-CoV-2 testing, SARS-CoV-2 vaccination, pediatric intensive care unit (PICU) admissions, and mortality. Children and adolescents hospitalized with COVID-19 or PIMS-TS during this time were included. Maternal, elective, and injury-related hospitalizations were excluded. Exposures Previous medical comorbidities, sociodemographic factors, and timing of hospitalization when different SARS-CoV-2 variants (ie, wild type, Alpha, Delta, and Omicron) were dominant in England. Main Outcomes PICU admission and death within 28 days of hospitalization with COVID-19 or PIMS-TS. Results A total of 10 540 hospitalizations due to COVID-19 and 997 due to PIMS-TS were identified within 1 125 010 emergency hospitalizations for other causes. The number of hospitalizations due to COVID-19 and PIMS-TS per new SARS-CoV-2 infections in England declined during the second year of the COVID-19 pandemic. Among 10 540 hospitalized children and adolescents, 448 (4.3%) required PICU admission due to COVID-19, declining from 162 of 1635 (9.9%) with wild type, 98 of 1616 (6.1%) with Alpha, and 129 of 3789 (3.4%) with Delta to 59 of 3500 (1.7%) with Omicron. Forty-eight children and adolescents died within 28 days of hospitalization due to COVID-19, and no children died of PIMS-TS (PIMS-S data were limited to November 2020 onward). Risk of severe COVID-19 in children and adolescents was associated with medical comorbidities and neurodisability regardless of SARS-CoV-2 variant. Results were similar when children and adolescents with prior SARS-CoV-2 exposure or vaccination were excluded. Conclusions In this study of data across the first 2 years of the COVID-19 pandemic, risk of severe disease from SARS-CoV-2 infection in children and adolescents in England remained low. Children and adolescents with multiple medical problems, particularly neurodisability, were at increased risk and should be central to public health measures as further variants emerge.
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Affiliation(s)
- Joseph L. Ward
- University College London Great Ormond St. Institute of Child Health, London, United Kingdom
| | - Rachel Harwood
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
- Alder Hey Children’s National Health Service Trust, Liverpool, United Kingdom
| | - Simon Kenny
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
- National Health Service England and Improvement, London, United Kingdom
| | - Joana Cruz
- University College London Great Ormond St. Institute of Child Health, London, United Kingdom
| | - Matthew Clark
- National Health Service England and Improvement, London, United Kingdom
| | - Peter J. Davis
- Paediatric Intensive Care Unit, Bristol Royal Hospital for Children, Bristol, United Kingdom
| | - Elizabeth S. Draper
- Paediatric Intensive Care Audit Network, Department of Health Sciences, University of Leicester, Leicester, United Kingdom
| | - Dougal Hargreaves
- Mohn Centre for Children’s Health and Wellbeing, Imperial College London, London, United Kingdom
| | - Shamez N. Ladhani
- UK Health Security Agency, London, United Kingdom
- Immunisation Department, UK Health Security Agency, London, United Kingdom
- Centre for Neonatal and Paediatric Infection, St George’s, University of London, London, United Kingdom
| | - Nick Gent
- Ministry of Health & Wellness, George Town, Cayman Islands
| | | | - Karen Luyt
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Steve Turner
- National Health Service Grampian, London, United Kingdom
| | - Elizabeth Whittaker
- Paediatric Infectious Diseases, Imperial College Healthcare National Health Service Trust, London, United Kingdom
- Section of Paediatric Infectious Diseases, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Alex Bottle
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
| | - Lorna K. Fraser
- Cicely Saunders Institute, King’s College London, London, United Kingdom
| | - Russell M. Viner
- University College London Great Ormond St. Institute of Child Health, London, United Kingdom
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8
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Soriano-Arandes A, Brett A, Buonsenso D, Emilsson L, de la Fuente Garcia I, Gkentzi D, Helve O, Kepp KP, Mossberg M, Muka T, Munro A, Papan C, Perramon-Malavez A, Schaltz-Buchholzer F, Smeesters PR, Zimmermann P. Policies on children and schools during the SARS-CoV-2 pandemic in Western Europe. Front Public Health 2023; 11:1175444. [PMID: 37564427 PMCID: PMC10411527 DOI: 10.3389/fpubh.2023.1175444] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 06/26/2023] [Indexed: 08/12/2023] Open
Abstract
During the pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), mitigation policies for children have been a topic of considerable uncertainty and debate. Although some children have co-morbidities which increase their risk for severe coronavirus disease (COVID-19), and complications such as multisystem inflammatory syndrome and long COVID, most children only get mild COVID-19. On the other hand, consistent evidence shows that mass mitigation measures had enormous adverse impacts on children. A central question can thus be posed: What amount of mitigation should children bear, in response to a disease that is disproportionally affecting older people? In this review, we analyze the distinct child versus adult epidemiology, policies, mitigation trade-offs and outcomes in children in Western Europe. The highly heterogenous European policies applied to children compared to adults did not lead to significant measurable differences in outcomes. Remarkably, the relative epidemiological importance of transmission from school-age children to other age groups remains uncertain, with current evidence suggesting that schools often follow, rather than lead, community transmission. Important learning points for future pandemics are summarized.
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Affiliation(s)
- Antoni Soriano-Arandes
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Ana Brett
- Infectious Diseases Unit and Emergency Service, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Milan, Italy
| | - Louise Emilsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Solna, Sweden
- Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Isabel de la Fuente Garcia
- Pediatric Infectious Diseases, National Pediatric Center, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
| | - Despoina Gkentzi
- Department of Paediatrics, Patras Medical School, Patras, Greece
| | - Otto Helve
- Department of Health Security, Institute for Health and Welfare, Helsinki, Finland
- Pediatric Research Center, Children's Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Kasper P. Kepp
- Section of Biophysical and Biomedicinal Chemistry, DTU Chemistry, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Maria Mossberg
- Department of Pediatrics, Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Taulant Muka
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Epistudia, Bern, Switzerland
| | - Alasdair Munro
- NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
- Faculty of Medicine, Institute of Life Sciences, University of Southampton, Southampton, United Kingdom
| | - Cihan Papan
- Institute for Hygiene and Public Health, University Hospital Bonn, Bonn, Germany
| | - Aida Perramon-Malavez
- Computational Biology and Complex Systems (BIOCOM-SC) Group, Department of Physics, Universitat Politècnica de Catalunya (UPC·BarcelonaTech), Barcelona, Spain
| | | | - Pierre R. Smeesters
- Department of Pediatrics, University Hospital Brussels, Academic Children’s Hospital Queen Fabiola, Université Libre de Bruxelles, Brussels, Belgium
- Molecular Bacteriology Laboratory, Université Libre de Bruxelles, Brussels, Belgium
| | - Petra Zimmermann
- Department of Community Health, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
- Department of Paediatrics, Fribourg Hospital, Fribourg, Switzerland
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9
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Hamza S, Martynova E, Garanina E, Shakirova V, Bilalova A, Moiseeva S, Khaertynova I, Ohlopkova O, Blatt N, Markelova M, Khaiboullina S. Neutralizing Antibodies in COVID-19 Serum from Tatarstan, Russia. Int J Mol Sci 2023; 24:10181. [PMID: 37373331 DOI: 10.3390/ijms241210181] [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: 05/08/2023] [Revised: 06/05/2023] [Accepted: 06/10/2023] [Indexed: 06/29/2023] Open
Abstract
The severity of COVID-19 is a result of the complex interplay between various branches of the immune system. However, our understanding of the role of neutralizing antibodies and the activation of cellular immune response in COVID-19 pathogenesis remains limited. In this study, we investigated neutralizing antibodies in patients with mild, moderate, and severe COVID-19, analyzing their cross-reactivity with the Wuhan and Omicron variants. We also assessed the activation of the immune response by measuring serum cytokines in patients with mild, moderate, and severe COVID-19. Our findings suggest the early activation of neutralizing antibodies in moderate COVID-19 compared to mild cases. We also observed a strong correlation between the cross-reactivity of neutralizing antibodies to the Omicron and Wuhan variants and the severity of the disease. In addition, we found that Th1 lymphocyte activation was present in mild and moderate cases, while inflammasomes and Th17 lymphocytes were activated in severe COVID-19. In conclusion, our data indicate that the early activation of neutralizing antibodies is evident in moderate COVID-19, and there is a strong correlation between the cross-reactivity of neutralizing antibodies and the severity of the disease. Our findings suggest that the Th1 immune response may play a protective role, while inflammasome and Th17 activation may be involved in severe COVID-19.
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Affiliation(s)
- Shaimaa Hamza
- OpenLab "Gene and Cell Technologies", Kazan Federal University, 420021 Kazan, Russia
| | - Ekaterina Martynova
- OpenLab "Gene and Cell Technologies", Kazan Federal University, 420021 Kazan, Russia
| | - Ekaterina Garanina
- OpenLab "Gene and Cell Technologies", Kazan Federal University, 420021 Kazan, Russia
| | - Venera Shakirova
- Department of Infectious Diseases, Kazan State Medical Academy, 420012 Kazan, Russia
| | - Alisa Bilalova
- Department of Infectious Diseases, Kazan State Medical Academy, 420012 Kazan, Russia
| | - Svetlana Moiseeva
- Department of Infectious Diseases, Kazan State Medical Academy, 420012 Kazan, Russia
| | - Ilsiyar Khaertynova
- Department of Infectious Diseases, Kazan State Medical Academy, 420012 Kazan, Russia
| | - Olesia Ohlopkova
- State Research Center of Virology and Biotechnology «Vector» of Rospotrebnadzor, 630559 Koltsovo, Russia
| | - Nataliya Blatt
- OpenLab "Gene and Cell Technologies", Kazan Federal University, 420021 Kazan, Russia
| | - Maria Markelova
- OpenLab "Gene and Cell Technologies", Kazan Federal University, 420021 Kazan, Russia
| | - Svetlana Khaiboullina
- OpenLab "Gene and Cell Technologies", Kazan Federal University, 420021 Kazan, Russia
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10
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Trigo-Tasende N, Vallejo JA, Rumbo-Feal S, Conde-Pérez K, Vaamonde M, López-Oriona Á, Barbeito I, Nasser-Ali M, Reif R, Rodiño-Janeiro BK, Fernández-Álvarez E, Iglesias-Corrás I, Freire B, Tarrío-Saavedra J, Tomás L, Gallego-García P, Posada D, Bou G, López-de-Ullibarri I, Cao R, Ladra S, Poza M. Wastewater early warning system for SARS-CoV-2 outbreaks and variants in a Coruña, Spain. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023:10.1007/s11356-023-27877-3. [PMID: 37286834 DOI: 10.1007/s11356-023-27877-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 05/19/2023] [Indexed: 06/09/2023]
Abstract
Wastewater-based epidemiology has been widely used as a cost-effective method for tracking the COVID-19 pandemic at the community level. Here we describe COVIDBENS, a wastewater surveillance program running from June 2020 to March 2022 in the wastewater treatment plant of Bens in A Coruña (Spain). The main goal of this work was to provide an effective early warning tool based in wastewater epidemiology to help in decision-making at both the social and public health levels. RT-qPCR procedures and Illumina sequencing were used to weekly monitor the viral load and to detect SARS-CoV-2 mutations in wastewater, respectively. In addition, own statistical models were applied to estimate the real number of infected people and the frequency of each emerging variant circulating in the community, which considerable improved the surveillance strategy. Our analysis detected 6 viral load waves in A Coruña with concentrations between 103 and 106 SARS-CoV-2 RNA copies/L. Our system was able to anticipate community outbreaks during the pandemic with 8-36 days in advance with respect to clinical reports and, to detect the emergence of new SARS-CoV-2 variants in A Coruña such as Alpha (B.1.1.7), Delta (B.1.617.2), and Omicron (B.1.1.529 and BA.2) in wastewater with 42, 30, and 27 days, respectively, before the health system did. Data generated here helped local authorities and health managers to give a faster and more efficient response to the pandemic situation, and also allowed important industrial companies to adapt their production to each situation. The wastewater-based epidemiology program developed in our metropolitan area of A Coruña (Spain) during the SARS-CoV-2 pandemic served as a powerful early warning system combining statistical models with mutations and viral load monitoring in wastewater over time.
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Affiliation(s)
- Noelia Trigo-Tasende
- University of A Coruña (UDC) - Microbiome and Health group (meiGAbiome), Institute of Biomedical Research (INIBIC) - University Hospital of A Coruña (CHUAC) - Interdisciplinary Center for Chemistry and Biology (CICA) - Spanish Network for Infectious Diseases (CIBERINFEC-ISCIII), Campus da Zapateira, 15008, A Coruña, Spain
| | - Juan A Vallejo
- University of A Coruña (UDC) - Microbiome and Health group (meiGAbiome), Institute of Biomedical Research (INIBIC) - University Hospital of A Coruña (CHUAC) - Interdisciplinary Center for Chemistry and Biology (CICA) - Spanish Network for Infectious Diseases (CIBERINFEC-ISCIII), Campus da Zapateira, 15008, A Coruña, Spain
| | - Soraya Rumbo-Feal
- University of A Coruña (UDC) - Microbiome and Health group (meiGAbiome), Institute of Biomedical Research (INIBIC) - University Hospital of A Coruña (CHUAC) - Interdisciplinary Center for Chemistry and Biology (CICA) - Spanish Network for Infectious Diseases (CIBERINFEC-ISCIII), Campus da Zapateira, 15008, A Coruña, Spain
| | - Kelly Conde-Pérez
- University of A Coruña (UDC) - Microbiome and Health group (meiGAbiome), Institute of Biomedical Research (INIBIC) - University Hospital of A Coruña (CHUAC) - Interdisciplinary Center for Chemistry and Biology (CICA) - Spanish Network for Infectious Diseases (CIBERINFEC-ISCIII), Campus da Zapateira, 15008, A Coruña, Spain
| | - Manuel Vaamonde
- Research Group MODES, Research Center for Information and Communication Technologies (CITIC), University of A Coruña (UDC), Campus de Elviña, 15071 , A Coruña, Spain
| | - Ángel López-Oriona
- Research Group MODES, Research Center for Information and Communication Technologies (CITIC), University of A Coruña (UDC), Campus de Elviña, 15071 , A Coruña, Spain
| | - Inés Barbeito
- Research Group MODES, Research Center for Information and Communication Technologies (CITIC), University of A Coruña (UDC), Campus de Elviña, 15071 , A Coruña, Spain
| | - Mohammed Nasser-Ali
- University of A Coruña (UDC) - Microbiome and Health group (meiGAbiome), Institute of Biomedical Research (INIBIC) - University Hospital of A Coruña (CHUAC) - Interdisciplinary Center for Chemistry and Biology (CICA) - Spanish Network for Infectious Diseases (CIBERINFEC-ISCIII), Campus da Zapateira, 15008, A Coruña, Spain
| | - Rubén Reif
- Center for Research in Biological Chemistry and Molecular Materials (CiQUS), University of Santiago de Compostela (USC), 15782, Santiago de Compostela, Spain
| | - Bruno K Rodiño-Janeiro
- BFlow, University of Santiago de Compostela (USC) and Health Research Institute of Santiago de Compostela (IDIS), Campus Vida, 15706, Santiago de Compostela, A Coruña, Spain
| | - Elisa Fernández-Álvarez
- University of A Coruña (UDC), Research Center for Information and Communication Technologies (CITIC), Database Laboratory, Campus de Elviña, 15071, A Coruña, Spain
| | - Iago Iglesias-Corrás
- University of A Coruña (UDC), Research Center for Information and Communication Technologies (CITIC), Database Laboratory, Campus de Elviña, 15071, A Coruña, Spain
| | - Borja Freire
- University of A Coruña (UDC), Research Center for Information and Communication Technologies (CITIC), Database Laboratory, Campus de Elviña, 15071, A Coruña, Spain
| | - Javier Tarrío-Saavedra
- Research Group MODES, Research Center for Information and Communication Technologies (CITIC), University of A Coruña (UDC), Campus de Elviña, 15071 , A Coruña, Spain
| | - Laura Tomás
- CINBIO, Universidade de Vigo, 36310, Vigo, Spain
- Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36312, Vigo, Spain
| | - Pilar Gallego-García
- CINBIO, Universidade de Vigo, 36310, Vigo, Spain
- Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36312, Vigo, Spain
| | - David Posada
- CINBIO, Universidade de Vigo, 36310, Vigo, Spain
- Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36312, Vigo, Spain
- Department of Biochemistry, Genetics, and Immunology, Universidade de Vigo, 36310, Vigo, Spain
| | - Germán Bou
- University of A Coruña (UDC) - Microbiome and Health group (meiGAbiome), Institute of Biomedical Research (INIBIC) - University Hospital of A Coruña (CHUAC) - Interdisciplinary Center for Chemistry and Biology (CICA) - Spanish Network for Infectious Diseases (CIBERINFEC-ISCIII), Campus da Zapateira, 15008, A Coruña, Spain
| | - Ignacio López-de-Ullibarri
- Research Group MODES, Research Center for Information and Communication Technologies (CITIC), University of A Coruña (UDC), Campus de Elviña, 15071 , A Coruña, Spain
| | - Ricardo Cao
- Research Group MODES, Research Center for Information and Communication Technologies (CITIC), University of A Coruña (UDC), Campus de Elviña, 15071 , A Coruña, Spain
| | - Susana Ladra
- University of A Coruña (UDC), Research Center for Information and Communication Technologies (CITIC), Database Laboratory, Campus de Elviña, 15071, A Coruña, Spain
| | - Margarita Poza
- University of A Coruña (UDC) - Microbiome and Health group (meiGAbiome), Institute of Biomedical Research (INIBIC) - University Hospital of A Coruña (CHUAC) - Interdisciplinary Center for Chemistry and Biology (CICA) - Spanish Network for Infectious Diseases (CIBERINFEC-ISCIII), Campus da Zapateira, 15008, A Coruña, Spain.
