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van der Feltz-Cornelis C, Turk F, Sweetman J, Khunti K, Gabbay M, Shepherd J, Montgomery H, Strain WD, Lip GYH, Wootton D, Watkins CL, Cuthbertson DJ, Williams N, Banerjee A. Prevalence of mental health conditions and brain fog in people with long COVID: A systematic review and meta-analysis. Gen Hosp Psychiatry 2024; 88:10-22. [PMID: 38447388 DOI: 10.1016/j.genhosppsych.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/16/2024] [Accepted: 02/19/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVE Long COVID can include impaired cognition ('brain fog'; a term encompassing multiple symptoms) and mental health conditions. We performed a systematic review and meta-analysis to estimate their prevalence and to explore relevant factors associated with the incidence of impaired cognition and mental health conditions. METHODS Searches were conducted in Medline and PsycINFO to cover the start of the pandemic until August 2023. Included studies reported prevalence of mental health conditions and brain fog in adults with long COVID after clinically-diagnosed or PCR-confirmed SARS-CoV-2 infection. FINDINGS 17 studies were included, reporting 41,249 long COVID patients. Across all timepoints (3-24 months), the combined prevalence of mental health conditions and brain fog was 20·4% (95% CI 11·1%-34·4%), being lower among those previously hospitalised than in community-managed patients(19·5 vs 29·7% respectively; p = 0·047). The odds of mental health conditions and brain fog increased over time and when validated instruments were used. Odds of brain fog significantly decreased with increasing vaccination rates (p = ·000). CONCLUSIONS Given the increasing prevalence of mental health conditions and brain fog over time, preventive interventions and treatments are needed. Research is needed to explore underlying mechanisms that could inform further research in development of effective treatments. The reduced risk of brain fog associated with vaccination emphasizes the need for ongoing vaccination programs.
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Affiliation(s)
- Christina van der Feltz-Cornelis
- Department of Health Sciences, University of York, York, United Kingdom; Hull York Medical School, (HYMS), University of York, York, United Kingdom; Institute of Health Informatics, University College London, London, United Kingdom.
| | - Fidan Turk
- Department of Health Sciences, University of York, York, United Kingdom
| | - Jennifer Sweetman
- Department of Health Sciences, University of York, York, United Kingdom
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Mark Gabbay
- Department of Primary Care and Mental Health University of Liverpool, Liverpool, United Kingdom
| | - Jessie Shepherd
- Department of Health Sciences, University of York, York, United Kingdom
| | - Hugh Montgomery
- Department of Medicine, University College London, London, United Kingdom
| | - W David Strain
- Diabetes and Vascular Medicine Research Centre, Institute of Clinical and Biomedical Science and College of Medicine and Health, University of Exeter, Exeter, UK
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom; Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Dan Wootton
- Institute of Infection Veterinary and Ecological Sciences and NIHR HPRU in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, United Kingdom; Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
| | - Caroline Leigh Watkins
- Lancashire Clinical Trials Unit, University of Central Lancashire, Preston, United Kingdom; School of Nursing and Midwifery, University of Central Lancashire, Preston, United Kingdom
| | - Daniel J Cuthbertson
- Institute of Cardiovascular and Metabolic Medicine, University of Liverpool, Liverpool, United Kingdom
| | - Nefyn Williams
- Department of Primary Care and Mental Health University of Liverpool, Liverpool, United Kingdom
| | - Amitava Banerjee
- Institute of Health Informatics, University College London, London, United Kingdom; Department of Cardiology, University College London Hospitals NHS Trust, London, United Kingdom; Department of Cardiology, Barts Health NHS Trust, London, United Kingdom
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2
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Delgado S, Somovilla P, Ferrer-Orta C, Martínez-González B, Vázquez-Monteagudo S, Muñoz-Flores J, Soria ME, García-Crespo C, de Ávila AI, Durán-Pastor A, Gadea I, López-Galíndez C, Moran F, Lorenzo-Redondo R, Verdaguer N, Perales C, Domingo E. Incipient functional SARS-CoV-2 diversification identified through neural network haplotype maps. Proc Natl Acad Sci U S A 2024; 121:e2317851121. [PMID: 38416684 DOI: 10.1073/pnas.2317851121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 01/08/2024] [Indexed: 03/01/2024] Open
Abstract
Since its introduction in the human population, SARS-CoV-2 has evolved into multiple clades, but the events in its intrahost diversification are not well understood. Here, we compare three-dimensional (3D) self-organized neural haplotype maps (SOMs) of SARS-CoV-2 from thirty individual nasopharyngeal diagnostic samples obtained within a 19-day interval in Madrid (Spain), at the time of transition between clades 19 and 20. SOMs have been trained with the haplotype repertoire present in the mutant spectra of the nsp12- and spike (S)-coding regions. Each SOM consisted of a dominant neuron (displaying the maximum frequency), surrounded by a low-frequency neuron cloud. The sequence of the master (dominant) neuron was either identical to that of the reference Wuhan-Hu-1 genome or differed from it at one nucleotide position. Six different deviant haplotype sequences were identified among the master neurons. Some of the substitutions in the neural clouds affected critical sites of the nsp12-nsp8-nsp7 polymerase complex and resulted in altered kinetics of RNA synthesis in an in vitro primer extension assay. Thus, the analysis has identified mutations that are relevant to modification of viral RNA synthesis, present in the mutant clouds of SARS-CoV-2 quasispecies. These mutations most likely occurred during intrahost diversification in several COVID-19 patients, during an initial stage of the pandemic, and within a brief time period.
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Affiliation(s)
- Soledad Delgado
- Departamento de Sistemas Informáticos, Escuela Técnica Superior de Ingeniería de Sistemas Informáticos, Universidad Politécnica de Madrid, Madrid 28031, Spain
| | - Pilar Somovilla
- Microbes in Health and Welfare Program, Centro de Biología Molecular "Severo Ochoa" (CSIC-UAM), Consejo Superior de Investigaciones Científicas, Madrid 28049, Spain
- Departamento de Biología Molecular, Universidad Autónoma de Madrid, Madrid 28049, Spain
| | - Cristina Ferrer-Orta
- Structural and Molecular Biology Department, Institut de Biología Molecular de Barcelona, Consejo Superior de Investigaciones Científicas, Barcelona 08028, Spain
| | - Brenda Martínez-González
- Department of Molecular and Cell Biology, Centro Nacional de Biotecnología, Consejo Superior de Investigaciones Científicas, Madrid 28049, Spain
- Department of Clinical Microbiology, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz University Hospital, Universidad Autónoma de Madrid, Madrid 28040, Spain
| | - Sergi Vázquez-Monteagudo
- Structural and Molecular Biology Department, Institut de Biología Molecular de Barcelona, Consejo Superior de Investigaciones Científicas, Barcelona 08028, Spain
| | | | - María Eugenia Soria
- Microbes in Health and Welfare Program, Centro de Biología Molecular "Severo Ochoa" (CSIC-UAM), Consejo Superior de Investigaciones Científicas, Madrid 28049, Spain
- Department of Clinical Microbiology, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz University Hospital, Universidad Autónoma de Madrid, Madrid 28040, Spain
| | - Carlos García-Crespo
- Microbes in Health and Welfare Program, Centro de Biología Molecular "Severo Ochoa" (CSIC-UAM), Consejo Superior de Investigaciones Científicas, Madrid 28049, Spain
| | - Ana Isabel de Ávila
- Microbes in Health and Welfare Program, Centro de Biología Molecular "Severo Ochoa" (CSIC-UAM), Consejo Superior de Investigaciones Científicas, Madrid 28049, Spain
| | - Antoni Durán-Pastor
- Department of Molecular and Cell Biology, Centro Nacional de Biotecnología, Consejo Superior de Investigaciones Científicas, Madrid 28049, Spain
| | - Ignacio Gadea
- Department of Clinical Microbiology, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz University Hospital, Universidad Autónoma de Madrid, Madrid 28040, Spain
| | - Cecilio López-Galíndez
- Unidad de Virología Molecular, Laboratorio de Referencia e Investigación en retrovirus, Centro Nacional de Microbiología, Instituto de salud Carlos III, Majadahonda 28222, Spain
| | - Federico Moran
- Departamento de Bioquímica y Biología Molecular, Universidad Complutense de Madrid, Madrid 28040, Spain
| | - Ramon Lorenzo-Redondo
- Department of Medicine, Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Center for Pathogen Genomics and Microbial Evolution, Northwestern University Havey Institute for Global Health, Chicago, IL 60611
| | - Nuria Verdaguer
- Structural and Molecular Biology Department, Institut de Biología Molecular de Barcelona, Consejo Superior de Investigaciones Científicas, Barcelona 08028, Spain
| | - Celia Perales
- Department of Molecular and Cell Biology, Centro Nacional de Biotecnología, Consejo Superior de Investigaciones Científicas, Madrid 28049, Spain
- Department of Clinical Microbiology, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz University Hospital, Universidad Autónoma de Madrid, Madrid 28040, Spain
| | - Esteban Domingo
- Microbes in Health and Welfare Program, Centro de Biología Molecular "Severo Ochoa" (CSIC-UAM), Consejo Superior de Investigaciones Científicas, Madrid 28049, Spain
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3
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Rubio A, de Toro M, Pérez-Pulido AJ. The most exposed regions of SARS-CoV-2 structural proteins are subject to strong positive selection and gene overlap may locally modify this behavior. mSystems 2024; 9:e0071323. [PMID: 38095866 PMCID: PMC10804949 DOI: 10.1128/msystems.00713-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 11/10/2023] [Indexed: 12/22/2023] Open
Abstract
The SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) pandemic that emerged in 2019 has been an unprecedented event in international science, as it has been possible to sequence millions of genomes, tracking their evolution very closely. This has enabled various types of secondary analyses of these genomes, including the measurement of their sequence selection pressure. In this work, we have been able to measure the selective pressure of all the described SARS-CoV-2 genes, even analyzed by sequence regions, and we show how this type of analysis allows us to separate the genes between those subject to positive selection (usually those that code for surface proteins or those exposed to the host immune system) and those subject to negative selection because they require greater conservation of their structure and function. We have also seen that when another gene with an overlapping reading frame appears within a gene sequence, the overlapping sequence between the two genes evolves under a stronger purifying selection than the average of the non-overlapping regions of the main gene. We propose this type of analysis as a useful tool for locating and analyzing all the genes of a viral genome when an adequate number of sequences are available.IMPORTANCEWe have analyzed the selection pressure of all severe acute respiratory syndrome coronavirus 2 genes by means of the nonsynonymous (Ka) to synonymous (Ks) substitution rate. We found that protein-coding genes are exposed to strong positive selection, especially in the regions of interaction with other molecules (host receptor and genome of the virus itself). However, overlapping coding regions are more protected and show negative selection. This suggests that this measure could be used to study viral gene function as well as overlapping genes.
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Affiliation(s)
- Alejandro Rubio
- Faculty of Experimental Sciences, Genetics Area, Andalusian Centre for Developmental Biology (CABD, UPO-CSIC-JA), University Pablo de Olavide, Sevilla, Spain
| | - Maria de Toro
- Genomics and Bioinformatics Core Facility, Center for Biomedical Research of La Rioja, Logroño, Spain
| | - Antonio J. Pérez-Pulido
- Faculty of Experimental Sciences, Genetics Area, Andalusian Centre for Developmental Biology (CABD, UPO-CSIC-JA), University Pablo de Olavide, Sevilla, Spain
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4
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Trovao NS, Pan V, Goel C, Gallego-García P, Liu Y, Barbara C, Borg R, Briffa M, Cilia C, Grech L, Vassallo M, Treangen TJ, Posada D, Beheshti A, Borg J, Zahra G. Evolutionary and spatiotemporal analyses reveal multiple introductions and cryptic transmission of SARS-CoV-2 VOC/VOI in Malta. Microbiol Spectr 2023; 11:e0153923. [PMID: 37800925 PMCID: PMC10714767 DOI: 10.1128/spectrum.01539-23] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 08/13/2023] [Indexed: 10/07/2023] Open
Abstract
IMPORTANCE Our study provides insights into the evolution of the coronavirus disease 2019 (COVID-19) pandemic in Malta, a highly connected and understudied country. We combined epidemiological and phylodynamic analyses to analyze trends in the number of new cases, deaths, tests, positivity rates, and evolutionary and dispersal patterns from August 2020 to January 2022. Our reconstructions inferred 173 independent severe acute respiratory syndrome coronavirus 2 introductions into Malta from various global regions. Our study demonstrates that characterizing epidemiological trends coupled with phylodynamic modeling can inform the implementation of public health interventions to help control COVID-19 transmission in the community.
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Affiliation(s)
- Nidia S. Trovao
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland, USA
- COVID-19 International Research Team, Medford, Massachusetts, USA
| | - Vincent Pan
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland, USA
- Harvard University, Cambridge, Massachusetts, USA
| | - Chirag Goel
- COVID-19 International Research Team, Medford, Massachusetts, USA
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Pilar Gallego-García
- CINBIO, Universidade de Vigo, Vigo, Spain
- Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain
| | - Yunxi Liu
- Department of Computer Science, Rice University, Houston, Texas, USA
| | - Christopher Barbara
- Molecular Diagnostics-Infectious Diseases, Department of Pathology, Mater Dei Hospital, Msida, Malta
| | - Rebecca Borg
- Molecular Diagnostics-Infectious Diseases, Department of Pathology, Mater Dei Hospital, Msida, Malta
| | - Mark Briffa
- Molecular Diagnostics-Infectious Diseases, Department of Pathology, Mater Dei Hospital, Msida, Malta
| | - Chanelle Cilia
- Molecular Diagnostics-Infectious Diseases, Department of Pathology, Mater Dei Hospital, Msida, Malta
| | - Laura Grech
- Molecular Diagnostics-Infectious Diseases, Department of Pathology, Mater Dei Hospital, Msida, Malta
| | - Mario Vassallo
- Department of Sociology, Faculty of Arts, University of Malta, Msida, Malta
| | - Todd J. Treangen
- Department of Computer Science, Rice University, Houston, Texas, USA
| | - David Posada
- CINBIO, Universidade de Vigo, Vigo, Spain
- Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain
- Department of Biochemistry, Genetics, and Immunology, Universidade de Vigo, Vigo, Spain
| | - Afshin Beheshti
- COVID-19 International Research Team, Medford, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- KBR, Space Biosciences Division, NASA Ames Research Center, Moffett Field, California, USA
| | - Joseph Borg
- COVID-19 International Research Team, Medford, Massachusetts, USA
- Department of Applied Biomedical Science, Faculty of Health Sciences, University of Malta, Msida, Malta
| | - Graziella Zahra
- Molecular Diagnostics-Infectious Diseases, Department of Pathology, Mater Dei Hospital, Msida, Malta
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5
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Espinoza B, Adiga A, Venkatramanan S, Warren AS, Chen J, Lewis BL, Vullikanti A, Swarup S, Moon S, Barrett CL, Athreya S, Sundaresan R, Chandru V, Laxminarayan R, Schaffer B, Poor HV, Levin SA, Marathe MV. Coupled models of genomic surveillance and evolving pandemics with applications for timely public health interventions. Proc Natl Acad Sci U S A 2023; 120:e2305227120. [PMID: 37983514 PMCID: PMC10691339 DOI: 10.1073/pnas.2305227120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 10/13/2023] [Indexed: 11/22/2023] Open
Abstract
Disease surveillance systems provide early warnings of disease outbreaks before they become public health emergencies. However, pandemics containment would be challenging due to the complex immunity landscape created by multiple variants. Genomic surveillance is critical for detecting novel variants with diverse characteristics and importation/emergence times. Yet, a systematic study incorporating genomic monitoring, situation assessment, and intervention strategies is lacking in the literature. We formulate an integrated computational modeling framework to study a realistic course of action based on sequencing, analysis, and response. We study the effects of the second variant's importation time, its infectiousness advantage and, its cross-infection on the novel variant's detection time, and the resulting intervention scenarios to contain epidemics driven by two-variants dynamics. Our results illustrate the limitation in the intervention's effectiveness due to the variants' competing dynamics and provide the following insights: i) There is a set of importation times that yields the worst detection time for the second variant, which depends on the first variant's basic reproductive number; ii) When the second variant is imported relatively early with respect to the first variant, the cross-infection level does not impact the detection time of the second variant. We found that depending on the target metric, the best outcomes are attained under different interventions' regimes. Our results emphasize the importance of sustained enforcement of Non-Pharmaceutical Interventions on preventing epidemic resurgence due to importation/emergence of novel variants. We also discuss how our methods can be used to study when a novel variant emerges within a population.
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Affiliation(s)
- Baltazar Espinoza
- Network Systems Science and Advanced Computing Division, Biocomplexity Institute, University of Virginia, Charlottesville, VA22904
| | - Aniruddha Adiga
- Network Systems Science and Advanced Computing Division, Biocomplexity Institute, University of Virginia, Charlottesville, VA22904
| | - Srinivasan Venkatramanan
- Network Systems Science and Advanced Computing Division, Biocomplexity Institute, University of Virginia, Charlottesville, VA22904
| | - Andrew Scott Warren
- Network Systems Science and Advanced Computing Division, Biocomplexity Institute, University of Virginia, Charlottesville, VA22904
| | - Jiangzhuo Chen
- Network Systems Science and Advanced Computing Division, Biocomplexity Institute, University of Virginia, Charlottesville, VA22904
| | - Bryan Leroy Lewis
- Network Systems Science and Advanced Computing Division, Biocomplexity Institute, University of Virginia, Charlottesville, VA22904
| | - Anil Vullikanti
- Network Systems Science and Advanced Computing Division, Biocomplexity Institute, University of Virginia, Charlottesville, VA22904
- Department of Computer Science, University of Virginia, Charlottesville, VA22904
| | - Samarth Swarup
- Network Systems Science and Advanced Computing Division, Biocomplexity Institute, University of Virginia, Charlottesville, VA22904
| | - Sifat Moon
- Network Systems Science and Advanced Computing Division, Biocomplexity Institute, University of Virginia, Charlottesville, VA22904
| | - Christopher Louis Barrett
- Network Systems Science and Advanced Computing Division, Biocomplexity Institute, University of Virginia, Charlottesville, VA22904
- Department of Computer Science, University of Virginia, Charlottesville, VA22904
| | - Siva Athreya
- Indian Statistical Institute, Bengaluru, Karnataka560059, India
- International Centre for Theoretical Sciences, Bengaluru, Karnataka560089, India
| | - Rajesh Sundaresan
- Department of Electrical and Communication Engineering, Indian Institute of Science, Bengaluru, Karnataka560012, India
- Robert Bosch Centre for Cyber-Physical Systems, Indian Institute of Science, Bengaluru, Karnataka560012, India
- Centre for Networked Intelligence, Indian Institute of Science, Bengaluru, Karnataka560012, India
| | - Vijay Chandru
- Strand Life Sciences, Bengaluru, Karnataka560024, India
- BioSystems Science and Engineering, Indian Institute of Science, Bengaluru, Karnataka560012, India
| | | | - Benjamin Schaffer
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ08544
- Department of Electrical and Computer Engineering, Princeton University, Princeton, NJ08544
| | - H. Vincent Poor
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ08544
| | - Simon A. Levin
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ08544
| | - Madhav V. Marathe
- Network Systems Science and Advanced Computing Division, Biocomplexity Institute, University of Virginia, Charlottesville, VA22904
- Department of Computer Science, University of Virginia, Charlottesville, VA22904
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6
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Llorente F, Pérez-Ramírez E, Pérez-Olmeda M, Dafouz-Bustos D, Fernández-Pinero J, Martínez-Cortés M, Jiménez-Clavero MÁ. The Detection of SARS-CoV-2 Antibodies in an Exposed Human Population Is Biased by the Immunoassay Used: Implications in Serosurveillance. Pathogens 2023; 12:1360. [PMID: 38003824 PMCID: PMC10675702 DOI: 10.3390/pathogens12111360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/10/2023] [Accepted: 11/14/2023] [Indexed: 11/26/2023] Open
Abstract
The presence of SARS-CoV-2 antibodies was examined over 7 months in a population of essential service workers exposed during the first epidemic wave in Madrid (Spain). Results obtained with different serological assays were compared. Firstly, serum samples obtained in April 2020 were analyzed using eleven SARS-CoV-2 antibody detection methods, including seven ELISAs, two CLIAs and two LFAs. While all of the ELISA tests and the Roche eCLIA method showed good performance, it was poorer for the Abbott CLIA and LFA tests. Sera from 115 workers with serologically positive results in April were collected 2 and 7 months after the first sampling and were analyzed using five of the tests previously assessed. The results showed that while some ELISA tests consistently detected the presence of anti-SARS-CoV-2 antibodies even 7 months after first detection, other methods, such as the Abbott CLIA test, showed an important reduction in sensitivity for these mature antibodies. The sensitivity increased after establishing new cut-off values, calculated taking into account both recent and old infections, suggesting that an adjustment of assay parameters may improve the detection of individuals exposed to the infection.
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Affiliation(s)
- Francisco Llorente
- Centro de Investigación en Sanidad Animal (CISA-INIA), CSIC, Valdeolmos, 28130 Madrid, Spain (M.Á.J.-C.)
| | - Elisa Pérez-Ramírez
- Centro de Investigación en Sanidad Animal (CISA-INIA), CSIC, Valdeolmos, 28130 Madrid, Spain (M.Á.J.-C.)
| | - Mayte Pérez-Olmeda
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28220 Majadahonda, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), 28029 Madrid, Spain
| | - Desirée Dafouz-Bustos
- Centro de Investigación en Sanidad Animal (CISA-INIA), CSIC, Valdeolmos, 28130 Madrid, Spain (M.Á.J.-C.)
| | - Jovita Fernández-Pinero
- Centro de Investigación en Sanidad Animal (CISA-INIA), CSIC, Valdeolmos, 28130 Madrid, Spain (M.Á.J.-C.)
| | | | - Miguel Ángel Jiménez-Clavero
- Centro de Investigación en Sanidad Animal (CISA-INIA), CSIC, Valdeolmos, 28130 Madrid, Spain (M.Á.J.-C.)
- Centro de Investigación Biomédica en Red de Epidemiologia y Salud Pública (CIBERESP), 28029 Madrid, Spain
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7
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Viver T, López-Causapé C, Ribot-Fraile P, Pérez-Mazón C, López-Solé D, Jiménez-Guerra G, Taltavull B, López-López A. The molecular epidemiology of SARS-CoV-2 in the Pityusic Islands shows multiple introductions and fast replacements of variants in a touristic worldwide hot spot. Sci Rep 2023; 13:18053. [PMID: 37872265 PMCID: PMC10593736 DOI: 10.1038/s41598-023-44668-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 10/11/2023] [Indexed: 10/25/2023] Open
Abstract
The public health emergency caused by the Covid-19 outbreak in March 2020 encouraged worldwide initiatives to monitor the genetic diversity and features of the SARS-CoV-2 circulating variants, mainly based on the genomic surveillance. However, due to the impossibility to carry out extensive sequencing in resource-limited hospitals, other PCR-based strategies could be applied to efficiently monitor the circulating variants without the need to greatly expand the sequencing capacity. In our case, overpassing the technical limitations inherent to a second level hospital, we were able to characterize the weekly distribution of SARS-CoV-2 by the RT-qPCR amplification patterns visualization, single nucleotide polymorphism genotyping, and sequencing of randomly selected samples. All these molecular approaches allowed us to trace the epidemiology of SARS-CoV-2 viruses circulating in Ibiza and Formentera (Balearic Islands, Spain) during the third to the sixth pandemic waves (January 2021-July 2022), in which three major lineages that were considered as VOCs (Alpha, Delta, and Omicron), and many other non-VOC variants were detected and tracked.
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Affiliation(s)
- T Viver
- Marine Microbiology Group, Mediterranean Institute for Advanced Studies (IMEDEA-CSIC-UIB), Esporles, Spain
| | - C López-Causapé
- Servicio de Microbiología, Hospital Universitario Son Espases, Majorca, Illes Balears, Spain
- Instituto de Investigación Sanitaria Illes Balears (IdISBa), Majorca, Illes Balears, Spain
| | - P Ribot-Fraile
- Servicio de Microbiología, Hospital Universitario Son Espases, Majorca, Illes Balears, Spain
- Instituto de Investigación Sanitaria Illes Balears (IdISBa), Majorca, Illes Balears, Spain
| | - C Pérez-Mazón
- Servicio de Microbiologíaa y Parasitología, Hospital Can Misses, C/ Corona s/n, 07800, Ibiza, Illes Balears, Spain
| | - D López-Solé
- Servicio de Microbiologíaa y Parasitología, Hospital Can Misses, C/ Corona s/n, 07800, Ibiza, Illes Balears, Spain
| | - G Jiménez-Guerra
- Servicio de Microbiologíaa y Parasitología, Hospital Can Misses, C/ Corona s/n, 07800, Ibiza, Illes Balears, Spain
| | - B Taltavull
- Instituto de Investigación Sanitaria Illes Balears (IdISBa), Majorca, Illes Balears, Spain
| | - A López-López
- Servicio de Microbiologíaa y Parasitología, Hospital Can Misses, C/ Corona s/n, 07800, Ibiza, Illes Balears, Spain.
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8
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Serrano AI, Aragoneses J, Suárez A, Rodríguez C, Aragoneses JM. Dental injury offenses and compensation imposed by Spanish courts, before and during Covid-19. A cross-sectional study. Sci Rep 2023; 13:16653. [PMID: 37789176 PMCID: PMC10547675 DOI: 10.1038/s41598-023-43863-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 09/29/2023] [Indexed: 10/05/2023] Open
Abstract
Injuries to the dentofacial region caused by third parties can affect physiological, sensory and esthetic functions with legal repercussions. The personal and social circumstances generated by Covid-19 and the governmental measures taken to control it, have increased the risk factors for violence and with it, the resulting injury rate. The aim of the present investigation was to compare the amount of civil liability for dental injury crimes agreed by Spanish courts, in certain Autonomous Communities, before and during the pandemic situation caused by Covid-19. For this purpose, a analytic cross-sectional study was carried out by analyzing sentences from the database of the Judicial Documentation Center. A comparison of means (one-way ANOVA) was used on the amount of compensation between the different years, and between the Autonomous Communities of Madrid, Catalonia Cataluña, Andalusia, the Canary Islands and the Valencian Community. It was observed that the year 2020 stood out for the increase in the number of cases of dental injury offenses. For its part, the Autonomous Community of Andalusia showed the highest amount of compensation during the pandemic, although the highest number of cases corresponded to the Community of Madrid. The statistical analysis yielded a probability of more than 0.05, which eliminated the possibility of significant differences in each of the comparisons.
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Affiliation(s)
- Ana Isabel Serrano
- Centro de Estudios Garrigues, Avenida Fernando Alonso nº 8, Alcobendas, Spain
| | - Javier Aragoneses
- Department of Medicine and Medical Specialties, Faculty of Health Sciences, University of Alcalá, 28801, Madrid, Spain
| | - Ana Suárez
- Department of Preclinical Dentistry, School of Biomedical Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670, Madrid, Spain.
| | - Cinthia Rodríguez
- Department of Dentistry, Universidad Federico Henriquez y Carvajal, 10106, Santo Domingo, Dominican Republic
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9
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Goiriz L, Ruiz R, Garibo-i-Orts Ò, Conejero JA, Rodrigo G. A variant-dependent molecular clock with anomalous diffusion models SARS-CoV-2 evolution in humans. Proc Natl Acad Sci U S A 2023; 120:e2303578120. [PMID: 37459528 PMCID: PMC10372551 DOI: 10.1073/pnas.2303578120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 06/11/2023] [Indexed: 07/20/2023] Open
Abstract
The evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in humans has been monitored at an unprecedented level due to the public health crisis, yet the stochastic dynamics underlying such a process is dubious. Here, considering the number of acquired mutations as the displacement of the viral particle from the origin, we performed biostatistical analyses from numerous whole genome sequences on the basis of a time-dependent probabilistic mathematical model. We showed that a model with a constant variant-dependent evolution rate and nonlinear mutational variance with time (i.e., anomalous diffusion) explained the SARS-CoV-2 evolutionary motion in humans during the first 120 wk of the pandemic in the United Kingdom. In particular, we found subdiffusion patterns for the Primal, Alpha, and Omicron variants but a weak superdiffusion pattern for the Delta variant. Our findings indicate that non-Brownian evolutionary motions occur in nature, thereby providing insight for viral phylodynamics.