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11
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Sathyaseelan C, Magateshvaren
Saras MA, Prasad Patro LP, Uttamrao PP, Rathinavelan T. CoVe-Tracker: An Interactive SARS-CoV-2 Pan Proteome Evolution Tracker. J Proteome Res 2023; 22:1984-1996. [PMID: 37036263 PMCID: PMC10108739 DOI: 10.1021/acs.jproteome.3c00068] [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: 02/03/2023] [Indexed: 04/11/2023]
Abstract
SARS-CoV-2 has significantly mutated its genome during the past 3 years, leading to the periodic emergence of several variants. Some of the variants possess enhanced fitness advantage, transmissibility, and pathogenicity and can also reduce vaccine efficacy. Thus, it is important to track the viral evolution to prevent and protect the mankind from SARS-CoV-2 infection. To this end, an interactive web-GUI platform, namely, CoVe-tracker (SARS-CoV-2 evolution tracker), is developed to track its pan proteome evolutionary dynamics (https://project.iith.ac.in/cove-tracker/). CoVe-tracker provides an opportunity for the user to fetch the country-wise and protein-wise amino acid mutations (currently, 44139) of SARS-CoV-2 and their month-wise distribution. It also provides position-wise evolution observed in the SARS-CoV-2 proteome. Importantly, CoVe-tracker provides month- and country-wise distributions of 2065 phylogenetic assignment of named global outbreak (PANGO) lineages and their 177564 variants. It further provides periodic updates on SARS-CoV-2 variant(s) evolution. CoVe-tracker provides the results in a user-friendly interactive fashion by projecting the results onto the world map (for country-wise distribution) and protein 3D structure (for protein-wise mutation). The application of CoVe-tracker in tracking the closest cousin(s) of a variant is demonstrated by considering BA.4 and BA.5 PANGO lineages as test cases. Thus, CoVe-tracker would be useful in the quick surveillance of newly emerging mutations/variants/lineages to facilitate the understanding of viral evolution, transmission, and disease epidemiology.
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Affiliation(s)
- Chakkarai Sathyaseelan
- Department of Biotechnology, Indian Institute
of Technology Hyderabad, Kandi, Telangana State 502285,
India
| | | | - L. Ponoop Prasad Patro
- Department of Biotechnology, Indian Institute
of Technology Hyderabad, Kandi, Telangana State 502285,
India
| | - Patil Pranita Uttamrao
- Department of Biotechnology, Indian Institute
of Technology Hyderabad, Kandi, Telangana State 502285,
India
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12
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Zhu Y, Xia Y, Pickering J, Bowen AC, Short KR. The role of children in transmission of SARS-CoV-2 variants of concern within households: an updated systematic review and meta-analysis, as at 30 June 2022. Euro Surveill 2023; 28:2200624. [PMID: 37140450 PMCID: PMC10161681 DOI: 10.2807/1560-7917.es.2023.28.18.2200624] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 03/17/2023] [Indexed: 05/05/2023] Open
Abstract
BackgroundMeta-analyses and single-site studies have established that children are less infectious than adults within a household when positive for ancestral SARS-CoV-2. In addition, children appear less susceptible to infection when exposed to ancestral SARS-CoV-2 within a household. The emergence of SARS-CoV-2 variants of concern (VOC) has been associated with an increased number of paediatric infections worldwide. However, the role of children in the household transmission of VOC, relative to the ancestral virus, remains unclear.AimWe aimed to evaluate children's role in household transmission of SARS-CoV-2 VOC.MethodsWe perform a meta-analysis of the role of children in household transmission of both ancestral SARS-CoV-2 and SARS-CoV-2 VOC.ResultsUnlike with the ancestral virus, children infected with VOC spread SARS-CoV-2 to an equivalent number of household contacts as infected adults and were equally as likely to acquire SARS-CoV-2 VOC from an infected family member. Interestingly, the same was observed when unvaccinated children exposed to VOC were compared with unvaccinated adults exposed to VOC.ConclusionsThese data suggest that the emergence of VOC was associated with a fundamental shift in the epidemiology of SARS-CoV-2. It is unlikely that this is solely the result of age-dependent differences in vaccination during the VOC period and may instead reflect virus evolution over the course of the pandemic.
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Affiliation(s)
- Yanshan Zhu
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia
- Wesfarmer's Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Perth, Australia
- These authors contributed equally to this manuscript
| | - Yao Xia
- Department of Microbiology, State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
- These authors contributed equally to this manuscript
| | - Janessa Pickering
- Wesfarmer's Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Perth, Australia
| | - Asha C Bowen
- Wesfarmer's Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Perth, Australia
- Department of Infectious Diseases, Perth Children's Hospital, Nedlands, Perth, Australia
| | - Kirsty R Short
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia
- Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, Australia
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13
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Rousseau A, Vauloup-Fellous C, Haigh O, Pavy S, Molinari D, Jauréguiberry S, Angoulvant A, Labetoulle M. Conjunctival conveyance of SARS-CoV-2 in asymptomatic and non-severe symptomatic COVID-19 patients. J Fr Ophtalmol 2023; 46:101-105. [PMID: 36635207 PMCID: PMC9812824 DOI: 10.1016/j.jfo.2022.09.018] [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: 08/01/2022] [Accepted: 09/13/2022] [Indexed: 01/07/2023]
Abstract
INTRODUCTION The prevalence of ocular conveyance of SARS-CoV-2 has been well described for severe/hospitalized cases, but scarcely reported in asymptomatic and non-severe patients, who are unaware that they are carriers. MATERIAL & METHODS This prospective cross-sectional study quantitatively evaluated SARS-CoV-2 shedding on the ocular surface (OS). Conjunctival testing was suggested to all hospital personnel being screened by nasopharyngeal (NP) SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR). Disease symptoms were evaluated using a standardized questionnaire and telephone follow-up 6±3 months later for disease evolution (recovery with/without severe disease). RESULTS Four hundred and eighty seven patients were included. From 46 NP SARS-CoV-2-positive subjects (cycle threshold [CT]=24.2±7.1), 13% tested positive at the OS (CT=36.4±2.8). Most SARS-CoV-2-positive subjects were symptomatic (n=40, 87%), while 6 were asymptomatic (being tested as contact cases). Systemic symptoms were not significantly different in OS-positive vs OS-negative subjects, although headache tended to be more frequent in OS-positives (83% vs 54%, P=0.06). None of the OS-positive subjects reported ocular symptoms and none developed severe disease requiring hospitalization or oxygen therapy. CONCLUSION SARS-CoV-2 shedding at the OS may occur in asymptomatic and non-severe COVID-19 individuals (including those absent of ocular symptoms). However, the high RT-PCR CT values attained may indicate a low risk of transmissibility via this route.
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Affiliation(s)
- A Rousseau
- Department of Ophthalmology, Hôpital Bicêtre, Assistance Publique - Hôpitaux de Paris, Paris-Saclay University, French Reference network for rare Ophthalmologic diseases (OPHTARA), Le Kremlin-Bicêtre, France; Immunology of viral and autoimmune disease, IMVA, IDMIT, U1184, CEA, Fontenay aux Roses, France
| | - C Vauloup-Fellous
- Division of Virology, Dept of Biology Genetics and PUI, Paris-Saclay University Hospital, APHP, Villejuif, France; Inserm U1193, Université Paris-Saclay, Villejuif, France
| | - O Haigh
- Immunology of viral and autoimmune disease, IMVA, IDMIT, U1184, CEA, Fontenay aux Roses, France
| | - S Pavy
- Department of Rheumatology, Hôpital Bicêtre, Assistance Publique - Hôpitaux de Paris, Paris-Saclay University, Le Kremlin-Bicêtre, France
| | - D Molinari
- Clinical Research Unit, Hôpital Bicêtre, Assistance Publique - Hôpitaux de Paris, Paris-Saclay University, Le Kremlin-Bicêtre, France
| | - S Jauréguiberry
- Department of Infectious and tropical diseases, Hôpital Bicêtre, Assistance Publique - Hôpitaux de Paris, Paris-Saclay University, Le Kremlin-Bicêtre, France; Université de Paris Saclay, INSERM, CESP (Centre de Recherche en Epidémiologie et Santé des Populations), Villejuif, France
| | - A Angoulvant
- Department of Infectious and tropical diseases, Hôpital Bicêtre, Assistance Publique - Hôpitaux de Paris, Paris-Saclay University, Le Kremlin-Bicêtre, France; QE-Le Moulon, INRA-Université Paris-Saclay-CNRS-AgroParisTech, 91400 Orsay, France
| | - M Labetoulle
- Department of Ophthalmology, Hôpital Bicêtre, Assistance Publique - Hôpitaux de Paris, Paris-Saclay University, French Reference network for rare Ophthalmologic diseases (OPHTARA), Le Kremlin-Bicêtre, France; Immunology of viral and autoimmune disease, IMVA, IDMIT, U1184, CEA, Fontenay aux Roses, France
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14
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Vardavas CI, Nikitara K, Aslanoglou K, Kamekis A, Puttige Ramesh N, Symvoulakis E, Agaku I, Phalkey R, Leonardi-Bee J, Fernandez E, Condell O, Lamb F, Deogan C, Suk JE. Systematic review of outbreaks of COVID-19 within households in the European region when the child is the index case. BMJ Paediatr Open 2023; 7:10.1136/bmjpo-2022-001718. [PMID: 36649374 PMCID: PMC9835947 DOI: 10.1136/bmjpo-2022-001718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/07/2022] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES This systematic review aims to identify the secondary attack rates (SAR) to adults and other children when children are the index cases within household settings. METHODS This literature review assessed European-based studies published in Medline and Embase between January 2020 and January 2022 that assessed the secondary transmission of SARS-CoV-2 within household settings. The inclusion criteria were based on the Population, Exposure, Outcome framework for systematic reviews. Thus, the study population was restricted to humans within the household setting in Europe (population), in contact with paediatric index cases 1-17 years old (exposure) that led to the transmission of SARS-CoV-2 reported as either an SAR or the probability of onward infection (outcome). RESULTS Of 1819 studies originally identified, 19 met the inclusion criteria. Overall, the SAR ranged from 13% to 75% in 15 studies, while there was no evidence of secondary transmission from children to other household members in one study. Evidence indicated that asymptomatic SARS-CoV-2 index cases also have a lower SAR than those with symptoms and that younger children may have a lower SAR than adolescents (>12 years old) within household settings. CONCLUSIONS SARS-CoV-2 secondary transmission from paediatric index cases ranged from 0% to 75%, within household settings between January 2020 and January 2022, with differences noted by age and by symptomatic/asymptomatic status of the index case. Given the anticipated endemic circulation of SARS-CoV-2, continued monitoring and assessment of household transmission is necessary.
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Affiliation(s)
- Constantine I Vardavas
- School of Medicine, University of Crete School of Medicine, Heraklion, Greece.,Department of Oral Health Policy and Epidemiology, Harvard University, Cambridge, Massachusetts, USA
| | - Katerina Nikitara
- School of Medicine, University of Crete School of Medicine, Heraklion, Greece
| | - Katerina Aslanoglou
- School of Medicine, University of Crete School of Medicine, Heraklion, Greece
| | - Apostolos Kamekis
- School of Medicine, University of Crete School of Medicine, Heraklion, Greece
| | - Nithya Puttige Ramesh
- Department of Oral Health Policy and Epidemiology, Harvard University, Cambridge, Massachusetts, USA
| | | | - Israel Agaku
- Department of Oral Health Policy and Epidemiology, Harvard University, Cambridge, Massachusetts, USA
| | - Revati Phalkey
- Centre for Evidence Based Healthcare, University of Nottingham, Nottingham, UK
| | - Jo Leonardi-Bee
- Centre for Evidence Based Healthcare, University of Nottingham, Nottingham, UK
| | - Esteve Fernandez
- Tobacco Control Unit, Catalan Institute of Oncology Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Barcelona, Spain.,Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvithe (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,CIBER Respiratory Diseases (CIBERES), Madrid, Spain.,Department of Clinical Sciences, School of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Orla Condell
- European Centre for Disease Prevention and Control (ECDC), Solna, Stockholm, Sweden
| | - Favelle Lamb
- European Centre for Disease Prevention and Control (ECDC), Solna, Stockholm, Sweden
| | - Charlotte Deogan
- European Centre for Disease Prevention and Control (ECDC), Solna, Stockholm, Sweden
| | - Jonathan E Suk
- European Centre for Disease Prevention and Control (ECDC), Solna, Stockholm, Sweden
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15
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Djordjevic M, Markovic S, Salom I, Djordjevic M. Understanding risk factors of a new variant outburst through global analysis of Omicron transmissibility. ENVIRONMENTAL RESEARCH 2023; 216:114446. [PMID: 36208783 DOI: 10.1016/j.envres.2022.114446] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 09/11/2022] [Accepted: 09/25/2022] [Indexed: 06/16/2023]
Abstract
The emergence of a new virus variant is generally recognized by its usually sudden and rapid spread (outburst) in a certain world region. Due to the near-exponential rate of initial expansion, the new strain may not be detected at its true geographical origin but in the area with the most favorable conditions leading to the fastest exponential growth. Therefore, it is crucial to understand better the factors that promote such outbursts, which we address in the example of analyzing global Omicron transmissibility during its global emergence/outburst in November 2021-February 2022. As predictors, we assemble a number of potentially relevant factors: vaccinations (both full and boosters), different measures of population mobility (provided by Google), estimated stringency of measures, the prevalence of chronic diseases, population age, the timing of the outburst, and several other socio-demographic variables. As a proxy for natural immunity (prevalence of prior infections in population), we use cumulative numbers of COVID-19 deaths. As a response variable (transmissibility measure), we use the estimated effective reproduction number (Re) averaged in the vicinity of the outburst maxima. To select significant predictors of Re, we use machine learning regressions that employ feature selection, including methods based on ensembles of decision trees (Random Forest and Gradient Boosting). We identify the young population, earlier infection onset, higher mobility, low natural immunity, and low booster prevalence as likely direct risk factors. Interestingly, we find that all these risk factors were significantly higher for Africa, though curiously somewhat lower in Southern African countries (where the outburst emerged) compared to other African countries. Therefore, while the risk factors related to the virus transmissibility clearly promote the outburst of a new virus variant, specific regions/countries where the outburst actually happens may be related to less evident factors, possibly random in nature.
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Affiliation(s)
- Marko Djordjevic
- Quantitative Biology Group, Institute of Physiology and Biochemistry, Faculty of Biology, University of Belgrade, Serbia.
| | - Sofija Markovic
- Quantitative Biology Group, Institute of Physiology and Biochemistry, Faculty of Biology, University of Belgrade, Serbia
| | - Igor Salom
- Institute of Physics Belgrade, National Institute of the Republic of Serbia, University of Belgrade, Serbia
| | - Magdalena Djordjevic
- Institute of Physics Belgrade, National Institute of the Republic of Serbia, University of Belgrade, Serbia
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16
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Li Y, Kim H, Ju Y, Park Y, Kang T, Yong D, Park HG. Ultrasensitive Isothermal Detection of SARS-CoV-2 Based on Self-Priming Hairpin-Utilized Amplification of the G-Rich Sequence. Anal Chem 2022; 94:17448-17455. [PMID: 36480911 PMCID: PMC9743493 DOI: 10.1021/acs.analchem.2c03442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 11/28/2022] [Indexed: 12/13/2022]
Abstract
The outbreak of the novel coronavirus disease 2019 (COVID-19) pandemic induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused millions of fatalities all over the world. Unquestionably, the effective and timely testing for infected individuals is the most imperative for the prevention of the ongoing pandemic. Herein, a new method was established for detecting SARS-CoV-2 based on the self-priming hairpin-utilized isothermal amplification of the G-rich sequence (SHIAG). In this strategy, the target RNA binding to the hairpin probe (HP) was uniquely devised to lead to the self-priming-mediated extension followed by the continuously repeated nicking and extension reactions, consequently generating abundant G-rich sequences from the intended reaction capable of producing fluorescence signals upon specifically interacting with thioflavin T (ThT). Based on the unique isothermal design concept, we successfully identified SARS-CoV-2 genomic RNA (gRNA) as low as 0.19 fM with excellent selectivity by applying only a single HP and further verified its practical diagnostic capability by reliably testing a total of 100 clinical specimens for COVID-19 with 100% clinical sensitivity and specificity. This study would provide notable insights into the design and evolution of new isothermal strategies for the sensitive and facile detection of SARS-CoV-2 under resource constraints.
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Affiliation(s)
- Yan Li
- Department of Chemical and Biomolecular Engineering
(BK21 Four), Korea Advanced Institute of Science and Technology
(KAIST), 291 Daehak-ro, Yuseong-gu, Daejeon34141, Republic of
Korea
| | - Hansol Kim
- Department of Chemical and Biomolecular Engineering
(BK21 Four), Korea Advanced Institute of Science and Technology
(KAIST), 291 Daehak-ro, Yuseong-gu, Daejeon34141, Republic of
Korea
| | - Yong Ju
- Department of Chemical and Biomolecular Engineering
(BK21 Four), Korea Advanced Institute of Science and Technology
(KAIST), 291 Daehak-ro, Yuseong-gu, Daejeon34141, Republic of
Korea
| | - Yeonkyung Park
- Department of Chemical and Biomolecular Engineering
(BK21 Four), Korea Advanced Institute of Science and Technology
(KAIST), 291 Daehak-ro, Yuseong-gu, Daejeon34141, Republic of
Korea
| | - Taejoon Kang
- Bionanotechnology Research Center, Korea
Research Institute of Bioscience and Biotechnology (KRIBB), Yuseong-gu,
Daejeon34141, Republic of Korea
- School of Pharmacy, Sungkyunkwan
University, 2066 Seobu-ro, Jangan-gu, Suwon, Gyeonggi-do16419,
Republic of Korea
| | - Dongeun Yong
- Department of Laboratory Medicine and
Research Institute of Bacterial Resistance, Yonsei University College of
Medicine, Seoul03722, Republic of Korea
| | - Hyun Gyu Park
- Department of Chemical and Biomolecular Engineering
(BK21 Four), Korea Advanced Institute of Science and Technology
(KAIST), 291 Daehak-ro, Yuseong-gu, Daejeon34141, Republic of
Korea
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17
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Wang C, Huang X, Lau EHY, Cowling BJ, Tsang TK. Association Between Population-Level Factors and Household Secondary Attack Rate of SARS-CoV-2: A Systematic Review and Meta-analysis. Open Forum Infect Dis 2022; 10:ofac676. [PMID: 36655186 PMCID: PMC9835764 DOI: 10.1093/ofid/ofac676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
Background Accurate estimation of household secondary attack rate (SAR) is crucial to understand the transmissibility of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The impact of population-level factors, such as transmission intensity in the community, on SAR estimates is rarely explored. Methods In this study, we included articles with original data to compute the household SAR. To determine the impact of transmission intensity in the community on household SAR estimates, we explored the association between SAR estimates and the incidence rate of cases by country during the study period. Results We identified 163 studies to extract data on SARs from 326 031 cases and 2 009 859 household contacts. The correlation between the incidence rate of cases during the study period and SAR estimates was 0.37 (95% CI, 0.24-0.49). We found that doubling the incidence rate of cases during the study period was associated with a 1.2% (95% CI, 0.5%-1.8%) higher household SAR. Conclusions Our findings suggest that the incidence rate of cases during the study period is associated with higher SAR. Ignoring this factor may overestimate SARs, especially for regions with high incidences, which further impacts control policies and epidemiological characterization of emerging variants.