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Affiliation(s)
- Lucas Goiriz
- BioInstituto de Biología Integrativa de Sistemas, Consejo Superior de Investigaciones Científicas – Universitat de València, 46980Paterna, Spain
- Institut Universitari de Matemàtica Pura i Aplicada, Universitat Politècnica de València, 46022Valencia, Spain
| | - Raúl Ruiz
- BioInstituto de Biología Integrativa de Sistemas, Consejo Superior de Investigaciones Científicas – Universitat de València, 46980Paterna, Spain
| | - Òscar Garibo-i-Orts
- Institut Universitari de Matemàtica Pura i Aplicada, Universitat Politècnica de València, 46022Valencia, Spain
| | - J. Alberto Conejero
- Institut Universitari de Matemàtica Pura i Aplicada, Universitat Politècnica de València, 46022Valencia, Spain
| | - Guillermo Rodrigo
- BioInstituto de Biología Integrativa de Sistemas, Consejo Superior de Investigaciones Científicas – Universitat de València, 46980Paterna, Spain
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10
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Garcia-Carretero R, Vazquez-Gomez O, Ordoñez-Garcia M, Garrido-Peño N, Gil-Prieto R, Gil-de-Miguel A. Differences in Trends in Admissions and Outcomes among Patients from a Secondary Hospital in Madrid during the COVID-19 Pandemic: A Hospital-Based Epidemiological Analysis (2020-2022). Viruses 2023; 15:1616. [PMID: 37515302 PMCID: PMC10384448 DOI: 10.3390/v15071616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/17/2023] [Accepted: 07/21/2023] [Indexed: 07/30/2023] Open
Abstract
Spain had some of Europe's highest incidence and mortality rates for coronavirus disease 2019 (COVID-19). This study highlights the impact of the COVID-19 pandemic on daily health care in terms of incidence, critical patients, and mortality. We describe the characteristics and clinical outcomes of patients, comparing variables over the different waves. We performed a descriptive, retrospective study using the historical records of patients hospitalized with COVID-19. We describe demographic characteristics, admissions, and occupancy. Time series allowed us to visualize and analyze trends and patterns, and identify several waves during the 27-month period. A total of 3315 patients had been hospitalized with confirmed COVID-19. One-third of these patients were hospitalized during the first weeks of the pandemic. We observed that 4.6% of all hospitalizations had been admitted to the intensive care unit, and we identified a mortality rate of 9.4% among hospitalized patients. Arithmetic- and semi-logarithmic-scale charts showed how admissions and deaths rose sharply during the first weeks, increasing by 10 every few days. We described a single hospital's response and experiences during the pandemic. This research highlights certain demographic profiles in a population and emphasizes the importance of identifying waves when performing research on COVID-19. Our results can extend the analysis of the impact of COVID-19 and can be applied in other contexts, and can be considered when further analyzing the clinical, epidemiological, or demographic characteristics of populations with COVID-19. Our findings suggest that the pandemic should be analyzed not as a whole but rather in different waves.
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Affiliation(s)
- Rafael Garcia-Carretero
- Department of Internal Medicine, Mostoles University Hospital, 28935 Móstoles, Madrid, Spain
| | - Oscar Vazquez-Gomez
- Department of Internal Medicine, Mostoles University Hospital, 28935 Móstoles, Madrid, Spain
| | - María Ordoñez-Garcia
- Department of Hematology, Mostoles University Hospital, 28935 Móstoles, Madrid, Spain
| | - Noelia Garrido-Peño
- Department of Pharmacy, Mostoles University Hospital, 28935 Móstoles, Madrid, Spain
| | - Ruth Gil-Prieto
- Department of Preventive Medicine and Public Health, Rey Juan Carlos University, 28922 Alcorcón, Madrid, Spain
| | - Angel Gil-de-Miguel
- Department of Preventive Medicine and Public Health, Rey Juan Carlos University, 28922 Alcorcón, Madrid, Spain
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11
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Cárdenas-Fuentes G, Bosch de Basea M, Cobo I, Subirana I, Ceresa M, Famada E, Gimeno-Santos E, Delgado-Ortiz L, Faner R, Molina-Molina M, Agustí À, Muñoz X, Sibila O, Gea J, Garcia-Aymerich J. Validity of prognostic models of critical COVID-19 is variable. A systematic review with external validation. J Clin Epidemiol 2023; 159:274-288. [PMID: 37142168 PMCID: PMC10152752 DOI: 10.1016/j.jclinepi.2023.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 01/26/2023] [Accepted: 04/25/2023] [Indexed: 05/06/2023]
Abstract
OBJECTIVES To identify prognostic models which estimate the risk of critical COVID-19 in hospitalized patients and to assess their validation properties. STUDY DESIGN AND SETTING We conducted a systematic review in Medline (up to January 2021) of studies developing or updating a model that estimated the risk of critical COVID-19, defined as death, admission to intensive care unit, and/or use of mechanical ventilation during admission. Models were validated in two datasets with different backgrounds (HM [private Spanish hospital network], n = 1,753, and ICS [public Catalan health system], n = 1,104), by assessing discrimination (area under the curve [AUC]) and calibration (plots). RESULTS We validated 18 prognostic models. Discrimination was good in nine of them (AUCs ≥ 80%) and higher in those predicting mortality (AUCs 65%-87%) than those predicting intensive care unit admission or a composite outcome (AUCs 53%-78%). Calibration was poor in all models providing outcome's probabilities and good in four models providing a point-based score. These four models used mortality as outcome and included age, oxygen saturation, and C-reactive protein among their predictors. CONCLUSION The validity of models predicting critical COVID-19 by using only routinely collected predictors is variable. Four models showed good discrimination and calibration when externally validated and are recommended for their use.
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Affiliation(s)
- Gabriela Cárdenas-Fuentes
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; School of Health Sciences, Blanquerna-Universitat Ramon Llull, Barcelona, Spain.
| | - Magda Bosch de Basea
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Inés Cobo
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Isaac Subirana
- Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Barcelona, Spain; CIBER Enfermedades Cardiovasculares (CIBERCV), ISCIII, Spain
| | - Mario Ceresa
- BCNMedTech, Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | | | - Elena Gimeno-Santos
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Respiratory Institute, Hospital Clinic, Barcelona, Spain
| | - Laura Delgado-Ortiz
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Rosa Faner
- Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Universitat de Barcelona, Barcelona, Spain; CIBER Enfermedades Respiratorias (CIBERES), ISCIII, Spain
| | - María Molina-Molina
- CIBER Enfermedades Respiratorias (CIBERES), ISCIII, Spain; Servicio de Neumología, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Spain; Instituto de Investigación Biomédica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Spain
| | - Àlvar Agustí
- Respiratory Institute, Hospital Clinic, Barcelona, Spain; Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Universitat de Barcelona, Barcelona, Spain; CIBER Enfermedades Respiratorias (CIBERES), ISCIII, Spain
| | - Xavier Muñoz
- CIBER Enfermedades Respiratorias (CIBERES), ISCIII, Spain; Servicio de Neumología, Hospital Universitario Vall d'Hebron, Barcelona, Spain; Departamento de Biología celular, fisiología e inmunología, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Oriol Sibila
- Respiratory Institute, Hospital Clinic, Barcelona, Spain; Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain; CIBER Enfermedades Respiratorias (CIBERES), ISCIII, Spain
| | - Joaquim Gea
- Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Enfermedades Respiratorias (CIBERES), ISCIII, Spain; Servicio de Neumología, Hospital del Mar-IMIM, Barcelona, Spain; Fundació Barcelona Respiratory Network (BRN), Barcelona, Spain
| | - Judith Garcia-Aymerich
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
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12
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Martínez-Martínez FJ, Massinga AJ, De Jesus Á, Ernesto RM, Cano-Jiménez P, Chiner-Oms Á, Gómez-Navarro I, Guillot-Fernández M, Guinovart C, Sitoe A, Vubil D, Bila R, Gujamo R, Enosse S, Jiménez-Serrano S, Torres-Puente M, Comas I, Mandomando I, López MG, Mayor A. Tracking SARS-CoV-2 introductions in Mozambique using pandemic-scale phylogenies: a retrospective observational study. Lancet Glob Health 2023; 11:e933-e941. [PMID: 37202028 DOI: 10.1016/s2214-109x(23)00169-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 03/09/2023] [Accepted: 03/23/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND From the start of the SARS-CoV-2 outbreak, global sequencing efforts have generated an unprecedented amount of genomic data. Nonetheless, unequal sampling between high-income and low-income countries hinders the implementation of genomic surveillance systems at the global and local level. Filling the knowledge gaps of genomic information and understanding pandemic dynamics in low-income countries is essential for public health decision making and to prepare for future pandemics. In this context, we aimed to discover the timing and origin of SARS-CoV-2 variant introductions in Mozambique, taking advantage of pandemic-scale phylogenies. METHODS We did a retrospective, observational study in southern Mozambique. Patients from Manhiça presenting with respiratory symptoms were recruited, and those enrolled in clinical trials were excluded. Data were included from three sources: (1) a prospective hospital-based surveillance study (MozCOVID), recruiting patients living in Manhiça, attending the Manhiça district hospital, and fulfilling the criteria of suspected COVID-19 case according to WHO; (2) symptomatic and asymptomatic individuals with SARS-CoV-2 infection recruited by the National Surveillance system; and (3) sequences from SARS-CoV-2-infected Mozambican cases deposited on the Global Initiative on Sharing Avian Influenza Data database. Positive samples amenable for sequencing were analysed. We used Ultrafast Sample placement on Existing tRees to understand the dynamics of beta and delta waves, using available genomic data. This tool can reconstruct a phylogeny with millions of sequences by efficient sample placement in a tree. We reconstructed a phylogeny (~7·6 million sequences) adding new and publicly available beta and delta sequences. FINDINGS A total of 5793 patients were recruited between Nov 1, 2020, and Aug 31, 2021. During this time, 133 328 COVID-19 cases were reported in Mozambique. 280 good quality new SARS-CoV-2 sequences were obtained after the inclusion criteria were applied and an additional 652 beta (B.1.351) and delta (B.1.617.2) public sequences were included from Mozambique. We evaluated 373 beta and 559 delta sequences. We identified 187 beta introductions (including 295 sequences), divided in 42 transmission groups and 145 unique introductions, mostly from South Africa, between August, 2020 and July, 2021. For delta, we identified 220 introductions (including 494 sequences), with 49 transmission groups and 171 unique introductions, mostly from the UK, India, and South Africa, between April and November, 2021. INTERPRETATION The timing and origin of introductions suggests that movement restrictions effectively avoided introductions from non-African countries, but not from surrounding countries. Our results raise questions about the imbalance between the consequences of restrictions and health benefits. This new understanding of pandemic dynamics in Mozambique can be used to inform public health interventions to control the spread of new variants. FUNDING European and Developing Countries Clinical Trials, European Research Council, Bill & Melinda Gates Foundation, and Agència de Gestió d'Ajuts Universitaris i de Recerca.
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Affiliation(s)
- Francisco José Martínez-Martínez
- Tuberculosis Genomics Unit, Instituto de Biomedicina de Valencia, Consejo Superior de Investigaciones Científicas, Valencia, Spain
| | | | - Áuria De Jesus
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | - Rita M Ernesto
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | - Pablo Cano-Jiménez
- Tuberculosis Genomics Unit, Instituto de Biomedicina de Valencia, Consejo Superior de Investigaciones Científicas, Valencia, Spain
| | - Álvaro Chiner-Oms
- Tuberculosis Genomics Unit, Instituto de Biomedicina de Valencia, Consejo Superior de Investigaciones Científicas, Valencia, Spain
| | - Inmaculada Gómez-Navarro
- Tuberculosis Genomics Unit, Instituto de Biomedicina de Valencia, Consejo Superior de Investigaciones Científicas, Valencia, Spain
| | - Marina Guillot-Fernández
- Tuberculosis Genomics Unit, Instituto de Biomedicina de Valencia, Consejo Superior de Investigaciones Científicas, Valencia, Spain
| | | | - António Sitoe
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | - Delfino Vubil
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | - Rubão Bila
- Hospital Distrital da Manhiça, Marracuene, Mozambique
| | | | - Sónia Enosse
- Instituto Nacional de Saúde, Marracuene, Mozambique
| | - Santiago Jiménez-Serrano
- Tuberculosis Genomics Unit, Instituto de Biomedicina de Valencia, Consejo Superior de Investigaciones Científicas, Valencia, Spain
| | - Manuela Torres-Puente
- Tuberculosis Genomics Unit, Instituto de Biomedicina de Valencia, Consejo Superior de Investigaciones Científicas, Valencia, Spain
| | - Iñaki Comas
- Tuberculosis Genomics Unit, Instituto de Biomedicina de Valencia, Consejo Superior de Investigaciones Científicas, Valencia, Spain; Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Inácio Mandomando
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique; Instituto Nacional de Saúde, Marracuene, Mozambique
| | - Mariana G López
- Tuberculosis Genomics Unit, Instituto de Biomedicina de Valencia, Consejo Superior de Investigaciones Científicas, Valencia, Spain.
| | - Alfredo Mayor
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique; ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Department of Physiologic Sciences, Faculty of Medicine, Universidade Eduardo Mondlane, Maputo, Mozambique
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13
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Vázquez-Morón S, Iglesias-Caballero M, Lepe JA, Garcia F, Melón S, Marimon JM, García de Viedma D, Folgueira MD, Galán JC, López-Causapé C, Benito-Ruesca R, Alcoba-Florez J, Gonzalez Candelas F, Toro MD, Fajardo M, Ezpeleta C, Lázaro F, Pérez Castro S, Cuesta I, Zaballos A, Pozo F, Casas I. Enhancing SARS-CoV-2 Surveillance through Regular Genomic Sequencing in Spain: The RELECOV Network. Int J Mol Sci 2023; 24:ijms24108573. [PMID: 37239920 DOI: 10.3390/ijms24108573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/25/2023] [Accepted: 05/03/2023] [Indexed: 05/28/2023] Open
Abstract
Millions of SARS-CoV-2 whole genome sequences have been generated to date. However, good quality data and adequate surveillance systems are required to contribute to meaningful surveillance in public health. In this context, the network of Spanish laboratories for coronavirus (RELECOV) was created with the main goal of promoting actions to speed up the detection, analyses, and evaluation of SARS-CoV-2 at a national level, partially structured and financed by an ECDC-HERA-Incubator action (ECDC/GRANT/2021/024). A SARS-CoV-2 sequencing quality control assessment (QCA) was developed to evaluate the network's technical capacity. QCA full panel results showed a lower hit rate for lineage assignment compared to that obtained for variants. Genomic data comprising 48,578 viral genomes were studied and evaluated to monitor SARS-CoV-2. The developed network actions showed a 36% increase in sharing viral sequences. In addition, analysis of lineage/sublineage-defining mutations to track the virus showed characteristic mutation profiles for the Delta and Omicron variants. Further, phylogenetic analyses strongly correlated with different variant clusters, obtaining a robust reference tree. The RELECOV network has made it possible to improve and enhance the genomic surveillance of SARS-CoV-2 in Spain. It has provided and evaluated genomic tools for viral genome monitoring and characterization that make it possible to increase knowledge efficiently and quickly, promoting the genomic surveillance of SARS-CoV-2 in Spain.