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Affiliation(s)
- Can Wang
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Xiaotong Huang
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Eric H Y Lau
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China,Laboratory of Data Discovery for Health Limited, Hong Kong Science and Technology Park, New Territories, Hong Kong Special Administrative Region, China
| | - Benjamin J Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China,Laboratory of Data Discovery for Health Limited, Hong Kong Science and Technology Park, New Territories, Hong Kong Special Administrative Region, China
| | - Tim K Tsang
- Correspondence: Tim K. Tsang, PhD, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 7 Sassoon Road, Pokfulam, Hong Kong Special Administrative Region, China ()
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18
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Su YCF, Ma JZJ, Ou TP, Pum L, Krang S, Raftery P, Kinzer MH, Bohl J, Ieng V, Kab V, Patel S, Sar B, Ying WF, Jayakumar J, Horm VS, Boukli N, Yann S, Troupin C, Heang V, Garcia-Rivera JA, Sengdoeurn Y, Heng S, Lay S, Chea S, Darapheak C, Savuth C, Khalakdina A, Ly S, Baril L, Manning JE, Simone-Loriere E, Duong V, Dussart P, Sovann L, Smith GJD, Karlsson EA. Genomic epidemiology of SARS-CoV-2 in Cambodia, January 2020 to February 2021. Virus Evol 2022; 9:veac121. [PMID: 36654682 PMCID: PMC9838690 DOI: 10.1093/ve/veac121] [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: 06/10/2022] [Revised: 10/05/2022] [Accepted: 12/16/2022] [Indexed: 12/23/2022] Open
Abstract
The first case of coronavirus disease 2019 (COVID-19) in Cambodia was confirmed on 27 January 2020 in a traveller from Wuhan. Cambodia subsequently implemented strict travel restrictions, and although intermittent cases were reported during the first year of the COVID-19 pandemic, no apparent widespread community transmission was detected. Investigating the routes of severe acute respiratory coronavirus 2 (SARS-CoV-2) introduction into the country was critical for evaluating the implementation of public health interventions and assessing the effectiveness of social control measures. Genomic sequencing technologies have enabled rapid detection and monitoring of emerging variants of SARS-CoV-2. Here, we detected 478 confirmed COVID-19 cases in Cambodia between 27 January 2020 and 14 February 2021, 81.3 per cent in imported cases. Among them, fifty-four SARS-CoV-2 genomes were sequenced and analysed along with representative global lineages. Despite the low number of confirmed cases, we found a high diversity of Cambodian viruses that belonged to at least seventeen distinct PANGO lineages. Phylogenetic inference of SARS-CoV-2 revealed that the genetic diversity of Cambodian viruses resulted from multiple independent introductions from diverse regions, predominantly, Eastern Asia, Europe, and Southeast Asia. Most cases were quickly isolated, limiting community spread, although there was an A.23.1 variant cluster in Phnom Penh in November 2020 that resulted in a small-scale local transmission. The overall low incidence of COVID-19 infections suggests that Cambodia's early containment strategies, including travel restrictions, aggressive testing and strict quarantine measures, were effective in preventing large community outbreaks of COVID-19.
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Affiliation(s)
- Yvonne C F Su
- Programme in Emerging Infectious Diseases, Duke-NUS Medical School, 8 College Rd 169857, Singapore
| | - Jordan Z J Ma
- Programme in Emerging Infectious Diseases, Duke-NUS Medical School, 8 College Rd 169857, Singapore
| | - Tey Putita Ou
- Virology Unit, World Health Organization COVID-19 Global Referral Laboratory, Institute Pasteur du Cambodge, 5 Preah Monivong Blvd (93), Phnom Penh 12201, Cambodia
- Ecole Doctorale GAIA, University of Montpelier, 641 Av. du Doyen Gaston Giraud, Montpellier 34000, France
| | - Leakhena Pum
- Virology Unit, World Health Organization COVID-19 Global Referral Laboratory, Institute Pasteur du Cambodge, 5 Preah Monivong Blvd (93), Phnom Penh 12201, Cambodia
| | - Sidonn Krang
- Communicable Disease Control Department, Ministry of Health, 80, 289 Samdach Penn Nouth St. (289), Phnom Penh 120407, Cambodia
| | - Philomena Raftery
- World Health Organization Country Office, 5 - St 205, Phnom Penh 12355, Cambodia
| | - Michael H Kinzer
- United States Centers for Disease Control and Prevention, 80, 289 Samdach Penn Nouth St. (289), Phnom Penh 120407, Cambodia
| | - Jennifer Bohl
- Laboratory of Malaria and Vector Research, US National Institute of Allergy and Infectious Diseases, Phnom Penh, Cambodia
- International Center of Excellence in Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Phnom Penh, Cambodia
| | - Vanra Ieng
- World Health Organization Country Office, 5 - St 205, Phnom Penh 12355, Cambodia
| | - Vannda Kab
- World Health Organization Country Office, 5 - St 205, Phnom Penh 12355, Cambodia
| | - Sarika Patel
- World Health Organization Country Office, 5 - St 205, Phnom Penh 12355, Cambodia
| | - Borann Sar
- United States Centers for Disease Control and Prevention, 80, 289 Samdach Penn Nouth St. (289), Phnom Penh 120407, Cambodia
| | - Wong Foong Ying
- Programme in Emerging Infectious Diseases, Duke-NUS Medical School, 8 College Rd 169857, Singapore
| | - Jayanthi Jayakumar
- Programme in Emerging Infectious Diseases, Duke-NUS Medical School, 8 College Rd 169857, Singapore
| | - Viseth Srey Horm
- Virology Unit, World Health Organization COVID-19 Global Referral Laboratory, Institute Pasteur du Cambodge, 5 Preah Monivong Blvd (93), Phnom Penh 12201, Cambodia
| | - Narjis Boukli
- Virology Unit, World Health Organization COVID-19 Global Referral Laboratory, Institute Pasteur du Cambodge, 5 Preah Monivong Blvd (93), Phnom Penh 12201, Cambodia
| | - Sokhoun Yann
- Virology Unit, World Health Organization COVID-19 Global Referral Laboratory, Institute Pasteur du Cambodge, 5 Preah Monivong Blvd (93), Phnom Penh 12201, Cambodia
| | - Cecile Troupin
- Virology Unit, World Health Organization COVID-19 Global Referral Laboratory, Institute Pasteur du Cambodge, 5 Preah Monivong Blvd (93), Phnom Penh 12201, Cambodia
| | - Vireak Heang
- Sequencing Mini-Platform, Institut Pasteur du Cambodge, 5 Preah Monivong Blvd (93), Phnom Penh 12201, Cambodia
- Naval Medical Research Unit TWO, Lot#: 80, 289 Samdach Penn Nout, Phnom Penh 120407, Cambodia
| | - Jose A Garcia-Rivera
- Naval Medical Research Unit TWO, Lot#: 80, 289 Samdach Penn Nout, Phnom Penh 120407, Cambodia
| | - Yi Sengdoeurn
- Communicable Disease Control Department, Ministry of Health, 80, 289 Samdach Penn Nouth St. (289), Phnom Penh 120407, Cambodia
| | - Seng Heng
- Communicable Disease Control Department, Ministry of Health, 80, 289 Samdach Penn Nouth St. (289), Phnom Penh 120407, Cambodia
| | - Sreyngim Lay
- Laboratory of Malaria and Vector Research, US National Institute of Allergy and Infectious Diseases, Phnom Penh, Cambodia
| | - Sophana Chea
- Laboratory of Malaria and Vector Research, US National Institute of Allergy and Infectious Diseases, Phnom Penh, Cambodia
| | - Chau Darapheak
- National Institute for Public Health, Lot#: 80, 289 Samdach Penn Nouth St (289), Phnom Penh 120407, Cambodia
| | - Chin Savuth
- National Institute for Public Health, Lot#: 80, 289 Samdach Penn Nouth St (289), Phnom Penh 120407, Cambodia
| | - Asheena Khalakdina
- World Health Organization Country Office, 5 - St 205, Phnom Penh 12355, Cambodia
| | - Sowath Ly
- Epidemiology and Public Health Unit, Institute Pasteur du Cambodge, 5 Preah Monivong Blvd (93), Phnom Penh 12201, Cambodia
| | - Laurence Baril
- Direction, Institute Pasteur du Cambodge, 5 Preah Monivong Blvd (93), Phnom Penh 12201, Cambodia
| | - Jessica E Manning
- Laboratory of Malaria and Vector Research, US National Institute of Allergy and Infectious Diseases, Phnom Penh, Cambodia
| | | | - Veasna Duong
- Virology Unit, World Health Organization COVID-19 Global Referral Laboratory, Institute Pasteur du Cambodge, 5 Preah Monivong Blvd (93), Phnom Penh 12201, Cambodia
| | - Philippe Dussart
- Virology Unit, World Health Organization COVID-19 Global Referral Laboratory, Institute Pasteur du Cambodge, 5 Preah Monivong Blvd (93), Phnom Penh 12201, Cambodia
| | - Ly Sovann
- Communicable Disease Control Department, Ministry of Health, 80, 289 Samdach Penn Nouth St. (289), Phnom Penh 120407, Cambodia
| | - Gavin J D Smith
- Programme in Emerging Infectious Diseases, Duke-NUS Medical School, 8 College Rd 169857, Singapore
- Centre for Outbreak Preparedness, Duke-NUS Medical School, 8 College Rd, Singapore 169857, Singapore
- SingHealth Duke-NUS Global Health Institute, SingHealth Duke-NUS Academic Medical Centre, 8 College Rd 169857, Singapore
- Duke Global Health Institute, Duke University, 310 Trent Dr, Durham, NC 27710, USA
| | - Erik A Karlsson
- Virology Unit, World Health Organization COVID-19 Global Referral Laboratory, Institute Pasteur du Cambodge, 5 Preah Monivong Blvd (93), Phnom Penh 12201, Cambodia
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19
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SARS-CoV-2 nasopharyngeal viral load in individuals infected with BA.2, compared to Alpha, Gamma, Delta and BA.1 variants: A single-center comparative analysis. J Clin Virol 2022; 157:105299. [PMID: 36183546 PMCID: PMC9511897 DOI: 10.1016/j.jcv.2022.105299] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/18/2022] [Accepted: 09/24/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND SARS-CoV-2 has evolved, leading to the emergence of new Variants Of Concern (VOCs) with significant impact on transmissibility. Although the transmission process is complex, higher nasopharyngeal viral load (NP-VL) can be considered as a proxy for greater transmissibility. OBJECTIVES The aim of this analysis was to compare NP-VL across a set of representative VOCs observed in mildly symptomatic patients. STUDY DESIGN Observational single-center comparative analysis of patients with early mild-to-moderate COVID-19, enrolled within the early treatment access program of Lazzaro Spallanzani Institute (March 2021-March 2022). NP-VL before drug administration was estimated through RT-PCR, based on cycle threshold values (CTs); VOCs were identified by Sanger sequencing. VOCs' average treatment effect (ATE) was estimated on the CTs fitted in the log2 scale, controlling for potential confounders. RESULTS A total of 707 patients were included. VOCs were: 10% Alpha, 3% Gamma, 34% Delta, 34% BA.1, 19% BA.2. Mean CTs for BA.1 and BA.2 were lower than Delta and BA.1, respectively. After adjusting for calendar time, age, immunodeficiency and vaccination, CTs for Gamma were lower than those seen for Alpha and higher than Delta, for Delta were similar to BA.1, for BA.2 were lower than Delta and BA.1. CONCLUSIONS Our analysis shows higher NP-VL of BA.2 compared to previously circulating VOCs, even after controlling for factors potentially contributing to the amount of nasopharyngeal viral RNA, included vaccination, supporting the increased transmissibility of BA.2. Further studies are necessary to clarify this mechanism and to provide guidance for public health measures.
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20
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Meurisse M, Van Oyen H, Blot K, Catteau L, Serrien B, Klamer S, Cauët E, Robert A, Van Goethem N. Evaluating methodological approaches to assess the severity of infection with SARS-CoV-2 variants: scoping review and applications on Belgian COVID-19 data. BMC Infect Dis 2022; 22:839. [DOI: 10.1186/s12879-022-07777-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 09/26/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Differences in the genetic material of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants may result in altered virulence characteristics. Assessing the disease severity caused by newly emerging variants is essential to estimate their impact on public health. However, causally inferring the intrinsic severity of infection with variants using observational data is a challenging process on which guidance is still limited. We describe potential limitations and biases that researchers are confronted with and evaluate different methodological approaches to study the severity of infection with SARS-CoV-2 variants.
Methods
We reviewed the literature to identify limitations and potential biases in methods used to study the severity of infection with a particular variant. The impact of different methodological choices is illustrated by using real-world data of Belgian hospitalized COVID-19 patients.
Results
We observed different ways of defining coronavirus disease 2019 (COVID-19) disease severity (e.g., admission to the hospital or intensive care unit versus the occurrence of severe complications or death) and exposure to a variant (e.g., linkage of the sequencing or genotyping result with the patient data through a unique identifier versus categorization of patients based on time periods). Different potential selection biases (e.g., overcontrol bias, endogenous selection bias, sample truncation bias) and factors fluctuating over time (e.g., medical expertise and therapeutic strategies, vaccination coverage and natural immunity, pressure on the healthcare system, affected population groups) according to the successive waves of COVID-19, dominated by different variants, were identified. Using data of Belgian hospitalized COVID-19 patients, we were able to document (i) the robustness of the analyses when using different variant exposure ascertainment methods, (ii) indications of the presence of selection bias and (iii) how important confounding variables are fluctuating over time.
Conclusions
When estimating the unbiased marginal effect of SARS-CoV-2 variants on the severity of infection, different strategies can be used and different assumptions can be made, potentially leading to different conclusions. We propose four best practices to identify and reduce potential bias introduced by the study design, the data analysis approach, and the features of the underlying surveillance strategies and data infrastructure.
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21
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Hamm SR, Rezahosseini O, Møller DL, Loft JA, Poulsen JR, Knudsen JD, Pedersen MS, Schønning K, Harboe ZB, Rasmussen A, Sørensen SS, Nielsen SD. Incidence and severity of SARS-CoV-2 infections in liver and kidney transplant recipients in the post-vaccination era: Real-life data from Denmark. Am J Transplant 2022; 22:2637-2650. [PMID: 35801693 PMCID: PMC9349423 DOI: 10.1111/ajt.17141] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/14/2022] [Accepted: 07/03/2022] [Indexed: 01/25/2023]
Abstract
Coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 has been associated with a high risk of adverse outcomes in solid organ transplant (SOT) recipients in the pre-vaccination era. In this retrospective cohort study, we examined the incidence and severity of COVID-19 in kidney and liver transplant recipients in Denmark in the post-vaccination era, from December 27, 2020, to December 27, 2021. We included 1428 SOT recipients with 143 cases of first-positive SARS-CoV-2 PCR test. The cumulative incidence of first-positive SARS-CoV-2 PCR test 1 year after initiation of vaccination was 10.4% (95% CI: 8.8-12.0), and the incidence was higher in kidney than in liver transplant recipients (11.6% [95% CI: 9.4-13.8] vs. 7.4% [95% CI: 5.1-9.8], p = .009). After the first-positive SARS-CoV-2 PCR test, the hospitalization rate was 31.5% (95% CI: 23.9-39.1), and 30-day all-cause mortality was 3.7% (95% CI: 0.5-6.8). Hospitalization was lower in vaccinated than in unvaccinated SOT recipients (26.4% [95% CI: 18.1-34.6] vs. 48.5% [95% CI: 31.4-65.5], p = .011), as was mortality (1.8% [95% CI: 0.0-4.3] vs. 9.1% [95% CI: 0.0-18.9], p = .047). In conclusion, SOT recipients remain at high risk of adverse outcomes after SARS-CoV-2 infections, with a lower risk observed in vaccinated than in unvaccinated SOT recipients.
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Affiliation(s)
- Sebastian Rask Hamm
- Viro-immunology Research Unit, Department of Infectious Diseases, Rigshospitalet Copenhagen University Hospital Copenhagen Denmark
| | - Omid Rezahosseini
- Viro-immunology Research Unit, Department of Infectious Diseases, Rigshospitalet Copenhagen University Hospital Copenhagen Denmark
| | - Dina Leth Møller
- Viro-immunology Research Unit, Department of Infectious Diseases, Rigshospitalet Copenhagen University Hospital Copenhagen Denmark
| | - Josefine Amalie Loft
- Viro-immunology Research Unit, Department of Infectious Diseases, Rigshospitalet Copenhagen University Hospital Copenhagen Denmark
| | - Johan Runge Poulsen
- Viro-immunology Research Unit, Department of Infectious Diseases, Rigshospitalet Copenhagen University Hospital Copenhagen Denmark
| | - Jenny Dahl Knudsen
- Department of Clinical Microbiology, Rigshospitalet Copenhagen University Hospital Copenhagen Denmark
| | - Martin Schou Pedersen
- Department of Clinical Microbiology, Rigshospitalet Copenhagen University Hospital Copenhagen Denmark
| | - Kristian Schønning
- Department of Clinical Microbiology, Rigshospitalet Copenhagen University Hospital Copenhagen Denmark
| | - Zitta Barrella Harboe
- Department of Pulmonary and Infectious Diseases, Hospital of North Zealand Copenhagen University Hospital Hillerød Denmark,Department of Clinical Medicine, Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
| | - Allan Rasmussen
- Department of Surgery and Transplantation, Rigshospitalet Copenhagen University Hospital Copenhagen Denmark
| | - Søren Schwartz Sørensen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark,Department of Nephrology, Rigshospitalet Copenhagen University Hospital Copenhagen Denmark
| | - Susanne Dam Nielsen
- Viro-immunology Research Unit, Department of Infectious Diseases, Rigshospitalet Copenhagen University Hospital Copenhagen Denmark,Department of Clinical Medicine, Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark,Susanne Dam Nielsen, Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, København, Denmark.
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22
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Suljič A, Sočan M, Mrzel M, Lunar MM, Korva M, Štorman A, Prosenc K, Janežič S, Žohar-Čretnik T, Zupanič T, Poljak M, Avšič-Županc T. Milder outcomes of SARS-CoV-2 genetically confirmed reinfections compared to primary infections with the delta variant: A retrospective case-control study. Front Med (Lausanne) 2022; 9:962653. [PMID: 36275814 PMCID: PMC9582599 DOI: 10.3389/fmed.2022.962653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 09/13/2022] [Indexed: 11/29/2022] Open
Abstract
Background SARS-CoV-2 infection does not confer long immunity. However, studies suggest that prior infection is associated with lower risk of reinfection and milder outcomes of recurrent infections. The aims of this retrospective observational case-control study were to describe the clinical and molecular characteristics of genetically confirmed Delta reinfection cases and to assess the potential protective role of preceding infection on the severity of reinfection. Methods We used next generation sequencing (NGS) to explore if cases with two positive real time RT-PCR tests > 90 days apart were infected with a different SARS-CoV-2 variant. Cases with confirmed reinfection between August 1st and October 31st, 2021 (the Delta wave) in Slovenia were matched 1:4 by age, sex and timeframe (week of positive test) with individuals with primary infection. Sociodemographic and epidemiologic data, vaccination status, and data on hospitalization and outcome of infection were retrieved from several centralized and standardized national databases. Additional epidemiologic surveys were performed on a limited number of cases and controls. Results We identified 628 cases of genetically confirmed reinfection during the study period and matched them with 2,512 control subjects with Delta primary infection. Primary infections in individuals with reinfection were mainly caused by B.1.258.17 (51.1%), followed by B.1.1.7 (15.1%) and reinfection was detected on average 271 days after primary infection (range 101–477 days). Our results show a substantially lower probability of hospitalization in cases with reinfection compared with controls (OR: 0.21, p = 0.017), but no significant difference was observed in intensive care unit admission and deaths. We observed a significantly lower proportion of vaccinated individuals among cases compared to controls (4.5% vs. 28.2%), suggesting that hybrid immunity leads to lower probability of reinfection. Detailed analysis of the temporal distribution of variants, responsible for reinfections, showed no significant differences in reinfection potential. Conclusion Reinfection with the SARS-CoV-2 Delta variant resulted in fewer hospitalizations compared to the primary Delta infection, suggesting that primary infection may, to some extent, produce at least short lasting protective immunity. This study provides additional insight into the reinfection dynamics that may allow appropriate public health measures to be taken in subsequent waves of the COVID-19 pandemic.
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Affiliation(s)
- Alen Suljič
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Ljubljana, Ljubljana, Slovenia
| | - Maja Sočan
- National Institute of Public Health, Ljubljana, Slovenia,*Correspondence: Maja Sočan,
| | - Maja Mrzel
- National Institute of Public Health, Ljubljana, Slovenia
| | - Maja M. Lunar
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Ljubljana, Ljubljana, Slovenia
| | - Miša Korva
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Ljubljana, Ljubljana, Slovenia
| | - Alenka Štorman
- National Laboratory of Health, Environment, and Food, Maribor, Slovenia
| | - Katarina Prosenc
- National Laboratory of Health, Environment, and Food, Maribor, Slovenia
| | - Sandra Janežič
- National Laboratory of Health, Environment, and Food, Maribor, Slovenia
| | | | - Tina Zupanič
- National Institute of Public Health, Ljubljana, Slovenia
| | - Mario Poljak
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Ljubljana, Ljubljana, Slovenia
| | - Tatjana Avšič-Županc
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Ljubljana, Ljubljana, Slovenia
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23
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Jessen R, Nielsen L, Larsen NB, Cohen AS, Gunalan V, Marving E, Alfaro-Núñez A, Polacek C, Fomsgaard A, Spiess K. A RT-qPCR system using a degenerate probe for specific identification and differentiation of SARS-CoV-2 Omicron (B.1.1.529) variants of concern. PLoS One 2022; 17:e0274889. [PMID: 36197885 PMCID: PMC9534396 DOI: 10.1371/journal.pone.0274889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 09/06/2022] [Indexed: 11/17/2022] Open
Abstract
Fast surveillance strategies are needed to control the spread of new emerging SARS-CoV-2 variants and gain time for evaluation of their pathogenic potential. This was essential for the Omicron variant (B.1.1.529) that replaced the Delta variant (B.1.617.2) and is currently the dominant SARS-CoV-2 variant circulating worldwide. RT-qPCR strategies complement whole genome sequencing, especially in resource lean countries, but mutations in the targeting primer and probe sequences of new emerging variants can lead to a failure of the existing RT-qPCRs. Here, we introduced an RT-qPCR platform for detecting the Delta- and the Omicron variant simultaneously using a degenerate probe targeting the key ΔH69/V70 mutation in the spike protein. By inclusion of the L452R mutation into the RT-qPCR platform, we could detect not only the Delta and the Omicron variants, but also the Omicron sub-lineages BA.1, BA.2 and BA.4/BA.5. The RT-qPCR platform was validated in small- and large-scale. It can easily be incorporated for continued monitoring of Omicron sub-lineages, and offers a fast adaption strategy of existing RT-qPCRs to detect new emerging SARS-CoV-2 variants using degenerate probes.
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Affiliation(s)
- Randi Jessen
- Test Center Denmark, Statens Serum Institut, Copenhagen, Denmark
| | - Line Nielsen
- Test Center Denmark, Statens Serum Institut, Copenhagen, Denmark
| | | | | | - Vithiagaran Gunalan
- Department of Virus and Microbiological Special Diagnostics, Statens Serum Institut, Copenhagen, Denmark
| | - Ellinor Marving
- Department of Virus and Microbiological Special Diagnostics, Statens Serum Institut, Copenhagen, Denmark
| | | | - Charlotta Polacek
- Department of Virus and Microbiological Special Diagnostics, Statens Serum Institut, Copenhagen, Denmark
| | | | - Anders Fomsgaard
- Department of Virus and Microbiological Special Diagnostics, Statens Serum Institut, Copenhagen, Denmark
| | - Katja Spiess
- Department of Virus and Microbiological Special Diagnostics, Statens Serum Institut, Copenhagen, Denmark
- * E-mail:
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24
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Freire-Neto FP, Teixeira DG, da Cunha DCS, Morais IC, Tavares CPM, Gurgel GP, Medeiros SDN, dos Santos DC, Sales ADO, Jeronimo SMB. SARS-CoV-2 reinfections with BA.1 (Omicron) variant among fully vaccinated individuals in northeastern Brazil. PLoS Negl Trop Dis 2022; 16:e0010337. [PMID: 36191040 PMCID: PMC9560550 DOI: 10.1371/journal.pntd.0010337] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 10/13/2022] [Accepted: 08/31/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The first case of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection in Rio Grande do Norte, northeastern Brazil, was diagnosed on March 12, 2020; thereafter, multiple surges of infection occurred, similar to what was seen elsewhere. These surges were mostly due to SARS-CoV-2 mutations leading to emergence of variants of concern (VoC). The introduction of new VoCs in a population previously exposed to SARS-CoV-2 or after vaccination has been a challenge to understanding the kinetics of the protective immune response against this virus. The aim of this study was to investigate the outbreak of SARS-CoV-2 reinfections observed in mid-January 2022 in Rio Grande do Norte state, Brazil. It describes the clinical and genomic characteristics of nine cases of reinfection that occurred coincident with the introduction of the omicron variant. METHODOLOGY/PRINCIPAL FINDINGS Of a total of 172,965 individuals with upper respiratory symptoms tested for SARS-CoV-2, between March 2020 through mid-February 2022, 58,097 tested positive. Of those, 444 had documented a second SARS-CoV-2 infection and nine reinfection cases were selected for sequencing. Genomic analysis revealed that virus lineages diverged between primary infections and the reinfections, with the latter caused by the Omicron (BA.1) variant among individuals fully vaccinated against SARS-CoV-2. CONCLUSIONS/SIGNIFICANCE Our findings suggest that the Omicron variant is able to evade both natural and vaccine-induced immunity, since all nine cases had prior natural infection and, in addition, were fully vaccinated, emphasizing the need to develop effective blocking vaccines.
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Affiliation(s)
- Francisco P. Freire-Neto
- Instituto de Medicina Tropical do Rio Grande do Norte, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Departmento de Bioquímica, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
- Getúlio Sales Diagnósticos, Natal, Rio Grande do Norte, Brazil
| | - Diego G. Teixeira
- Instituto de Medicina Tropical do Rio Grande do Norte, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Dayse C. S. da Cunha
- Instituto de Medicina Tropical do Rio Grande do Norte, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Ingryd C. Morais
- Instituto de Medicina Tropical do Rio Grande do Norte, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Celisa P. M. Tavares
- Instituto de Medicina Tropical do Rio Grande do Norte, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | | | | | - David C. dos Santos
- Instituto Metrópole Digital, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | | | - Selma M. B. Jeronimo
- Instituto de Medicina Tropical do Rio Grande do Norte, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Departmento de Bioquímica, Centro de Biociências, Universidade Federal do Rio Grande Norte, Natal, Rio Grande do Norte, Brazil
- Instituto Nacional de Ciência e Tecnologia de Doenças Tropicais, Natal, Rio Grande do Norte, Brazil
- * E-mail:
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25
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Freire-Neto FP, Teixeira DG, da Cunha DCS, Morais IC, Tavares CPM, Gurgel GP, Medeiros SDN, Santos DCD, Sales ADO, Jeronimo SMB. SARS-CoV-2 reinfections with BA.1 (Omicron) variant among fully vaccinated individuals in northeastern Brazil. PLoS Negl Trop Dis 2022; 16:e0010337. [PMID: 36191040 DOI: 10.1101/2022.04.08.22272726] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 10/13/2022] [Accepted: 08/31/2022] [Indexed: 05/23/2023] Open
Abstract
BACKGROUND The first case of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection in Rio Grande do Norte, northeastern Brazil, was diagnosed on March 12, 2020; thereafter, multiple surges of infection occurred, similar to what was seen elsewhere. These surges were mostly due to SARS-CoV-2 mutations leading to emergence of variants of concern (VoC). The introduction of new VoCs in a population previously exposed to SARS-CoV-2 or after vaccination has been a challenge to understanding the kinetics of the protective immune response against this virus. The aim of this study was to investigate the outbreak of SARS-CoV-2 reinfections observed in mid-January 2022 in Rio Grande do Norte state, Brazil. It describes the clinical and genomic characteristics of nine cases of reinfection that occurred coincident with the introduction of the omicron variant. METHODOLOGY/PRINCIPAL FINDINGS Of a total of 172,965 individuals with upper respiratory symptoms tested for SARS-CoV-2, between March 2020 through mid-February 2022, 58,097 tested positive. Of those, 444 had documented a second SARS-CoV-2 infection and nine reinfection cases were selected for sequencing. Genomic analysis revealed that virus lineages diverged between primary infections and the reinfections, with the latter caused by the Omicron (BA.1) variant among individuals fully vaccinated against SARS-CoV-2. CONCLUSIONS/SIGNIFICANCE Our findings suggest that the Omicron variant is able to evade both natural and vaccine-induced immunity, since all nine cases had prior natural infection and, in addition, were fully vaccinated, emphasizing the need to develop effective blocking vaccines.
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Affiliation(s)
- Francisco P Freire-Neto
- Instituto de Medicina Tropical do Rio Grande do Norte, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Departmento de Bioquímica, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
- Getúlio Sales Diagnósticos, Natal, Rio Grande do Norte, Brazil
| | - Diego G Teixeira
- Instituto de Medicina Tropical do Rio Grande do Norte, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Dayse C S da Cunha
- Instituto de Medicina Tropical do Rio Grande do Norte, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Ingryd C Morais
- Instituto de Medicina Tropical do Rio Grande do Norte, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Celisa P M Tavares
- Instituto de Medicina Tropical do Rio Grande do Norte, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | | | | | - David C Dos Santos
- Instituto Metrópole Digital, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | | | - Selma M B Jeronimo
- Instituto de Medicina Tropical do Rio Grande do Norte, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Departmento de Bioquímica, Centro de Biociências, Universidade Federal do Rio Grande Norte, Natal, Rio Grande do Norte, Brazil
- Instituto Nacional de Ciência e Tecnologia de Doenças Tropicais, Natal, Rio Grande do Norte, Brazil
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26
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Khatamzas E, Antwerpen MH, Rehn A, Graf A, Hellmuth JC, Hollaus A, Mohr AW, Gaitzsch E, Weiglein T, Georgi E, Scherer C, Stecher SS, Gruetzner S, Blum H, Krebs S, Reischer A, Leutbecher A, Subklewe M, Dick A, Zange S, Girl P, Müller K, Weigert O, Hopfner KP, Stemmler HJ, von Bergwelt-Baildon M, Keppler OT, Wölfel R, Muenchhoff M, Moosmann A. Accumulation of mutations in antibody and CD8 T cell epitopes in a B cell depleted lymphoma patient with chronic SARS-CoV-2 infection. Nat Commun 2022; 13:5586. [PMID: 36151076 PMCID: PMC9508331 DOI: 10.1038/s41467-022-32772-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 08/15/2022] [Indexed: 11/29/2022] Open
Abstract
Antibodies against the spike protein of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) can drive adaptive evolution in immunocompromised patients with chronic infection. Here we longitudinally analyze SARS-CoV-2 sequences in a B cell-depleted, lymphoma patient with chronic, ultimately fatal infection, and identify three mutations in the spike protein that dampen convalescent plasma-mediated neutralization of SARS-CoV-2. Additionally, four mutations emerge in non-spike regions encoding three CD8 T cell epitopes, including one nucleoprotein epitope affected by two mutations. Recognition of each mutant peptide by CD8 T cells from convalescent donors is reduced compared to its ancestral peptide, with additive effects resulting from double mutations. Querying public SARS-CoV-2 sequences shows that these mutations have independently emerged as homoplasies in circulating lineages. Our data thus suggest that potential impacts of CD8 T cells on SARS-CoV-2 mutations, at least in those with humoral immunodeficiency, warrant further investigation to inform on vaccine design. SARS-CoV-2 mutations associated with the escape from antibody-mediated neutralization have been widely reported. Here, in a patient with defective antibody responses, the authors find a potential association between SARS-CoV-2 mutations and CD8 T alterations to implicate possible contributions of CD8 T cells in evasion of SARS-CoV-2 from host immunity.
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Affiliation(s)
- Elham Khatamzas
- Department of Medicine III, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany. .,Division of Infectious Diseases and Tropical Medicine, Center for Infectious Diseases, Heidelberg Hospital, Heidelberg, Germany. .,COVID-19 Registry of the LMU Munich (CORKUM), University Hospital, Ludwig-Maximilians University Munich, Munich, Germany.