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Affiliation(s)
- Sonia Vázquez-Morón
- Respiratory Viruses and Influenza Unit, National Centre for Microbiology, Instituto de Salud Carlos III, 28222 Majadahonda, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), ISCIII, 28029 Madrid, Spain
| | - María Iglesias-Caballero
- Respiratory Viruses and Influenza Unit, National Centre for Microbiology, Instituto de Salud Carlos III, 28222 Majadahonda, Spain
| | - José Antonio Lepe
- Microbiology Service, Hospital Universitario Virgen del Rocio, 41013 Sevilla, Spain
| | - Federico Garcia
- Microbiology Service, Hospital Universitario San Cecilio, Instituto de Investigación Biosanitaria Ibs. Granada, 18016 Granada, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), ISCIII, 28029 Madrid, Spain
| | - Santiago Melón
- Microbiology Service, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain
| | - José M Marimon
- Microbiology Service, Instituto de Investigación Sanitaria Biodonostia, Hospital Universitario Donostia, 20014 Donostia-San Sebastian, Spain
| | - Darío García de Viedma
- Microbiology Service, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, 28007 Madrid, Spain
| | - Maria Dolores Folgueira
- Microbiology Department, Hospital Universitario 12 de Octubre, Biomedical Research Institute imas12, 28041 Madrid, Spain
- Department of Medicine, School of Medicine, Universidad Complutense, 28040 Madrid, Spain
| | - Juan Carlos Galán
- CIBER de Epidemiología y Salud Pública (CIBERESP), ISCIII, 28029 Madrid, Spain
- Microbiology Service, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain
| | - Carla López-Causapé
- Microbiology Service, Hospital Universitario Son Espases, 07120 Palma de Mallorca, Spain
| | - Rafael Benito-Ruesca
- Microbiology Service, Hospital Clínico Universitario Lozano Blesa, Departamento de Microbiología, Facultad de Medicina, Instituto de Investigación Sanitaria de Aragón, Universidad de Zaragoza, 50009 Zaragoza, Spain
| | - Julia Alcoba-Florez
- Microbiology Service, Hospital Universitario Ntra. Sra de Candelaria, 38010 Santa Cruz de Tenerife, Spain
| | - Fernando Gonzalez Candelas
- CIBER de Epidemiología y Salud Pública (CIBERESP), ISCIII, 28029 Madrid, Spain
- Joint Research Unit Infection and Public Health FISABIO-University of Valencia, Institute for Integrative Systems Biology (I2SysBio), 46020 Valencia, Spain
| | - María de Toro
- Plataforma de Genómica y Bioinformática, Centro de Investigación Biomédica de La Rioja (CIBIR), 26006 Logroño, Spain
| | - Miguel Fajardo
- Microbiology Service, Hospital Universitario de Badajoz, 06080 Badajoz, Spain
| | - Carmen Ezpeleta
- Complejo Hospitalario de Navarra and Navarra De Servicios Y Tecnologías S A (NASERTIC), 31008 Pamplona, Spain
| | - Fernando Lázaro
- Microbiology Service, Hospital Universitario La Paz, 28046 Madrid, Spain
| | - Sonia Pérez Castro
- Microbiology Service, Complexo Hospitalario Universitario de Vigo, 36204 Vigo, Spain
| | - Isabel Cuesta
- Bioinformatics Unit, Unidades Centrales Científico Técnicas, Instituto de Salud Carlos III, 28222 Majadahonda, Spain
| | - Angel Zaballos
- Genomics Unit, Unidades Centrales Científico Técnicas, Instituto de Salud Carlos III, 28222 Majadahonda, Spain
| | - Francisco Pozo
- Respiratory Viruses and Influenza Unit, National Centre for Microbiology, Instituto de Salud Carlos III, 28222 Majadahonda, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), ISCIII, 28029 Madrid, Spain
| | - Inmaculada Casas
- Respiratory Viruses and Influenza Unit, National Centre for Microbiology, Instituto de Salud Carlos III, 28222 Majadahonda, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), ISCIII, 28029 Madrid, Spain
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14
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Rombauts A, Bódalo Torruella M, Abelenda-Alonso G, Perera-Bel J, Ferrer-Salvador A, Acedo-Terrades A, Gabarrós-Subirà M, Oriol I, Gudiol C, Nonell L, Carratalà J. Dynamics of Gene Expression Profiling and Identification of High-Risk Patients for Severe COVID-19. Biomedicines 2023; 11:biomedicines11051348. [PMID: 37239019 DOI: 10.3390/biomedicines11051348] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 04/28/2023] [Accepted: 05/01/2023] [Indexed: 05/28/2023] Open
Abstract
The clinical manifestations of SARS-CoV-2 infection vary widely, from asymptomatic infection to the development of acute respiratory distress syndrome (ARDS) and death. The host response elicited by SARS-CoV-2 plays a key role in determining the clinical outcome. We hypothesized that determining the dynamic whole blood transcriptomic profile of hospitalized adult COVID-19 patients and characterizing the subgroup that develops severe disease and ARDS would broaden our understanding of the heterogeneity in clinical outcomes. We recruited 60 hospitalized patients with RT-PCR-confirmed SARS-CoV-2 infection, among whom 19 developed ARDS. Peripheral blood was collected using PAXGene RNA tubes within 24 h of admission and on day 7. There were 2572 differently expressed genes in patients with ARDS at baseline and 1149 at day 7. We found a dysregulated inflammatory response in COVID-19 ARDS patients, with an increased expression of genes related to pro-inflammatory molecules and neutrophil and macrophage activation at admission, in addition to an immune regulation loss. This led, in turn, to a higher expression of genes related to reactive oxygen species, protein polyubiquitination, and metalloproteinases in the latter stages. Some of the most significant differences in gene expression found between patients with and without ARDS corresponded to long non-coding RNA involved in epigenetic control.
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Affiliation(s)
- Alexander Rombauts
- Department of Infectious Diseases, Hospital Universitari de Bellvitge-IDIBELL, 08908 Barcelona, Spain
| | | | - Gabriela Abelenda-Alonso
- Department of Infectious Diseases, Hospital Universitari de Bellvitge-IDIBELL, 08908 Barcelona, Spain
| | - Júlia Perera-Bel
- MARGenomics, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain
| | - Anna Ferrer-Salvador
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, 08028 Barcelona, Spain
| | | | - Maria Gabarrós-Subirà
- MARGenomics, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain
| | - Isabel Oriol
- Department of Infectious Diseases, Hospital Universitari de Bellvitge-IDIBELL, 08908 Barcelona, Spain
| | - Carlota Gudiol
- Department of Infectious Diseases, Hospital Universitari de Bellvitge-IDIBELL, 08908 Barcelona, Spain
- Department of Medicine, Universitat de Barcelona, 08007 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Lara Nonell
- MARGenomics, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain
| | - Jordi Carratalà
- Department of Infectious Diseases, Hospital Universitari de Bellvitge-IDIBELL, 08908 Barcelona, Spain
- Department of Medicine, Universitat de Barcelona, 08007 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
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Pérez-Gómez B, Pastor-Barriuso R, Fernández-de-Larrea N, Hernán MA, Pérez-Olmeda M, Oteo-Iglesias J, Fernández-Navarro P, Fernández-García A, Martín M, Cruz I, Sanmartín JL, León-Paniagua J, Muñoz-Montalvo JF, Blanco F, Yotti R, Pollán M. SARS-CoV-2 Infection During the First and Second Pandemic Waves in Spain: the ENE-COVID Study. Am J Public Health 2023; 113:533-544. [PMID: 36893370 PMCID: PMC10088950 DOI: 10.2105/ajph.2023.307233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2023] [Indexed: 03/11/2023]
Abstract
Objectives. To describe participant characteristics associated with severe acute respiratory syndrome coronavirus 2 infection in Spain's first 2 COVID-19 waves per the Spanish National Seroepidemiological Survey of SARS-CoV-2 Infection (ENE-COVID). Methods. A representative cohort of the noninstitutionalized Spanish population, selected through stratified 2-stage sampling, answered a questionnaire and received point-of-care testing April to June 2020 (first wave: n = 68 287); previously seronegative participants repeated the questionnaire and test November 2020 (second wave: n = 44 451). We estimated seropositivity by wave and participant characteristics, accounting for sampling weights, nonresponse, and design effects. Results. We found that 6.0% (95% confidence interval [CI] = 5.7%, 6.4%) of Spain's population was infected by June and 3.8% (95% CI = 3.5%, 4.1%) more by November 2020. Both genders were equally affected. Seroprevalence decreased with age in adults 20 years and older in the second wave; socioeconomic differences increased. Health care workers were affected at 11.1% (95% CI = 9.0%, 13.6%) and 6.1% (95% CI = 4.4%, 8.5%) in the first and second waves, respectively. Living with an infected person increased infection risk to 22.1% (95% CI = 18.9%, 25.6%) in the first and 35.0% (95% CI = 30.8%, 39.4%) in the second wave. Conclusions. ENE-COVID characterized the first 2 pandemic waves, when information from surveillance systems was incomplete. (Am J Public Health. 2023;113(5):533-544. https://doi.org/10.2105/AJPH.2023.307233).
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Affiliation(s)
- Beatriz Pérez-Gómez
- Beatriz Pérez-Gómez, Roberto Pastor-Barriuso, Nerea Fernández-de-Larrea, Pablo Fernández-Navarro, and Marina Pollán are with the National Centre for Epidemiology and the Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. Miguel A. Hernán is with the Departments of Epidemiology and Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA. Mayte Pérez-Olmeda, Jesús Oteo-Iglesias, and Aurora Fernández-García are with the National Centre for Microbiology and the Consortium for Biomedical Research in Infectious Diseases (CIBERINFEC), ISCIII. Mariano Martín, José L. Sanmartín, Juan F. Muñoz-Montalvo, and Faustino Blanco are with the Deputy Directorate of Information Technologies, Ministry of Health, Madrid, Spain. Israel Cruz is with the National School of Public Health, ISCIII. José León-Paniagua and Raquel Yotti are with ISCIII
| | - Roberto Pastor-Barriuso
- Beatriz Pérez-Gómez, Roberto Pastor-Barriuso, Nerea Fernández-de-Larrea, Pablo Fernández-Navarro, and Marina Pollán are with the National Centre for Epidemiology and the Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. Miguel A. Hernán is with the Departments of Epidemiology and Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA. Mayte Pérez-Olmeda, Jesús Oteo-Iglesias, and Aurora Fernández-García are with the National Centre for Microbiology and the Consortium for Biomedical Research in Infectious Diseases (CIBERINFEC), ISCIII. Mariano Martín, José L. Sanmartín, Juan F. Muñoz-Montalvo, and Faustino Blanco are with the Deputy Directorate of Information Technologies, Ministry of Health, Madrid, Spain. Israel Cruz is with the National School of Public Health, ISCIII. José León-Paniagua and Raquel Yotti are with ISCIII
| | - Nerea Fernández-de-Larrea
- Beatriz Pérez-Gómez, Roberto Pastor-Barriuso, Nerea Fernández-de-Larrea, Pablo Fernández-Navarro, and Marina Pollán are with the National Centre for Epidemiology and the Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. Miguel A. Hernán is with the Departments of Epidemiology and Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA. Mayte Pérez-Olmeda, Jesús Oteo-Iglesias, and Aurora Fernández-García are with the National Centre for Microbiology and the Consortium for Biomedical Research in Infectious Diseases (CIBERINFEC), ISCIII. Mariano Martín, José L. Sanmartín, Juan F. Muñoz-Montalvo, and Faustino Blanco are with the Deputy Directorate of Information Technologies, Ministry of Health, Madrid, Spain. Israel Cruz is with the National School of Public Health, ISCIII. José León-Paniagua and Raquel Yotti are with ISCIII
| | - Miguel A Hernán
- Beatriz Pérez-Gómez, Roberto Pastor-Barriuso, Nerea Fernández-de-Larrea, Pablo Fernández-Navarro, and Marina Pollán are with the National Centre for Epidemiology and the Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. Miguel A. Hernán is with the Departments of Epidemiology and Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA. Mayte Pérez-Olmeda, Jesús Oteo-Iglesias, and Aurora Fernández-García are with the National Centre for Microbiology and the Consortium for Biomedical Research in Infectious Diseases (CIBERINFEC), ISCIII. Mariano Martín, José L. Sanmartín, Juan F. Muñoz-Montalvo, and Faustino Blanco are with the Deputy Directorate of Information Technologies, Ministry of Health, Madrid, Spain. Israel Cruz is with the National School of Public Health, ISCIII. José León-Paniagua and Raquel Yotti are with ISCIII
| | - Mayte Pérez-Olmeda
- Beatriz Pérez-Gómez, Roberto Pastor-Barriuso, Nerea Fernández-de-Larrea, Pablo Fernández-Navarro, and Marina Pollán are with the National Centre for Epidemiology and the Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. Miguel A. Hernán is with the Departments of Epidemiology and Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA. Mayte Pérez-Olmeda, Jesús Oteo-Iglesias, and Aurora Fernández-García are with the National Centre for Microbiology and the Consortium for Biomedical Research in Infectious Diseases (CIBERINFEC), ISCIII. Mariano Martín, José L. Sanmartín, Juan F. Muñoz-Montalvo, and Faustino Blanco are with the Deputy Directorate of Information Technologies, Ministry of Health, Madrid, Spain. Israel Cruz is with the National School of Public Health, ISCIII. José León-Paniagua and Raquel Yotti are with ISCIII
| | - Jesús Oteo-Iglesias
- Beatriz Pérez-Gómez, Roberto Pastor-Barriuso, Nerea Fernández-de-Larrea, Pablo Fernández-Navarro, and Marina Pollán are with the National Centre for Epidemiology and the Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. Miguel A. Hernán is with the Departments of Epidemiology and Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA. Mayte Pérez-Olmeda, Jesús Oteo-Iglesias, and Aurora Fernández-García are with the National Centre for Microbiology and the Consortium for Biomedical Research in Infectious Diseases (CIBERINFEC), ISCIII. Mariano Martín, José L. Sanmartín, Juan F. Muñoz-Montalvo, and Faustino Blanco are with the Deputy Directorate of Information Technologies, Ministry of Health, Madrid, Spain. Israel Cruz is with the National School of Public Health, ISCIII. José León-Paniagua and Raquel Yotti are with ISCIII
| | - Pablo Fernández-Navarro
- Beatriz Pérez-Gómez, Roberto Pastor-Barriuso, Nerea Fernández-de-Larrea, Pablo Fernández-Navarro, and Marina Pollán are with the National Centre for Epidemiology and the Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. Miguel A. Hernán is with the Departments of Epidemiology and Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA. Mayte Pérez-Olmeda, Jesús Oteo-Iglesias, and Aurora Fernández-García are with the National Centre for Microbiology and the Consortium for Biomedical Research in Infectious Diseases (CIBERINFEC), ISCIII. Mariano Martín, José L. Sanmartín, Juan F. Muñoz-Montalvo, and Faustino Blanco are with the Deputy Directorate of Information Technologies, Ministry of Health, Madrid, Spain. Israel Cruz is with the National School of Public Health, ISCIII. José León-Paniagua and Raquel Yotti are with ISCIII
| | - Aurora Fernández-García
- Beatriz Pérez-Gómez, Roberto Pastor-Barriuso, Nerea Fernández-de-Larrea, Pablo Fernández-Navarro, and Marina Pollán are with the National Centre for Epidemiology and the Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. Miguel A. Hernán is with the Departments of Epidemiology and Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA. Mayte Pérez-Olmeda, Jesús Oteo-Iglesias, and Aurora Fernández-García are with the National Centre for Microbiology and the Consortium for Biomedical Research in Infectious Diseases (CIBERINFEC), ISCIII. Mariano Martín, José L. Sanmartín, Juan F. Muñoz-Montalvo, and Faustino Blanco are with the Deputy Directorate of Information Technologies, Ministry of Health, Madrid, Spain. Israel Cruz is with the National School of Public Health, ISCIII. José León-Paniagua and Raquel Yotti are with ISCIII
| | - Mariano Martín
- Beatriz Pérez-Gómez, Roberto Pastor-Barriuso, Nerea Fernández-de-Larrea, Pablo Fernández-Navarro, and Marina Pollán are with the National Centre for Epidemiology and the Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. Miguel A. Hernán is with the Departments of Epidemiology and Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA. Mayte Pérez-Olmeda, Jesús Oteo-Iglesias, and Aurora Fernández-García are with the National Centre for Microbiology and the Consortium for Biomedical Research in Infectious Diseases (CIBERINFEC), ISCIII. Mariano Martín, José L. Sanmartín, Juan F. Muñoz-Montalvo, and Faustino Blanco are with the Deputy Directorate of Information Technologies, Ministry of Health, Madrid, Spain. Israel Cruz is with the National School of Public Health, ISCIII. José León-Paniagua and Raquel Yotti are with ISCIII
| | - Israel Cruz
- Beatriz Pérez-Gómez, Roberto Pastor-Barriuso, Nerea Fernández-de-Larrea, Pablo Fernández-Navarro, and Marina Pollán are with the National Centre for Epidemiology and the Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. Miguel A. Hernán is with the Departments of Epidemiology and Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA. Mayte Pérez-Olmeda, Jesús Oteo-Iglesias, and Aurora Fernández-García are with the National Centre for Microbiology and the Consortium for Biomedical Research in Infectious Diseases (CIBERINFEC), ISCIII. Mariano Martín, José L. Sanmartín, Juan F. Muñoz-Montalvo, and Faustino Blanco are with the Deputy Directorate of Information Technologies, Ministry of Health, Madrid, Spain. Israel Cruz is with the National School of Public Health, ISCIII. José León-Paniagua and Raquel Yotti are with ISCIII
| | - José L Sanmartín
- Beatriz Pérez-Gómez, Roberto Pastor-Barriuso, Nerea Fernández-de-Larrea, Pablo Fernández-Navarro, and Marina Pollán are with the National Centre for Epidemiology and the Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. Miguel A. Hernán is with the Departments of Epidemiology and Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA. Mayte Pérez-Olmeda, Jesús Oteo-Iglesias, and Aurora Fernández-García are with the National Centre for Microbiology and the Consortium for Biomedical Research in Infectious Diseases (CIBERINFEC), ISCIII. Mariano Martín, José L. Sanmartín, Juan F. Muñoz-Montalvo, and Faustino Blanco are with the Deputy Directorate of Information Technologies, Ministry of Health, Madrid, Spain. Israel Cruz is with the National School of Public Health, ISCIII. José León-Paniagua and Raquel Yotti are with ISCIII
| | - José León-Paniagua
- Beatriz Pérez-Gómez, Roberto Pastor-Barriuso, Nerea Fernández-de-Larrea, Pablo Fernández-Navarro, and Marina Pollán are with the National Centre for Epidemiology and the Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. Miguel A. Hernán is with the Departments of Epidemiology and Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA. Mayte Pérez-Olmeda, Jesús Oteo-Iglesias, and Aurora Fernández-García are with the National Centre for Microbiology and the Consortium for Biomedical Research in Infectious Diseases (CIBERINFEC), ISCIII. Mariano Martín, José L. Sanmartín, Juan F. Muñoz-Montalvo, and Faustino Blanco are with the Deputy Directorate of Information Technologies, Ministry of Health, Madrid, Spain. Israel Cruz is with the National School of Public Health, ISCIII. José León-Paniagua and Raquel Yotti are with ISCIII
| | - Juan F Muñoz-Montalvo
- Beatriz Pérez-Gómez, Roberto Pastor-Barriuso, Nerea Fernández-de-Larrea, Pablo Fernández-Navarro, and Marina Pollán are with the National Centre for Epidemiology and the Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. Miguel A. Hernán is with the Departments of Epidemiology and Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA. Mayte Pérez-Olmeda, Jesús Oteo-Iglesias, and Aurora Fernández-García are with the National Centre for Microbiology and the Consortium for Biomedical Research in Infectious Diseases (CIBERINFEC), ISCIII. Mariano Martín, José L. Sanmartín, Juan F. Muñoz-Montalvo, and Faustino Blanco are with the Deputy Directorate of Information Technologies, Ministry of Health, Madrid, Spain. Israel Cruz is with the National School of Public Health, ISCIII. José León-Paniagua and Raquel Yotti are with ISCIII
| | - Faustino Blanco
- Beatriz Pérez-Gómez, Roberto Pastor-Barriuso, Nerea Fernández-de-Larrea, Pablo Fernández-Navarro, and Marina Pollán are with the National Centre for Epidemiology and the Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. Miguel A. Hernán is with the Departments of Epidemiology and Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA. Mayte Pérez-Olmeda, Jesús Oteo-Iglesias, and Aurora Fernández-García are with the National Centre for Microbiology and the Consortium for Biomedical Research in Infectious Diseases (CIBERINFEC), ISCIII. Mariano Martín, José L. Sanmartín, Juan F. Muñoz-Montalvo, and Faustino Blanco are with the Deputy Directorate of Information Technologies, Ministry of Health, Madrid, Spain. Israel Cruz is with the National School of Public Health, ISCIII. José León-Paniagua and Raquel Yotti are with ISCIII
| | - Raquel Yotti
- Beatriz Pérez-Gómez, Roberto Pastor-Barriuso, Nerea Fernández-de-Larrea, Pablo Fernández-Navarro, and Marina Pollán are with the National Centre for Epidemiology and the Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. Miguel A. Hernán is with the Departments of Epidemiology and Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA. Mayte Pérez-Olmeda, Jesús Oteo-Iglesias, and Aurora Fernández-García are with the National Centre for Microbiology and the Consortium for Biomedical Research in Infectious Diseases (CIBERINFEC), ISCIII. Mariano Martín, José L. Sanmartín, Juan F. Muñoz-Montalvo, and Faustino Blanco are with the Deputy Directorate of Information Technologies, Ministry of Health, Madrid, Spain. Israel Cruz is with the National School of Public Health, ISCIII. José León-Paniagua and Raquel Yotti are with ISCIII
| | - Marina Pollán
- Beatriz Pérez-Gómez, Roberto Pastor-Barriuso, Nerea Fernández-de-Larrea, Pablo Fernández-Navarro, and Marina Pollán are with the National Centre for Epidemiology and the Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. Miguel A. Hernán is with the Departments of Epidemiology and Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA. Mayte Pérez-Olmeda, Jesús Oteo-Iglesias, and Aurora Fernández-García are with the National Centre for Microbiology and the Consortium for Biomedical Research in Infectious Diseases (CIBERINFEC), ISCIII. Mariano Martín, José L. Sanmartín, Juan F. Muñoz-Montalvo, and Faustino Blanco are with the Deputy Directorate of Information Technologies, Ministry of Health, Madrid, Spain. Israel Cruz is with the National School of Public Health, ISCIII. José León-Paniagua and Raquel Yotti are with ISCIII
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López-Andreo MJ, Vicente-Romero MR, Bernal E, Navarro-González I, Salazar-Martínez F, Cánovas-Cánovas V, Gil-Ortuño C, Riquelme-Rocamora MG, Solano F, Ibáñez-López FJ, Tomás C, Candel-Pérez C, Pérez-Parra S, Flores-Flores C. Whole Sequencing and Detailed Analysis of SARS-CoV-2 Genomes in Southeast Spain: Identification of Recurrent Mutations in the 20E (EU1) Variant with Some Clinical Implications. Diseases 2023; 11:diseases11020054. [PMID: 37092436 PMCID: PMC10123601 DOI: 10.3390/diseases11020054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 03/25/2023] [Accepted: 03/29/2023] [Indexed: 04/03/2023] Open
Abstract
During the COVID-19 pandemic caused by SARS-CoV-2, new waves have been associated with new variants and have the potential to escape vaccinations. Therefore, it is useful to conduct retrospective genomic surveillance research. Herein, we present a detailed analysis of 88 SARS-CoV-2 genomes belonging to samples taken from COVID-19 patients from October 2020 to April 2021 at the “Reina Sofía” Hospital (Murcia, Spain) focused to variant appeared later. The results at the mentioned stage show the turning point since the 20E (EU1) variant was still prevalent (71.6%), but Alpha was bursting to 14.8%. Concern mutations have been found in 5 genomes classified as 20E (EU1), which were not characteristic of this still little evolved variant. Most of those mutations are found in the spike protein, namely Δ69–70, E484K, Q675H and P681H. However, a relevant deletion in ORF1a at positions 3675–3677 was also identified. These mutations have been reported in many later SARS-CoV-2 lineages, including Omicron. Taken together, our data suggest that preferential emergence mutations could already be present in the early converging evolution. Aside from this, the molecular information has been contrasted with clinical data. Statistical analyses suggest that the correlation between age and severity criteria is significantly higher in the viral samples with more accumulated changes.
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Affiliation(s)
- María José López-Andreo
- Servicio de Biología Molecular, Área Científica y Técnica de Investigación (ACTI), Universidad de Murcia, 30100 Murcia, Spain
| | | | - Enrique Bernal
- Laboratorio de Microbiología del Hospital General Universitario Reina Sofía de Murcia, 30003 Murcia, Spain
- Correspondence: (E.B.); (F.S.)
| | - Inmaculada Navarro-González
- Servicio de Biología Molecular, Área Científica y Técnica de Investigación (ACTI), Universidad de Murcia, 30100 Murcia, Spain
| | - Francisco Salazar-Martínez
- Servicio de Biología Molecular, Área Científica y Técnica de Investigación (ACTI), Universidad de Murcia, 30100 Murcia, Spain
| | - Vanesa Cánovas-Cánovas
- Servicio de Biología Molecular, Área Científica y Técnica de Investigación (ACTI), Universidad de Murcia, 30100 Murcia, Spain
| | - Cristina Gil-Ortuño
- Servicio de Biología Molecular, Área Científica y Técnica de Investigación (ACTI), Universidad de Murcia, 30100 Murcia, Spain
| | - María Gema Riquelme-Rocamora
- Servicio de Biología Molecular, Área Científica y Técnica de Investigación (ACTI), Universidad de Murcia, 30100 Murcia, Spain
| | - Francisco Solano
- Departamento de Bioquímica y Biología Molecular B e Inmunología, Universidad de Murcia, 30100 Murcia, Spain
- Correspondence: (E.B.); (F.S.)
| | - Francisco Javier Ibáñez-López
- Sección de Apoyo Estadístico, Servicio de Investigación Biosanitaria, Área Científica y Técnica de Investigación (ACTI), Universidad de Murcia, 30100 Murcia, Spain
| | - Cristina Tomás
- Laboratorio de Microbiología del Hospital General Universitario Reina Sofía de Murcia, 30003 Murcia, Spain
| | - Carmen Candel-Pérez
- Laboratorio de Microbiología del Hospital General Universitario Reina Sofía de Murcia, 30003 Murcia, Spain
| | | | - César Flores-Flores
- Servicio de Biología Molecular, Área Científica y Técnica de Investigación (ACTI), Universidad de Murcia, 30100 Murcia, Spain
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Polo R, García-Albéniz X, Terán C, Morales M, Rial-Crestelo D, Garcinuño MA, García Del Toro M, Hita C, Gómez-Sirvent JL, Buzón L, Díaz de Santiago A, Arellano JP, Sanz J, Bachiller P, Alfaro EM, Díaz-Brito V, Masiá M, Hernández-Torres A, Guerra JM, Santos J, Arazo P, Muñoz L, Arribas JR, Martínez de Salazar P, Moreno S, Hernán MA, Del Amo J. Daily tenofovir disoproxil fumarate/emtricitabine and hydroxychloroquine for pre-exposure prophylaxis of COVID-19: a double-blind placebo-controlled randomized trial in healthcare workers. Clin Microbiol Infect 2023; 29:85-93. [PMID: 35940567 PMCID: PMC9352647 DOI: 10.1016/j.cmi.2022.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 07/06/2022] [Accepted: 07/09/2022] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To assess the effect of hydroxychloroquine (HCQ) and Tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) as pre-exposure prophylaxis on COVID-19 risk. METHODS EPICOS is a double-blind, placebo-controlled randomized trial conducted in Spain, Bolivia, and Venezuela. Healthcare workers with negative SARS-CoV-2 IgM/IgG test were randomly assigned to the following: daily TDF/FTC plus HCQ for 12 weeks, TDF/FTC plus HCQ placebo, HCQ plus TDF/FTC placebo, and TDF/FTC placebo plus HCQ placebo. Randomization was performed in groups of four. Primary outcome was laboratory-confirmed, symptomatic COVID-19. We also studied any (symptomatic or asymptomatic) COVID-19. We compared group-specific 14-week risks via differences and ratios with 95% CIs. RESULTS Of 1002 individuals screened, 926 (92.4%) were eligible and there were 14 cases of symptomatic COVID-19: 220 were assigned to the TDF/FTC plus HCQ group (3 cases), 231 to the TDF/FTC placebo plus HCQ group (3 cases), 233 to the TDF/FTC plus HCQ placebo group (3 cases), and 223 to the double placebo group (5 cases). Compared with the double placebo group, 14-week risk ratios (95% CI) of symptomatic COVID-19 were 0.39 (0.00-1.98) for TDF + HCQ, 0.34 (0.00-2.06) for TDF, and 0.49 (0.00-2.29) for HCQ. Corresponding risk ratios of any COVID-19 were 0.51 (0.21-1.00) for TDF + HCQ, 0.81 (0.44-1.49) for TDF, and 0.73 (0.41-1.38) for HCQ. Adverse events were generally mild. DISCUSSION The target sample size was not met. Our findings are compatible with both benefit and harm of pre-exposure prophylaxis with TDF/FTC and HCQ, alone or in combination, compared with placebo.