| | - Markus H Antwerpen
- Bundeswehr, Institute of Microbiology Munich, Munich, Germany.,German Center for Infection Research (DZIF), partner site Munich, Munich, Germany
| | - Alexandra Rehn
- Bundeswehr, Institute of Microbiology Munich, Munich, Germany.,German Center for Infection Research (DZIF), partner site Munich, Munich, Germany
| | - Alexander Graf
- Laboratory for Functional Genome Analysis, Gene Center, Ludwig-Maximilians University Munich, Munich, Germany
| | - Johannes Christian Hellmuth
- Department of Medicine III, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany.,COVID-19 Registry of the LMU Munich (CORKUM), University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Alexandra Hollaus
- Department of Medicine III, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany.,German Center for Infection Research (DZIF), partner site Munich, Munich, Germany
| | - Anne-Wiebe Mohr
- Department of Medicine III, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany.,German Center for Infection Research (DZIF), partner site Munich, Munich, Germany
| | - Erik Gaitzsch
- Department of Medicine III, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Tobias Weiglein
- Department of Medicine III, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Enrico Georgi
- Bundeswehr, Institute of Microbiology Munich, Munich, Germany.,German Center for Infection Research (DZIF), partner site Munich, Munich, Germany
| | - Clemens Scherer
- COVID-19 Registry of the LMU Munich (CORKUM), University Hospital, Ludwig-Maximilians University Munich, Munich, Germany.,Department of Medicine I, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Stephanie-Susanne Stecher
- Department of Medicine II, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Stefanie Gruetzner
- Institute for Transfusion Medicine and Haemostasis, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Helmut Blum
- Laboratory for Functional Genome Analysis, Gene Center, Ludwig-Maximilians University Munich, Munich, Germany
| | - Stefan Krebs
- Laboratory for Functional Genome Analysis, Gene Center, Ludwig-Maximilians University Munich, Munich, Germany
| | - Anna Reischer
- Department of Medicine III, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Alexandra Leutbecher
- Department of Medicine III, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Marion Subklewe
- Department of Medicine III, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Andrea Dick
- Laboratory for Immunogenetics, University of Munich, LMU, Munich, Germany
| | - Sabine Zange
- Bundeswehr, Institute of Microbiology Munich, Munich, Germany.,German Center for Infection Research (DZIF), partner site Munich, Munich, Germany
| | - Philipp Girl
- Bundeswehr, Institute of Microbiology Munich, Munich, Germany.,German Center for Infection Research (DZIF), partner site Munich, Munich, Germany
| | - Katharina Müller
- Bundeswehr, Institute of Microbiology Munich, Munich, Germany.,German Center for Infection Research (DZIF), partner site Munich, Munich, Germany
| | - Oliver Weigert
- Department of Medicine III, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany.,German Cancer Consortium (DKTK), Munich, Germany
| | - Karl-Peter Hopfner
- Gene Center and Department of Biochemistry, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Hans-Joachim Stemmler
- Department of Medicine III, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Michael von Bergwelt-Baildon
- Department of Medicine III, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany.,COVID-19 Registry of the LMU Munich (CORKUM), University Hospital, Ludwig-Maximilians University Munich, Munich, Germany.,German Cancer Consortium (DKTK), Munich, Germany
| | - Oliver T Keppler
- COVID-19 Registry of the LMU Munich (CORKUM), University Hospital, Ludwig-Maximilians University Munich, Munich, Germany.,German Center for Infection Research (DZIF), partner site Munich, Munich, Germany.,Max von Pettenkofer Institute & Gene Center, Virology, Faculty of Medicine, Ludwig-Maximilians University, Munich, Germany
| | - Roman Wölfel
- Bundeswehr, Institute of Microbiology Munich, Munich, Germany.,German Center for Infection Research (DZIF), partner site Munich, Munich, Germany
| | - Maximilian Muenchhoff
- COVID-19 Registry of the LMU Munich (CORKUM), University Hospital, Ludwig-Maximilians University Munich, Munich, Germany.,German Center for Infection Research (DZIF), partner site Munich, Munich, Germany.,Max von Pettenkofer Institute & Gene Center, Virology, Faculty of Medicine, Ludwig-Maximilians University, Munich, Germany
| | - Andreas Moosmann
- Department of Medicine III, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany.,German Center for Infection Research (DZIF), partner site Munich, Munich, Germany
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27
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Lyngse FP, Mortensen LH, Denwood MJ, Christiansen LE, Møller CH, Skov RL, Spiess K, Fomsgaard A, Lassaunière R, Rasmussen M, Stegger M, Nielsen C, Sieber RN, Cohen AS, Møller FT, Overvad M, Mølbak K, Krause TG, Kirkeby CT. Household transmission of the SARS-CoV-2 Omicron variant in Denmark. Nat Commun 2022; 13:5573. [PMID: 36151099 PMCID: PMC9508106 DOI: 10.1038/s41467-022-33328-3] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 09/13/2022] [Indexed: 01/07/2023] Open
Abstract
In late 2021, the Omicron SARS-CoV-2 variant overtook the previously dominant Delta variant, but the extent to which this transition was driven by immune evasion or a change in the inherent transmissibility is currently unclear. We estimate SARS-CoV-2 transmission within Danish households during December 2021. Among 26,675 households (8,568 with the Omicron VOC), we identified 14,140 secondary infections within a 1-7-day follow-up period. The secondary attack rate was 29% and 21% in households infected with Omicron and Delta, respectively. For Omicron, the odds of infection were 1.10 (95%-CI: 1.00-1.21) times higher for unvaccinated, 2.38 (95%-CI: 2.23-2.54) times higher for fully vaccinated and 3.20 (95%-CI: 2.67-3.83) times higher for booster-vaccinated contacts compared to Delta. We conclude that the transition from Delta to Omicron VOC was primarily driven by immune evasiveness and to a lesser extent an inherent increase in the basic transmissibility of the Omicron variant.
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Affiliation(s)
- Frederik Plesner Lyngse
- Department of Economics & Center for Economic Behavior and Inequality, University of Copenhagen, Øster Farimagsgade 5, DK-1353, Copenhagen K, Denmark. .,Danish Ministry of Health, Holbergsgade 6, DK-1057, Copenhagen K, Denmark. .,Statens Serum Institut, Artillerivej 5, DK-2300, Copenhagen S, Denmark.
| | - Laust Hvas Mortensen
- Statistics Denmark, Sejrøgade 11, DK-2100, Copenhagen, Denmark.,Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Øster Farimagsgade 5, DK-1353, Copenhagen K, Denmark
| | - Matthew J Denwood
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Grønnegårdsvej 8, DK-1870, Frederiksberg C, Copenhagen, Denmark
| | - Lasse Engbo Christiansen
- Department of Applied Mathematics and Computer Science, Dynamical Systems, Technical University of Denmark, Richard Petersens Plads, 324, DK-2800, Kgs. Lyngby, Denmark
| | | | - Robert Leo Skov
- Statens Serum Institut, Artillerivej 5, DK-2300, Copenhagen S, Denmark
| | - Katja Spiess
- Statens Serum Institut, Artillerivej 5, DK-2300, Copenhagen S, Denmark
| | - Anders Fomsgaard
- Statens Serum Institut, Artillerivej 5, DK-2300, Copenhagen S, Denmark
| | - Ria Lassaunière
- Statens Serum Institut, Artillerivej 5, DK-2300, Copenhagen S, Denmark
| | - Morten Rasmussen
- Statens Serum Institut, Artillerivej 5, DK-2300, Copenhagen S, Denmark
| | - Marc Stegger
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Artillerivej 5, DK-2300, Copenhagen S, Denmark
| | - Claus Nielsen
- Statens Serum Institut, Artillerivej 5, DK-2300, Copenhagen S, Denmark
| | - Raphael Niklaus Sieber
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Artillerivej 5, DK-2300, Copenhagen S, Denmark
| | | | | | - Maria Overvad
- Statens Serum Institut, Artillerivej 5, DK-2300, Copenhagen S, Denmark
| | - Kåre Mølbak
- Statens Serum Institut, Artillerivej 5, DK-2300, Copenhagen S, Denmark.,Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Grønnegårdsvej 8, DK-1870, Frederiksberg C, Copenhagen, Denmark
| | - Tyra Grove Krause
- Statens Serum Institut, Artillerivej 5, DK-2300, Copenhagen S, Denmark
| | - Carsten Thure Kirkeby
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Grønnegårdsvej 8, DK-1870, Frederiksberg C, Copenhagen, Denmark
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28
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Gorgels KMF, van Alphen LB, van der Veer BMJW, Hackert VH, Hensels AYJ, Heijer CDJD, Dingemans J, Savelkoul PHM, Hoebe CJPA. Increased transmissibility of SARS-CoV-2 alpha variant (B.1.1.7) in children: three large primary school outbreaks revealed by whole genome sequencing in the Netherlands. BMC Infect Dis 2022; 22:713. [PMID: 36038845 PMCID: PMC9421630 DOI: 10.1186/s12879-022-07623-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 06/07/2022] [Indexed: 11/18/2022] Open
Abstract
Background Variant of concern (VOC) SARS-CoV-2 alpha variant (B.1.1.7) was the dominant strain in the Netherlands between March 2021–June 2021. We describe three primary school outbreaks due to the alpha variant using whole genome sequencing with evidence of large-scale transmission among children, teachers and their household contacts. Method All outbreaks described were investigated by the South Limburg Public Health Service, the Netherlands. A case was defined as an individual with a real-time polymerase chain reaction test or antigen test positive for SARS-CoV-2. Whole genome sequencing was performed on random samples from at least one child and one teacher of each affected class. Results Peak attack rates in classes were 53%, 33% and 39%, respectively. Specific genotypes were identified for each school across a majority of affected classes. Attack rates were high among staff members, likely to promote staff-to-children transmission. Cases in some classes were limited to children, indicating child-to-child transmission. At 39%, the secondary attack rate (SAR) in household contacts of infected children was remarkably high, similar to SAR in household contacts of staff members (42%). SAR of household contacts of asymptomatic children was only 9%. Conclusion Our findings suggest increased transmissibility of the alpha variant in children compared to preceding non-VOC variants, consistent with a substantial rise in the incidence of cases observed in primary schools and children aged 5–12 since the alpha variant became dominant in March 2021. Lack of mandatory masking, insufficient ventilation and lack of physical distancing also probably contributed to the school outbreaks. The rise of the delta variant (B.1.617.2) since July 2021 which is estimated to be 55% more transmissible than the alpha variant, provides additional urgency to adequate infection prevention in school settings. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07623-9.
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Affiliation(s)
- Koen M F Gorgels
- Department of Sexual Health, Infectious Diseases and Environmental Health, South Limburg Public Health Service, PO Box 33, 6400 AA, Heerlen, The Netherlands.
| | - Lieke B van Alphen
- Department of Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre (MUMC+), P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - Brian M J W van der Veer
- Department of Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre (MUMC+), P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - Volker H Hackert
- Department of Sexual Health, Infectious Diseases and Environmental Health, South Limburg Public Health Service, PO Box 33, 6400 AA, Heerlen, The Netherlands.,Department of Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre (MUMC+), P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands.,Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Audrey Y J Hensels
- Department of Sexual Health, Infectious Diseases and Environmental Health, South Limburg Public Health Service, PO Box 33, 6400 AA, Heerlen, The Netherlands
| | - Casper D J den Heijer
- Department of Sexual Health, Infectious Diseases and Environmental Health, South Limburg Public Health Service, PO Box 33, 6400 AA, Heerlen, The Netherlands.,Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Jozef Dingemans
- Department of Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre (MUMC+), P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - Paul H M Savelkoul
- Department of Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre (MUMC+), P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - Christian J P A Hoebe
- Department of Sexual Health, Infectious Diseases and Environmental Health, South Limburg Public Health Service, PO Box 33, 6400 AA, Heerlen, The Netherlands.,Department of Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre (MUMC+), P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands.,Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
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29
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Yang D, Hansel DE, Curlin ME, Townes JM, Messer WB, Fan G, Qin X. Bimodal distribution pattern associated with the PCR cycle threshold (Ct) and implications in COVID-19 infections. Sci Rep 2022; 12:14544. [PMID: 36008543 PMCID: PMC9406279 DOI: 10.1038/s41598-022-18735-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 08/18/2022] [Indexed: 11/21/2022] Open
Abstract
SARS-CoV-2 is notable for its extremely high level of viral replication in respiratory epithelial cells, relative to other cell types. This may partially explain the high transmissibility and rapid global dissemination observed during the COVID-19 pandemic. Polymerase chain reaction (PCR) cycle threshold (Ct) number has been widely used as a proxy for viral load based on the inverse relationship between Ct number and amplifiable genome copies present in a sample. We examined two PCR platforms (Centers for Disease Control and Prevention 2019-nCoV Real-time RT-PCR, Integrated DNA Technologies; and TaqPath COVID-19 multi-plex combination kit, ThermoFisher Scientific) for their performance characteristics and Ct distribution patterns based on results generated from 208,947 clinical samples obtained between October 2020 and September 2021. From 14,231 positive tests, Ct values ranged from 8 to 39 and displayed a pronounced bimodal distribution. The bimodal distribution persisted when stratified by gender, age, and time period of sample collection during which different viral variants circulated. This finding may be a result of heterogeneity in disease progression or host response to infection irrespective of age, gender, or viral variants. Quantification of respiratory mucosal viral load may provide additional insight into transmission and clinical indicators helpful for infection control.
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Affiliation(s)
- Doris Yang
- Department of Pathology and Laboratory Medicine, Oregon Health & Science University School of Medicine, 3181 SW Sam Jackson Park Road, L-113, Portland, OR, 97239, USA
| | - Donna E Hansel
- Department of Pathology and Laboratory Medicine, Oregon Health & Science University School of Medicine, 3181 SW Sam Jackson Park Road, L-113, Portland, OR, 97239, USA
| | - Marcel E Curlin
- Department of Medicine, Division of Infectious Diseases, Oregon Health & Science University School of Medicine, Portland, OR, 97239, USA
| | - John M Townes
- Department of Medicine, Division of Infectious Diseases, Oregon Health & Science University School of Medicine, Portland, OR, 97239, USA
| | - William B Messer
- Department of Medicine, Division of Infectious Diseases, Oregon Health & Science University School of Medicine, Portland, OR, 97239, USA.,Department Molecular Microbiology and Immunology, Oregon Health & Science University School of Medicine, Portland, OR, 97239, USA
| | - Guang Fan
- Department of Pathology and Laboratory Medicine, Oregon Health & Science University School of Medicine, 3181 SW Sam Jackson Park Road, L-113, Portland, OR, 97239, USA
| | - Xuan Qin
- Department of Pathology and Laboratory Medicine, Oregon Health & Science University School of Medicine, 3181 SW Sam Jackson Park Road, L-113, Portland, OR, 97239, USA.
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30
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Sumner KM, Karron RA, Stockwell MS, Dawood FS, Stanford JB, Mellis A, Hacker E, Thind P, Castro MJE, Harris JP, Knoll MD, Schappell E, Hetrich MK, Duque J, Jeddy Z, Altunkaynak K, Poe B, Meece J, Stefanski E, Tong S, Lee JS, Dixon A, Veguilla V, Rolfes MA, Porucznik CA. Impact of age and symptom development on SARS-CoV-2 transmission in households with children—Maryland, New York, and Utah, August 2020–October 2021. Open Forum Infect Dis 2022; 9:ofac390. [PMID: 35991589 PMCID: PMC9384637 DOI: 10.1093/ofid/ofac390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/05/2022] [Indexed: 11/13/2022] Open
Abstract
ABSTRACT
Background
Households are common places for spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We investigated factors associated with household transmission and acquisition of SARS-CoV-2.
Methods
Households with children ages <18 years were enrolled into prospective, longitudinal cohorts and followed August 2020─August 2021 in Utah, September 2020─August 2021 in New York City, and November 2020─October 2021 in Maryland. Participants self-collected nasal swabs weekly and with onset of acute illness. Swabs were tested for SARS-CoV-2 using reverse-transcription polymerase chain reaction. We assessed factors associated with SARS-CoV-2 acquisition using a multi-level logistic regression adjusted for household size and clustering and SARS-CoV-2 transmission using a logistic regression adjusted for household size.
Results
Among 2,053 people (513 households) enrolled, 180 people (8.8%; in 76 households) tested positive for SARS-CoV-2. Compared to children <12y, odds of acquiring infection were lower for adults ≥18y (adjusted odds ratio[aOR]:0.34, 95% confidence interval[CI]:0.14–0.87); however, this may reflect vaccination status, which protected against SARS-CoV-2 acquisition (aOR:0.17, 95%CI:0.03–0.91). Odds of onward transmission was similar between symptomatic and asymptomatic primary cases (aOR:1.00, 95%CI:0.35–2.93) and did not differ by age (12–17vs. < 12y aOR:1.08, 95%CI:0.20–5.62; ≥18vs. < 12y aOR:1.70, 95%CI:0.52–5.83).
Conclusions
Adults had lower odds of acquiring SARS-CoV-2 compared to children, but this association might be influenced by COVID-19 vaccination, which was primarily available for adults and protective against infection. In contrast, all ages, regardless of symptoms and COVID-19 vaccination, had similar odds of transmitting SARS-CoV-2. Findings underscore the importance of SARS-CoV-2 mitigation measures for persons of all ages.
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Affiliation(s)
- Kelsey M Sumner
- Centers for Disease Control and Prevention COVID-19 Response , Atlanta, GA , USA
- Epidemic Intelligence Service, Centers for Disease Control and Prevention , Atlanta, GA , USA
| | - Ruth A Karron
- Center for Immunization Research, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University , Baltimore, MD , USA
| | - Melissa S Stockwell
- Division of Child and Adolescent Health, Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center , New York, NY , USA
- Department of Population and Family Health, Mailman School of Public Health, Columbia University Irving Medical Center , New York, NY , USA
| | - Fatimah S Dawood
- Centers for Disease Control and Prevention COVID-19 Response , Atlanta, GA , USA
| | - Joseph B Stanford
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine , Salt Lake City, UT , USA
| | - Alexandra Mellis
- Centers for Disease Control and Prevention COVID-19 Response , Atlanta, GA , USA
| | - Emily Hacker
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine , Salt Lake City, UT , USA
| | - Priyam Thind
- Division of Child and Adolescent Health, Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center , New York, NY , USA
| | - Maria Julia E Castro
- Division of Child and Adolescent Health, Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center , New York, NY , USA
| | - John Paul Harris
- Division of Child and Adolescent Health, Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center , New York, NY , USA
| | - Maria Deloria Knoll
- International Vaccine Access Center, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University , Baltimore, MD , USA
| | - Elizabeth Schappell
- Center for Immunization Research, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University , Baltimore, MD , USA
| | - Marissa K Hetrich
- International Vaccine Access Center, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University , Baltimore, MD , USA
| | | | | | | | | | - Jennifer Meece
- Marshfield Clinic Research Institute , Marshfield, WI , USA
| | | | - Suxiang Tong
- Centers for Disease Control and Prevention COVID-19 Response , Atlanta, GA , USA
| | - Justin S Lee
- Centers for Disease Control and Prevention COVID-19 Response , Atlanta, GA , USA
| | - Ashton Dixon
- Centers for Disease Control and Prevention COVID-19 Response , Atlanta, GA , USA
| | - Vic Veguilla
- Centers for Disease Control and Prevention COVID-19 Response , Atlanta, GA , USA
| | - Melissa A Rolfes
- Centers for Disease Control and Prevention COVID-19 Response , Atlanta, GA , USA
| | - Christina A Porucznik
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine , Salt Lake City, UT , USA
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Waltenburg MA, Whaley MJ, Chancey RJ, Donnelly MA, Chuey MR, Soto R, Schwartz NG, Chu VT, Sleweon S, McCormick DW, Uehara A, Retchless AC, Tong S, Folster JM, Petway M, Thornburg NJ, Drobeniuc J, Austin B, Hudziec MM, Stringer G, Albanese BA, Totten SE, Matzinger SR, Staples JE, Killerby ME, Hughes LJ, Matanock A, Beatty M, Tate JE, Kirking HL, Hsu CH. Household Transmission and Symptomology of Severe Acute Respiratory Syndrome Coronavirus 2 Alpha Variant among Children-California and Colorado, 2021. J Pediatr 2022; 247:29-37.e7. [PMID: 35447121 PMCID: PMC9015725 DOI: 10.1016/j.jpeds.2022.04.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/30/2022] [Accepted: 04/15/2022] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To assess the household secondary infection risk (SIR) of B.1.1.7 (Alpha) and non-Alpha lineages of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among children. STUDY DESIGN During January to April 2021, we prospectively followed households with a SARS-CoV-2 infection. We collected questionnaires, serial nasopharyngeal swabs for reverse transcription polymerase chain reaction testing and whole genome sequencing, and serial blood samples for serology testing. We calculated SIRs by primary case age (pediatric vs adult), household contact age, and viral lineage. We evaluated risk factors associated with transmission and described symptom profiles among children. RESULTS Among 36 households with pediatric primary cases, 21 (58%) had secondary infections. Among 91 households with adult primary cases, 51 (56%) had secondary infections. SIRs among pediatric and adult primary cases were 45% and 54%, respectively (OR, 0.79; 95% CI, 0.41-1.54). SIRs among pediatric primary cases with Alpha and non-Alpha lineage were 55% and 46%, respectively (OR, 1.52; 95% CI, 0.51-4.53). SIRs among pediatric and adult household contacts were 55% and 49%, respectively (OR, 1.01; 95% CI, 0.68-1.50). Among pediatric contacts, no significant differences in the odds of acquiring infection by demographic or household characteristics were observed. CONCLUSIONS Household transmission of SARS-CoV-2 from children and adult primary cases to household members was frequent. The risk of secondary infection was similar among child and adult household contacts. Among children, household transmission of SARS-CoV-2 and the risk of secondary infection was not influenced by lineage. Continued mitigation strategies (eg, masking, physical distancing, vaccination) are needed to protect at-risk groups regardless of virus lineage circulating in communities.