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Affiliation(s)
- Rosa Polo
- Division for HIV, STI, Viral Hepatitis and TB Control, Ministry of Health, Madrid, Spain
| | - Xabier García-Albéniz
- CAUSALab, Harvard T.H. Chan School of Public Health, Boston, MA, USA; RTI Health Solutions, Barcelona, Spain
| | - Carolina Terán
- Facultad de Medicina Universidad Mayor, Real y Pontificia de San Francisco Xavier de Chuquisaca, Hospital Santa Bárbara, Sucre, Bolivia
| | | | - David Rial-Crestelo
- Hospital Doce de Octubre, Madrid, Spain; CIBER de Enfermedades Infecciosas, Institute of Health Carlos III, Madrid, Spain
| | | | | | | | | | - Luis Buzón
- Hospital Universitario de Burgos, Burgos, Spain
| | | | | | - Jesus Sanz
- CIBER de Enfermedades Infecciosas, Institute of Health Carlos III, Madrid, Spain; Hospital Universitario de la Princesa, Madrid, Spain
| | | | | | | | - Mar Masiá
- CIBER de Enfermedades Infecciosas, Institute of Health Carlos III, Madrid, Spain; Hospital General Universitario de Elche, Alicante, Spain
| | | | | | - Jesús Santos
- Hospital Universitario Virgen de la Victoria de Málaga, Málaga, Spain
| | - Piedad Arazo
- Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Leopoldo Muñoz
- Complejo Hospitalario Universitario de Granada, Granada, Spain
| | - Jose Ramon Arribas
- CIBER de Enfermedades Infecciosas, Institute of Health Carlos III, Madrid, Spain; Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
| | - Pablo Martínez de Salazar
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Santiago Moreno
- CIBER de Enfermedades Infecciosas, Institute of Health Carlos III, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Miguel A Hernán
- CAUSALab, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Departments of Epidemiology and Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Julia Del Amo
- Division for HIV, STI, Viral Hepatitis and TB Control, Ministry of Health, Madrid, Spain; CIBER de Enfermedades Infecciosas, Institute of Health Carlos III, Madrid, Spain.
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Bousali M, Pogka V, Vatsellas G, Loupis T, Athanasiadis EI, Zoi K, Thanos D, Paraskevis D, Mentis A, Karamitros T. Tracing the First Days of the SARS-CoV-2 Pandemic in Greece and the Role of the First Imported Group of Travelers. Microbiol Spectr 2022; 10:e0213422. [PMID: 36409093 PMCID: PMC9769540 DOI: 10.1128/spectrum.02134-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 10/31/2022] [Indexed: 11/23/2022] Open
Abstract
The first SARS-CoV-2 case in Greece was confirmed on February 26, 2020, and since then, multiple strains have circulated the country, leading to regional and country-wide outbreaks. Our aim is to enlighten the events that took place during the first days of the SARS-CoV-2 pandemic in Greece, focusing on the role of the first imported group of travelers. We used whole-genome SARS-CoV-2 sequences obtained from the infected travelers of the group as well as Greece-derived and globally subsampled sequences and applied dedicated phylogenetics and phylodynamics tools as well as in-house-developed bioinformatics pipelines. Our analyses reveal the genetic variants circulating in Greece during the first days of the pandemic and the role of the group's imported strains in the course of the first pandemic wave in Greece. The strain that dominated in Greece throughout the first wave, bearing the D614G mutation, was primarily imported from a certain group of travelers, while molecular and clinical data suggest that the infection of the travelers occurred in Egypt. Founder effects early in the pandemic are important for the success of certain strains, as those arriving early, several times, and to diverse locations lead to the formation of large transmission clusters that can be estimated using molecular epidemiology approaches and can be a useful surveillance tool for the prioritization of nonpharmaceutical interventions and combating present and future outbreaks. IMPORTANCE The strain that dominated in Greece during the first pandemic wave was primarily imported from a group of returning travelers in February 2020, while molecular and clinical data suggest that the origin of the transmission was Egypt. The observed molecular transmission clusters reflect the transmission dynamics of this particular strain bearing the D614G mutation while highlighting the necessity of their use as a surveillance tool for the prioritization of nonpharmaceutical interventions and combating present and future outbreaks.
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Affiliation(s)
- Maria Bousali
- Bioinformatics and Applied Genomics Unit, Department of Microbiology, Hellenic Pasteur Institute, Athens, Greece
| | - Vasiliki Pogka
- Bioinformatics and Applied Genomics Unit, Department of Microbiology, Hellenic Pasteur Institute, Athens, Greece
- Laboratory of Medical Microbiology, Department of Microbiology, Hellenic Pasteur Institute, Athens, Greece
| | - Giannis Vatsellas
- Greek Genome Center, Biomedical Research Foundation of the Academy of Athens (BRFAA), Athens, Greece
| | - Theodoros Loupis
- Greek Genome Center, Biomedical Research Foundation of the Academy of Athens (BRFAA), Athens, Greece
- Haematology Research Laboratory, Biomedical Research Foundation of the Academy of Athens (BRFAA), Athens, Greece
| | - Emmanouil I. Athanasiadis
- Greek Genome Center, Biomedical Research Foundation of the Academy of Athens (BRFAA), Athens, Greece
| | - Katerina Zoi
- Greek Genome Center, Biomedical Research Foundation of the Academy of Athens (BRFAA), Athens, Greece
- Haematology Research Laboratory, Biomedical Research Foundation of the Academy of Athens (BRFAA), Athens, Greece
| | - Dimitris Thanos
- Greek Genome Center, Biomedical Research Foundation of the Academy of Athens (BRFAA), Athens, Greece
| | - Dimitrios Paraskevis
- Department of Hygiene Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Andreas Mentis
- Laboratory of Medical Microbiology, Department of Microbiology, Hellenic Pasteur Institute, Athens, Greece
| | - Timokratis Karamitros
- Bioinformatics and Applied Genomics Unit, Department of Microbiology, Hellenic Pasteur Institute, Athens, Greece
- Laboratory of Medical Microbiology, Department of Microbiology, Hellenic Pasteur Institute, Athens, Greece
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Bordoy AE, Vallès X, Not A, Chiner-Oms Á, Saludes V, Torres Cervós J, Roset Roig A, Juan-Andres C, Sureda H, Pardo-Amil V, García I, Guitart Rossell G, Cambra Cibeira L, Casañ C, Giménez M, Blanco I, Torres-Puente M, Cancino-Muñoz I, González-Candelas F, Comas I, Martró E. Epidemiological and Genomic Analysis of a Large SARS-CoV-2 Outbreak in a Long-Term Care Facility in Catalonia, Spain. mSphere 2022; 7:e0034622. [PMID: 36448779 DOI: 10.1128/msphere.00346-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Limiting outbreaks in long-term care facilities (LTCFs) is a cornerstone strategy to avoid an excess of COVID-19-related morbidity and mortality and to reduce its burden on the health system. We studied a large outbreak that occurred at an LTCF, combining methods of classical and genomic epidemiology analysis. The outbreak lasted for 31 days among residents, with an attack rate of 98% and 57% among residents and staff, respectively. The case fatality rate among residents was 16% (n = 15). Phylogenetic analysis of 59 SARS-CoV-2 isolates revealed the presence of two closely related viral variants in all cases (B.1.177 lineage), revealing a far more complex outbreak than initially thought and suggesting an initial spread driven by staff members. In turn, our results suggest that resident relocations to mitigate viral spread might have increased the risk of infection for staff members, creating secondary chains of transmission that were responsible for prolonging the outbreak. Our results highlight the importance of considering unnoticed chains of transmission early during an outbreak and making an adequate use and interpretation of diagnostic tests. Outbreak containment measures should be carefully tailored to each LTCF. IMPORTANCE The impact of COVID-19 on long-term care facilities (LTCFs) has been disproportionately large due to the high frailty of the residents. Here, we report epidemiological and genomic findings of a large outbreak that occurred at an LTCF, which ultimately affected almost all residents and nearly half of staff members. We found that the outbreak was initially driven by staff members; however, later resident relocation to limit the outbreak resulted in transmission from residents to staff members, evidencing the complexity and different phases of the outbreak. The phylogenetic analysis of SARS-CoV-2 isolates indicated that two closely related variants were responsible for the large outbreak. Our study highlights the importance of combining methods of classical and genomic epidemiology to take appropriate outbreak containment measures in LTCFs.
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Qanneta R. Pandemia COVID-19: experiencia e impacto en un centro hospitalario de atención intermedia de Tarragona. Rev Esp Geriatr Gerontol 2022; 57:237-238. [PMID: 35961797 PMCID: PMC9289004 DOI: 10.1016/j.regg.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 06/30/2022] [Accepted: 07/06/2022] [Indexed: 11/03/2022]
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21
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Alkhamis MA, Fountain-Jones NM, Khajah MM, Alghounaim M, Al-Sabah SK. Comparative Phylodynamics Reveals the Evolutionary History of SARS-CoV-2 Emerging Variants in the Arabian Peninsula. Virus Evol 2022; 8:veac040. [PMID: 35677574 PMCID: PMC9129158 DOI: 10.1093/ve/veac040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 05/12/2022] [Accepted: 05/18/2022] [Indexed: 11/18/2022] Open
Abstract
Emerging severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants continue to be responsible for an unprecedented worldwide public health and economic catastrophe. Accurate understanding and comparison of global and regional evolutionary epidemiology of novel SARS-CoV-2 variants are critical to guide current and future interventions. Here, we utilized a Bayesian phylodynamic pipeline to trace and compare the evolutionary dynamics, spatiotemporal origins, and spread of five variants (Alpha, Beta, Delta, Kappa, and Eta) across the Arabian Peninsula. We found variant-specific signatures of evolution and spread that are likely linked to air travel and disease control interventions in the region. Alpha, Beta, and Delta variants went through sequential periods of growth and decline, whereas we inferred inconclusive population growth patterns for the Kappa and Eta variants due to their sporadic introductions in the region. Non-pharmaceutical interventions imposed between mid-2020 and early 2021 likely played a role in reducing the epidemic progression of the Beta and the Alpha variants. In comparison, the combination of the non-pharmaceutical interventions and the rapid rollout of vaccination might have shaped Delta variant dynamics. We found that the Alpha and Beta variants were frequently introduced into the Arab peninsula between mid-2020 and early 2021 from Europe and Africa, respectively, whereas the Delta variant was frequently introduced between early 2021 and mid-2021 from East Asia. For these three variants, we also revealed significant and intense dispersal routes between the Arab region and Africa, Europe, Asia, and Oceania. In contrast, the restricted spread and stable effective population size of the Kappa and the Eta variants suggest that they no longer need to be targeted in genomic surveillance activities in the region. In contrast, the evolutionary characteristics of the Alpha, Beta, and Delta variants confirm the dominance of these variants in the recent outbreaks. Our study highlights the urgent need to establish regional molecular surveillance programs to ensure effective decision making related to the allocation of intervention activities targeted toward the most relevant variants.
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Affiliation(s)
- Moh A Alkhamis
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Health Sciences Centre, Kuwait University, Kuwait City, Kuwait
| | | | - Mohammad M Khajah
- Systems and Software development Department, Kuwait Institute for Scientific Research, Kuwait
| | - Mohammad Alghounaim
- Departement of pediatrics, Amiri Hospital, Ministry of Health, Kuwait
- Jaber Al-Ahmad Al-Sabah Hospital, Ministry of Health, Kuwait
| | - Salman K Al-Sabah
- Jaber Al-Ahmad Al-Sabah Hospital, Ministry of Health, Kuwait
- Department of Surgery, Faculty of Medicine, Health Sciences Center, Kuwait University, Kuwait
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22
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Serwin K, Aksak-Wąs B, Parczewski M. Phylodynamic Dispersal of SARS-CoV-2 Lineages Circulating across Polish-German Border Provinces. Viruses 2022; 14. [PMID: 35632625 DOI: 10.3390/v14050884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/18/2022] [Accepted: 04/21/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction: The emergence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has evolved into a worldwide outbreak, with significant molecular evolution over time. Large-scale phylodynamic studies allow to map the virus spread and inform preventive strategies. Aim: This study investigates the extent of binational dispersal and dynamics of SARS-CoV-2 lineages between seven border provinces of the adjacent countries of Poland and Germany to reconstruct SARS-CoV-2 transmission networks. Methods: Following three pandemic waves from March 2020 to the end of May 2021, we analysed a dataset of 19,994 sequences divided into B.1.1.7|Alpha and non-Alpha lineage groups. We performed phylogeographic analyses using the discrete diffusion models to identify the pathways of virus spread. Results: Based on population dynamics inferences, in total, 673 lineage introductions (95% HPD interval 641−712) for non-Alpha and 618 (95% HPD interval 599−639) for B.1.1.7|Alpha were identified in the area. For non-Alpha lineages, 5.05% binational, 86.63% exclusively German, and 8.32% Polish clusters were found, with a higher frequency of international clustering observed for B.1.1.7|Alpha (13.11% for binational, 68.44% German and 18.45% Polish, p < 0.001). We identified key transmission hubs for the analysed lineages, namely Saxony, West Pomerania and Lower Silesia. Conclusions: Clustering patterns between Poland and Germany reflect the viral variant transmission dynamics at the international level in the borderline area. Tracing the spread of the virus between two adjacent large European countries may provide a basis for future intervention policies in cross-border cooperation efforts against the spread of the pandemics.