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Affiliation(s)
- Michelle A. Waltenburg
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA,Reprint requests: Michelle A. Waltenburg, DVM, MPH, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA 30329
| | - Melissa J. Whaley
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Rebecca J. Chancey
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Marisa A.P. Donnelly
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA
| | - Meagan R. Chuey
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA,County of San Diego Health and Human Services Agency, San Diego, CA
| | - Raymond Soto
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA
| | - Noah G. Schwartz
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA
| | - Victoria T. Chu
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA
| | - Sadia Sleweon
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - David W. McCormick
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA
| | - Anna Uehara
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Adam C. Retchless
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Suxiang Tong
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Jennifer M. Folster
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Marla Petway
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Natalie J. Thornburg
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Jan Drobeniuc
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Brett Austin
- County of San Diego Health and Human Services Agency, San Diego, CA
| | | | - Ginger Stringer
- Colorado Department of Public Health and Environment, Denver, CO
| | | | - Sarah E. Totten
- Colorado Department of Public Health and Environment, Denver, CO
| | | | - J. Erin Staples
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Marie E. Killerby
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Laura J. Hughes
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Almea Matanock
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Mark Beatty
- County of San Diego Health and Human Services Agency, San Diego, CA
| | - Jacqueline E. Tate
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Hannah L. Kirking
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Christopher H. Hsu
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
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32
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Corbisier P, Petrillo M, Marchini A, Querci M, Buttinger G, Bekliz M, Spiess K, Polacek C, Fomsgaard A, Van den Eede G. A qualitative RT-PCR assay for the specific identification of the SARS-CoV-2 B.1.1.529 (Omicron) Variant of Concern. J Clin Virol 2022; 152:105191. [PMID: 35640400 PMCID: PMC9126828 DOI: 10.1016/j.jcv.2022.105191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 05/11/2022] [Accepted: 05/22/2022] [Indexed: 11/22/2022]
Abstract
A one-step RT-PCR assay for the specific detection of SARS-CoV-2 Omicron. The assay was evaluated in silico, and validaded on synthetic RNA genomes and clinical samples. The analytical sensitivity and specificity of the assay allow the fast detection of SARS-CoV-2 Omicron even at low concentration level. In contrast to other RT-PCR assays based on the deletion 69-70, this assay is able to detect the Omicron lineage BA.1 but also the currently prevalent BA.2 lineage. The assay represents an advantageous alternative to sequencing or to the S gene target failure assays.
Objectives The aim of this study was to develop a RT-PCR assay for the specific detection of the SARS-CoV-2 Omicron Variant of Concern (VOC) as a rapid alternative to sequencing. Methods A RT-PCR was designed in silico and then validated using characterised clinical samples containing Omicron (both BA.1 and BA.2 lineages) and the Omicron synthetic RNA genome. As negative controls, SARS-CoV-2 positive clinical samples collected in May 2020, and synthetic RNA genomes of the isolate Wuhan Hu-1 and of the Alpha (B.1.1.7), Beta (B.1.351), Gamma (P.1), Kappa (B.1.617.1), Iota (B.1.526), Epsilon (B.1.429) and Delta (B.1.617.2) SARS-CoV-2 VOC were used. Results Experiments performed using as templates the synthetic RNA genomes demonstrate the high specificity of the PCR-method for the SARS-CoV-2 Omicron. Despite the synthetic RNAs were used at high copy numbers, specific signal was mainly detected with the Omicron synthetic genome. Only a non-specific late signal was detected using the Alpha variant genome, but these results were considered negligible as Alpha VOC has been replaced by the Delta and it is not circulating anymore in the world. Using our method, we confirmed the presence of Omicron on clinical samples containing this variant but not of other SARS-CoV-2 lineages. The method is highly sensitive and can detect up to 1 cp of the Omicron virus per µl. Conclusions The method presented here, in combination with other methods in use for detection of SARS-CoV-2, can be used for an early identification of Omicron.
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33
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Chu VT, Schwartz NG, Donnelly MAP, Chuey MR, Soto R, Yousaf AR, Schmitt-Matzen EN, Sleweon S, Ruffin J, Thornburg N, Harcourt JL, Tamin A, Kim G, Folster JM, Hughes LJ, Tong S, Stringer G, Albanese BA, Totten SE, Hudziec MM, Matzinger SR, Dietrich EA, Sheldon SW, Stous S, McDonald EC, Austin B, Beatty ME, Staples JE, Killerby ME, Hsu CH, Tate JE, Kirking HL, Matanock A. Comparison of Home Antigen Testing With RT-PCR and Viral Culture During the Course of SARS-CoV-2 Infection. JAMA Intern Med 2022; 182:701-709. [PMID: 35486394 PMCID: PMC9055515 DOI: 10.1001/jamainternmed.2022.1827] [Citation(s) in RCA: 63] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
IMPORTANCE As self-collected home antigen tests become widely available, a better understanding of their performance during the course of SARS-CoV-2 infection is needed. OBJECTIVE To evaluate the diagnostic performance of home antigen tests compared with reverse transcription-polymerase chain reaction (RT-PCR) and viral culture by days from illness onset, as well as user acceptability. DESIGN, SETTING, AND PARTICIPANTS This prospective cohort study was conducted from January to May 2021 in San Diego County, California, and metropolitan Denver, Colorado. The convenience sample included adults and children with RT-PCR-confirmed infection who used self-collected home antigen tests for 15 days and underwent at least 1 nasopharyngeal swab for RT-PCR, viral culture, and sequencing. EXPOSURES SARS-CoV-2 infection. MAIN OUTCOMES AND MEASURES The primary outcome was the daily sensitivity of home antigen tests to detect RT-PCR-confirmed cases. Secondary outcomes included the daily percentage of antigen test, RT-PCR, and viral culture results that were positive, and antigen test sensitivity compared with same-day RT-PCR and cultures. Antigen test use errors and acceptability were assessed for a subset of participants. RESULTS This study enrolled 225 persons with RT-PCR-confirmed infection (median [range] age, 29 [1-83] years; 117 female participants [52%]; 10 [4%] Asian, 6 [3%] Black or African American, 50 [22%] Hispanic or Latino, 3 [1%] Native Hawaiian or Other Pacific Islander, 145 [64%] White, and 11 [5%] multiracial individuals) who completed 3044 antigen tests and 642 nasopharyngeal swabs. Antigen test sensitivity was 50% (95% CI, 45%-55%) during the infectious period, 64% (95% CI, 56%-70%) compared with same-day RT-PCR, and 84% (95% CI, 75%-90%) compared with same-day cultures. Antigen test sensitivity peaked 4 days after illness onset at 77% (95% CI, 69%-83%). Antigen test sensitivity improved with a second antigen test 1 to 2 days later, particularly early in the infection. Six days after illness onset, antigen test result positivity was 61% (95% CI, 53%-68%). Almost all (216 [96%]) surveyed individuals reported that they would be more likely to get tested for SARS-CoV-2 infection if home antigen tests were available over the counter. CONCLUSIONS AND RELEVANCE The results of this cohort study of home antigen tests suggest that sensitivity for SARS-CoV-2 was moderate compared with RT-PCR and high compared with viral culture. The results also suggest that symptomatic individuals with an initial negative home antigen test result for SARS-CoV-2 infection should test again 1 to 2 days later because test sensitivity peaked several days after illness onset and improved with repeated testing.
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Affiliation(s)
- Victoria T Chu
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia.,Epidemic Intelligence Service, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Noah G Schwartz
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia.,Epidemic Intelligence Service, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Marisa A P Donnelly
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia.,Epidemic Intelligence Service, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Meagan R Chuey
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia.,Epidemic Intelligence Service, US Centers for Disease Control and Prevention, Atlanta, Georgia.,County of San Diego Health and Human Services Agency, San Diego, California
| | - Raymond Soto
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia.,Epidemic Intelligence Service, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Anna R Yousaf
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia.,Epidemic Intelligence Service, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Emily N Schmitt-Matzen
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia.,Epidemic Intelligence Service, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sadia Sleweon
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jasmine Ruffin
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Natalie Thornburg
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jennifer L Harcourt
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Azaibi Tamin
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Gimin Kim
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jennifer M Folster
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Laura J Hughes
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Suxiang Tong
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ginger Stringer
- Colorado Department of Public Health and Environment, Denver
| | | | - Sarah E Totten
- Colorado Department of Public Health and Environment, Denver
| | | | | | - Elizabeth A Dietrich
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sarah W Sheldon
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sarah Stous
- County of San Diego Health and Human Services Agency, San Diego, California
| | - Eric C McDonald
- County of San Diego Health and Human Services Agency, San Diego, California
| | - Brett Austin
- County of San Diego Health and Human Services Agency, San Diego, California
| | - Mark E Beatty
- County of San Diego Health and Human Services Agency, San Diego, California
| | - J Erin Staples
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Marie E Killerby
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Christopher H Hsu
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jacqueline E Tate
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Hannah L Kirking
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Almea Matanock
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
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Merhi G, Trotter AJ, de Oliveira Martins L, Koweyes J, Le-Viet T, Abou Naja H, Al Buaini M, Prosolek SJ, Alikhan NF, Lott M, Tohmeh T, Badran B, Jupp OJ, Gardner S, Felgate MW, Makin KA, Wilkinson JM, Stanley R, Sesay AK, Webber MA, Davidson RK, Ghosn N, Pallen M, Hasan H, Page AJ, Tokajian S. Replacement of the Alpha variant of SARS-CoV-2 by the Delta variant in Lebanon between April and June 2021. Microb Genom 2022; 8. [PMID: 35876490 PMCID: PMC9455693 DOI: 10.1099/mgen.0.000838] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
The COVID-19 pandemic continues to expand globally, with case numbers rising in many areas of the world, including the Eastern Mediterranean Region. Lebanon experienced its largest wave of COVID-19 infections from January to April 2021. Limited genomic surveillance was undertaken, with just 26 SARS-CoV-2 genomes available for this period, nine of which were from travellers from Lebanon detected by other countries. Additional genome sequencing is thus needed to allow surveillance of variants in circulation. In total, 905 SARS-CoV-2 genomes were sequenced using the ARTIC protocol. The genomes were derived from SARS-CoV-2-positive samples, selected retrospectively from the sentinel COVID-19 surveillance network, to capture diversity of location, sampling time, sex, nationality and age. Although 16 PANGO lineages were circulating in Lebanon in January 2021, by February there were just four, with the Alpha variant accounting for 97 % of samples. In the following 2 months, all samples contained the Alpha variant. However, this had changed dramatically by June and July 2021, when all samples belonged to the Delta variant. This study documents a ten-fold increase in the number of SARS-CoV-2 genomes available from Lebanon. The Alpha variant, first detected in the UK, rapidly swept through Lebanon, causing the country's largest wave to date, which peaked in January 2021. The Alpha variant was introduced to Lebanon multiple times despite travel restrictions, but the source of these introductions remains uncertain. The Delta variant was detected in Gambia in travellers from Lebanon in mid-May, suggesting community transmission in Lebanon several weeks before this variant was detected in the country. Prospective sequencing in June/July 2021 showed that the Delta variant had completely replaced the Alpha variant in under 6 weeks.
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Affiliation(s)
- Georgi Merhi
- Department of Natural Sciences, Lebanese American University, School of Arts and Sciences, Byblos, Lebanon
| | | | | | - Jad Koweyes
- Department of Natural Sciences, Lebanese American University, School of Arts and Sciences, Byblos, Lebanon
| | - Thanh Le-Viet
- Quadram Institute Bioscience, Norwich Research Park, Norwich, Norfolk, UK
| | - Hala Abou Naja
- Ministry of Public Health, Epidemiological Surveillance Program, Museum Square, Beirut, Lebanon
| | - Mona Al Buaini
- National Influenza Centre Research Laboratory, Rafic Hariri University Hospital, Beirut, Lebanon
| | - Sophie J Prosolek
- Quadram Institute Bioscience, Norwich Research Park, Norwich, Norfolk, UK
| | | | - Martin Lott
- Quadram Institute Bioscience, Norwich Research Park, Norwich, Norfolk, UK
| | - Tatiana Tohmeh
- Ministry of Public Health, Epidemiological Surveillance Program, Museum Square, Beirut, Lebanon
| | - Bassam Badran
- Laboratory of Molecular Biology and Cancer Immunology, Faculty of Sciences, Lebanese University, Lebanon
| | - Orla J Jupp
- University of East Anglia, Norwich, Norfolk, UK
| | | | | | | | | | - Rachael Stanley
- Norfolk and Norwich University Hospital, Norwich, Norfolk, UK
| | | | - Mark A Webber
- Quadram Institute Bioscience, Norwich Research Park, Norwich, Norfolk, UK.,University of East Anglia, Norwich, Norfolk, UK
| | | | - Nada Ghosn
- Ministry of Public Health, Epidemiological Surveillance Program, Museum Square, Beirut, Lebanon
| | - Mark Pallen
- Quadram Institute Bioscience, Norwich Research Park, Norwich, Norfolk, UK.,University of East Anglia, Norwich, Norfolk, UK
| | | | - Andrew J Page
- Quadram Institute Bioscience, Norwich Research Park, Norwich, Norfolk, UK
| | - Sima Tokajian
- Department of Natural Sciences, Lebanese American University, School of Arts and Sciences, Byblos, Lebanon
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35
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Corbisier P, Petrillo M, Marchini A, Querci M, Buttinger G, Bekliz M, Spiess K, Polacek C, Fomsgaard A, Van den Eede G. A qualitative RT-PCR assay for the specific identification of the SARS-CoV-2 B.1.1.529 (Omicron) Variant of Concern. J Clin Virol 2022. [PMID: 35640400 DOI: 10.5281/zenodo.5747872] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
OBJECTIVES The aim of this study was to develop a RT-PCR assay for the specific detection of the SARS-CoV-2 Omicron Variant of Concern (VOC) as a rapid alternative to sequencing. METHODS A RT-PCR was designed in silico and then validated using characterised clinical samples containing Omicron (both BA.1 and BA.2 lineages) and the Omicron synthetic RNA genome. As negative controls, SARS-CoV-2 positive clinical samples collected in May 2020, and synthetic RNA genomes of the isolate Wuhan Hu-1 and of the Alpha (B.1.1.7), Beta (B.1.351), Gamma (P.1), Kappa (B.1.617.1), Iota (B.1.526), Epsilon (B.1.429) and Delta (B.1.617.2) SARS-CoV-2 VOC were used. RESULTS Experiments performed using as templates the synthetic RNA genomes demonstrate the high specificity of the PCR-method for the SARS-CoV-2 Omicron. Despite the synthetic RNAs were used at high copy numbers, specific signal was mainly detected with the Omicron synthetic genome. Only a non-specific late signal was detected using the Alpha variant genome, but these results were considered negligible as Alpha VOC has been replaced by the Delta and it is not circulating anymore in the world. Using our method, we confirmed the presence of Omicron on clinical samples containing this variant but not of other SARS-CoV-2 lineages. The method is highly sensitive and can detect up to 1 cp of the Omicron virus per µl. CONCLUSIONS The method presented here, in combination with other methods in use for detection of SARS-CoV-2, can be used for an early identification of Omicron.
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Affiliation(s)
| | | | - Antonio Marchini
- European Commission, Joint Research Centre (JRC), Geel 2400, Belgium
| | | | - Gerhard Buttinger
- European Commission, Joint Research Centre (JRC), Geel 2400, Belgium
| | - Meriem Bekliz
- Geneva Centre for Emerging Viral Diseases, Department of Microbiology and Molecular Medicine, University of Geneva, University Hospital Geneva (HUG), Switzerland
| | - Katja Spiess
- Virus Research & Development lab, Department of Virus & Microbiologic Special Diagnostics, Statens Serum Institut, Denmark
| | - Charlotta Polacek
- Virus Research & Development lab, Department of Virus & Microbiologic Special Diagnostics, Statens Serum Institut, Denmark
| | - Anders Fomsgaard
- Virus Research & Development lab, Department of Virus & Microbiologic Special Diagnostics, Statens Serum Institut, Denmark
| | - Guy Van den Eede
- European Commission, Joint Research Centre (JRC), Geel 2400, Belgium
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36
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Effect of vaccination on household transmission of SARS-CoV-2 Delta variant of concern. Nat Commun 2022; 13:3764. [PMID: 35773247 PMCID: PMC9244879 DOI: 10.1038/s41467-022-31494-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 06/17/2022] [Indexed: 11/21/2022] Open
Abstract
Effective vaccines protect individuals by not only reducing the susceptibility to infection, but also reducing the infectiousness of breakthrough infections in vaccinated cases. To disentangle the vaccine effectiveness against susceptibility to infection (VES) and vaccine effectiveness against infectiousness (VEI), we took advantage of Danish national data comprising 24,693 households with a primary case of SARS-CoV-2 infection (Delta Variant of Concern, 2021) including 53,584 household contacts. In this setting, we estimated VES as 61% (95%-CI: 59-63), when the primary case was unvaccinated, and VEI as 31% (95%-CI: 26-36), when the household contact was unvaccinated. Furthermore, unvaccinated secondary cases with an infection exhibited a three-fold higher viral load compared to fully vaccinated secondary cases with a breakthrough infection. Our results demonstrate that vaccinations reduce susceptibility to infection as well as infectiousness, which should be considered by policy makers when seeking to understand the public health impact of vaccination against transmission of SARS-CoV-2. COVID-19 vaccines may reduce the susceptibility of an individual to infection and/or the infectiousness of breakthrough infections. Here, the authors use data from Denmark and estimate that vaccine effectiveness was 61% for susceptibility and 31% for infectiousness during a period of Delta variant dominance.