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Chen Z, Azman AS, Chen X, Zou J, Tian Y, Sun R, Xu X, Wu Y, Lu W, Ge S, Zhao Z, Yang J, Leung DT, Domman DB, Yu H. Global landscape of SARS-CoV-2 genomic surveillance and data sharing. Nat Genet 2022; 54:499-507. [PMID: 35347305 PMCID: PMC9005350 DOI: 10.1038/s41588-022-01033-y] [Citation(s) in RCA: 105] [Impact Index Per Article: 52.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 02/11/2022] [Indexed: 12/02/2022]
Abstract
Genomic surveillance has shaped our understanding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants. We performed a global landscape analysis on SARS-CoV-2 genomic surveillance and genomic data using a collection of country-specific data. Here, we characterize increasing circulation of the Alpha variant in early 2021, subsequently replaced by the Delta variant around May 2021. SARS-CoV-2 genomic surveillance and sequencing availability varied markedly across countries, with 45 countries performing a high level of routine genomic surveillance and 96 countries with a high availability of SARS-CoV-2 sequencing. We also observed a marked heterogeneity of sequencing percentage, sequencing technologies, turnaround time and completeness of released metadata across regions and income groups. A total of 37% of countries with explicit reporting on variants shared less than half of their sequences of variants of concern (VOCs) in public repositories. Our findings indicate an urgent need to increase timely and full sharing of sequences, the standardization of metadata files and support for countries with limited sequencing and bioinformatics capacity.
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Affiliation(s)
- Zhiyuan Chen
- Department of Infectious Diseases, Huashan Hospital, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
| | - Andrew S Azman
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Xinhua Chen
- Department of Infectious Diseases, Huashan Hospital, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
| | - Junyi Zou
- Department of Infectious Diseases, Huashan Hospital, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
| | - Yuyang Tian
- Department of Infectious Diseases, Huashan Hospital, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
| | - Ruijia Sun
- Department of Infectious Diseases, Huashan Hospital, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
| | - Xiangyanyu Xu
- Department of Infectious Diseases, Huashan Hospital, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
| | - Yani Wu
- School of Public Health, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wanying Lu
- Department of Infectious Diseases, Huashan Hospital, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
| | - Shijia Ge
- Department of Infectious Diseases, Huashan Hospital, School of Public Health, Fudan University, Shanghai, China
| | - Zeyao Zhao
- Department of Infectious Diseases, Huashan Hospital, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
| | - Juan Yang
- Department of Infectious Diseases, Huashan Hospital, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
| | - Daniel T Leung
- Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City, UT, USA
- Division of Microbiology & Immunology, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Daryl B Domman
- Center for Global Health, Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Hongjie Yu
- Department of Infectious Diseases, Huashan Hospital, School of Public Health, Fudan University, Shanghai, China.
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China.
- Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China.
- National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China.
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Padilla-Blanco M, Aguiló-Gisbert J, Rubio V, Lizana V, Chillida-Martínez E, Cardells J, Maiques E, Rubio-Guerri C. The Finding of the Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) in a Wild Eurasian River Otter (Lutra lutra) Highlights the Need for Viral Surveillance in Wild Mustelids. Front Vet Sci 2022; 9:826991. [PMID: 35433914 PMCID: PMC9010019 DOI: 10.3389/fvets.2022.826991] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 02/14/2022] [Indexed: 01/02/2023] Open
Abstract
Animals have been involved in the three known outbreaks of severe respiratory syndromes due to coronaviruses (years 2005, 2012, and 2019). The pandemic nature of the SARS-CoV-2 outbreak increases the likelihood of infection from humans of susceptible animal species that, thus, could become secondary viral hosts and even disease reservoirs. We present evidence of spillover infection of wild mustelids by reporting the presence of SARS-CoV-2 in a Eurasian river otter found near a water reservoir in the Valencian Community (Spain). We detected the virus using two different commercial RTqPCR assays on RNA extracted from the nasopharynx (swabbing) and from lung tissue and mediastinal lymph node homogenates. The corresponding samples from two additional otters from distant sites tested negative in identical assays. The diagnosis in the positive otter was confirmed by two-tube RT-PCR assay in which RNA was first retrotranscribed, and then specific regions of the spike (S), nucleocapsid (N), and ORF10 genes were separately amplified from the produced cDNA, followed by electrophoretic visualization and Sanger sequencing. The sequences of the amplified products revealed some non-synonymous changes in the N and ORF10 partial sequences, relative to the consensus sequence. These changes, identified already in human patient samples, point to human origin of the virus, although their specific combination was unique. These findings, together with our previous report of SARS-CoV-2 infection of feral American mink, highlight the need for SARS-CoV-2 surveillance of wild or feral mustelids to evaluate the risk that these animals could become SARS-CoV-2 reservoirs.
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Affiliation(s)
- Miguel Padilla-Blanco
- Department of Pharmacy, Facultad de Ciencias de la Salud, Universidad Cardenal Herrera-CEU, Valencia, Spain
| | - Jordi Aguiló-Gisbert
- Servicio de Análisis, Investigación, Gestión de Animales Silvestres (SAIGAS), Facultad de Veterinaria, Universidad Cardenal Herrera-CEU, Valencia, Spain
| | - Vicente Rubio
- Instituto de Biomedicina de Valencia del Consejo Superior de Investigaciones Científicas, Centro de Investigació Biomédica en la Red sobre Enfermedades Raras, Instituto de Salud Carlos III, Valencia, Spain
| | - Víctor Lizana
- Servicio de Análisis, Investigación, Gestión de Animales Silvestres (SAIGAS), Facultad de Veterinaria, Universidad Cardenal Herrera-CEU, Valencia, Spain
- Wildlife Ecology & Health Group (WE&H), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Eva Chillida-Martínez
- Servicio de Análisis, Investigación, Gestión de Animales Silvestres (SAIGAS), Facultad de Veterinaria, Universidad Cardenal Herrera-CEU, Valencia, Spain
| | - Jesús Cardells
- Servicio de Análisis, Investigación, Gestión de Animales Silvestres (SAIGAS), Facultad de Veterinaria, Universidad Cardenal Herrera-CEU, Valencia, Spain
- Wildlife Ecology & Health Group (WE&H), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Elisa Maiques
- Department of Biomedical Sciences, Facultad de Ciencias de la Salud, Universidad Cardenal Herrera-CEU, Valencia, Spain
- *Correspondence: Elisa Maiques
| | - Consuelo Rubio-Guerri
- Department of Pharmacy, Facultad de Ciencias de la Salud, Universidad Cardenal Herrera-CEU, Valencia, Spain
- Consuelo Rubio-Guerri
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25
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Wang F, Zhang L, Ding L, Wang L, Deng Y. Fear of COVID-19 Among College Students: A Systematic Review and Meta-Analysis. Front Public Health 2022; 10:846894. [PMID: 35299699 PMCID: PMC8921101 DOI: 10.3389/fpubh.2022.846894] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 01/31/2022] [Indexed: 12/20/2022] Open
Abstract
Background Mental health issue among college students is routinely a major public health concern, and coronavirus disease 2019 (COVID-19) pandemic may have exacerbated the students' mental health issues which include psychological distress, panic disorder, insomnia, and posttraumatic stress symptoms. However, few studies reached a consensus on the impact of COVID-19 fear on mental health among college students. Therefore, we aimed to conduct a systematic review and meta-analysis that quantitatively synthesized the fear among college students during the COVID-19 pandemic. Methods PubMed, EMBASE, CINAHL, and PsycINFO electronic databases were systematically searched to identify cross-sectional study reporting the state of COVID-19 fear examined by the Fear of COVID-19 Scale (FCV-19S) published up until November 20, 2021. Methodological quality was complied with the evaluation criteria of the Agency for Healthcare Research and Quality. The random effects model was employed to estimate the pooled mean of FCV-19S score. Subgroup analysis and meta-regression analysis were also conducted. Publication bias was assessed by Begg's test and funnel plot. Results A total of 16 studies with a sample size of 11,872 were included. A pooled mean of FCV-19S score was 17.60 [95% confidence interval (CI): 16.41–18.78]. The mean of COVID-19 fear in women (17.11, 95% CI: 16.59–17.64) was higher than that in men (15.21, 95% CI: 14.33–16.08). The highest and lowest pooled means of FCV-19S score were observed in the studies conducted in multiple countries that include Israel, Russian, and Belarus (21.55, 95% CI: 20.77–22.33) and in Europe (16.52, 95% CI: 15.26–17.77), respectively. No significant publication bias was detected by Begg's test. Conclusions College students experienced a moderate level of fear caused by COVID-19 pandemic. It is necessary to design and implement prevention programs that target the mental health of college students. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021287017, identifier: CRD42021287017.
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Affiliation(s)
- Fang Wang
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, China
| | - Le Zhang
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, China
| | - Lu Ding
- Department of Public Health, Second Affiliated Hospital of Shandong First Medical University, Tai'an, China
| | - Lei Wang
- School of Pharmaceutical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, China
| | - Yang Deng
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, China
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Raghwani J, du Plessis L, McCrone JT, Hill SC, Parag KV, Thézé J, Kumar D, Puvar A, Pandit R, Pybus OG, Fournié G, Joshi M, Joshi C. Genomic Epidemiology of Early SARS-CoV-2 Transmission Dynamics, Gujarat, India. Emerg Infect Dis 2022; 28:751-758. [PMID: 35203112 PMCID: PMC8962880 DOI: 10.3201/eid2804.212053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Limited genomic sampling in many high-incidence countries has impeded studies of severe respiratory syndrome coronavirus 2 (SARS-CoV-2) genomic epidemiology. Consequently, critical questions remain about the generation and global distribution of virus genetic diversity. We investigated SARS-CoV-2 transmission dynamics in Gujarat, India, during the state’s first epidemic wave to shed light on spread of the virus in one of the regions hardest hit by the pandemic. By integrating case data and 434 whole-genome sequences sampled across 20 districts, we reconstructed the epidemic dynamics and spatial spread of SARS-CoV-2 in Gujarat. Our findings indicate global and regional connectivity and population density were major drivers of the Gujarat outbreak. We detected >100 virus lineage introductions, most of which appear to be associated with international travel. Within Gujarat, virus dissemination occurred predominantly from densely populated regions to geographically proximate locations that had low population density, suggesting that urban centers contributed disproportionately to virus spread.
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27
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López-Causapé C, Fraile-Ribot PA, Jiménez-Serrano S, Cabot G, Del Barrio-Tofiño E, Prado MC, Linares JM, López A, Hurtado A, Riera E, Serra A, Roselló E, Carbó L, Fernández-Baca MV, Gallegos C, Saurina J, Arteaga E, Salom MM, Salvá A, Nicolau A, González-Candelas F, Comas I, Oliver A. A Genomic Snapshot of the SARS-CoV-2 Pandemic in the Balearic Islands. Front Microbiol 2022; 12:803827. [PMID: 35095814 PMCID: PMC8790175 DOI: 10.3389/fmicb.2021.803827] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 12/15/2021] [Indexed: 11/29/2022] Open
Abstract
Objective: To analyze the SARS-CoV-2 genomic epidemiology in the Balearic Islands, a unique setting in which the course of the pandemic has been influenced by a complex interplay between insularity, severe social restrictions and tourism travels. Methods: Since the onset of the pandemic, more than 2,700 SARS-CoV-2 positive respiratory samples have been randomly selected and sequenced in the Balearic Islands. Genetic diversity of circulating variants was assessed by lineage assignment of consensus whole genome sequences with PANGOLIN and investigation of additional spike mutations. Results: Consensus sequences were assigned to 46 different PANGO lineages and 75% of genomes were classified within a VOC, VUI, or VUM variant according to the WHO definitions. Highest genetic diversity was documented in the island of Majorca (42 different lineages detected). Globally, lineages B.1.1.7 and B.1.617.2/AY.X were identified as the 2 major lineages circulating in the Balearic Islands during the pandemic, distantly followed by lineages B.1.177/B.1.177.X. However, in Ibiza/Formentera lineage distribution was slightly different and lineage B.1.221 was the third most prevalent. Temporal distribution analysis showed that B.1 and B.1.5 lineages dominated the first epidemic wave, lineage B.1.177 dominated the second and third, and lineage B.1.617.2 the fourth. Of note, lineage B.1.1.7 became the most prevalent circulating lineage during first half of 2021; however, it was not associated with an increased in COVID-19 cases likely due to severe social restrictions and limited travels. Additional spike mutations were rarely documented with the exception of mutation S:Q613H which has been detected in several genomes (n = 25) since July 2021. Conclusion: Virus evolution, mainly driven by the acquisition and selection of spike substitutions conferring biological advantages, social restrictions, and size population are apparently key factors for explaining the epidemic patterns registered in the Balearic Islands.