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Sun C, Xie C, Bu GL, Zhong LY, Zeng MS. Molecular characteristics, immune evasion, and impact of SARS-CoV-2 variants. Signal Transduct Target Ther 2022; 7:202. [PMID: 35764603 PMCID: PMC9240077 DOI: 10.1038/s41392-022-01039-2] [Citation(s) in RCA: 53] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 05/16/2022] [Accepted: 05/22/2022] [Indexed: 01/18/2023] Open
Abstract
The persistent COVID-19 pandemic since 2020 has brought an enormous public health burden to the global society and is accompanied by various evolution of the virus genome. The consistently emerging SARS-CoV-2 variants harboring critical mutations impact the molecular characteristics of viral proteins and display heterogeneous behaviors in immune evasion, transmissibility, and the clinical manifestation during infection, which differ each strain and endow them with distinguished features during populational spread. Several SARS-CoV-2 variants, identified as Variants of Concern (VOC) by the World Health Organization, challenged global efforts on COVID-19 control due to the rapid worldwide spread and enhanced immune evasion from current antibodies and vaccines. Moreover, the recent Omicron variant even exacerbated the global anxiety in the continuous pandemic. Its significant evasion from current medical treatment and disease control even highlights the necessity of combinatory investigation of the mutational pattern and influence of the mutations on viral dynamics against populational immunity, which would greatly facilitate drug and vaccine development and benefit the global public health policymaking. Hence in this review, we summarized the molecular characteristics, immune evasion, and impacts of the SARS-CoV-2 variants and focused on the parallel comparison of different variants in mutational profile, transmissibility and tropism alteration, treatment effectiveness, and clinical manifestations, in order to provide a comprehensive landscape for SARS-CoV-2 variant research.
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Affiliation(s)
- Cong Sun
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Department of Experimental Research, Sun Yat-sen University Cancer Center, Sun Yat-sen University, 510060, Guangzhou, China
| | - Chu Xie
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Department of Experimental Research, Sun Yat-sen University Cancer Center, Sun Yat-sen University, 510060, Guangzhou, China
| | - Guo-Long Bu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Department of Experimental Research, Sun Yat-sen University Cancer Center, Sun Yat-sen University, 510060, Guangzhou, China
| | - Lan-Yi Zhong
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Department of Experimental Research, Sun Yat-sen University Cancer Center, Sun Yat-sen University, 510060, Guangzhou, China
| | - Mu-Sheng Zeng
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Department of Experimental Research, Sun Yat-sen University Cancer Center, Sun Yat-sen University, 510060, Guangzhou, China. .,Guangdong-Hong Kong Joint Laboratory for RNA Medicine, 510060, Guangzhou, China.
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Identification of SARS-CoV-2 Variants of Concern Using Amplicon Next-Generation Sequencing. Microbiol Spectr 2022; 10:e0073622. [PMID: 35758686 PMCID: PMC9430688 DOI: 10.1128/spectrum.00736-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
COVID-19 is caused by SARS-CoV-2, several virulent variants of which have emerged since 2019. More than 529 million people have been infected, and at least 6 million have died. Our aim was to develop a fast, accurate, low-cost method for detecting and identifying newly emerging variants of concern (VOCs) that could pose a global threat. The 341-bp DNA sequence of a specific region of the SARS-CoV-2’s spike protein was amplified by a one-step PCR on RNA samples from 46 patients. The product was sequenced using next-generation sequencing (NGS). DNA sequences from seven genomes, the original Wuhan isolate and six different representative variants obtained from the GISAID website, were used as references. Complete whole-genome sequences from local isolates were also obtained from the GISAID website, and their RNA was used for comparison. We used an amplicon-based NGS method (termed VOC-NGS) for genotyping and successfully identified all 46 samples. Fifteen (32.6%) were like the original isolate. Twenty-seven were VOCs: nine (19.5%) Alpha, eight (19%) Delta, six (14%) Beta, and four (8.7%) Omicron. Two were variants of interest (VOI): one (2%) Kappa and one (2%) Zeta. Two samples were mixtures of two variants, one of Alpha and Beta and one of Alpha and Delta. The Spearman correlation between whole-genome sequencing (WGS) and VOC-NGS was significant (P < 0.001) with perfect agreement (Kappa = 0.916) for 36/38 (94.7%) samples with VOC-NGS detecting all the known VOCs. Genotyping by VOC-NGS enables rapid screening of high-throughput clinical samples that includes the identification of VOCs and mixtures of variants, at lower cost than WGS. IMPORTANCE The manuscript described SARS-Cov-2 genotyping by VOC-NGS, which presents an ideal balance of accuracy, rapidity, and cost for detecting and globally tracking VOCs and some VOI of SARS-CoV-2. A large number of clinical samples can be tested together. Rapid introduction of new mutations at a specific site of the spike protein necessitates efficient strain detection and identification to enable choice of treatment and the application of vaccination, as well as planning public health policy.
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Hoteit R, Yassine HM. Biological Properties of SARS-CoV-2 Variants: Epidemiological Impact and Clinical Consequences. Vaccines (Basel) 2022; 10:919. [PMID: 35746526 PMCID: PMC9230982 DOI: 10.3390/vaccines10060919] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/18/2022] [Accepted: 05/21/2022] [Indexed: 02/06/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a virus that belongs to the coronavirus family and is the cause of coronavirus disease 2019 (COVID-19). As of May 2022, it had caused more than 500 million infections and more than 6 million deaths worldwide. Several vaccines have been produced and tested over the last two years. The SARS-CoV-2 virus, on the other hand, has mutated over time, resulting in genetic variation in the population of circulating variants during the COVID-19 pandemic. It has also shown immune-evading characteristics, suggesting that vaccinations against these variants could be potentially ineffective. The purpose of this review article is to investigate the key variants of concern (VOCs) and mutations of the virus driving the current pandemic, as well as to explore the transmission rates of SARS-CoV-2 VOCs in relation to epidemiological factors and to compare the virus's transmission rate to that of prior coronaviruses. We examined and provided key information on SARS-CoV-2 VOCs in this study, including their transmissibility, infectivity rate, disease severity, affinity for angiotensin-converting enzyme 2 (ACE2) receptors, viral load, reproduction number, vaccination effectiveness, and vaccine breakthrough.
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Affiliation(s)
- Reem Hoteit
- Clinical Research Institute, Faculty of Medicine, American University of Beirut, Beirut 110236, Lebanon;
| | - Hadi M. Yassine
- Biomedical Research Center and College of Health Sciences-QU Health, Qatar University, Doha 2713, Qatar
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Le Neindre K, Couturier J, Schnuriger A, Jolivet S, Gouot C, Majerholc M, Supplisson P, Tan C, Perrier M, Lazare C, Morand-Joubert L, Barbut F. Environmental severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) contamination in hospital rooms during the first and third coronavirus disease 2019 (COVID-19) waves. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2022; 2:e82. [PMID: 36483393 PMCID: PMC9726484 DOI: 10.1017/ash.2022.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 06/17/2023]
Abstract
We investigated the frequency, distribution, and risk factors of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) environmental contamination around infected patients during the first and third wave of the coronavirus disease 2019 pandemic. The shedding of SARS-CoV-2 in rooms of infected patients was limited in our hospital setting.
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Affiliation(s)
- Killian Le Neindre
- Department of Environmental Microbiology, Saint-Antoine Hospital, Sorbonne Université, Assistance Publique – Hôpitaux de Paris (AP-HP), Paris, France
| | - Jeanne Couturier
- Infection Control Unit, Saint-Antoine Hospital, Sorbonne Université, Assistance Publique – Hôpitaux de Paris (AP-HP), Paris, France
| | - Aurélie Schnuriger
- Department of Virology, Saint-Antoine Tenon Trousseau Hospitals, Sorbonne Université, Assistance Publique – Hôpitaux de Paris (AP-HP), France
- Department of Virology, Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (iPLESP), Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Sarah Jolivet
- Infection Control Unit, Saint-Antoine Hospital, Sorbonne Université, Assistance Publique – Hôpitaux de Paris (AP-HP), Paris, France
| | - Cyril Gouot
- Infection Control Unit, Saint-Antoine Hospital, Sorbonne Université, Assistance Publique – Hôpitaux de Paris (AP-HP), Paris, France
| | - Mickaël Majerholc
- Infection Control Unit, Saint-Antoine Hospital, Sorbonne Université, Assistance Publique – Hôpitaux de Paris (AP-HP), Paris, France
| | - Pierre Supplisson
- Infection Control Unit, Saint-Antoine Hospital, Sorbonne Université, Assistance Publique – Hôpitaux de Paris (AP-HP), Paris, France
| | - Céline Tan
- Infection Control Unit, Saint-Antoine Hospital, Sorbonne Université, Assistance Publique – Hôpitaux de Paris (AP-HP), Paris, France
| | - Marine Perrier
- Department of Virology, Saint-Antoine Tenon Trousseau Hospitals, Sorbonne Université, Assistance Publique – Hôpitaux de Paris (AP-HP), France
| | - Christelle Lazare
- Department of Environmental Microbiology, Saint-Antoine Hospital, Sorbonne Université, Assistance Publique – Hôpitaux de Paris (AP-HP), Paris, France
| | - Laurence Morand-Joubert
- Department of Virology, Saint-Antoine Tenon Trousseau Hospitals, Sorbonne Université, Assistance Publique – Hôpitaux de Paris (AP-HP), France
- Department of Virology, Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (iPLESP), Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Frédéric Barbut
- Department of Environmental Microbiology, Saint-Antoine Hospital, Sorbonne Université, Assistance Publique – Hôpitaux de Paris (AP-HP), Paris, France
- Infection Control Unit, Saint-Antoine Hospital, Sorbonne Université, Assistance Publique – Hôpitaux de Paris (AP-HP), Paris, France
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Chaguza C, Coppi A, Earnest R, Ferguson D, Kerantzas N, Warner F, Young HP, Breban MI, Billig K, Koch RT, Pham K, Kalinich CC, Ott IM, Fauver JR, Hahn AM, Tikhonova IR, Castaldi C, De Kumar B, Pettker CM, Warren JL, Weinberger DM, Landry ML, Peaper DR, Schulz W, Vogels CBF, Grubaugh ND. Rapid emergence of SARS-CoV-2 Omicron variant is associated with an infection advantage over Delta in vaccinated persons. MED 2022; 3:325-334.e4. [PMID: 35399324 PMCID: PMC8983481 DOI: 10.1016/j.medj.2022.03.010] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 03/25/2021] [Accepted: 03/29/2022] [Indexed: 11/30/2022]
Abstract
Background The SARS-CoV-2 Omicron variant became a global concern due to its rapid spread and displacement of the dominant Delta variant. We hypothesized that part of Omicron's rapid rise was based on its increased ability to cause infections in persons that are vaccinated compared to Delta. Methods We analyzed nasal swab PCR tests for samples collected between December 12 and 16, 2021, in Connecticut when the proportion of Delta and Omicron variants was relatively equal. We used the spike gene target failure (SGTF) to classify probable Delta and Omicron infections. We fitted an exponential curve to the estimated infections to determine the doubling times for each variant. We compared the test positivity rates for each variant by vaccination status, number of doses, and vaccine manufacturer. Generalized linear models were used to assess factors associated with odds of infection with each variant among persons testing positive for SARS-CoV-2. Findings For infections with high virus copies (Ct < 30) among vaccinated persons, we found higher odds that they were infected with Omicron compared to Delta, and that the odds increased with increased number of vaccine doses. Compared to unvaccinated persons, we found significant reduction in Delta positivity rates after two (43.4%-49.1%) and three vaccine doses (81.1%), while we only found a significant reduction in Omicron positivity rates after three doses (62.3%). Conclusion The rapid rise in Omicron infections was likely driven by Omicron's escape from vaccine-induced immunity. Funding This work was supported by the Centers for Disease Control and Prevention (CDC).
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Affiliation(s)
- Chrispin Chaguza
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Andreas Coppi
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, CT, USA
| | - Rebecca Earnest
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - David Ferguson
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, CT, USA
| | - Nicholas Kerantzas
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, CT, USA
| | - Frederick Warner
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, CT, USA
| | - H Patrick Young
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, CT, USA
| | - Mallery I Breban
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Kendall Billig
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Robert Tobias Koch
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Kien Pham
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Chaney C Kalinich
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Isabel M Ott
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Joseph R Fauver
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
- College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Anne M Hahn
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Irina R Tikhonova
- Yale Center for Genome Analysis, Yale University, New Haven, CT, USA
| | | | - Bony De Kumar
- Yale Center for Genome Analysis, Yale University, New Haven, CT, USA
| | - Christian M Pettker
- Quality and Safety, Yale New Haven Health, New Haven, CT, USA
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA
| | - Joshua L Warren
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - Daniel M Weinberger
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Marie L Landry
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA
- Section of Infectious Diseases, Department of Medicine, Yale School of Medicine, New Haven, CT, USA
- Clinical Virology Laboratory, Yale New Haven Hospital, New Haven, CT, USA
| | - David R Peaper
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Wade Schulz
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, CT, USA
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Chantal B F Vogels
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Nathan D Grubaugh
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
- Department of Ecology and Evolutionary Biology, Yale University, New Haven, CT, USA
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42
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Chaguza C, Coppi A, Earnest R, Ferguson D, Kerantzas N, Warner F, Young HP, Breban MI, Billig K, Koch RT, Pham K, Kalinich CC, Ott IM, Fauver JR, Hahn AM, Tikhonova IR, Castaldi C, De Kumar B, Pettker CM, Warren JL, Weinberger DM, Landry ML, Peaper DR, Schulz W, Vogels CBF, Grubaugh ND. Rapid emergence of SARS-CoV-2 Omicron variant is associated with an infection advantage over Delta in vaccinated persons. MED 2022; 3:325-334.e4. [PMID: 35399324 DOI: 10.1101/2022.01.22.22269660] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 03/25/2021] [Accepted: 03/29/2022] [Indexed: 05/22/2023]
Abstract
BACKGROUND The SARS-CoV-2 Omicron variant became a global concern due to its rapid spread and displacement of the dominant Delta variant. We hypothesized that part of Omicron's rapid rise was based on its increased ability to cause infections in persons that are vaccinated compared to Delta. METHODS We analyzed nasal swab PCR tests for samples collected between December 12 and 16, 2021, in Connecticut when the proportion of Delta and Omicron variants was relatively equal. We used the spike gene target failure (SGTF) to classify probable Delta and Omicron infections. We fitted an exponential curve to the estimated infections to determine the doubling times for each variant. We compared the test positivity rates for each variant by vaccination status, number of doses, and vaccine manufacturer. Generalized linear models were used to assess factors associated with odds of infection with each variant among persons testing positive for SARS-CoV-2. FINDINGS For infections with high virus copies (Ct < 30) among vaccinated persons, we found higher odds that they were infected with Omicron compared to Delta, and that the odds increased with increased number of vaccine doses. Compared to unvaccinated persons, we found significant reduction in Delta positivity rates after two (43.4%-49.1%) and three vaccine doses (81.1%), while we only found a significant reduction in Omicron positivity rates after three doses (62.3%). CONCLUSION The rapid rise in Omicron infections was likely driven by Omicron's escape from vaccine-induced immunity. FUNDING This work was supported by the Centers for Disease Control and Prevention (CDC).
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Affiliation(s)
- Chrispin Chaguza
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Andreas Coppi
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, CT, USA
| | - Rebecca Earnest
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - David Ferguson
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, CT, USA
| | - Nicholas Kerantzas
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, CT, USA
| | - Frederick Warner
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, CT, USA
| | - H Patrick Young
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, CT, USA
| | - Mallery I Breban
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Kendall Billig
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Robert Tobias Koch
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Kien Pham
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Chaney C Kalinich
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Isabel M Ott
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Joseph R Fauver
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
- College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Anne M Hahn
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Irina R Tikhonova
- Yale Center for Genome Analysis, Yale University, New Haven, CT, USA
| | | | - Bony De Kumar
- Yale Center for Genome Analysis, Yale University, New Haven, CT, USA
| | - Christian M Pettker
- Quality and Safety, Yale New Haven Health, New Haven, CT, USA
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA
| | - Joshua L Warren
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - Daniel M Weinberger
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Marie L Landry
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA
- Section of Infectious Diseases, Department of Medicine, Yale School of Medicine, New Haven, CT, USA
- Clinical Virology Laboratory, Yale New Haven Hospital, New Haven, CT, USA
| | - David R Peaper
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Wade Schulz
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, CT, USA
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Chantal B F Vogels
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Nathan D Grubaugh
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
- Department of Ecology and Evolutionary Biology, Yale University, New Haven, CT, USA
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SARS-CoV-2 Variants – Evolution, Spike Protein, and Vaccines. Biomed J 2022; 45:573-579. [PMID: 35526825 PMCID: PMC9072773 DOI: 10.1016/j.bj.2022.04.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 04/09/2022] [Accepted: 04/29/2022] [Indexed: 12/11/2022] Open
Abstract
Despite the rising natural and vaccines mediated immunity, several countries have experienced a resurgence of the Coronavirus disease of 2019 (COVID-19) due to the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants. From Alpha to Omicron, the variants of concern (VOC) have evolved several spike protein mutations that may have an impact on virus characteristics, such as transmissibility and antigenicity. In this review, we describe the evolution of SARS-CoV-2, summarize current knowledge of epidemiological and clinical features of the variants, and discuss the response strategies in terms of vaccines to reduce the burden of COVID-19.
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44
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Braeye T, Catteau L, Brondeel R, van Loenhout JAF, Proesmans K, Cornelissen L, Van Oyen H, Stouten V, Hubin P, Billuart M, Djiena A, Mahieu R, Hammami N, Van Cauteren D, Wyndham-Thomas C. Vaccine effectiveness against onward transmission of SARS-CoV2-infection by variant of concern and time since vaccination, Belgian contact tracing, 2021. Vaccine 2022; 40:3027-3037. [PMID: 35459558 PMCID: PMC9001203 DOI: 10.1016/j.vaccine.2022.04.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 04/04/2022] [Accepted: 04/05/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND During the first half of 2021, we observed high vaccine effectiveness (VE) against SARS-CoV2-infection. The replacement of the alpha-'variant of concern' (VOC) by the delta-VOC and uncertainty about the time course of immunity called for a re-assessment. METHODS We estimated VE against transmission of infection (VET) from Belgian contact tracing data for high-risk exposure contacts between 26/01/2021 and 14/12/2021 by susceptibility (VEs) and infectiousness of breakthrough cases (VEi) for a complete schedule of Ad26.COV2.S, ChAdOx1, BNT162b2, mRNA-1273 as well as infection-acquired and hybrid immunity. We used a multilevel Bayesian model and adjusted for personal characteristics (age, sex, household), background exposure, calendar week, VOC and time since immunity conferring-event. FINDINGS VET-estimates were higher for mRNA-vaccines, over 90%, compared to viral vector vaccines: 66% and 80% for Ad26COV2.S and ChAdOx1 respectively (Alpha, 0-50 days after vaccination). Delta was associated with a 40% increase in odds of transmission and a decrease of VEs (72-64%) and especially of VEi (71-46% for BNT162b2). Infection-acquired and hybrid immunity were less affected by Delta. Waning further reduced VET-estimates: from 81% to 63% for BNT162b2 (Delta, 150-200 days after vaccination). We observed lower initial VEi in the age group 65-84 years (32% vs 46% in the age group 45-64 years for BNT162b2) and faster waning. Hybrid immunity waned slower than vaccine-induced immunity. INTERPRETATION VEi and VEs-estimates, while remaining significant, were reduced by Delta and waned over time. We observed faster waning in the oldest age group. We should seek to improve vaccine-induced protection in older persons and those vaccinated with viral-vector vaccines.
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Affiliation(s)
- Toon Braeye
- Department of Epidemiology and Public Health, Sciensano, Juliette Wytsmansstraat 14, 1000 Brussel, Belgium.
| | - Lucy Catteau
- Department of Epidemiology and Public Health, Sciensano, Juliette Wytsmansstraat 14, 1000 Brussel, Belgium
| | - Ruben Brondeel
- Department of Epidemiology and Public Health, Sciensano, Juliette Wytsmansstraat 14, 1000 Brussel, Belgium
| | - Joris A F van Loenhout
- Department of Epidemiology and Public Health, Sciensano, Juliette Wytsmansstraat 14, 1000 Brussel, Belgium
| | - Kristiaan Proesmans
- Department of Epidemiology and Public Health, Sciensano, Juliette Wytsmansstraat 14, 1000 Brussel, Belgium
| | - Laura Cornelissen
- Department of Epidemiology and Public Health, Sciensano, Juliette Wytsmansstraat 14, 1000 Brussel, Belgium
| | - Herman Van Oyen
- Department of Epidemiology and Public Health, Sciensano, Juliette Wytsmansstraat 14, 1000 Brussel, Belgium; Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, 9000 Gent, Belgium
| | - Veerle Stouten
- Department of Epidemiology and Public Health, Sciensano, Juliette Wytsmansstraat 14, 1000 Brussel, Belgium
| | - Pierre Hubin
- Department of Epidemiology and Public Health, Sciensano, Juliette Wytsmansstraat 14, 1000 Brussel, Belgium
| | - Matthieu Billuart
- Department of Epidemiology and Public Health, Sciensano, Juliette Wytsmansstraat 14, 1000 Brussel, Belgium
| | - Achille Djiena
- Agence pour une Vie de Qualité, Rue de la Rivelaine 11, 6061 Charleroi, Belgium
| | - Romain Mahieu
- Common Community Commission Brussels, Rue Belliard 71/1, 1040 Brussels, Belgium
| | - Naima Hammami
- Agency for Care and Health, Infection Prevention and Control, Flemish Community, Koningin Maria Hendrikaplein 70 bus 55, 9000 Gent, Belgium
| | - Dieter Van Cauteren
- Department of Epidemiology and Public Health, Sciensano, Juliette Wytsmansstraat 14, 1000 Brussel, Belgium
| | - Chloé Wyndham-Thomas
- Department of Epidemiology and Public Health, Sciensano, Juliette Wytsmansstraat 14, 1000 Brussel, Belgium
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Madewell ZJ, Yang Y, Longini IM, Halloran ME, Dean NE. Household Secondary Attack Rates of SARS-CoV-2 by Variant and Vaccination Status: An Updated Systematic Review and Meta-analysis. JAMA Netw Open 2022; 5:e229317. [PMID: 35482308 PMCID: PMC9051991 DOI: 10.1001/jamanetworkopen.2022.9317] [Citation(s) in RCA: 105] [Impact Index Per Article: 52.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
IMPORTANCE An overall household secondary attack rate (SAR) of 18.9% (95% CI, 16.2%-22.0%) through June 17, 2021 was previously reported for SARS-CoV-2. Emerging variants of concern and increased vaccination have affected transmission rates. OBJECTIVE To evaluate how reported household SARs changed over time and whether SARs varied by viral variant and index case and contact vaccination status. DATA SOURCES PubMed and medRxiv from June 18, 2021, through March 8, 2022, and reference lists of eligible articles. Preprints were included. STUDY SELECTION Articles with original data reporting the number of infected and total number of household contacts. Search terms included SARS-CoV-2, COVID-19, variant, vaccination, secondary attack rate, secondary infection rate, household, index case, family contacts, close contacts, and family transmission. DATA EXTRACTION AND SYNTHESIS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guideline was followed. Meta-analyses used generalized linear mixed models to obtain SAR estimates and 95% CIs. MAIN OUTCOMES AND MEASURES SAR stratified by covariates according to variant, index case and contact vaccination status, and index case identification period. SARs were used to estimate vaccine effectiveness on the basis of the transmission probability for susceptibility to infection (VES,p), infectiousness given infection (VEI,p), and total vaccine effectiveness (VET,p). RESULTS Household SARs were higher for 33 studies with midpoints in 2021 to 2022 (37.3%; 95% CI, 32.7% to 42.1%) compared with 63 studies with midpoints through April 2020 (15.5%; 95% CI, 13.2% to 18.2%). Household SARs were 42.7% (95% CI, 35.4% to 50.4%) for Omicron (7 studies), 36.4% (95% CI, 33.4% to 39.5%) for Alpha (11 studies), 29.7% (95% CI, 23.0% to 37.3%) for Delta (16 studies), and 22.5% (95% CI, 18.6% to 26.8%) for Beta (3 studies). For full vaccination, VES,p was 78.6% (95% CI, 76.0% to 80.9%) for Alpha, 56.4% (95% CI, 54.6% to 58.1%) for Delta, and 18.1% (95% CI, -18.3% to 43.3%) for Omicron; VEI,p was 75.3% (95% CI, 69.9% to 79.8%) for Alpha, 21.9% (95% CI, 11.0% to 31.5%) for Delta, and 18.2% (95% CI, 0.6% to 32.6%) for Omicron; and VET,p was 94.7% (95% CI, 93.3% to 95.8%) for Alpha, 64.4% (95% CI, 58.0% to 69.8%) for Delta, and 35.8% (95% CI, 13.0% to 52.6%) for Omicron. CONCLUSIONS AND RELEVANCE These results suggest that emerging SARS-CoV-2 variants of concern have increased transmissibility. Full vaccination was associated with reductions in susceptibility and infectiousness, but more so for Alpha than Delta and Omicron. The changes in estimated vaccine effectiveness underscore the challenges of developing effective vaccines concomitant with viral evolution.
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Affiliation(s)
| | - Yang Yang
- Department of Biostatistics, University of Florida, Gainesville
| | - Ira M. Longini
- Department of Biostatistics, University of Florida, Gainesville
| | - M. Elizabeth Halloran
- Fred Hutchinson Cancer Research Center, Seattle, Washington
- Department of Biostatistics, University of Washington, Seattle
| | - Natalie E. Dean
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia
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Ogata T, Tanaka H, Nozawa Y, Mukouyama K, Tanaka E, Osaki N, Noguchi E, Seo K, Wada K. Increased Secondary Attack Rate among Unvaccinated Household Contacts of Coronavirus Disease 2019 Patients with Delta Variant in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073889. [PMID: 35409572 PMCID: PMC8997792 DOI: 10.3390/ijerph19073889] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/15/2022] [Accepted: 03/21/2022] [Indexed: 02/06/2023]
Abstract
This study aimed to elucidate the household secondary attack rate (HSAR) of the Delta variant in comparison to the Alpha variant, and evaluate the risk factors among unvaccinated household contacts of patients with coronavirus disease 2019 (COVID-19). We studied household contacts of index cases of COVID-19 infected with Delta (L452R mutation), Alpha (N501Y mutation), and wild strain from December 2020 through November 2021 in Itako, Japan. The HSARs of the entire household contact, and the contact of index case with Delta variant were calculated and compared across the risk factors. We used a generalized estimating equation regression model for the multivariate analysis. We enrolled 1257 unvaccinated contacts from 580 households. The HSAR was higher in household contacts of index patients with Delta (48.5%) than with Alpha variant (21.7%) (aOR = 3.34, p = 0.000). In Delta variants, the HSAR was higher in household contacts with spousal relationships to index patients (63.4%) than contacts with other relationships (45.5%) (aOR 1.94, p = 0.026), and was lower in household contacts of index patients aged ≤19 (33.1%) than for contacts of index cases aged 20–59 years (52.6%) (aOR = 0.50, p = 0.027). The result of our study can be used to devise informed strategy to prevent transmission within households.
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Affiliation(s)
- Tsuyoshi Ogata
- Itako Public Health Center of Ibaraki Prefectural Government, Itako 311-2422, Japan; (Y.N.); (K.M.); (E.T.); (N.O.); (E.N.); (K.S.)
- Correspondence:
| | - Hideo Tanaka
- Fujiidera Public Health Center of Osaka Prefectural Government, Fujiidera 583-0024, Japan;
| | - Yumiko Nozawa
- Itako Public Health Center of Ibaraki Prefectural Government, Itako 311-2422, Japan; (Y.N.); (K.M.); (E.T.); (N.O.); (E.N.); (K.S.)
| | - Kazue Mukouyama
- Itako Public Health Center of Ibaraki Prefectural Government, Itako 311-2422, Japan; (Y.N.); (K.M.); (E.T.); (N.O.); (E.N.); (K.S.)
| | - Emiko Tanaka
- Itako Public Health Center of Ibaraki Prefectural Government, Itako 311-2422, Japan; (Y.N.); (K.M.); (E.T.); (N.O.); (E.N.); (K.S.)
| | - Natsumi Osaki
- Itako Public Health Center of Ibaraki Prefectural Government, Itako 311-2422, Japan; (Y.N.); (K.M.); (E.T.); (N.O.); (E.N.); (K.S.)
| | - Etsuko Noguchi
- Itako Public Health Center of Ibaraki Prefectural Government, Itako 311-2422, Japan; (Y.N.); (K.M.); (E.T.); (N.O.); (E.N.); (K.S.)
| | - Kayoko Seo
- Itako Public Health Center of Ibaraki Prefectural Government, Itako 311-2422, Japan; (Y.N.); (K.M.); (E.T.); (N.O.); (E.N.); (K.S.)
| | - Koji Wada
- Department of Public Health, Faculty of Medicine and Graduate School of Public Health, International University of Health and Welfare, Tokyo 107-8402, Japan;
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Madewell ZJ, Yang Y, Longini IM, Halloran ME, Dean NE. Household secondary attack rates of SARS-CoV-2 by variant and vaccination status: an updated systematic review and meta-analysis. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2022.01.09.22268984. [PMID: 35043125 PMCID: PMC8764734 DOI: 10.1101/2022.01.09.22268984] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
We previously reported a household secondary attack rate (SAR) for SARS-CoV-2 of 18.9% through June 17, 2021. To examine how emerging variants and increased vaccination have affected transmission rates, we searched PubMed from June 18, 2021, through January 7, 2022. Meta-analyses used generalized linear mixed models to obtain SAR estimates and 95%CI, disaggregated by several covariates. SARs were used to estimate vaccine effectiveness based on the transmission probability for susceptibility ( VE S,p ), infectiousness ( VE I,p ), and total vaccine effectiveness ( VE T,p ). Household SAR for 27 studies with midpoints in 2021 was 35.8% (95%CI, 30.6%-41.3%), compared to 15.7% (95%CI, 13.3%-18.4%) for 62 studies with midpoints through April 2020. Household SARs were 38.0% (95%CI, 36.0%-40.0%), 30.8% (95%CI, 23.5%-39.3%), and 22.5% (95%CI, 18.6%-26.8%) for Alpha, Delta, and Beta, respectively. VE I,p , VE S,p , and VE T,p were 56.6% (95%CI, 28.7%-73.6%), 70.3% (95%CI, 59.3%-78.4%), and 86.8% (95%CI, 76.7%-92.5%) for full vaccination, and 27.5% (95%CI, -6.4%-50.7%), 43.9% (95%CI, 21.8%-59.7%), and 59.9% (95%CI, 34.4%-75.5%) for partial vaccination, respectively. Household contacts exposed to Alpha or Delta are at increased risk of infection compared to the original wild-type strain. Vaccination reduced susceptibility to infection and transmission to others. SUMMARY Household secondary attack rates (SARs) were higher for Alpha and Delta variants than previous estimates. SARs were higher to unvaccinated contacts than to partially or fully vaccinated contacts and were higher from unvaccinated index cases than from fully vaccinated index cases.
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Affiliation(s)
| | - Yang Yang
- Department of Biostatistics, University of Florida, Gainesville, FL
| | - Ira M. Longini
- Department of Biostatistics, University of Florida, Gainesville, FL
| | - M. Elizabeth Halloran
- Fred Hutchinson Cancer Research Center, Seattle, WA
- Department of Biostatistics, University of Washington, Seattle, WA
| | - Natalie E. Dean
- Department of Biostatistics, University of Florida, Gainesville, FL
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48
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Yu PY, Yang TJ, Hsu STD. Biophysical and structural characterizations of the effects of mutations on the structure–activity relationships of SARS-CoV-2 spike protein. Methods Enzymol 2022; 675:299-321. [PMID: 36220274 PMCID: PMC9388326 DOI: 10.1016/bs.mie.2022.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Mutations on the spike (S) protein of SARS-CoV-2 could induce structural changes that help increase viral transmissibility and enhance resistance to antibody neutralization. Here, we report a robust workflow to prepare recombinant S protein variants and its host receptor angiotensin-convert enzyme 2 (ACE2) by using a mammalian cell expression system. The functional states of the S protein variants are investigated by cryo-electron microscopy (cryo-EM) and negative staining electron microscopy (NSEM) to visualize their molecular structures in response to mutations, receptor binding, antibody binding, and environmental changes. The folding stabilities of the S protein variants can be deduced from morphological changes based on NSEM imaging analysis. Differential scanning calorimetry provides thermodynamic information to complement NSEM. Impacts of the mutations on host receptor binding and antibody neutralization are in vitro by kinetic binding analyses in addition to atomic insights gleaned from cryo-electron microscopy (cryo-EM). This experimental strategy is generally applicable to studying the molecular basis of host-pathogen interactions.
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49
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Munch PK, Espenhain L, Hansen CH, Krause TG, Ethelberg S. Case-control study of activities associated with SARS-CoV-2 infection in an adult unvaccinated population and overview of societal COVID-19 epidemic counter measures in Denmark. PLoS One 2022; 17:e0268849. [PMID: 36383627 PMCID: PMC9668151 DOI: 10.1371/journal.pone.0268849] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 10/24/2022] [Indexed: 11/17/2022] Open
Abstract
Measures to restrict physical inter-personal contact in the community have been widely implemented during the COVID-19 pandemic. We studied determinants for infection with SARS-CoV-2 with the aim of informing future public health measures. We conducted a national matched case-control study among unvaccinated not previously infected adults aged 18-49 years. Cases were selected among those testing positive for SARS-CoV-2 by RT-PCR over a five-day period in June 2021. Controls were selected from the national population register and were individually matched on age, sex and municipality of residence. Cases and controls were interviewed via telephone about contact with other persons and exposures in the community. We determined matched odds ratios (mORs) and 95% confidence intervals (95%CIs) by conditional logistical regression with adjustment for household size and immigration status. For reference, we provide a timeline of non-pharmaceutical interventions in place in Denmark from February 2020 to March 2022. We included 500 cases and 529 controls. We found that having had contact with another individual with a known infection was the main determinant for SARS-CoV-2 infection: reporting close contact with an infected person who either had or did not have symptoms resulted in mORs of 20 (95%CI:9.8-39) and 8.5 (95%CI 4.5-16) respectively. Community exposures were generally not associated with disease; several exposures were negatively associated. Consumption of alcohol in restaurants or cafés, aOR = 2.3 (95%CI:1.3-4.2) and possibly attending fitness centers, mOR = 1.4 (95%CI:1.0-2.0) were weakly associated with SARS-CoV-2 infection. Apart from these two factors, no community activities were more common amongst cases under the community restrictions in place during the study. The strongest risk factor for transmission was contact to an infected person. Results were in agreement with findings of our similar study conducted six month earlier.
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Affiliation(s)
- Pernille Kold Munch
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Laura Espenhain
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Christian Holm Hansen
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Tyra Grove Krause
- Division of Infectious Disease Preparedness, Statens Serum Institut, Copenhagen, Denmark
| | - Steen Ethelberg
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
- Department of Public Health, Global Health Section, University of Copenhagen, Copenhagen, Denmark
- * E-mail:
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