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Affiliation(s)
- Carla López-Causapé
- Servicio de Microbiología y Unidad de Investigación, Hospital Universitario Son Espases, Instituto de Investigación Sanitaria de las Islas Baleares, Palma, Spain.,CIBER en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Pablo A Fraile-Ribot
- Servicio de Microbiología y Unidad de Investigación, Hospital Universitario Son Espases, Instituto de Investigación Sanitaria de las Islas Baleares, Palma, Spain.,CIBER en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | | | - Gabriel Cabot
- Servicio de Microbiología y Unidad de Investigación, Hospital Universitario Son Espases, Instituto de Investigación Sanitaria de las Islas Baleares, Palma, Spain.,CIBER en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Ester Del Barrio-Tofiño
- Servicio de Microbiología y Unidad de Investigación, Hospital Universitario Son Espases, Instituto de Investigación Sanitaria de las Islas Baleares, Palma, Spain.,CIBER en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - M Carmen Prado
- Servicio de Microbiología y Unidad de Investigación, Hospital Universitario Son Espases, Instituto de Investigación Sanitaria de las Islas Baleares, Palma, Spain
| | - Juana María Linares
- Servicio de Microbiología y Unidad de Investigación, Hospital Universitario Son Espases, Instituto de Investigación Sanitaria de las Islas Baleares, Palma, Spain
| | - Aranzazu López
- Servicio de Microbiología, Hospital Can Misses, Ibiza, Spain
| | | | - Elena Riera
- Servicio de Microbiología, Hospital de Manacor, Manacor, Spain
| | - Antoni Serra
- Servicio de Microbiología, Hospital de Manacor, Manacor, Spain
| | - Eva Roselló
- Servicio de Microbiología, Hospital Mateu Orfila, Mahón, Spain
| | - Lluis Carbó
- Servicio de Microbiología, Hospital Mateu Orfila, Mahón, Spain
| | | | - Carmen Gallegos
- Servicio de Microbiología, Hospital Universitari Son Llàtzer, Palma, Spain
| | - Juan Saurina
- Servicio de Microbiología, Hospital Comarcal de Inca, Inca, Spain
| | - Emilio Arteaga
- Servicio de Microbiología, Hospital Comarcal de Inca, Inca, Spain
| | | | - Antonia Salvá
- Gabinete Técnico-Asistencial, Servicio de Salud de las Islas Baleares, Palma, Spain
| | - Antoni Nicolau
- Servicio de Epidemiología de las Islas Baleares, Palma, Spain
| | - Fernando González-Candelas
- Unidad Mixta de Investigación "Infección y Salud Pública" FISABIO-Universidad de Valencia, Instituto de Biología Integrativa de Sistemas (I2SysBIO, CSIC-UV), Valencia, Spain.,CIBER en Epidemiología y Salud Publica (CIBERESP), Madrid, Spain
| | - Iñaki Comas
- Instituto de Biomedicina de Valencia, Valencia, Spain.,CIBER en Epidemiología y Salud Publica (CIBERESP), Madrid, Spain
| | - Antonio Oliver
- Servicio de Microbiología y Unidad de Investigación, Hospital Universitario Son Espases, Instituto de Investigación Sanitaria de las Islas Baleares, Palma, Spain.,CIBER en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
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28
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Caniego-Casas T, Martínez-García L, Alonso-Riaño M, Pizarro D, Carretero-Barrio I, Martínez-de-Castro N, Ruz-Caracuel I, de Pablo R, Saiz A, Royo RN, Santiago A, Rosas M, Rodríguez-Peralto JL, Pérez-Mies B, Galán JC, Palacios J. RNA SARS-CoV-2 Persistence in the Lung of Severe COVID-19 Patients: A Case Series of Autopsies. Front Microbiol 2022; 13:824967. [PMID: 35173701 PMCID: PMC8841799 DOI: 10.3389/fmicb.2022.824967] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 01/03/2022] [Indexed: 12/21/2022] Open
Abstract
The exact role of viral replication in patients with severe COVID-19 has not been extensively studied, and it has only been possible to demonstrate the presence of replicative virus for more than 3 months in a few cases using different techniques. Our objective was to study the presence of RNA SARS-CoV-2 in autopsy samples of patients who died from COVID-19 long after the onset of symptoms. Secondary superimposed pulmonary infections present in these patients were also studied. We present an autopsy series of 27 COVID-19 patients with long disease duration, where pulmonary and extrapulmonary samples were obtained. In addition to histopathological analysis, viral genomic RNA (gRNA) and viral subgenomic RNA (sgRNA) were detected using RT-PCR and in situ hybridization, and viral protein was detected using immunohistochemistry. This series includes 26 adults with a median duration of 39 days from onset of symptoms to death (ranging 9–108 days), 92% of them subjected to immunomodulatory therapy, and an infant patient. We detected gRNA in the lung of all but one patient, including those with longer disease duration. SgRNA was detected in 11 out of 17 patients (64.7%) with illness duration up to 6 weeks and in 3 out of 9 patients (33.3%) with more than 6 weeks of disease progression. Viral protein was detected using immunohistochemistry and viral mRNA was detected using in situ hybridization in 3 out of 4 adult patients with illness duration of <2 weeks, but in none of the 23 adult patients with an illness duration of >2 weeks. A remarkable result was the detection of viral protein, gRNA and sgRNA in the lung cells of the pediatric patient after 95 days of illness. Additional pulmonary infections included: 9 acute bronchopneumonia, 2 aspergillosis, 2 cytomegalovirus, and 1 BK virus infection. These results suggest that in severe COVID-19, SARS-CoV-2 could persist for longer periods than expected, especially in immunocompromised populations, contributing to the persistence of chronic lung lesions. Additional infections contribute to the fatal course of the disease.
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Affiliation(s)
- Tamara Caniego-Casas
- Pathology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Instituto Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain
- CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
| | - Laura Martínez-García
- Instituto Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain
- Microbiology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Madrid, Spain
| | - Marina Alonso-Riaño
- Pathology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
- Instituto 12 de Octubre for Health Research, Madrid, Spain
- Faculty of Medicine, Complutense University, Madrid, Spain
| | - David Pizarro
- Pathology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Instituto Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain
- CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
| | - Irene Carretero-Barrio
- Pathology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Faculty of Medicine, University of Alcalá, Alcalá de Henares, Spain
| | - Nilda Martínez-de-Castro
- Anaesthesiology and Surgical Critical Care Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | | | - Raúl de Pablo
- Instituto Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain
- Faculty of Medicine, University of Alcalá, Alcalá de Henares, Spain
- Medical Intensive Care Unit, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Ana Saiz
- Pathology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Faculty of Medicine, University of Alcalá, Alcalá de Henares, Spain
| | - Rosa Nieto Royo
- Respiratory Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Ana Santiago
- Pathology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Marta Rosas
- Pathology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Instituto Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain
| | - José L. Rodríguez-Peralto
- Pathology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
- Instituto 12 de Octubre for Health Research, Madrid, Spain
- Faculty of Medicine, Complutense University, Madrid, Spain
| | - Belén Pérez-Mies
- Pathology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Instituto Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain
- CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
- Faculty of Medicine, University of Alcalá, Alcalá de Henares, Spain
| | - Juan C. Galán
- Instituto Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain
- Microbiology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Madrid, Spain
| | - José Palacios
- Pathology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Instituto Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain
- CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
- Faculty of Medicine, University of Alcalá, Alcalá de Henares, Spain
- *Correspondence: José Palacios,
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29
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Badiola JJ, Otero A, Sevilla E, Marín B, García Martínez M, Betancor M, Sola D, Pérez Lázaro S, Lozada J, Velez C, Chiner-Oms Á, Comas I, Cancino-Muñoz I, Monleón E, Monzón M, Acín C, Bolea R, Moreno B. SARS-CoV-2 Outbreak on a Spanish Mink Farm: Epidemiological, Molecular, and Pathological Studies. Front Vet Sci 2022; 8:805004. [PMID: 35127883 PMCID: PMC8814420 DOI: 10.3389/fvets.2021.805004] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 12/21/2021] [Indexed: 01/29/2023] Open
Abstract
Farmed minks have been reported to be highly susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and may represent a risk to humans. In this study, we describe the first outbreak of SARS-CoV-2 occurred on a mink farm in Spain, between June and July 2020, involving 92,700 animals. The outbreak started shortly after some farm workers became seropositive for SARS-CoV-2. Minks showed no clinical signs compatible with SARS-CoV-2 infection throughout the outbreak. Samples from 98 minks were collected for histopathological, serological, and molecular studies. Twenty out of 98 (20.4%) minks were positive by RT-qPCR and 82 out 92 (89%) seroconverted. This finding may reflect a rapid spread of the virus at the farm with most of the animals overcoming the infection. Additionally, SARS-CoV-2 was detected by RT-qPCR in 30% of brain samples from positive minks. Sequencing analysis showed that the mink sequences were not closely related with the other mink SARS-CoV-2 sequences available, and that this mink outbreak has its probable origin in one of the genetic variants that were prevalent in Spain during the first COVID-19 epidemic wave. Histological studies revealed bronchointerstitial pneumonia in some animals. Immunostaining of viral nucleocapsid was also observed in nasal turbinate tissue. Farmed minks could therefore constitute an important SARS-CoV-2 reservoir, contributing to virus spread among minks and humans. Consequently, continuous surveillance of mink farms is needed.
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Affiliation(s)
- Juan José Badiola
- Centro de Encefalopatías y Enfermedades Transmisibles Emergentes, Facultad de Veterinaria, Universidad de Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria de Aragón (IISA), Zaragoza, Spain
| | - Alicia Otero
- Centro de Encefalopatías y Enfermedades Transmisibles Emergentes, Facultad de Veterinaria, Universidad de Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria de Aragón (IISA), Zaragoza, Spain
- *Correspondence: Alicia Otero
| | - Eloisa Sevilla
- Centro de Encefalopatías y Enfermedades Transmisibles Emergentes, Facultad de Veterinaria, Universidad de Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria de Aragón (IISA), Zaragoza, Spain
| | - Belén Marín
- Centro de Encefalopatías y Enfermedades Transmisibles Emergentes, Facultad de Veterinaria, Universidad de Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria de Aragón (IISA), Zaragoza, Spain
| | - Mirta García Martínez
- Centro de Encefalopatías y Enfermedades Transmisibles Emergentes, Facultad de Veterinaria, Universidad de Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria de Aragón (IISA), Zaragoza, Spain
| | - Marina Betancor
- Centro de Encefalopatías y Enfermedades Transmisibles Emergentes, Facultad de Veterinaria, Universidad de Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria de Aragón (IISA), Zaragoza, Spain
| | - Diego Sola
- Centro de Encefalopatías y Enfermedades Transmisibles Emergentes, Facultad de Veterinaria, Universidad de Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria de Aragón (IISA), Zaragoza, Spain
| | - Sonia Pérez Lázaro
- Centro de Encefalopatías y Enfermedades Transmisibles Emergentes, Facultad de Veterinaria, Universidad de Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria de Aragón (IISA), Zaragoza, Spain
| | - Jenny Lozada
- Centro de Encefalopatías y Enfermedades Transmisibles Emergentes, Facultad de Veterinaria, Universidad de Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria de Aragón (IISA), Zaragoza, Spain
| | - Carolina Velez
- Facultad de Ciencias Veterinarias, Universidad Nacional de La Pampa, General Pico, Argentina
| | - Álvaro Chiner-Oms
- Instituto de Biomedicina de Valencia-Consejo Superior de Investigaciones Científicas (IBV-CSIC), Valencia, Spain
| | - Iñaki Comas
- Instituto de Biomedicina de Valencia-Consejo Superior de Investigaciones Cientìficas (IBV-CSIC), CIBER in Epidemiology and Public Health, Valencia, Spain
| | - Irving Cancino-Muñoz
- Instituto de Biomedicina de Valencia-Consejo Superior de Investigaciones Científicas (IBV-CSIC), Valencia, Spain
| | - Eva Monleón
- Centro de Encefalopatías y Enfermedades Transmisibles Emergentes, Facultad de Veterinaria, Universidad de Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria de Aragón (IISA), Zaragoza, Spain
| | - Marta Monzón
- Centro de Encefalopatías y Enfermedades Transmisibles Emergentes, Facultad de Veterinaria, Universidad de Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria de Aragón (IISA), Zaragoza, Spain
| | - Cristina Acín
- Centro de Encefalopatías y Enfermedades Transmisibles Emergentes, Facultad de Veterinaria, Universidad de Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria de Aragón (IISA), Zaragoza, Spain
| | - Rosa Bolea
- Centro de Encefalopatías y Enfermedades Transmisibles Emergentes, Facultad de Veterinaria, Universidad de Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria de Aragón (IISA), Zaragoza, Spain
| | - Bernardino Moreno
- Centro de Encefalopatías y Enfermedades Transmisibles Emergentes, Facultad de Veterinaria, Universidad de Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria de Aragón (IISA), Zaragoza, Spain
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30
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Abstract
This paper investigates the role of large outbreaks on the persistence of Covid-19 over time. Using data from 650 European regions in 14 countries, I first show that winter school holidays in late February/early March 2020 (weeks 8, 9 and 10) led to large regional outbreaks of Covid-19 in the spring with the spread being 60% and up-to over 90% higher compared to regions with earlier school holidays. While the impact of these initial large outbreaks fades away over the summer months, it systematically reappears from the fall as regions with school holidays in weeks 8, 9 and 10 had 30–70% higher spread. This suggests that following a large outbreak, there is a strong element of underlying (latent) regional persistence of Covid-19. The strong degree of persistence highlights the long-term benefits of effective (initial) containment policies, as once a large outbreak has occurred, Covid-19 persists. This result emphasizes the need for vaccinations against Covid-19 in regions that have recently experienced large outbreaks but are well below herd-immunity, to avoid a new surge of cases.
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31
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Ruiz-Rodriguez P, Francés-Gómez C, Chiner-Oms Á, López MG, Jiménez-Serrano S, Cancino-Muñoz I, Ruiz-Hueso P, Torres-Puente M, Bracho MA, D'Auria G, Martinez-Priego L, Guerreiro M, Montero-Alonso M, Gómez MD, Piñana JL, González-Candelas F, Comas I, Marina A, Geller R, Coscolla M; SeqCOVID-SPAIN Consortium. Evolutionary and Phenotypic Characterization of Two Spike Mutations in European Lineage 20E of SARS-CoV-2. mBio 2021;:e0231521. [PMID: 34781748 DOI: 10.1128/mBio.02315-21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
We have detected two mutations in the spike protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at amino acid positions 1163 and 1167 that appeared independently in multiple transmission clusters and different genetic backgrounds. Furthermore, both mutations appeared together in a cluster of 1,627 sequences belonging to clade 20E. This cluster is characterized by 12 additional single nucleotide polymorphisms but no deletions. The available structural information on the S protein in the pre- and postfusion conformations predicts that both mutations confer rigidity, which could potentially decrease viral fitness. Accordingly, we observed reduced infectivity of this spike genotype relative to the ancestral 20E sequence in vitro, and the levels of viral RNA in nasopharyngeal swabs were not significantly higher. Furthermore, the mutations did not impact thermal stability or antibody neutralization by sera from vaccinated individuals but moderately reduce neutralization by convalescent-phase sera from the early stages of the pandemic. Despite multiple successful appearances of the two spike mutations during the first year of SARS-CoV-2 evolution, the genotype with both mutations was displaced upon the expansion of the 20I (Alpha) variant. The midterm fate of the genotype investigated was consistent with the lack of advantage observed in the clinical and experimental data.
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